scholarly journals Development and psychometric evaluation of the Transdiagnostic Decision Tool: matched care for patients with a mental disorder in need of highly specialised care

BJPsych Open ◽  
2020 ◽  
Vol 6 (5) ◽  
Author(s):  
Frédérique C. W. van Krugten ◽  
Christina M. van der Feltz-Cornelis ◽  
Manon A. Boeschoten ◽  
Saskia A. M. van Broeckhuysen-Kloth ◽  
Jonna F. van Eck van der Sluijs ◽  
...  
Keyword(s):  
Convergent Validity ◽  
Interrater Reliability ◽  
Mental Health Problems ◽  
Treatment Strategies ◽  
Area Under The Curve ◽  
Mental Healthcare ◽  
Psychometric Evaluation ◽  
Post Traumatic Stress ◽  
Decision Tool ◽  
Decision Tools

Background Early identification of patients with mental health problems in need of highly specialised care could enhance the timely provision of appropriate care and improve the clinical and cost-effectiveness of treatment strategies. Recent research on the development and psychometric evaluation of diagnosis-specific decision-support algorithms suggested that the treatment allocation of patients to highly specialised mental healthcare settings may be guided by a core set of transdiagnostic patient factors. Aims To develop and psychometrically evaluate a transdiagnostic decision tool to facilitate the uniform assessment of highly specialised mental healthcare need in heterogeneous patient groups. Method The Transdiagnostic Decision Tool was developed based on an analysis of transdiagnostic items of earlier developed diagnosis-specific decision tools. The Transdiagnostic Decision Tool was psychometrically evaluated in 505 patients with a somatic symptom disorder or post-traumatic stress disorder. Feasibility, interrater reliability, convergent validity and criterion validity were assessed. In order to evaluate convergent validity, the five-level EuroQol five-dimensional questionnaire (EQ-5D-5L) and the ICEpop CAPability measure for Adults (ICECAP-A) were administered. Results The six-item clinician-administered Transdiagnostic Decision Tool demonstrated excellent feasibility and acceptable interrater reliability. Spearman's rank correlations between the Transdiagnostic Decision Tool and ICECAP-A (−0.335), EQ-5D-5L index (−0.386) and EQ-5D-visual analogue scale (−0.348) supported convergent validity. The area under the curve was 0.81 and a cut-off value of ≥3 was found to represent the optimal cut-off value. Conclusions The Transdiagnostic Decision Tool demonstrated solid psychometric properties and showed promise as a measure for the early detection of patients in need of highly specialised mental healthcare.

scholarly journals Development and psychometric evaluation of performance-based upper extremity motor control test (PB-UE-MCT) for people with cerebral palsy

2021 ◽  
Vol 29 ◽  
Author(s):  
Fatemeh Etemad Shams ◽  
Malek Amini ◽  
Afsoon Hassani Mehraban ◽  
Mehdi Alizadeh Zarei ◽  
Dorsa Kalani
Keyword(s):  
Cerebral Palsy ◽  
Motor Control ◽  
Upper Extremity ◽  
Internal Consistency ◽  
Convergent Validity ◽  
Interrater Reliability ◽  
Correlation Coefficients ◽  
Psychometric Evaluation ◽  
Control Test ◽  
Intrarater Reliability

Abstract Introduction Upper extremity disorders limits the performance in the activities of daily living, especially, in bilateral (two-handed) activities. Objective This study was designed to develop a performance-based upper extremity motor control test (PB-UE-MCT) and to measure its psychometric properties (including, convergent validity, intrarater reliability, and interrater reliability) for people with cerebral palsy (CP). Method The PB-UE-MCT was developed in three phases, including planning, construction, and psychometric evaluation. The participants included 50 people with CP with an age range of 6 to 18 years. To measure internal consistency, Cronbach's alpha was run (n=50). Intrarater and interrater reliability was measured for 25 participants. To assess convergent validity, the correlations of the PB-UE-MCT with the Manual Ability Classification System (MACS) and with the Selective Control Upper Extremity Scale (SCUES) were calculated. Results The values obtained for Cronbach's alpha (.90 to .96) indicated the excellent internal consistency of the PB-UE-MCT. The ICC values for intrarater reliability and interrater reliability were between .84 and .99 and between .89 and .99, respectively. The correlation coefficients obtained for the items of the PB-UE-MCT and those of the MACS were between .51 and .73. The correlation coefficients of the items of the PB-UE-MCT with those of the SCUES were in the range of .67 to .98, which proves the PB-UE-MCT's good to excellent levels of convergent validity. Conclusion The results confirm that the PB-UE-MCT is a valid and reliable tool for evaluating the upper extremity performance of people with CP through task analysis.

