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Selected AbstractsHigh-end specificity of the children's depression inventory in a sample of anxiety-disordered youthDEPRESSION AND ANXIETY, Issue 1 2005Jonathan S. Comer M.A. Abstract Using a receiver operating characteristic (ROC) analysis, the present study investigated the ability of the Children's Depression Inventory (CDI) to correctly detect depression in a sample of treatment-seeking anxious youth (N=44). The ADIS-C/P was used to determine diagnostic status of participants. Anxious children who met diagnostic criteria for a depressive disorder scored higher on the CDI than anxious children who did not meet criteria for a depressive disorder, supporting the CDI as a continuous measure of depressive symptomatology. In contrast, with regard to detecting a depressive disorder, CDI cut scores did not achieve favorable values across diagnostic utility indices (including the cut score of 13 that has been recommended). These findings support the CDI as a continuous measure of depressive symptoms, but do not support the CDI as a sole assessment for a diagnosis of depression within a sample of anxiety-disordered youth. Depression and Anxiety 22:11,19, 2005. © 2005 Wiley-Liss, Inc. [source] A review of mathematical learning disabilities in children with fragile X syndromeDEVELOPMENTAL DISABILITIES RESEARCH REVIEW, Issue 1 2009Melissa M. Murphy Abstract The prevalence rate of mathematical learning disabilities (MLD) among children with fragile X syndrome who do not meet criteria for intellectual and developmental disabilities (,50% of female children) exceeds the rate reported in the general population. The purpose of this article is two-fold: (1) to review the findings on MLD in persons with fragile X syndrome; and (2) to discuss fragile X syndrome as a possible model for understanding pathways to MLD. © 2009 Wiley-Liss, Inc. Dev Disabil Res Rev 2009;15:21,27. [source] Sexual orientation, substance use behaviors and substance dependence in the United StatesADDICTION, Issue 8 2009Sean Esteban McCabe ABSTRACT Aims To assess past-year prevalence rates of substance use behaviors and substance dependence across three major dimensions of sexual orientation (identity, attraction and behavior) in a large national sample of adult women and men in the United States. Design Data were collected from structured diagnostic face-to-face interviews using the Alcohol Use Disorder and Associated Disabilities Interview Schedule DSM-IV version IV (AUDADIS-IV). Setting Prevalence estimates were based on data collected from the 2004,2005 (wave 2) National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Participants A large national sample of 34 653 adults aged 20 years and older: 52% female, 71% white, 12% Hispanic, 11% African American, 4% Asian and 2% Native American. Findings Approximately 2% of the population self-identified as lesbian, gay or bisexual; 4% reported at least one life-time same-sex sexual partner and 6% reported same-sex sexual attraction. Although non-heterosexual orientation was generally associated with a higher risk of substance use and substance dependence, the majority of sexual minority respondents did not report substance use or meet criteria for DSM-IV substance dependence. There was considerable variation in substance use outcomes across sexual orientation dimensions; these variations were more pronounced among women than among men. Conclusions Results support previous research findings of heightened risk of substance use and substance dependence among some sexual minority groups and point to the need for research that examines the reasons for such differences. Results also highlight important gender differences and question previous findings indicating uniformly higher risk for substance dependence among sexual minorities. Risks appear to vary based on gender and how sexual orientation is defined. Findings have implications for more effective prevention and intervention efforts that target subgroups at greatest risk. [source] Highlights in Biocatalysis , Historical Landmarks and Current TrendsENGINEERING IN LIFE SCIENCES (ELECTRONIC), Issue 4 2005T. Bornscheuer Abstract Biocatalysis has ancient roots, yet it is developing into a key tool for synthesis in a wide range of applications. Important events in the history of enzyme technology from the 19th century onwards are highlighted. Considering the most relevant progress steps, the production of penicillanic acid and the impact of genetic engineering are traced in more detail. Applied biocatalysis has been defined as the application of a biocatalyst to achieve