scholarly journals Performance on bedside tests of attention and organized thinking in patients with dementia free from delirium

2018 ◽  
Vol 31 (1) ◽  
pp. 73-81 ◽  
Author(s):  
Letty Oudewortel ◽  
Karlijn J. Joling ◽  
Cees M. P. M. Hertogh ◽  
Viona J. M. Wijnen ◽  
Anne A. M. van der Brug ◽  
...  
Keyword(s):  
False Positive ◽  
Wide Spectrum ◽  
False Positive Rate ◽  
Cross Sectional Study ◽  
Cognitive Disorder ◽  
Test Results ◽  
Severe Dementia ◽  
Cross Sectional ◽  
Dsm Iv ◽  
Bedside Tests

ABSTRACTObjectives:Bedside tests of attention and organized thinking were performed in patients with cognitive impairment or dementia but without delirium, to provide estimates of false positive rates for detecting delirium superimposed on dementia (DSD).Design and Setting:This cross-sectional study was conducted in outpatients and institutionalized patients without delirium representing a wide spectrum of severity of cognitive impairments.Participants:Patients with dementia or a cognitive disorder according to DSM IV criteria, after exclusion of (suspected) delirium according to DSM IV criteria.Measurements:Tests for inattention and disorganized thinking from the CAM-ICU were assessed.Results:The sample included 163 patients (mean age 83 years (SD 6; 64% women)), with Alzheimer's disease as most prevalent (45%) diagnosis and a mean MMSE-score of 16.8 (SD 7.5). False positive rates of the test of attention varied from 0.04 in patients with normal to borderline cognitive function to 0.8 in those with severe dementia. The false positive rate of the test of disorganized thinking was zero in the normal to borderline group, increasing to 0.67 in patients with severe dementia. When combining test results false positive rates decreased to 0.03 in patients with MMSE scores above 9.Conclusion:Use of simple bedside tests of attention and organized thinking for the clinical diagnosis of DSD will result in high rates of false positive observations if used regardless of the severity of dementia. However, if test results are combined they may be useful to exclude DSD in patients with minimal to moderate degrees of dementia, but not in the severe group.

scholarly journals False Positive Rates and Associated Risk Factors on the VOMS and mBESS in U.S. Military Personnel

2021 ◽  
Author(s):  
Anthony P. Kontos ◽  
MAJ Katrina Monti ◽  
Shawn R. Eagle ◽  
MAJ Eliot Thomasma ◽  
Cyndi L. Holland ◽  
...  
Keyword(s):  
Risk Factors ◽  
Motion Sickness ◽  
Military Personnel ◽  
False Positive ◽  
False Positive Rate ◽  
Cross Sectional Study ◽  
False Positives ◽  
Chi Square ◽  
Cross Sectional ◽  
History Of

ABSTRACT Context: In 2018, the U.S. military developed the Military Acute Concussion Evaluation-2 (MACE-2) to inform acute evaluation of mTBI. However, researchers have yet to investigate false positive rates for components of the MACE-2 including the Vestibular-Ocular Motor Screen (VOMS) and modified Balance Error Scoring System (mBESS) in military personnel. Objective: To examine factors associated with false positives in VOMS and mBESS in U.S. Army Special Operations Command (USASOC) personnel. Design: Cross-sectional study. Setting: Military medical clinic. Participants: 416 healthy USASOC personnel completed medical history, VOMS, and mBESS evaluations. Main Outcome Measures: False positive rates for the VOMS (2+ on VOMS symptom item, ≥ 5 cm for near point of convergence [NPC] distance) and mBESS (total score >4) were determined using chi-square analyses and independent samples t-tests. Multivariable logistic regressions (LR) with adjusted odds ratios (aOR) were performed to identify risk factors for false positives on VOMS and mBESS. VOMS items false positive rates ranged from 10.6% (smooth pursuits) to 17.5% (NPC). mBESS total score false positive rate was 36.5%. Results: The multivariable LR model supported three significant predictors of VOMS false positives including age (OR= 1.07, 95% CI= 1.02–1.12, p=0.007), migraine (OR=2.49, 95% CI= 1.29–4.81, p=0.007), and motion sickness history (OR=2.46, 95% CI= 1.34–4.50, p=0.004). Results of the multivariable LR model supported only motion sickness history as a significant predictor (OR=2.34, 95% CI= 1.34–4.05, p=0.002) of mBESS false positives. Conclusions: There were low false positive rates across VOMS items, which were associated with age, history of mTBI, migraine, and motion sickness. False positives for the mBESS total score were higher (36.5%) and were only associated with a history of motion sickness. These risk factors for false positives should be considered when administering and interpreting VOMS and mBESS components of the MACE-2 in this population.

