Longitudinal Follow-Up of Death Anxiety and Psychophysical-Symptom Experience of Participants in the Silent Mentor Program

2021 ◽  
pp. 003022282110436
Author(s):  
Li Ping Wong ◽  
Sik Loo Tan ◽  
Haridah Alias ◽  
Thiam Eng Sia ◽  
Aik Saw

This study assessed death anxiety (Death Anxiety Questionnaire, DAQ) and psychophysical- (psychological and physical) symptom experience following cadaveric dissection among the Silent Mentor Program (SMP) participants before thawing (T1), after the suturing, dressing and coffining session (T2), and one month post-program (T3). There was a significant decline in the total DAQ score comparing T1 and T2 ( t = 7.69, p < 0.001) and T2 and T3 ( t = 5.00, p < 0.001) and T1 and T3 (t = 10.80, p < 0.001). There was a significant reduction in total psychological-symptom score comparing T1 and T2 ( t = 4.92, p < 0.001) and between T1 and T3 ( t = 4.85, p < 0.001). However, for the physical-symptom experience, a significant increase in the physical-symptom score between T1 and T2 ( t = –3.25, p = 0.001) was reported but the scores reduced significantly one month after the program (T2–T3; t = 4.12, p < 0.001). The mentoring concept of the SMP program has beneficial effects on improving attitude towards death and psychophysical-symptom experience associated with cadaver dissection.

2020 ◽  
Vol 12 (1) ◽  
pp. 39-47
Author(s):  
Kumudini Subedi ◽  
Binita Sharma ◽  
Sabina Shrestha

Introduction: Vernal Keratoconjunctivitis is a chronic bilateral seasonally exacerbated allergy affecting the conjunctiva and cornea of children. As technology has advanced, newer medications have been developed for the control of the disease. Purpose: To assess the effectiveness of an immunomodulator, cyclosporine, in the treatment of vernal keratoconjunctivitis. Materials and methods: Fifty patients of moderate, severe to very severe vernal keratoconjunctivitis were selected for the study. They were given cyclosporine 0.05% eye drops in loading dose followed by gradual tapering. Symptoms and signs were recorded at presentation, after two weeks, after four weeks, after two months and after three months. Results: Vernal keratoconjunctivitis, being a chronic disease showed marked improvement with immunomodulator therapy. There was significant improvement in the symptom and sign score initially, at the first follow up itself with symptom score reduction from median of mean of 2.4 to 0.6 (p=0.00) and a similar sign score reduction from 1.75 to 0.625 (p=0.00). There was gradually more improvement as therapy continued and the beneficial effects were maintained till the end point of the study at three months where median of mean symptom score was 0.4 (p=0.00) and similar sign score of 0.375 (p= 0.000). Conclusion: Topical cyclosporine proved to be an effective and safe treatment strategy to treat cases of moderate, severe and very severe vernal keratoconjunctivitis.


2019 ◽  
Vol 18 (3) ◽  
pp. 232-238 ◽  
Author(s):  
Emanuela Onesti ◽  
Vittorio Frasca ◽  
Marco Ceccanti ◽  
Giorgio Tartaglia ◽  
Maria Cristina Gori ◽  
...  

Background: The cannabinoid system may be involved in the humoral mechanisms at the neuromuscular junction. Ultramicronized-palmitoylethanolamide (μm-PEA) has recently been shown to reduce the desensitization of Acetylcholine (ACh)-evoked currents in denervated patients modifying the stability of ACh receptor (AChR) function. <p> Objective: To analyze the possible beneficial effects of μm-PEA in patients with myasthenia gravis (MG) on muscular fatigue and neurophysiological changes. <p> Method: The duration of this open pilot study, which included an intra-individual control, was three weeks. Each patient was assigned to a 1-week treatment period with μm-PEA 600 mg twice a day. A neurophysiological examination based on repetitive nerve stimulation (RNS) of the masseteric and the axillary nerves was performed, and the quantitative MG (QMG) score was calculated in 22 MG patients every week in a three-week follow-up period. AChR antibody titer was investigated to analyze a possible immunomodulatory effect of PEA in MG patients. <p> Results: PEA had a significant effect on the QMG score (p=0.03418) and on RNS of the masseteric nerve (p=0.01763), thus indicating that PEA reduces the level of disability and decremental muscle response. Antibody titers did not change significantly after treatment. <p> Conclusion: According to our observations, μm-PEA as an add-on therapy could improve muscular response to fatigue in MG. The possible modulation of AChR currents as a means of eliciting a direct effect from PEA on the conformation of ACh receptors should be investigated. The co-role of cytokines also warrants an analysis. Given the rapidity and reversibility of the response, we suppose that PEA acts directly on AChR, though further studies are needed to confirm this hypothesis.


