bluuebunny/crossref_metadata_2025_split huggingface dataset:
Background and design of the symptom burden in end‐stage liver disease patient‐caregiver dyad study
Authors: Hansen Lissi , Lyons Karen S. , Dieckmann Nathan F. , Chang Michael F. , Hiatt Shirin , Solanki Emma , Lee Christopher S. 
Published: June 2017

ABSTRACTOver half a million Americans are affected by cirrhosis, the cause of end‐stage liver disease (ESLD). Little is known about how symptom burden changes over time in adults with ESLD and their informal caregivers, which limits our ability to develop palliative care interventions that can optimize symptom management and quality of life in different patient‐caregiver dyads. The purpose of this article is to describe the background and design of a prospective, longitudinal descriptive study, “Symptom Burden in End‐Stage Liver Disease Patient‐Caregiver Dyads,” which is currently in progress. The study is designed to (i) identify trajectories of change in physical and psychological symptom burden in adults with ESLD; (ii) identify trajectories of change in physical and psychological symptom burden in caregivers of adults with ESLD; and (iii) determine predictors of types of patient‐caregiver dyads that would benefit from tailored palliative care interventions. We aim for a final sample of 200 patients and 200 caregivers who will be followed over 12 months. Integrated multilevel and latent growth mixture modeling will be used to identify trajectories of change in symptom burden, linking those changes to clinical events, and quality of life outcomes and characterizing types of patient‐caregiver dyads based on patient‐, caregiver‐, and dyad‐level factors. Challenges we have encountered include unexpected attrition of study participants, participants not returning their baseline questionnaires, and hiring and training of research staff. The study will lay the foundation for future research and innovation in ESLD, end‐of‐life and palliative care, and caregiving.
Prescribing trends and indications of antipsychotic medication in Hong Kong from 2004 to 2014: General and vulnerable patient groups
Authors: Lao Kim S.J. , Tam Anthony W.Y. , Wong Ian C.K. , Besag Frank M.C. , Man Kenneth K.C. , Chui Celine S.L. , Chan Esther W. 
Published: June 2017

AbstractPurposeAntipsychotic‐prescribing patterns remain unclear in Asia. The aims of our study were to investigate prescribing trends of antipsychotic medication in the general population, children, and older patients by drug generation (first or second), the prescribing trend in pregnant women, the probable indication for antipsychotic prescription, and the prescribing trend by dosage form.MethodsThis descriptive study identified and included all patients prescribed with antipsychotic in Hong Kong from 2004 to 2014 using the Clinical Data Analysis and Report System. This study calculated and reported the prevalence of antipsychotic prescribing in patient groups of interest, the percentage with diagnoses of mental disorders were derived, and the prevalence of antipsychotic by dosage forms.ResultsThe study included 10 109 206 prescriptions of any antipsychotics to 256 903 patients. Over the study period, the prevalence of antipsychotic prescribing increased from 1.06% to 1.54% in the general population, from 0.10% to 0.23% in children (3‐17 years old), and from 2.61% to 3.26% in older patients (≥65 years old). The prevalence of second‐generation antipsychotics increased, but the prevalence of first‐generation antipsychotics did not. Prevalence of antipsychotic prescribing in prepregnancy, pregnancy, and postpartum timeframes varied from 0.18% to 0.38%. The percentage of incident prescriptions with a diagnosis of psychosis decreased from 54.1% to 47.5%.ConclusionsAntipsychotics have been increasingly prescribed in the general population, children, and older patients. There is an increase in second‐generation antipsychotic prescribing. Over half of incident users had a recent diagnosis of a nonpsychotic mental disorder in 2014, suggesting that off‐label prescribing of antipsychotics might be common.
Understanding how coping strategies and quality of life maintain hope in patients deliberating phase I trial participation
Authors: van der Biessen Diane A. , van der Helm Peer G. , Klein Dennis , van der Burg Simone , Mathijssen Ron H. , Lolkema Martijn P. , de Jonge Maja J. 
Published: June 2017