scholarly journals Veteran and military mental health: the Australian experience

2014 ◽  
Vol 11 (4) ◽  
pp. 83-85 ◽  
Author(s):  
David Forbes ◽  
Olivia Metcalf
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Mental Healthcare ◽  
Publicly Funded ◽  
Post Traumatic Stress ◽  
Military Mental Health ◽  
Evidence Based Treatments ◽  
Post Traumatic ◽  
Australian Experience ◽  
Peacekeeping Missions

Australia has deployed over 25 000 personnel to recent conflicts in the Middle East and has been involved in peacekeeping missions. Australian veterans report elevated rates of mental health problems such as post-traumatic stress disorder, anxiety disorders, affective disorders and substance use disorders. Veteran healthcare is delivered through publicly funded services, as well as through private services, at primary, secondary and tertiary levels. Some of the challenges involve coordination of services for veterans transitioning from Defence to Veterans' Affairs, service delivery across a large continent and stigma inhibiting service-seeking. Initiatives have been introduced in screening and delivery of evidence-based treatments. While challenges remain, Australia has come a long way towards an integrated and comprehensive approach to veteran mental healthcare.

CODEM Instrument

GeroPsych ◽  
2014 ◽  
Vol 27 (1) ◽  
pp. 23-31 ◽  
Author(s):  
Anne Kuemmel (This author contributed eq ◽  
Julia Haberstroh (This author contributed ◽  
Johannes Pantel
Keyword(s):  
Convergent Validity ◽  
Interrater Reliability ◽  
Discriminant Validity ◽  
Assessment Tool ◽  
Intraclass Correlation ◽  
Well Being ◽  
Communication Behavior ◽  
People With Dementia ◽  
Pearson's R ◽  
Pearson’S R

Communication and communication behaviors in situational contexts are essential conditions for well-being and quality of life in people with dementia. Measuring methods, however, are limited. The CODEM instrument, a standardized observational communication behavior assessment tool, was developed and evaluated on the basis of the current state of research in dementia care and social-communicative behavior. Initially, interrater reliability was examined by means of videoratings (N = 10 people with dementia). Thereupon, six caregivers in six German nursing homes observed 69 residents suffering from dementia and used CODEM to rate their communication behavior. The interrater reliability of CODEM was excellent (mean κ = .79; intraclass correlation = .91). Statistical analysis indicated that CODEM had excellent internal consistency (Cronbach’s α = .95). CODEM also showed excellent convergent validity (Pearson’s R = .88) as well as discriminant validity (Pearson’s R = .63). Confirmatory factor analysis verified the two-factor solution of verbal/content aspects and nonverbal/relationship aspects. With regard to the severity of the disease, the content and relational aspects of communication exhibited different trends. CODEM proved to be a reliable, valid, and sensitive assessment tool for examining communication behavior in the field of dementia. CODEM also provides researchers a feasible examination tool for measuring effects of psychosocial intervention studies that strive to improve communication behavior and well-being in dementia.

