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Mental Impairment (mental + impairment)
Selected AbstractsRisk assessment and management: A community forensic mental health practice modelINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 4 2002Teresa Kelly ABSTRACT: In Victoria, the Crimes (Mental Impairment and Unfitness to be Tried) Act (1997) reformed legal practice in relation to the detention, management and release of persons found by a court to be not guilty on the grounds of insanity or unfit to be tried. This Act provides a legal structure for such ,forensic patients' to move from secure inpatient facilities into the community. This new legislative landscape has generated challenges for all stakeholders and has provided the impetus for the development of a risk assessment and management model. The key components of the model are the risk profile, assessment and management plan. The discussion comprises theory, legislation, practice implications and limitations of the model. Practice implications concern the provision of objective tools, which identify risk and document strategic interventions to support clinical management. Some of the practice limitations include the model's applicability to risk assessment and management and its dependence on a mercurial multi-service interface in after-hours crisis situations. In addition to this, the paper articulates human limitations implicit in the therapeutic relationship that necessarily underpins the model. The paper concludes with an exploration of the importance of evaluative processes as well as the need for formal support and education for clinicians. [source] The enigma of Lenin's (1870,1924) maladyEUROPEAN JOURNAL OF NEUROLOGY, Issue 6 2004V. Lerner The health of heads of states is not always handled in the same way as an incapacitating disability in ordinary professionals. Instead of suspension of responsibilities, the health status of political leaders is concealed, especially when the illness is perceived as stigmatizing, such as organic mental impairment or sexual disorder. The objective of the present paper is to analyse the malady of Lenin (1870,1924) in the light of relevant and new medical information. It is hoped that this will accentuate the need for transparency when the health of a statesman is concerned. [source] Hashimoto's encephalopathy: a treatable cause of mental impairment, stroke and seizuresEUROPEAN JOURNAL OF NEUROLOGY, Issue 6 2003T. Rekand No abstract is available for this article. [source] X-linked mental retardation and epigeneticsJOURNAL OF CELLULAR AND MOLECULAR MEDICINE, Issue 4 2006Guy Froyen Abstract The search for the genetic defects in constitutional diseases has so far been restricted to direct methods for the identification of genetic mutations in the patients' genome. Traditional methods such as karyotyping, FISH, mutation screening, positional cloning and CGH, have been complemented with newer methods including array-CGH and PCR-based approaches (MLPA, qPCR). These methods have revealed a high number of genetic or genomic aberrations that result in an altered expression or reduced functional activity of key proteins. For a significant percentage of patients with congenital disease however, the underlying cause has not been resolved strongly suggesting that yet other mechanisms could play important roles in their etiology. Alterations of the ,native' epigenetic imprint might constitute such a novel mechanism. Epigenetics, heritable changes that do not rely on the nucleotide sequence, has already been shown to play a determining role in embryonic development, X-inactivation, and cell differentiation in mammals. Recent progress in the development of techniques to study these processes on full genome scale has stimulated researchers to investigate the role of epigenetic modifications in cancer as well as in constitutional diseases. We will focus on mental impairment because of the growing evidence for the contribution of epigenetics in memory formation and cognition. Disturbance of the epigenetic profile due to direct alterations at genomic regions, or failure of the epigenetic machinery due to genetic mutations in one of its components, has been demonstrated in cognitive derangements in a number of neurological disorders now. It is therefore tempting to speculate that the cognitive deficit in a significant percentage of patients with unexplained mental retardation results from epigenetic modifications. [source] Fever, mental impairment, acute anemia, and renal failure in patient undergoing orthotopic liver transplantation: Posttransplantation malariaLIVER TRANSPLANTATION, Issue 4 2006Francesco Menichetti A case of post-transplant malaria is described. The patient presented fever and severe anemia after orthotopic liver transplantation. Diagnosis was made only after the review of donor characteristics. Although a high parasitemia was found at the moment of diagnosis, the treatment with quinine and doxycycline was successful. Donor epidemiology should always be considered for a prompt diagnosis of rare tropical diseases in the graft recipients. Liver Transpl 12:674,676, 2006. © 2006 AASLD. [source] Fragile X mental retardation: Misregulation of protein synthesis in the developing brain?MICROSCOPY RESEARCH AND TECHNIQUE, Issue 3 2002Yue FengArticle first published online: 18 APR 200 Abstract Fragile X mental retardation results from the absence of a selective RNA-binding protein, FMRP. Previous studies demonstrated that FMRP forms messenger ribonucleoprotein (mRNP) complexes to associate with translating polyribosomes, suggesting that FMRP is involved in regulating protein synthesis. We are now facing the changing questions: How does FMRP influence protein synthesis in