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Screening Tool (screening + tool)
Kinds of Screening Tool Selected AbstractsThe Identification of Seniors At Risk Screening Tool: Further Evidence of Concurrent and Predictive ValidityJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2004Nandini Dendukuri PhD Objectives: To evaluate the validity of the Identification of Seniors at Risk (ISAR) screening tool for detecting severe functional impairment and depression and predicting increased depressive symptoms and increased utilization of health services. Setting: Four university-affiliated hospitals in Montreal. Design: Data from two previous studies were available: Study 1, in which the ISAR scale was developed (n=1,122), and Study 2, in which it was used to identify patients for a randomized trial of a nursing intervention (n=1,889 with administrative data, of which 520 also had clinical data). Participants: Patients aged 65 and older who were to be released from an emergency department (ED). Measurements: Baseline validation criteria included premorbid functional status in both studies and depression in Study 2 only. Increase in depressive symptoms at 4-month follow-up was assessed in Study 2. Information on health services utilization during the 5 months after the ED visit (repeat ED visits and hospitalization in both studies, visits to community health centers in Study 2) was available by linkage with administrative databases. Results: Estimates of the area under the receiver operating characteristic curve (AUC) for concurrent validity of the ISAR scale for severe functional impairment and depression ranged from 0.65 to 0.86. Estimates of the AUC for predictive validity for increased depressive symptoms and high utilization of health services ranged from 0.61 to 0.71. Conclusion: The ISAR scale has acceptable to excellent concurrent and predictive validity for a variety of outcomes, including clinical measures and utilization of health services. [source] Nutritional status of preoperative colorectal cancer patientsJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 4 2010S. T. Burden Abstract Background:, The present study aimed to determine the extent of malnutrition in preoperative colorectal cancer patients. Malnutrition has been shown to affect post-operative outcome, so it would be beneficial to identify those who are malnourished or who are at risk of becoming so preoperatively. We examine whether weight loss is related to the length of stay or changes in fat free mass. Methods:, Patients were enrolled consecutively from outpatients 2,4 weeks prior to surgery. Assessments included body mass index, percentage weight loss, dynamometry, Malnutrition Universal Screening Tool, Subjective Global Assessment and bioelectrical impedance. Cancer staging and hospital length of stay were recorded. Results:, One hundred and thirty-two patients were eligible and 87 enrolled. Sixty-seven patients were weight losing and 20% had lost >10% of their usual body weight. Handgrip strength was lower in malnourished patients compared to those who had not lost weight (mean 19.4 and 27.3 kg, respectively, P = 0.013). Mean (SD) fat free mass in patients with a weight loss >10% was 39.7 (13.5) kg and, in those with <10% weight loss, was 51.9 (12.0) kg (P = 0.001). This difference was not demonstrated for fat. Conclusions:, Over half of these patients had lost weight prior to surgery and one in five were malnourished. Body composition measurements demonstrated that malnourished patients had significantly less fat free mass compared to patients who were not clinically malnourished. Nutritional screening would be beneficial in this group preoperatively to identify weight-losing patients at an early stage in the care pathway when they initially enter the secondary care system. [source] A randomised, controlled trial of the effects of an energy-dense supplement on energy intake, appetite and blood lipids in malnourished community-based elderly patientsJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 4 2008G.P. Hubbard Background:, Disease-related malnutrition is common in the elderly and if left untreated may have severe consequences (Stratton & Elia, 2003). One of the strategies used to combat malnutrition is the use of high-energy, low-volume [18.8 kJ mL,1 (4.5 kcal ml,1)] nutritional supplements. This study aimed to investigate the effects of an energy dense supplement on energy intake, appetite and blood lipids in elderly patients at risk of malnutrition. Methods:, In this randomised, controlled, parallel study, 42 community-based patients (mean (SD) age: 84 (7.0) years, mean body mass index (BMI): 20.9 (3.5) kg m,2), identified as being at medium or high risk of malnutrition [Malnutrition Universal Screening Tool (MUST) (Elia, 2003)] were randomised (using standard randomisation methods) to receive either; (i) 1674 kJ day,1 (400 kcal day,1) (in 3 × 30 mL doses) of an energy-dense supplement (Calogen, Nutricia®) (n = 19) or (ii) dietary advice in the form of a standardised dietary advice sheet (n = 23), for 4 weeks. Energy intake, appetite, blood lipids [i.e. total cholesterol, low density lipoprotein (LDL) cholesterol (subset analysis only)], body weight, gastro-intestinal tolerance, product compliance and product acceptability were assessed during the 4 week study. Results are presented as mean (SD). Paired t -test and one way anova statistical analyses were undertaken using SPSS v15. Ethical approval for this study was obtained from the appropriate committee. Results:, Supplementation with the energy dense supplement significantly increased mean total daily energy intake by +1736 kJ (+415 kcal, P = 0.009) from 6456 (2330) kJ [1543 (557) kcal] to 8192 (1477) kJ [1958 (353) kcal], with no significant effect on voluntary food intake or appetite scores (for hunger, fullness and desire to eat). In the dietary advice group, although mean total daily energy intake was also significantly increased by +1105 kJ (+264 kcal, P = 0.026) from 5623 (2107) kJ [1344 (503) kcal] to 6728 (2029) kJ [1608 (485) kcal], it was significantly lower than