Hyperkinetic disorder in a community service for people with intellectual disability

2018 ◽  
pp. 1-5
Author(s):  
Sonn Patel ◽  
Evan Yacoub
Keyword(s):  
Intellectual Disability ◽  
Clinical Sample ◽  
Information Service ◽  
Point Prevalence ◽  
Online Information ◽  
Hyperkinetic Disorder ◽  
Cross Sectional ◽  
Large Variability ◽  
Number Of Patients ◽  
Adults And Children

BackgroundThere appears to be a higher rate of prevalence of hyperkinetic disorder in the intellectual disability (ID) population, although there is a large variability in rates in previous studies. Hyperkinetic disorder can be a challenge to diagnose in a population with ID and can present a barrier to the development of the activities of daily living in an already vulnerable population.ObjectivesOur objective was to examine the point prevalence of hyperkinetic disorder in the ID population in a community ID service and also to determine the prevalence of hyperkinetic disorder based on the level of ID.MethodsA cross-sectional review of the Online Information Service ‘OLIS’ database was undertaken to establish the total number of patients with ID and those with comorbid hyperkinetic disorder. The overall point prevalence and prevalence based on the level of ID was calculated from the collected data.ResultsThe point prevalence of hyperkinetic disorder in the population with ID was similar to that found in studies in the general population at 3.1% in adults and 32.6% in children. When divided by the level of disability, the calculated point prevalence in both adults and children was highest in the population with mild ID and decreased as the level of disability increased.ConclusionThis report contributes to previous research establishing the rates of hyperkinetic disorder in an ID population and establishes the point prevalence of hyperkinetic disorder in individuals diagnosed with ID in a clinical sample.

Prevalence of epilepsy in autism spectrum disorders: A systematic review and meta-analysis

Autism ◽  
2021 ◽  
pp. 136236132110450
Author(s):  
Xian Liu ◽  
Xin Sun ◽  
Caihong Sun ◽  
Mingyang Zou ◽  
Yiru Chen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Intellectual Disability ◽  
Human Development ◽  
Human Development Index ◽  
Clinical Sample ◽  
Meta Analysis ◽  
Population Based ◽  
Cross Sectional ◽  
Development Index ◽  
Pooled Prevalence

The literature from inception to 2020 on the prevalence of epilepsy in autistic individuals was systematically reviewed and further explored by subgroup analyses and meta-regression models. This systematic review is registered with PROSPERO (CRD42020179725). A total of 66 studies from 53 articles were included. The updated pooled prevalence of epilepsy in autistic individuals was 10% (95% CI: 6–14). The respective prevalence estimate of epilepsy was 19% (95% CI: 6–35) in the clinical sample-based cross-sectional study, 7% (95% CI: 3–11) in the cohort study, and 9% (95% CI: 5–15) in the population-based cross-sectional study. The pooled prevalence of epilepsy was 7% (95% CI: 4–11) in autistic children and 19% (95% CI: 14–24) in autistic adults. Compared to the school-aged group, the adolescence group (OR: 1.15, 95% CI: 1.06–1.25) and the pre-school group (OR: 1.06, 95% CI: 0.94–1.19) were positively associated with the prevalence of epilepsy. The moderators of age, human development index of the country, gender, and intellectual function accounted for most of the heterogeneity. The prevalence estimates were associated with age, female gender, intellectual disability rate, and the human development index of countries. About 1/10 autistic individuals co-occurred with epilepsy, which was common in the clinical setting, adolescents, adults, females, or patients with intellectual disability, and less common in the country with high human development index. Lay abstract Autistic individuals experience higher co-occurring medical conditions than the general population, and yet the estimates of autistic individuals with epilepsy are not updated. Co-occurrence of epilepsy in autistic individuals often aggravated cognitive impairment and increased the risk of poor long-term prognosis. Thus, an updated systematic review and meta-analysis was conducted to study the relevant articles published from inception to 2020, evaluate the prevalence of epilepsy in autistic individuals, and further explore the putative factors influencing the prevalence. A total of 66 studies from 53 articles were included in this study. The results showed that epilepsy is more common in autistic individuals than in the general population. The prevalence of epilepsy in autistic individuals in the clinical sample-based studies was higher than that in the population-based based cross-sectional or cohort studies. The prevalence of epilepsy in autistic adults was higher than that in autistic children. A significantly increased prevalence of epilepsy was detected in the autistic adolescent group (11–17 years old), and a higher trend of prevalence of epilepsy was observed in the autistic pre-school group (⩽ 6 -years-old) than that of the autistic school-aged group (7–10 years-old). The prevalence of epilepsy increased with age, female rate, and low intellectual function rate of autistic individuals. However, the human development index of countries was negatively associated with the pooled prevalence, which could be attributed to the different levels of awareness, diagnostic technologies, and autism-service support worldwide. About 1/10 autistic individuals also had epilepsy, which was common in the clinical setting, adolescents, adults, females, or patients with intellectual disability and less common in the country with high human development index. Thus, these findings provided critical and innovative views on the prevalence of epilepsy in autistic individuals and contributed to the targeted clinical management and preventive measures.

