Intricacies, Complexities, and Limitations of Research on Autism Treatments: An Examination of Seven Treatment Approaches

2011 ◽  
Vol 13 (2) ◽  
pp. 155-168 ◽  
Author(s):  
Burton Norman Seitler
Keyword(s):  
Treatment Method ◽  
Scientific Investigation ◽  
Toxic Substances ◽  
Treatment Approaches ◽  
Factors Associated ◽  
Behavioral Treatments ◽  
Special Diets ◽  
Conducting Research ◽  
Autism Treatments ◽  
Neurotoxic Agent

Part 1 of this article, published in Volume 12, Issue 2, probed factors associated with autism. Many of those factors had to do with how toxic substances are polluting our environment. Investigative chicanery involving one neurotoxic agent in particular (thimerosal) was uncovered. The controversy surrounding this neurotoxic agent was examined in some detail, and questions were raised whether information about the degree of toxicity of thimerosal was being minimized, distorted, or covered up by authorities and agencies in positions of influence. Other potentially harmful sources that might differentially contribute to what some might regard as an autism epidemic were listed and described as well.In this section, science and scientific investigation are described, with particular reference to the complexities, intricacies, and difficulties inherent in conducting research on autistic children, and how these intricacies complicate drawing definitive conclusions about if, how, or why a treatment method did or did not work. In addition, seven treatment approaches to autism are listed, along with concise descriptions of these methods and a general rationale underpinning each method. Considerable attention is paid to applied behavior analysis (ABA) because most behavioral treatments derive from it. Commentary on other treatments is provided, such as psychoanalysis, special diets, and chelation. In particular, aftereffects associated with medication tactics are noted.

scholarly journals Drinking water consumption patterns in Canadian communities (2001–2007)

2011 ◽  
Vol 10 (1) ◽  
pp. 69-86 ◽  
Author(s):  
S. M. Roche ◽  
A. Q. Jones ◽  
S. E. Majowicz ◽  
S. A. McEwen ◽  
K. D. M. Pintar
Keyword(s):  
Drinking Water ◽  
Water Consumption ◽  
Tap Water ◽  
Treatment Method ◽  
Pooled Analysis ◽  
Bottled Water ◽  
Consumption Patterns ◽  
Cross Sectional ◽  
Factors Associated ◽  
Water Users

A pooled analysis of seven cross-sectional studies from Newfoundland and Labrador, Waterloo and Hamilton Regions, Ontario and Vancouver, East Kootenay and Northern Interior Regions, British Columbia (2001 to 2007) was performed to investigate the drinking water consumption patterns of Canadians and to identify factors associated with the volume of tap water consumed. The mean volume of tap water consumed was 1.2 L/day, with a large range (0.03 to 9.0 L/day). In-home water treatment and interactions between age and gender and age and bottled water use were significantly associated with the volume of tap water consumed in multivariable analyses. Approximately 25% (2,221/8,916) of participants were classified as bottled water users, meaning that 75% or more of their total daily drinking water intake was bottled. Approximately 48.6% (4,307/8,799) of participants used an in-home treatment method to treat their tap water for drinking purposes. This study provides a broader geographic perspective and more current estimates of Canadian water consumption patterns than previous studies. The identified factors associated with daily water consumption could be beneficial for risk assessors to identify individuals who may be at greater risk of waterborne illness.

scholarly journals Early postoperative complications and 90-day mortality in patients undergoing radical cystectomy

2020 ◽  
Vol 74 ◽  
pp. 354-361
Author(s):  
Paweł Hackemer ◽  
Bartosz Małkiewicz ◽  
Fryderyk Menzel ◽  
Krzysztof Tupikowski ◽  
Aleksandra Drabik ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Radical Cystectomy ◽  
Complication Rate ◽  
Wound Dehiscence ◽  
Treatment Method ◽  
Regional Lymph Nodes ◽  
Factors Associated ◽  
American Society ◽  
Muscle Invasive

