scholarly journals P.124 Baseline Assessment of Attention and Executive Function Deficits in Children with Neurodevelopmental Disorders: Data from a Speciality Attention Clinic

2021 ◽  
Vol 48 (s3) ◽  
pp. S54-S55
Author(s):  
B Wiley ◽  
F Ghanim ◽  
K Taylor ◽  
K Murias
Keyword(s):  
Executive Function ◽  
High Risk ◽  
Neurodevelopmental Disorder ◽  
Clinic Visit ◽  
Assessment System ◽  
Stress Index ◽  
Treatment Information ◽  
Behavioural Difficulties ◽  
Behaviour Rating ◽  
Clinically Significant

Background: Attention and executive function (EF) deficits in children negatively impact academics, social interactions, and overall quality of life. Children with other brain-based disorders are at high risk for attention and EF concerns, but the effects of these impairments are not well studied in the literature. The Complex Attention and Executive Function Clinic at the Alberta Children’s Hospital collected baseline data on patients referred for concerns of attention deficits co-occurring with diagnosed neurologic illness/injury, or neurodevelopmental disorder (NDD). Methods: The Behaviour Rating Inventory of Executive Function (BRIEF-2), Behaviour Assessment System for Children (BASC-3), Parenting Stress Index (PSI-4) and medical and past treatment information were collected on initial clinic visit for patients aged 5-15 years. Results: BRIEF-2 Global Executive Composite demonstrated 88.9% of children had clinically elevated scores. Clinically significant scores were observed in 55.5% for BASC-3 Adaptive Skills index and 40% of parents in PSI-4 Total Stress scores. Conclusions: Children with neurologic illness/NDDs are at high risk of clinical impairments in attention and EF. In children referred for attention and behavioural regulation, there is clinically significant increased reporting of executive function impairment out of proportion to other behavioural difficulties. The clinic aims to improve overall functioning through treatment of unmanaged attention and EF deficits.

scholarly journals Self-Rated Health Status as a Predictor of Executive Function in Older Latinos

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 331-332
Author(s):  
Jacqueline Guzman ◽  
Yuliana Soto ◽  
David Marquez ◽  
Susan Aguinaga
Keyword(s):  
Executive Function ◽  
High Risk ◽  
Cognitive Decline ◽  
Behavioral Interventions ◽  
Controlled Trial ◽  
Self Rated Health ◽  
Excellent Health ◽  
Trail Making ◽  
Fair Poor ◽  
The Relationship

Abstract Latinos have high risk of Alzheimer’s disease and related dementias (ADRD). Self-rated health (SRH) has been used to predict cognitive decline. Early detection of executive function changes may help identify those at higher risk of cognitive decline. The purpose of this study was to examine the relationship between SRH and executive function in Latinos. Latinos (N=333, 84.4% female, Mage= 64.9 ± 7.08) from the BAILA randomized controlled trial self-rated their health as 1) poor/fair, 2) good, and 3) very good/excellent. Executive function was assessed by the Trail-making B, Verbal Fluency, Stroop C & CW, and the Digit Modality tests and stratified by SRH. One-way analysis of variance showed that the effect of SRH was significant for Trails B, F(2,298)=4.01, p=.019 and Stroop CW, F(2,298)=3.07, p=.048. Tukey’s test indicated that participants who rated their health as fair/poor took longer to complete Trails B (M=196.78±83.0 seconds) compared to those who rated their health as good (M=185.25 ± 85.1 seconds) and very good/excellent (M=149.25±95.3 seconds). Stroop CW results demonstrated that those in the fair/poor health category scored lower (M=17.22±6.6) than those in good (M=19.70±8.5 words/minutes) and very good/excellent health categories (M=18.73±8.2 words/minute). In sum, the results suggest SRH is related to executive function such that lower categories of SRH are indicative of poorer executive function. SRH might be used as a proxy for executive function and as a tool that community leaders can use to identify individuals at high risk of ADRD in need of behavioral interventions.

scholarly journals Couples’ experiences with expanded carrier screening: evaluation of a university hospital screening offer

2021 ◽  
Author(s):  
Ivy van Dijke ◽  
Phillis Lakeman ◽  
Naoual Sabiri ◽  
Hanna Rusticus ◽  
Cecile P. E. Ottenheim ◽  
...  
Keyword(s):  
High Risk ◽  
Medical Center ◽  
Informed Choice ◽  
Carrier Screening ◽  
University Hospital ◽  
Structured Interviews ◽  
Expanded Carrier Screening ◽  
Post Test ◽  
Future Child ◽  
Clinically Significant