scholarly journals Characterization of depressive syndrome in schizophrenic outpatients

2002 ◽  
Vol 24 (1) ◽  
pp. 18-25 ◽  
Author(s):  
Flávio Soares de Araújo ◽  
Kátia Petribú ◽  
Othon Bastos
Keyword(s):  
Clinical Features ◽  
Clinical Picture ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Depressive Syndrome ◽  
Psychosocial Stressors ◽  
First Episode ◽  
Psychotic Episode ◽  
Cross Sectional ◽  
Dsm Iv

OBJECTIVE: The authors carried out a cross-sectional study with the aim of characterizing and describing depressive pictures in schizophrenic patients seen at the Psychiatry Outpatient Clinic of the Federal University of Pernambuco (HC-UFPE). The patients had the diagnosis of schizophrenia confirmed on the basis of the operating criteria of the DSM-IV. METHODS: Those who where in the period of stabilization of the clinical picture were selected for the study defined according the following criteria:the last psychotic episode must be happened two months before at least, and during this period the alterations of the antipsychotics doses had been lower than 5 mg of haloperidol or equivalent doses of others neuroleptics. A total of one hundred and four patients took part. Following the identification of the depressive symptoms using the Calgary Depression Scale for Schizophrenia (CDSS), thirty-one patients (29.8%) fulfilled the diagnostic criteria described in the DSM-IV. Of these, 22.1% had the diagnosis of major depression and 7.7% of minor depression according the DSM-IV. Two groups were constituted: Group A, schizophrenics with a depressive syndrome, and Group B, schizophrenics without such a syndrome. An assessment was made of the distribution of the symptoms of the CDSS scores in both groups, the sociodemographic, clinical and therapeutic variables in relation to the frequency of the depressive syndrome, and the patients clinical course. For the investigation of certain clinical features, the following tools were used: problem list (psychosocial stressors) contained in axis IV of the DSM-IV intended to detect the presence of factors triggering the initial episode of schizophrenia and the Global Assessment of Functioning (GAF -- Axis V -- DSM-IV) to characterize the current functioning of the patients. CONCLUSIONS: The results obtained allowed the authors to draw the following conclusions: all the items that comprise the Brazilian version of the CDSS were statistically significant in characterizing the depressive syndrome; a comparison of the sociodemographic and therapeutic variables revealed no statistically significant differences between the two groups, and this was also the case with the majority of the clinical features. Statistically significant differences, however, were found in relation to the greater frequency of life events (psychosocial stressors) in triggering the first episode of schizophrenia and the higher incidence of affective disorders antecedents in family members (first and second degree) among the depressed patients. The mean duration of the depressive syndrome during follow-up of the patients was 5.30 months. The patients in whom there was a recurrence of the psychotic episode presented a delusional-hallucinatory clinical picture. This study seeks to contribute to the inclusion of the Postpsychotic Depressive Disorder (PSD) of Schizophrenia (DSM-IV), in the group of Schizophrenic Disorders.

scholarly journals Turkish Midwifery Students’ Fear of Delivery Process

2019 ◽  
Vol 8 (3) ◽  
pp. 121-127
Author(s):  
Neslihan Keser Özcan ◽  
Nur Elçin Boyacıoğlu ◽  
Neriman Güdücü ◽  
Seda Göncü Serhatlıoğlu ◽  
Emine Yıldırım ◽  
...  
Keyword(s):  
Sampling Method ◽  
Cross Sectional Study ◽  
Normal Vaginal Delivery ◽  
Decision Making Process ◽  
Test Results ◽  
Cross Sectional ◽  
Wrong Decision ◽  
Mean Values ◽  
Breech Delivery ◽  
Spearman Correlation Test

Introduction: Fear affects a person’s decision-making process and causes a midwife to make a wrong decision about normal vaginal delivery and cesarean delivery, so research was carried out in order to determine the fields related to delivering process in which students experience the most fear and feel sufficient. Methods: A descriptive/cross-sectional study was performed between September and October 2017. The sample consisted of 732 students selected with the convenience maximum variation sampling method from six universities studying in the third and fourth years of a midwifery program. The study measured data collected with a questionnaire entitled “Midwives’ Fear of Delivery Process”. The data were analyzed in with the SPSS for Windows using percentage and mean values and Spearman correlation test. Results: In general, students are more afraid of practices with which they say they have more experience such as vaginal palpation (3.30 (0.884), rs=0.131, P*lt;0.001), and they are less afraid of practices (interventional) with which they have less experience such as breech delivery (1.70 (0.915), rs=0.048, P=0.197) or no experience at all and of cases in which they can get hurt. The students feel most sufficient when performing prenatal and postnatal practices. Conclusion: The results of our study parallel the conclusion in the literature that students are afraid of the fields that they have practiced most. Before clinical practice, instructors can determine students’ fears and deficiencies in relation to procedures and areas of practice and can develop approaches for alleviating their fears and weaknesses.