Introduction: The standard treatment method of muscle-invasive bladder cancer is radical cystectomy. This complex procedure consists of removing the urinary bladder with distal ureters and regional lymph nodes. Additionally, the prostate with seminal vesicles in men and uterus with ovaries in women should be excised. Therefore, this demanding oncological surgery is associated with a high occurrence of complications. The aim of this study was to assess the complications after radical cystectomy and identify the factors associated with severe complications and high mortality rate. Materials/Methods: We retrospectively analyzed medical data of 213 patients who underwent a radical cystectomy. Preoperative risk factors were assessed based on American Society of Anesthesiologists classification (ASA) and the Charlson Comorbidity Index (CCI). Clavien-Dindo classification was also included in our analysis. We investigated various factors associated with 30-day and 90-day mortality. Results: Complications after surgery were reported in 38% (n = 81) of patients in the studied group. Excluding perioperative high fever, the complication rate was 18%. The following complications were observed in 30-day postoperative period: wound infection (n = 6), wound dehiscence (n = 4), mechanical bowel obstruction (n = 3), hemorrhage (n = 2), cardiological (n = 8), stroke (n = 3). Observed 30-day mortality was 2.3% (n = 5), while 90-day mortality was 8.9% (n = 19). The mortality rate was associated with the stage of cancer and the type of urinary diversion. Conclusions: Radical cystectomy is a complex and traumatic urological surgery. It is associated with a significant complication rate and mortality, and it negatively affects quality of life. Therefore, all known risk factors should be thoroughly assessed preoperatively to select optimal treatment. Furthermore, the patient should be carefully informed about the risks associated with the surgery.

scholarly journals Fatores associados à sobrecarga em cuidadores familiares na radioterapia

2019 ◽  
Vol 13 ◽  
Author(s):  
Daniel De Macêdo Rocha ◽  
Aliny De Oliveira Pedrosa ◽  
Aline Costa De Oliveira ◽  
Claudia Daniella Avelino Vasconcelos Benício ◽  
Ítalo Arão Pereira Ribeiro ◽  
...  
Keyword(s):  
Family Caregivers ◽  
Treatment Method ◽  
Educational Interventions ◽  
Public Health Policies ◽  
Factors Associated ◽  
Analysis And Synthesis ◽  
Clinical Conditions ◽  
Stress Fatigue ◽  
Care Deficit ◽  
Radiotherapy Treatment

Objetivo: analisar os fatores associados à sobrecarga em cuidadores familiares de pacientes em tratamento radioterápico. Método: trata-se de estudo bibliográfico, tipo revisão integrativa da literatura, por meio da busca nas bases de dados MEDLINE, CINAHL, SCOPUS, Web of ScienceTM e LILACS. Compôs-se a amostra por 15 estudos primários, publicados até 2017, nos idiomas inglês, português e espanhol. Realizaram-se a análise crítica e a síntese dos resultados de forma descritiva, o que possibilitou a classificação por similaridade semântica e a construção de duas categorias temáticas. Apresentaram-se os resultados em forma de figuras. Resultados: verificou-se que os fatores associados à sobrecarga se relacionaram tanto aos pacientes quanto aos cuidadores, sendo eles o deficit do autocuidado, as condições clínicas, a alteração do sono e as pressões psicossociais. Identificaram-se, dentre as manifestações de sobrecarga, o estresse, a fadiga, a exaustão e a intensificação de sintomas depressivos e ansiosos. Conclusão: evidenciou-se que o tratamento radioterápico gera sobrecarga para os cuidadores familiares, sendo necessárias intervenções educativas, estratégias assistenciais e implementação de políticas públicas de saúde para a minimização desses efeitos. Descritores: Neoplasia; Radioterapia; Cuidador Familiar; Ônus da Doneça; Enfermagem; Cuidados de Enfermagem.ABSTRACTObjective: to analyze the factors associated with overload in family caregivers of patients undergoing radiotherapy treatment. Method: this is a bibliographic study, integrative literature review type, by searching the databases MEDLINE, CINAHL, SCOPUS, Web of ScienceTM and LILACS. The sample consisted of 15 primary studies, published until 2017, in English, Portuguese and Spanish. Critical analysis and synthesis of the results were performed descriptively, which allowed the classification by semantic similarity and the construction of two thematic categories. The results were presented as figures. Results: it was found that factors associated with overload were related to both patients and caregivers, such as self-care deficit, clinical conditions, sleep disturbance and psychosocial pressures. Among the manifestations of overload, stress, fatigue, exhaustion and intensification of depressive and anxious symptoms were identified. Conclusion: it was evidenced that radiotherapy treatment generates overload for family caregivers, requiring educational interventions, care strategies and implementation of public health policies to minimize these effects. Descriptors: Neoplasms; Radiotherapy; Family Caregivers; Cost of Illness; Nursing; Nursing Care.RESUMENObjetivo: analizar los factores asociados con la sobrecarga en cuidadores familiares de pacientes sometidos a tratamiento de radioterapia. Método: este es un estudio bibliográfico, tipo de revisión de literatura integradora, mediante la búsqueda en las bases de datos MEDLINE, CINAHL, SCOPUS, Web ofScienceTM y LILACS. La muestra consistió en 15 estudios primarios, publicados hasta 2017, en inglés, portugués y español. El análisis crítico y la síntesis de los resultados se realizaron de forma descriptiva, lo que permitió la clasificación por similitud semántica y la construcción de dos categorías temáticas. Los resultados se presentaron en forma de figuras. Resultados: se encontró que los factores asociados con la sobrecarga estaban relacionados tanto con los pacientes como con los cuidadores, siendo ellos el déficit de autocuidado, las condiciones clínicas, los trastornos del sueño y las presiones psicosociales. Entre las manifestaciones de sobrecarga, se identificaron estrés, fatiga, agotamiento e intensificación de síntomas depresivos y ansiosos. Conclusión: se evidenció que el tratamiento con radioterapia genera una sobrecarga para los cuidadores familiares, que requiere intervenciones educativas, estrategias de atención e implementación de políticas de salud pública para minimizar estos efectos. Descriptores: Neoplasias; Radioterapia; Cuidador Familiar; Costo de Enfermedad; Enfermería; Atención de Enfermería.