scholarly journals 2019. Multicentric Antimicrobial Point Prevalence Survey in Four Tertiary Care Hospitals in Southern India

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S677-S678
Author(s):  
Shilpa Prakash ◽  
Arun Wilson ◽  
Anup R Warrier ◽  
Rachana Babu ◽  
Sonya Joy ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Point Prevalence ◽  
Antimicrobial Use ◽  
Prevalence Survey ◽  
Cross Sectional ◽  
Resource Limited ◽  
Defined Daily Doses ◽  
Number Of Patients ◽  
Days Of Therapy ◽  
Tertiary Care Hospitals

Abstract Background Antibiotic consumption data are scarce in the subcontinent. Defined Daily Doses (Doses) and Days of Therapy (DOT)-based metrics both have inherent disadvantages limiting their application in resource-limited settings primarily in terms of resource hours.. Point Prevalence Study (PPS) offers an offer an initial feasible step for describing antimicrobial use and identifying targets to reduce inappropriate use. Aim of the present study was to use PPS to identify quantitative and qualitative aspects of antimicrobial consumption. Methods A cross-sectional hospital-based PPS was conducted in 4 tertiary care hospitals—Aster Medcity (Kochi, Kerala), Aster MIMS (Calicut, Kerala), Aster Ramesh (Guntur, Andhra Pradesh), and Aster CMI (Bengaluru, Karnataka)—based on a standardized format derived from the GLOBAL-PPS initiative and WHO resources. Results The total number of patients surveyed was 944.42.7% patients had a standing antibiotic order, out of which 19.80%patients were receiving reserve antimicrobials (WHO classification). 76.23% of prescriptions were used empirically, 16.08% were used as prophylaxis meanwhile 7.67% had a culture-based indication. The overall DOT (per 1000 patient-days) for all antimicrobials in the 4 centers were 86.54, 64.19, 93.71 and 85.93 respectively with a cumulative mean DOT of 82.59. Reserve antimicrobials DOT were 26.28, 14.83, 28.08 and 19.61, respectively, with a mean of 22.2. The most common class of antimicrobial prescribed was β lactam -β lactamase inhibitors (BL/BLI) 27.3% while Carbapenems (8.16%) was the most common amongst reserve antimicrobials. Out of all the prescriptions only 7.67% had indications documented. Documented errors of dosing were seen in 8 patients. Adherence to monitoring for ADE was done in 92.57%. Conclusion The study reveals antibiotic use in almost 40% of patients under survey with a DOT of 82.59 per 1000 patient-days. Improving empirical use of antimicrobials, BL/BLI focused intervention and improved documentation has been identified as potential areas for intervention based on this study.The study also highlights the scope of PPS as an effective tool in resource-limited setting to define and refine antimicrobial use and contribute toward antimicrobial stewardship as well as other activities aimed reducing antimicrobial resistance across a range of settings. Disclosures All authors: No reported disclosures.

scholarly journals Increased prevalence of intellectual disabilities in higher-intensity mental healthcare settings

