Reactive Attachment Disorder (RAD), only diagnosed in the context of early abuse and neglect, is characterised by failure to seek and accept comfort. It involves lack of activation of the - developmentally essential - attachment system, hence has profound developmental disadvantages. RAD usually resolves quickly in the context of adequate...
Parents perceptions of autism and theirhealth-seeking behavemelyvalg9
Parents' perceptions of autism and their
health-seeking behaviors
Maria Isabel O. Quilendrino a,*, Mary Anne R. Castor a,
Nenacia Ranali Nirena P. Mendoza b, Jacqueline R. Vea c,
Nina T. Castillo-Carandang c
a Department of Clinical Epidemiology and Department of Pediatrics, College of Medicine, University of the Philippines,
Manila, Philippines
b Department of Clinical Epidemiology and Department of Family and Community Medicine, College of Medicine,
University of the Philippines, Manila, Philippines
c Department of Clinical Epidemiology, College of Medicine, University of the Philippines, Manila, Philippines
c l i n i c a l e p i d e m i o l o g y a n d g l o b a l h e a l t h 3 ( 2 0 1 5 ) s 1 0 – s 1 5
a r t i c l e i n f o
Article history:
Received 15 September 2015
Accepted 13 November 2015
Available online 7 December 2015
Keywords:
Autism
Autistic disorder
Behavior
Perception
a b s t r a c t
Background: Parents' health-seeking behaviors, which in turn may be related to their per-
ceptions, are hypothesized to be the major determinant of the timing of diagnosis and
subsequent intervention for children with autism.
Objective: The primary objective of this study was to describe parental perceptions of autism
and health-seeking behaviors for urban Filipino children aged 2–6 years.
Methods: This was a cross-sectional study conducted in several phases. The first phase
involved collection of qualitative data from key informant interviews and small group
discussions. The second phase involved the development of a validated and reliable ques-
tionnaire, which was administered to 41 parents of children with autism, aged 2–6 years.
Results: Parents had varying perceptions of autism. They were generally undecided with
regard to the etiology of autism, but were in agreement that psychosocial factors, such as
parental sins and curses, were unlikely to be associated with autism. The most common
presenting symptom noted by parents was a qualitative impairment in social interaction.
There was a noted trend towards earlier age of symptom recognition (mean of 24 months)
and diagnosis of autism (mean of 39 months) among parents with younger children.
Conclusion: The results of this study showed some trends: There is improved awareness
regarding autism and the needs of children with autism. Parents tend to disagree with
previous myths about autism. There was an observable trend toward earlier diagnosis for
this group.
# 2015 INDIACLEN. Published by Elsevier, a division of Reed Elsevier India, Pvt. Ltd. All
rights reserved.
* Corresponding author. Tel.: +63 9178033888; fax: +63 27311631.
E-mail address: [email protected] (M.I.O. Quilendrino).
Available online at www.sciencedirect.com
ScienceDirect
journal homepage: www.elsevier.com/locate/cegh
http://dx.doi.org/10.1016/j.cegh.2015.11.003
2213-3984/# 2015 INDIACLEN. Published by Elsevier, a division of Reed Elsevier India, Pvt. Ltd. All rights reserved.
http://crossmar ...
Clinical Assessment of Children and Adolescents with DepressionCarlo Carandang
“Clinical Assessment of Children and Adolescents with Depression,”
Halifax, Nova Scotia, Canada; October 1, 2008
Pediatric Grand Rounds, IWK Health Centre
*Although the core symptoms of depression are similar across the life span, developmental differences exist and should be taken into account in the assessment
*With increasing age, there generally is an increase in melancholic symptoms, delusions, substance abuse, and suicidal ideation/attempts.
