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Sample records for disease self-help groups

  1. Some Critical Differences between Self-Help and Therapy Groups.

    ERIC Educational Resources Information Center

    Riordan, Richard J.; Beggs, Marilyn S.

    1988-01-01

    Presents a scheme for addressing differences between self-help groups and therapy groups, characterizing a list of group work parameters according to emphasis placed on each in therapy groups in contrast with self-help groups. Distinguishes between support groups, started by professional helping organizations or individuals, and self-help groups,…

  2. Anorexia Nervosa and Bulimia: A Self-Help Group.

    ERIC Educational Resources Information Center

    Franko, Debra L.

    1987-01-01

    Implemented weekly self-help group for female anorexics and bulimics. Eighteen women who had consistently attended sessions evaluated group six months after it had begun. Found that self-help group benefited most members. Discusses findings in relation to curative factors of such groups. Offers suggestions for professionals interested in…

  3. Care for chronic illness in Australian general practice – focus groups of chronic disease self-help groups over 10 years: implications for chronic care systems reforms

    PubMed Central

    Martin, Carmel M; Peterson, Chris; Robinson, Rowena; Sturmberg, Joachim P

    2009-01-01

    Background Chronic disease is a major global challenge. However, chronic illness and its care, when intruding into everyday life, has received less attention in Asia Pacific countries, including Australia, who are in the process of transitioning to chronic disease orientated health systems. Aim The study aims to examine experiences of chronic illness before and after the introduction of Australian Medicare incentives for longer consultations and structured health assessments in general practice. Methods Self-help groups around the conditions of diabetes, epilepsy, asthma and cancer identified key informants to participate in 4 disease specific focus groups. Audio taped transcripts of the focus groups were coded using grounded theory methodology. Key themes and lesser themes identified using a process of saturation until the study questions on needs and experiences of care were addressed. Thematic comparisons were made across the 2002/3 and 1992/3 focus groups. Findings At times of chronic illness, there was need to find and then ensure access to 'the right GP'. The 'right GP or specialist' committed to an in-depth relationship of trust, personal rapport and understanding together with clinical and therapeutic competence. The 'right GP', the main specialist, the community nurse and the pharmacist were key providers, whose success depended on interprofessional communication. The need to trust and rely on care providers was balanced by the need for self-efficacy 'to be in control of disease and treatment' and 'to be your own case manager'. Changes in Medicare appeared to have little penetration into everyday perceptions of chronic illness burden or time and quality of GP care. Inequity of health system support for different disease groupings emerged. Diabetes, asthma and certain cancers, like breast cancer, had greater support, despite common experiences of disease burden, and a need for research and support programs. Conclusion Core themes around chronic illness

  4. Rwandan self-help group grows apace.

    PubMed

    1993-01-01

    Donald de Gagne' is a Canadian who was diagnosed with AIDS in January 1988. He was interviewed in a previous issue of global AIDSnews for his role in helping to launch a self-support group for people with AIDS in Kigali, Rwanda. The publication has now published excerpts of a correspondence sent from the managing committee of the group in response to the interview. The group was formed in January 1992 with the primary goal of fighting against the psychosocial alienation felt by HIV-infected people in Rwanda. The group became known as the Rwandan Mirror of Health Association (ARMS) on March 21, 1992. The initial group membership expanded rapidly to include 120 members by April 1993. Membership consists of individuals from a variety of socioeconomic backgrounds even though most members are low-income residents of Kigali. ARMS has not yet finished the paperwork necessary to become legally recognized by the government, but has nonetheless initiated training and information activities by its members. The population of Rwanda is beginning is destigmatize people with AIDS. ARMS representatives have attended international forums and conferences, while the organization has hosted journalists and other interested professionals. The group exists upon funds from the Norwegian Red Cross in Rwanda through Info-SIDA even though it would like to bring in 1000 Rwanda francs annually per member; microeconomic constraints will make this latter objective difficult to realize. ARMS' wish list includes a multipurpose facility in which to hold meetings and accommodate the office of a permanent secretariat along with a small store of drugs to treat minor AIDS-related infections. The group also needs operating funds for the permanent secretariat and funds for a study to determine the cost of meeting these needs. ARMS thanks all in advance who may render tangible assistance.