BJPsych Open ◽  
2021 ◽  
Vol 7 (3) ◽  
Author(s):  
Jeanet G. Nieuwenhuis ◽  
Peter Lepping ◽  
Niels L. Mulder ◽  
Henk L. I. Nijman ◽  
Mike Veereschild ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
Cognitive Decline ◽  
Intellectual Disabilities ◽  
Mental Healthcare ◽  
Intellectual Functioning ◽  
Community Treatment ◽  
Mild Intellectual Disability ◽  
Cross Sectional ◽  
Healthcare Settings ◽  
Number Of Patients

Background It has been suggested that people with intellectual disabilities have a higher likelihood to develop psychiatric disorders, and that their treatment prognosis is relatively poor. Aims We aimed to establish the prevalence of intellectual disability in different mental healthcare settings, and estimate percentage of cognitive decline. We hypothesised that the prevalence of intellectual disabilities increases with intensity of care. Method A cross-sectional study was conducted in different settings in a mental healthcare trust in the Netherlands. We used the Screener for Intelligence and Learning Disabilities (SCIL) to identify suspected mild intellectual disability (MID) or borderline intellectual functioning (BIF). We identified patients with a high level of education and low SCIL score to estimate which patients may have had cognitive decline. Results We included 1213 consecutive patients. Over all settings, 41.4% of participating patients were positive for MID/BIF and 20.2% were positive for MID only. Prevalence of suspected MID/BIF increased by setting, from 27.1% in out-patient settings to 41.9% in flexible assertive community treatment teams and admission wards, to 66.9% in long-stay wards. Only 85 (7.1%) of all patients were identified as possibly having cognitive decline. Of these, 25.9% were in long-stay wards and had a diagnosis of schizophrenia or substance use disorder. Conclusions Low intellectual functioning is common in Dutch mental healthcare settings. Only a modest number of patients were identified as suffering from cognitive decline rather than suspected MID/BIF from birth. Therefore, we recommend improved screening of psychiatric patients for intellectual functioning at the start of treatment.

scholarly journals Listening Difficulties in Children with Normal Audiograms: Relation to Hearing and Cognition

2020 ◽  
Author(s):  
Lauren Petley ◽  
Lisa L Hunter ◽  
Lina Motlagh Zadeh ◽  
Nicholette Sloat ◽  
Audrey Perdew ◽  
...  
Keyword(s):  
Cognitive Processing ◽  
Cognitive Abilities ◽  
Information Service ◽  
Control Group ◽  
Clinical Test ◽  
Online Information ◽  
Typically Developing ◽  
Card Sorting ◽  
Laboratory Assessment ◽  
Cross Sectional

Objectives: Children presenting at audiology services with listening difficulties often have normal audiograms, yet the appropriate approach for the further assessment and clinical management of these children is currently unclear. In this study we assessed listening ability in a large (n = 146) and heterogeneous sample of 6-13 year-old children with normal audiograms using a reliable and validated caregiver questionnaire. The results were related to a multifaceted laboratory assessment of the children's audiological, psychoacoustic, physiological and cognitive abilities. This report is an overview of the study and focuses on the children's behavioral performance. The overall goals of the study are to understand the auditory and other neural mechanisms underlying childhood listening difficulties and to translate that understanding into clinical assessment and, ultimately, intervention. Design: Cross-sectional behavioral assessment of children recruited through relevant clinics of Cincinnati Children's Hospital, and advertisements placed in the hospital online information service. We aimed recruitment into two demographically-matched groups, a 'listening difficulties' group and a 'typically developing' control group. Caregivers completed the 'ECLiPS' questionnaire and the resulting 'total' standardized composite score formed the basis of further descriptive statistics, univariate and multivariate modeling of experimental data. Results: All scores of the ECLiPS, the SCAN-3:C, a standardized clinical test suite for auditory processing, and the NIH Cognition Toolbox were significantly lower for children with listening difficulties than for their typically developing peers, using group comparisons via t-tests and Wilcoxon Rank Sum tests. A similar effect was observed on the LiSN-S test for speech sentence-in-noise intelligibility, but only reached significance for the Low Cue and High Cue conditions, and the Talker Advantage derived score. Stepwise regression to examine factors contributing to the ECLiPS Total scaled score (pooled across groups) yielded a model that explained 42% of its variance based on the SCAN composite, LiSN-S Talker Advantage, and the NIH Toolbox Picture Vocabulary and Dimensional Change Card Sorting scores (F4,95 = 17.35, p < 0.001). High correlations were observed between many test scores including the ECLiPS, SCAN and NIH Toolbox composite measures. LiSN-S Advantage measures generally correlated weakly and non-significantly with non-LiSN-S measures. However, a significant interaction was found between extended high frequency threshold and LiSN-S Talker Advantage. Conclusions: Children with listening difficulties but normal audiograms have problems with the cognitive processing of auditory and non-auditory stimuli that include both fluid and crystallized reasoning. Analysis of poor performance on the LiSN-S Talker Advantage measure identified subclinical hearing loss as a possible minor contributing factor to talker segregation. Beyond auditory tests, evaluation of children with complaints of listening difficulties should include standardized caregiver observations and consideration of broad cognitive abilities.