in the energy dense group [-1464 kJ (-350 kcal), P = 0.012] at week 4. Both energy-dense and dietary advice groups maintained weight during the study. No significant adverse effects on blood lipid concentrations were observed in either group, with a significant decrease in total cholesterol concentrations [from 4.26 (1.0) mM to 3.96 (0.8) mM, P = 0.03] and LDL cholesterol concentrations [from 2.32 (0.6) mM to 2.06 (0.5) mM, P = 0.03] in the energy dense group (subset analysis, n = 9). Both supplementation with energy dense supplement and dietary advice were well tolerated with no gastro-intestinal side effects. The energy dense supplement was well accepted with >80% of patients rating it as pleasant and convenient, with an enjoyable taste. Compliance with the energy dense supplement was high, with 95% of patients consuming the recommended dose of 3 × 30 mL throughout the study. Discussion:, This study in elderly patients with or at risk of malnutrition suggests that the energy dense supplement is effective in significantly improving total intakes of energy with no suppression of appetite or voluntary dietary intake, enabling patients to maintain weight and that the energy dense supplement is well tolerated and accepted, with excellent compliance and no adverse effects on blood lipids. Conclusions:, This randomised controlled trial suggests that an energy-dense supplement is an effective, well tolerated and safe method of providing energy supplementation for the management of elderly patients with or at risk of malnutrition in clinical practice. References, Elia, M. (2003) The "MUST" report. Nutritional screening for adults: a multidisciplinary responsibility. Redditch, UK: BAPEN. Available at http://www.bapen.org.uk (accessed on 15 March 2008). Stratton, R.J., Green, C.J. & Elia, M. (2003) Disease-related malnutrition: an evidence-based approach. Oxford: CABI publishing. [source] An observational study of screening for malnutrition in elderly people living in sheltered accommodationJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 1 2008D. G. Harris Abstract Background, Elderly people are particularly at risk of malnutrition. There is no consensus regarding the optimal malnutrition screening test for elderly people and little is known about the prevalence of malnutrition in elderly people living in sheltered housing. Method, An observational study comparing sensitivity, specificity and positive and negative predictive values of the following screening measures in elderly people living in sheltered accommodation: body mass index, mid-arm circumference, albumin, haemoglobin, lymphocyte count, cholesterol and the Malnutrition Universal Screening Tool (MUST) and Mini Nutritional Assessment (MNA). A dietitian assessment was used as the gold standard to establish whether there was a risk of malnutrition. Results, Of 100 people recruited (31 male and 69 female with average age 79.3 years) ten were categorized at risk by the dietitian assessment. The MUST score was the most sensitive and specific screening measure (100% and 98% respectively) with a negative predictive value of 1. The sensitivity and specificity of the other measures were: MNA 80% and 90%, mid-arm circumference 70% and 99%, BMI 60% and 90%, albumin 30% and 77%, haemoglobin 50% and 61%, lymphocyte count 20% and 86%, low cholesterol 30% and 90%. Conclusions, Ten per cent of elderly people in sheltered housing are at risk of malnutrition. The MUST screening tool is a sensitive and specific method of identifying those requiring further nutritional assessment. [source] Risk of malnutrition in a sample of acute and long-stay NHS Fife in-patients: an auditJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 1 2008C. H. S. Ruxton Abstract Background, Hospital malnutrition (undernutrition) continues to attract concern. The implementation of standards for food and fluids in Scotland provided the stimulus for an audit of current practices in NHS Fife hospitals in order to provide baseline data with which to evaluate progress. Methods, One hundred and fifty in-patients were recruited from wards likely to yield those with a high risk of malnutrition. Using patient records and anthropometry, data were collected on weight, weight change, body mass index (BMI), mid-upper-arm circumference (MUAC), dietetic referral, therapeutic diets and patients' perceptions of nutritional status. Malnutrition was estimated by comparing BMI, weight change and MUAC with the Malnutrition Universal Screening Tool (MUST) and standards published by the Scottish Intercollegiate Guidelines Network (SIGN). Results, Depending upon the standard used, the minimum risk of malnutrition varied from 14 to 25%. The prevalence was lower than that reported previously, although methods were not directly comparable. Obesity was also evident with 42% of patients having a BMI > 25. Mean weight change from admission to audit was +0.4 kg, with a wide range (,11 kg to +13 kg). Most patients identified as malnourished were referred to the dietitian or given nutritional support. Conclusions, Fewer patients were at risk of malnutrition than expected. However, improving the provision of food and fluids remains a priority in Fife as malnutrition and eating problems can occur across the entire BMI spectrum. [source] ,tieredScreen' , Layered Virtual Screening Tool for the Identification of Novel Estrogen Receptor Alpha ModulatorsMOLECULAR INFORMATICS, Issue 5 2010Yidong Yang Abstract A novel tiered Structure-Based (SB) Virtual Screening (VS) workflow called tieredScreen was designed and implemented. The automated protocol utilises diverse computational tools in a synergistic manner to reduce false positives and increase the likelihood of converging on putative active molecules. The performance of the novel VS workflow was validated using the Directory of Useful Decoys (DUD) Estrogen Receptor , (ER,) antagonist dataset, and successfully deployed for the identification of novel antagonists of ER, from a screening collection of ca. 160,000 commercially available compounds. As well as yielding nanomolar (nM) active ligands