The Implementation of a Personalized Dynamic Approach for the Management of Prolonged Concussion Symptoms

2021 ◽  
pp. 1-14
Author(s):  
Jim Wright ◽  
McKay Moore Sohlberg
Keyword(s):  
Strategy Instruction ◽  
Functional Change ◽  
Strategy Training ◽  
Current Evidence ◽  
Cognitive Strategy Instruction ◽  
Dynamic Approach ◽  
Implementation Phase ◽  
Symptom Profile ◽  
Discharge Plan ◽  
The Individual

Purpose This clinical focus article reviews the existing treatment literature on the management of prolonged concussion symptoms (PCS) for specifying treatment components that hold the most promise for effectively targeting functional goals that are disrupted due to cognitive impairments. Current evidence suggests the treatment ingredients of psychoeducation and cognitive strategy instruction can be effective for addressing changes in functioning due to perceived cognitive deficits in attention, working memory, and executive functioning. Based on the literature, we propose a personalized, dynamic approach to managing PCS that is tailored to the symptom profile of the individual client and consists of three phases, treatment setup, implementation of treatment, and discharge plan, in which the implementation phase consists of psychoeducation and strategy training. The unique aspect of this approach is the use of individualized status tracking measures on goal progress as well as strategy use and perceived strategy helpfulness to empirically guide treatment. Client performance directs clinical decisions, and the clinician adapts treatment components in order to facilitate functional change. Conclusion We provide a case example of an adolescent client treated in our university clinic to demonstrate the implementation of the proposed personalized and dynamic approach to PCS management.

Prediction of pre-eclampsia

2021 ◽  
pp. 1753495X2098401
Author(s):  
Konstantinos Giannakou
Keyword(s):  
Early Recognition ◽  
Routine Care ◽  
Current Evidence ◽  
Individual Risk ◽  
Negative Consequences ◽  
Predictive Tool ◽  
Mortality And Morbidity ◽  
Maternal Mortality And Morbidity ◽  
Conducting Research ◽  
The Individual

Pre-eclampsia is a leading cause of neonatal and maternal mortality and morbidity that complicates approximately 2–8% of all pregnancies worldwide. The precise cause of pre-eclampsia is not completely understood, with several environmental, genetic, and maternal factors involved in its pathogenesis and pathophysiology. An accurate predictor of pre-eclampsia will facilitate early recognition, close surveillance according to the individual risk and early intervention, and reduce the negative consequences of the disorder. Current evidence shows that no single test predicts pre-eclampsia with sufficient accuracy to be clinically useful. A combination of markers into multiparametric models may provide a more useful and feasible predictive tool for pre-eclampsia screening in the routine care setting than a test of either component alone. This review presents a summary of the current advances on prediction of pre-eclampsia, highlighting their performance and applicability. Key priorities when conducting research on predicting pre-eclampsia are also analyzed.

The development of a cognitive rehabilitation and psycho-social group programme for teenage and young adult survivors of brain tumours: A feasibility study

2021 ◽  
pp. 135910452110555
Author(s):  
Daniel Glazer ◽  
Xeni Daniilidi ◽  
Charlotte Valentino
Keyword(s):  
Young Adult ◽  
Feasibility Study ◽  
Social Group ◽  
Brain Tumours ◽  
Cognitive Rehabilitation ◽  
Real Life ◽  
Adult Survivors ◽  
Strategy Training ◽  
Current Evidence ◽  
Current Evidence Base

Introduction and aims Treatment for childhood and adolescent brain tumours is often intensive, with significant neurocognitive and psycho-social late effects ( Zeltzer et al., 2009 ). This feasibility Study aimed to inform the development of a cognitive rehabilitation and psycho-social group intervention for Teenage and Young Adult (TYA) survivors of brain tumours. Methods A group-based intervention incorporated ideas from the current evidence base, including psychoeducation and compensatory strategy training, with a focus on real-life goals and improving quality of life. Participants ( N = 19, 13–24 years) were recruited from the University College London Hospital TYA Oncology Service. Participants had received treatment for a malignant brain tumour and had completed their treatment at least 1 year prior to participation. Four group-based, whole-day interventions ran every 3 months throughout a year. Feasibility criteria were established to answer questions about acceptability of the intervention and recruitment. Results Qualitative and quantitative feedback from all four groups demonstrated acceptability and suitability of the intervention with regards to the content, structure and delivery. Recruitment presented more of a challenge with 35% fewer referrals than expected. Discussion and conclusion Feedback suggests that the intervention is suitable and acceptable, whilst limitations include numbers of referrals and referral pathways. Future directions are discussed.

