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Comprehensive Treatment (comprehensive + treatment)
Selected AbstractsAugmentation of atypical antipsychotics with valproic acid.HUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 8 2009An open-label study for most difficult patients with schizophrenia Abstract Objective Most difficult inpatients with schizophrenia are in serious needs but obviously underrepresented in clinical trials. Methods Very challenging patients received open-label treatment with atypical antipsychotics concurrently augmented with valproic acid. The primary outcome was the newly developed Functional Assessment for Comprehensive Treatment of Schizophrenia (FACT-Sz). Patients improving more than 20 points were classified as responders. Results Mean age and illness duration of 28 participants (22male) were 42 y.o. and 20 years, respectively. They had spent a half of their life admitted after the onset. The average Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression-Severity (CGI-S) were very severe at 79 and 6.1, respectively, with the baseline Global Assessment of Functioning (GAF) of as low as 21. As a result of augmentation, there were nine responders, 12 partial responders, and seven non-responders including only two patients who got worse. The main antipsychotics were mostly either risperidone or olanzapine. Mean maximum oral dose and blood level of valproic acid were 1907,mg and 91.7,µg/ml, respectively. Overall significant improvements whilst to an inadequate degree were noted in clinical parameters. Valproate augmentation was generally well tolerated but serious adverse effects included thrombocytopenia, anaemia and sedation/falls. Conclusions While these preliminary results need to be tested against tenacious monotherapy or polypharmacy involving clozapine, augmenting atypical antipsychotics with valproic acid can be useful for very severe schizophrenia. Copyright © 2009 John Wiley & Sons, Ltd. [source] Quality of life in Chinese elderly people with depressionINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 4 2006Sally W. C. Chan Abstract Background Depression is the most prevalent functional mental disorder of later life. It is estimated that about 5% of the elderly population of Hong Kong are suffering from depression. Aim To investigate the self-rated quality of life of community-dwelling elderly people diagnosed with depression, and to examine the relationships between quality of life and mental, physical health, functional status and social support. Methods and results A cross-sectional descriptive survey was conducted in psychiatric outpatient clinics. A convenience sample of 80 Chinese elderly people with a diagnosis of depressive disorder was recruited. Perception of quality of life was measured by the Hong Kong Chinese World Health Organization Quality of Life Scale,Brief Version. Participants' mental status, functional abilities, physical health condition, and social support status were assessed. Sixty-one (76.3%) participants were female. They were least satisfied with ,meaningfulness of life', ,life enjoyment', ,concentration and thinking', ,energy' and ,work capacity'. Functional abilities had a positive association with participants' perceived quality of life, level of depression and number of physical health conditions had a negative association. Participants had low ratings of quality of life when compared with healthy persons and persons with chronic physical problems. Findings are discussed in light of the socio-cultural environment in Hong Kong. Conclusion Comprehensive treatment and better control of depression, including different modes of medical and psychosocial intervention, could help to improve participants' perception of quality of life. A longitudinal study with a larger sample with various levels of depression and socio-demographic characteristics is recommended. Copyright © 2006 John Wiley & Sons, Ltd. [source] The exponentiated Gumbel distribution with climate applicationENVIRONMETRICS, Issue 1 2006Saralees Nadarajah Abstract The Gumbel distribution is perhaps the most widely applied statistical distribution for climate modeling. In this article we introduce a distribution that generalizes the standard Gumbel distribution in the same way the exponentiated exponential distribution generalizes the standard exponential distribution. We refer to this new distribution as the exponentiated Gumbel distribution. We provide a comprehensive treatment of the mathematical properties of this new distribution and illustrate its use for modeling rainfall data from Orlando, Florida. Among the mathematical properties, we derive the analytical shapes of the corresponding probability density function and the hazard rate function, calculate expressions for the nth moment and the asymptotic distribution of the extreme order statistics, and investigate