  5. Role of Self-help Group in Substance Addiction Recovery

    NASA Astrophysics Data System (ADS)

    Das, Prangya Paramita Priyadarshini

    2012-11-01

    Background: The Narcotics Anonymous (NA)/Alcoholic Anonymous(AA) is based on the philosophy of self-help, where the former addicts and recovering addicts share experiences, provide emotional support and do active monitoring through mentoring. In mentoring, a former addict with longer duration of drug-free life acts as a guide to the newly recovering addict. Objective: The objective was to study the effect of involvement in self help group upon addictís level of depression, functional social support, and anxiety. Method: The size of the sample was 60. 30 addicts were taken from rehabilitation centre and 30 were taken from self-help groups. ANOVA was used to analyze the result. Result: In all the criteria it was found that there exists a significant impact of Self-help group. Conclusion: Self-help group provide clients with a social network of individuals with similar problems and experiences, since most of these individuals may be isolated from society due to the social stigma attached to their addictions. The transition from being help recipients to being helpers enables recovering addicts to build their self-confidence and feelings of being wanted and desired in society, which facilitates their self-confidence and positive self-esteem.

  6. Self-Help Support Groups for Teachers Under Stress.

    ERIC Educational Resources Information Center

    Walley, William V.; Stokes, Joseph P.

    The development of a program of self-help support groups for teachers experiencing stress in Chicago public schools is described. These support groups attempted to alleviate stress-related illness by reducing teacher isolation and by enabling teachers to help each other cope with problems and fears. The support groups were led by teachers who…

  7. Persuasion in a Self-Help Group: Processes and Consequences.

    ERIC Educational Resources Information Center

    Jurik, Nancy C.

    1987-01-01

    Examined techniques of persuasion used in self-help organization for persons with mental problems. Concludes that successful affiliation with the group is a conversion process and that, although acceptance of the organizational ideology may facilitate an individual member's recovery, it simultaneously reinforces an understanding of mental problems…

  8. An organizational typology for self-help groups.

    PubMed

    Schubert, M A; Borkman, T J

    1991-10-01

    Those investigating the nature and functioning of self-help groups have been handicapped by the lack of a conceptual framework to bridge the diversity among such groups as well as to clarify the boundaries between consumer-owned and professionally owned groups. This paper describes a typology that classifies local units of these groups in terms of differences and similarities in their organizational structures. Rooted in organizational theory, it has two dimensions: external dependence upon resources and internal extent of experiential authority. Using it, the authors identified five types of groups, referred to as Unaffiliated, Federated, Affiliated, Hybrid, and Managed. The typology was validated with actual groups.

  9. Responding to local needs. Self-help groups.

    PubMed

    Jayaseelan, J

    1993-01-01

    Pink Triangle, the only community-based group in Malaysia which works with men who have sex with men, took initial steps in August 1992 to establish a self-help project for people who are HIV-seropositive. Supporting people who are HIV-positive and fighting for their rights is new in Malaysia. The group has thus far been publicized through its public education events, hospitals, and other nongovernmental organizations. For the first time, information is being published specifically by and for people living with HIV/AIDS. The project also has a phone line to allow people to speak anonymously with someone who shares their experience. Many callers are men who have sex with men in the social context of intense prejudice and discrimination. Afraid to openly acknowledge their sexuality with strangers, the callers have yet to accede to meeting each other face-to-face in a group setting. The author notes in closing that Pink Triangle must be realistic about what can be achieved in Malaysia and allow the group to develop according to people's needs and not on the basis of a model imported from outside of the country.