a desired conversion selectively, under controlled, mild conditions in a bioreactor. Biocatalysts are currently used to produce a wide range of products in the fields of food manufacture (such as bread, cheese, beer), fine chemicals (e.g., amino acids, vitamins), and pharmaceuticals (e.g., derivatives of antibiotics). They not only provide access to innovative products and processes, but also meet criteria of sustainability. In organic synthesis, recombinant technologies and biocatalysts have greatly widened the scope of application. Examples of current applications and processes are given. Recent developments and trends are presented as a survey, covering new methods for accessing biodiversity with new enzymes, directed evolution for improving enzymes, designed cells, and integrated downstream processing. [source] Problem of Distinguishing False-Positive Tests from Acute or Transient Helicobacter pylori InfectionsHELICOBACTER, Issue 2 2006Zhannat Z. Nugalieva Abstract Background:, Reliable detection of acute Helicobacter pylori infections remains problematic. The high prevalence of false-positive non-invasive tests in low H. pylori prevalence populations makes identification of acute and transient infections difficult. Methods:, We explored the use of serum pepsinogens (PG) for diagnosis of acute infection in patients following H. pylori challenge such that the onset of the infection was known. We then compared those findings to a group of children with presumed acute infections defined as a positive urea breath test (UBT) and negative IgG serology. Results:, We examined the pattern and calculated cut-off values of PG levels in 18 adult volunteers with known acute H. pylori infection. We then compared the results with sera from nine symptomatic children with presumed acute H. pylori infection and a matched control group of nine children who did not meet criteria for acute H. pylori infection. In acute infection, both PGI and II levels increased following H. pylori infection reaching a peak by 2 weeks post-infection. The frequency of a positive test defined as a value > mean +2 SD was 17, 71, and 94% at week 1, 2, and 4 post-infection, respectively. Only one child with presumed acute H. pylori infection had an elevated serum PGI and one had an elevated PGII. Five of the children had follow-up UBTs and four were negative consistent with the diagnosis of false-positive UBT. H. pylori infection was confirmed in the child with an elevated PGI level. Conclusions:, These data suggest that a single positive noninvasive test in populations of low prevalence is most likely a false-positive result. This suggests that a single positive test requires confirmation preferably using a test that measures a different parameter (e.g., UBT confirmed by stool antigen test). It appears that most "transient"H. pylori infections are diagnosed on the basis of false-positive tests. PG levels are possible candidates as the confirmatory test. [source] Laboratory studies of binge eating disorderINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue S1 2003B. Timothy Walsh Abstract Introduction Because of questions about the accuracy of reported food intake, and in order to study psychological and environmental factors which might affect eating, a number of investigators have examined the eating behavior of individuals with binge eating disorder (BED) under controlled conditions that permit food consumption to be measured. Methods Published studies that evaluated the eating behavior of individuals with BED in a laboratory were reviewed. Results In laboratory meals, individuals with BED consumed more kilocalories than individuals of similar weight who did not meet criteria for BED. These differences are observed consistently when subjects are asked to binge eat and when they are not. Conclusions In a laboratory setting, individuals with BED exhibit objectively abnormal eating behavior. These data support, but do not prove, the validity of BED as a diagnostic entity. © 2003 by Wiley Periodicals, Inc. Int J Eat Disord 34: S30,S38, 2003. [source] Reduction in Fear of Falling Through Intense Tai Chi Exercise Training in Older, Transitionally Frail AdultsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 7 2005Richard W. Sattin MD Objectives: To determine whether an intense tai chi exercise program could reduce fear of falling better than a wellness education (WE) program in older adults who had fallen previously and meet criteria for transitioning to frailty. Design: Cluster-randomized, controlled trial of 48 weeks' duration. Setting: Ten matched pairs of congregate living facilities in the greater