Author(s):  
Luca Pingani ◽  
Sara Evans-Lacko ◽  
Sandra Coriani ◽  
Silvia Ferrari ◽  
Maria Filosa ◽  
...  

The primary aim is to describe the changes in the knowledge of mental health conditions, the attitudes toward the mentally ill, and the intended behaviour towards people with mental illness among the entire student population of the third year of a degree course in Psychology. A total of 570 students attended a seminar on stigma towards mental illness and were invited to complete an online survey which collected data on sociodemographic characteristics and three validated questionnaires evaluating different aspects of stigma at three different time points (pre-intervention, post-intervention, and at one year follow up). A total of 253 students (44.39%) completed the questionnaires at t0, t1, and t2. The mean age of the sample was 23.7 (SD = ±5.89), and 86.96% (n = 220) were females. Between t0 and t1, a statistically significant improvement was observed for all three outcomes, while the intended behaviour outcome was no longer significant between t1 and t2 (Z = −0.70; p = 0.48). Females and who participated live at the seminar maintained a significant knowledge of mental illness and a better attitude toward community mental health care. The effects of the seminar focused on reducing stigma tended to diminish over time at one year follow-up, particular in relation to intended behaviour.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lin Yan ◽  
Mingbo Zhang ◽  
Fang Xie ◽  
Jun Ma ◽  
Jing Xiao ◽  
...  

Abstract Background Radiofrequency ablation (RFA) is recommended for the treatment of benign thyroid nodules. However, data on the clinical role of RFA for benign thyroid nodules in patients with history of thyroid lobectomy are insufficient. The purpose of this study was to evaluate the efficacy and safety of radiofrequency ablation (RFA) for benign thyroid nodules in patients who had previously undergoing thyroid lobectomy. Methods From May 2015 to October 2018, a total of 20 patients (19 females, 1 male, mean age 49.50 ± 14.26 years, range 22–74 years) with 20 benign thyroid nodules (mean volume 15.04 ± 21.17 ml, range 0.40–69.67 ml) who had undergone previous thyroid lobectomy were included in this retrospective study. Patients were followed up at 3, 6, 12 months after RFA and every 12 months thereafter by ultrasound, clinical evaluation and thyroid function. Volume, volume reduction rate (VRR), symptom score and cosmetic score were evaluated. Results During the mean follow-up time of 21.24 ± 16.41 months, the mean nodule volume decreased significantly from 15.04 ± 21.17 ml to 1.29 ± 1.17 ml (P = 0.018) with a mean VRR of 85.41 ± 12.17%. Therapeutic success was achieved in a single session for all thyroid nodules. The symptom score (P = 0.001) and cosmetic score (P = 0.001) were both significantly reduced at the last follow-up. The levels of free triiodothyronine (fT3), free thyroxine (fT4) and thyroid stimulating hormone were not significantly different at the last follow-up from those prior to treatment (all P > 0.05). No life-threatening complications or sequelae occurred after RFA. Conclusions As a minimally invasive modality, RFA was a safe, effective, and thyroid function-preserving option for patients with symptomatic benign thyroid nodules after a previous lobectomy.


