bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation(DC‐LD) and the diagnosis of anxiety disorders: a review
Authors: Bailey N. M. , Andrews T. M. 
Published: October 2003

AbstractBackground/Methods During the development ofDiagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities[DC‐LD] a literature review of diagnostic issues in anxiety disorders in adults with intellectual disability (ID) was undertaken using electronic and hand searching of journals.Results Relevant general concepts in the general population are reviewed briefly before those related specifically to adults with ID. The literature relating to the diagnosis of specific anxiety disorders is reviewed, although with the exception of obsessive compulsive disorder this consists mainly of case reports. Difficulties in the use of diagnostic systems developed for the general population for the diagnosis of anxiety disorders in adults with ID are frequently commented upon.Conclusions It is concluded that anxiety disorders are well recognized in adults with ID, although their prevalence is uncertain, and that the use of modified diagnostic criteria may aid further research in this area.
Intellectual disabilities, depressive episode, diagnostic criteria and Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation (DC‐LD)
Authors: Smiley Elita , Cooper Sally‐Ann 
Published: October 2003

AbstractBackground  Depressive episode is one of the most common types of psychiatric illness that occurs in adults with intellectual disabilities.Methods  A comprehensive literature search was undertaken using Medline, PsychLIT and hand‐searching of key journals. This paper reviews the evidence and integrates findings, to report how evidence relates to the development of the new Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation[DC‐LD] depressive episode criteria.Results  This area is better researched than many others, providing evidence on clinical symptomatology and presentation. In view of the lack of utility of standard diagnostic criteria developed for use with the general population, and set within the historical context, there are clearly identified reasons for the introduction of DC‐LD. The depressive episode category has been informed by the evidence, and field trials showed excellent validity compared with the gold standard of learning disabilities psychiatric assessment.Conclusions  The DC‐LD depressive episode category may improve clinical diagnosis and facilitate research. Its usefulness and limitations are yet to be determined in detail.
Attention deficit hyperactivity disorder: review of ADHD in learning disability: the Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation[DC‐LD] criteria for diagnosis
Authors: Seager Marian C. , O'Brien Gregory 
Published: October 2003

AbstractBackground  Attention deficit hyperactivity disorder [ADHD)]is believed to be common among people with learning disabilities. Classification systems in current use have presented diagnostic difficulties in this area, when used for people with learning disability (particularly adults).Methods  A literature search using electronic databases was undertaken, and journals were hand‐searched for articles relevant to the diagnosis of mental disorders in adults with intellectual disabilities.Results  There is preliminary evidence that ADHD is more common in this population than among the non‐learning‐disabled population, and indeed that rates of hyperactivity increase with increasing severity of learning disability. There are also associations between ADHD and certain causal syndromes of learning disability.Conclusion  While available evidence suggests that ADHD may be common among children and adults with learning disabilities, research has been hindered by deficits in currently used diagnostic classification systems. With the recent development of criteria for the diagnosis of ADHD in learning‐disabled adults, and the publication of these in Diagnostic Criteria for Learning Disabilities/Mental Retardation[DC‐LD] there is scope for an increase in the level of interest in the study of ADHD among adults with learning disabilities.
The classification of problem behaviour in Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation (DC‐LD)
Authors: O'Brien Gregory 
Published: October 2003

AbstractBackground Problem behaviour is common among adults with learning disabilities, often to an extent that it impacts upon the functioning and social inclusion of the individual, and of the individual's family and immediate social network.Methods/Results However, most approaches to the classification and diagnosis of psychiatric disorder among people with learning disability do not deal with problem behaviour as a diagnosis. The recent innovation of the Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation (DC‐LD) includes diagnostic criteria for problem behaviour. The background and the thinking behind these criteria are reviewed.Conclusions It is proposed that the adoption of such criteria offers the possibility of improved services for the individuals concerned, with resultant improvements in their adaptation and social inclusion.
Delirium in adults with intellectual disabilities and DC‐LD
Authors: Simpson Neill 
Published: October 2003

