scholarly journals Disagreement between assessment of ASD utilizing the ADOS-2 and DSM-5 – A preliminary study

2020 ◽  
Vol 13 ◽  
pp. 17-26
Author(s):  
Ornit Freudenstein ◽  
Hagit Shimoni ◽  
Shahar Gindi ◽  
Yael Leitner
Keyword(s):  
Clinical Practice ◽  
Preliminary Data ◽  
Clinical Training ◽  
Case Series ◽  
Series Data ◽  
Sources Of Information ◽  
Multiple Sources ◽  
Dsm 5 ◽  
Preliminary Study ◽  
Morbid Conditions

Presented study addressed different assessment of ASD obtained with the use of the ADOS-2 and compared with the DSM-5 with children between 8 and 10 years old. Case series data were used on four children who were referred with suspected autism, and as a result a discre- pancy was found between the ADOS-2 assessment and the overall diagnosis. Initial findings indicated that age, additional diagnoses, and over-reliance on observa- tion may bias the ADOS-2 classification. In particular, children who were diagnosed with other disorders that share symptoms with ASD exhibit behaviors that may bias the ADOS-2 classification as it relies on observed behavior without considering the underlying cause. This discrepancy points to the importance of utilizing and integrating multiple sources of information in the process of establishing an ASD diagnosis, and suggests a need for specialized clinical training in diagnosing autism and other related co-morbid conditions in children aged 8–10. This preliminary data calls for further research into the area, especially due to the cur- rent over-reliance on the ADOS-2 in clinical practice and research.

Assessing and managing the risk of violence to others

2020 ◽  
pp. 1461-1468
Author(s):  
Alec Buchanan
Keyword(s):  
Risk Assessment ◽  
Clinical Practice ◽  
Protective Factors ◽  
Empirical Data ◽  
Predictive Accuracy ◽  
Good Practice ◽  
Violence Risk ◽  
Sources Of Information ◽  
Multiple Sources ◽  
Patient Violence

Assessing and managing the risk of patient violence is integral to the clinical practice of psychiatry. This chapter reviews the principles governing the assessment of violence risk in psychiatry, discusses clinical practice in this area, and examines the limits of psychiatric violence risk assessment. Assessment involves both the identification of risk and protective factors and a cause-based analysis based on an understanding of the case. Good practice involves the use of multiple sources of information and the integration of information gleaned from the identification of correlates of violence and a cause-based analysis. Empirical data on the limits to the predictive accuracy that can be achieved suggest that information concerning risk will usually be one of many pieces of information governing the management of a case.

Good practice in attention deficit hyperactivity disorder

2000 ◽  
Vol 17 (2) ◽  
pp. 62-66
Author(s):  
Fiona McNicholas
Keyword(s):  
Clinical Practice ◽  
Peer Relationships ◽  
Treatment Options ◽  
Neuropsychological Testing ◽  
Good Practice ◽  
Good Clinical Practice ◽  
Diagnosis And Treatment ◽  
Sources Of Information ◽  
Multiple Sources ◽  
Educational History

AbstractMajor advances have been made in ADHD over the years, both in terms of diagnostic validity, different subtypes, comorbidities and treatment options. A comprehensive assessment needs to include medical, developmental and educational history using multiple sources of information and across different settings. In certain cases, additional investigations and neuropsychological testing may need to complement basic physical and neurological examination. The focus of treatment must include not only the core ADHD symptoms but also additional comorbid problems, family and peer relationships, and academic achievement. Treatment should therefore be multi-modal with simultaneous medication, behavioural and educational management. Both diagnosis and treatment response needs to be reviewed regularly to ensure optimal response with minimal adverse side effects.The increased awareness of ADHD by both clinicians and other professionals has resulted in a huge increase of referrals for assessment, diagnosis and treatment. In particular, families are becoming increasingly knowledgeable about the disorder and are rightly requesting adequate assessment and treatment of their children. It is therefore essential that all clinicians are equally knowledgeable about the advances in this area and offer a service to families which represents good clinical practice. This article reviews what constitutes good clinical practice in ADHD.