Psychological/psychiatric impact of the novel coronavirus outbreak: lessons learnt from China and call for timely crisis interventions in Italy

2020 ◽  
Author(s):  
Patrizia Zeppegno ◽  
Carla Gramaglia ◽  
Chiara Guerriero ◽  
Fabio Madeddu ◽  
Raffaella Calati
Keyword(s):  
Mental Health ◽  
Migrant Workers ◽  
Mental Health Problems ◽  
Virus Disease ◽  
Selection Process ◽  
Psychiatric Patients ◽  
Homeless People ◽  
World Health ◽  
Rapid Review ◽  
Post Traumatic Stress

Background: The World Health Organization declared the Corona Virus Disease 19 (Covid-19) a pandemic in March 2020. Psychological impact of Covid-19 can be consisent and should be prevented with adequate measures. Methods: We performed a literature mini review searching for studies in PubMed focusing on the psychological/psychiatric impact of Covid-19.Results: The selection process yielded 34 papers focusing on the relation between Covid-19 and mental health: 9 correspondence, 8 letters to the editor, 7 commentaries, 3 editorials, 4 original studies, 2 brief reports, and 1 a rapid review. The majority of the articles were performed in China. They focused on the general population and particular categories considered more fragile, e.g., psychiatric patients, older adults, international migrant workers, homeless people. Authors are unanimous in believing that Covid-19 will likely increase the risk of mental health problems and worsen existing psychiatric disorders/symptoms in patients, exposed subjects, and staff. Together with the negative emotionality related to the unpredictability of the situation, uncertainty concerning the risk, excessive fear, fear of death, loneliness, guilt, stigma, denial, anger, frustration, boredome, some symptoms might appear such as insomnia until patophobia (specifically, coronaphobia), depressive and anxiety disorders, post-traumatic stress disorder, and suicidal risk.Limitations: Literature is rapidly increasing and present results are only partial. Conclusions: Mental health care should not be overlooked in this moment. The experience of China should be of help for all the countries facing with Covid-19, among them Italy.

An Unbiased Predictive Model to Detect DNA Methylation Propensity of CpG Islands in the Human Genome

2020 ◽  
Vol 15 ◽  
Author(s):  
Dicle Yalcin ◽  
Hasan H. Otu
Keyword(s):  
Model Building ◽  
De Novo ◽  
Cpg Islands ◽  
Treatment Strategies ◽  
Area Under The Curve ◽  
Global Methylation ◽  
Sequence Features ◽  
A Genome ◽  
Combined Features ◽  
Epigenetic Repression

Background: Epigenetic repression mechanisms play an important role in gene regulation, specifically in cancer development. In many cases, a CpG island’s (CGI) susceptibility or resistance to methylation are shown to be contributed by local DNA sequence features. Objective: To develop unbiased machine learning models–individually and combined for different biological features–that predict the methylation propensity of a CGI. Methods: We developed our model consisting of CGI sequence features on a dataset of 75 sequences (28 prone, 47 resistant) representing a genome-wide methylation structure. We tested our model on two independent datasets that are chromosome (132 sequences) and disease (70 sequences) specific. Results: We provided improvements in prediction accuracy over previous models. Our results indicate that combined features better predict the methylation propensity of a CGI (area under the curve (AUC) ~0.81). Our global methylation classifier performs well on independent datasets reaching an AUC of ~0.82 for the complete model and an AUC of ~0.88 for the model using select sequences that better represent their classes in the training set. We report certain de novo motifs and transcription factor binding site (TFBS) motifs that are consistently better in separating prone and resistant CGIs. Conclusion: Predictive models for the methylation propensity of CGIs lead to a better understanding of disease mechanisms and can be used to classify genes based on their tendency to contain methylation prone CGIs, which may lead to preventative treatment strategies. MATLAB and Python™ scripts used for model building, prediction, and downstream analyses are available at https://github.com/dicleyalcin/methylProp_predictor.

Psychotherapeutic components of commercially available virtual reality games (Preprint)

2020 ◽  
Author(s):  
Almira Osmanovic Thunström ◽  
Iris Sarajlic Vuković ◽  
Lilas Ali ◽  
Tomas Larson ◽  
Steinn Steingrimsson
Keyword(s):  
Mental Health ◽  
Virtual Reality ◽  
Mental Health Problems ◽  
Treatment Strategies ◽  
Treatment Method ◽  
Health Problems ◽  
E Learning ◽  
The Mean ◽  
Unique Games

