Collaboration and individual memory: Evidence from immediate and delayed recognition

This chapter will review the available evidence on individuals with co-occurring diagnoses of autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). This chapter contends that children diagnosed with both disorders (ASD+ADHD) are a subset of the ASD population that is at risk for delayed recognition of their ASD diagnosis, poor treatment response, and poorer functional outcomes compared to those with ASD without ADHD. Specifically, the chapter highlights the best estimates of the prevalence of the comorbidity, the developmental trajectory of people with co-occurring ASD and ADHD, how ADHD symptoms change across development, overlapping genetic and neurobiological risk factors, psychometrics of ADHD diagnostic instruments in an ASD population, neuropsychological and functional impairments associated with co-occurring ASD and ADHD, and the current state of evidence-based treatment for both ASD and ADHD symptoms. Finally, the chapter discusses fruitful avenues of research for improving understanding of this high-risk comorbidity so that mechanism-to-treatment pathways for ADHD in children with ASD can be better developed.

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Atypical Pyoderma gangrenosum: a case of delayed recognition

Journal of Community Hospital Internal Medicine Perspectives ◽

10.1080/20009666.2020.1866250 ◽

2021 ◽

Vol 11 (2) ◽

pp. 242-248

Author(s):

Anum Qureshi ◽

Kia Persaud ◽

Sajida Zulfiqar ◽

Ranadheer Dande ◽

Chahat Puri ◽

...

Keyword(s):

Pyoderma Gangrenosum ◽

Delayed Recognition

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Contributions of Hypoxia-Awareness Training to the Familiarization of Personal Symptoms for Occupational Safety in the Flight Environment

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18062904 ◽

2021 ◽

Vol 18 (6) ◽

pp. 2904

Author(s):

Kwo-Tsao Chiang ◽

Min-Yu Tu ◽

Chao-Chien Cheng ◽

Hsin-Hui Chen ◽

Wun-Wei Huang ◽

...

Keyword(s):

Occupational Safety ◽

Safety Issue ◽

Hot Flashes ◽

Occurrence Rate ◽

Flight Safety ◽

Awareness Training ◽

The Past ◽

Individual Memory ◽

The Individual ◽

Poor Concentration

Hypoxia remains a flight-safety issue in terms of aviation medicine. Hypoxia-awareness training has been used to help aircrew members recognize personal hypoxia symptoms. There is still no study, as yet, to establish the association of within-subject data between inflight hypoxia events and the altitude chamber. The main purpose of our study was to use paired subjects’ data on inflight hypoxia symptoms compared with those experienced during training. A questionnaire was developed to obtain information on military aircrew members in 2018. Among 341 subjects, 46 (13.49%) suffered from inflight hypoxia. The majority of the subjects detected ongoing inflight hypoxia on the basis of their previous experience with personal hypoxia symptoms or sensations in previous chamber flights. Of the top five hypoxia symptoms, the data revealed that hot flashes, poor concentration, and impaired cognitive function appeared both during the inflight events and during the hypoxia-awareness training. The occurrence rate of hypoxia symptoms was found to not be significantly different between the in-flight events and the past chamber flights through an analysis of within-subject data. Because the individual memory had faded away over time, fresher hypoxia awareness training is still mandatory and valuable to recall personal hypoxia experience for military aircrew members.

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Evolution of the deployed medical director role in an era of contingency operations: reflections from a United Nations operation

BMJ Military Health ◽

10.1136/bmjmilitary-2020-001690 ◽

2021 ◽

pp. bmjmilitary-2020-001690

Author(s):

Giles Nordmann ◽

J Ralph ◽

J E Smith

Keyword(s):

United Nations ◽

Selection Process ◽

Memory Loss ◽

Medical Director ◽

Corporate Memory ◽

Individual Memory ◽

Treatment Facilities ◽

The Uk ◽

The Military ◽

And Training

This paper examines the development and evolution of the deployed medical director (DMD) role and argues for the re-establishment of a formal selection process and training pathway. Recent deployments into new areas of operations, deployment of smaller medical treatment facilities (MTFs), the reduced numbers of deployments for clinicians, working with various multinational partners and both military and civilian organisations all pose specific problems for DMDs. The initial and then continued deployment of a secondary care role 2 MTF as part of the United Nations Mission in South Sudan illustrated some of these challenges. Although a novel operation, the broad categories of these new challenges were similar to the historical challenges facing the first DMDs in Afghanistan. Corporate memory loss may be unavoidable to some degree due to rapid turnover in appointments, particularly in single service and joint headquarters. However, individual memory and experience remains extant within the military medical deployable workforce. After the cessation of UK military deployed hospital care involvement in Afghanistan, the UK DMD formal training pathway ended. This paper argues for the re-establishment of a more formal DMD selection process and training pathway to ensure that organisational learning is optimised.

