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Medical Sciences	50%

Selected Abstracts

Thermodynamic characterization of hybrid polymer blend systems

POLYMER ENGINEERING & SCIENCE, Issue 6 2009
Amos Ophir
A thermodynamic model was used to predict the morphology of hybrid multicomponent polymer blend systems. Two systems were studied, both including two noncompatible polymers, a third compatibilizer polymer and layered, organo-treated clays. The polar and nonpolar contributions of the surface energies of the components of the systems were calculated using measurements of the contact angles. The morphology of the multicomponent systems and the relative position of the organo-clays within them, were predicted by calculating the interaction energies between the different components of the system and evaluating these values according to the Vaia and Giannelis thermodynamic model for polymer melt intercalation in organically modified layered silicates. The experimental results show good correlation with the prediction that the organo-clays will have higher affinity to the compatibilizer polymer component situated at the interface between the two noncompatible blend components. In addition, the presence of the organo-clays in this interface was found to have a significant additional compatibilizing effect between the two polymer phases. The results presented in this work support the idea that hybrid formation via polymer melt intercalation depends mostly on energetic factors that can be determined from surface energies of polymers and organo-modified layered silicates, also in the case of multiphase polymer system. POLYM. ENG. SCI., 2009. © 2009 Society of Plastics Engineers [source]

Depression during pregnancy: detection, comorbidity and treatment

ASIA-PACIFIC PSYCHIATRY, Issue 1 2010
Maria Muzik
Abstract Depression during pregnancy is common (,15%). Routine prenatal depression screening coupled with the use of physician collaborators to assist in connecting women with care is critical to facilitate treatment engagement with appropriate providers. Providers should be aware of risk factors for depression , including a previous history of depression, life events, and interpersonal conflict , and should appropriately screen for such conditions. Depression during pregnancy has been associated with poor pregnancy outcomes including preeclampsia, insufficient weight gain, decreased compliance with prenatal care, and premature labor. Current research has questioned the overall benefit of treating depression during pregnancy with antidepressants when compared to the risk of untreated depression for mother and child. Published guidelines favor psychotherapy above medication as the first line treatment for prenatal depression. Poor neonatal adaptation or withdrawal symptoms in the neonate may occur with fetal exposure in late pregnancy, but the symptoms are mild to moderate and transient. The majority of mothers who decide to stop taking their antidepressants during pregnancy suffer relapsing symptoms. If depression continues postpartum, there is an increased risk of poor mother,infant attachment, delayed cognitive and linguistic skills in the infant, impaired emotional development, and behavioral problems in later life. Bipolar depression, anxiety and substance use disorders, and/or presence of severe psychosocial stress can lead to treatment-resistance. Modified and more complex treatment algorithms are then warranted. Psychiatric medications, interpersonal or cognitive-behavioral therapy, and adjunctive parent,infant/family treatment, as well as social work support, are modalities often required to comprehensively address all issues surrounding the illness. [source]

Findings on the impact of treatment for childhood acute lymphoblastic leukaemia on family relationships

CHILD & FAMILY SOCIAL WORK, Issue 3 2001
Pam McGrath
ABSTRACT Paediatric acute lymphoblastic leukaemia (ALL) has provided a landmark in cancer therapy as the first disseminated and otherwise lethal malignancy to be curable in the majority of patients. Although the success rate is high, this benefit is achieved through a long, invasive and very arduous treatment process. The experience of undergoing such intensive treatments affects not only the child, but the entire family. To date, however, psychosocial research is only beginning to describe the depth and breadth of the impact on families of this experience. This paper presents findings from a recent qualitative study of families coping with the initial stage (induction remission) of treatment for childhood ALL. The findings indicate that the experience is so profoundly disturbing and disruptive that it challenges the families' sense of normalcy and stability. These findings provide evidence of significant hardship and stress, with the consequent indication of the need for social work support. Above all, such families need to hear the comforting message from social workers that what they are experiencing is normal under the circumstances. Along with practical assistance, they need reassurance about the intensity of feelings they will experience and an affirmation of the difficulty of the challenges they face. [source]

Laryngeal Cancer Cost Analysis: Association of Case-Mix and Treatment Characteristics With Medical Charges,

THE LARYNGOSCOPE, Issue 1 2000
David J. Arnold MD
Abstract Objectives: To examine the relationship of various pretreatment case-mix characteristics and treatment modalities with medical charges incurred during diagnosis, treatment, and 2-year follow-up for patients with laryngeal cancer. Design: Retrospective chart review and billing record analysis. Methods: The charts and billing records of patients diagnosed with laryngeal cancer at the University of Iowa Hospitals and Clinics (UIHC) between January 1, 1991 and December 31, 1994 were reviewed. The independent variables included various pretreatment patient-mix and tumor characteristics (age, AJCC TNM clinical stage, smoking history, ASA class, and comorbidity as defined by Kaplan-Feinstein grade) as well as type of treatment. The dependent variables included total physician, office, and university hospital-based charges incurred during the pretreatment evaluation and 0- to 3-, 3- to 12-, and 12- to 24-month billing periods after the initiation of cancer-directed therapy. Total 1-year and 2-year charges were also evaluated. Univariate and multivariate analyses were used to investigate the relationships between dependent and independent variables and to develop models predictive of management charges during the individual and total billing periods. Results: Pretreatment charges showed no significant associations (P < .05) with any of the independent variables. Multiple regression analyses indicated that comorbidity, stage, and initial treatment modality were significant variables in one or more of the models predicting charges incurred during the 0- to 3-month, 3- to 12-month, total 1-year, and total 2-year billing periods. The models yielded R2 values for the total 1- and 2-year billing periods of 0.5246 and 0.5055, respectively. Conclusions: This work supports continued study of measures that may result in earlier detection of laryngeal cancer as a potential means of reducing management charges. These results also indicate that a more accurate method of stratifying the disease severity of laryngeal cancer patients for reimbursement purposes would include measurements of the severity of the index disease as well as comorbid diseases. [source]