scholarly journals Management of urological dysfunction in pediatric patients with spinal dysraphism: review of the literature

2012 ◽  
Vol 33 (4) ◽  
pp. E4 ◽  
Author(s):  
Matthew A. Amarante ◽  
Jeffrey A. Shrensel ◽  
Krystal L. Tomei ◽  
Peter W. Carmel ◽  
Chirag D. Gandhi
Keyword(s):  
Neural Tube ◽  
Multidisciplinary Approach ◽  
Spinal Dysraphism ◽  
Treatment Strategies ◽  
Daily Basis ◽  
Congenital Deformities ◽  
Urological Complications ◽  
Number Of Individuals ◽  
Cns Malformations

An intact, fully functional spine is the result of a complex sequence of embryological events involving both nervous and musculoskeletal system precursors. Deviations from this highly ordered system can result in congenital abnormalities ranging from clinically insignificant cosmetic changes to CNS malformations that are incompatible with life. Closure of the neural tube, which is believed to be the embryological event gone awry in these cases, is complete by just 28 days' gestation, often before pregnancy is detected. Although progress has been made to help prevent neural tube defects in the children of those attempting to conceive, these congenital deformities unfortunately continue to affect a startling number of infants worldwide each year. Furthermore, the precise mechanisms governing closure of the neural tube and how they might be interrupted remain elusive. What is known is that there are a large number of individuals who must deal with congenital spine dysraphism and the clinical sequelae on a daily basis. Bladder and urinary dysfunction are frequently encountered, and urological care is a critical, often neglected, component in the lifelong multidisciplinary approach to treatment. Although many treatment strategies have been devised, a need remains for evidence-based interventions, analysis of quality of life, and preemptive education of both caregivers and patients as they grow older. Pediatric neurosurgeons in particular have the unique opportunity to address these issues, often in the first few days of life and throughout pre- and postoperative evaluation. With proper management instituted at birth, many patients could potentially delay or avoid the potential urological complications resulting from congenital neurogenic bladder.

scholarly journals Outcome Measures for Dementia in the Advanced Stage and at the End of Life

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Ladislav Volicer ◽  
Jenny T. van der Steen
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Symptom Control ◽  
Treatment Strategies ◽  
Family Satisfaction ◽  
Research Use ◽  
Advanced Dementia ◽  
Optimal Care ◽  
Number Of Individuals

Increasing life span and lack of medication for prevention or treatment of progressive dementias will significantly increase the number of individuals with advanced dementia worldwide. Providing optimal care for them will stretch health care resources and will require evaluation of different treatment strategies. This paper is presenting measures that may be used in this patient population. Evaluation of global goals of palliative care may include measuring quality of life by QUALID scale, comfort by DS-DAT scale, and engagement by MPES scale. Symptom control may be achieved by measuring pain by PAINAD or PACSLAC scales, by evaluating behavioral symptoms and their management (agitation by SOAPD scale, apathy by AES scale and rejection of care by RTC-DAT scale), and by monitoring patients for dyspnea using RDOS scale. Outcomes of palliative care at the end of life may be evaluated by EOLD-CAD scale and by determining family satisfaction with care (EOLD-SWC). Items included in these scales, psychometric properties, and research use of these scales are described. It is hoped that information in this paper will stimulate research interest in this important area.

Boilerplate

2012 ◽  
Author(s):  
Margaret Jane Radin
Keyword(s):  
Economic Efficiency ◽  
Analytical Framework ◽  
Daily Basis ◽  
Regulatory Agencies ◽  
Jury Trial ◽  
Comprehensive Treatment ◽  
New Methods ◽  
And Control ◽  
Fine Print

Boilerplate—the fine-print terms and conditions that we become subject to when we click “I agree” online, rent an apartment, or enter an employment contract, for example—pervades all aspects of our modern lives. On a daily basis, most of us accept boilerplate provisions without realizing that should a dispute arise about a purchased good or service, the nonnegotiable boilerplate terms can deprive us of our right to jury trial and relieve providers of responsibility for harm. Boilerplate is the first comprehensive treatment of the problems posed by the increasing use of these terms, demonstrating how their use has degraded traditional notions of consent, agreement, and contract, and sacrificed core rights whose loss threatens the democratic order. This book examines attempts to justify the use of boilerplate provisions by claiming either that recipients freely consent to them or that economic efficiency demands them, and it finds these justifications wanting. It argues that our courts, legislatures, and regulatory agencies have fallen short in their evaluation and oversight of the use of boilerplate clauses. To improve legal evaluation of boilerplate, the book offers a new analytical framework, one that takes into account the nature of the rights affected, the quality of the recipient's consent, and the extent of the use of these terms. It goes on to offer possibilities for new methods of boilerplate evaluation and control, and concludes by discussing positive steps that NGOs, legislators, regulators, courts, and scholars could take to bring about better practices.

Multidisciplinary Approach to Rectal Cancer: Are we Ready for Selective Treatment Strategies?

