bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Single Mothers' Group for Mothers of Children Attending an Outpatient Psychiatric Clinic: Preliminary Results
Authors: Jane E Mcnamee , Ellen L Lipman , Hicks Frances 
Published: April 2017

Objectives To provide a preliminary report of data from 2 support groups for single mothers, all of whom were mothers of children attending a child outpatient psychiatric clinic. The groups' 2 purposes were: 1. to assess the feasibility of adding structured evaluation to a common clinical intervention; 2. to improve single mothers' parenting skills through raised levels of self-esteem, increased capacity for family functioning and reduced levels of depression. Method Three structured evaluation instruments were used to measure the domains of self-esteem, family functioning and depression. These instruments were given to both groups of women on 3 occasions: 1. before the group; 2. after the group; 3. at a follow-up session 4 months after group termination. Open-ended questions were also asked at group termination. Results The questionnaire response rate was 100%; overall response rate for the 3 open-ended questions was 89%. Comparisons of pre-group and post-group scores showed that there was a significant increase in self-esteem (p < 0.01) and significant improvements in family functioning (p < 0.05) and depression (p < 0.01). Conclusion It is possible to introduce a structured evaluation component into a common clinical intervention, and this support group seemed to assist single mothers' parenting skills. Methodologic concerns and future directions are discussed.
Folie Simultanée in Monozygotic Twins
Authors: White Thomas G 
Published: April 2017

Objective To present a case report of folie simultanée in monozygotic twins. The literature describing folie à deux in twins is also reviewed and the common clinical findings are presented. Method Case presentation and review of the literature. Results Clinical observations of monozygotic twins with folie simultanée suggest that the delusions tend to progress over time with each twin reinforcing the delusion in the second. Conclusions The concept of a delusion resonating between individuals may account for the rapid progression and escalation of these delusions.
Looking at Legislative and Judicial Views of Psychic Trauma - Fluctuating Recognition and Discrimination
Authors: Hoffman Brian F 
Published: April 2017

Objective To describe how Canadian courts and legislation have viewed psychic or emotional trauma in the past century and the principles that are used. Methods The author reviews major trends in legislation and judicial findings pertaining to emotional trauma and gives examples of the fluctuating and ambivalent recognition by the courts. Results The courts have progressed from refusing to acknowledge emotional trauma, to accepting emotional trauma when accompanied by physical trauma, and finally acknowledging emotional trauma even in the absence of physical injury and the “indirect” emotional trauma suffered by the relatives of victims. However, from time to time, the courts or legislation may appear to deny the distress, dysfunction or the rights of a person who suffers significant emotional symptoms after an injury. This occurred recently in Ontario where injured persons in motor vehicle accidents who suffered emotional trauma were not allowed to sue for compensation from June 1990 to January 1994. Combined efforts by a coalition of mental health professionals with victims of trauma at least partially reversed the discriminatory laws. Conclusions Psychiatrists must continue to play a vital role in the education of the courts, politicians and the public about the realities of emotional trauma and mental illness and their long-term impact so that fair compensation can be assessed by the courts and discriminatory legislation reversed.
Clinical Management of Tourette's Syndrome and Associated Disorders
Authors: Sandor P 
Published: April 2017

ObjectiveTo review the clinical management of Tourette's syndrome (TS) and the associated disorders, namely obsessive-compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD) with an emphasis on the pharmacologic intervention strategies.MethodEnglish language literature on the pharmacologic management of TS and the associated disorders published between 1985 and 1994 was critically reviewed.ResultsPharmacologic management was placed in the context of the overall clinical management. Pharmacologic strategies for treatment of TS, OCD and ADHD were organized according to the therapeutic agent class.ConclusionsThe treatment of TS and its associated disorders requires the application of the full range of psychiatric skills to achieve a favourable outcome.
Conceptual Models and Integrative Therapy: Anorexia Nervosa as a Prototype
Authors: Greben Daniel H , Kaplan Allan S 
Published: April 2017

Objective To demonstrate how an integrative approach to psychiatric treatment can confer specific advantages. Method The impact of conceptual models on clinical information processing and therapeutic intervention, and the potential benefits resulting from the incorporation of multiple treatment modalities are outlined. These principles are applied using anorexia nervosa (AN) as a prototypical disorder. Results A brief structured review of the broad range of models which have been applied to AN illustrates the impact of conceptualization on outcome. The opportunity for positive integrative effects in the treatment of AN are demonstrated. They are seen to be related to 6 factors: flexibility, patient-treatment matching, stage-treatment matching, facilitation, complementarity, and synergism. Conclusion Integrative methods can address some limitations in clinical information processing associated with the exclusive application of a single conceptual model. Positive integrative effects are demonstrated in the context of AN; however, the approach is recommended for more general application.
Informed consent and the aftermath of cardiopulmonary resuscitation: Ethical considerations
Authors: Bjorklund Pamela , Lund Denise M 
Published: April 2017