Percutaneous Mitral Annuloplasty for Treatment of Functional Mitral Regurgitation

2009 ◽  
Vol 5 (1) ◽  
pp. 67
Author(s):  
Lutz Buellesfeld ◽  
Lazar Mandinov ◽  
Eberhard Grube ◽  
◽  
◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Coronary Sinus ◽  
Standard Of Care ◽  
Mitral Annulus ◽  
Functional Mitral Regurgitation ◽  
Invasive Treatment ◽  
Large Variability ◽  
Mitral Annuloplasty ◽  
Number Of Patients ◽  
Anatomical Relationship

Functional mitral regurgitation affects a substantial proportion of patients with congestive heart failure due to myocardial infarction or dilated cardiomyopathy. Functional mitral regurgitation greatly increases morbidity and mortality. Surgical annuloplasty is the standard of care for symptomatic patients with moderate or severe functional mitral regurgitation; however, a large number of patients are refused surgery. Several percutaneous approaches have been developed to address the need for less invasive treatment of mitral annulus dilatation. Devices using coronary sinus to cinch the mitral annulus are relatively easy to use; however, a number of factors may limit their clinical application, such as suboptimal anatomical relationship between the coronary sinus and mitral annulus, risk of coronary artery compression, large variability in the coronary venous anatomy and conflict with other therapies such as ablation or cardiac resynchronisation. Direct mitral annuloplasty is anticipated to be more effective than the coronary sinus approaches; however, it has yet to prove its safety and efficacy in carefully designed clinical trials. The best candidates and the best timing for each percutaneous mitral annuloplasty therapy, whether direct or indirect, have yet to be identified.

PENGARUH PEMBERIAN PELAYANAN INFORMASI OBAT DAN KONSELING TERHADAP TINGKAT KEPATUHAN MINUM OBAT PADA PASIEN DIABETES MELITUS DENGAN HIPERTENSI DI RUMAH SAKIT DAERAH IDAMAN BANJARBARU

2020 ◽  
Vol 5 (2) ◽  
pp. 240-249
Author(s):  
Satrio Wibowo Rahmatullah ◽  
◽  
Ika Maulida Nurrahma ◽  
Adnan Syahrizal
Keyword(s):  
Drug Information ◽  
Treatment Success ◽  
Information Service ◽  
Regional Hospital ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Quasi Experimental ◽  
High Level ◽  
Chi Square Analysis

Compliance to achieve treatment success can be improved by providing drug information services (PIO) and counseling to improve understanding of treatment instructions. The general objective of this study was to determine the effect of drug information service and counseling on the level of medication adherence in patients with diabetes mellitus (DM) with hypertension in the Banjarbaru Regional Hospital. This study uses a quasi experimental method with a cross sectional approach and takes patient data prospectively. The results of this study indicate that the group given PIO and counseling showed a high level of adherence as many as 20 respondents (100%). Whereas in the group that was not given PIO and the counseling level of adherence was low, there were 4 respondents (20%). Based on the mann-whitney analysis p-value = 0,000 (<α = 0.05) so that there are differences in the group with PIO and counseling with groups without PIO and counseling, while the chi square analysis p-value = 0.004 (<α = 0 , 05) so that PIO and counseling have a significant effect on the level of adherence to taking medication in patients with DM with hypertension at the Banjarbaru Regional Hospital.