identified previously through a docking only protocol, from a selection of eight virtual hits suggested by tieredScreen, four novel nM ER, binding chemotypes were identified and biologically validated , demonstrating the applicability of a tiered intervention for virtual screening. [source] Potential Screening Tool For Alzheimer's DiseaseNURSING FOR WOMENS HEALTH, Issue 4 2003Carolyn Davis Cockey MLS executive editor No abstract is available for this article. [source] Treating Pain Patients at Risk: Evaluation of a Screening Tool in Opioid-Treated Pain Patients With and Without AddictionPAIN MEDICINE, Issue 2 2003FACP, Robert Friedman MD ABSTRACT Patients receiving opioid treatment for chronic pain, many of whom were hospitalized with medical complications of substance abuse, were asked to complete a screening questionnaire to help validate a simple self-administered survey. Questions relating to tobacco abuse and prior treatment for drug and alcohol abuse distinguished patients with addiction and pain from opioid-treated chronic pain patients. [source] (216) Pain and Addiction: Screening Patients at RiskPAIN MEDICINE, Issue 3 2001Victor Li Introduction: Addictive disease is a common co-morbidity in chronic pain patients [1]. 26% of patients on methadone treatment believed that prescribed opioids led to their addiction [2]. We report initial validation of a Screening Tool for Addiction Risk (STAR). Methods: Questions based on prior studies of pain and addiction, addiction-screening tools [3,4], discussions with clinicians experienced in pain medicine and addiction, and our clinical experience were used to develop the STAR. After obtaining IRB approval, chronic pain patients completed the 14-item STAR questionnaire. 14 patients with chronic pain and history of drug addiction (DSM-IV Criteria) and 34 additional chronic pain patients completed the survey as part of their initial clinical evaluation. Patient responses were compared to determine which were questions accounted for statistically significant differences. Results: Questions related to respondent classification of addict based on chi-square analysis and Fisher's exact test were: prior treatment in a drug rehabilitation facility (p < 0.00001), nicotine use (p < 0.0032), feeling of excessive nicotine use (p < 0.0007), and treatment in another pain clinic (p < 0.018). A factor analysis linked addiction to first three questions mentioned above. Question: "Have you ever been treated in a drug or alcohol rehabilitation facility?" had a positive predictive value of 93% for addiction. Responses to recreational substance use, alcohol abuse, recent anxiety or depression, unemployment, emergency room visits, family history of drug or alcohol abuse, multiple physicians prescribing pain medication, or a prior history of physical or emotional abuse were not different between either patient group. Discussion: Screening for addiction is an important part of management of chronic pain patients. A history of treatment in drug or alcohol rehabilitation facility and questions related to cigarette smoking may be useful to screen for potential risk of addiction. Further investigations needed to validate results of this study. [source] The RAFFT as a Screening Tool for Adolescent Substance Use DisordersTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 1 2000Leo Bastiaens M.D. The objective of this study was to measure the sensitivity and specificity of the RAFFT, a screening instrument for problematic adolescent substance use. Two hundred and twenty-six adolescent patients, aged 13 to 18, who were referred to an emergency room or an ambulatory evaluation clinic were included. Patients answered the five questions of the RAFFT before a comprehensive psychiatric assessment was completed. Diagnoses were made according to DSM-IV. The best results were obtained with two positive answers on the RAFFT: a sensitivity of 89% and a specificity of 69% in the screening for substance abuse or dependence. The RAFFT performed well in this highly selected patient population. [source] Longitudinal study of the Home Falls and Accidents Screening Tool in identifying older people at increased risk of fallsAUSTRALASIAN JOURNAL ON AGEING, Issue 2 2009Lynette Mackenzie Aim:, To evaluate the predictive validity and responsiveness of the Home Falls and Accidents Screening Tool (HOME FAST). Methods:, A prospective study of 727 community dwelling Veterans and war widows aged 70 years and over. The outcome was 6-month recall of any fall at 3-year follow-up. Baseline measurements were taken of common falls risk factors, and home hazards (using the HOME FAST). Changes in the prevalence of HOME FAST items were calculated and a logistic regression model was computed to determine predictors of falls at follow-up. Results:, Prevalence of 14 HOME FAST items was significantly reduced from baseline to follow-up (P , 0.05). Falls were significantly related to the baseline HOME FAST score (odds ratio (OR) 1.016, 95% confidence interval (CI) 1.004,1.098, P = 0.006), and a reduction in home hazards at follow-up (OR 0.984, 95% CI 0.973,0.996, P = 0.02). Conclusion:, The HOME FAST can predict falls in older people and is responsive to change. [source] The state of residential care for people with mental illness; insights from an audit of the screening tool for entry to licensed residential facilitiesAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2 2009Lauren J. Bailey Abstract Objective: To describe the medical and psychiatric profile of people assessed with the ,Screening Tool for Entry to Licensed Residential Centres' (Boarding House Screening Tool), examine the impact on their accommodation and the screening process. Methods: Copies of all of the Boarding House Screening Tools completed by the Camperdown Aged Care Assessment Team in 2003 and 2004 were examined. Accommodation status in 2006 was obtained from the Boarding House Team, GP or hospital database. A structured telephone survey of Aged Care Assessment Team staff was performed. Results: Thirty-nine Boarding House Screening Tools were reviewed. The mean age of the