the variation of the skewness and kurtosis measures. We also discuss estimation by the method of maximum likelihood. Copyright © 2005 John Wiley & Sons, Ltd. [source] Toward a comprehensive treatment of temporal constraints about periodic eventsINTERNATIONAL JOURNAL OF INTELLIGENT SYSTEMS, Issue 4 2003Paolo Terenziani In this article, we propose an Allen-like approach to deal with different types of temporal constraints about periodic events. We consider the different components of such constraints (thus, unlike Allen, we also take into account quantitative constraints) including frame times, user-defined periods, qualitative temporal constraints, and numeric quantifiers and the interactions between such components. We propose a specialized high-level formalism to represent temporal constraints about periodic events; temporal reasoning on the formalism is performed by a path-consistency algorithm repeatedly applying our operations of inversion, intersection, and composition and by a specialized reasoner about periods and numeric quantification. The high-level formalism has been designed in such a way that different types of temporal constraints about periodic events can be represented in a compact and (hopefully) user-friendly way and path-consistency-based temporal reasoning on the formalism can be performed in polynomial time. We also prove that our definitions of inversion, intersection, and composition and, thus, of our path-consistency algorithm, are correct. This article also sketches the general architecture of the temporal manager for periodic events (TeMP+), that has been designed on the basis of our approach. As a working example, we show an application of our approach to scheduling in a school. © 2003 Wiley Periodicals, Inc. [source] Relational problems and psychiatric symptoms in couple therapyINTERNATIONAL JOURNAL OF SOCIAL WELFARE, Issue 4 2005Ann-Marie Lundblad This article describes couples attending family counselling in Sweden. The study group is compared with clinical groups and non-clinical groups. Self-rating instruments were com-pleted by 317 women and 312 men to evaluate the following: marital satisfaction (DAS), expressed emotion (QAFM), family climate (FC), psychiatric symptoms (SCL-90) and sense of coherence (SOC). This group had several problems: marital relationships, disrupted family functioning, dyadic interactions characterised by criticism and open arguments, and multiple psychological symptoms. The women were espe-cially discontent in the relationship, and they exhibited higher symptom strain and lower sense of coherence than the men did. Compared with non-clinical populations, this group was severely distressed and was similar to in-patient families in child psychiatric clinics. The low sense of coherence of the individuals in the group under study means that their sense of having a meaningful life and their ability to comprehend and manage problems were severely compromised. Adequate and comprehensive treatment within the framework of social pro-grammes should be made available to these couples and others in a similar situation. [source] Responding to society's needs: Prescription privileges for psychologistsJOURNAL OF CLINICAL PSYCHOLOGY, Issue 6 2002Mary Ann Norfleet The health care revolution has contributed to the natural evolution of the role of psychologists. This has led to the necessity for future psychologists to have the authority to prescribe psychotropic medications in order to offer the best-available, comprehensive treatment to the public. Psychologists' training gives them a unique role in addressing the psychosocial aspects of medical problems, in collaboration with primary-care physicians. Prescribing psychologists are cost-effective, many practice in rural areas where people have no other access to mental health care, and they will be able to treat other underserved populations such as the poor, the elderly, the chronically mentally ill, children, and prisoners in the criminal justice system. Prescribing psychologists will have an increasingly prominent role in future health care policy decisions and practice. © 2002 Wiley Periodicals, Inc. J Clin Psychol 58: 599,610, 2002. [source] On the design of ultrafast shutters for time-resolved synchrotron experimentsJOURNAL OF SYNCHROTRON RADIATION, Issue 1 2007Milan Gembicky A comprehensive treatment of the limitations and possibilities for single-pulse selection in synchrotron operating modes with ,150,ns bunch separation, as occurs in the standard operating mode at the Advanced Photon Source, is presented. It is shown that the strength of available materials and allowable kinetic energy build-up limit single-bunch selection for this separation to sample sizes of ,100,µm, and that for minimization of kinetic energy build-up it is preferable to increase the r.p.m. within physically acceptable limits rather than increase