Cognitive Strategy Instruction for Adolescents: What We Know about the Promise, What We Don't Know about the Potential

2008 ◽  
Vol 78 (1) ◽  
pp. 84-106 ◽  
Author(s):  
MARK CONLEY
Keyword(s):  
Adolescent Literacy ◽  
Teacher Educator ◽  
Cognitive Strategies ◽  
Strategy Instruction ◽  
Cognitive Strategy ◽  
School To Work ◽  
Future Research ◽  
Great Promise ◽  
Cognitive Strategy Instruction ◽  
Literacy Research

"Strategy instruction" is quickly becoming one of the most common — and perhaps the most commonly misunderstood — components of adolescent literacy research and practice. In this essay, veteran teacher educator Mark Conley argues that a particular type of strategy instruction known as cognitive strategy instruction holds great promise for improving adolescents' reading, writing, and thinking across content areas. However, he further suggests that we do not yet have the research needed to adequately understand and maximize the potential of cognitive strategy instruction in secondary content-area classrooms. After situating cognitive strategy instruction in the larger context of research on adolescent literacy and school-to-work transitions, Conley provides classroom examples of cognitive strategy instruction, demonstrates the need for meaningful integration of cognitive strategies in teacher education, and recommends specific directions for future research needed to understand and maximize the benefits of cognitive strategy instruction for adolescents.

scholarly journals Sperm ultrastructure of Pochazia shantungensis (Chou & Lu) and Ricania speculum (Walker) (Hemiptera, Ricaniidae) with phylogenetic implications

ZooKeys ◽  
2019 ◽  
Vol 880 ◽  
pp. 43-59
Author(s):  
Zhen Jiang ◽  
Jianing Liu ◽  
Daozheng Qin
Keyword(s):  
Neck Region ◽  
Mature Spermatozoon ◽  
Current Evidence ◽  
Sperm Ultrastructure ◽  
Transmission Electron ◽  
Phylogenetic Implications ◽  
Dense Substance ◽  
The Individual ◽  
Relationship Of ◽  
Centriole Adjunct

The sperm ultrastructure of two ricaniid species, Pochazia shantungensis (Chou & Lu) and Ricania speculum (Walker), was investigated using light and transmission electron microscopy. Both species have monoflagellate sperm, the shape and ultrastructure of the mature spermatozoon of these two species are similar in morphology, and 128 spermatozoa are organized into sperm bundles with their heads embedded in a homogenous matrix forming the spermatodesmata. The individual sperm is filiform and includes the head, neck and flagellum. The head is needle-like, with a bilayer acrosome and an inferior elongated nucleus which is formed of homogeneously compact and electron-dense chromatin. The neck region is indistinct and is comprised of the centriole and centriole adjunct with a homogeneous dense substance. The long flagellum has the typical 9 + 9 + 2 axoneme microtubule pattern and two symmetrical mitochondrial derivatives with an orderly array of cristae flanking both sides, and a pair of well-developed fishhook-shaped accessory bodies. Current evidence shows that ricaniid species have D-shaped mitochondrial derivatives in cross-section and a serrated electron-dense region. The phylogenetic relationship of Fulgoroidea with other superfamilies in Auchenorrhyncha is briefly discussed.

scholarly journals The MRCPsych OSCE workshop: a new game to play?

2004 ◽  
Vol 28 (2) ◽  
pp. 62-65 ◽  
Author(s):  
Asim Naeem ◽  
Joan Rutherford ◽  
Chris Kenn
Keyword(s):  
Clinical Examination ◽  
Royal College ◽  
Clinical Competence ◽  
Reliability And Validity ◽  
Objective Structured Clinical Examination ◽  
Current Evidence ◽  
Consecutive Series ◽  
Patient Assessment ◽  
Good Reliability ◽  
The Individual

In line with the Royal College of Psychiatrists' commitment to improve its professional examinations based on the best current evidence, Spring 2003 has seen the introduction of the objective structured clinical examination (OSCE). This has replaced the individual patient assessment (IPA) in the MRCPsych Part I clinical examination. An OSCE consists of a series of time-limited clinical tasks that candidates have to perform in a consecutive series of ‘stations' or booths. They have the advantage of being able to test clinical competence using a number of different scenarios via a standardised format (Katona et al, 2000). Their use has become widespread over recent years, particularly in undergraduate psychiatry exams (Brewin & Cantwell, 1997), as they have good reliability and validity (Hodges et al, 1998). This was confirmed by the College's initial pilot OSCE, which had a κ score of around 0.8 for the examination as a whole (Oyebode, 2002).

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