Critical Issues in the Evaluation of Comorbidity of Psychiatric Disorders

1996 ◽  
Vol 168 (S30) ◽  
pp. 9-16 ◽  
Author(s):  
Hans-Ulrich Wittchen
Keyword(s):  
Interdisciplinary Approach ◽  
Epidemiological Studies ◽  
Comorbid Conditions ◽  
Substantial Variation ◽  
Research And Practice ◽  
Cognitive Markers ◽  
Potential Value ◽  
Critical Issues ◽  
Definition Of ◽  
Study Designs

Comorbidity has become an increasingly popular theme in psychiatry and clinical psychology, although its heuristic value was recognised long ago. Frequently used in research and practice, no definition of comorbidity is uniformly accepted and it has no comprehensive and coherent theoretical framework. These factors have led to substantial variation in the magnitude of comorbidity across studies. The variability in the definition, assessment and design of comorbidity studies has led to an increasingly complex and confusing picture about the potential value of this concept. The full exploration of mechanisms of comorbidity requires an interdisciplinary approach to investigating nosology, assessment, and underlying models of comorbidity, as well as experimental study designs beyond the scope of clinical and epidemiological studies. A more precise specification of comorbidity patterns might help identify common biochemical and cognitive markers relevant in the aetiology of specific mental disorders as well as comorbid conditions. Critical issues that might help us understand and explain the variability of findings are described.

Critical issues of the biopsychosocial treatment of Parkinson’s disease

2015 ◽  
Vol 156 (12) ◽  
pp. 472-478 ◽  
Author(s):  
Péter Kincses ◽  
Norbert Kovács ◽  
Kázmér Karádi ◽  
János Kállai
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Psychological Health ◽  
Interdisciplinary Approach ◽  
Cognitive Status ◽  
Psychological Burden ◽  
Her Family ◽  
Critical Issues

This paper is a summary report on the basic questions of the biopsychosocial approach to Parkinson’s disease. It deals with cognitive, affective and psychological health issues which significantly influence the outcome of the physical rehabilitation. In spite of the unchanged cognitive status, the psychological burden of the changes in the quality of life, the obstruction, the change in the affective tone, and the shrinking ability to fulfil social roles decrease the patient’s quality of life. An interdisciplinary approach is best suited for mitigating these effects. Not only the patient but also his/her family and environment is seriously affected by the disease and its consequences. Treatment and rehabilitation options for increasing or maintaining the quality of life of the affected patients are diverse, and significantly depend on the features of the health care system. The authors believe that the following review emphasizing health psychological principles may contribute to the work of professionals working in clinical and rehabilitational fields and through them may increase the quality of life of patients and their family. Orv. Hetil., 2015, 156(12), 472–478.

The Rise of Partnerships: From Local to Global

2018 ◽  
Author(s):  
Barbara Gray ◽  
Jill Purdy
Keyword(s):  
Nongovernmental Organizations ◽  
Public Services ◽  
Civic Society ◽  
Robust Solutions ◽  
Essential Components ◽  
Critical Issues ◽  
Definition Of ◽  
Societal Problems ◽  
Shared Norms ◽  
Multistakeholder Partnerships

Multistakeholder partnerships (MSPs) are formed to tackle knotty societal problems, promote innovation, provide public services, expand governance capabilities, set standards for a field, or resolve conflicts that impede progress on critical issues. Partnerships are viewed as collaboration among four types of stakeholders: businesses, governments, nongovernmental organizations (NGOs), and civic society. The objective of collaboration is to create a richer, more comprehensive appreciation of the iss/problem than any of the partners could construct alone by viewing it from the perspectives of all the stakeholders and designing robust solutions. Such partnerships are necessary because few organizations contain sufficient knowledge and resources to fully analyze issues and take action on them unilaterally. Five essential components of a rigorous definition of collaboration are presented: interdependence among partners, emergence of shared norms, wrestling with differences, respect for different competencies, and assuming joint responsibility for outcomes. Several examples of MSPs are provided.