Supporting the Development of Clinical Reasoning of Preprofessional Novices in Dysphagia Management

2019 ◽  
Vol 40 (03) ◽  
pp. 151-161 ◽  
Author(s):  
Sebastian Doeltgen ◽  
Stacie Attrill ◽  
Joanne Murray
Keyword(s):  
Clinical Reasoning ◽  
Clinical Decision Making ◽  
Management Practice ◽  
Clinical Decision ◽  
Assessment Process ◽  
Evidence Based ◽  
Sources Of Information ◽  
Multiple Sources ◽  
Implicit Processing ◽  
Reasoning Skills

AbstractProficient clinical reasoning is a critical skill in high-quality, evidence-based management of swallowing impairment (dysphagia). Clinical reasoning in this area of practice is a cognitively complex process, as it requires synthesis of multiple sources of information that are generated during a thorough, evidence-based assessment process and which are moderated by the patient's individual situations, including their social and demographic circumstances, comorbidities, or other health concerns. A growing body of health and medical literature demonstrates that clinical reasoning skills develop with increasing exposure to clinical cases and that the approaches to clinical reasoning differ between novices and experts. It appears that it is not the amount of knowledge held, but the way it is used, that distinguishes a novice from an experienced clinician. In this article, we review the roles of explicit and implicit processing as well as illness scripts in clinical decision making across the continuum of medical expertise and discuss how they relate to the clinical management of swallowing impairment. We also reflect on how this literature may inform educational curricula that support SLP students in developing preclinical reasoning skills that facilitate their transition to early clinical practice. Specifically, we discuss the role of case-based curricula to assist students to develop a meta-cognitive awareness of the different approaches to clinical reasoning, their own capabilities and preferences, and how and when to apply these in dysphagia management practice.

scholarly journals Mobility Trends before and after the Pandemic Outbreak: Analyzing the Metropolitan Area of Barcelona through the Lens of Equality and Sustainability

2021 ◽  
Vol 13 (14) ◽  
pp. 7908
Author(s):  
Lucía Mejía-Dorantes ◽  
Lídia Montero ◽  
Jaume Barceló
Keyword(s):  
Metropolitan Area ◽  
Spatial Arrangement ◽  
Individual Characteristics ◽  
Sources Of Information ◽  
Mobility Patterns ◽  
Multiple Sources ◽  
Temporal Dimension ◽  
Population Groups ◽  
Highly Educated ◽  
Before And After

The spatial arrangement of a metropolis is of utmost importance to carry out daily activities, which are constrained by space and time. Accessibility is not only shaped by the spatial and temporal dimension, but it is also defined by individual characteristics, such as gender, impairments, or socioeconomic characteristics of the citizens living or commuting in this area. This study analyzes mobility trends and patterns in the metropolitan area of Barcelona before and after the COVID-19 pandemic outbreak, with special emphasis on gender and equality. The study draws on multiple sources of information; however, two main datasets are analyzed: two traditional travel surveys from the transport metropolitan area of Barcelona and two coming from smartphone data. The results show that gender plays a relevant role when analyzing mobility patterns, as already highlighted in other studies, but, after the pandemic outbreak, some population groups were more likely to change their mobility patterns, for example, highly educated population groups and those with higher income. This study also highlights that e-activities may shape new mobility patterns and living conditions for some population segments, but some activities cannot be replaced by IT technologies. For all these reasons, city and transport planning should foster sustainable development policies, which will provide the maximum benefit for society.

scholarly journals International teleproctoring in neurointerventional surgery and its potential impact on clinical trials in the era of COVID-19: legal and technical considerations

2020 ◽  
pp. neurintsurg-2020-017053
Author(s):  
Emanuele Orru' ◽  
Miklos Marosfoi ◽  
Neil V Patel ◽  
Alexander L Coon ◽  
Christoph Wald ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Clinical Practice ◽  
High Resolution ◽  
Situational Awareness ◽  
Flow Diverter ◽  
Multiple Sources ◽  
Remote Supervision ◽  
Angiography Suite ◽  
The Us ◽  
Travel Restrictions