  10. Self-Help Group Leaders as Community Helpers: An Impact Assessment.

    ERIC Educational Resources Information Center

    Meissen, Greg; Warren, Mary; Nansel, Tonja; Goodman, Samantha

    2002-01-01

    A study examined costs and benefits perceived by 26 self-help group leaders who helped rural Kansas communities in extending the use, awareness, and effectiveness of self-help groups. Findings that satisfaction in helping was the major benefit and time constraints the major cost were used to tailor leadership roles. Self-help group activity…

  11. Illness and Prevention: Self-Help Groups for Families Faced with Scoliosis.

    ERIC Educational Resources Information Center

    Hinrichsen, Gregory A.; And Others

    The purpose of this study was to determine what kinds of people are motivated to join a medical self-help group and whether and in what areas of psychological and social functioning such self-help groups have positive benefits for adolescents and their families. Extensive survey questionnaires were sent throughout the United States to all former…

  12. Adolescent Substance-Use Frequency following Self-Help Group Attendance and Outpatient Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Gangi, Jennifer; Darling, Carol A.

    2012-01-01

    Despite the heterogeneity of posttreatment outcomes, the likelihood of relapse is often dependent on several factors, including participation in continuing care services such as self-help groups. However, few studies have examined the use of self-help groups among adolescent outpatients. Therefore, in this study, investigators examined self-help…

  13. [Use of and participation in self-help groups for methadone substitution patients].

    PubMed

    Verthein, U; Raschke, P

    1999-12-01

    To evaluate the importance of self-help groups and the patients' readiness to participate in such groups a sample of 675 methadone patients in Hamburg was asked by means of questionnaires. 43% of the patients had heard of self-help groups. One quarter of them (10% of the whole sample) had participated in self-help groups at some time. The greatest importance of self-help organisations is attached to a representation of the interests of methadone patients to improve their overall situation. Another important purpose of self-help groups is seen in getting help for legal, financial and social problems. Getting in contact with other clients or offering breakfast/lunch, washing clothes or shower facilities etc. is not evaluated as an important task for self-help organisations. Patients who are working on a regular basis and living in stable conditions are less interested in participating in self-help groups. Thus, the participants in self-help groups can hardly benefit from the experiences of the socially better integrated methadone patients.

  14. [Organization of self-help groups for patients with psychogenic eating disorders].

    PubMed

    Krch, F

    1991-04-01

    The author pays attention to the organization of self-help groups of women suffering from anorexia nervosa and bulimia and illustrates them on several examples of self-help groups in the USA, Austria and Czechoslovakia. Great attention is paid to the BASH programme (Bulimia Anorexia Self-help) in St. Louis in the USA, one of the first self-help groups developing within the framework of a therapeutic and research institution for patients with psychogenic eating disorders. In the conclusion of the review the author presents his own experience with the organization of a MAB (mental anorexia--bulimia club) founded in 1989 at the Psychiatric Clinic of the Faculty of General Medicine, Charles University in Prague, attached to the Unit of specialized care of patients with psychogenic eating disorders. He emphasizes the necessity of differentiated and long-term therapeutic action on patients with psychogenic eating disorders where self-help groups hold an irreplaceable place. Attention is drawn to the fact that in addition to detection, emotional and social rehabilitation in the treatment of patients with preclinical symptoms a very important place is held by self-help groups which have a specific therapeutic influence and importance.

  15. Expanding Self-Help Group Participation in Culturally Diverse Urban Areas: Media Approaches to Leveraging Referent Power

    ERIC Educational Resources Information Center

    Humphreys, Keith; Macus, Sue; Stewart, Eric; Oliva, Elizabeth

    2004-01-01

    Accumulating research attests to the benefits of self-help groups for people who have various chronic health problems. Expansion of self-help group participation may enable a broader portion of society to experience these health benefits. The Media and Education for Self-Help (MESH) Project was an effort to increase interest in health-related…

  16. Measurement of Attitudes of Rural Women towards Self-Help Groups

    ERIC Educational Resources Information Center

    Meena, M. S.; Jain, Dilip; Meena, H. R.