What are Hidden Facts behind Intestinal Parasitic Infections in Ilam City?

2019 ◽  
Vol 19 (3) ◽  
pp. 284-287
Author(s):  
S. Viesy ◽  
J. Abdi ◽  
Z. Rezaei
Keyword(s):  
Public Health ◽  
Intestinal Parasites ◽  
Parasitic Infection ◽  
Public Health Education ◽  
Health Problems ◽  
Parasitic Infections ◽  
Blastocystis Hominis ◽  
Cross Sectional ◽  
Intestinal Parasitic Infections ◽  
Number Of Patients

Background: Intestinal parasitic infections are the one of the most common health problems in developing countries. Objective: A number of patients die annually due to complications caused by these parasites.Therefore, the aim of this study was to investigate the rate and type of parasitic infections, determine the factors affecting them in Ilam city and also provide strategies to prevent them.In this descriptive cross-sectional study conducted in one of the Ilam labs in 2016, 417 stool specimens were randomly collected. All specimens were examined using direct and ethanol formaldehyde.Suspect specimens were examined using Trichrom staining. Demographic information was also recorded in a questionnaire, and finally the results were analyzed using statistical software SPSS 20.The data were then compared with Chi-square test. Results: Out of the 417 patients examined, 59 (14.1%) were infected with intestinal parasites. The type of parasitic infection in 9.4% was Blastocystis hominis, 3.6% Entamoeba coli, 0.5% Entamoeba histolytica, 0.5% Giardia and 0.2% Trichomonas hominis. Conclusion: Despite the improvement of public health, parasitic infections are still considered as one of the health problems in the city of Ilam. Therefore, proper planning, public health education, raising the level of health in the area and the provision of safe drinking water are some of the ways to reduce parasitic infections in the region.

A cross-sectional survey among physicians on Internet use for epilepsy-related information (Preprint)

2019 ◽  
Author(s):  
Francesco Brigo ◽  
Simona Lattanzi ◽  
Giorgia Giussani ◽  
Laura Tassi ◽  
Nicola Pietrafusa ◽  
...  
Keyword(s):  
Internet Use ◽  
The Internet ◽  
Online Information ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Related Information ◽  
Internet Users ◽  
Therapeutic Decisions ◽  
The Individual ◽  
The Web

BACKGROUND The Internet has become one of the most important sources of health information, accessed daily by an ever-growing number of both patients and physicians, seeking medical advice and clinical guidance. A deeper insight into the current use of the Web as source of information on epilepsy would help in clarifying the individual attitude towards this medium by Internet users. OBJECTIVE We investigated views towards the Internet in a sample of Italian healthcare specialists involved in epilepsy field, to explore factors which explained the influence of information found on the internet. METHODS This study was a self-administered survey conducted in a group of members of the Italian Chapter of the International League Against Epilepsy (ILAE) in January 2018. RESULTS 184 questionnaires were analyzed. 97.8% of responders reported to seek online information on epilepsy. The Internet was most frequently searched to obtain new information (69.9%) or to confirm a diagnostic or therapeutic decision (37.3%). The influence of consulting the Internet on clinical practice was associated with registration to social network(s) (OR: 2.94; 95%CI: 1.28-6.76; p=0.011), higher frequency of Internet use (OR: 3.66; 95%CI: 1.56-9.21; p=0.006) and higher confidence in reliability of online information (OR: 2.61; 95%CI: 1.09-6.26; p=0.031). No association was found with age, sex, years in epilepsy practice or easiness to find online information. CONCLUSIONS Internet is frequently used among healthcare professionals involved in the epilepsy to obtain information about this disease. The attitude of being influenced by the Internet for diagnostic and/or therapeutic decisions in epilepsy is independent on age and years of experience in epilepsy, and probably reflects an individual approach towards the Web.