Impact of the National Amyotrophic Lateral Sclerosis (ALS) Registry's Research Notification Mechanism (RNM) on Patient Recruitment for Clinical Trials and Epidemiological Studies (Preprint)

2021 ◽  
Author(s):  
Paul Mehta ◽  
Jaime Raymond ◽  
Moon Kwon Han ◽  
Theodore Larson ◽  
James D Berry ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Statistical Power ◽  
Epidemiological Studies ◽  
Patient Recruitment ◽  
Toxic Substances ◽  
Eligibility Criteria ◽  
Institutional Review ◽  
Eligibility Requirements ◽  
Conducting Research ◽  
New Research

BACKGROUND Researchers face challenges in patient recruitment, especially for rare, fatal diseases like ALS. These challenges include obtaining sufficient statistical power as well as meeting eligibility requirements such as age, sex, and study proximity. Similarly, persons with ALS (PALS) face difficulty finding and enrolling in research studies for which they are eligible. OBJECTIVE To describe how the federal Agency for Toxic Substances and Disease Registry’s (ATSDR) National ALS Registry is linking PALS to scientists who are conducting research, clinical trials, and epidemiological studies. METHODS Through the Registry’s online Research Notification Mechanism, PALS can elect to be notified about new research opportunities. This mechanism allows researchers to upload a standardized application outlining their study design and objectives, and proof of Institutional Review Board (IRB) approval. If the application is approved, ATSDR queries the Registry for PALS meeting the study’s specific eligibility criteria, and then distributes the researcher’s study material and contact information to PALS via email. PALS then need to contact the researcher directly to take part in any research. Such an approach allows ATSDR to protect the confidentiality of Registry enrollees. RESULTS From 2013 – 2019, a total of 46 institutions around the US. have leveraged this tool and over 600,000 emails have been sent resulting conservatively in over 2,000 patients recruited for clinical trials and epidemiological studies. CONCLUSIONS The National ALS Registry’s Research Notification Mechanism benefits PALS by connecting them to appropriate ALS research. Simultaneously, the system benefits researchers by expediting recruitment, increasing sample size, and efficiently identifying PALS meeting specific eligibility requirements. As more researchers learn about and use this mechanism, both PALS and researchers can hasten research and expand trial options for PALS.

Research Brief: The Teen ADHD Workshop to Improve Adolescent ADHD Treatment Engagement

2017 ◽  
Vol 24 (8) ◽  
pp. 1192-1198 ◽  
Author(s):  
Erin Schoenfelder ◽  
Connor McCabe ◽  
Aurora Fife ◽  
Lisa Herzig ◽  
Kym Ahrens
Keyword(s):  
Treatment Method ◽  
Post Intervention ◽  
Treatment Participation ◽  
Adhd Treatment ◽  
Treatment Knowledge ◽  
Evidence Based Treatments ◽  
Post Test ◽  
Stimulant Medications ◽  
Special Diets ◽  
Willingness To Use

Objective: Adolescents with ADHD are at risk of functional problems that may be mitigated by consistent ADHD treatment. This study pilots a brief intervention for adolescents with ADHD and their parents to increase treatment knowledge and family motivation to seek treatment. Method: The 3-hr curriculum was developed by a multidisciplinary team and included psychoeducation, goal setting, and motivational interviewing. Fifteen adolescents and 20 caregivers participated in the workshop, completed pre- and post-test assessments, and reported on acceptability. Results: Acceptability and satisfaction with the intervention were high. Perceived knowledge of ADHD increased post intervention; stigma was unchanged. Parents reported more acceptability of stimulant medications and less willingness to use special diets or cognitive games. Family feedback informed modifications to the curriculum. Conclusion: The Teen ADHD Workshop is a feasible and acceptable intervention to increase knowledge of ADHD and evidence-based treatments. Further research will evaluate effects on treatment participation.