AbstractBackground  No systematic studies of delirium in adults with intellectual disabilities have been reported. Reasons for the absence of research are discussed.Methods  Two cases of delirium are described which meet the Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation [DC‐LD].Conclusions  DC‐LD offers a diagnostic framework that permits comparison with premorbid cognitive function.
Diagnosis and classification of eating disorders in adults with intellectual disability: the Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation (DC‐LD) approach
Authors: Gravestock Shaun 
Published: October 2003

AbstractBackground  Previous classifications of eating disorders [EDs] employed a narrower concept of EDs. They did not include the wide range of abnormal eating behaviours [AEBs], persistent feeding disorders and EDs psychopathology, aetiological and comorbidity factors seen in adults with intellectual disability [ID].Methods  The International Classification of Diseases − 10 [ICD‐10], ICD‐10‐MR, Diagnostic and Statistical Manual − IV [DSM‐IV] and Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation[DC‐LD] diagnostic approaches to EDs in adults with ID are compared.Results  The DC‐LD encourages conceptually clearer and systematic hierarchical differential diagnostic classification of AEBs and EDs. The DC‐LD also allows consideration of relevant aetiological and comorbidity issues. DC‐LD‐based multi‐axial case formulation supports the multimodal clinical assessment of AEBs and EDs.Conclusions  Further research should develop similar systematic and evidence‐based multicomponent clinical diagnostic, management and service models for adults with ID and EDs.
Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation (DC‐LD) and psychiatric phenotypes
Authors: Clarke David 
Published: October 2003

AbstractBackground  The concept of behavioural phenotypes is reviewed, with emphasis on the need to research reasons for heterogeneity.Methods/Results  The classification of emotional, behavioural, linguistic and cognitive abnormalities associated with genetic disorders may be improved through the use of the Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation.Conclusions  Examples of such abnormalities are discussed, showing how more accurate descriptions can result in improved diagnosis and treatment.
Distribution and status of feral wild boar Sus scrofa in Dorset, southern England
Authors: WILSON CHARLES J. 
Published: October 2003

ABSTRACT 1. A recently established feral population of wild boar Sus scrofa in Dorset, southern England, was studied by collecting details of escapes, live sightings and animals killed, by examining field signs and by making direct observations in the field. 2. Records were obtained from 47 national grid kilometre squares. Two or more records were received for 27 km2 and the presence of boar confirmed by field signs in 21 of these. The population appears to have originated from escapes in winter 1994/95 and to have remained largely confined to within 11 km of the escape site. The large number of animals killed, relative to the number of animals which escaped, reports of shot sows carrying foetuses and observations of sows with piglets in the field, confirmed that breeding had taken place. 3. Estimates of live weight, estimated age, or descriptions of the animals killed were used to allocate each to a broad age class and thus construct a retrospective census. This suggested that the minimum population size peaked at about 30 animals in 1998 but that the pre‐breeding population has probably remained at fewer than 20 animals.
The process of dispersal in badgers Meles meles
Authors: ROPER T. J. , OSTLER J. R. , CONRADT L. 
Published: October 2003

ABSTRACT 1. Radio‐telemetry was used to track dispersal in five adult Eurasian badgers Meles meles (four males and one female) from three social groups. 2. All animals moved to a territory immediately neighbouring their home territory. Three of the males dispersed simultaneously as a ‘coalition’; the other two individuals dispersed solitarily. 3. The process of dispersal took from 2 to 9 months. Dispersing animals first made nocturnal forays into the new territory but returned to their own territory to sleep. They then began to sleep progressively more often in setts in the new territory, and less often in their original territory. During this period, dispersers foraged in both the old and the new territory, before eventually settling into a home range centred exclusively on the new territory. 4. We conclude that dispersal can be a lengthy and complex process, even when the distance involved is small.
A traditional healers’ training model in rural Nepal: strengthening their roles in community health
Authors: Poudyal Amod K. , Jimba Masamine , Murakami Izumi , Silwal Ram C. , Wakai Susumu , Kuratsuji Tadatoshi 
Published: October 2003