AbstractObjectiveThis study aimed to understand how hope and motivation of patients considering phase I trial participation are affected by psychological factors such as coping strategies and locus of control (LoC) and general well‐being as measured by the quality of life (QoL).MethodsAn exploratory cross‐sectional study was performed in patients with incurable cancer (N = 135) referred to our phase I unit for the first time. Patients were potentially eligible for phase I trial participation and participated in our study while deliberating phase I trial participation. We used questionnaires on hope, motivation to participate, coping, LoC, and QoL. To investigate the nature and magnitude of the relationships between the scales, a structural equation modeling (SEM) was fitted to the data.ResultsHope significantly predicted the motivation to participate in phase I trials. Predictors of hope were a combination of flexible and tenacious goal pursuit (both P < .01), internal LoC (P < .01), and QoL (P < .01). The SEM showed an exact fit to the data, using a null hypothesis significance test: chi‐square (8) = 9.30, P = .32.ConclusionsPatients considering phase I trial participation seem to use a pact of tenacious and flexible coping and control to stay hopeful. Furthermore, hope and QoL positively affected each other. The psychological pact may promote an adaptation enabling them to adjust to difficult circumstances by unconsciously ignoring information, called dissonance reduction. This mechanism may impair their ability to provide a valid informed consent. We suggest including a systematic exploration of patients' social context and values before proposing a phase I trial.
Effects of stepped psychooncological care on referral to psychosocial services and emotional well‐being in cancer patients: A cluster‐randomized phase III trial
Authors: Singer Susanne , Danker Helge , Roick Julia , Einenkel Jens , Briest Susanne , Spieker Henning , Dietz Andreas , Hoffmann Isabell , Papsdorf Kirsten , Meixensberger Jürgen , Mössner Joachim , Schiefke Franziska , Dietel Anja , Wirtz Hubert , Niederwieser Dietger , Berg Thomas , Kersting Anette 
Published: June 2017

AbstractObjectiveEmotional distress in cancer patients often goes unnoticed in daily routine; therefore, distress screening is now recommended in many national guidelines. However, screening alone does not necessarily translate into better well‐being. We examined whether stepped psychooncological care improves referral to consultation‐liaison (CL) services and improves well‐being.MethodsIn a cluster‐randomized trial, wards were randomly allocated to stepped versus standard care. Stepped care comprised screening for distress, consultation between doctor and patient about the patient's need for CL services, and provision of CL service. Primary outcomes were referral to psychosocial services and emotional well‐being half a year after baseline, measured with the Hospital Anxiety and Depression Scale. A secondary endpoint was uptake of outpatient health care. Analysis employed mixed‐effects multivariate regression modeling.ResultsThirteen wards were randomized; 1012 patients participated. With stepped care (N = 570; 7 wards), 22% of the patients were referred to CL services and 3% with standard care (N = 442; 6 wards; odds ratio [OR] 10.0; P < .001). Well‐being 6 months after baseline was 9.5 after stepped care (N = 341) and 9.4 after standard care (N = 234, β −0.3; P = .71). After stepped care, patients with psychiatric comorbidity went more often to psychotherapists (OR 4.0, P = .05) and to psychiatrists (OR 2.3, P = .12), whereas patients without comorbidity used psychiatrists less often (OR 0.4, P = .04) than in standard care.ConclusionsStepped care resulted in better referral to CL services. The patients' emotional well‐being was not improved, but uptake of outpatient psychiatric help was increased in patients with psychiatric comorbidity and decreased in patients without.
Clustering high‐dimensional mixed data to uncover sub‐phenotypes: joint analysis of phenotypic and genotypic data
Authors: McParland D. , Phillips C. M. , Brennan L. , Roche H. M. , Gormley I. C. 
Published: June 2017