Attitudinal Factors Associated with Individual Faculty Research Productivity in Academic Dentistry

1993 ◽  
Vol 76 (3_suppl) ◽  
pp. 1191-1198 ◽  
Author(s):  
James E. Jones ◽  
Gerald C. Preusz
Keyword(s):  
Research Productivity ◽  
Response Rate ◽  
Positive Association ◽  
Full Time ◽  
Significant Positive Association ◽  
Factors Associated ◽  
Associate Dean ◽  
Attitudinal Factors ◽  
Faculty Research Productivity ◽  
Conducting Research

The purpose of this study was to examine attitudinal factors associated with increased research productivity of individual clinical faculty in 66 United States and Canadian schools of dentistry. Thirteen variables, evaluating the subjects perceptions of their research background, work environment, attitude and outcome effects from publishing, and the use of colleagues in conducting research, were evaluated. The 833 respondents represented a response rate of 64.9% (833/1200) from a 50% stratified random sample of faculty who (1) had full-time appointments and held at least the D.M.D. or D.D.S. degree or the foreign equivalent, (2) taught in a clinical department of the dental school, and (3) were not departmental chairpersons or administrators (assistant dean, associate dean, or dean). Respondents reported a mean of 10.3 yr. (range = 1 to 45, SD = 7.3) in full-time dental education (career age) and a mean of 10.1 career publications (range = 0 to 110, SD = 13.8). Analysis of variance for mean number of career publications, by increasing agreement in response to each attitudinal variable, yielded a significant positive association for each of the 13 attitudinal variables. Implications of the findings were discussed with respect to strategies for improving research productivity of individual faculty.

Cognitive-Behavioral Treatments for Tinnitus: A Review of the Literature

2014 ◽  
Vol 25 (01) ◽  
pp. 029-061 ◽  
Author(s):  
Rilana F.F. Cima ◽  
Gerhard Andersson ◽  
Caroline J. Schmidt ◽  
James A. Henry
Keyword(s):  
Common Ground ◽  
Behavioral Therapy ◽  
Experimental Studies ◽  
Additional Treatment ◽  
Stepped Care ◽  
Cognitive Behavioral ◽  
Treatment Approaches ◽  
Educational Counseling ◽  
Care Approach ◽  
Behavioral Treatments

Background: Tinnitus can be defined as the perception of an auditory sensation, perceivable without the presence of an external sound. Purpose: The aim of this article is to systematically review the peer-reviewed literature on treatment approaches for tinnitus based on cognitive-behavioral therapy (CBT) and to provide a historical overview of developments within these approaches. Research Design: Experimental studies, (randomized) trials, follow-up assessments, and reviews assessing educational, counseling, psychological, and CBT treatment approaches were identified as a result of an electronic database metasearch. Results: A total of 31 (of the initial 75 studies) were included in the review. Results confirm that CBT treatment for tinnitus management is the most evidence-based treatment option so far. Though studied protocols are diverse and are usually a combination of different treatment elements, and tinnitus diagnostics and outcome assessments vary over investigations, a common ground of therapeutic elements was established, and evidence was found to be robust enough to guide clinical practice. Conclusions: Treatment strategy might best be CBT-based, moving toward a more multidisciplinary approach. There is room for the involvement of different disciplines, using a stepped-care approach. This may provide brief and effective treatment for a larger group of tinnitus patients, and additional treatment steps can be provided for those suffering on a more severe level.

Hormesis and homeopathy: Bridge over troubled waters

2010 ◽  
Vol 29 (7) ◽  
pp. 567-571 ◽  
Author(s):  
Menachem Oberbaum ◽  
Shepherd Roee Singer ◽  
Noah Samuels
Keyword(s):  
Scientific Research ◽  
Empirical Method ◽  
Scientific Investigation ◽  
Toxic Substances ◽  
Standard Laboratory ◽  
Laboratory Procedure ◽  
Healing Response ◽  
Threshold Doses