SummaryIn this paper, we evaluated a western medical training model for traditional healers (THs) in rural Nepal. We used semi‐structured interviews to compare 48 trainees with 30 randomly selected untrained THs, 1 year after the training was completed. We asked them about their knowledge of the causes, prevention and treatment of common illnesses and HIV/AIDS, and their relationship with government health workers (GHWs) in the area. Nine GHWs were also interviewed about their perceptions of THs. We found that trained THs had a better knowledge of allopathic medicine, practised modern treatment using first aid kits, and were more likely to refer patients to GHWs. They also improved their relationships with the GHWs. Up‐scaling this model is a challenge for improving community health care in Nepal in the future.
Home treatment of ‘malaria’ in children in rural Gambia is uncommon
Authors: Clarke Siân E. , Rowley Jane , Bøgh Claus , Walraven Gijs E. L. , Lindsay Steven W. 
Published: October 2003

SummaryHome treatment with antimalarials is a common practice in many countries, and may save lives by ensuring that more malaria cases receive prompt treatment. Through retrospective surveys we found that home treatment of young children with antimalarials was uncommon in rural Gambia. Few families kept medicines in the home in case of illness, 28% kept paracetamol and only 8% kept chloroquine. Less than 10% of cases of childhood ‘malaria’ had been treated with chloroquine at home, and 69% of those giving home medication did not know the correct dosage for a child. The most common course of treatment was the use of paracetamol and/or tepid sponging to reduce fever, before the child was taken to a government health facility. Treating a child with antimalarials at home was more costly than other forms of treatment. The low cost associated with the use of health services for children and the limited availability of antimalarials outside major towns contribute to the high use of government health services. This shows that that home treatment cannot be assumed to be the predominant mode of malaria treatment throughout Africa, and highlights the need for country‐specific policies based on accurate local knowledge of treatment practices in both rural and urban areas.
Assessing the efficacy of chloroquine and sulfadoxine–pyrimethamine for treatment of uncomplicated Plasmodium falciparum malaria in the Democratic Republic of Congo
Authors: Kazadi Walter M. , Vong Sirenda , Makina Burstein N. , Mantshumba Jean C. , Kabuya Willy , Kebela Benoit I. , Ngimbi Nkuku P. 
Published: October 2003

SummaryWe evaluated the in vivo responses to chloroquine (CQ), the first line antimalarial, and to sulfadoxine–pyrimethamine (SP), the most readily available and affordable alternative treatment, in children under 5 with acute uncomplicated Plasmodium falciparum malaria in seven sites of Democratic Republic of Congo (DRC) between May 2000 and November 2001, using the standard 14‐day WHO protocol. In the CQ group, the overall treatment failure rate was 45.4% (95% CI: 40.1–50.8) of 350 infections successfully tested; in the SP group it was 7.5% (95% CI: 5.0–11.0) of 333 infections. Of 191 patients who had an adequate clinical response (ACR) in the CQ group, 127 (66.5%; range: 62.5–71.4) still had parasitaemia on day 14. In the SP group, only 21 (6.8%; range: 2.2–12.8) of 308 patients with an ACR were still parasitaemic on day 14. Using pooled data from three rural sites, haematological recovery was better in the SP group (mean of haematocrit difference between days 14 and 0 among anaemic children: 4.7 vs. 3.2; P < 0.01, Wilcoxon test). These findings suggest that CQ is no longer effective in DRC and that SP may be a good alternative for its replacement as first line antimalarial treatment. The Ministry of Health (MOH) therefore now recommends SP as the first line antimalarial drug in DRC, as an interim step, 18 months after launching the first study. Additional studies are needed to select alternative therapies that might replace SP or improve its efficacy, should it prove ineffective in the future.
Multicentre laboratory evaluation of Brugia Rapid dipstick test for detection of brugian filariasis
Authors: Rahmah N. , Shenoy R. K. , Nutman T. B. , Weiss N. , Gilmour K. , Maizels R. M. , Yazdanbakhsh M. , Sartono E. 
Published: October 2003