BackgroundExisting travel restrictions limit the mobility of proctors, significantly delaying clinical trials and the introduction of new neurointerventional devices. We aim to describe in detail technical and legal considerations regarding international teleproctoring, a tool that could waive the need for in-person supervision during procedures.MethodsInternational teleproctoring was chosen to provide remote supervision during the first three intracranial aneurysm treatments with a new flow diverter (currently subject of a clinical trial) in the US. Real-time, high-resolution transmission software streamed audiovisual data to a proctor located in Canada. The software allowed the transmission of images in a de-identified, HIPAA-compliant manner.ResultsAll three flow diverters were implanted as desired by operator and proctor and without complication. The proctor could swap between images from multiple sources and reported complete spatial and situational awareness, without any significant lag or delay in communication. Procedural times and radiologic dose were similar to those of uncomplicated, routine flow diversion cases at our institution.ConclusionsInternational teleproctoring was successfully implemented in our clinical practice. Its first use provided important insights for establishing this tool in our field. With no clear horizon for lifting the current travel restrictions, teleproctoring has the potential to remove the need for proctor presence in the angiography suite, thereby allowing the field to advance through the continuation of trials and the introduction of new devices in clinical practice. In order for this tool to be used safely and effectively, highly reliable connection and high-resolution equipment is necessary, and multiple legal nuances have to be considered.

scholarly journals Peer Mentoring as a Tool for Developing Soft Skills in Clinical Practice: A 3-Year Study

2021 ◽  
Vol 9 (5) ◽  
pp. 57
Author(s):  
Antonio M. Lluch ◽  
Clàudia Lluch ◽  
María Arregui ◽  
Esther Jiménez ◽  
Luis Giner-Tarrida
Keyword(s):  
Clinical Practice ◽  
Skill Acquisition ◽  
Clinical Training ◽  
Peer Mentoring ◽  
Clinical Skills ◽  
Technical Skills ◽  
Study Groups ◽  
Self Evaluation ◽  
Academic Knowledge ◽  
Post Hoc

Education currently focuses on improving academic knowledge and clinical skills, but it is also important for students to develop personal and interpersonal skills from the start of their clinical practice. The aim was to evaluate the effect of peer mentoring in third-year students and to gauge the evolution of non-technical skills (NTS) acquisition up to the fifth year. The study groups were selected between September 2015 and May 2018, based on the NTS training they had or had not received: (1) fifth-year students with no training (G1); (2) third-year students mentored in NTS (G2a); and (3) a small group of fifth-year students who became mentors (G2b). A total of 276 students who took part in this study were assessed using a 114-item self-evaluation questionnaire. Data were collected from seven surveys conducted between September 2015 and May 2018, and statistical analysis was performed using one-way ANOVA and Fisher’s post-hoc test. G2a improved their non-technical skill acquisition over three years of clinical training up to their fifth year. This group and G2b showed statistically significant differences compared to non-mentored students (G1). Peer mentoring at the beginning of clinical practice is a valid option for training students in non-technical skills.

scholarly journals Progression from Type 2 Macular Neovascularization to Fibrovascular Pigment Epithelial Detachment

Vision ◽  
2021 ◽  
Vol 5 (2) ◽  
pp. 16
Author(s):  
Hoang Mai LE ◽  
Gérard Mimoun ◽  
Salomon Y. Cohen ◽  
Camille Jung ◽  
Oudy Semoun ◽  
...  
Keyword(s):  
High Myopia ◽  
Case Series ◽  
Age Related Macular Degeneration ◽  
Series Data ◽  
Pigment Epithelial Detachment ◽  
Angioid Streaks ◽  
Pigment Epithelial ◽  
Anti Vegf

The aim of this study was to report unusual progression of type 2 macular neovascularization (MNV) associated with age-related macular degeneration (AMD), high myopia or angioid streaks. Retrospective multicentric observational case series data were used. Eyes that progressed from type 2 MNV secondary to AMD, high myopia or angioid streaks to fibrovascular pigment epithelial detachment (PED) were included. A total of 29 treatment-naive eyes from 29 patients with type 2 MNV secondary to AMD (n = 14), high myopia (n = 10) or angioid streaks (n = 5) that progressed to a fibrovascular PED on Spectral Domain-Optical Coherence Tomography were used. This progression occurred within 3 months after anti-VEGF therapy initiation. Logarithm of minimum angle of resolution (LogMAR) visual acuity improved significantly after anti-VEGF therapy, from 0.55 (SD ± 0.30) (20/63–20/80) at baseline to 0.30 (20/40) at 3 months, and 0.33 (20/40) at the final follow-up (mean follow up: 3.68 years). Mean number of intravitreal injections per year for patients with a total follow-up ≥ 12 months (n = 24) was 4.3 ± 2.1 per year. Progression from type 2 MNV to a fibrovascular PED may occur in patients suffering from AMD, high myopia or angioid streaks. This progression appears early after initiation of anti-VEGF therapy and is associated with a favorable visual and anatomical outcome, at least on a short follow up basis.

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