Atlanta area. Participants: Sample of 291 women and 20 men, aged 70 to 97. Measurements: Activity-related fear of falling using the Activities-Specific Balance Confidence Scale (ABC) and the Fall Efficacy Scale at baseline and every 4 months for 1 year. Demographics, time to first fall and all subsequent falls, functional measures, Centers for Epidemiologic Studies Depression Scale, medication use, level of physical activity, comorbidities, and adherence to interventions. Results: Mean ABC was similar in both cohort groups at the time of randomization but became significantly higher (decreased fear) in the tai chi cohort at 8 months (57.9 vs 49.0, P<.001) and at study end (59.2 vs 47.9, P<.001). After adjusting for covariates, the mean ABC after 12 months of intervention was significantly greater in the tai chi group than in the WE group, with the differences increasing with time (mean difference at 12 months=9.5 points, 95% confidence interval=4.8,14.2, P<.001). Conclusion: Tai chi led to a significantly greater reduction in fear of falling than a WE program in transitionally frail older adults. The mean percentage change in ABC scores widened between tai chi and WE participants over the trial period. Tai chi should be considered in any program designed to reduce falling and fear of falling in transitionally frail older adults. [source] Musculoskeletal Pain and Risk for Falls in Older Disabled Women Living in the CommunityJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 4 2002Suzanne G. Leveille PhD OBJECTIVES: To determine whether musculoskeletal pain increased risk for falls in older women with disabilities. DESIGN: Prospective population-based cohort study. SETTING: The city and county of the eastern area of Baltimore. PARTICIPANTS: One thousand two women aged 65 and older, participants in the Women's Health and Aging Study, representing the one-third of older women who were living at home with disabilities, followed semiannually for 3 years beginning in 1991. MEASUREMENTS: Pain was categorized into four groups according to severity and location. Widespread pain was defined as pain in the upper and lower extremities and in the axial skeletal region, with moderate to severe pain in at least one region (, 4 on a 10-point numeric rating scale, 10 = excruciating pain). Moderate to severe lower extremity pain that did not meet criteria for widespread pain was the next category. The reference category was no pain or mild pain in one site. The additional category of "other pain" was pain that did not fit into the other three groups. The occurrence of falls and fall-related injuries were assessed at each interview. RESULTS: Of the 940 women who participated in at least one follow-up examination, 39% fell in first year; of the survivors, 36% fell in Year 2, and 39% in Year 3. After adjusting for several major risk factors for falls, women with widespread pain had an increased likelihood of falling during follow-up (adjusted odds ratio (AOR) = 1.66, 95% confidence interval (CI) = 1.25,2.21) compared with those with no or mild pain in only one musculoskeletal site. Women who had other musculoskeletal pain but not widespread pain or lower extremity pain also had an increased risk of falls (AOR = 1.36, 95% CI = 1.02,1.82). Among women with musculoskeletal pain, risk for falls was lower in those who used daily analgesic medication. Risk for recurrent falls and self-reported fractures due to falls was also elevated in women with musculoskeletal pain, most consistently in women with widespread pain. CONCLUSIONS: Musculoskeletal pain, particularly widespread pain, is a substantial risk factor for falls in older women with disabilities. These findings add an important dimension to our understanding of the multifactorial processes leading to falls in older persons. J Am Geriatr Soc 50:671,678, 2002. [source] Treatment of obsessive-compulsive disorder in patients who have comorbid major depressionJOURNAL OF CLINICAL PSYCHOLOGY, Issue 11 2004Jonathan S. Abramowitz Many patients who have obsessive-compulsive disorder (OCD) also meet criteria for additional diagnoses such as mood, anxiety, and personality disorders. The presence of severe depression, and major depressive disorder per se, impedes response to treatment for OCD that uses the best available treatments. In this article, the comorbidity data in OCD are reviewed, then the relationship between depression and OCD treatment outcome is reviewed. Next, the derivation and implementation of a treatment program specifically for depressed OCD patients are illustrated with a case example. The article closes with a discussion of