AbstractPreconception carrier screening offers couples the possibility to receive information about the risk of having a child with a recessive disorder. Since 2016, an expanded carrier screening (ECS) test for 50 severe autosomal recessive disorders has been available at Amsterdam Medical Center, a Dutch university hospital. This mixed-methods study evaluated the experiences of couples that participated in the carrier screening offer, including high-risk participants, as well as participants with a general population risk. All participants received genetic counselling, and pre- (n = 132) and post-test (n = 86) questionnaires and semi-structured interviews (n = 16) were administered. The most important reason to have ECS was to spare a future child a life with a severe disorder (47%). The majority of survey respondents made an informed decision (86%), as assessed by the Multidimensional Measure of Informed Choice. Among the 86 respondents, 27 individual carriers and no new carrier couples were identified. Turn-around time of the test results was considered too long and costs were perceived as too high. Overall, mean levels of anxiety were not clinically elevated. High-risk respondents (n = 89) and pregnant respondents (n = 13) experienced higher levels of anxiety before testing, which decreased after receiving the test result. Although not clinically significant, distress was on average higher for carriers compared to non-carriers (p < 0.0001). All respondents would opt for the test again, and 80.2% would recommend it to others. The results suggest that ECS should ideally be offered before pregnancy, to minimise anxiety. This study could inform current and future implementation initiatives of preconception ECS.

scholarly journals POSSIBILITY FOR NON-INVASIVE DIAGNOSIS OF CHRONIC ENDOMETRITIS IN WOMEN AT RISK DURING PREGRAVID PREPARATION

2019 ◽  
Vol 72 (1) ◽  
pp. 64-67
Author(s):  
Olena О. Taranovska ◽  
Volodymyr К. Likhachov ◽  
Ludmyla М. Dobrovolska ◽  
Oleg G. Makarov ◽  
Yanina V. Shymanska
Keyword(s):  
High Risk ◽  
Luteal Phase ◽  
The Other ◽  
Menstrual Blood ◽  
Control Group ◽  
Simple Method ◽  
Chronic Endometritis ◽  
Non Invasive ◽  
Additional Group ◽  
Clinically Significant

Introduction: Detection and treatment of chronic endometritis (CE) is clinically significant, though involves intrauterine intervention to collect endometrium. The aim: To estimate the possibility to use fertility α2-microglobulin (FAMG) as the marker of the high risk for CE. Materials and methods: 70 women with CE who were planning pregnancy were tested for FAMG in menstrual blood. 40 of them received treatment of CE. The other 30 women refused from the proposed treatment. The control group involved 30 women who had neither CE nor luteal phase deficiency (LPD). Additional group (20 women) had LPD without CE. Results: The decrease of FAMG by 2.4 times was noted in women with CE (16.3 ± 3.9 μg/ml against 39.8 ± 8.3 μg/ml in the controls). In LPD the index was 5.6 times lower. After treatment the level of FAMG was increasing. Conclusions: The decrease of the amount of FAMG in menstrual blood is specific for women both with CE and LPD. Detection of abnormally low rates of FAMG in all women with CE enables, with the exception of absolute hypoprogesteronemia and LPD, using it as a simple method of estimation of the functional state of endometrium. Its application can be very useful both for non-invasive diagnosis of CE and subsequent evaluation of treatment of this pathology.

Using the Surgical Risk Preoperative Assessment System to Define the “High Risk” Surgical Patient

2022 ◽  
Vol 270 ◽  
pp. 394-404
Author(s):  
Adam R. Dyas ◽  
Michael R. Bronsert ◽  
Robert A. Meguid ◽  
Kathryn L. Colborn ◽  
Anne Lambert-Kerzner ◽  
...  
Keyword(s):  
High Risk ◽  
Preoperative Assessment ◽  
Assessment System ◽  
Surgical Patient ◽  
Surgical Risk ◽  
High Risk Surgical Patient

An impairment in brain function

2021 ◽  
pp. 89-102
Author(s):  
Mark Selikowitz
Keyword(s):  
Executive Function ◽  
Frontal Lobe ◽  
Brain Function ◽  
Genetic Factors ◽  
Front Part ◽  
Behavioural Difficulties ◽  
Gene Defects ◽  
The Brain ◽  
Chemical Messengers ◽  
Executive Function Deficits