*In contrast, younger children tend to have more somatic sxs, separation anxiety, behavior problems, temper tantrums, and hallucinations
*Direct interviews with children and adolescents are critical because parents and teachers may not be aware of the youth’s depressive symptoms
*Discrepant information between parents and their children should be solve in a cordial and non judgmental way
*Assessment of suicidal and homicidal ideation and behaviors is mandatory
*The interview process and screening questions utilized by research interviews such as the Schedule for Affective Disorders and Schizophrenia for School Age Children, Present and Lifetime Version (KSADS-PL) can be useful
*Detection and diagnosis can be enhanced by available parent and child self-report measures
Parents perceptions of autism and theirhealth-seeking behavemelyvalg9
Parents' perceptions of autism and their
health-seeking behaviors
Maria Isabel O. Quilendrino a,*, Mary Anne R. Castor a,
Nenacia Ranali Nirena P. Mendoza b, Jacqueline R. Vea c,
Nina T. Castillo-Carandang c
a Department of Clinical Epidemiology and Department of Pediatrics, College of Medicine, University of the Philippines,
Manila, Philippines
b Department of Clinical Epidemiology and Department of Family and Community Medicine, College of Medicine,
University of the Philippines, Manila, Philippines
c Department of Clinical Epidemiology, College of Medicine, University of the Philippines, Manila, Philippines
c l i n i c a l e p i d e m i o l o g y a n d g l o b a l h e a l t h 3 ( 2 0 1 5 ) s 1 0 – s 1 5
a r t i c l e i n f o
Article history:
Received 15 September 2015
Accepted 13 November 2015
Available online 7 December 2015
Keywords:
Autism
Autistic disorder
Behavior
Perception
a b s t r a c t
Background: Parents' health-seeking behaviors, which in turn may be related to their per-
ceptions, are hypothesized to be the major determinant of the timing of diagnosis and
subsequent intervention for children with autism.
Objective: The primary objective of this study was to describe parental perceptions of autism
and health-seeking behaviors for urban Filipino children aged 2–6 years.
Methods: This was a cross-sectional study conducted in several phases. The first phase
involved collection of qualitative data from key informant interviews and small group
discussions. The second phase involved the development of a validated and reliable ques-
tionnaire, which was administered to 41 parents of children with autism, aged 2–6 years.
Results: Parents had varying perceptions of autism. They were generally undecided with
regard to the etiology of autism, but were in agreement that psychosocial factors, such as
parental sins and curses, were unlikely to be associated with autism. The most common
presenting symptom noted by parents was a qualitative impairment in social interaction.
There was a noted trend towards earlier age of symptom recognition (mean of 24 months)
and diagnosis of autism (mean of 39 months) among parents with younger children.
Conclusion: The results of this study showed some trends: There is improved awareness
regarding autism and the needs of children with autism. Parents tend to disagree with
previous myths about autism. There was an observable trend toward earlier diagnosis for
this group.
# 2015 INDIACLEN. Published by Elsevier, a division of Reed Elsevier India, Pvt. Ltd. All
rights reserved.
* Corresponding author. Tel.: +63 9178033888; fax: +63 27311631.
E-mail address: [email protected] (M.I.O. Quilendrino).
Available online at www.sciencedirect.com
ScienceDirect
journal homepage: www.elsevier.com/locate/cegh
http://dx.doi.org/10.1016/j.cegh.2015.11.003
2213-3984/# 2015 INDIACLEN. Published by Elsevier, a division of Reed Elsevier India, Pvt. Ltd. All rights reserved.
http://crossmar ...
Clinical Assessment of Children and Adolescents with DepressionCarlo Carandang
“Clinical Assessment of Children and Adolescents with Depression,”
Halifax, Nova Scotia, Canada; October 1, 2008
Pediatric Grand Rounds, IWK Health Centre
*Although the core symptoms of depression are similar across the life span, developmental differences exist and should be taken into account in the assessment
*With increasing age, there generally is an increase in melancholic symptoms, delusions, substance abuse, and suicidal ideation/attempts.
*In contrast, younger children tend to have more somatic sxs, separation anxiety, behavior problems, temper tantrums, and hallucinations
*Direct interviews with children and adolescents are critical because parents and teachers may not be aware of the youth’s depressive symptoms
*Discrepant information between parents and their children should be solve in a cordial and non judgmental way
*Assessment of suicidal and homicidal ideation and behaviors is mandatory
*The interview process and screening questions utilized by research interviews such as the Schedule for Affective Disorders and Schizophrenia for School Age Children, Present and Lifetime Version (KSADS-PL) can be useful
*Detection and diagnosis can be enhanced by available parent and child self-report measures
Disruptive behavioral disorder & Anxiety disorder in childDr Slayer
-Is characterized by enduring pattern of NEGATIVISTIC, DISOBEDIENT and HOSTILE behavior toward authority figures as well as inability to take responsibility for mistakes, leading to placing blame on others.