implications and directions gleaned from this single case study. © 2004 Wiley Periodicals, Inc. J Clin Psychol/In Session. [source] What can we learn from tuberous sclerosis complex (TSC) about autism?JOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 10 2008P. J. De Vries Tuberous Sclerosis Complex (TSC) is now recognized as one of the medical conditions most commonly associated with autism. Between 1,5% of those with autism have TSC and up to 50% of people with TSC meet criteria for an autism spectrum disorder. The clinical characteristics of autism in TSC are qualitatively indistinguishable from those of idiopathic autism. So, what can TSC teach us about autism? We will present an overview of the neuropsychiatric features of TSC and will proceed with an examination of aetiological models of autism in TSC. Structural models (suggesting that autism is caused by brain lesions in specific neuroanatomical locations) and seizure models (suggesting that the age, type and control of seizures may predict autism) have both received some support, but with limited replication. More recently, molecular approaches have suggested that dysregulation of intracellular signalling through the TSC1/2-mTOR pathway may be sufficient to lead to socialization deficits and autism, and that drugs that act as mTOR inhibitors may reverse some aspects of the learning and social deficits in TSC. [source] Apparent wall thickening of cystic renal lesions on MRIJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 1 2008Vikas Gulani MD Abstract Purpose To show that cystic renal lesions that would otherwise meet criteria for simple cysts can demonstrate perceptible walls or increased wall thickness on MRI, sometimes causing these lesions to be "upgraded." It was hypothesized that thickening of cyst walls on MRI can be artifactual, due to data truncation, applied filtering, and low signal-to-noise ratio (SNR). Materials and Methods k-Space data for a 4-cm cyst were created in a 40-cm field of view (FOV) (512 × 512 matrix). Additional data sets were created using the central 512 × 256 and 512 × 128 points. Noise was simulated so that the cyst SNR was approximately 7, 14, and 20, respectively. Actual wall thickness was set at 0.25 mm, and cyst:wall signal at 1:4. An inverse two-dimensional (2D) fast Fourier transform (FFT) yielded simulated images. A Fermi filter was applied to reduce ringing. Images/projections were examined for wall thickening. Seven patients with initially thick-walled cysts on fat-saturated spoiled gradient-echo (FS-SPGR) images were scanned with increasing resolution (256 × 128 and 256 × 256; four patients were also scanned with 512 × 512). Average wall thickness at each resolution was compared using a two-tailed paired Student's t -test. Results Simulations showed apparent wall thickening at low resolution, improving with higher resolutions. Low SNR and application of the Fermi filter made it difficult to identify ringing as the cause of this thickening. The simulation results were confirmed on seven patients, whose cyst walls proved to be artifactually thickened (P < 0.01). Conclusion Thickening of cyst walls on MRI can be artifactual. Upon encountering thick-walled cystic renal lesions, high-resolution images can be acquired to exclude apparent thickening. J. Magn. Reson. Imaging 2008;28103,110. © 2008 Wiley-Liss, Inc. [source] Sensory Processing and Adaptive Behavior Deficits of Children Across the Fetal Alcohol Spectrum Disorder ContinuumALCOHOLISM, Issue 6 2010Joshua L. Carr Background:, Prenatal alcohol exposure can have detrimental effects on a child's development of adaptive behaviors necessary for success in the areas of academic achievement, socialization, and self-care. Sensory processing abilities have been found to affect a child's ability to successfully perform adaptive behaviors. The current study explored whether significant differences in sensory processing abilities, adaptive behavior, and neurocognitive functioning are observed between children diagnosed with partial Fetal Alcohol Syndrome (pFAS), Alcohol-Related Neurodevelopmental Disorder (ARND), or children who were prenatally exposed to alcohol (PEA), but did not meet criteria for an FASD diagnosis. The influence of IQ on adaptive behavior as well as further exploration of the relationship between sensory processing and adaptive behavior deficits among these children was also examined. Methods:, A secondary analysis was conducted on some of the Short Sensory Profile (SSP) scores, Adaptive Behavior Assessment System,Second Edition (ABAS-II) scores, and Wechsler Intelligence Scale,Fourth Edition/Wechsler