Consanguineous marriage makes congenital heart diseases more complexRamachandra Barik
Introduction: Inbreeding increases homozygotes for autosomal recessive disorders resulting in high prevalence of congenital heart disease (CHD). This cross-section looks whether consanguineous marriage (CM) makes CHDs more complex.
Subjects and Methods: This was an observational study which looked at the cross-section of a cohort of consecutive 113 patients having different CHD who visited Nizam Institute of Medical Sciences, Andhra Pradesh, during the year 2016 for surgery or intervention. The definitive diagnosis of CHD was supported by clinical profile, chest X-ray, echo, ultrasound abdomen, and cardiac catheterization which is appropriate. The study population was divided into CM group and distance marriage (DM) group. The categorical variables were analyzed using descriptive statistics.
Results: Out of 113 patients with CHD, 61 (54%) were females. A majority 104 (94%) were Hindu. About 74% of patients were from below poverty line category. Approximately 27% and 73% patients were born out of consanguineous and DM, respectively. Most of the patients were from a rural background, and 63.7% had an education level of ≤10th class. Approximately, a total of 50 (44.2%) patients had complex CHDs (CCHDs). CCHD had significant association with CM (odds ratio: 2.60 95% confidence interval: 1.11–6.09, and P = 0.02).
Conclusion: As there was a significant association of CCHD with inbreed marriage, this observation discourages CM.
Consanguineous marriage makes congenital heart diseases more complexRamachandra Barik
Introduction: Inbreeding increases homozygotes for autosomal recessive disorders resulting in high prevalence of congenital heart disease (CHD). This cross-section looks whether consanguineous marriage (CM) makes CHDs more complex.
Subjects and Methods: This was an observational study which looked at the cross-section of a cohort of consecutive 113 patients having different CHD who visited Nizam Institute of Medical Sciences, Andhra Pradesh, during the year 2016 for surgery or intervention. The definitive diagnosis of CHD was supported by clinical profile, chest X-ray, echo, ultrasound abdomen, and cardiac catheterization which is appropriate. The study population was divided into CM group and distance marriage (DM) group. The categorical variables were analyzed using descriptive statistics.
Results: Out of 113 patients with CHD, 61 (54%) were females. A majority 104 (94%) were Hindu. About 74% of patients were from below poverty line category. Approximately 27% and 73% patients were born out of consanguineous and DM, respectively. Most of the patients were from a rural background, and 63.7% had an education level of ≤10th class. Approximately, a total of 50 (44.2%) patients had complex CHDs (CCHDs). CCHD had significant association with CM (odds ratio: 2.60 95% confidence interval: 1.11–6.09, and P = 0.02).
Conclusion: As there was a significant association of CCHD with inbreed marriage, this observation discourages CM.
The Prevalence and Coverage of Serious Health Risks in Popular Women's MagazinesShanna Kurpe
A content analysis of the coverage and emphasis of serious health risks in popular women's magazines. This was presented at the 2009 AEJMC conference in Boston, where I won the Top Faculty Paper in my division.
The Prevalence and Coverage of Serious Health Risks in Popular Women's MagazinesShanna Kurpe
A content analysis of the coverage and emphasis of serious health risks in popular women's magazines. This was presented at the 2009 AEJMC conference in Boston, where I won the Top Faculty Paper in my division.
https://userupload.net/06gt5zcwvh90
Genetic counseling is the process of advising individuals and families affected by or at risk of genetic disorders to help them understand and adapt to the medical, psychological and familial implications of genetic contributions to disease.[1] The process integrates:
Interpretation of family and medical histories to assess the chance of disease occurrence or recurrence
Education about inheritance, testing, management, prevention, resources
Counseling to promote informed choices and adaptation to the risk or condition.
Child Development, JanuaryFebruary 2002, Volume 73, Number .docxbissacr
Child Development, January/February 2002, Volume 73, Number 1, Pages 1–21
Nature, Nurture, and Development: From Evangelism through
Science toward Policy and Practice
Michael Rutter
During the second half of the 20th century there was an immense increase in both empirical findings on, and
conceptual understanding of, the effects of nature, nurture, and developmental processes on psychological
functioning—both normal and abnormal. Unfortunately, the good science has also been accompanied by ex-
cessive polarizing claims and by unwarranted extrapolations. This article provides a summary review of the
real gains in knowledge, outlines some of the misleading claims, and notes the potential for research and for
science-led improvements in policies and practice. The need to bring about a better interpretation of genetic,
psychosocial, and developmental research strategies and theoretical concepts is emphasized.