scholarly journals Etiological Pattern of Dementia in Bangladesh

2016 ◽  
Vol 32 (2) ◽  
pp. 85-90
Author(s):  
MRK Khan ◽  
AN Rizvi ◽  
MA Habib ◽  
MK Hasan ◽  
A Mamun ◽  
...  
Keyword(s):  
Vascular Dementia ◽  
Neurodegenerative Disorder ◽  
Psychosocial Interventions ◽  
Cross Sectional Study ◽  
Chronic Subdural Haematoma ◽  
Cross Sectional ◽  
Dementia Patients ◽  
Dsm Iv ◽  
Medical University ◽  
State Examination

Background: Dementia is a chronic & progressive neurodegenerative disorder affecting usually older people of more than 65 years in which there are disturbances of multiple higher cortical functions including memory, thinking, orientation & others. Dementia patients are increasing in number as the population of older age group is increasing. All types of dementia are treatable, at least with psychosocial interventions. So, accurate diagnosis and evaluation of etiological pattern is essential. Methods: This cross sectional study was carried out in the Department of Neurology, Bangabandu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2012 to December 2012 on 88 patients with dementia diagnosed on the basis of mini mental state examination and DSM-IV criteria. Results: Vascular dementia was the underlying diagnosis in most of the cases (43.3 %) followed by Alzheimers Disease (20.2%) and Parkinson Disease (9%). Other causes were Mixed Dementia, Intracranial Space Occupying Lesion, Post Encephalitic, Hypoxic Encephalitic, Chronic Subdural Haematoma and Tubercular Meningitis. Conclusion: Vascular dementia is more than Alzheimer’s Dementia in Bangladesh. Multiple vascular risk factors contribute to this. Bangladesh Journal of Neuroscience 2016; Vol. 32 (2): 85-90

scholarly journals Suicide, the main cause of referral of patients from a general hospital for psychiatric evaluation

2021 ◽  
Vol 5 (1) ◽  
pp. 018-021
Author(s):  
Gómez Elena ◽  
Guzmán Marianela ◽  
Torres Oriol Yuguero
Keyword(s):  
Suicide Attempts ◽  
Hospital Admissions ◽  
Cross Sectional Study ◽  
Psychiatric Evaluation ◽  
Outpatient Basis ◽  
Test Results ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test ◽  
Life Threatening

Introduction: Psychiatric emergencies constitute between 1% - 10% of general emergencies in Spain, of which a quarter will end up being hospital admissions. There is little literature on patients who are referred from general to specialized hospitals. Methods: Cross-Sectional study of all the patients referred in 2018. Sociodemographic variables and clinical variables, such as diagnosis and discharge destination, were analyzed. An analysis was performed by comparing means with the Chi Square test. Results: 433 derived emergencies were analyzed. Most of the patients were women. The main reason for derivation were suicide attempts. Of those patients, 40% required hospitalizations. More than 50% of the derived emergencies were referred to the home and followed up on an outpatient basis. Conclusion: Most derived emergencies are referred to the home after evaluation. This implies that most are not life-threatening and that with adequate tools for evaluating suicide risk, we could avoid transfers and improve the resolution of these cases.

scholarly journals Analysis of Lifestyle, Advertising Effectiveness, and Instant Coffee Consumption among Peri-Urban Farmers

2021 ◽  
Vol 6 (2) ◽  
pp. 167-182
Author(s):  
Moh. Djemdjem Djamaludin ◽  
Dewi Mutia Silmie
Keyword(s):  
Sampling Method ◽  
Agricultural Land ◽  
Coffee Consumption ◽  
Cross Sectional Study ◽  
Advertising Effectiveness ◽  
Test Results ◽  
Sectional Study ◽  
Cross Sectional ◽  
Instant Coffee ◽  
The Public