Preschool and Primary Scale of Intelligence,Third Edition (WISC- IV/WPPSI,III) scores of 46 children between 3 and 14 years of age with pFAS, ARND, or who were PEA. Results:, Greater sensory processing deficits were found in children with a diagnosis of pFAS and ARND compared to those in the PEA group. Children with an ARND diagnosis scored significantly worse on measures of adaptive behavior than the PEA group. Children with pFAS scored significantly lower than children with ARND or PEA on perceptual/performance IQ. No correlation was found between IQ scores and adaptive behaviors across the FASD diagnostic categories. A significant positive correlation was found between SSP and ABAS-II scores. Conclusions:, Regardless of the diagnosis received under the FASD umbrella, functional difficulties that could not be observed using traditional measures of intelligence were found, supporting guidelines that a broad range of standardized assessments be included when screening children for FASD. [source] Emergency room vital signs and PTSD in a treatment seeking sample of motor vehicle accident survivorsJOURNAL OF TRAUMATIC STRESS, Issue 3 2002Edward B. Blanchard Abstract Seeking to replicate earlier reports by Shalev et al. (1998) and R. A. Bryant. A. G. Harvey. R. M. Guthrie, and M. L. Moulds (2000) that elevated heart rate (HR) shortly after a trauma was predictive of later posttraumatic stress disorder (PTSD), we examined vital sign data on 74 treatment-seeking motor vehicle accident (MVA) survivors, taken in the Emergency Department (ED) following their MVAs. Contrary to expectations, we found that those with elevated HRs in the ED were significantly less likely to meet criteria for PTSD 13 months post-MVA and that those with elevated HRs had lower levels of posttraumatic stress symptoms. Likewise, those with current PTSD had lower ED values of HR and DBP than did those who did not currently meet criteria for PTSD. [source] Fluctuation of gastrointestinal symptoms in the community: a 10-year longitudinal follow-up studyALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 8 2008A. C. FORD Summary Background, There are few studies examining the stability of gastrointestinal symptoms during prolonged periods of follow-up. Aim, To examine this issue in individuals previously recruited into a community screening programme for Helicobacter pylori providing symptom data at study entry. Methods, All traceable participants were sent dyspepsia and IBS questionnaires by post at 10 years. Symptom subgroups were assigned at baseline and 10-year follow-up. Individuals symptomatic at both time points who changed subgroup were compared with those symptomatic and remaining in the same subgroup. Results, Three-thousand eight hundred and nineteen individuals provided data. At baseline, 2417 (63%) were asymptomatic or did not meet diagnostic criteria for a subgroup. Of these, 1648 (68%) remained asymptomatic at 10 years, whilst 769 (32%) reported symptoms. Of the 1402 individuals symptomatic at baseline, 404 (29%) remained in the same subgroup at 10 years, 603 (43%) changed subgroup and symptoms resolved or did not meet criteria for a subgroup in 395 (28%). Symptom stability was more likely in males [odds ratio (OR): 1.50; 99% confidence interval (CI): 0.97,2.31] and older subjects (OR per year: 1.09; 99% CI: 1.01,1.17). Conclusion, Of those subjects symptomatic at baseline, almost three-quarters remained symptomatic at 10 years, but over 40% changed symptom subgroup. [source] Myelodysplastic syndromes associated with interstitial deletion of chromosome 5q: Clinicopathologic correlations and new insights from the prelenalidomide era,,AMERICAN JOURNAL OF HEMATOLOGY, Issue 9 2008Shernan G. Holtan To better estimate prognosis for patients with myelodysplastic syndromes (MDS) associated with clonal interstitial deletions of the long arm of chromosome 5 (del(5q)), we reviewed the medical records of 130 adults with del(5q) MDS seen at our institution over a 15-year period. Overall median survival of this cohort was 9.5 months, shorter than reported in earlier series. The least favorable outcomes are associated with complex cytogenetics, lack of any normal metaphases, normocytic rather than macrocytic erythrocyte indices, and low baseline lymphocyte counts. Lymphopenia but not neutropenia at the time of diagnosis appears to be a new adverse prognostic indicator. Cytogenetic breakpoints defined by G-banded karyotyping correlate poorly with particular disease features. Surprisingly, survival of patients with treatment-related MDS was equivalent to that of de novo MDS with del(5q) in this series. Morphologic