Development and preliminary validation of the First Episode Social Functioning Scale for early psychosis

The current study aimed at developing and conducting a preliminary validation a novel social functioning measure for people with early psychosis. The First Episode Social Functioning Scale (FESFS) was developed to cover many domains specific to this population in their contemporary reality. The self-report version of the FESFS was administered to 203 individuals receiving services in first episode clinics. Scores of the GAF, SOFAS, Social Functioning Scale and BPRS were also obtained for parts of the sample to calculate convergent and discriminant validity. A subgroup also answered the FESFS at several time points during treatment in order to determine sensibility to change. Principal component factor analyses and internal consistency analyses revealed the following nine factors with alphas ranging from 0.63 to 0.80: Friendships and social activities, Independent living skills, Interacting with people, Family, Intimacy, Relationships and social activities at work, Work abilities, Relationships and social activities at school, Educational abilities. Convergent and discriminant validity were demonstrated, as well as sensitivity to change. Clinical and research utility of the FESFS are discussed.     

Bihemispheric gunshot wounds: survival and long-term neuropsychological follow-up of three siblings

Purpose

Penetrating gunshot wounds to the head (GSWH) have notoriously poor outcomes with extremely high mortality. Long-term follow-up data of affected children is scant in the medical literature. This report summarizes clinical presentation, management, and long-term outcomes from three children who survived “execution style” frontal, bihemispheric gunshot wounds with no or minimal surgical intervention.

Methods

A retrospective chart review of available medical records and outcomes from standardized, validated psychological instruments was undertaken, summarized, and evaluated.

Results

Despite bihemispheric injuries in each patient, no patient required operative intervention. Each child survived without readily evident neurologic impairment; however, the extent of impaired executive function varied widely, and severe disinhibition remains profoundly disabling in one survivor.

Conclusions

Bihemispheric penetrating gunshot injuries are not uniformly fatal and can occasionally be associated with long-term favorable survival; however, impaired executive function has significant potential to be profoundly disabling in these injuries.     

Changes in Nutrients and Food Groups Intake Following Laparoscopic Roux-en-Y Gastric Bypass (RYGB)

Background

Serial changes in dietary intake, including specific food groups and nutrients during the first year following Roux-en-Y gastric bypass (RYGB) are of interest due to surgically induced alterations in meal size, food intolerances present after surgery, and potential nutrient deficiencies. To help improve the nutritional health of surgical patients, this study’s purpose was to examine changes in macro- and micronutrients, food groups, and selected foods during 12 months of follow-up in post-RYGB individuals.

Methods

RYGB patients (n?=?17) completed 4-day food records at baseline (prior to surgery) and then at 3 weeks, 3 months, 6 months, and 12 months after surgery. Mean daily intake was determined at each time for energy intake, macro- and micronutrients, food groups, and selected foods in targeted food groups.

Results

A dramatic decrease in mean (±SEM) daily energy intake occurred—2,150?±?165 kcal at baseline vs. 649?±?40 kcal at 3 weeks; energy intake continually increased to a high of 1,307?±?129 kcal by 12 months. More than 50 % of patients had low intake of vitamins D, E, C, folate, and calcium, magnesium, and potassium at 12 months. Servings from vegetables, grains, fats, and sweetened beverages were lower, whereas, meats, dairy, fruits, and sweets showed only small, transient changes following surgery.

Conclusions

The reduction in energy intake following RYGB is from selected food groups and not solely a reduction in portion sizes across the diet. The lower intake of micronutrients indicates potential risk for deficiencies unless supplements are used. These findings can help in the clinical management of surgical patients to improve nutritional health.     

Skeletal muscle cell transplantation: models and methods

Journal of Muscle Research and Cell Motility - Xenografts of skeletal muscle are used to study muscle repair and regeneration, mechanisms of muscular dystrophies, and potential cell therapies for...     

The Oregon Child Absenteeism Due to Respiratory Disease Study (ORCHARDS): Rationale,objectives, and design

BackgroundInfluenza viruses pose significant disease burdens through seasonal outbreaks and unpredictable pandemics. Existing surveillance programs rely heavily on reporting of medically attended influenza (MAI). Continuously monitoring cause‐specific school absenteeism may identify local acceleration of seasonal influenza activity. The Oregon Child Absenteeism Due to Respiratory Disease Study (ORCHARDS; Oregon, WI) implements daily school‐based monitoring of influenza‐like illness‐specific student absenteeism (a‐ILI) in kindergarten through Grade 12 schools and assesses this approach for early detection of accelerated influenza and other respiratory pathogen transmission in schools and surrounding communities.MethodsStarting in September 2014, ORCHARDS combines automated reporting of daily absenteeism within six schools and home visits to school children with acute respiratory infection (ARI). Demographic, epidemiological, and symptom data are collected along with respiratory specimens. Specimens are tested for influenza and other respiratory viruses. Household members can opt into a supplementary household transmission study. Community comparisons are possible using a pre‐existing and highly effective influenza surveillance program, based on MAI at five family medicine clinics in the same geographical area.ResultsOver the first 5 years, a‐ILI occurred on 6634 (0.20%) of 3,260,461 student school days. Viral pathogens were detected in 64.5% of 1728 children with ARI who received a home visit. Influenza was the most commonly detected virus, noted in 23.3% of ill students.ConclusionORCHARDS uses a community‐based design to detect influenza trends over multiple seasons and to evaluate the utility of absenteeism for early detection of accelerated influenza and other respiratory pathogen transmission in schools and surrounding communities.     

RETRACTED ARTICLE: MicroRNA-30c-regulated HDAC9 mediates chemoresistance of breast cancer

Cancer Chemotherapy and Pharmacology - Although histone deacetylase (HDAC) inhibitors have been shown to effectively induce the inhibition of proliferation and migration in breast cancer, the...     

Expanding the geriatric mental health workforce through utilization of non-licensed providers

Objectives: We evaluate policy and practice strategies for bolstering the geriatric mental healthcare workforce and describe costs and considerations of implementing one approach.

Method: Narrative overview of the literature and policy retrieved from searches of databases, hand searches, and authoritative texts. We identified three proposed strategies to increase the geriatric mental healthcare workforce: (1) production of more geriatric mental health providers; (2) team-based care; and (3) non-licensed providers. We evaluate each in terms of challenges and potential and provide estimates of costs, policy, and practice considerations for training, employing, and supervising non-licensed mental health providers.

Results: Use of non-licensed providers is key to reforms needed to allow a more older adults to access necessary mental healthcare. Licensed and non-licensed providers have achieved similar improvements for generalized anxiety disorder among patients, although non-licensed providers did so at a lower cost.

Conclusion: Supervised non-licensed providers can extend the reach of licensed providers for specific mental health conditions, resulting in lower costs and increased number of patients treated. Although several barriers to implementation exist, policy and infrastructure changes that may support this type of care delivery model are emerging from reforms in financing and associated delivery initiatives created by the Affordable Care Act.