Coffee consumption is increasing because many types of coffee are circulating, such as instant coffee among the public. The instant coffee studied in this study is the Iwan Fals edition of instant coffee. This study aimed to analyse the lifestyle and effectiveness of instant coffee advertising on instant coffee consumption among peri-urban farmers in Bogor Regency. This study used a cross-sectional study design located in Cibungbulang District, Bogor Regency. The location was chosen purposive because it is a peri-urban area that has more than 20% of agricultural land. A total of 100 respondents in this study were selected using a purposive sampling method with the criteria of a farmer and in the last 12 months consuming and viewing Iwan Fals edition coffee advertisements. The results of this study found that the maker's lifestyle is the most (32%) owned by the respondents. The effectiveness of instant coffee advertising in this study is included in the effective category (3.54). The results showed a relationship between gender, believing lifestyle, trying hard lifestyle with instant coffee consumption. The influence test results found an influence of male gender and lifestyle beliefs on instant coffee consumption. In general, respondents are classified as effective in consuming coffee because of their lifestyle and increase energy.

scholarly journals Children's Values, Social Support, Mother's Roles, and Psychosocial Stimulation in Boys and Girls

2021 ◽  
Vol 6 (1) ◽  
pp. 20-36
Author(s):  
Dwi Hastuti ◽  
Lia Shafira Arlianty ◽  
Megawati Simanjuntak
Keyword(s):  
Social Support ◽  
Psychosocial Development ◽  
Economic Value ◽  
Simple Random Sampling ◽  
Cross Sectional Study ◽  
Information Support ◽  
Test Results ◽  
Cross Sectional ◽  
Psychosocial Stimulation ◽  
The City

Psychosocial development is a developmental stage that every child will pass. This study aimed to analyze the influence of family and child characteristics, child value, social support, mother's involvement in psychosocial stimulation in boys and girls. The research design that was used in this study was a cross-sectional study. Site selection was chosen purposively, namely in the city of Medan. Research locations were in two villages, namely Kota Maksum, Medan Labuhan Subdistrict and Kota Besar Village, Medan Area District. The sample pulling technique uses simple random sampling with a sample of mothers who have children aged 2-3 years and come from a complete family of 150 people. Respondents interviewed with the questionnaire were mothers. Correlation test results showed a significant positive relationship between maternal age, children's values, dimensions of psychological value and dimensions of economic value, social support, dimensions of information support and dimensions of reward support, and mothers' role in care with psychosocial stimulation.

scholarly journals Covid-19 Positive Antenatal Patients in Obstetrics and Gynea Unit, Peshawar

2021 ◽  
Vol 8 (2) ◽  
pp. 14-18
Author(s):  
Rabeea Sadaf ◽  
Muhammed Zahid ◽  
Nasreen Kishwar ◽  
Umaiyma Farhad ◽  
Behzad Khan Khalil
Keyword(s):  
Well Being ◽  
Cross Sectional Study ◽  
Positive Test ◽  
Test Results ◽  
Cross Sectional ◽  
Cesarean Birth ◽  
Asymptomatic Patients ◽  
Primary Responsibility ◽  
Polymerase Chain ◽  
Antenatal Visits

OBJECTIVES: The study aimed to determine the frequency of COVID-19 positive antenatal patients admitted in Obstetrics & Gynecology unit Hayatabad Medical Complex Peshawar with the concerns that pregnant women may be more susceptible to COVID-19 as they may be more vulnerable to respiratory infection. METHODOLOGY: This was a descriptive cross-sectional study conducted at Obstetrics & Gynecology units Hayatabad Medical Complex Peshawar from May 12th, 2020, to November 29th, 2020, screening and testing of patients admitted for childbirth was in HMC. Screening consisted of questions related to travel, contacts, and symptoms of COVID-19. All patients without a prior diagnosis of COVID-19 underwent SARS-CoV-2 polymerase chain reaction (PCR) testing of nasopharyngeal swabs, with rapid testing available. Patients scheduled for cesarean birth were screened and tested at preoperative visits RESULTS:  One hundred eighty-two patients presenting for antenatal visits were screened; 6.5% (12 out of 182) were previously diagnosed with COVID-19. The remaining 170 patients were tested at admission, and 17.6% (30 out of 170) tested positive for SARS-CoV-2. Twenty-two of the 30 who tested positive for SARS-CoV-2 (73.3%) were asymptomatic. The overall prevalence of positive test results among asymptomatic patients was 14.1% (22 out of 156). The prevalence of positive test results among asymptomatic patients increased from 1.29% (2 out of 155). CONCLUSION: The evidence on this novel infection is changing almost daily, although it will likely be many months before, we can determine the true impact it will have on both maternal and fetal well‐being. In the interim, our primary responsibility is to ensure all women have access to safe maternity services. KEYWORDS: Asymptomatic, COVID-19 Positive, Antenatal Patients, Obstetrics & Gynecology, Infection

scholarly journals How can automated linguistic analysis help to discern functional cognitive disorder from healthy controls and mild cognitive impairment?