the disc radius to obtain a desirable peripheral speed. A slight modification of the equal-bunch spacing standard fill patterns is proposed that allows use of samples as large as 500,µm. The corresponding peripheral speed of the chopper wheel is ,600,m,s,1, which is within the limits of high-strength titanium alloys. For smaller samples, peripheral speeds are proportionally lower. Versatility can be achieved with interchangeable chopper wheels and the use of different orientations of the rotation axis relative to the X-ray beam, which opens the possibility of larger, rather than one-of-a-kind, production runs. [source] Preliminary results of interstitial motexafin lutetium-mediated PDT for prostate cancerLASERS IN SURGERY AND MEDICINE, Issue 5 2006K.L. Du MD Abstract Background and Objectives Interstitial photodynamic therapy (PDT) is an emerging modality for the treatment of solid organ disease. Our group at the University of Pennsylvania has performed extensive studies that demonstrate the feasibility of interstitial PDT for prostate cancer. Our preclinical and clinical experience is herein detailed. Study Design/Materials and Methods We have treated 16 canines in preclinical studies, and 16 human subjects in a Phase I study, using motexafin lutetium-mediated PDT for recurrent prostate adenocarcinoma. Dosimetry of light fluence, drug level and oxygen distribution for these patients were performed. Results We demonstrate the safe and comprehensive treatment of the prostate using PDT. However, there is significant variability in the dose distribution and the subsequent tissue necrosis throughout the prostate. Conclusions PDT is an attractive option for the treatment of prostate adenocarcinoma. However, the observed variation in PDT dose distribution translates into uncertain therapeutic reproducibility. Our future focus will be on the development of an integrated system that is able to both detect and compensate for dose variations in real-time, in order to deliver a consistent overall PDT dose distribution. Lasers Surg. Med. 38:427,434, 2006. © 2006 Wiley-Liss, Inc. [source] EROS AND/AS DESIRE,A THEOLOGICAL AFFIRMATION: PAUL TILLICH READ IN THE LIGHT OF JEAN-LUC MARION'S THE EROTIC PHENOMENONMODERN THEOLOGY, Issue 2 2010JAN-OLAV HENRIKSEN The article interprets Tillich's varied elaborations on different aspects of eros, mainly in his Systematic Theology, by reading them in the light of Jean-Luc Marion's phenomenological description of eros in its various aspects in The Erotic Phenomenon. The erotic in Tillich not only has to do with sex and desire, but also with his commitment to a realistic approach to what it means to be human, to human culture, and to confronting false and estranging interpretations of basic human phenomena. What seems to be missing in Tillich, however, is a more comprehensive treatment of eros/desire that would make possible an understanding of the phenomenological (and consequently existential) fullness of this phenomenon. I suggest that this can be achieved by reading Tillich by way of Marion's phenomenological analysis. This also has the virtue of overcoming the all-too abstract character of Tillich's reasoning without at the same time dismissing Tillich's treatment of eros. I will also draw out some implications for how one might deal with eros and desire in the emerging discussion in present systematic theology. [source] Lithium treatment in Aarhus: contributions and controversies through half a centuryACTA PSYCHIATRICA SCANDINAVICA, Issue 2004Per Vestergaard In 1954 the first of several hundred publications on the use of lithium for treatment of affective disorders, lithium's unwanted effects, and its pharmacology was authored at the Aarhus University Psychiatric Hospital, the majority with Professor, now emeritus, Mogens Schou playing the principal part. The early part of this long series of papers highlights the pharmacology of lithium with its renal excretion, low therapeutic index, and ensuing risk of intoxication, the prophylactic effect not only against manic episodes but also the depressive ones and finally the long-term renal structural and functional impairment. Later papers present the problems related to lithium's lower effectiveness in routine clinical use, the problems of non-adherence, the dose effect relationships, and the problems inherent to establishing effective treatment service delivery. The present priority of the Aarhus lithium group is the simple large scale pragmatic effectiveness studies in which, together with domestic and foreign collaborators, we compare the long-term effectiveness of lithium with new promising drugs with mood stabilizing properties. The story of treatment with lithium in aarhus highlights important steps in the development of effective and comprehensive treatments for bipolar patients. 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