Current Issue : October - December Volume : 2014 Issue Number : 4 Articles : 6 Articles
Aim of this study is to find out biological, social and psychological factors of suicide in hospitalized cases who were committed suicide or those who were attempted suicide. The anterospective and retrospective analysis of serial case review from June 2006 to June 2012 by applying psychoanalytic method showed approximately all were suffering from psychiatric disorder most commonly with depression 90.9%. Common method to suicide is hanging, but most successful complete method is jump from height (2/3 among complete than 18.20% in total attempt of suicide). Another mode is use of sedative/hypnotics. Poor reorganization improper diagnosis and delayed help might be the reason for completed suicide. In hospitalized physical illness and its poor defined prognosis, substance use disorder, depression and associated psychotic phenomena and impulsivity are found in 19.09%. In-attainment of goal and frustration in 72.70%, family factor e.g. lack of support and economy in 18.20% were noted as factors for suicide....
Background: Juvenile dermatomyositis (JDM) is a rare but severe autoimmune inflammatory myositis of childhood.\nInternational collaboration is essential in order to undertake clinical trials, understand the disease and improve\nlong-term outcome. The aim of this study was to propose from existing collaborative initiatives a preliminary\nminimal dataset for JDM. This will form the basis of the future development of an international consensus-approved\nminimum core dataset to be used both in clinical care and inform research, allowing integration of data between\ncentres.\nMethods: A working group of internationally-representative JDM experts was formed to develop a provisional\nminimal dataset. Clinical and laboratory variables contained within current national and international collaborative\ndatabases of patients with idiopathic inflammatory myopathies were scrutinised. Judgements were informed by\npublished literature and a more detailed analysis of the Juvenile Dermatomyositis Cohort Biomarker Study and\nRepository, UK and Ireland.\nResults: A provisional minimal JDM dataset has been produced, with an associated glossary of definitions. The\nprovisional minimal dataset will request information at time of patient diagnosis and during on-going prospective\nfollow up. At time of patient diagnosis, information will be requested on patient demographics, diagnostic criteria\nand treatments given prior to diagnosis. During on-going prospective follow-up, variables will include the presence\nof active muscle or skin disease, major organ involvement or constitutional symptoms, investigations, treatment,\nphysician global assessments and patient reported outcome measures.\nConclusions: An internationally agreed minimal dataset has the potential to significantly enhance collaboration,\nallow effective communication between groups, provide a minimal standard of care and enable analysis of the\nlargest possible number of JDM patients to provide a greater understanding of this disease. This preliminary dataset\ncan now be developed into a consensus-approved minimum core dataset and tested in a wider setting with the\naim of achieving international agreement....
Background: Although significant progress has been made in clinical trials of women-controlled methods of HIV\nprevention such as microbicides and Pre-exposure Prophylaxis (PrEP), low adherence to experimental study\nproducts remains a major obstacle to being able to establish their efficacy in preventing HIV infection. One factor\nthat influences adherence is the ability of trial participants to attend regular clinic visits at which trial products are\ndispensed, adherence counseling is administered, and participant safety is monitored. We conducted a qualitative\nstudy of the social contextual factors that influenced adherence in the VOICE (MTN-003) trial in Johannesburg,\nSouth Africa, focusing on study participation in general, and study visits in particular.\nMethods: The research used qualitative methodologies, including in-depth interviews (IDI), serial ethnographic\ninterviews (EI), and focus group discussions (FGD) among a random sub-sample of 102 female trial participants,\n18 to 40 years of age. A socio-ecological framework that explored those factors that shaped trial participation and\nadherence to study products, guided the analysis. Key codes were developed to standardize subsequent coding\nand a node search was used to identify texts relating to obstacles to visit adherence. Our analysis includes coded\ntranscripts from seven FGD (N = 40), 41 IDI, and 64 serial EI (N = 21 women).\nResults: Women�s kinship, social, and economic roles shaped their ability to participate in the clinical trial. Although\nparticipants expressed strong commitments to attend study visits, clinic visit schedules and lengthy waiting times\ninterfered with their multiple obligations as care givers, wage earners, housekeepers, and students.\nConclusions: The research findings highlight the importance of the social context in shaping participation in HIV\nprevention trials, beyond focusing solely on individual characteristics. This points to the need to focus interventions\nto improve visit attendance by promoting a culture of active and engaged participation...