-AGGRESSIONS and VIOLATIONS of the rights of the others
Violations include cruelty to people and animals, destruction of property, deceitfulness or theft and serious violation of rules
-Increased and INAPPROPRIATE ANXIETY around separation from attachment figures or home, which is developmentally abnormal and results in impaired normal functioning
emotional problems in youngsters.
•Conduct disorder usually happens between the ages of 6 and 15.
•factors contributing to development of conduct disorder
•brain damage
•child abuse or neglect
•genetic vulnerability
• school failure
• traumatic life experiences.
Loading…
Changes from DSM-IV to DSM-V
•The chapter on “Disruptive, impulse-control, and conduct disorders” is new to DSM-5.
•It brings together disorders that were previously included in the chapter “Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence”.
Learning Resources to be used as references to support your answer.docxsmile790243
Learning Resources to be used as references to support your answer.
USW1_SOCW_6090_howToWriteADiagnosisInDSM5.pdfUSW1_SOCW_6090_WK03_Chase.pdf
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
· “Neurodevelopmental Disorders” (pp. 31–86)
· “Other Conditions That May Be a Focus of Clinical Attention” (pp. 715–727)
Bell, A. S. (2011). A critical review of ADHD diagnostic criteria: What to address in the DSM-V. Journal of Attention Disorders, 15(1), 3–10.
Note: You will access this article from the Walden Library databases.
How to Write a Diagnosis According to DSM-5 and ICD-10-CM (PDF)
Teicher, M. H., Samson, J. A., Polcari, A., & McGreenery, C. E. (2006). Sticks, stones, and hurtful words: Relative effects of various forms of childhood maltreatment. American Journal of Psychiatry, 163(6), 993–1000.
Note: You will access this article from the Walden Library databases.
Working With Children and Adolescents: The Case of Chase (PDF)
Wing, L., Gould, J., & Gillberg, C. (2011). Autism spectrum disorders in the DSM-V: Better or worse than the DSM-IV? Research in Developmental Disabilities, 32, 768–773.
Note: You will access this article from the Walden Library databases.
Wiki Assignment Instructions (PDF)
Kieling, C., Kieling, R. R., Frick, P. J., Rohde, L. A., Moffitt, T., Nigg, J. T., Tannock, R., & Castellanos, F. X. (2010) The age at onset of attention deficit hyperactivity disorder. American Journal of Psychiatry, 167, 14–15.
Note: You will access this article from the Walden Library databases.
Murphy, C., & Taylor, E. (2006). Need to know ADHD. Pulse, 66(34), 38–42.
Note: You will access this article from the Walden Library databases.
Discussion - Week 3
Collapse
Top of Form
Total views: 35 (Your views: 4)
Discussion: Influences on Diagnosis and Outcome
The addition of more Z Codes to the DSM-5 is congruent to how a social worker as a clinician should conduct an assessment and determine the appropriate treatment.
For this Discussion, review The Case of Chase, analyze Chase’s story, and note his original DSM-IV diagnosis. Using the DSM-5 diagnostic criteria, determine Chase’s primary clinical diagnosis. Next, note the changes in the Autism Spectrum disorders, and include the Other Conditions That May Be a Focus of Clinical Attention (ICD-10-CM, Z codes) in your diagnosis. Then identify the potential risk and prognostic factors from both the biological and environmental perspective.
By Day 3
Post your response to the following:
· What should Chase’s diagnosis be according to the DSM-5 criteria?
· What predisposing and risk factors led to the outcome of this case?
· What potential protective factors could have been introduced to address this situation?
· ...
