Alternative Diagnostic Models of the Psychotic Disorders: Evidence-Based Choices

2021 ◽  
pp. 1-13
Author(s):  
Bruce M. Cohen ◽  
Dost Öngür ◽  
Suzann M. Babb
Keyword(s):  
Psychotic Disorders ◽  
Underlying Structure ◽  
Evidence Based ◽  
Diagnostic Systems ◽  
Response Factors ◽  
Structural Choice ◽  
Treatment Models ◽  
Diagnostic Models ◽  
The Right ◽  
Best Fit

Standard diagnostic systems, the predominantly categorical DSM-5 and ICD-11, have limitations in validity, utility, and predictive and descriptive power. For psychotic disorders, these issues were partly addressed in current versions, but additional modifications are thought to be needed. Changes should be evidence based. We reviewed categorical, modified-categorical, and continuum-based models versus factor-based models of psychosis. Factors are clusters of symptoms or single prominent aspects of illness. Consistent evidence from studies of the genetics, pathobiology, and clinical presentation of psychotic disorders all support an underlying structure of factors, not categories, as best characterizing psychoses. Factors are not only the best fit but also comprehensive, as they can encompass any key feature of illness, including symptoms and course, as well as determinants of risk or response. Factors are inherently dimensional, even multidimensional, as are the psychoses themselves, and they provide the detail needed for either grouping or distinguishing patients for treatment decisions. The tools for making factor-based diagnoses are available, reliable, and concordant with actual practices used for clinical assessments. If needed, factors can be employed to create categories similar to those in current use. In addition, they can be used to define unique groupings of patients relevant to specific treatments or studies of the psychoses. Lastly, factor-based classifications are concordant with other comprehensive approaches to psychiatric nosology, including personalized (precision treatment) models and hierarchical models, both of which are currently being explored. Factors might be considered as the right primary structural choice for future versions of standard diagnostic systems, both DSM and ICD.

The Development of the Mental Representation of Numbers 0-10 in Elementary School Children

2020 ◽  
Author(s):  
Anat Feldman ◽  
Michael Shmueli ◽  
Dror Dotan ◽  
Joseph Tzelgov ◽  
Andrea Berger
Keyword(s):  
Sixth Grade ◽  
Number Line ◽  
Number Representation ◽  
Large Numbers ◽  
Position Task ◽  
Sigmoidal Curve ◽  
Anchor Points ◽  
The Right ◽  
Line P ◽  
Best Fit

In recent years, there has been growing interest in the development of mental number line (MNL) representation examined using a number-to-position task. In the present study, we investigated the development of number representation on a 0-10 number line using a computerized version of the number-to-position task on a touchscreen, with restricted response time; 181 children from first through sixth grade were tested. We found that the pattern of estimated number position on the physical number line was best fit by the sigmoidal curve function–which was characterized by underestimation of small numbers and overestimation of large numbers–and that the breakpoint changed with age. Moreover, we found that significant developmental leaps in MNL representation occurred between the first and second grades and again between the second and third grades, which was reflected in the establishment of the right endpoint and the number 5 as anchor points, yielding a more accurate placement of other numbers along the number line.

Comparison of the efficiency of the indexes of Pont and Korkhause with Kernott technique in patients with narrowing of maxilla

2020 ◽  
Vol 20 (3) ◽  
pp. 199-203
Author(s):  
O. I. Admakin ◽  
I. A. Solop ◽  
A. D. Oksentyuk
Keyword(s):  
Dental Treatment ◽  
Standard Analysis ◽  
Clinical Hospital ◽  
Control Models ◽  
Diagnostic Models ◽  
Left And Right ◽  
The Asymmetry ◽  
The Right ◽  
The University ◽  
Medical University

Relevance. The narrowing of the maxilla is one of the most common pathologies in orthodontics. Recent studies show that the narrowing is always asymmetric which is connected to the rotation of the maxilla. To choose the treatment correctly one need a calculation that reveals the asymmetry, which is impossible with using standard indexes.Purpose – to compare efficiency of indexes of Pont and Korkhause with the Kernott's method in patients with narrowing of the maxilla.Materials and methods. The study involved 35 children aged from 8 to 12 years old undergoing dental treatment in the University Children's Clinical Hospital of the First Moscow State Medical University with no comorbidities. For every patient a gypsum model was prepared and after that to carry out the biometrical calculation. In this study two indexes were used: Pont's index and Korkhause's; using this standard analysis the narrowing of the maxilla was revealed. After using Pont's Index and Korkhaus analysis all the models were calculated by the method of Kernott with Kernott's dynamic pentagon.Results. As a result of the analysis of the control diagnostic models a narrowing of the maxilla in 69% of cases (n = 24) was revealed in all cases, the deviation of the size of the dentition was asymmetric. Thus, 65% of the surveyed models showed a narrowing on the right. This narrowing was of a different severity and averaged 15 control models.Conclusions. This shows that for the biometrics of diagnostic models it is necessary to use methods that allow to estimate the width of the dentition rows on the left and on the right separately. To correct the asymmetric narrowing of the dentition, it is preferable to use non-classical expanding devices that act equally on the left and right sides separetly.