The LIPGENE‐SU.VI.MAX study, like many others, recorded high‐dimensional continuous phenotypic data and categorical genotypic data. LIPGENE‐SU.VI.MAX focuses on the need to account for both phenotypic and genetic factors when studying the metabolic syndrome (MetS), a complex disorder that can lead to higher risk of type 2 diabetes and cardiovascular disease. Interest lies in clustering the LIPGENE‐SU.VI.MAX participants into homogeneous groups or sub‐phenotypes, by jointly considering their phenotypic and genotypic data, and in determining which variables are discriminatory. A novel latent variable model that elegantly accommodates high dimensional, mixed data is developed to cluster LIPGENE‐SU.VI.MAX participants using a Bayesian finite mixture model. A computationally efficient variable selection algorithm is incorporated, estimation is via a Gibbs sampling algorithm and an approximate BIC‐MCMC criterion is developed to select the optimal model. Two clusters or sub‐phenotypes (‘healthy’ and ‘at risk’) are uncovered. A small subset of variables is deemed discriminatory, which notably includes phenotypic and genotypic variables, highlighting the need to jointly consider both factors. Further, 7 years after the LIPGENE‐SU.VI.MAX data were collected, participants underwent further analysis to diagnose presence or absence of the MetS. The two uncovered sub‐phenotypes strongly correspond to the 7‐year follow‐up disease classification, highlighting the role of phenotypic and genotypic factors in the MetS and emphasising the potential utility of the clustering approach in early screening. Additionally, the ability of the proposed approach to define the uncertainty in sub‐phenotype membership at the participant level is synonymous with the concepts of precision medicine and nutrition. Copyright © 2017 John Wiley & Sons, Ltd.
Migrants and Psychosomatic Symptoms: An Evaluation in an Emergency Centre
Authors: Perito M. , Calia R.M. , Carpentieri G. , De Guglielmo S. , Del Buono G. , Fasano V. , Fiorentino N. , Napolitano R. , Forgione M. , Scotti D. , Solomita B. , Franza F. 
Published: June 2017

IntroductionIn recent years, there has been an increase in migration in Europe. Particularly, Italy has been one of the most important landing place. Currently, migrants in the province of Avellino, South Italy city, amount to about 1400, housed in 40 facilities in 23 municipalities. Psychological interest on migration and its impact on lifestyle patterns has increased in recent years.ObjectivesThere are few studies that evaluated the frequent psychosomatic symptoms in these populations. Despite the trauma experienced, they are not able to give a name to the suffered and somatized pain.AimAssessment of somatic symptoms reported by the immigrant cohort after a three-month observation period.MethodsWe included 50 migrants (21.3 mean years) hosted in emergency centre in Avellino, Italy. All guests have conducted psychological clinical interviews. At baseline, were administered following scales: the patient health questionnaire (PHQ-9); Illness Behaviour Inventory (IBI); Symptoms checklist-90-Revised (SCL-90-R) scale. Same data was collected after three months.ResultsThe migrant group was a heterogeneous group. Overall data on IBI and PHQ-9 scale indicate a statistically significant variation baseline vs deadline Data of IBI scale is statistically significant [T-Score: 3,921; P: 003]; also with PHQ-9 [T0 vs. T1: T-Score: 3,986; P: .003]. Similar results have been found with SCL-90-R.ConclusionsIn their vocabulary, terms such as anxiety, sadness, fear exist hardly. They tend to minimize the psychological pain, not because I do not feel, but because move it on the body. They have difficulty to talk about emotions, not just a matter of culture and language, but also because they are ashamed.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Cerebellar Activity in Young People with Familial Risk for Psychosis — The Oulu Brain and Mind Study
Authors: Jukur T. , Kiviniemi V. , Veijola J. 
Published: June 2017

ObjectiveThe cerebellum plays a critical role in cognition and behavior. Altered function of the cerebellum has been related to schizophrenia and psychosis but it is not known how this applies to spontaneous resting state activity in young people with familial risk for psychosis.MethodsWe conducted resting-state functional MRI (R-fMRI) in 72 (29 male) young adults with a history of psychosis in one or both parents (FR) but without their own psychosis, and 72 (29 male) similarly healthy control subjects without parental psychosis. Both groups in the Oulu Brain and Mind Study were drawn from the Northern Finland Birth Cohort 1986. Participants were 20–25 years old. Parental psychosis was established using the Care Register for Health Care. R-fMRI data pre-processing was conducted using independent component analysis with 30 and 70 components. A dual regression technique was used to detect between- group differences in the cerebellum with p b 0.05 threshold corrected for multiple comparisons.ResultsFR participants demonstrated statistically significantly increased activity compared to control subjects in the anterior lobe of the right cerebellum in the analysis with 70 components. The volume of the increased activity was 73 mm3. There was no difference between the groups in the analysis with 30 components (Fig. 1).ConclusionThe finding suggests that increased activity of the anterior lobe of the right cerebellum may be associated with increased vulnerability to psychosis. The finding is novel, and needs replication to be confirmed.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Case Report of Progressive Supranuclear Palsy (PSP)
Authors: Garcia B. 
Published: June 2017