Ulcerative Colitis with Aseptic Abscesses Controlled by Vedolizumab: A Case R...clinicsoncology
Aseptic abscesses (AAs) are neutrophilic infiltrative lesions that often coincide with systemic inflammatory disorders such as inflammatory bowel diseases (IBD). According to recent literature, medical therapies in IBD with AAs include corticosteroid, immunosuppressants and anti-TNFα biologics.
Prevalence and Determinants of Distress Among Residents During COVID Crisisclinicsoncology
Residents are predisposed to develop distress, burnout, and depression. With COVID-19, new stressful working conditions were imposed. This study aims to assess the impact of COVID-19 on residents’ wellbeing in France.
A Road from Coronary to Pulmonary: A Rare Imaging Presentationclinicsoncology
Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease. Its association with Pulmonary Atresia is considered to be the most severe form, the diagnosis of which plays an important role in determination of the treatment protocol. In such cases, systemic vascular channels called Major Aortopulmonary Collateral Arteries (MAPCA’s) develop from aorta and its major branches to supply and maintain the pulmonary circulation. Such patients commonly undergo a Cardiac CT as an imperative pre-operative investigation for detailed information of these collaterals which helps plan further management. Here, we present a Case Report of an adult female patient with Pentalogy of Fallot wherein, a Cardiac CT showed the presence of dilated coronary-to-pulmonary collateral circulation. i.e. CAPA apart from the normally visualized MAPCA’s, an extremely rare occurrence.
More Related Content
Similar to Parallel Lives: A Case Series of Three Boys with Persistent Reactive Attachment Disorder
Disruptive behavioral disorder & Anxiety disorder in childDr Slayer
-Is characterized by enduring pattern of NEGATIVISTIC, DISOBEDIENT and HOSTILE behavior toward authority figures as well as inability to take responsibility for mistakes, leading to placing blame on others.
-AGGRESSIONS and VIOLATIONS of the rights of the others
Violations include cruelty to people and animals, destruction of property, deceitfulness or theft and serious violation of rules
-Increased and INAPPROPRIATE ANXIETY around separation from attachment figures or home, which is developmentally abnormal and results in impaired normal functioning
emotional problems in youngsters.
•Conduct disorder usually happens between the ages of 6 and 15.
•factors contributing to development of conduct disorder
•brain damage
•child abuse or neglect
•genetic vulnerability
• school failure
• traumatic life experiences.
Loading…
Changes from DSM-IV to DSM-V
•The chapter on “Disruptive, impulse-control, and conduct disorders” is new to DSM-5.
•It brings together disorders that were previously included in the chapter “Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence”.
Learning Resources to be used as references to support your answer.docxsmile790243
Learning Resources to be used as references to support your answer.
USW1_SOCW_6090_howToWriteADiagnosisInDSM5.pdfUSW1_SOCW_6090_WK03_Chase.pdf
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
· “Neurodevelopmental Disorders” (pp. 31–86)
· “Other Conditions That May Be a Focus of Clinical Attention” (pp. 715–727)
Bell, A. S. (2011). A critical review of ADHD diagnostic criteria: What to address in the DSM-V. Journal of Attention Disorders, 15(1), 3–10.
Note: You will access this article from the Walden Library databases.
How to Write a Diagnosis According to DSM-5 and ICD-10-CM (PDF)
Teicher, M. H., Samson, J. A., Polcari, A., & McGreenery, C. E. (2006). Sticks, stones, and hurtful words: Relative effects of various forms of childhood maltreatment. American Journal of Psychiatry, 163(6), 993–1000.
Note: You will access this article from the Walden Library databases.
Working With Children and Adolescents: The Case of Chase (PDF)
Wing, L., Gould, J., & Gillberg, C. (2011). Autism spectrum disorders in the DSM-V: Better or worse than the DSM-IV? Research in Developmental Disabilities, 32, 768–773.
Note: You will access this article from the Walden Library databases.
Wiki Assignment Instructions (PDF)
Kieling, C., Kieling, R. R., Frick, P. J., Rohde, L. A., Moffitt, T., Nigg, J. T., Tannock, R., & Castellanos, F. X. (2010) The age at onset of attention deficit hyperactivity disorder. American Journal of Psychiatry, 167, 14–15.
Note: You will access this article from the Walden Library databases.