2016 ◽  
Vol 61 (12) ◽  
pp. 797-802 ◽  
Author(s):  
Geneviève Gariépy ◽  
Frank J. Elgar

Objective: To describe trends in psychological health symptoms in Canadian youth from 2002 to 2014 and examine gender and socioeconomic differences in these trends. Method: We used data from the Canadian Health Behaviour in School-aged Children (HBSC) study. We assessed psychological symptoms from a validated symptom checklist and calculated a symptom score (range, 0-16). We stratified our analyses by gender and affluence tertile based on an index of material assets. We then plotted trends in symptom score and calculated the probability of experiencing specific symptoms over time. Results: Between 2002 and 2014, psychological symptom score increased by 1.01 (95% confidence interval [CI], 0.73 to 1.41), 1.08 (95% CI, 0.79 to 1.37), and 0.84 (95% CI, 0.55 to 1.13) points in girls in the low-, middle-, and high-affluence tertiles, respectively. In boys, psychological symptoms decreased by –0.39 (95% CI, –0.66 to –0.12) and –0.12 (95% CI, –0.43 to 0.19) points in the high- and middle-affluence tertiles, respectively, and increased by 0.30 (95% CI, –0.04 to 0.63) points in the low-affluence tertile. The probability of feeling anxious and having sleep problems at least once a week notably increased in girls from all affluence groups, while the probability of feeling depressed and irritable decreased among boys from the high-affluence tertile. Conclusion: Psychological symptoms increased in Canadian adolescent girls across all affluence groups while they remained stable in boys from low and middle affluence and decreased in boys from high affluence. Specific psychological symptoms followed distinct trends. Further research is needed to uncover the mechanisms driving these trends.


2020 ◽  
Vol 11 (5) ◽  
pp. 469-476
Author(s):  
X. Qi ◽  
G. Fan ◽  
H. Jia

Vestibular migraine (VM) has emerged as one of the major vestibular syndromes. Although probiotics have exhibited beneficial effects on migraine headache, its effect on VM is not clear. This trial aimed to investigate the treatment efficacy of the probiotic Lactobacillus casei Shirota (LcS) on symptoms of VM. 247 VM patients were enrolled, of which 204 eligible patients receiving either LcS or placebo on a daily basis completed the 4 month study. They were re-visited at 2 and 4 months after study initiation to assess treatment outcomes. The primary endpoints were vestibular symptoms, evaluated by the number of vertiginous attacks during the past week, the Vertigo Severity Score (VSS), and Dizziness Handicap Inventory (DHI) scores. The secondary endpoints were anxiety and depressive symptoms, evaluated using Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) scores. Efficacy of LcS over placebo was not obvious at 2 month follow-up. At 4 month follow-up, while both LcS and placebo groups of VM patients displayed alleviated symptoms, the extents of the improvements were significantly better in LcS group than those of placebo group, with regard to vestibular symptoms using DHI and VSS, as well as anxiety and depressive symptoms using BAI and BDI. Although placebo effect cannot be ignored in intervention for VM patients, the probiotic LcS still exhibits considerable efficacy against VM symptoms over a 4 month study period, supporting further clinical study of a larger and more diverse cohort.


2020 ◽  
Vol 34 (4) ◽  
pp. 346-354
Author(s):  
Michele Honicky ◽  
João Paulo Zattar ◽  
Mariana Saciloto ◽  
Mariana Abe Vicente Cavagnari ◽  
Claudia Nodari ◽  
...  