The Roman Retail Revolution

2018 ◽  
Author(s):  
Steven J. R. Ellis
Keyword(s):  
Interdisciplinary Approach ◽  
Vital Role ◽  
Archaeological Material ◽  
Roman World ◽  
The Social ◽  
History Of ◽  
Food And Drink ◽  
Bodies Of Evidence ◽  
Definition Of ◽  
The University

Tabernae were ubiquitous among all Roman cities, lining the busiest streets and dominating their most crowded intersections, and in numbers not known by any other form of building. That they played a vital role in the operation of the city—indeed in the very definition of urbanization—is a point too often under-appreciated in Roman studies, or at best assumed. The Roman Retail Revolution is a thorough investigation into the social and economic worlds of the Roman shop. With a focus on food and drink outlets, and with a critical analysis of both archaeological material and textual sources, Ellis challenges many of the conventional ideas about the place of retailing in the Roman city. A new framework is forwarded, for example, to understand the motivations behind urban investment in tabernae. Their historical development is also unraveled to identify three major waves—or, revolutions—in the shaping of retail landscapes. Two new bodies of evidence underpin the volume. The first is generated from the University of Cincinnati’s recent archaeological excavations into a Pompeian neighborhood of close to twenty shop-fronts. The second comes from a field survey of the retail landscapes of more than a hundred cities from across the Roman world. The richness of this information, combined with an interdisciplinary approach to the lives of the Roman sub-elite, results in a refreshingly original look at the history of retailing and urbanism in the Roman world.

scholarly journals Protocol Deviations: A Holistic Approach from Defining to Reporting

2021 ◽  
Author(s):  
Laura Galuchie ◽  
Catherine Stewart ◽  
Frank Meloni
Keyword(s):  
Holistic Approach ◽  
Rapid Identification ◽  
Study Program ◽  
Protocol Deviation ◽  
Definition Of ◽  
Investigational Agents ◽  
Or Organization ◽  
Study Designs ◽  
Consistent Application

AbstractImproving interpretation of existing guidelines and management of protocol deviation processes could increase process efficiencies and help reduce noise to support rapid identification of important protocol deviations. Towards this end, TransCelerate identified key principles to build upon and clarify the definition of a protocol deviation and developed a holistic approach to protocol deviation management. The approaches are flexible to suit a variety of indications, study designs, and investigational agents while also supporting consistent application within a study, program or organization.

scholarly journals Definitions and Prevalence of Multimorbidity in Large Database Studies: A Scoping Review

2021 ◽  
Vol 18 (4) ◽  
pp. 1673
Author(s):  
Ying Pin Chua ◽  
Ying Xie ◽  
Poay Sian Sabrina Lee ◽  
Eng Sing Lee
Keyword(s):  
Scoping Review ◽  
Chronic Conditions ◽  
Meta Analysis ◽  
Epidemiological Studies ◽  
Cross Sectional ◽  
Coding Systems ◽  
Wide Range ◽  
Scoping Reviews ◽  
Retrospective Cohort Studies ◽  
Definition Of

Background: Multimorbidity presents a key challenge to healthcare systems globally. However, heterogeneity in the definition of multimorbidity and design of epidemiological studies results in difficulty in comparing multimorbidity studies. This scoping review aimed to describe multimorbidity prevalence in studies using large datasets and report the differences in multimorbidity definition and study design. Methods: We conducted a systematic search of MEDLINE, EMBASE, and CINAHL databases to identify large epidemiological studies on multimorbidity. We used the Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews (PRISMA-ScR) protocol for reporting the results. Results: Twenty articles were identified. We found two key definitions of multimorbidity: at least two (MM2+) or at least three (MM3+) chronic conditions. The prevalence of multimorbidity MM2+ ranged from 15.3% to 93.1%, and 11.8% to 89.7% in MM3+. The number of chronic conditions used by the articles ranged from 15 to 147, which were organized into 21 body system categories. There were seventeen cross-sectional studies and three retrospective cohort studies, and four diagnosis coding systems were used. Conclusions: We found a wide range in reported prevalence, definition, and conduct of multimorbidity studies. Obtaining consensus in these areas will facilitate better understanding of the magnitude and epidemiology of multimorbidity.