Murphy, C., & Taylor, E. (2006). Need to know ADHD. Pulse, 66(34), 38–42.
Note: You will access this article from the Walden Library databases.
Discussion - Week 3
Collapse
Top of Form
Total views: 35 (Your views: 4)
Discussion: Influences on Diagnosis and Outcome
The addition of more Z Codes to the DSM-5 is congruent to how a social worker as a clinician should conduct an assessment and determine the appropriate treatment.
For this Discussion, review The Case of Chase, analyze Chase’s story, and note his original DSM-IV diagnosis. Using the DSM-5 diagnostic criteria, determine Chase’s primary clinical diagnosis. Next, note the changes in the Autism Spectrum disorders, and include the Other Conditions That May Be a Focus of Clinical Attention (ICD-10-CM, Z codes) in your diagnosis. Then identify the potential risk and prognostic factors from both the biological and environmental perspective.
By Day 3
Post your response to the following:
· What should Chase’s diagnosis be according to the DSM-5 criteria?
· What predisposing and risk factors led to the outcome of this case?
· What potential protective factors could have been introduced to address this situation?
· ...
Ulcerative Colitis with Aseptic Abscesses Controlled by Vedolizumab: A Case R...clinicsoncology
Aseptic abscesses (AAs) are neutrophilic infiltrative lesions that often coincide with systemic inflammatory disorders such as inflammatory bowel diseases (IBD). According to recent literature, medical therapies in IBD with AAs include corticosteroid, immunosuppressants and anti-TNFα biologics.
Prevalence and Determinants of Distress Among Residents During COVID Crisisclinicsoncology
Residents are predisposed to develop distress, burnout, and depression. With COVID-19, new stressful working conditions were imposed. This study aims to assess the impact of COVID-19 on residents’ wellbeing in France.
A Road from Coronary to Pulmonary: A Rare Imaging Presentationclinicsoncology
Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease. Its association with Pulmonary Atresia is considered to be the most severe form, the diagnosis of which plays an important role in determination of the treatment protocol. In such cases, systemic vascular channels called Major Aortopulmonary Collateral Arteries (MAPCA’s) develop from aorta and its major branches to supply and maintain the pulmonary circulation. Such patients commonly undergo a Cardiac CT as an imperative pre-operative investigation for detailed information of these collaterals which helps plan further management. Here, we present a Case Report of an adult female patient with Pentalogy of Fallot wherein, a Cardiac CT showed the presence of dilated coronary-to-pulmonary collateral circulation. i.e. CAPA apart from the normally visualized MAPCA’s, an extremely rare occurrence.
Patients with severe acute respiratory syndrome coronavirus 2 (SARS-Cov2) infection mainly present severe pneumonia associated with complications related to cytokine storm syndrome. So, it was associated with thrombotic incidents like acute limb ischemia and pulmonary embolism.
Loop –Mediated Isothermal Amplification (LAMP) Based POINT-OF-CARE for Rapid ...clinicsoncology
Abstract Infectious diseases, including foodborne diseases, to this day remain a major health threat worldwide. Molecular diagnostics, based on nucleic acid (NA) amplification technologies, are in the forefront for the detection of pathogens. Polymerase chain reaction (PCR) is one of the most widely used methods for nucleic acid amplification in pathogen diagnostic.
Wen Dan Tang: A Potential Jing Fang Decoction for Headache Disordersclinicsoncology
Chinese herbal medicine is considered relatively safe, inexpensive, and easily accessible. Furthermore, it is becoming increasingly popular in the western countries. Wen Dan Tang, a Jing Fang ancient classical Chinese herbal formula, with a broad indication profile, has been used for several centuries in China to treat various illnesses.
In bioelectronic terms, the organism is understood as an integrated circuit of biological piezo, pyroelectrics, ferromagnets and semiconductors, filled with bioplasm and managed electronically by quantum processes.
Sexual Function and Dysfunction among Patients with Systemic and Auto-Immune ...clinicsoncology
Systemic autoimmune diseases affect various organs and they can determine sexual dysfunction in females and males patients particularly with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), systemic sclerosis (SSc), Sjögren syndrome (SS), antiphospholipid syndrome, Behçet’s disease and other vasculitis. Sexual dysfunction among patients with rheumatic diseases is multifactorial due to disease-related factors (chronic disease aspects, disease activity) as well as therapy.