Background: Patients often are confronted with the choice to allow cardiopulmonary resuscitation (CPR) should cardiac arrest occur. Typically, informed consent for CPR does not also include detailed discussion about survival rates, possible consequences of survival, and/or potential impacts on functionality post-CPR. Objective: A lack of communication about these issues between providers and patients/families complicates CPR decision-making and highlights the ethical imperative of practice changes that educate patients and families in those deeper and more detailed ways. Design: This review integrates disparate literature on the aftermath of CPR and the ethics implications of CPR decision-making as it relates to and is affected by informed consent and subsequent choices for code status by seriously ill patients and their surrogates/proxies within the hospital setting. Margaret Urban Walker’s moral philosophy provides a framework to view informed consent as a practice of responsibility. Ethical considerations: Given nurses’ communicative skills, ethos of care and advocacy, and expertise in therapeutic relationships, communication around DNAR decision-making might look quite different if institutional norms in education, healthcare, law, and public policy held nurses overtly responsible for informed consent in some greater measure. Findings: Analysis from this perspective shows where changes in informed consent practices are needed and where leverage might be exerted to create change in the direction of deeper and more detailed discussions about CPR survival rates and possible consequences of survival.
Testing a New Intervention With Incarcerated Women Serving Life Sentences
Authors: Fedock Gina , Kubiak Sheryl , Bybee Deborah 
Published: April 2017

Purpose: Incarcerated women serving life sentences are a growing subpopulation with multiple mental health needs. However, no existing interventions have been designed for or tested with this population. Method: This study tested a gender-responsive, trauma-informed intervention ( Beyond Violence) and examined changes in incarcerated women’s mental health and anger expression. Pre-, post-, and follow-up surveys were administered to two treatment groups with women with life sentences ( n = 26). Multilevel modeling was conducted to assess changes over time for women’s mental health and anger expression and to compare outcomes for women based on time served. Results: Significant positive outcomes were found for all women for some anger measures, and women who had been in prison for less than 10 years started with higher scores on multiple measures and showed significant changes over time. Discussion: This study offers insight into social work practice, policy advocacy, and research for this population of women.
Aneurysm size and the Windkessel effect: An analysis of contrast intensity in digital subtraction angiography
Authors: Hussein Ahmed E , Esfahani Darian R , Linninger Andreas , Charbel Fady T , Hsu Chih-Yang , Charbel Fady T , Alaraj Ali 
Published: April 2017

Large cerebral aneurysms are considered more dangerous than their smaller counterparts, with higher risk of subarachnoid hemorrhage. Understanding the hemodynamics of large aneurysms has potential to predict their response to treatment. Digital subtraction angiography images for patients with intracranial aneurysms over a seven-year period were reviewed. Unruptured solitary aneurysms of the internal carotid artery (ICA) proximal to the terminus and posterior communicating artery were included. Contrast intensity over time was analyzed at the center of the M1 segment of the middle cerebral artery distal to the aneurysm and compared to the contralateral side. Analysis included time to peak (TP)10%–100% (time needed for contrast to change from 10% intensity to 100%), washout time (WT)100%–10% (time for 100% intensity to 10%), and quartile time (QT)25%–25% (time for 25% intensity during vessel filling to 25% during emptying). Fifty patients met the inclusion criteria. Analysis over the ipsilateral M1 segment revealed a significant increase in QT25%–25% (8.5 vs 7.6 seconds, p = 0.006) compared to the contralateral side. There was a correlation between TP10%–100% and QT25%–25% with aneurysm size (Pearson’s r = 0.37, p = 0.007 and r = 0.43, p = 0.001, respectively). Larger ICA aneurysms were associated with delayed contrast intensity times . A plausible mechanism is that large aneurysms act as a capacitance chamber (Windkessel effect) that slow the arrival of contrast distal to the aneurysm. This may be of significance for large aneurysms after treatment, where the loss of the Windkessel effect places the distal circulation at greater risk for hemorrhage, and warrants further study.
Work right to right work: An automythology of chronic illness and work
Authors: Vijayasingham Lavanya 
Published: April 2017