scholarly journals A Generalized Stability Theorem for Discrete-Time Nonautonomous Chaos System with Applications

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Mei Zhang ◽  
Danling Wang ◽  
Lequan Min ◽  
Xue Wang
Keyword(s):  
Discrete Time ◽  
Chaotic Map ◽  
Stability Theorem ◽  
Pseudorandom Number Generator ◽  
Generalized Synchronization ◽  
Key Space ◽  
Chaos System ◽  
Definition Of ◽  
Study Designs ◽  
Generalized Stability

Firstly, this study introduces a definition of generalized stability (GST) in discrete-time nonautonomous chaos system (DNCS), which is an extension for chaos generalized synchronization. Secondly, a constructive theorem of DNCS has been proposed. As an example, a GST DNCS is constructed based on a novel 4-dimensional discrete chaotic map. Numerical simulations show that the dynamic behaviors of this map have chaotic attractor characteristics. As one application, we design a chaotic pseudorandom number generator (CPRNG) based on the GST DNCS. We use the SP800-22 test suite to test the randomness of four 100-key streams consisting of 1,000,000 bits generated by the CPRNG, the RC4 algorithm, the ZUC algorithm, and a 6-dimensional CGS-based CPRNG, respectively. The numerical results show that the randomness performances of the two CPRNGs are promising. In addition, theoretically the key space of the CPRNG is larger than 21116. As another application, this study designs a stream avalanche encryption scheme (SAES) in RGB image encryption. The results show that the GST DNCS is able to generate the avalanche effects which are similar to those generated via ideal CPRNGs.

Primary Care: The Future for Pediatric Education

PEDIATRICS ◽  
1990 ◽  
Vol 86 (5) ◽  
pp. 653-659
Author(s):  
Joel J. Alpert
Keyword(s):  
Primary Care ◽  
Rural Areas ◽  
Primary Care Physicians ◽  
Geographic Location ◽  
Pediatric Care ◽  
Past Century ◽  
Inner Cities ◽  
Critical Issues ◽  
Definition Of ◽  
Care Problems

There is a continuing crisis in primary care, characterized by inadequate numbers of appropriately trained primary care physicians and the failure to mount an effective and consistent graduate educational program for primary care. This paper reviews the history of the primary care crisis; revisits the definition of primary care; and, through identification of critical issues, presents a primary care educational agenda for the 1990s. Pediatrics is at a crossroads regarding primary care, as powerful social and economic forces are impacting on today's major pediatric care problems. Before the second World War there were more than 300 primary care physicians available for each 100 000 of our population. Today the ratio is 75 for 100 000. This is despite the fact that a shortage of 50 000 physicians 10 years ago no longer exists. The majority view is that a physician surplus of 70 000 will be present by the early 1990s.1 Whether there is a surplus is subject to interpretation and the surplus may end up as nonexistent. Moreover, the availability of primary care physicians varies with geographic location, and even a single figure for this nation provides a distorted picture. The shortage is especially serious in inner cities and in many rural areas. In addition, the use of overall numbers assumes that all primary care physicians are appropriately trained in the general disciplines. For the past century, physicians have cared for patients usually as family physicians. Today, however, the generalist has been replaced by the specialist. Is this a function of financial rewards and society's needs and values or the educational experience?

Cybervictimization. Research Matrix

2021 ◽  
Author(s):  
D.V. Zhmurov ◽  
Keyword(s):  
Meta Analysis ◽  
Interdisciplinary Approach ◽  
The United States ◽  
Personal Factors ◽  
Crime Victim ◽  
Internet Crime ◽  
Definition Of ◽  
Object Of Study ◽  
System Characteristics