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Management of constipation in patients with schizophrenia—a case study and review of literature

Middle East Current Psychiatry ◽

10.1186/s43045-021-00097-6 ◽

2021 ◽

Vol 28 (1) ◽

Author(s):

Ashish Sarangi ◽

Sabiha Armin ◽

Aurelio Vargas ◽

Victoria M. Chu ◽

Kristen Fain ◽

...

Keyword(s):

Side Effect ◽

Negative Symptoms ◽

Early Recognition ◽

Cardiovascular Complications ◽

Cochrane Library ◽

Main Body ◽

Complication Rates ◽

Anticholinergic Effects ◽

Routine Surveillance ◽

Delayed Recognition

Abstract Background Schizophrenia is a disorder that affects about 1% of the US population, with an extensive impact on patients’ health and their risk of later developing comorbidities from treatment. While literature on the side effect profile of antipsychotics is abundant, there are few studies on identification of anticholinergic effects on gut motility and prophylaxis development. The aim of this review is to consider antipsychotic-associated constipation in patients with schizophrenia and to discuss management of antipsychotic-induced constipation as documented in the literature. Main body We present a case of antipsychotic-induced constipation and conducted a literature review assessing the prevalence of this issue in this population. The search was done on Embase, MEDLINE, Cochrane Library, and PubMed databases. Key word searches included constipation with concurrent antipsychotic use, antipsychotics and anticholinergic effects, factors causing constipation in schizophrenia, social disparities involved with constipation, and colorectal cancer screenings. Main findings included high complication rates that may be explained by clozapine-specific side effects, negative health habits, disease, and treatment-related metabolic disorders. Co-existing negative symptoms could also be associated with health outcomes and was found to have adverse consequences on schizophrenia progression. Comorbidities of diabetes and cardiovascular complications contributed to gut hypomotility. Caregiver burden was a factor in delayed recognition of constipation as a side effect. Routine surveillance for symptoms and optimization of medications facilitates early recognition of constipation. Conclusion Overall, there is insufficient trial-based evidence to compare the effectiveness and safety of common pharmacological interventions for constipation, such as lactulose, polyethylene glycol, stool softeners, and lubricant laxatives.

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Imaging features and differential diagnoses of non-neoplastic diffuse mediastinal diseases

Insights into Imaging ◽

10.1186/s13244-020-00909-z ◽

2020 ◽

Vol 11 (1) ◽

Author(s):

Flavian Tabotta ◽

Gilbert R. Ferretti ◽

Helmut Prosch ◽

Samia Boussouar ◽

Anne-Laure Brun ◽

...

Keyword(s):

Early Stage ◽

Specific Treatment ◽

Imaging Features ◽

Mediastinal Diseases ◽

Pictorial Review ◽

Wide Range ◽

Chest X Ray ◽

Delayed Recognition ◽

Patient’S History ◽

Contiguous Spread

Abstract Acute or chronic non-neoplastic diffuse mediastinal diseases have multiple causes, degrees of severity, and a wide range of management. Some situations require emergency care while others do not need specific treatment. Although the diagnosis may be suspected on chest X-ray, it is mainly based on CT. A delayed recognition is not uncommonly observed. Some findings may prompt the radiologist to look for specific associated injuries or lesions. This pictorial review will successively describe the various non-neoplastic causes of diffuse mediastinal diseases with their typical findings and major differentials. First, pneumomediastinum that can be provoked by extra- or intra-thoracic triggers requires the knowledge of patient’s history or recent occurrences. Absence of any usual etiological factor should raise suspicion of cocaine inhalation in young individuals. Next, acute mediastinitis may be related to post-operative complications, esophageal perforation, or contiguous spread of odontogenic or retropharyngeal infections. The former diagnosis is not an easy task in the early stage, owing to the similarities of imaging findings with those of normal post-operative appearance during the first 2–3 weeks. Finally, fibrosing mediastinitis that is linked to an excessive fibrotic reaction in the mediastinum with variable compromise of mediastinal structures, in particular vascular and airway ones. Differential diagnosis includes tumoral and inflammatory infiltrations of the mediastinum.

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