SummaryA multicentre evaluation of the Brugia Rapid dipstick test was performed using 1263 serum samples in four international laboratories, i.e. T.D. Medical College (TDMC, India), National Institutes of Health (NIH, USA), Swiss Tropical Institute (STI, Switzerland) and Leiden University Medical Centre (LUMC, Netherlands). In comparison with microscopy, the dipstick demonstrated sensitivities of 97.2% (70 of 72) at TDMC, 91.6% (175 of 191) at LUMC and 100% (six of six) at STI. Sera of chronic patients showed a positivity rate of 11.3% (19 of 168) and 61.2% (71of 116) at TDMC and LUMC, respectively. All 266 sera of non‐endemic normals from STI, NIH and LUMC tested negative with the dipstick. At LUMC, sera of ‘endemic normals’ (amicrofilaraemics with no clinical disease) from an area with approximately 35% microfilaria positivity showed 60.8% positive results (31 of 51), thus demonstrating the likelihood of many cryptic infections occuring in this population. Specificities of the test with Onchocerca volvulus sera were 98.8% (80 of 81) and 100% (10 of 10) at the NIH and STI, respectively; while specificity with Loa loa sera at the NIH was 84.6% (44 of 52). At the STI, the dipstick test also demonstrated 100% specificity when tested with 75 sera from various protozoan and helminthic infections.
Effectiveness of feedback for improving case management of malaria, diarrhoea and pneumonia – a randomized controlled trial at provincial hospitals in Lao PDR
Authors: Wahlström Rolf , Kounnavong Sengchanh , Sisounthone Bouathong , Phanyanouvong Ampayvanh , Southammavong Thanakhanh , Eriksson Bo , Tomson Göran 
Published: October 2003

SummaryBackground Standard Treatment Guidelines were introduced to all prescribers at provincial hospitals in Lao PDR and treatment indicators were developed within the National Drug Policy programme to monitor compliance.Objectives To evaluate the effects of an educational intervention to improve treatment practices of malaria, diarrhoea and pneumonia.Methods Randomized controlled trial with prescribers at 24 departments at eight provincial hospitals, matched into four pairs. The three departments of internal medicine, paediatrics and out‐patients in each pair were randomized into intervention or control group. The 6‐month intervention was conducted by members of the Drug and Therapeutics Committees, and comprised monthly audit sessions in the form of outcome feedback using indicator scores on recorded treatment of malaria, diarrhoea and pneumonia. We measured treatment indicator scores 6 months after the end of the intervention compared with baseline.Results The aggregated mean scores for all diseases, and for malaria and diarrhoea, improved significantly. For pneumonia, improvement was seen in both the intervention and control groups. Record keeping was improved for all three diseases. For malaria, there were improvements in recording patients’ history, and in frequency of microscope testing; for diarrhoea, regarding weight measurements, palpation of the fontanel for children under 2 years, and reduction of irrational use of anti‐diarrhoeals and antibiotics; for pneumonia, in recording respiratory count, and reducing irrational use of anti‐histamines and anti‐cough medications.Conclusions Audit–feedback systems to improve quality of care are feasible and effective also in hospital settings in low‐income countries.
Evaluation of a simple operational approach for monitoring resistance to antimalarial drugs in Peru
Authors: Ruebush Trenton K. , Levin Andrew , Gonzaga Victor , Neyra Daniel , Marquiño Wilmer 
Published: October 2003

