Attentional Bias and Its Modification in Contamination OCD Symptomatology

Attentional biases, particularly difficulty disengaging, have been found in contamination obsessive–compulsive disorder (OCD) and may be a maintaining factor. Attentional bias modification (ABM) may reduce this bias and avoidance behavior. This study examined attentional biases in 54 individuals with contamination OCD symptomatology and whether ABM reduces biases and symptoms. Participants completed one 30 min session of either ABM training or a control task and a spatial cueing task before and after to assess attentional bias. Questionnaires and behavioral tasks were also completed. Participants returned for a follow up 1 month later. As expected, there was evidence of difficulty disengaging from threats directly and indirectly associated with disease. Attention training led to a reduction in this bias, which was maintained for 1 month. However, there was no improvement in avoidance or contamination fear on a behavioral task, contamination OCD symptoms, safety behaviors and anxiety. Implications for treatment of OCD are discussed.     

Tödliche Attacken von Hunden auf Kinder

This article describes four cases of fatal dog attacks on children. These cases have in common that in each case at least two dogs participated in the attack on the child and severe injuries were predominantly found in the head and neck region. The injury patterns are similar to those found after cadaver scavenging and also by catching prey and hunting behavior and thus the ultimate fixed action pattern of predatory behavior in wolves and domestic dogs. The ultimate fixed action pattern of predatory behavior is the killing of the prey. The so-called scheme of catching prey is based on genetic disposition and learning experiences and can include humans (children) in extremely severe cases or be associated with social aggression interactive with humans (children). The causes of death in the cases described here were exsanguination and air embolism. The autopsy of two dogs demonstrated human tissue of the deceased children in the stomach contents. These cases demonstrate the vulnerability of children to dog attacks especially in the region of the head and neck, a region which is normally the target of attacks in hunting behavior. This study demonstrates the need for interdisciplinary scientific cooperation and describes the steps necessary to elucidate and prevent attacks by domestic dogs.     

Attitudes of healthcare staff in the treatment of children and adolescents with intellectual disability: A brief report

Background Children with an intellectual disability (ID) have complex health needs that extend beyond the expected cognitive deficits, affecting a myriad of developmental domains. These children frequently receive inadequate health care such that their needs remain poorly managed.

Methods Staff from the Sydney Children’s Hospital Network (N?=?160) completed a survey on attitudes, experiences, and training satisfaction when working with patients with ID. The 48-question needs analysis survey was distributed electronically to staff from a variety of disciplines and experience levels.

Results Although staff considered themselves broadly competent in caring for children with ID, they were less confident in specific skills, such as managing associated challenging behaviours in the clinic. As confidence in skills such as these decreased, the desire for further training increased.

Conclusion This study emphasises the importance of providing accessible, high-quality professional development resources to further develop these skills.     

Exercise Capacity and Quality of Life in Patients with Schizophrenia

The aim of this study was to resolve the relationship between physical capacity (PC) and quality of life (Qol) in schizophrenic patients and healthy controls. 31 patients (PG: 18 male, 13 female) and a control group (CG) of 50 healthy subjects (15 male, 35 female) were involved. PC was assessed as peak oxygen uptake [VO₂peak, (ml (min kg_KG)^?1)] and power output expressed as watts per kilogram (W kg^?1). Qol was assessed using the SF-36 questionnaire. Patients with schizophrenia showed reduced VO₂peak (male: PG 29 ± 5 vs. CG 44 ± 10; female: PG 21 ± 4 vs. CG 30 ± 8) and power output (male: PG 2.04 ± 0.47 vs. CG 3.43 ± 0.70; female PG 1.40 ± 0.28 vs. CG 2.43 ± 0.52). Scales of the SF-36 questionnaire were lower in the PG. While in the CG correlations were found between PC and several subscales of Qol, this was not the case in the PG. The restricted PC seen in the PG showed no relation to their subjectively assessed worsened Qol, which would indicate that schizophrenic patients evaluate limitations arising from this differently than healthy control subjects.     

Pulmonary hypertension and right ventricular dysfunction in left heart disease (group 2 pulmonary hypertension)

Group 2 pulmonary hypertension is most frequently caused by left heart disease, a heterogeneous set of disorders. These processes include left ventricular systolic dysfunction, left ventricular dysfunction with preserved ejection fraction and valvular (mitral and/or aortic) diseases. Left heart disease may cause passive backward transmission of pressure leading to elevated left atrial and pulmonary arterial pressures due to a myriad of processes. Increasingly, it has been recognized that some patients may develop pulmonary arterial pressure out of proportion from what is expected. This is believed to be due to increases in vasomotor tone and/or vascular remodeling. Over time patients may go on to develop progressive right ventricular dysfunction, a marker for poor prognosis. This review will explore the different characteristics of these conditions including the incidence, pathophysiology, clinical implications, prognosis and current state of available medical therapies.     

Further insight on the hypoglycemic and nonhypoglycemic effects of troglitazone 400 or 600 mg/d: effects on the very-low-density and high-density lipoprotein particle distribution.

The effects of troglitazone 400 or 600 mg/d on the glycemic control, very-low-density lipoprotein (VLDL), and high-density lipoprotein (HDL) subclass concentrations and plasminogen-activator inhibitor 1 (PAI-1) levels were assessed in patients with type 2 diabetes that had not been controlled with dietary treatment. This was a multicenter, open-label, parallel-groups study. It included a run-in 4-week diet period and a 24-week randomized treatment. Fifty one patients received 400 mg/d and 55 patients 600 mg. The mean HbA(1c) concentration at the end of the study was similar for both doses. Troglitazone, regardless of dose, significantly improved insulin sensitivity assessed by the homeostasis model (HOMA). PAI-1 levels were significantly decreased in both groups by 13%. Higher HDL cholesterol concentrations and lower triglycerides levels were observed at the end of treatment. Triglyceride contents were reduced only in the lighter VLDL1. The change in HDL cholesterol concentration resulted from a combination of increased HDL3 cholesterol and lower HDL2 cholesterol levels. No differences were found in the effects of both treatment groups on the evaluated parameters. Our data provide new information about the actions of the drug on the lipid profile. Troglitazone reduces triglyceride levels by lowering the triglycerides content of the VLDL1 particles and increases HDL cholesterol concentrations by increasing HDL3 cholesterol levels.