The Role of the Pharmacist in Patient Care (Book Review)clinicsoncology
Most people on the outside of the health care profession are not familiar with this new role of the pharmacist. The general public has created a stereotypical pharmacist’s picture as being a person who stands behind a counter, dispenses medicine with some instructions to the respective consumer. Pharmacy practice has changed substantially in recent years.
Guillain Barre Syndrome & Covid-19: A Case Reportclinicsoncology
Besides respiratory symptoms, coronavirus disease 2019 (COVID-19), like the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), has neurological signs. Symptoms like myalgia, headaches, dizziness, anosmia, ageusia and disorder of consciousness confirms that the nervous system is involved in COVID-19 infection.
‘Double X’ Cross Fixationin Paediatric Supracondylar Humerus Fractures: A 20-...clinicsoncology
Over the last 50 years, the developments emerged in the diagnosis and treatment of supracondylar humerus fractures (SHF) have significantly reduced the number of severe complications while certain complications with dreadful evolution, such as elbow stiffness or Volkmann’s syndrome, have completely vanished. During my residency, in 1982, on the suggestion of Prof. Pesamosca, I have performed a surgical intervention for a patient diagnosed with SHF
A hookah (shisha, waterpipe) use may increase the risk of suffering from serious symptoms due to COVID-19. Like smoking, hookahs may exacerbate the risk for severe COVID-19 through shared use and being difficult-to-clean the long pipes and having a cold water reservoir.
Can Lung Ultrasound in Patients with Fever of Unknown Origin Detect Early Sig...clinicsoncology
The increasing interest in Lung Ultrasound (LUS) over the last years led to a great diffusion and better experience in using this technique, which became an essential tool for clinicians. During the current Coronavirus Disease 2019 (COVID-19) pandemic
Postpartum Meningitis by Enterococcus Faecalis Secondary to Neuraxial Anesthesiaclinicsoncology
Meningitis is an infrequent and serious cause of postpartum fever that requires early diagnosis and treatment to prevent serious complications and to reduce the high mortality rate
Herpes Simplex Encephalitis in Medulloblastoma Patients: Case Report and Revi...clinicsoncology
Encephalitis caused by Herpes Simplex Virus (HSV) and medulloblastoma are both fairly rare disorders with relatively poor prognoses. We experienced a case of HSV encephalitis (HSE) in which the patient presented 1 year after surgical resection and radiation therapy and 1 month after chemotherapy....
Superior Mesenteric Artery Syndrome Treated by Laparoscopic Duodenojejunostomyclinicsoncology
Superior Mesenteric Artery syndrome (SMA Sd) is a very rare disease. It is suspected in the case of intestinal obstruction in severely underweight patients. When conservative management fails surgery becomes needed, with laparoscopic duodenojejunostomy being the best approach....
Colopleural Fistula. A Case Report and Review of Literatureclinicsoncology
The presence of a colopleural fistula is a rare event related to several factors, inadequate placement of drains, poor surgical technique, infection or dehiscence of a GI anastomosis. Only a small percentage occurs as a complication of inflammatory bowel disease, cancer, trauma or radiation.
Atypical Presentation of Post-Kala Azar Dermal Leishmaniasis in Bhutanclinicsoncology
This article describes an atypical case of post-kala azar dermal leishmaniasis associated with complications due to delayed diagnosis and poor case management.