the brain? What is the target for FMRP in learning and memory? How does the absence of FMRP cause misregulation of protein synthesis, which in turn leads to mental impairment in fragile X syndrome? Models for abnormal neuronal function as a result of misregulated translation due to the absence of FMRP are discussed. Microsc. Res. Tech. 57:145,147, 2002. © 2002 Wiley-Liss, Inc. [source] Rhythmic cortical myoclonus in Niemann,Pick disease type CMOVEMENT DISORDERS, Issue 9 2006Laura Canafoglia MD Abstract We here describe a patient with late-infantile Niemann,Pick disease type C (NPC) presenting with worsening myoclonus, seizures, cerebellar symptoms, mild mental impairment, and gaze palsy. Electroencephalographic (EEG) ,polymyographic examinations showed abnormally high and diffuse background alpha-activity, enhanced by intermittent photic stimulation. The electromyographic (EMG) showed quasirhythmic myoclonic jerks during motor activation. EEG,EMG frequency analysis (better than jerk-locked back-averaging) demonstrated the cortical origin of the myoclonus. Our observations indicate that cortical myoclonus may occur as the main symptom of NPC. © 2006 Movement Disorder Society [source] Cutis marmorata telangiectatica congenita and chronic autoimmune urticaria in a young manTHE JOURNAL OF DERMATOLOGY, Issue 3 2007Lucilla MELANI ABSTRACT A 20-year-old man with mental impairment, was referred to us for evaluation of recurring idiopathic urticaria episodes, characterized by a diffuse spreading of wheals and severe itching lacking response to traditional antihistamines. Upon physical examination, he showed a persistent, generalized, reticular, red-bluish vascular skin pattern in association with diffuse arborizing telangiectasias. Such lesions were present from an early age. Laboratory and instrumental tests, performed in order to exclude any condition associated with livedo did not evidence pathological results. He was found to be positive for antinuclear autoantibodies (ANA; 1:640). Histopathologically, numerous dilated capillary vessels associated with sparse extravasated erythrocytes were observed in the upper dermis. We performed an autologous serum skin test (ASST), which resulted in a positive, suggesting an autoimmune basis of the condition. On the basis of clinical and histopathological findings, and in the absence of other clinical and laboratory data suggesting other neoplastic, immunological or systemic diseases, the diagnosis of cutis marmorata telangiectatica congenita (CMTC) associated with chronic autoimmune urticaria (CAIU) was made. CMTC is a rare congenital vascular disorder, consisting in an anomalous, persistent, red-bluish marbling of the skin, that can be associated with a wide spectrum of cutaneous and extracutaneous anomalies. In our case, neither physical examination nor instrumental investigation demonstrated any of these anomalies, with the exception of cognitive impairment. We report this case because of the rarity of a diagnosis of CMTC in an adult patient, because this condition has almost always previously been diagnosed in infancy, or it comes to observation because of the presence of associated disorders, as in our case for chronic urticaria. [source] Leukocyte cDNA Analysis of NSD1 Derived from Confirmed Sotos Syndrome PatientsANNALS OF HUMAN GENETICS, Issue 6 2007M. Duno Summary Background: Haploinsufficiency of the NSD1 gene leads to Sotos syndrome (Sos), which is characterised by excessive growth, especially during childhood, distinct craniofacial features and variable degree of mental impairment. A wide spectrum of NSD1 mutations have been described in Sos patients, ranging from more than 100 different single nucleotide changes, to partial gene deletions, and to microdeletions of various sizes comprising the entire NSD1 locus. Objective: To investigate the NSD1 cDNA sequence in genetically confirmed Sos patients harbouring truncating and missense mutations. Method: Total RNA was isolated from a 250 ,l standard EDTA blood sample from nine genetically verified Sos patients, and subsequent reverse-transcribed into cDNA followed by PCR and direct sequencing of specific NSD1 cDNA sequences. Results: All nine mutations, including missense, nonsense and whole exon deletions, previously identified in genomic DNA, could confidently be detected in cDNA. Several NSD1 transcript splice variants were detected. Conclusion: Despite the fact that Sos is caused by haploinsufficiency, NSD1 transcripts containing nonsense and frame shift mutations can be detected in leukocyte-derived cDNA. The possibility therefore exists that certain NSD1 mutations are expressed and contribute to the phenotypic variability of Sos. NSD1 cDNA analysis is likely to enhance mutation detection in Sos patients. [source] Mosaicism and phenotype in ring chromosome 20 syndromeACTA NEUROLOGICA SCANDINAVICA, Issue 3 2005T. Nishiwaki Ring chromosome 20 [r(20)] syndrome is a rare chromosomal disorder characterized by epilepsy, mild to moderate mental impairment, and malformation. Patients generally show mosaicism in 1,100% of lymphocytes with r(20). We report here a patient with r(20) syndrome who exhibited mild phenotype with the small ratio of mosaicism (13%) with r(20). Although previous small-scale studies concluded that the mosaicism ratio was unrelated to clinical phenotype, our reassessment of all 57 reported cases has revealed that the ratio is significantly associated with age at seizure onset, intelligence quotient, and malformation, but not with the response of epilepsy to drug treatment. Our results provide important clinical information and prediction for r(20) syndrome. [source] Cognitive outcome of status epilepticus in adultsEPILEPSIA, Issue 2007Christoph Helmstaedter