screened population was 43 yrs (range 22-76 yrs), most were men (36M: 3F). Eighty-two per cent had a listed psychiatric diagnosis, 23% a recent history of substance abuse, 10% a diagnosis of intellectual disability/cognitive impairment and 28% had more than two listed medical diagnoses. Seven people (18%), diagnosed with Schizophrenia, were not approved by the Boarding House Screening Tool because of high care needs and/or violent behaviour, however, only one remained in a high care facility in 2006. Forty-two per cent of people approved by the Boarding House Screening Tool were living in Licensed Boarding Houses in 2006. Conclusion and implications: People being assessed for entry to Licensed Boarding Houses are young with high levels of psychiatric illness, medical co-morbidity and drug and alcohol use. The Boarding House Screening Tool is effective in keeping people who are not approved out of Licensed Boarding Houses; however, even if approved this accommodation is short-term in the majority of cases. [source] Development and pilot-testing of a psoriasis screening toolBRITISH JOURNAL OF DERMATOLOGY, Issue 4 2009P.L. Dominguez Summary Background, There is a need to validate psoriasis self-reports in epidemiological studies, where individuals may not be seeing dermatologists or other health care providers. Objectives, To develop and pilot test the Psoriasis Screening Tool (PST) in an ambulatory setting. Patients and methods, The PST was designed with eight closed-ended questions requiring a ,yes' or ,no' response. Typical images of skin, nail and scalp changes in psoriasis were included with respective questions. We administered the PST to 222 consecutive individuals being seen at a dermatology clinic. All English-speaking subjects completed the PST without assistance. A board-certified dermatologist established the diagnosis of psoriasis or excluded psoriasis in all participants. Results, A total of 222 completed PST questionnaires were included for analysis. There were 111 individuals in the psoriasis group and 111 individuals in the nonpsoriasis group. A combination of three questions resulted in a sensitivity of 96·4% [95% confidence interval (CI) 93·2,98·0] and specificity of 97·3% (95% CI 94·1,98·9) for psoriasis. Adding a pictorial question increased the sensitivity of the screening tool to 98·2% (95% CI 95·0,99·5). Of the 111 individuals with psoriasis, 69% answered yes to having plaque-type psoriasis, 50% answered yes to having nail involvement, 66% answered yes to having scalp involvement, and 59% answered yes to having inverse-type psoriasis. Conclusions, This pilot study suggests that the PST can distinguish individuals with psoriasis from individuals without psoriasis in an English-speaking population being seen at an outpatient dermatology clinic. Furthermore, the PST may be used to identify psoriasis phenotypes. Although the PST may be limited by spectrum bias in this pilot study, we believe it remains a reliable tool to collect information on psoriasis in remote populations. [source] Fecal Occult Blood Testing Has Great Potential as a Screening Tool for Colorectal CancerCA: A CANCER JOURNAL FOR CLINICIANS, Issue 5 2010John Henry Dreyfuss No abstract is available for this article. [source] Screening Tools for Neuropathic Pain: Are They Adaptable in Different Languages and Cultures?PAIN MEDICINE, Issue 7 2010Nadine Attal MD No abstract is available for this article. [source] The state of residential care for people with mental illness; insights from an audit of the screening tool for entry to licensed residential facilitiesAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2 2009Lauren J. Bailey Abstract Objective: To describe the medical and psychiatric profile of people assessed with the ,Screening Tool for Entry to Licensed Residential Centres' (Boarding House Screening Tool), examine the impact on their accommodation and the screening process. Methods: Copies of all of the Boarding House Screening Tools completed by the Camperdown Aged Care Assessment Team in 2003 and 2004 were examined. Accommodation status in 2006 was obtained from the Boarding House Team, GP or hospital database. A structured telephone survey of Aged Care Assessment Team staff was performed. Results: Thirty-nine Boarding House Screening Tools were reviewed. The mean age of the screened population was 43 yrs (range 22-76 yrs), most were men (36M: 3F). Eighty-two per cent had a listed psychiatric diagnosis, 23% a recent history of substance abuse, 10% a diagnosis of intellectual disability/cognitive impairment and 28% had more than two listed medical diagnoses. Seven people (18%), diagnosed with Schizophrenia, were not approved by the Boarding House Screening Tool because of high care needs and/or violent behaviour, however, only one remained in a high care facility in 2006. Forty-two per cent of people approved by the Boarding House Screening Tool were living in Licensed Boarding Houses in 2006. Conclusion and implications: People being assessed for entry to Licensed Boarding Houses are young with high levels of psychiatric illness, medical co-morbidity and drug and alcohol use. The Boarding House Screening Tool is effective in keeping people who are not approved out of Licensed Boarding Houses; however, even if approved this accommodation is short-term in the majority of cases. [source] Special focus: Cell and protein manipulationBIOTECHNOLOGY JOURNAL, Issue 2 2009Article first published online: 18 FEB 200 Synthetic biotechnology: The challenge Screening tool for induced pluripotent stem cells Method to limit oncogene expression to stem cells Intravital two-photon microscopy to solve meningitis mystery Electrostatic forces involved in a packaging motor Simulated Raman scattering microscopy offers high sensitivity in real-time imaging Alternative way to save brain cells after stroke or head trauma [source] Screening tools for depressed mood after childbirth in UK-based South Asian women: a systematic reviewJOURNAL OF ADVANCED NURSING, Issue 6 2007Soo M. Downe Abstract Aim., This paper is a report of a systematic review to answer the