The article presents an analysis of the cybervictimization phenomenon. The author justifies the use of an integrative (interdisciplinary) approach to the study of this problem, proposes the definition of the term under study as a process or end result of becoming a crime victim in the sphere of unified computer networks. A theoretical and methodological matrix for the analysis of cybervictimization (PCPPE model) was developed. The model includes five system characteristics of cybervictimization, the comprehensive study of which to a maximum extent will simplify the understanding of the essence of the object of study. These characteristics include: profiling, conditionality, prevalence, predictability and epidemicity. Each of these aspects is explained in detail: the author developed a detailed nomenclature of cybervictimization forms. The problems of identifying its extent, as well as the determinant role of gender, age, behavioral and personal factors are discussed in the article, and a list of key cybervictimization acts is formulated. This meta-analysis includes thirteen global categories and about seventy of its accent forms. Among the global categories the following ones are identified: threats, harassment, illegal interest, infringement, insult, spoofing, disclosure, compulsion, seizure, infecting, access and use. The prevalence rates of cybervictimization on the example of the United States (Internet Crime Report) are also studied, certain aspects of the methodology of cyber victim number counting are considered.

scholarly journals Student access to and skills in using technology in an open and distance learning context

2012 ◽  
Vol 13 (4) ◽  
pp. 250 ◽  
Author(s):  
Hanlie Liebenberg ◽  
Yuraisha Chetty ◽  
Paul Prinsloo
Keyword(s):  
Higher Education ◽  
Distance Learning ◽  
Digital Divide ◽  
South African ◽  
Learning Context ◽  
Access To Technology ◽  
Critical Issues ◽  
Information And Communication ◽  
Definition Of ◽  
South African Higher Education

<p>Amidst the different challenges facing higher education, and particularly distance education (DE) and open distance learning (ODL), access to information and communication technology (ICT) and students’ abilities to use ICTs are highly contested issues in the South African higher education landscape. While there are various opinions about the scope and definition of the digital divide, increasing empirical evidence questions the uncritical use of the notion of the digital divide in South African and international higher education discourses.</p><p>In the context of the University of South Africa (Unisa) as a mega ODL institution, students’ access to technology and their functional competence are some of the critical issues to consider as Unisa prepares our graduates for an increasingly digital and networked world.</p><p>This paper discusses a descriptive study that investigated students’ access to technology and their capabilities in using technology, within the broader discourse of the “digital divide.” Results support literature that challenges a simplistic understanding of the notion of the “digital divide” and reveal that the nature of access is varied.</p>

Second-hand smoke and the risk of tuberculosis: a systematic review and a meta-analysis

2015 ◽  
Vol 143 (15) ◽  
pp. 3158-3172 ◽  
Author(s):  
O. F. DOGAR ◽  
N. PILLAI ◽  
N. SAFDAR ◽  
S. K. SHAH ◽  
R. ZAHID ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Statistical Significance ◽  
Epidemiological Studies ◽  
Second Hand Smoke ◽  
Significant Heterogeneity ◽  
Inclusion Criteria ◽  
Tb Treatment ◽  
Marked Variability ◽  
Shs Exposure ◽  
Study Designs

SUMMARYThere is limited evidence and lack of consensus whether second-hand smoke (SHS) increases risk of tuberculosis (TB), which has substantial implications for unrestricted smoking indoors and TB control policies. We aimed to establish the association between SHS and the risk of acquiring and worsening of TB in non-smokers. We identified 428 articles in the initial search and 12 comparative epidemiological studies met our inclusion criteria. Exposure to SHS was found to have a higher risk of TB infection [risk ratio (RR) 1·19, 95% confidence interval (CI) 0·90–1·57] compared to non-exposure; however, this did not reach statistical significance. There was marked variability (I2 = 74%, P = 0·0008) between studies’ results, which could be explained by the differences in the diagnostic criteria used. Exposure to SHS was found to be statistically significantly associated (RR 1·59, 95% CI 1·11–2·27) with the risk of TB disease. There was significant heterogeneity (I2 = 77%, P = 0·0006) between studies’ results, which was sourced to the internal characteristics of the studies rather than combining different study designs. We did not find any studies for SHS and TB treatment-related outcomes. Thus, we conclude that SHS exposure may increase the risk of acquiring TB infection and progression to TB disease; however, the evidence remains scanty and weak.

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