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S7-S7
Author(s):  
Lizzie Beavis ◽  
Ronan O'Malley ◽  
Bahman Mirheidari ◽  
Heidi Christensen ◽  
Daniel Blackburn
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Delayed Diagnosis ◽  
Age Of Acquisition ◽  
Linguistic Analysis ◽  
Cross Sectional Study ◽  
Cognitive Disorder ◽  
Remote Memory ◽  
Healthy Controls ◽  
Cross Sectional

AimsThe disease burden of cognitive impairment is significant and increasing. The aetiology of cognitive impairment can be structural, such as in mild cognitive impairment (MCI) due to early Alzheimer's disease (AD), or in functional cognitive disorder (FCD), where there is no structural pathology. Many people with FCD receive a delayed diagnosis following invasive or costly investigations. Accurate, timely diagnosis improves outcomes across all patients with cognitive impairment. Research suggests that analysis of linguistic features of speech may provide a non-invasive diagnostic tool. This study aimed to investigate the linguistic differences in conversations between people with early signs of cognitive impairment with and without structural pathology, with a view to developing a screening tool using linguistic analysis of conversations.MethodIn this explorative, cross-sectional study, we recruited 25 people with MCI considered likely due to AD, (diagnosed according to Petersen's criteria and referred to as PwMCI), 25 healthy controls (HCs) and 15 people with FCD (PwFCD). Participants’ responses to a standard questionnaire asked by an interactional virtual agent (Digital Doctor) were quantified using previously identified parameters. This paper presents statistical analyses of the responses and a discussion of the results.ResultPwMCI produced fewer words than PwFCD and HCs. The ratio of pauses to speech was generally lower for PwMCI and PwFCD than for HCs. PwMCI showed a greater pause to speech ratio for recent questions (such as ‘what did you do at the weekend?’) compared with the HCs. Those with FCD showed the greatest pause to speech ratio in remote memory questions (such as ‘what was your first job?’). The average age of acquisition of answers for verbal fluency questions was lower in the MCI group than HCs.ConclusionThe results and qualitative observations support the relative preservation of remote memory compared to recent memory in MCI due to AD and decreased spontaneous elaboration in MCI compared with healthy controls and patients with FCD. Word count, age of acquisition and pause to speech ratio could form part of a diagnostic toolkit in identifying those with structural and functional causes of cognitive impairment. Further investigation is required using a large sample.

scholarly journals Performance and Symptom Validity Assessment in Patients with Apathy and Cognitive Impairment

2019 ◽  
Vol 26 (3) ◽  
pp. 314-321 ◽  
Author(s):  
Brechje Dandachi-FitzGerald ◽  
Annelien A. Duits ◽  
Albert F.G. Leentjens ◽  
Frans R.J. Verhey ◽  
Rudolf W.H.M. Ponds
Keyword(s):  
Cognitive Impairment ◽  
Test Performance ◽  
False Positive ◽  
False Positive Rate ◽  
Symptom Validity ◽  
Cross Sectional ◽  
Validity Test ◽  
Validity Assessment ◽  
Validity Tests

AbstractObjective:Performance and symptom validity tests (PVTs and SVTs) measure the credibility of the assessment results. Cognitive impairment and apathy potentially interfere with validity test performance and may thus lead to an incorrect (i.e., false-positive) classification of the patient’s scores as non-credible. The study aimed at examining the false-positive rate of three validity tests in patients with cognitive impairment and apathy.Methods:A cross-sectional, comparative study was performed in 56 patients with dementia, 41 patients with mild cognitive impairment, and 41 patients with Parkinson’s disease. Two PVTs – the Test of Memory Malingering (TOMM) and the Dot Counting Test (DCT) – and one SVT – the Structured Inventory of Malingered Symptomatology (SIMS) – were administered. Apathy was measured with the Apathy Evaluation Scale, and severity of cognitive impairment with the Mini Mental State Examination.Results:The failure rate was 13.7% for the TOMM, 23.8% for the DCT, and 12.5% for the SIMS. Of the patients with data on all three tests (n = 105), 13.5% failed one test, 2.9% failed two tests, and none failed all three. Failing the PVTs was associated with cognitive impairment, but not with apathy. Failing the SVT was related to apathy, but not to cognitive impairment.Conclusions:In patients with cognitive impairment or apathy, failing one validity test is not uncommon. Validity tests are differentially sensitive to cognitive impairment and apathy. However, the rule that at least two validity tests should be failed to identify non-credibility seemed to ensure a high percentage of correct classification of credibility.

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