WITHWomen: User Centered Approach to the Design and Development of a suite of Intimate Partner Violence Screening and Safety Planning Web-Applications (Preprint)

2020 ◽  
Author(s):  
Patricia O'Campo ◽  
Alisa Velonis ◽  
Pearl Buhariwala ◽  
Janisha Kamalanathan ◽  
Maha Awaiz Hassan
Keyword(s):  
Partner Violence ◽  
Web Applications ◽  
Lessons Learned ◽  
Evidence Based ◽  
Safety Planning ◽  
Future Design ◽  
Mhealth Technology ◽  
The Right ◽  
Safe Access ◽  
Health Applications

BACKGROUND The popularity of mHealth technology has resulted in the development of numerous applications for almost every type of self-improvement or disease management. M- and e-health solutions for increasing awareness about and safety around partner violence is no exception. OBJECTIVE These applications allow women to control access to these resources and provide unlimited, and with the right design features, safe access when these resources are needed. Few applications, however, have been designed in close collaboration with intended users to ensure relevance and effectiveness. METHODS We report here on the design of a pair of evidence-based m- and e-health applications to facilitate early identification of unsafe relationship behaviors and tailored safety planning to reduce harm from violence including the methods by which we collaborated with and sought input from population of intended users. RESULTS The demographic characteristics of those who participated in the various surveys and interviews to inform the development of our screening and safety-decision support app are presented in (Table 2). CONCLUSIONS Finally, we share challenges we faced and lessons learned that might inform future design efforts of m- and e-health evidence-based applications.

scholarly journals Comparison of the accuracy of intraoral scans between complete-arch scan and quadrant scan

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Youn-Gyeong Moon ◽  
Kyung-Min Lee
Keyword(s):  
Third Molar ◽  
Careful Consideration ◽  
Missing Teeth ◽  
Posterior Teeth ◽  
Anterior Teeth ◽  
Posterior Quadrant ◽  
Left Posterior ◽  
The Right ◽  
Best Fit ◽  
Posterior Area

Abstract Objective To compare the accuracy of complete-arch scans and quadrant scans obtained using a direct chairside intraoral scanner. Material and methods Intraoral scans were obtained from 20 adults without missing teeth except for the third molar. Maxillary and mandibular complete-arch scans were carried out, and 4 quadrant scans for each arch were performed to obtain right posterior, right anterior, left anterior, and left posterior quadrant scans. Complete-arch scans and quadrant scans were compared with corresponding model scans using best-fit surface-based registration. Shell/shell deviations were computed for complete-arch scans and quadrant scans and compared between the complete-arch scans and each quadrant scans. In addition, shell/shell deviations were calculated also for each individual tooth in complete-arch scans to evaluate factors which influence the accuracy of intraoral scans. Results Complete-arch scans showed relatively greater errors (0.09 ~ 0.10 mm) when compared to quadrant scans (0.05 ~ 0.06 mm). The errors were greater in the maxillary scans than in the mandibular scans. The evaluation of errors for each tooth showed that the errors were greater in posterior teeth than in anterior teeth. Comparing the right and left errors, the right side posterior teeth showed a more substantial variance than the left side in the mandibular scans. Conclusion The scanning accuracy has a difference between complete-arch scanning and quadrant scanning, particularly in the posterior teeth. Careful consideration is needed to avoid scanning inaccuracy for maxillary or mandibular complete-arch, particularly in the posterior area because a complete-arch scan might have potential error than a quadrant scan.

scholarly journals 101 Case report: to stent, or not to stent? The pale cast of evidence-based practice in acute stroke

2019 ◽  
Vol 90 (e7) ◽  
pp. A33.1-A33
Author(s):  
Chris Blair ◽  
Kartik Bhatia ◽  
David Brunacci ◽  
John Worthington ◽  
Rebekah Ahmed
Keyword(s):  
Blood Pressure ◽  
Acute Stroke ◽  
Evidence Based Practice ◽  
Blood Pressure Monitoring ◽  
Neurological Deficits ◽  
Evidence Based ◽  
Limb Weakness ◽  
Vasopressor Support ◽  
Course Of Action ◽  
The Right