ADHD is usually due to a depletion of certain chemical messengers in the front part of the brain. The major cause of this depletion relates to a number of defective genes. ADHD shares some of its causative genes with certain other conditions, so having ADHD makes also having these other conditions more likely. To help many children with learning and behavioural difficulties, we need to treat an impairment in their brain function. This chapter discusses impairment in brain function as a cause of ADHD, including executive function deficits, frontal lobe underactivity, neurotransmitter depletion, gene defects, and non-genetic factors. It also describes the mechanism of comorbidity.

scholarly journals Development of Executive Functions as Reflected in Daily Life Behaviors in Young Adults at Ultra-High Risk for Psychosis: Associations With Symptoms and Functioning

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Louise Birkedal Glenthøj ◽  
Carsten Hjorthøj ◽  
Tina Dam Kristensen ◽  
Christina Wenneberg ◽  
Merete Nordentoft ◽  
...  
Keyword(s):  
High Risk ◽  
Executive Functions ◽  
Social Functioning ◽  
Clinical Symptoms ◽  
Daily Life ◽  
Real Life ◽  
Psychotic Symptoms ◽  
Ultra High Risk ◽  
Behaviour Rating

Abstract There is a paucity of evidence on executive functions (EF) as reflected in daily life behaviors in individuals at ultra-high risk (UHR) for psychosis. This prospective follow-up study investigated the 1-year development in EF in UHR compared to healthy controls (HC) and how this change may relate to change in severity of clinical symptoms, social communication, and functioning. UHR (N = 132) and HC (N = 66) were assessed with the Behaviour Rating Inventory of Executive Function–Adult version (BRIEF-A) self and informant report at baseline and 12 months follow-up comprising the Behavioral Regulation Index (BRI) and the Metacognition Index (MI). Additionally, data on depressive-, negative-, and attenuated psychotic symptoms and everyday social functioning were collected. The study found UHR to display large baseline impairments in EF in real life on both self- and informant reports. UHR and HC showed a significantly different development of EF over time, with UHR displaying greater improvements in EF compared to HC. Change in clinical symptoms did not relate to improvements in EF, except for depressive symptoms negatively associating with the development of the MI. Improvements on the BRI and MI were significantly associated with improvements in social functioning. Findings suggest the potential of UHR individuals displaying a larger ongoing maturational development of daily life EF than HC that seems predominantly independent of development of clinical symptoms. If replicated, this supports a maturational trajectory of daily life EF in UHR that approaches, but do not reach, the level of HC and may indicate a window of opportunity for targeted remediation approaches.

scholarly journals SIX MONTHS OF GEROFIT RESULTS IN MOBILITY IMPROVEMENTS IN OLDER VETERANS REGARDLESS OF BMI CLASSIFICATION

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S34-S34
Author(s):  
Odessa Addison ◽  
Jamie Giffuni ◽  
Monica Serra ◽  
Leslie Katzel
Keyword(s):  
High Risk ◽  
General Population ◽  
Significant Interaction ◽  
Mobility Limitations ◽  
Walk Distance ◽  
Mobility Function ◽  
Clinically Significant ◽  
Minute Walk Distance ◽  
Weight Groups ◽  
Minute Walk

Abstract Older Veterans represent a unique population at high risk for mobility limitations. They are also more likely to be overweight or obese when compared to the general population. We sought to compare changes in mobility function across the obesity spectrum in older Gerofit participants at six different sites. Two-hundred and seventy Veterans (mean age: 74 years) completed six-months of Gerofit participation and mobility assessments at baseline, three and six months. Our assessments included gait-speed, six-minute walk distance, 30-second chair stands, and the eight foot up and go. When comparing weight groups, we found no significant interaction of weight and time, however we found clinically significant (P&lt;0.02) improvements of 7-20% across all mobility measures. Six-months of Gerofit participation appears to be one way to improve mobility function in older Veterans across the weight spectrum.

scholarly journals Potential Drug-Drug and Herb-Drug Interactions in Patients With Cancer: A Prospective Study of Medication Surveillance