INTRODUCTION
Over the last half century, there has been an explosion
of knowledge on the effects of nature, nurture, and
developmental processes. As a result, we have a much
improved understanding of many of the mechanisms
involved in normal and abnormal development,
which carries with it a huge potential for improving
children’s lives. Unfortunately, these advances have
been accompanied by as much misleading scientific
evangelism and journalistic hype as by good science
and honest reporting. As a consequence, both the pages
of scientific journals and the media have been full of the
most absurd confrontations and polarizations. These
have given rise to an unhelpful level of misunder-
standing of the true scientific advances and, more es-
pecially, about their meaning and the implications for
policy and practice. Of course, there have also been
numerous examples of good reporting by scientists
and by journalists. There is every reason to be in-
debted to both. The need is to avoid the twin dangers
of destructive cynicism and gullible expectation.
Nature, nurture, and development are dealt with
in this article as separate topics (with the focus being
mainly on their effects on psychopathology). In each
case, the real advances in knowledge are considered
first, some of the misleading claims are outlined sec-
ond, and the potential for research and for improve-
ments in policies and practice are noted third. Al-
though these are considered as supposedly separate
influences, the truth is that they are closely inter-
twined. The separation is heuristically useful for test-
ing causal hypotheses, but it is crucial that such hy-
potheses deal with the different forms of interplay
that may be occurring. To a considerable extent, it is
the failure to do so that has led to many of the polar-
izing battles and absurd claims.
NATURE: GENETIC RISK AND
PROTECTIVE MECHANISMS
With regard to the influences that reflect nature,
quantitative genetics and molecular genetics are dis-
cussed separately, because they have rather different
patterns .
Similar to Epigenetics and the autosomal dna of human populations (20)
Conclusions reached from my involvement with the Canadian criminal justice system. 2011.
amd- 2021
References of papers published by Dr Mansfield Mela, and others regarding FASD, PAE, Mental Health, and the Justice System.
Dr Mela is one of the very few Forensic Psychiatrists who understands and advocates for those with FASD.
The Nomenclature of the Consequences of Prenatal Alcohol Exposure: PAE, and t...BARRY STANLEY 2 fasd
An historical account of the nomenclature relating to the effects of alcohol on the developing fetus.
The significance of facial features; the dose/threshold question; epigenetics, transgenerational consequences, and adult health issues, are raised.
The inadequacy of the present nomenclature is detailed
Effects of Hyperbaric Oxygen Therapy on Brain Perfusion, Cognition and Behavi...BARRY STANLEY 2 fasd
Abstract
A 15-year-old girl diagnosed with FASD underwent 100 courses of hyperbasic oxygen therapy (HBOT). Prior to HBOT, single motion emission compute tomographic begin imaging (SPECT)
revealed areas of hypo-perfusion bilaterally in the orbitofrontal region, temporal lobes and right dorsolateral—frontal, as well the medial aspect of the left cerebellum. Following two sets of HBOT treatments (60 plus 40), over 6 months, there was improvement in perfusion to the left cerebellum as well as the right frontal lobe. This was paralleled by improvement in immediate cognitive tests and an increase in functional brain volume. A follow-up 18 months after HBOT showed sustained
improvement in attention with no need for methylphenidate, as well as in math skills and writing.
This year as a priority of Proof Alliance’s legislative platform, major legislation that requires all children entering foster care be screened for prenatal exposure to alcohol in Minnesota was passed and signed into law. It is believed Minnesota is the first state in the nation to pass this legislation.
Four year follow-up of a randomized controlled trial of choline for neurodeve...BARRY STANLEY 2 fasd
Abstract
Background
Despite the high prevalence of fetal alcohol spectrum disorder (FASD), there are few interventions targeting its core neurocognitive and behavioral deficits. FASD is often conceptualized as static and permanent, but interventions that capitalize on brain plasticity and critical developmental windows are emerging. We present a long-term follow-up study evaluating the neurodevelopmental effects of choline supplementation in children with FASD 4 years after an initial efficacy trial
Abstract
This presentation includes a brief review of research into boredom, normal brain resting state and corresponding default mode[s].