IntroductionWith approximately 200 procedures performed in the last year at our centre, worthwhile clinical lessons continue to emerge in the practice of endovascular clot retrieval (ECR) for acute stroke. This case demonstrates the value of considered clinical appraisal in a dynamic, information-rich setting. A 68 year-old man with established vertebrobasilar atherosclerotic disease developed capricious, blood pressure-sensitive neurological deficits after successful ECR for a basilar artery stroke, inviting the possibility of further intervention in the form of intracranial stenting. We avoided pursuing this course of action in favour of a more measured approach, entailing the provision of vasopressor support over the following week.MethodFollowing ECR, our patient was admitted to the intensive care unit for continuous blood pressure monitoring and close observation of his neurological deficits with serial NIHSS (National Institutes of Health Stroke Scale) scoring. Systolic blood pressures were maintained between 140–160 mmHg using vasopressor support, with the aim of allowing time for recovery of vascular autoregulation and collateralization.ResultsOver six days, the patient developed moderate left upper and lower limb weakness. An MRI performed on Day 5 revealed limited interval infarction of the right hemipons and cerebellum, with complete re-occlusion of the mid-basilar arterial segment. He left the ICU with a NIHSS score of 7, and was living independently at 90-day follow-up (Modified Rankin Score 1).ConclusionThe ultimately favourable net outcome for our patient clearly illustrates the imperative to remain within the boundaries of evidence-based practice in this bold and rapidly evolving discipline.

Flag Verification on the High Seas: Understanding Requirements for Masters and Commanders

2015 ◽  
Vol 30 (2) ◽  
pp. 335-360 ◽  
Author(s):  
Angeline Lewis
Keyword(s):  
Law Enforcement ◽  
Reasonable Doubt ◽  
Law Of The Sea ◽  
Evidence Based ◽  
Objective Evidence ◽  
United Nations Convention ◽  
Enforcement Authority ◽  
The Right ◽  
Proper Balance ◽  
High Seas

Operational reporting from the Middle East indicates that the exercise by warships of a right of visit on the high seas, in order to verify the flag of the boarded vessel, is an important part of contemporary maritime enforcement operations. However, this reliance on ‘flag verification boardings,’ pursuant to Article 110 of the United Nations Convention on the Law of the Sea 1982, challenges the proper balance of law enforcement authority against the traditional freedom of navigation. It is therefore necessary to establish clearly for both civilian masters and warship commanders where the evidentiary threshold for reasonable doubt as to the nationality of vessels lies, so as to justify non-consensual visit and search by a foreign warship. This article makes an objective, evidence-based assessment of the threshold, concluding with a caution against over-stretching the right of visit to accommodate law enforcement purposes not envisaged in the drafting of Article 110.

scholarly journals Psychotic spectrum disorders in childhood

2008 ◽  
Vol 136 (9-10) ◽  
pp. 555-558
Author(s):  
Smiljka Popovic-Deusic ◽  
Milica Pejovic-Milovancevic ◽  
Saveta Draganic-Gajic ◽  
Olivera Aleksic-Hil ◽  
Dusica Lecic-Tosevski
Keyword(s):  
Diagnostic Criteria ◽  
Pervasive Developmental Disorders ◽  
Developmental Disorders ◽  
Psychotic Disorders ◽  
Classification Systems ◽  
Infancy And Childhood ◽  
Icd 10 ◽  
Long Time ◽  
Early Infantile Autism ◽  
The Right

For a long time, there was a strong belief of existing continuity between childhood-onset psychoses and adult psychoses. Important moment in understanding psychotic presentations during infancy and childhood is Kanner's description of early infantile autism. Later studies of Rutter and Kolvin, as well as new classification systems, have delineated pervasive developmental disorders from all other psychotic disorders in childhood. But clinical experience is showing that in spite of existence of the group of pervasive developmental disorders with subgroups within it and necessary diagnostic criteria there are children with pervasive symptoms, who are not fulfilling all necessary diagnostic criteria for pervasive developmental disorder. Therefore, in this paper we are discussing and pointing at psychotic spectrum presentations in children, which have not the right place in any existing classification system (ICD-10, DSM-IV).

scholarly journals Nurse Advocacy: Adopting a Health in All Policies Approach

2018 ◽  
Vol 23 (3) ◽  
Author(s):  
Shanita Williams ◽  
Janice Phillips ◽  
Kirk Koyama
Keyword(s):  
Social Determinants ◽  
Social Factors ◽  
Social Groups ◽  
Health Inequities ◽  
Health Needs ◽  
Economic Conditions ◽  
Evidence Based ◽  
Health In All Policies ◽  
Policy Advocacy ◽  
The Right

Policy advocacy and committed resources are essential to address social factors that shape population health. In this article, we discuss nurse advocacy to advance public health and health equity through targeted social determinants, particularly on behalf of poor and disadvantaged persons. We discuss components of the right social policies and consider evidence-based policies that have linked improvements in social and economic conditions with increased physical, emotional, and mental health outcomes among poor and disadvantaged social groups. With a partnership perspective, select social determinants of health (SDOH) and mitigating policies focus nurses' social policy advocacy to improve the health of disadvantaged populations and reduce health inequities. We suggest nurses engage in multisectoral partnerships and adopt a Health in All Policies (HiAP) approach to address social and health needs of concern. The conclusion offers resources and strategies to promote nurse engagement in health policy.

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