SummarySince 1994, the Peruvian Malaria Control Program has used a simplified operational approach for monitoring antimalarial drug efficacy, in which blood smears are taken 7 and 14 days after treatment from all patients diagnosed with malaria at Ministry of Health facilities. The proportion of patients with parasitaemia on one of their return visits provides an indication of the efficacy of the drug being administered. We compared this approach for antimalarial drug resistance monitoring to the more labour‐intensive and expensive World Health Organization (WHO) 14‐day in vivo efficacy trial at six sites in the Amazon Basin and the north coast of Peru. Although the proportion of treatment failures at 7 and 14 days identified by the operational monitoring system was considerably lower than the results of the WHO in vivo efficacy test, the operational approach did accurately reflect the overall efficacy or lack of efficacy of the drugs being evaluated. Differences in the results of the two methods were greatest in the Peruvian Amazon region, where fully supervised treatment and patient follow‐up is very difficult due to the widely dispersed population. While the operational approach cannot be considered an alternative to WHO in vivo testing for evaluating the efficacy of antimalarial drugs or for recommending changes in malaria treatment policy, if treatment is supervised and follow‐up blood smears taken as scheduled, this method could serve as a simple, inexpensive and sustainable early warning system for reduced drug efficacy.
How many sputum smears are necessary for case finding in pulmonary tuberculosis?
Authors: Yassin Mohammed A. , Cuevas Luis E. 
Published: October 2003

SummaryWe reviewed the laboratory registers of 42 tuberculosis (TB) diagnostic centres in the southern region of Ethiopia to determine the value of submitting serial sputum samples for the diagnosis of pulmonary TB (PTB) and estimate the proportion of suspects that are smear positive. A total of 15 821 TB suspects submitted three smears each (47 463 smears) in 2000 with a median of 228 per centre. The smear positivity rate (two or more positive smears) was 25%, with a range of 16.8–36.4% per zone. This exceeds the international recommendations of examining 10 suspects to identify one case. A total of 4099 (26%) of the suspects had at least one positive smear with 3753 (91.6%) of the first specimens being positive. A further 303 (7.4%) were negative in the first specimen but had a positive second specimen and 42 (1%) suspects had two negative specimens followed by a positive third smear. The value of the third sputum is negligible as 99% of the cases were identified from the first and second specimens. Reducing the number of specimens to two or even one would have multiple advantages in countries where laboratories are usually over‐burdened and are not easily accessible to the population. Submission of two specimens on the same day could improve compliance in submitting samples and collecting results as the number of diagnostic visits would be reduced without significant loss of sensitivity.
Mumbai disease in far western Nepal: HIV infection and syphilis among male migrant‐returnees and non‐migrants
Authors: Poudel Krishna C. , Okumura Junko , Sherchand Jeevan B. , Jimba Masamine , Murakami Izumi , Wakai Susumu 
Published: October 2003

SummaryObjective To measure the seroprevalence of human immunodeficiency virus (HIV) infection and syphilis, and to assess the behavioural risk factors for these infections among migrant‐returnees and non‐migrants in far western Nepal.Methods In April 2001, we recruited 97 male migrant‐returnees and 40 non‐migrants from five rural villages in Doti district where migration to Mumbai is common. For data collection, we conducted a serological examination for HIV and syphilis, and a perception and behaviour survey on HIV and other sexually transmitted infections.Results We found that 11 of 137 men (8%) were positive for HIV infection and 30 men (22%) for syphilis. The respondents, especially the migrant‐returnees from Mumbai, were engaging in risky behaviours such as pre‐ or extramarital sex, and sex with multiple partners, including sex workers.Conclusions This study revealed high HIV and syphilis prevalence among the male migrant‐returnees and non‐migrants in far western Nepal where migration to Mumbai is common. The prevalent behaviours, particularly among the migrant‐returnees, imply urgent needs of the behavioural modification programme in this area to prevent the spread of HIV infection to general population.