Development and Performance Assessment of a Digital Serious Game to Assess Multi-Patient Care Skills in a Simulated Pediatric Emergency Department

2020 ◽  
Vol 51 (4) ◽  
pp. 550-570
Author(s):  
Cindy Luu ◽  
Thomas B. Talbot ◽  
Cha Chi Fung ◽  
Eyal Ben-Isaac ◽  
Juan Espinoza ◽  
...  
Keyword(s):  
Emergency Department ◽  
Diagnostic Accuracy ◽  
Patient Care ◽  
Skill Acquisition ◽  
Video Game ◽  
Rank Correlation ◽  
Fixed Time ◽  
Serious Game ◽  
Cross Sectional ◽  
Number Of Patients

Objective. Multi-patient care is important among medical trainees in an emergency department (ED). While resident efficiency is a typically measured metric, multi-patient care involves both efficiency and diagnostic / treatment accuracy. Multi-patient care ability is difficult to assess, though simulation is a potential alternative. Our objective was to generate validity evidence for a serious game in assessing multi-patient care skills among a variety of learners. Methods. This was a cross-sectional validation study using a digital serious game VitalSignsTM simulating multi-patient care within a pediatric ED. Subjects completed 5 virtual “shifts,” triaging, stabilizing, and discharging or admitting patients within a fixed time period; patients arrived at cascading intervals with pre-programmed deterioration if neglected. Predictor variables included generic multi-tasking ability, video game experience, medical knowledge, and clinical efficiency with real patients. Outcome metrics in 3 domains measured diagnostic accuracy (i.e. critical orders, diagnoses), efficiency (i.e. number of patients, time-to-order) and critical thinking (number of differential diagnoses); MANOVA determined differences between novice learners and expected expert physicians. Spearman Rank correlation determined associations between levels of expertise. Results. Ninety-five subjects’ gameplays were analyzed. Diagnostic accuracy and efficiency distinguished skill level between residency trained (residents, fellows and attendings) and pre-residency trained (medical students and undergraduate) subjects, particularly for critical orders, patients seen, and correct diagnoses (p < 0.003). There were moderate to strong correlations between the game’s diagnostic accuracy and efficiency metrics compared to level of training, including patients seen (rho = 0.47, p < 0.001); critical orders (rho = 0.80, p < 0.001); time-to-order (rho = −0.24, p = 0.025); and correct diagnoses (rho = 0.69, p < 0.001). Video game experience also correlated with patients seen (rho = 0.24, p = 0.003). Conclusion. A digital serious game depicting a busy virtual ED can distinguish between expected experts in multi-patient care at the pre- vs. post-residency level. Further study can focus on whether the game appropriately assesses skill acquisition during residency.

scholarly journals Perceived Efficiency Outcomes, Sources and Awareness of Online Health Information among the Elderly during COVID-19

2021 ◽  
Vol 18 (15) ◽  
pp. 8121
Author(s):  
Gizell Green ◽  
Riki Tesler ◽  
Cochava Sharon
Keyword(s):  
Health Status ◽  
Health Information ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Online Health Information ◽  
Online Information ◽  
Safety Skills ◽  
Cross Sectional ◽  
Information Efficiency ◽  
Online Sources

The Internet and social media are crucial platforms for health information. Factors such as the efficiency of online health information, the outcomes of seeking online health information and the awareness of reliable sources have become increasingly important for the elderly during the COVID-19 pandemic. This study aimed to examine differences between elderly individuals’ income above and below the average monthly wage in relation to their online health information efficiency and the outcomes of seeking online health information; to evaluate types of online information sources with online health information efficiency and the outcomes of seeking online health information; and to explore online health information efficiency as a mediator between health status and awareness of online sources. A cross-sectional study design was conducted with 336 elderly participants age 65 or older. The participants volunteered to complete a questionnaire. No differences were found between the two groups regarding efficiency in retrieving health information from official online health sites and Google. Perceived efficiency mediated health status and awareness of online sources. In these challenging times, it is important to provide a tailor-made education strategy plan for reliable sources of online health information for the elderly, in order to enhance their technology safety skills. It is also important to explore other mediating variables between health status and awareness of online sources.

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