question: what is the relevance, acceptability, validity and effectiveness of tools designed to screen for postnatal depressed mood for South Asian women living in the UK? Background., Standard methods to screen women for postnatal depressed mood were developed with Caucasian populations. This study reviews postnatal screening tools adapted or developed for United Kingdom-based South Asian women. Method., A structured systematic review of English language studies initially was completed between 1980 and May 2003, and later updated to January 2005. The review was based on an a priori search strategy with inclusion and exclusion criteria and analysis included a quality assessment tool. Findings were tabulated against criteria for acceptability and effectiveness of diagnostic tools. Results., Seven papers were included in the review. None addressed all preset quality criteria. Four papers among them reported on translations of two existing tools (Edinburgh Postnatal Depression Scale and General Household Questionnaire). Two new tools were reported between the remaining three papers (Punjabi Postnatal Depression Scale and ,Doop Chaon'©). Doop Chaon is a visual tool. The other tools used either Bengali or Punjabi, based on written scales. The General Household Questionnaire did not appear to be appropriate for this population. None of the studies were rigorous enough to demonstrate generalizable sensitivity or specificity. Qualitative data indicated that women preferred face-to-face interviews to self-complete questionnaires. Conclusions., None of the tools are currently sufficiently evaluated for clinical practice. Questions are raised specifically about use of language-based tools to measure postnatal depressed mood in this population and about the extent to which focused interviews could be used as an alternative for specific sub-sections of population groups. [source] Indicators of anxiety and depression in women with the fragile X premutation: assessment of a clinical sampleJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 7 2010A. Lachiewicz Abstract Background Current research suggests that depression and anxiety may be common problems in women with the fragile X (FMR1) premutation. Methods To learn more about this in a clinical setting, we asked 33 women with the FMR1 premutation and 20 women without the FMR1 premutation to complete the Brief Carroll Depression Scale (Brief CDS) and the Multidimensional Anxiety Questionnaire (MAQ) and to provide information about mental health medication use. Questionnaire findings were compared between groups and with normative samples. Trinucleotide (CGG) repeat counts were also correlated to checklist findings. Results Both women with the FMR1 premutation and the comparison group had high current mental health medication use (33% vs. 35%). Approximately 1/3 of the women from both groups had high Brief CDS Total T-scores (33% vs. 30%). More women with the FMR1 premutation had at least one elevated MAQ Total or sub-scale T-score than the comparison group (39% vs. 10%, P = 0.03). Twenty-one per cent of women with the FMR1 premutation had all three of the indicators of distress targeted in this study vs. none of the women in the comparison samples (P < 0.05). There was no statistically significant correlation between CGG repeat size and abnormal checklist findings using the Spearman rank correlation, although a higher percentage of women with >100 CGG repeats (57%) had an elevated Brief CDS Total T-score than women with ,100 CGG repeats (16%) (P = 0.02). More women with >100 CGG repeats also had all three indicators of anxiety and depression (P = 0.03). Conclusions Women with the FMR1 premutation appear to have a high incidence of depression and increased symptoms of anxiety. Screening tools like the Brief CDS and the MAQ may be useful to identify these women in the clinic setting. Positive identification could lead to increased mental health care and treatment. [source] Social and emotional detachment: A cross-cultural comparison of the non-disruptive behavioural psychopathic traits in childrenCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 3 2009Eirini Manti Background,Questions about the international reliability and validity of aspects of psychopathy have been raised for adults, but hardly considered when applying the constructs to children. Aims/objectives,Our aim was to compare the psychometrics of a new instrument to measure psychopathic traits in children between two countries , the Netherlands and Greece. We also tested the hypothesis that, in both countries, both narcissistic-egocentric and callous-unemotional dimensions would be related to observed behavioural disorders. Methods,The Social and Emotional Detachment Questionnaire was used to assess narcissistic-egocentric and callous-unemotional dimensions of personality in representative national and community samples of 4,12-year-old children in the Netherlands and Greece, respectively. Parents filled in the questionnaires anonymously and also provided ratings of conduct disorders. Results,A two-dimensional construct of the psychopathic syndrome depicting, respectively, narcissistic and unemotional traits was reliable and valid in both countries, although there was considerable correlation between these two dimensions, which we designated ,social detachment' and ,emotional detachment', respectively. In both countries, the composite of social and emotional detachment was associated with aggressive and antisocial conduct disorders. Conclusions/implications,The reliability, validity and predictive value of this questionnaire must be tested further, for example, through multiple informants and longitudinally, but our findings that the tool performs robustly in two very different European countries is encouraging in terms of its potential value as a clinical screening tool and a tool for furthering the understanding of serious behavioural disorders in children. Copyright © 2009 John Wiley & Sons, Ltd. [source] Diagnostic utility of the Quick Inventory of Depressive Symptomatology (QIDS-C16 and QIDS-SR16) in the elderlyACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2010P. M. Doraiswamy Doraiswamy PM, Bernstein IH, Rush AJ, Kyutoku Y, Carmody TJ, Macleod L, Venkatraman S, Burks M, Stegman D, Witte B, Trivedi MH. Diagnostic utility of the Quick Inventory of Depressive Symptomatology (QIDS-C16 and QIDS-SR16) in the elderly. Objective:, To evaluate psychometric properties and comparability ability of the Montgomery-Åsberg Depression Rating Scale (MADRS) vs. the Quick Inventory of Depressive Symptomatology,Clinician-rated (QIDS-C16) and Self-report (QIDS-SR16) scales to detect a current major depressive episode in the elderly. Method:, Community and clinic subjects (age ,60 years) were administered the Mini-International Neuropsychiatric Interview (MINI) for DSM-IV and three depression scales randomly. Statistics included classical test and Samejima item response theories, factor analyzes, and receiver operating characteristic methods. Results:, In 229 elderly patients (mean age = 73 years, 39% male, 54% current depression), all three scales were unidimensional and with nearly equal Cronbach , reliability (0.85,0.89). Each scale discriminated persons with major depression from the non-depressed, but the QIDS-C16 was slightly more accurate. Conclusion:, All three tests are valid for detecting geriatric major depression with the QIDS-C16 being slightly better. Self-rated QIDS-SR16 is recommended as a screening tool as it is least expensive and least time consuming. [source] Recognition of depressive symptoms in the elderly: What can help the patient and the doctorDEPRESSION AND ANXIETY, Issue 3 2002Ioannis A. Parashos M.D. Abstract The general public heavily underrecognizes depression and depressive symptoms. This underrecognition is more pronounced among elderly people, and this study is an initial attempt to quantify the problem in a Greek elderly sample. Additionally the authors attempt to identify patient-related factors, which can assist a subject to recognize the depressive symptoms and the general practitioner to note their existence. Members of senior citizen centers (n = 682) participated in presentations about "depression in the elderly" and completed a questionnaire including the GDS-4 scale, four questions concerning depression risk factors and a question concerning a recent visit to a physician for depressive symptoms. Amongst those participating, 35.8% presented depressive symptoms (GDS-4 , 2). The calculated rate for recognition of depression in the studied population was very low (17.3%). Patients with depressive symptoms were more often females and had a higher proportion of past history of depression and a lack of social support. Patients with a past history of depression and more severe forms of illness consulted a doctor more frequently. Finally, subjects suffering from depressive symptoms and comorbid medical illness were characterized by a higher proportion of past history, lack of support, and existence of multiple risk factors. The authors propose that the inclusion in public campaigns of activities with an experiential dimension, e.g., patient videos and the use of a very simple screening tool, such as the GDS-4 scale by general practitioners (GP), could be helpful in improving the recognition of depressive symptoms by the patient and his/her relatives and its diagnosis by the doctor. This proposition awaits formal proof in future studies. Depression and Anxiety 15:111,116, 2002. © 2002 Wiley-Liss, Inc. [source] A systematic review of studies validating the Edinburgh Postnatal Depression Scale in antepartum and postpartum womenACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2009J. Gibson Objective:, The Edinburgh Postnatal Depression Scale (EPDS) is the most widely used screening tool for postpartum depression (PPD). We systematically reviewed the published evidence on its validity in detecting PPD and antepartum depression (APD) up to July 2008. Method:, Systematic review of validation studies of the EPDS included 1987,2008. Cut-off points of 9/10 for possible PPD, 12/13 for probable PPD and 14/15 for APD were used. Results:, Thirty-seven studies met the inclusion criteria. Sensitivity and specificity of cut-off points showed marked heterogeneity between different studies. Sensitivity results ranged from 34 to 100% and specificity from 44 to 100%. Positive likelihood ratios ranged from 1.61 to 78. Conclusion:, Heterogeneity among study findings may be due to differences in study methodology, language and diagnostic interview/criteria used. Therefore, the results of different studies may not be directly comparable and the EPDS may not be an equally valid screening tool across all settings and contexts. [source] Single Question about Drunkenness to Detect College Students at Risk for InjuryACADEMIC EMERGENCY MEDICINE, Issue 6 2006Mary Claire O'Brien MD Abstract Objectives: To examine the frequency of injuries reported by college students who replied affirmatively to the question, "In a typical week, how many days do you get drunk?" Methods: In Fall 2003, a Web-based survey was administered to a stratified random sample of 3,909 college students from ten North Carolina (NC) universities. Students answered questions regarding alcohol use and its consequences. Data were analyzed using multiple logistic regression, controlling for within-school clustering of drinking behaviors and adjusting for other significant covariates. Adjusted odds ratios (AORs) and 95% confidence intervals (CI) were calculated for significant predictors (p < 0.05). Results: Two thousand four hundred eighty-eight students reported that they are current drinkers; 1,353 (54.4%) reported getting drunk at least once in a typical week. Compared with students who did not report getting drunk at least once a week, these students had higher odds of being hurt or injured at least once as a result of their own drinking (AOR = 4.97; 95% CI = 3.47 to 7.09), experiencing a fall from a height that required medical treatment (AOR = 2.16; 95% CI = 1.36 to 3.43), and being taken advantage of sexually as a result of another's drinking (AOR = 2.59; 95% CI = 1.72 to 