Background: The process and effectiveness of knowledge translation (KT) interventions targeting policymakers are\nrarely reported. In Cambodia, a low-income country (LIC), an intervention aiming to provide evidence-based knowledge\non pneumonia to health authorities was developed to help update pediatric and adult national clinical guidelines.\nThrough a case study, we assessed the effectiveness of this KT intervention, with the goal of identifying the barriers to KT\nand suggest strategies to facilitate KT in similar settings.\nMethods: An extensive search for all relevant sources of data documenting the processes of updating adult and\npediatric pneumonia guidelines was done. Documents included among others, reports, meeting minutes, and email\ncorrespondences. The study was conducted in successive phases: an appraisal of the content of both adult and pediatric\npneumonia guidelines; an appraisal of the quality of guidelines by independent experts, using the AGREE-II instrument; a\ndescription and modeling of the KT process within the guidelines updating system, using the Unified Modeling\nLanguage (UML) tools 2.2; and the listing of the barriers and facilitators to KT we identified during the study.\nResults: The first appraisal showed that the integration of the KT key messages in pediatric and adult guidelines\nvaried with a better efficiency in the pediatric guidelines. The overall AGREE-II quality assessments scored 37%\nand 44% for adult and pediatric guidelines, respectively. Scores were lowest for the domains of ââ?¬Ë?rigor of developmentââ?¬â?¢\nand ââ?¬Ë?editorial independence.ââ?¬â?¢ The UML analysis highlighted that time frames and constraints of the involved stakeholders\ngreatly differed and that there were several missed opportunities to translate on evidence into the adult pneumonia\nguideline. Seventeen facilitating factors and 18 potential barriers to KT were identified. Main barriers were related to the\nabsence of a clear mandate from the Ministry of Health for the researchers and to a lack of synchronization between\nknowledge production and policy-making.\nConclusions: Study findings suggest that stakeholders, both researchers and policy makers planning to update clinical\nguidelines in LIC may need methodological support to overcome the expected barriers....
The last two decades have seen a strong rise in empirical research in the mechanisms of emotion dysregulation in\nborderline personality disorder. Major findings comprise structural as well as functional alterations of brain regions\ninvolved in emotion processing, such as amygdala, insula, and prefrontal regions. In addition, more specific\nmechanisms of disturbed emotion regulation, e.g. related to pain and dissociation, have been identified. Most\nrecently, social interaction problems and their underlying neurobiological mechanisms, e.g. disturbed trust or\nhypersensitivity to social rejection, have become a major focus of BPD research. This article covers the current state\nof knowledge and related relevant research goals. The first part presents a review of the literature. The second part\ndelineates important open questions to be addressed in future studies. The third part describes the research\nagenda for a large German center grant focusing on mechanisms of emotion dysregulation in BPD....
Background: The feasibility of distal femur epiphysis preservation through epiphyseal distraction by external fixator\nin childhood osteosarcoma was explored.\nMethods: Between July 2007 and May 2011, 10 children who were suffering from distal femur osteosarcoma\nreceived epiphyseal distraction by external fixator, combined with tumor resection and repair with massive allograft\nbone to preserve the epiphysis of the distal femur and knee function. There were six male and four female patients,\n9- to 14-years old (average 10.5 years old). The tumors were staged clinically according to the Enneking staging\nmethod: six cases were classified as stage in IIA and four cases as stage in IIB. All patients were diagnosed by biopsy,\nthen received chemotherapy before and after surgery. All patients received tumor bone resection and the defects\nof the bone were repaired with massive allograft bone that was fixed by intramedullary nails; the distracted epiphysis\nand allograft bone were fixed with cancellous screws.\nResults: All cases received follow-up from 15 to 56 months (average 38.5 months). There were no local recurrences.\nOne case died of lung metastasis and one case had poor incision healing for rejection of allograft bone. According to\nthe functional evaluation criteria of the International Society of Limb Salvage (ISOLS) after operation, five cases were\nrated excellent, four cases good and one case fair. The ratio of excellent or good was 90.0%. There was no statistically\nsignificant difference in length between the operated and the normal lower limbs during the last review.\nConclusions: Epiphyseal distraction by external fixator can result in satisfactory limb length and joint function for\nchildren with a malignant bone tumor....
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