Objectives Chronic illness is known to disrupt and redirect the usual course of work trajectories. This article aims to portray the longitudinal course of negotiating work after multiple sclerosis. Methods Using therapy and personal journals to reconstruct memories and experience, an autoethnography is produced and narrated within Campbell’s “Hero’s Journey” automythology framework. Results The narrative highlights the intrasubjectivity of illness meaning—the changing internal meaning-making and external behavior and decision-making dynamics. The journey of being inhibited to “Work Right”, to “Looking for the Right” and ultimately, finding “Right Work” is charted; portrayed as a bittersweet maneuver to achieve work–illness equilibrium. Discussion This journey traverses a spectrum of negative coping—the exhibition of deviant work behaviors, disengagement and depression; to recalibration and renewal; culminating in living the “new normal”, and finding moral and meaningful work engagements. Life trajectories with chronic illness are often skewed and redirected; but longitudinal narratives of normalization and coping also highlight the pursuits to secure and maintain a life of meaning and value.
The role of sebelipase alfa in the treatment of lysosomal acid lipase deficiency
Authors: Erwin Angelika L. 
Published: April 2017

Lysosomal acid lipase deficiency (LALD) is a lysosomal storage disorder (LSD) characterized either by infantile onset with fulminant clinical course and very poor prognosis or childhood/adult-onset disease with an attenuated phenotype. The disorder is often misdiagnosed or remains undiagnosed in children and adults due to a rather unspecific clinical presentation with dyslipidemia and steatohepatitis. Until recently, no good treatment options were available for LALD. Despite supportive and symptomatic therapies, death occurred before 1 year of age in patients with infantile-onset disease and patients with childhood/adult-onset LALD suffered from significant complications, such as liver cirrhosis, requiring liver transplantation and early-onset cardiovascular disease. With the recent approval of sebelipase alfa for clinical use in infantile- as well as childhood/adult-onset LALD, a new treatment era for this disorder has begun. Sebelipase alfa is a recombinant human lysosomal acid lipase (LAL), which is administered via the intravenous route. Clinical trials have shown significant improvement of disease parameters such as liver transaminases, hepatomegaly, and dyslipidemia in childhood/adult-onset LALD patients. Treatment of infants with the severe infantile-onset form of the disease has led to improved survival beyond the age of 1 year, and also showed improvement of hepatic and gastrointestinal symptoms, as well as growth. Overall, sebelipase alfa has a favorable safety profile and promises to be a good long-term treatment option for patients with LALD, with significant reduction of disease burden and increased life expectancy.
Risk factors for adverse drug reactions in pediatric inpatients: a systematic review
Authors: Andrade Paulo Henrique Santos , Santos Adriano da Silva , Souza Carlos Adriano Santos , Lobo Iza Maria Fraga , da Silva Wellington Barros 
Published: April 2017

Background: The main objective of the present systematic review is to identify potential risk factors for adverse drug reactions (ADRs) through prospective cohort studies in pediatric inpatients. Methods: The data search was done in the following electronic databases PubMed/MEDLINE; Scopus; LILACS and Web of Science from the earliest record until 31 May 2015. Two reviewers independently screened each study and one of them assessed the methodological quality according to the Newcastle–Ottawa scale for cohort studies. The data extraction was conducted according to Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative for cohort studies. Results: The only risk factor observed in all studies was the increase in the number of prescription drugs. However, other factors were identified, such as the increase in the length of stay or the number of low- or high-risk drugs prescribed, use of general anesthesia and oncological diagnosis. The cumulative incidence of ADR was 16.4% (95% confidence interval: 15.6 to 17.2). The main professional responsible for ADR identification was the pharmacist and the dominant category among the ADRs were gastrointestinal disorders. In addition, analgesics, antibacterial agents and corticosteroids were the drug classes commonly associated with ADRs. The methodology used in this study was tried to homogenize the data extracted; however, this was not sufficient to correct the discrepancies so it was not possible to perform a meta-analysis. Conclusions: The increase in the number of prescription drugs was the main risk factor in this population. However, additional studies are required to identify the risk factors for ADRs in pediatric inpatients.
Screening for valve disease in patients with hyperprolactinaemia disorders prescribed cabergoline: a service evaluation and literature review
Authors: Gamble David , Fairley Rachel , Harvey Roderick , Farman Colin , Cantley Nathan , Leslie Stephen J. 
Published: April 2017