3.89). Students who reported getting drunk at least one day in a typical week also were more likely to cause an injury requiring medical treatment to someone else. They had higher odds of causing injury in an automobile crash (AOR = 1.84; 95% CI = 1.01 to 3.40), of causing a burn that required medical treatment (AOR = 2.85; 95% CI = 1.51 to 5.39), and of causing a fall from a height that required medical treatment (AOR = 2.02; 95% CI = 1.01 to 4.04). Getting drunk was a better indicator of "self-experienced injury" and of "injury caused to someone else" than was binge drinking, for all outcomes (p < 0.05). Conclusions: The single question, "In a typical week, how many days do you get drunk?" identifies college students who are at higher than normal risk of injury as a result of their own drinking and the drinking of others. Future research should assess this question's effectiveness as a screening tool in campus health centers and in emergency departments. [source] HbA1c levels in non-diabetic Dutch children aged 8,9 years: the PIAMA birth cohort studyDIABETIC MEDICINE, Issue 2 2009H. Jansen Abstract Aim, Glycated haemoglobin (HbA1c) is considered the best index of glycaemic control in established diabetes. It may also be useful in the diagnosis of diabetes and as a screening tool. Little is known about the distribution of HbA1c in healthy children and its predictors. The aim of this study is to describe the distribution of HbA1c in non-diabetic Dutch children aged 8,9 years and to investigate potential associations of HbA1c in this group. Methods HbA1c was measured in 788 non-diabetic children aged 8,9 years participating in the PIAMA birth cohort study. Data on parents and children were collected prospectively by questionnaires. Weight, height and waist and hip circumference of the children were measured when blood samples were taken. Results, Mean (sd) HbA1c was 4.9 ± 0.33%, range 3.5,6.0%. HbA1c was significantly higher in boys (4.9 ± 0.31 vs. 4.9 ± 0.33%) and in children of mothers with gestational diabetes (5.0 ± 0.37 vs. 4.9 ± 0.32%). We found a significant inverse association between HbA1c and haemoglobin (regression coefficient: ,0.169 (95% CI ,0.221 to ,0.118), P < 0.001). HbA1c was not significantly associated with age, body mass index, waist circumference, parental diabetes or maternal body mass index. Conclusions, We found no significant relation between known risk factors for Type 2 diabetes and HbA1c at age 8,9 years. Moreover, there was a significant inverse association between haemoglobin and HbA1c. These results suggest that HbA1c may not only reflect the preceding blood glucose levels, but seems to be determined by other factors as well. [source] HbA1c as a screening tool for detection of Type 2 diabetes: a systematic reviewDIABETIC MEDICINE, Issue 4 2007C. M. Bennett Abstract Aim To assess the validity of glycated haemoglobin A1c (HbA1c) as a screening tool for early detection of Type 2 diabetes. Methods Systematic review of primary cross-sectional studies of the accuracy of HbA1c for the detection of Type 2 diabetes using the oral glucose tolerance test as the reference standard and fasting plasma glucose as a comparison. Results Nine studies met the inclusion criteria. At certain cut-off points, HbA1c has slightly lower sensitivity than fasting plasma glucose (FPG) in detecting diabetes, but slightly higher specificity. For HbA1c at a Diabetes Control and Complications Trial and UK Prospective Diabetes Study comparable cut-off point of , 6.1%, the sensitivity ranged from 78 to 81% and specificity 79 to 84%. For FPG at a cut-off point of , 6.1 mmol/l, the sensitivity ranged from 48 to 64% and specificity from 94 to 98%. Both HbA1c and FPG have low sensitivity for the detection of impaired glucose tolerance (around 50%). Conclusions HbA1c and FPG are equally effective screening tools for the detection of Type 2 diabetes. The HbA1c cut-off point of > 6.1% was the recommended optimum cut-off point for HbA1c in most reviewed studies; however, there is an argument for population-specific cut-off points as optimum cut-offs vary by ethnic group, age, gender and population prevalence of diabetes. Previous studies have demonstrated that HbA1c has less intra-individual variation and better predicts both micro- and macrovascular complications. Although the current cost of HbA1c is higher than FPG, the additional benefits in predicting costly preventable clinical complications may make this a cost-effective choice. [source] The accuracy of cystatin C and commonly used creatinine-based methods for detecting moderate and mild chronic kidney disease in diabetesDIABETIC MEDICINE, Issue 4 2007R. J. MacIsaac Abstract Background, The accuracy of measuring serum cystatin C levels for detecting various stages of chronic kidney disease (CKD) in diabetes is still unclear. Methods In a cross-sectional study of 251 subjects, a reference glomerular filtration rate (GFR) was measured using 99cTc-DTPA plasma clearance (iGFR). Multivariate analysis was used to identify independent clinical and biochemical associations with serum cystatin C and iGFR levels. The diagnostic accuracy of cystatin C and commonly used creatinine-based methods of measuring renal function (serum creatinine, the MDRD four-variable and Cockcroft,Gault formulae) for detecting mild and moderate CKD was also compared. Results, In the entire study population the same five variables, age, urinary albumin excretion rates, haemoglobin, history of macrovascular disease and triglyceride levels were independently associated with both cystatin C and iGFR levels. A serum cystatin C level cut-off > 82.1 nmol/l (1.10 mg/l) had the best test characteristics as a screening tool for detecting moderate CKD (< 60 ml/min per 1.73 m2) when compared with creatinine-based methods. At the upper threshold for mild CKD (< 90 ml/min per 1.73 m2), cystatin C also had greater diagnostic accuracy than creatinine, but had similar diagnostic accuracy when compared with creatinine-based formulae for predicting renal function. Conclusions, This study suggests that the clinical and biochemical