features associated with del(5q) are diverse. Most patients with del(5q) MDS do not meet criteria for WHO-defined 5q-syndrome, and the presence of del(5q) does not appear to modify the clinical phenotype otherwise risk-stratified by the International Prognostic Scoring System (IPSS). Additional important prognostic factors not taken into account by the IPSS include the baseline erythrocyte indices, lymphocyte count, and clonal burden. Am. J. Hematol., 2008. © 2008 Wiley-Liss, Inc. [source] Gender disparities in mental health service use of Puerto Rican children and adolescentsTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 8 2006José J. Cabiya Background:, Differences in service utilization indicating that boys use more mental health services than girls were analyzed to see if they could be explained by known correlates of service use. These correlates were arranged into individual (severe emotional disturbance, level of impairment and externalizing disorders), family (parental education, psychopathology and parental concern) and school factors (difficulties with school work). The objectives were to understand and identify the factors accounting for gender differences in mental health service utilization in order to develop alternatives to promote equity in service delivery. Methods:, A representative sample of 1,896 children 4 to 17 years of age and their primary caretakers were interviewed for this study. Reports of service use were obtained using the Service Assessment for Children and Adolescents. Logistic regression was used to assess the relationship between gender and service use, adjusting for known correlates. Results:, Our results showed that, except for impairment, other individual, family and school factors did not explain gender differences in service utilization. Males with impairment were 2.87 times more likely to receive services than impaired females (p , .01), and this result continued to hold true for impaired undiagnosed boys compared to impaired diagnoses-free girls (p , .001). Conclusions:, Our findings showed a service disparity between impaired boys and girls who did not meet criteria for a DSM IV diagnosis, but no observed differences in service use between boys and girls who met criteria for severe emotional disturbance (SED). Continued investigations are necessary to analyze, assess and understand the different circumstances that bring boys and girls into treatment, followed by the development of appropriate intervention programs at the school and community levels. [source] Evaluating Theories of Health Behavior Change: A Hierarchy of Criteria Applied to the Transtheoretical ModelAPPLIED PSYCHOLOGY, Issue 4 2008James O. Prochaska The most common criteria recommended by philosophers of science for evaluating theories were organised within a hierarchy ranging from the least to the most risky tests for theories of health behavior change. The hierarchy progressed across: (1) Clarity; (2) Consistency; (3) Parsimony; (4) Testable; (5) Predictive Power; (6) Explanatory Power; (7) Productivity; (8) Generalisable; (9) Integration; (10) Utility; (11) Efficacy; and (12) Impact. The hierarchy was applied to the Transtheoretical Model (TTM) as an example of a health behavior change theory. The application was from the perspective of critics and advocates of TTM. Examples of basic and applied research challenging and supporting TTM across the hierarchy of criteria are presented. The goal is to provide a model for comparing alternative theories and to evaluate progress across the hierarchy within a particular theory. As theories meet criteria at each step in the hierarchy, the research and applications they generate can have increasing impacts on the science and practice of health behavior change. Les critères les plus courants mis en avant par les philosophes des sciences pour l'évaluation des théories ont été structurés dans le cadre d'une hiérarchie allant des épreuves les moins aux plus exigeantes en ce qui concerne les théories portant sur les changements de comportement relatifs à la santé. Cette hiérarchie progresse ainsi: 1) Clarté; 2) Cohérence; 3) Economie; 4) Accès à la vérification; 5) Pouvoir prédictif ; 6) Pouvoir explicatif; 7) Valeur heuristique; 8) Possibilités de généralisation; 9) Intégration; 10) Utilité; 11) Efficacité; 12) Impact. Cette hiérarchie a été appliquée au Modèle Transthéorique (TTM) pris comme exemple de théorie du changement comportemental liéà la santé, aussi bien du point de vue des défenseurs que des critiques du TTM. On présente des exemples de recherches fondamentales et appliquées mettant à l'épreuve