Objectives: The indication for screening for valvular heart disease in patients taking cabergoline is based on evidence from patients with Parkinson’s disease on high-dose medication. However, current patients take much lower doses for indications such as hyperprolactinaemia disorders. Contemporary guidelines for echocardiogram monitoring in patients taking cabergoline are conflicting. This study aimed to review current clinical practice in our area regarding echocardiographic screening and to review the literature examining the evidence of valvular heart disease in patients taking lower dose cabergoline. Methods: This was a retrospective study of all patients with hyperprolactinaemia disorders prescribed cabergoline in a single UK NHS health board between January 2014 and July 2015. The proportion of patients receiving baseline and follow-up echocardiograms was recorded. A review of the published literature was carried out using the databases EMBASE and Medline to examine the current evidence for the effect cabergoline has on cardiac valves in patients treated for hyperprolactinaemia disorders. Results: The mean age was 51.7 ± 16.5 years with a 64.4% female predominance. The mean duration of therapy was 5.9 years ± 4.1 years. Of the total cohort ( n = 45), two (4.4%) patients had an initial baseline echocardiogram and five (13.2%) had follow-up echocardiograms every 24 months. Of the 25 articles identified, 12 showed no clinically significant evidence of valvular dysfunction in the cabergoline group groups. Of the remaining 13 articles, evidence for valvular changes was confined to high cumulative dose cabergoline patients and there was only one confirmed case of ‘cabergoline associated valvulopathy’ described. Conclusions: Clinically significant valvular dysfunction is uncommon and generally only reported in high cumulative dose treatment groups. We propose that clearer national guidelines are required and that echocardiogram screening be reserved for patients who are high risk, are taking a high weekly dose (≥2 mg cabergoline weekly) or high cumulative dose.
A text message intervention to reduce first year university students’ alcohol use: A pilot experimental study
Authors: Riordan Benjamin C , Conner Tamlin S , Flett Jayde AM , Scarf Damian 
Published: April 2017

Objective The aim of Orientation Week is to help new students acclimatize to university life. However, Orientation Week is characterized by heavy alcohol use and during this time students may develop drinking patterns that persist into the academic year. The aim of the current study was to refine a brief Ecological Momentary Intervention (EMI) and test its effectiveness in reducing students’ alcohol use during both Orientation Week and throughout the academic year. Method We conducted two focus groups with students who had received a pilot intervention. We then updated and trialled the intervention with students from two residential colleges (College 1 n = 117 and College 2 n = 269) who were assigned to either an Ecological Momentary Assessment (EMA) condition or an EMA-EMI condition. Students in both conditions reported their pre-university drinking and their drinking during Orientation Week and the academic year via text message. In addition to the EMA messages, during Orientation Week, participants in the EMA-EMI condition received messages highlighting the potential social consequences of heavy alcohol use. Results In College 1 those in the EMA-EMI condition consumed fewer drinks, relative to those in the EMA condition, across both Orientation Week (9.7 vs. 15.5; t(98) = 2.138, p = .018) and the academic year. (4.3 vs. 6.8; t(98) = 1.788, p = .039). There were, however, no significant differences between conditions in College 2. Conclusion The current findings suggest that EMIs may be successful under certain circumstances and may provide a simple, cost-effective means of intervening.
The Impact of Travel 2.0 on Travelers Booking and Reservation Behaviors
Authors: Elci Alev , Abubakar A. Mohammed , Ilkan Mustafa , Kolawole Eluwole Kayode , Lasisi Temitope Taiwo 
Published: April 2017

The Internet offers a rich atmosphere for prospective travelers to gain familiarity, and harvest and retrieve travel-related information and resources. An increasing number of tourism and hospitality firms have turned their attention to new business opportunities on the Web. Travel 2.0 has emerged as a new tool for competitive advantage. This study draws on social cognitive theory and the DeLone and McLean Information Systems (D&M IS) success model to diagnose the impact of websites design quality on booking/reservation intentions from a travelers’ perspective. This research model was tested with 700 valid data collected from travelers using Travel 2.0 websites through online survey using SPSS v18 for the analysis. The results of the data analysis provided support for the hypothesized relationships of e-service and system quality with booking/reservation/purchase behavioral intention implying that an e-travel site’s quality is an essential success factor for tourism enterprises. However, information quality of an e-travel site is negatively related to booking/reservation intention. Cross-sectional design and self-report measures are the shortcomings of the study. Little research has been done on the relation between websites design (e-service, information, and system) quality, and booking/reservation intention. This article presents new insights into how these variables may influence potential tourist.
Construction of Heritage: Small and Medium Towns of Gurgaon District
Authors: Munjal Parul G. 
Published: April 2017

Global discourses around heritage are grappling with idea of including dissonant, non-compliant voices and expanding the definition of heritage from the physical to a cultural process, pushing beyond the authorized heritage discourse. The dialogical model of heritage is presented as a means to break down the divide between laypersons and experts, suggesting new models for decision-making in the future. It is problematic to contextualize this discourse in the Indian context, more so in small and medium towns where this intellectual debate has never been formalized. Yet, there are existing ways in which the local stakeholders maintain and use sites or structures from the past that they value. Identification of these ways of keeping and using could be a step towards demystifying the construct of heritage in the local community. The Gurgaon district has witnessed an unprecedented urban growth rate from 2001 to 2011 and the eight historic small and medium towns of the district are on the verge of being enveloped in the rapid urban development. This impending change calls for a need to examine the heritage sites of these towns. Studying the historic structures in six of these towns points to the role of history and religion as connectors to heritage. This role has been explored on ground and at an ideological level, as an attempt towards understanding the construct of heritage as a process in play.