Cutaneous Larva Migrans: A Case Report in a Traveler Childclinicsoncology
Cutaneous Larva Migrans (CLM) is the most common skin disease of tropical origincaused by hookworms larvae, occurring in international travelers. Typical manifestations consist of erythematous, serpiginous slightly elevated linear cutaneous lesions
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
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Parallel Lives: A Case Series of Three Boys with Persistent Reactive Attachment Disorder
1. Parallel Lives: A Case Series of Three Boys with Persistent Reac-
tive Attachment Disorder
Nelson R1*
, Chadwick G1
, Bruce M2
and Minnis H1
1
University of Glasgow, Glasgow, UK
2
NHS Lothian, Lothian, Scotland
Volume 1 Issue 4- 2018
Received Date: 10 Oct 2018
Accepted Date: 30 Oct 2018
Published Date: 06 Nov 2018
1. Abstract
Reactive Attachment Disorder (RAD), only diagnosed in the context of early abuse and neglect, is
characterised by failure to seek and accept comfort. It involves lack of activation of the - develop-
mentally essential - attachment system, hence has profound developmental disadvantages. RAD
usually resolves quickly in the context of adequate care and has been assumed never to persist
once the child is in a nurturing placement. We challenge this existing paradigm by presenting
three cases of children whose RAD symptoms have persisted despite living in placements judged,
by both social and child health services, to be of good quality. All three boys met DSM 5 criteria
for RAD in late childhood/early adolescence and had had stable RAD symptoms since before age
5. In the absence of longitudinal data, except from unusual institutionalised samples, it has been
impossible to evidence RAD beyond pre-school and virtually nothing is known about factors pre-
dicting its stability. This case series and systematic review provides the first opportunity to generate
testable hypotheses about environmental circumstances and coexisting symptomatology that may
influence RAD trajectories. As predicted more than a decade ago, persistence of RAD has had pro-
foundly negative developmental implications for the children and an extremely detrimental effect
on family life and relationships. Recognition of RAD symptoms is challenging because symptoms
are classically internalising and therefore easy to miss. This case series will allow paediatricians to
better recognise the subtle symptoms of RAD in order to improve their care of these children and
their families.
Annals of Clinical and Medical
Case Reports
Citation: Nelson R, Chadwick G, Bruce M and Minnis H, Parallel Lives: A Case Series of Three Boys with
Persistent Reactive Attachment Disorder. Annals of Clinical and Medical Case Reports. 2018; 1(4): 1-5.
United Prime Publications: http://unitedprimepub.com
*Corresponding Author (s): Rebecca Nelson, ACE Centre, Academic CAMHS, Level 4 West
Ambulatory Care Hospital, Glasgow, G3 8SJ, University of Glasgow, UK, E-mail: Rebecca.
nelson@glasgow.ac.uk
Case Report
2. Abbreviations
ADHD - Attention-Deficit/Hyperactivity Disorder
ASD - Autism Spectrum Disorder
CAMHS - Child and Adolescent Mental Health Services
DSED - Disinhibited Social Engagement Disorder
DSM-V - Diagnostic and Statistical Manual version 5
PTSD - Post-traumatic Stress Disorder
RAD - Reactive Attachment Disorder
WASI - Weschler Abbreviated Scale of Intelligence
WISC - Weschler Intelligence Scale for Children
WPPSI - Weschler Pre-school and Primary Scale of Intelligence
3. Introduction
Reactive Attachment Disorder (RAD) represents a closing down
of the attachment system [1-3], therefore is associated with pro-
found developmental disadvantages [1, 5, 6]. Because of its rar-
ity, large scale longitudinal studies are impossible and persistence
beyond early childhood has never been proven out-with institu-
tionalised populations [7].
For rare diseases, the case series can provide the most robust
methodology available [8]. We present three cases, following
CARE guidelines [8], all of whom experienced severe maltreat-
ment in early life and were then placed, between age three and
five, with adoptive or foster parents who had undergone stringent
background checks and had ongoing support. All boys and their
families gave informed consent to the inclusion of their case re-
ports. Names have been changed to protect identity.
3. 4.1. Case 1, John
When assessed at age 9, RAD symptoms were noted since age 4.
In addition, John was also diagnosed with Post-traumatic stress
disorder (PTSD), Conduct Disorder and Attention deficit/Hy-
peractivity Disorder (ADHD). He had intensive relationship-fo-
cused psychotherapeutic treatment, with his adoptive mother, but
symptoms persisted.