    2008-01-01

    Self-help groups (SHGs) have emerged as an effective mechanism of empowerment and development of women as well as being on efficient mode of promoting group action and technology dissemination. Initiatives were undertaken at the Central Institute of Post-Harvest Engineering and Technology (CIPHET), Ludhiana to facilitate the formation of women's…

  17. The Role of a Self-Help Group in Working with Parents of a Stillborn Baby.

    ERIC Educational Resources Information Center

    Wilson, Ann L.; Soule, Douglas J.

    1981-01-01

    Studies how a self-help group can facilitate parents' mourning process following a stillbirth. With family-to-family contact and group discussions, the reality of the stillbirth is validated, the empty feelings of the loss the parents are experiencing are acknowledged, and the guilt the couples are feeling is eased. (Author)

  18. Factors Predicting Attendance at Self-Help Groups after Substance Abuse Treatment: Preliminary Findings.

    ERIC Educational Resources Information Center

    Humphreys, Keith; And Others

    1991-01-01

    Followed 201 treated substance abusers for 6 months and found that Blacks and women were more likely to attend self-help groups and that measures of social stability did not predict attendance. Found that persons who attended groups had more severe problems in several domains. (Author/NB)

  19. Padres Maltratadores: Grupos de Autoayuda (Abusive Parents: Self-Help Groups).

    ERIC Educational Resources Information Center

    Intebi, Irene V.; Groisman, Adriana E.

    1991-01-01

    Causes of child abuse by parents are discussed. A therapy program in Buenos Aires (Argentina) for abusive parents is described. The program utilizes self-help groups as part of the therapeutic plan and has found them to be promising. Referral, types of interactions with the groups, and short-, medium-, and long-term objectives are discussed. (BRM)

  20. Beyond the therapeutic: A Habermasian view of self-help groups' place in the public sphere.

    PubMed

    Chaudhary, Sarah; Avis, Mark; Munn-Giddings, Carol

    2013-02-01

    Self-help groups in the United Kingdom continue to grow in number and address virtually every conceivable health condition, but they remain the subject of very little theoretical analysis. The literature to date has predominantly focused on their therapeutic effects on individual members. And yet they are widely presumed to fulfil a broader civic role and to encourage democratic citizenship. The article uses Habermas' model of the public sphere as an analytical tool with which to reconsider the literature on self-help groups in order to increase our knowledge of their civic functions. In doing this it also aims to illustrate the continuing relevance of Habermas' work to our understanding of issues in health and social care. We consider, within the context of current health policies and practices, the extent to which self-help groups with a range of different forms and functions operate according to the principles of communicative rationality that Habermas deemed key to democratic legitimacy. We conclude that self-help groups' civic role is more complex than is usually presumed and that various factors including groups' leadership, organisational structure and links with public agencies can affect their efficacy within the public sphere.

  1. Beyond the therapeutic: A Habermasian view of self-help groups' place in the public sphere

    PubMed Central

    Chaudhary, Sarah; Avis, Mark; Munn-Giddings, Carol

    2013-01-01

    Self-help groups in the United Kingdom continue to grow in number and address virtually every conceivable health condition, but they remain the subject of very little theoretical analysis. The literature to date has predominantly focused on their therapeutic effects on individual members. And yet they are widely presumed to fulfil a broader civic role and to encourage democratic citizenship. The article uses Habermas' model of the public sphere as an analytical tool with which to reconsider the literature on self-help groups in order to increase our knowledge of their civic functions. In doing this it also aims to illustrate the continuing relevance of Habermas' work to our understanding of issues in health and social care. We consider, within the context of current health policies and practices, the extent to which self-help groups with a range of different forms and functions operate according to the principles of communicative rationality that Habermas deemed key to democratic legitimacy. We conclude that self-help groups' civic role is more complex than is usually presumed and that various factors including groups' leadership, organisational structure and links with public agencies can affect their efficacy within the public sphere. PMID:23326207