2017 ◽  
Vol 13 (7) ◽  
pp. e613-e622 ◽  
Author(s):  
Allan Ramos-Esquivel ◽  
Álvaro Víquez-Jaikel ◽  
Cristina Fernández
Keyword(s):  
High Risk ◽  
Prospective Study ◽  
Drug Interactions ◽  
Anticancer Therapy ◽  
Herbal Supplement ◽  
Herbal Supplements ◽  
Patients With Cancer ◽  
Clinical Consequences ◽  
Clinically Significant ◽  
A Prospective Study

Purpose: Patients with cancer frequently use herbal supplements and concomitant medications along with antineoplastic agents. These patients are at high risk of herb-drug interactions (HDIs) and drug-drug interactions (DDIs). We aimed to determine clinically relevant DDIs and HDIs leading to pharmaceutical intervention. Methods: Patients starting a new anticancer therapy were asked to complete a questionnaire to identify concomitant use of any over-the-counter drug or herbal supplement. Potential DDIs and HDIs were identified using two different databases. If a potentially clinically relevant DDI was recognized by the clinical pharmacist, a notification was sent to the prescribing oncologist, who decided whether to carry out a suggested intervention. Regression analyses were performed to identify variables associated with clinically relevant DDIs. Results: A total of 149 patients were included in this study, with 36 potentially clinically relevant DDIs identified in 26 patients (17.4%; 95% CI, 11.3% to 23.5%), all of them leading to therapy modifications. In total, four patients (2.7%; 95% CI, 0.1% to 5.3%) had experienced clinical consequences from DDIs at the time of pharmacist notification. Additionally, 84 patients (56.4%; 95% CI, 48.4% to 64.4%) reported using concurrent herbal supplements, and 122 possible HDIs were detected. Concomitant use of two or more drugs was independently associated with high risk of a clinically significant DDI (odds ratio, 2.53; 95% CI, 1.08 to 5.91; P = .03). Conclusion: Potentially clinically relevant DDIs and possible HDIs were frequently detected in this prospective study. A multidisciplinary approach is required to identify and avoid potentially harmful combinations with anticancer therapy.

scholarly journals A Simple Clinical Tool for Stratifying Risk of Clinically Significant CKD after Nephrectomy: Development and Multinational Validation

2020 ◽  
Vol 31 (5) ◽  
pp. 1107-1117 ◽  
Author(s):  
Robert J. Ellis ◽  
Sharon J. Del Vecchio ◽  
Kevin M.J. Gallagher ◽  
Danielle N. Aliano ◽  
Neil Barber ◽  
...  
Keyword(s):  
High Risk ◽  
Kidney Cancer ◽  
Regression Models ◽  
Population Based ◽  
Risk Category ◽  
Shared Decision ◽  
Clinical Tool ◽  
Kidney Tumors ◽  
Logistic Regression Models ◽  
Clinically Significant

BackgroundClinically significant CKD following surgery for kidney cancer is associated with increased morbidity and mortality, but identifying patients at increased CKD risk remains difficult. Simple methods to stratify risk of clinically significant CKD after nephrectomy are needed.MethodsTo develop a tool for stratifying patients’ risk of CKD arising after surgery for kidney cancer, we tested models in a population-based cohort of 699 patients with kidney cancer in Queensland, Australia (2012–2013). We validated these models in a population-based cohort of 423 patients from Victoria, Australia, and in patient cohorts from single centers in Queensland, Scotland, and England. Eligible patients had two functioning kidneys and a preoperative eGFR ≥60 ml/min per 1.73 m2. The main outcome was incident eGFR <45 ml/min per 1.73 m2 at 12 months postnephrectomy. We used prespecified predictors—age ≥65 years old, diabetes mellitus, preoperative eGFR, and nephrectomy type (partial/radical)—to fit logistic regression models and grouped patients according to degree of risk of clinically significant CKD (negligible, low, moderate, or high risk).ResultsAbsolute risks of stage 3b or higher CKD were <2%, 3% to 14%, 21% to 26%, and 46% to 69% across the four strata of negligible, low, moderate, and high risk, respectively. The negative predictive value of the negligible risk category was 98.9% for clinically significant CKD. The c statistic for this score ranged from 0.84 to 0.88 across derivation and validation cohorts.ConclusionsOur simple scoring system can reproducibly stratify postnephrectomy CKD risk on the basis of readily available parameters. This clinical tool’s quantitative assessment of CKD risk may be weighed against other considerations when planning management of kidney tumors and help inform shared decision making between clinicians and patients.

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