BACKGROUND Immersive virtual reality (VR) games are increasingly becoming part of everyday life. Several studies support immersive VR technology as a treatment method for mental health problems. There is however minimal research into the feasibility, prevalence, and quality of commercially available VR games on commercial platforms as tools for treatment or add on to treatment of mental health problems. OBJECTIVE The aim of this study was to explore the prevalence, feasibility and quality of commercially available games related to psychotherapy on a commercially available platform. METHODS We performed a search for keywords related to diagnosis and treatment strategies of mental health problems. The search was performed during March 27th on STEAM (VR content and gaming platform). A usability scale was used as a tool to look at the interaction and usability of the games, the VR-UI-UX-8. The tool contains 8 statements about usability scored 0-10, 0 indicating “Not at all” and 10 indicating “very much so”. The score ranges from 0-80 with a higher score indicating worse usability. RESULTS In total, 516 hits were found, 371 unique games. After the games were reviewed, 83 games passed the inclusion criteria, were purchased and played. Majority of the games which were excluded were either not connected to mental health, contained violence, adult content or were in other ways irrelevant or inappropriate. The mean score for the games on the VR-UI-UX-8 was 16.5 (standard deviation 15.8) with a range from 0-68. Most relevant and feasible games were found in the search words meditation, mindfulness, and LSD. CONCLUSIONS Commercial platforms hold great potential for VR games with psychotherapeutic components. The platforms are only at the beginning of the development towards serious games, e-learning and psychotherapeutic treatments. Currently the quality and usability for clinical and at home applicability are scarce, but hold great potential.

Interventions for Mental Health Problems in Later Life

2010 ◽  
pp. 810-837
Author(s):  
Jason M. Holland ◽  
Dolores Gallagher-Thompson
Keyword(s):  
Older Adults ◽  
Mental Health Problems ◽  
Later Life ◽  
Clinical Psychologist ◽  
Post Traumatic Stress ◽  
Future Directions ◽  
Use Of Technology ◽  
Worldwide Population ◽  
Challenges And Opportunities ◽  
Post Traumatic

Older adults are increasingly making up a larger segment of the worldwide population, which presents both challenges and opportunities for the clinical psychologist in the 21st century. In this chapter, we address some of the unique aspects of working with this population, focusing on general guidelines for tailoring interventions for older adults, specific treatments for particular problems commonly faced in later life, as well as issues of diversity and how they might impact psychotherapy with older clients. We also outline several areas in geropsychology that are in need of further investigation, namely the use of technology, post-traumatic stress, and family therapy, and offer some recommendations for future directions in this field of study.

scholarly journals Physiological parameters of mental health predict the emergence of post-traumatic stress symptoms in physicians treating COVID-19 patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
T. Dolev ◽  
S. Zubedat ◽  
Z. Brand ◽  
B. Bloch ◽  
E. Mader ◽  
...  
Keyword(s):  
Mental Health ◽  
Sleep Quality ◽  
Traumatic Stress ◽  
A Priori ◽  
Treatment Strategies ◽  
Physiological Measures ◽  
Post Traumatic Stress ◽  
Stress Symptoms ◽  
Post Traumatic

AbstractLack of established knowledge and treatment strategies, and change in work environment, may altogether critically affect the mental health and functioning of physicians treating COVID-19 patients. Thus, we examined whether treating COVID-19 patients affect the physicians’ mental health differently compared with physicians treating non-COVID-19 patients. In this cohort study, an association was blindly computed between physiologically measured anxiety and attention vigilance (collected from 1 May 2014 to 31 May 31 2016) and self-reports of anxiety, mental health aspects, and sleep quality (collected from 20 April to 30 June 2020, and analyzed from 1 July to 1 September 2020), of 91 physicians treating COVID-19 or non-COVID-19 patients. As a priori hypothesized, physicians treating COVID-19 patients showed a relative elevation in both physiological measures of anxiety (95% CI: 2317.69–2453.44 versus 1982.32–2068.46; P < 0.001) and attention vigilance (95% CI: 29.85–34.97 versus 22.84–26.61; P < 0.001), compared with their colleagues treating non-COVID-19 patients. At least 3 months into the pandemic, physicians treating COVID-19 patients reported high anxiety and low quality of sleep. Machine learning showed clustering to the COVID-19 and non-COVID-19 subgroups with a high correlation mainly between physiological and self-reported anxiety, and between physiologically measured anxiety and sleep duration. To conclude, the pattern of attention vigilance, heightened anxiety, and reduced sleep quality findings point the need for mental intervention aimed at those physicians susceptible to develop post-traumatic stress symptoms, owing to the consequences of fighting at the forefront of the COVID-19 pandemic.

scholarly journals Does the Type of Exposure to Workplace Violence Matter to Nurses’ Mental Health?