This is a case of an old man, affected by progressive supranuclear palsy (PSP), admitted due to behavioral alteration in long-term home. Medical background PSP's diagnosis in 2008. Debuts in the form of lower limb tremor, Bradykinesia and tendency to fall. Hypomimia, hypotonia, rigidity and slight postural tremor in upper limbs. Partial response to anti-Parkinson drugs. Psychiatric background, premorbid personality prone to cognitive rigidity, dichotomous thinking and impulsiveness. Join in acute unit from February to May 2012, where it is oriented as a depression of adaptive features. Several antidepressants were tested with partial response (venlafaxine, reboxetine, mirtazapina, bupropion, sertraline). Current episode patient, who comes presenting behavioral alteration with poor tolerance to the limitations imposed by the disease and passive aggressive behaviors. His wife reports difficulties in ambulation, increment of falls, and lack of hygiene and dietary transgression. Complementary explorations blood test: hemogram and biochemical unaltered, hypertriglyceridemia, syphilis, HIV serology negative. Diagnosis stable PSP, behavioral disorders are objectified within his personality disorder. Pharmacological approach. In case levodopa causes clinical symptoms of postural hypotension, stalevo is decreased and sinemet is removed. Slight improvement is noticed. Case review PSP is an uncommon brain disorder that affects movement, control of walking and balance, vision, cognitive impairment and neuropsychiatric disorders. It is associated with the deposition of hyperphosphorylated, tau, in the pallidum, subthalamic nucleus, red nucleus, etc. Cognitive deficits and neuropsychiatric symptoms may precede the onset of Parkinsonism. Most changes are referred to personality, with presence of irritability, impulsivity. Psychotic symptoms may exist. There are no disease-modifying treatments. Management should focus on optimizing life quality.Disclosure of interestThe author has not supplied his declaration of competing interest.
Self-compassion, Well-being and Health in Elderly: Are there Related?
Authors: Cunha M. , Parente L. , Galhardo A. , Couto M. 
Published: June 2017

IntroductionThe increase in aging population is a major advance in society, but also a great challenge, imposing the need for actions that promote successful aging, with higher subjective well-being and better health.Objectives(1) analyse the possible influence of socio-demographic variables in self-compassion, satisfaction with life, affection, physical and mental health (study variables); (2) understand how is that the study variables are associated with each other in old age; and (3) explore which variables best predict satisfaction with life and health in the elderly.MethodThe study sample consists of 155 individuals, aged between 65 and 94 years old, institutionalised and non-institutionalised.Results(1) significant correlations were found between some demographic and the study variables. (2) Significant associations were also found between self-compassion, subjective well-being and health. (3) linear regression analysis revealed that physical health is best predicted by greater life satisfaction and lower age; mental health is best predicted by increased satisfaction with life, self-compassion and decreased negative affect; and, finally, life satisfaction is predicted by a higher physical health and self-compassion.ConclusionsThese results suggest the importance of developing psychological skills such as warmth, tolerance and the acceptance of suffering bearing in mind that the elderly may experience difficulties resulting from the developmental characteristics of old age. Our findings suggest the possible beneficial effect of compassion, focused therapies designed for this specific population, particularly contributing to the promotion of life satisfaction and mental health of the Portuguese elderly.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The Neutrophil and Platelet to Lymphocyte Ratios in People with Subjective, Mild Cognitive Impairment and Early Alzheimer's Disease
Authors: Kalelioglu T. , Yuruyen M. , Gultekin G. , Yavuzer H. , Ozturk Y. , Kurt M. , Topcu Y. , Doventas A. , Emul M. 
Published: June 2017