Summary There is no doubt that structural morphological brain lesions and malformations in epilepsy represent major etiological factors for the cognitive impairments seen in this disease. The role of epileptic activity and seizures for cognition and cognitive development, however, is less easily determined. Epileptic dysfunction ranges from interictal and periictal activity over self-terminating seizures to non-convulsive and convulsive status epilepticus, which appear the most severe conditions along this continuum. The decisive question in this regard is as to whether cognitive impairments observed in the acute epileptic condition are reversible or not. Impairments from interictal or postictal epileptic dysfunction are reversible and may interfere at most with brain maturation and cognitive development in the young patient. Seizures and ictal dysfunction in contrast, even when reversible, can leave a permanent trace which extends the phase of postictal recovery. As for status epilepticus and subsequent cognitive decline it often remains open whether the epileptic condition itself or the underlying clinical condition is causative for the aftermath. While there is evidence for both possibilities, group data from neuropsychological cross sectional and longitudinal studies indicate that more severe mental impairments, which in turn indicate more severe clinical conditions, appear to be a risk factor for sustaining status epilepticus, rather than that status epilepticus causes the cognitive decline. Reviewing the literature the cognitive condition in patients with status epilepticus varies with the type of epilepsy, the etiology of epilepsy, severity of the status, and the age of the patient. [source] Reliability and validity of the Leisure Satisfaction Scale (LSS , short form) and the Adolescent Leisure Interest Profile (ALIP)OCCUPATIONAL THERAPY INTERNATIONAL, Issue 2 2002Angela N. Trottier MClSc, OT Reg (Ont) Occupational Therapist Abstract This study aimed to evaluate the reliability and validity of the Leisure Satisfaction Scale (LSS , short form) and the Adolescent Leisure Interest Profile (ALIP). The LSS and the ALIP are instruments that occupational therapists can use to evaluate the leisure activities that clients enjoy. Evaluation of leisure interest and participation will assist in creating goals for therapy to maximize a client's ability to participate in leisure activities. This study examined the test,retest reliability and concurrent validity of the LSS and the ALIP using a sample of 37 adolescents between the ages of 13 and 17 with no known impairments. The assessments were administered individually or in small groups 7 to 17 days apart. Cronbach's alpha was used to determine the internal consistency. Pearson product moment correlations were calculated to examine the test,retest reliability of the 60 subscales and the six question totals of the ALIP, as well as for the 6 subscales and total score of the LSS. Concurrent validity was evaluated between the ,How often?' question of the ALIP and the LSS (short form). Based on the study results, the ALIP and the LSS seem to have good test,retest reliability levels when used with adolescents with no known physical or mental impairments. The concurrent validity between the two instruments was not supported, with many of the scores indicating only weak or no association to each of the subscales, suggesting that the assessments differ in some fundamental way. However, the evidence of some relationships between subscales may indicate some areas where the ALIP and the LSS are similar. Copyright © 2002 Whurr Publishers Ltd. [source] Disability and employment among U.S. working-age immigrantsAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 4 2010Huiyun Xiang MD Abstract Background There is little research which examines disability status and the employment decisions of the US immigrant working-age population. Methods The 2007 American Community Survey data were analyzed to compare disabilities and employment characteristics between immigrant and US-born adults 18,64 years of age. Separate logistic regression models of employment were constructed among persons with disabilities and among persons without disabilities. Each multivariate model included nativity/citizenship, sex, race/ethnicity, age, and education. Results In 2007, 40.8% (95% CI: 39.9,41.7) of immigrants with disabilities were employed, while only 34.9% (95% CI: 34.6,35.2) of US-born persons with disabilities were employed. For each type of disability, including difficulty working, immigrants with disabilities were more likely than their US-born counterparts to be employed. The median wage/salary incomes for persons with disabilities, foreign-born and US-born, respectively, were $20,000 and $22,000. In contrast, the median wage/salary incomes of foreign-born persons with mental impairments, self-care limitations, or participation restrictions exceeded those of US-born persons with these same disabilities. Nativity and citizenship had different effects in separate logistic models of employment for persons with disabilities and persons without disabilities. Among persons with disabilities, foreign-born citizens were more likely to be employed than the US-born, OR,=,1.40 (95% CI: 1.33,1.48), and non-citizens were also more likely to be employed, OR,=,1.74 (95% CI: 1.62,1.87), than US-born persons. Among persons without disabilities, foreign-born non-citizens were less likely to be employed than the US-born, OR,=,0.82 (95% CI: 0.82,0.85). Conclusion Immigrants with disabilities were more frequently employed than US-born persons with disabilities for all types of disabilities. Am. J. Ind. Med. 53:425,434, 2010. © 2010 Wiley-Liss, Inc. [source] | ||||||||||