Healthcare ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 41
Author(s):  
Farinaz Havaei
Keyword(s):  
Mental Health ◽  
Workplace Violence ◽  
Violence Exposure ◽  
Mental Health Problems ◽  
Survey Methods ◽  
Health Problems ◽  
Cumulative Exposure ◽  
Post Traumatic Stress ◽  
Indirect Exposure ◽  
The Impact

Workplace violence is a prevalent phenomenon in healthcare, particularly among nursing professionals. Exposure to workplace violence may be direct through firsthand involvement, indirect through secondhand witnessing, or both. Even though implications for victims of workplace violence have been well-studied, less is known about the various types of exposure and their effects on nurse mental health. The purpose of this study is to examine the impact of workplace-violence exposure types on the mental health of nurses, while accounting for the intensity of the incident/s. This study employs an exploratory correlational design with survey methods. Nurses from British Columbia (BC), Canada, were invited by the provincial nurses’ union to complete an electronic survey in Fall 2019. A total of 2958 responses from direct-care nurses in acute-care settings were analyzed using logistic regression. The results showed that mental-health problems increased with cumulative exposure; even though nurses with solely indirect exposure to workplace violence did not report greater mental-health problems, those experiencing solely direct exposure, or both direct and indirect exposure, were two to four times more likely to report high levels of post-traumatic stress disorder (PTSD), anxiety, depression and burnout compared to their counterparts with no exposure. There is an urgent need for better mental-health support, prevention policies and practices that take into account the type of workplace-violence exposure.

scholarly journals Gene expression-based biomarkers designating glioblastomas resistant to multiple treatment strategies

2021 ◽  
Author(s):  
Otília Menyhárt ◽  
János Tibor Fekete ◽  
Balázs Győrffy
Keyword(s):  
Gene Expression ◽  
Treatment Strategies ◽  
Area Under The Curve ◽  
Predictive Biomarkers ◽  
Subsequent Treatment ◽  
Survival Status ◽  
Multiple Treatment ◽  
Post Surgery ◽  
Potential Biomarker ◽  
Elevated Expression

Abstract Despite advances in molecular characterization of glioblastoma multiforme (GBM), only a handful of predictive biomarkers exist with limited clinical relevance. We aimed to identify differentially expressed genes in tumor samples collected at surgery associated with response to subsequent treatment, including temozolomide (TMZ) and nitrosoureas. Gene expression was collected from multiple independent datasets. Patients were categorized as responders/nonresponders based on their survival status at 16 months post-surgery. For each gene, the expression was compared between responders and nonresponders with a Mann-Whitney U test and receiver operating characteristic. The package "roc" was used to calculate the area under the curve (AUC). The integrated database comprises 454 GBM patients from three independent datasets and 10,103 genes. The highest proportion of responders (68%) were among patients treated with TMZ combined with nitrosoureas, where FCGR2B upregulation provided the strongest predictive value (AUC=0.72, p &lt; 0.001). Elevated expression of CSTA and MRPS17 was associated with a lack of response to multiple treatment strategies. DLL3 upregulation was present in subsequent responders to any treatment combination containing TMZ. Three genes (PLSCR1, MX1, and MDM2) upregulated both in the younger cohort and in patients expressing low MGMT delineate a subset of patients with worse prognosis within a population generally associated with a favorable outcome. The identified transcriptomic changes provide biomarkers of responsiveness, offer avenues for preclinical studies, and may enhance future GBM patient stratifications. The described methodology provides a reliable pipeline for the initial testing of potential biomarker candidates for future validation studies.

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