BackgroundIn this study we aimed to explore the role of inflammation in subjects with mild Alzheimer dementia (AD), mild cognitive impairment (MCI) and subjective cognitive decline (SCD) via new potential inflammation markers of Neutrophil-lymphocyte ratio (NLR) and Platelet-lymphocyte ratio (PLR). NLR and PLR are useful and cost-effective biomarkers, showing peripheral systemic inflammation, were previously shown in neuropsychiatric disorders [1].MethodsIn screening phase the patients were assessed with mini-mental state examination, clinical dementia rating scale (CDR), geriatric depression scale (GDS) and Hachinski Ischemic Scale (HIS) after unstructured psychiatric interview according to diagnostic and statistical manual of mental disorder, Text Revised (DSM-IV, TR). Spectrum of cognitive decline includes 31 patients with mild Alzheimer's disease, 30 subjects with mild cognitive impairment, 31 individuals with subjective cognitive decline. Thirty-one healthy controls enrolled to the study.ResultsNLR value of patients with AD was 2.38 ± 0.81, subjects with MCI was 2.48 ± 1.19, SCD group was 2.24 ± 1.11 and control group was 1.85 ± 0.80. NLR was significantly higher in AD and MCI groups when compared with control group (P = 0.006, P = 0.03, respectively). Platelet-lymphocyte ratio was not correlated with cognitive impairment. Neutrophil counts were indifferent when comparing either of groups. Lymphocyte levels were significantly lower in each of cognitive decline groups when compared to healthy controls.ConclusionThe present findings suggest that systemic inflammation may have a role in developing Alzheimer's Disease.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Sources of Meaning in Family Caregivers of Terminally Ill Patients Supported by a Palliative Nursing Care Team – A Naturalistic Three-month Cohort Study
Authors: Valdes-Stauber J. , Lemanczyk R. , Kilian R. 
Published: June 2017

ObjectivesTo identify possible change patterns or robustness in sources of meaning in family caregivers of pre-terminal patients after onset of support at home by an outreach palliative nursing team during a survey period of three months.MethodsOne hundred caregivers of terminally ill patients were included in a prospective observational trial. The Sources of Meaning and Meaning in Life Questionnaire (SoMe) was administered at four points of measurement: T0 (immediately before onset of palliative care); T1 (one week after T0); T2 (one month after T0); T3 (three months after T0). Descriptive statistics, random effects regression analyses; multivariate linear and quadratic regression models were performed for the full (n = 100) as well as for the reduced sample (n = 24).ResultsGrowth curve analyses reveal significant parabolic changes for the dimension “order” and for the subscales “social commitment”, “tradition”, “morality”, and “fun”. All other dimensions or subscales remained stable during the time of the study. Cross-sectional multivariate regression models (T0) showed negative associations of some dimensions with patients’ age and psychological burden of the family caregiver while psychological burden of patients was found to be positively associated with some dimensions. No significant effects of interaction variables with time (linear and quadratic).ConclusionsWith few exceptions, family carers seem to keep a stable sense of meaning in life during the final stage of their relatives’ terminal illness. Particular associations between sources of meaning and age of patients as well as psychological burden both of patients and carers have to be taken into consideration in support planning.Disclosure of interestThe authors have not supplied their declaration of competing interest.
The effectiveness of emotion regulation and distress tolerance skills on improving coping strategies and reduce perceived stress in prisoners
Authors: Davoood R. , Ghahari S. 
Published: June 2017

ObjectiveThe aim of this study was the effectiveness of emotion regulation and distress tolerance skills on improving coping strategies and reduce perceived stress in prisoners in Foman city in Iran.MethodThe study population was consisted of 200 prisoners of Foman Penitentiary in 2016. Then, 30 prisoners were selected randomly in two groups (15 persons each group) were replaced. Emotion regulation and distress tolerance training was given to the experimental group for 12 sessions and the control group were in waiting list. Both groups at baseline and end of intervention phase filled coping responses inventory Bellinger and mouse and Cohen perceived stress questionnaire – version 14 questions (PSS-14). Data were analysed by using the software spss22.FindingsEmotion regulation and distress tolerance skills have been effective on Improving problem-focused coping strategies and reduce perceived stress in prisoners (P < 0/001).Discussion and conclusionemotion regulation and distress tolerance skills can improve problem-focused coping strategies and reduce the use of emotion-focused coping strategies and perceived stress in prisoners.Disclosure of interestThe authors have not supplied their declaration of competing interest.