parameters associated with serum cystatin C levels are closely linked to those associated with GFR and highlights the potential usefulness of screening for moderate or mild CKD in subjects with diabetes by simply measuring serum cystatin C levels. [source] ,Numbness of the feet' is a poor indicator for polyneuropathy in Type 2 diabetic patientsDIABETIC MEDICINE, Issue 2 2000L. V. Franse Summary Aims To identify neuropathic sensory symptoms associated with a clinical neurological examination (CNE) and to investigate whether these symptoms could be used as a diagnostic or screening tool for diabetic polyneuropathy in general practice. Methods Five hundred and eighty-eight patients with Type 2 diabetes, recruited from 26 general practices in the Netherlands, underwent a CNE and completed a diabetes symptom checklist that included 10 items on neuropathic sensory symptoms. Linear regression analyses were performed to assess the association between neuropathic symptoms and CNE. Receiver operating characteristic (ROC) curves were created to assess the diagnostic properties of neuropathic symptoms. Results In this population, with a mean age of 66.8 years, 32% were identified with diabetic polyneuropathy according to the CNE. Variables that showed the strongest association with CNE score were age (, = 0.41), symptoms of sensory alteration (, = 0.27), and the item ,numbness of the feet' (, = 0.35) in particular. ROC curves showed that prediction of diabetic polyneuropathy from these symptoms was unsatisfying. The sensitivity and specificity of daily symptoms of ,numbness of the feet' were 28% and 93%, respectively, in patients <,68 years, and 22% and 92%, respectively, in patients ,,68 years. Conclusions Identification of neuropathic sensory symptoms is not useful as a diagnostic or even a screening tool in the assessment of diabetic neuropathy in daily practice. Therefore, the results reported in this paper mandate an annual foot examination by the general practitioner. [source] Identifying young people who drink too much: the clinical utility of the five-item Alcohol Use Disorders Identification Test (AUDIT)DRUG AND ALCOHOL REVIEW, Issue 1 2001HELEN MILES Researcher Abstract The current study investigated the patterns and consequences of alcohol use among young people and their perceptions of associate health risk, and explored the clinical utility of the five-item version of the Alcohol Use Disorders Identification Test (AUDIT) in screening young people for hazardous drinking. A cross-sectional sample of 393 young people aged 16,19 years were accessed through two tertiary colleges in South London and self-completed an anonymous, confidential questionnaire recording the five-item AUDIT, patterns of alcohol consumption, hazardous consequences and perception of associate health risk. Over 90% of the sample reported drinking alcohol regularly, commonly excessive weekend use and related physical, psychological and social consequences. A significant minority (20.4% of males, 18.0% of females) reported consumption of alcohol in excess of UK recommended limits, while almost a third (34.2% of males, 30.2% of females) reported scores in the ,hazardous' range of the five-item AUDIT. However, the majority had little perception of associate health risk, perceiving their use to be ,light' and unproblematic. Only one in 10 of those drinking at ,hazardous' levels recognized their alcohol use as problematic, most believing the hazardous consequences of this use were acceptable. Self-reported patterns of alcohol consumption (except age first used) and total number of psychological and social hazardous consequences were found to significantly predict AUDIT scores using linear regression analysis. Therefore the five-item AUDIT appears to have predictive validity, reflecting self-reported alcohol consumption, perception of associate health risk and hazardous consequences among young people. It is concluded that it may consequently have clinical utility as a simple screening tool (suitable for use by a variety of professionals in contact with young people) for the identification of hazardous alcohol consumption among this population. [source] CE-ESI-MS/MS as a rapid screening tool for the comparison of protein,ligand interactionsELECTROPHORESIS, Issue 7 2010Thomas Hoffmann Abstract In drug development, the combinatorial synthesis of drug libraries is common use, therefore efficient tools for the characterization of drug candidates and the extent of interaction between a drug and its target protein is a central question of analytical interest. While biological activity is tested today by enzyme assays, MS techniques attract more and more attention as an alternative for a rapid comparison of drug,target interactions. CE enables the separation of proteins and drug,enzyme complexes preserving their physiological activity in aqueous media. By hyphenating CE with ESI-MS/MS, the binding strength of enzyme inhibitors can be deduced from MS/MS experiments, which selectively release the inhibitor from the drug,target complex after CID. In this study, ,-chymotrypsin (CT), a serine protease, was chosen as a model compound. Chymostatin is a naturally occurring peptide aldehyde binding to CT through a hemiacetal bond and electrostatic interaction. First, a CE separation was developed, which allows the analysis of ,-CT and a chymotrypsin,chymostatin complex under MS-compatible conditions. The use of neutral-coated CE capillaries was mandatory to reduce analyte,wall interactions. ESI-quadrupole ion trap-MS was worked out to demonstrate the selective drug release after CID. Fragmentation of the drug,enzyme complex was monitored in dependence from the excitation energy in the ion trap, leading to the V50 voltage that enables 50% complex fragmentation as a reference value for chymotrypsin,chymostatin complex. A stable CE-ESI-MS/MS setup was established, which preserves the drug,enzyme complexes during ionization,desolvation processes. With this optimized setup, different CT inhibitors could be investigated and compared. [source] | ||||||||||||||||||||||||||||||||||||||||||||||