Introduction: Immunomodulator glutamine and probiotic Lactobacillus at certain doses have beneficial effects by modulation of the immune system and may assist in the integrity of therespiratory system. However, studies about the effects of glutamine or Lactobacillus pool on the prevention and control of asthma in children are still scarce. The aim of study was to evaluate the effect of the use of glutamine and Lactobacillus pool on the attenuation of clinical asthma symptoms in children. Methods: Longitudinal study, 45 children with medical diagnosis of asthma distributed in three groups: control group (C), glutamine group (G), Lactobacillus group (L). Group G was supplemented with L-glutamine powder (0.3 g/kg/day). Group L used a pool of Lactoba- cillus (Lactobacillus casei, paracasei, rhamnosus, acidophilus and Bifidobacterium lactis) (2 g/day). Group C received no glutamine or Lactobacillus pool. Clinical characteristics and symptoms of respiratory diseases were assessed by study-specific anamnesis and ISSAC Questionnaire (to obtain diagnostic scores and asthma symptoms) for 4 months. To test for differences between groups, the ANOVA test with Tukey post-hoc test was used. It was considered significant p <0.05. Results: Initial ISSAC score was (C=8.67±1.77, L=7.80±1.52 and G=8.00 ± 1.46, p=0.31). At the first follow-up, the ISSAC score indicated that group G had improvement in the clinical characteristics of asthma (C=6.47±2.29, L = 5.07±2.28, G = 4.00±1.73, p <0.05), as also occurred in the following months until the last follow-up (C=5.93±2.28, L=5.13±2.13, G=4.00±1.96, p<0.05). After supplementation, group G presented lower mean duration of asthma attack (p=0.01), lower number of asthma attack (p<0.05), lower prevalence of typical asthma symptoms, as cough and wheezing (p<0.05). Conclusion: Glutamine supplementation attenuated the typical asthma symptoms, while the use of Lactobacillus pool did not attenuate the symptoms. Glutamine may be a new strategy for prevention and control of asthma in children.


Author(s):  
Sloane A McGraw ◽  
Chris Healy ◽  
Burhan Mohamedali ◽  
Anupama Shivaraju ◽  
Adhir Shroff

Background: Management of lipids is vital in patients with underlying coronary artery disease (CAD). According to the American College of Cardiology (ACC) guidelines, all patients with CAD should have low density lipoproteins (LDL) goals to be less than 100 mg/dl with the therapeutic option of treatment to less than 70 mg/dl. This can be achieved using multiple lipid lowering agents, however statin use is encouraged in CAD patients due to its multiple beneficial effects. Methods: We conducted a retrospective cohort study focusing on lipid management and statin use in 857 veterans undergoing percutaneous coronary intervention (PCI) between September 2004 and December 2009 at the Jesse Brown Veterans Hospital in Chicago, IL. Values were collected both pre-intervention as well as at six month follow up. Results: Both pre and post PCI, focus was maintained on the total cholesterol as well as the LDL levels. The mean total cholesterol prior to intervention was 166mg/dl and decreased to150mg/dl at six month follow up. The LDL mean pre-PCI was 98mg/dl and at six months the mean LDL decreased to 86mg/dl. With regards to ACC guidelines, the percent at goal for LDL less than 100mg/dl increased from 59% pre-PCI to 74% post-PCI Furthermore, treatment to less than 70mg/dl increased from 22 to 32% at six months. Lastly, the use of statins increased from 72 to 89%. Conclusions: There were in improvements in both total cholesterol and LDL values at six months post-PCI. There were also improvements in the percentage of patients who met the ACC recommended goal of LDL cholesterol less than 100mg/dl and the suggested goal of 70mg/dl. At six months, there was also an increase in usage of statin therapy.


1995 ◽  
Vol 166 (1) ◽  
pp. 61-67 ◽  
Author(s):  
Hai-Gwo Hwu ◽  
Happy Tan ◽  
Chu-Chang Chen ◽  
Ling-Ling Yeh

BackgroundThe clinical significance in schizophrenia of positive and negative symptoms at discharge was assessed.MethodOf schizophrenic patients fulfilling DSM–III criteria, 113 were recruited for this study. Personal, social and psychopathological data were collected and all cases were followed up at one and two years after discharge.ResultsThe presence of positive symptoms (64 cases), without concomitant negative symptoms, did not predict the follow-up social function and positive symptom score. Conversely, the presence of negative symptoms (31 cases) predicted worse social functioning (P < 0.05 to P < 0.005) and higher positive symptom scores (P < 0.01) at follow-up using MANOVA. Eighteen cases (15.9%) had neither positive nor negative symptoms and had the best clinical outcome.ConclusionsNegative, but not positive, symptoms assessed at discharge are an important predictor of poor outcome. In addition, negative symptoms may themselves expose a biological vulnerability to the presence of positive symptoms.


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