4.2. Case 2, Brian
When assessed at age 12, RAD symptoms were noted since age
3.At age thirteen, Brian was moved to a small residential unit
where he continued to have problems seeking and accepting
comfort from his keyworkers and his parents, who continued to
visit. At age fifteen he continued to demonstrate RAD symptoms
and difficult behaviour and was moved into a residential place-
ment where he was the only child, and received intensive one to
one care from a small team of staff. Involvement with his parents
increased resulting in leading to weekend home passes. By age
sixteen, when last assessed, Brian was no longer violent, no lon-
ger met criteria for RAD and was being investigated for possible
ADHD.
4.3. Case 3, Andrew
When assessed at age 14, RAD symptoms were noted since age 4
years and the foster placement was in jeopardy. Ongoing health
concerns relating to his premature birth included mild left-sided
hemiplegia, talipes and partial sightedness. At first assessment, his
foster carer had never considered whether or how Andrew had
sought comfort as a young child, but described how he would
stand silently by while physical care was provided to other foster
children, all of whom had severe or profound physical and learn-
ing disabilities.
After two sessions of psychotherapy in which the therapist en-
couraged both Andrew and his foster mother to notice and re-
spond to each other’s signals, symptoms improved markedly.
None of the boys had symptoms of Autism Spectrum Disorder:
during assessment, social communication was typical apart from
emotional withdrawal and none had repetitive or stereotyped in-
terests.
5. Family Perspective
Parents took part in qualitative interviews to explore the impact
of RAD symptoms on the family. Transcripts were read indepen-
dently by RN and GC and three common themes were extracted
across families [13].
5.1. Family strain
High levels of stress characterised all aspects of family life. Bur-
densome child behaviours included lack of understanding of
social cues, violence and eliciting negative attention. There was
emotional separation between the child and the rest of the family.
This was described, by John’s mother, as living “parallel lives; one
life with my husband, biological son and dog, and the other with
John.”
5.2. Frustration
A key frustration for families was lack of understanding of the
child’s emotions and the child’s emotional unresponsiveness and
abnormal interactions. Another frustration was the significant
delay in identification of the problem and the associated lack of
support, resulting in years of isolated suffering.
Resentment: Feelings of resentment were evident in all three fami-
lies due to the significant strain that RAD had put on their family
and their relationships. Both adoptive couples had experienced
marital difficulties ascribed to the burden of their child’s prob-
lems.
6. Discussion
Persistent RAD is rare: only a handful of cases were diagnosed by
HM in over 20 years of clinical practice. All had associated devel-
opmental/neurodevelopmental problems, as previously described
[5, 6, 14, 15]. All placements had been threatened with break-
down. John has persistent symptoms despite treatment, Andrew
had rapid symptom resolution after psychotherapy in adolescence
and Brian had symptom resolution after intensive one-to-one
residential support. This provides the new insights that persistent
RAD, while rare, threatens family life - but treatment is possible,
even in adolescence.
Our systematic literature review found individual and contextual
factors to be associated with RAD. Contextual factors include
institutionalization [16], quality of care giving in the institution
[16-19], harsh parenting, parental negativity [20], parental mental
health problems [21, 22] and longer exposure to the maltreating
pre-care environment [23]. Individual factors include male gen-
der [22], reduced grey matter volume [24], lower cognitive ability
[25], dopaminergic dysfunction [18, 26]; and genetic factors, par-
ticularly for males [21]. RAD is associated with depressive symp-
toms [18], social and emotional difficulties [18, 27], functional
impairment [17, 18, 22], behavioural and conduct problems [22,
27, 28], hyperactivity [20, 28]; internalising symptoms [17, 28,
29], externalising symptoms [28], stereotypies [17], help seeking
from services [22], callous-unemotional traits [27] and symptoms
of Disinhibited Social Engagement Disorder (DSED) [17, 18, 22,
27]. Studies were of moderate to high quality, but findings were
not always consistent across studies, possibly due to a lack of con-
sistent measures for RAD, confounding, differing sample types
and modest sample sizes.
United Prime Publications: http://unitedprimepub.com 3
Volume 1 Issue 4 -2018 Case Report
4. To conclude, in rare cases RAD can persist despite years of nur-
turing care. Symptoms are easy to miss but are associated with se-
vere family stress and other developmental problems. Paediatri-
cians should always consider RAD when assessing children with
a maltreatment history.
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