2013 ◽  
Vol 999 (999) ◽  
pp. 1-7
Author(s):  
Antonio Avallone ◽  
Luigi Aloj ◽  
Paolo Delrio ◽  
Biagio Pecori ◽  
Alessandra Leone ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Multidisciplinary Approach ◽  
Treatment Strategies ◽  
Selective Treatment

Nanotechnology: its application in treating Neurodegenerative diseases

2020 ◽  
Vol 19 ◽  
Author(s):  
Falaq Naz ◽  
Yasir Hasan Siddique
Keyword(s):  
Quality Of Life ◽  
Neurodegenerative Diseases ◽  
Blood Brain Barrier ◽  
Huntington Disease ◽  
Treatment Strategies ◽  
Present Review ◽  
Brain Barrier ◽  
Treatment Level ◽  
Blood Brain

: Neurodegenerative diseases including Alzheimer’s, Parkinson’s and Huntington disease are have serious concern due to its effect on the quality of life of affected persons. Neurodegenerative diseases have some limitations for both diagnostic as well as at treatment level. Introducing nanotechnology, for the treatment of these diseases may contribute significantly in solving the problem. There are several treatment strategies for the neurodegenerative diseases, but their limitations are the entry into the due to the presence of the blood-brain barrier (BBB). The present review highlights the application of nanotechnology during last 20 years for the treatment of neurodegenerative diseases.

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.

scholarly journals Epilepsy in Down Syndrome: A Highly Prevalent Comorbidity

2021 ◽  
Vol 10 (13) ◽  
pp. 2776
Author(s):  
Miren Altuna ◽  
Sandra Giménez ◽  
Juan Fortea
Keyword(s):  
Down Syndrome ◽  
Functional Outcomes ◽  
Clinical Presentation ◽  
Late Onset ◽  
Current Knowledge ◽  
Epileptic Seizures ◽  
Myoclonic Epilepsy ◽  
Increased Risk ◽  
Number Of Individuals

Individuals with Down syndrome (DS) have an increased risk for epilepsy during the whole lifespan, but especially after age 40 years. The increase in the number of individuals with DS living into late middle age due to improved health care is resulting in an increase in epilepsy prevalence in this population. However, these epileptic seizures are probably underdiagnosed and inadequately treated. This late onset epilepsy is linked to the development of symptomatic Alzheimer’s disease (AD), which is the main comorbidity in adults with DS with a cumulative incidence of more than 90% of adults by the seventh decade. More than 50% of patients with DS and AD dementia will most likely develop epilepsy, which in this context has a specific clinical presentation in the form of generalized myoclonic epilepsy. This epilepsy, named late onset myoclonic epilepsy (LOMEDS) affects the quality of life, might be associated with worse cognitive and functional outcomes in patients with AD dementia and has an impact on mortality. This review aims to summarize the current knowledge about the clinical and electrophysiological characteristics, diagnosis and treatment of epileptic seizures in the DS population, with a special emphasis on LOMEDS. Raised awareness and a better understanding of epilepsy in DS from families, caregivers and clinicians could enable earlier diagnoses and better treatments for individuals with DS.

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 Supranational Assessment of the Quality of Probiotics: Collaborative Initiative between Independent Accredited Testing Laboratories

2021 ◽  
Vol 9 (7) ◽  
pp. 1456
Author(s):  
Jean-Pol Warzée ◽  
Marina Elli ◽  
Abdoulaye Fall ◽  
Daniela Cattivelli ◽  
Jean-Yves François
Keyword(s):  
Daily Basis ◽  
Qualitative Assessment ◽  
Close Collaboration ◽  
Quality Label ◽  
Accredited Laboratories ◽  
Quantitative Analyses ◽  
Quality Of Food ◽  
The Eu

Recent acquisitions about the role of the microbiota in the functioning of the human body make it possible to envisage an increasing use of beneficial microbes, and more particularly of probiotics as well as their metabolites, as nutritional supplements. National and EU authorities are engaged in assuring the safety and quality of food supplements and in defining rules to assess and communicate their efficacy on human health. The quality of probiotics, intended as strains’ identification, viability, and stability over time, is a crucial factor of credibility with consumers and health professionals. Analytical technologies for the quality control of probiotics must also be adapted to new preparations, such as those including new multistrains complex combinations. Accredited laboratories face this relevant challenge on a daily basis. Through its close collaboration with the laboratory commissioned to produce the specifications for its ESLP quality label (identification and quantitative analyses) together with its scientific committee, the ESLP has been focusing on this issue for 10 years. Recently, as part of the internationalization of the ESLP quality label, a new and unique initiative in Europe for the evaluation of the quality of probiotic preparations has been carried out. The collaboration between two accredited laboratories in Belgium and in Italy represented a concrete example of supranational collaboration in the assessment of the quality of probiotic preparations. Results show that both laboratories are in line as expected in terms of performance. Common approaches to the qualitative assessment of probiotic preparations, especially for complex and composite recipes, in terms of number of strains and included substances, should be encouraged and promoted all over the EU.

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