The possible equivalence to the brain activity of those with FASD in relation to “being bored” is explored, with reference to brain anatomy and function.
Actual FASD clinical cases are presented to illustrate what individuals with FASD mean by “boredom”: describing the role of perseveration as a relief process.
Finally, the manner in which these processes are misinterpreted is explored, with implications for Psychiatry and the Justice System.
Association Between Prenatal Exposure to Alcohol and Tobacco and Neonatal Bra...BARRY STANLEY 2 fasd
IMPORTANCE Research to date has not determined a safe level of alcohol or tobacco use during pregnancy. Electroencephalography (EEG) is a noninvasive measure of cortical function that has previously been used to examine effects of in utero exposures and associations with
neurodevelopment.
OBJECTIVE To examine the association of prenatal exposure to alcohol (PAE) and tobacco smoking (PTE) with brain activity in newborns.
CONCLUSIONS AND RELEVANCE These findings suggest that even low levels of PAE or PTE are
associated with changes in offspring brain development.
Submitted to –
National Institute for Health and Care Excellence Fetal alcohol spectrum disorder
Consultation on draft quality standard – deadline for comments 5pm on 03/04/20
Clinical course and risk factors for mortality of adult inpatients with covid...BARRY STANLEY 2 fasd
Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help
clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale
for a strategy of isolation of infected patients and optimal antiviral interventions in the future.
Outcomes of Online Mindfulness-Based Cognitive Therapy for Patients With Residual Depressive SymptomsA Randomized Clinical Trial
Zindel V. Segal, PhD1; Sona Dimidjian, PhD2; Arne Beck, PhD3; et alJennifer M. Boggs, PhD3; Rachel Vanderkruik, MA2; Christina A. Metcalf, MA2; Robert Gallop, PhD4; Jennifer N. Felder, PhD5; Joseph Levy, BA2
Author Affiliations
JAMA Psychiatry. Published online January 29, 2020. doi:10.1001/jamapsychiatry.2019.4693
Significance for fasd
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
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Epigenetics and the autosomal dna of human populations
1. Epigenetics and the Autosomal DNA of Human Populations:
Clinical Perspectives and Personal
Genome Tests.
The International Journal of Community Diversity Volume 13, 2014,
ondiversity.com, ISSN: 2327-0004
Abstract: Although the fields of direct-to-the-consumer DNA testing and
genetic counseling have experienced rapid growth in the past five years
in providing people with increasingly accurate analyses of their ancestry,
admixture, family medical history and risk factors for disease, the subtle
role of epigenetics in heredity has so far not been comparably exploited
in medical research nor greatly appreciated by the wider public. The
history of DNA testing in the consumer realm reveals a shift from sex-
linked testing and easily traced Y chromosome and mitochondrial lines
of descent to an emphasis on autosomal results, which are more
diversified, complex and determinative. Matches showing ancestral
relatedness are now possible to autosomal populations based on forensic
science, ethnic strains and multi-generational markers, such as Native
American and Jewish. Epigenetics, defined as the superstructure of
genes, is beginning to be linked to population genetics to explore the
environmental effect upon genes, nutrition and a host of
transgenerational factors in susceptibility to diabetes, cancer, stress and
other diseases or conditions. Specific areas discussed here are the
Dutch Hunger Winter Study, methylation, cancer, stress, environmental
toxins including fungicides and air pollution and neurological diseases.
The emerging field of epigenetics with its emphasis on environment and
nutrition is thus superseding the older model of genetic determinism in
dictating people's health decisions, self-identity and ways of
understanding their individual ancestry and ethnicity.
Comment
2. An interesting paper, including a summary of everything that affects the
epigenetics of the developing fetus, with the exceptions of prenatal and
preconceptual alcohol. The question is, why have they been omitted?
The one epigenetically sensitive agent that human migrations have taken
with them, over thousands of years, has been alcohol: not fungicides or
other products of the petrochemical age.
For all those years preconceptual and prenatal alcohol have contributed
to the chaos of conflict. Now they are acting synergistically and
enhancing the epigenetic consequences of petrochemical products.
Addressing the impact of those products, without including the role of
preconceptual and prenatal alcohol, will be futile.