ou confirmant le TTM à partir de la hiérarchie des critères. L'objectif est d'avoir un modèle permettant de comparer différentes théories et d'évaluer la progression d'une théorie particulière le long de la hiérarchie. Comme les théories trouvent un critère à chaque échelon de la hiérarchie, les recherches et les applications qu'elles génèrent peuvent avoir des retombées croissantes sur la science et la pratique du changement de comportement relatif à la santé. [source] Psychiatric disorders in advanced cancerCANCER, Issue 8 2007Michael Miovic MD Abstract BACKGROUND. Emotional distress and psychiatric disorders are common among patients with advanced cancer. Oncologists play an important role in screening for these conditions, providing first-line treatment and referring patients for further evaluation and treatment when indicated. METHODS. The literature on psycho-oncology was reviewed, focusing on the epidemiology, assessment, and treatment of psychiatric disorders (adjustment disorders, major depression, anxiety and post-traumatic stress, personality disorders, substance abuse, and major mental disorders such as schizophrenia and bipolar disorder) in patients with advanced cancer. Communication skills and the role of the oncologist in dealing with end-of-life issues were also reviewed. Relevant data were summarized from the most recent systematic reviews, epidemiological studies, and intervention trials. Clinical recommendations are provided. RESULTS. About 50% of patients with advanced cancer meet criteria for a psychiatric disorder, the most common being adjustment disorders (11%,35%) and major depression (5%,26%). Both psychosocial and pharmacological treatments are effective for anxiety and depression, although existing studies have methodological limitations. Collaboration with mental health specialists is recommended for patients with personality disorders, major mental illness, and substance abuse problems. Effective communication involves active listening, exploring emotion and meaning, addressing prognosis, and discussing end-of-life issues when relevant. CONCLUSIONS. Treating psychiatric conditions improves quality of life in patients with advanced cancer. Oncologists play a key role in screening for psychiatric disorders, initiating first-line treatments for depression and anxiety, and communicating with patients and caregivers about prognosis and end-of-life issues. Cancer 2007. © 2007 American Cancer Society. [source] Some cases of common variable immunodeficiency may be due to a mutation in the SBDS gene of Shwachman,Diamond syndromeCLINICAL & EXPERIMENTAL IMMUNOLOGY, Issue 3 2008S. Khan Summary Known genetic defects currently account for only a small proportion of patients meeting criteria for ,probable' or ,possible' common variable immunodeficiency (CVID). A 59-year-old male with a 12-year history of CVID on intravenous immunoglobulin (IVIG) is presented who developed bronchiectasis, cytopenias and malabsorption that are recognized complications of CVID. Work-up for his malabsorption suggested the possibility of Shwachman,Diamond syndrome, confirmed by mutation testing. With the identification of the molecular defect in Shwachman,Diamond syndrome (SDS), it is becoming clear that not all SDS patients have the prominent features of neutropenia or pancreatic malabsorption. A meta-analysis of published immunological defects in SDS suggests that four of 14 hypogammaglobulinaemic SDS patients meet criteria for ,possible' CVID. Mutations in the SBDS gene may therefore be the fifth identified molecular defect in CVID. [source] Psychometric testing of the Swedish version of the Philadelphia Geriatric Center Multilevel Assessment InstrumentINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 3 2007Margareta Minhage OT We examined whether the Swedish adaptation of the Philadelphia Geriatric Center Multilevel Assessment Instrument (PGCMAI) developed by Lawton meets criteria for reliability and validity in an elderly Swedish population with locomotor disability. Data were collected, using the mid-length version of the instrument, from 199 elderly people with locomotor disability in two Swedish counties. Reliability was determined by Cronbach's alpha and construct validity was tested by means of exploratory factor analysis. Comparison was made with the Standardized Practical Equipment (SPE) test. Factor analysis identified eight factors, which were comparable to the original eight domains. There was a logical correlation between the PGCMAI and the SPE test. Further psychometric testing is recommended on other groups of elderly people. [source] | ||||||||||||||||