Homeopathy is an empirical method of treatment. Hormesis, while stemming from within the rationalist tradition, has yet to be explained according to current pharmacological theory. Both share in common sub-threshold doses of toxic substances and an initial semi-toxicological insult followed by a greater compensatory (or healing) response. We question whether the differences between these fields may be amenable to scientific research. We identify five cardinal differences between homeopathy and hormesis: (1) Hormesis is a universal phenomenon, while homeopathy is highly specific; (2) Hormesis uses only measurable quantities of compounds, as opposed to homeopathy, which frequently administers medicines at dilutions far beyond the material range; (3) Preparation of hormetic solutions follows standard laboratory procedure, while homeopathy requires a sequential series of dilutions, each followed by vigorous shaking (‘succussion’); (4) The effects of hormesis are moderate and temporary, while homeopathy claims curative and permanent responses and (5) Hormesis is a lab phenomenon observed primarily in healthy organisms, whereas homeopathy is a mode of treatment administered primarily to ailing individuals. We believe that all five of these differences are amenable to scientific investigation, and suggest comparing succussed to non-succussed diluted solutions as an optimal first evaluation. We conclude that while certain differences exist between hormesis and homeopathy, hormesis may in fact be a subset of homeopathy.

Objective Assessments in Diagnoses and Treatment: A Proposed Change in Paradigm

2020 ◽  
pp. 155005942098399
Author(s):  
Lukasz M. Konopka ◽  
Alice Glowacki ◽  
Christian J. Konopka ◽  
Ronald Wuest
Keyword(s):  
Psychiatric Disorders ◽  
Diagnostic Criteria ◽  
Brain Function ◽  
Standard Approach ◽  
Treatment Approaches ◽  
Patient Diagnosis ◽  
Behavioral Assessments ◽  
Behavioral Treatments ◽  
Diagnostic Biases ◽  
Current Paradigm

For patients with psychiatric disorders, current diagnostic and treatment approaches are far from optimal. The clinical interview drives the standard approach—matching symptoms to diagnostic criteria—and results in standardized pharmacological and behavioral treatments, often, with inadequate outcome; but now, recent imaging advances can correlate behavioral assessments with brain function and measure them against normative databases to provide data critical for the reevaluation of patient diagnosis and treatment. This article addresses the data that support a redefinition of our current paradigm. We believe a neurobehavioral approach provides for more personalized treatment approaches unbound from classically defined diagnostic biases.

80 THE PROGNOSTIC FACTORS ASSOCIATED WITH LONG-TERM SURVIVAL IN THE PATIENTS WITH SYNCHRONOUS OLIGOMETASTATIC ESOPHAGEAL ADENOCARCINOMA

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Masaaki Iwatsuki ◽  
Kazuto Harada ◽  
Hideo Baba ◽  
Jaffer Ajani
Keyword(s):  
Esophageal Adenocarcinoma ◽  
Univariate Analysis ◽  
Treatment Method ◽  
Term Survival ◽  
Long Term Survival ◽  
Factors Associated ◽  
Oligometastatic Disease ◽  
Node Metastases ◽  
Stage Ivb

Abstract   Patients with gastrointestinal cancer are increasingly being diagnosed with oligometastatic disease due to the development of sensitive imaging. Oligometastases (OLM) represent a clinical and anatomical manifestation of resistant localized cancer and/or metastases. However, oligometastatic disease is complicated by the lack of uniformity due to the heterogeneity of cancer, therefore, differing prognoses. The aim of this study is to identify the factors associated with long-term survival in the patients with synchronous oligometastatic esophageal adenocarcinoma (EAC). Methods Between 2002 and 2016, of 1400 patients with EAC (esophagus and Siewert types I and II) treated at our institute, 233 patients initially diagnosed with stage IVB were enrolled. OLM was defined as only metastasized to one organ and less than 5 metastases. We retrospectively analyzed the association between clinicopathological factors and prognosis, especially focused on the pattern of metastases. Results Eighty-five patients (36.5%) had OLM, and 148 (63.5%) had non-oligometastais (Non-OLM). The patients in OLM had significantly better overall survival (OS) than the patients in Non-OLM (p = 0.0001). Univariate analysis showed pattern of metastases (lymphatic OLM) and treatment method (consolidative local radiotherapy: CLT) were significantly associated with prognosis (p = 0.04 and 0.01). Multivariate analysis revealed that lymph node metastases (cN0-N1), number of metastasis (solitary) and treatment (CLT) were independent predictors for OS of patients with OLM. (p = 0.03, 0.01 and 0.001). In OLM patients, the patients with lymphatic OLM who received CLT had more favorable prognosis (5-years survival rate 25%). Conclusion This study suggests that CLT is one of the promising modalities for oligometastatic patients with EAC, especially the patients with lymphatic OLM.

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