  2. The Benefits of Parenting Self-Help Groups for Rural Latino Parents.

    ERIC Educational Resources Information Center

    Wituk, Scott; Commer, Amy; Lindstrom, Julie; Meisen, Greg

    2001-01-01

    A survey of 118 rural, mostly female, Latino participants in Parents Helping Parents (PHP)--a Kansas network of parenting self-help groups--found high satisfaction with PHP. PHP provided support and information concerning child rearing and child development, improved family communication, and increased the use of alternative means of discipline.…

  3. Expanding Our Understanding of Self-Help Support Groups for Substance Use Issues

    ERIC Educational Resources Information Center

    Dadich, Ann

    2010-01-01

    Self-Help Support Groups (SHSGs) for substance use issues are recognized in current policies for their role in reducing substance use. However, these policies recognize only their therapeutic value. This article argues that SHSGs can offer more than therapeutic advantage. This contention follows a study involving young people who were involved in…

  4. A Guide for Developing Self-Help/Advocacy Groups for Parents of Children with Serious Emotional Problems. Workbook Series for Developing Self-Help/Advocacy Groups for Parents of Children with Serious Emotional Problems.

    ERIC Educational Resources Information Center

    Donner, Richard; Fine, Glenda Z.

    This workbook is a guide for the development of self-help/advocacy groups for parents of children and adolescents who have serious emotional problems. The workbook offers background information and then offers guidelines for: (1) creating a beginning plan for the development of a self-help/advocacy group; (2) developing concrete plans for…

  5. Self-help energy conservation programs for low-income groups: the SMILE experience

    SciTech Connect

    Bachman, A.L.

    1980-05-01

    The implementation of a pilot program of self-help energy conservation projects in low-income neighborhoods in Lafayette, Louisiana, is described. The program was designed to meet the needs of a specific group of people within the context of their particular energy use patterns, their housing stock, and the climate of the southcentral region. A wider application is indicated, however, and the report focuses on those elements of the program that could be applied in other regions. Special attention is devoted to weatherproofing, and an informational booklet on this topic is included.

  6. Exploring and encouraging through social interaction: a qualitative study of nurses' participation in self-help groups for cancer patients.

    PubMed

    Adamsen, Lis; Rasmussen, Julie Midtgaard

    2003-02-01

    Self-help groups are a growing phenomenon across national borders. Current sociologic empirical evidence shows that nurses and other healthcare professionals have become an integral part of self-help groups. The aim of the study is to describe and highlight the experiences of patients with cancer (n = 21) and oncology nurses (n = 12) with self-help groups. These experiences are drawn on to illustrate the characteristics of professional involvement in self-help groups for patients with cancer. Data were obtained by individual qualitative interviews. The results show that the nurse functions as a social networker and uses her contextual competence by consciously encouraging relationships between fellow patients. Furthermore, the study illustrates that the nurse's involvement with self-help groups for patients with cancer serves as a complementary dimension to the traditional nursing discourse. It is concluded that when individualized care is supported through social practice and when personal issues are exchanged and negotiated, the nurse facilitates a milieu of togetherness in self-help groups for patients with cancer. The concept of self-help groups is a valuable contribution to new theories and service development in psychosocial care and complies with the understanding of the postmodern individual, who viewed as primarily responsible for negotiating, socializing, and making his or her own decisions.

  7. Utilisation of rheumatology care services in Germany: the case of physical therapy and self-help groups

    PubMed Central

    Thieme, Holm; Borgetto, Bernhard

    2012-01-01

    Physical Therapy (PT) and self-help groups (SHG) are important components of health care in rheumatic diseases. The utilisation of PT and SHG by patients with rheumatic diseases may be influenced by several factors. The aim of this study is to summarize the evidence on PT and SHG utilisation of patients with rheumatic diseases in Germany. We systematically searched the MEDLINE-database for studies that evaluated the utilisation and factors that possibly influence the utilisation of PT and SHG. Eight studies were found for PT-utilisation and one for SHG-utilisation. Between 25 and 59 percent of patients with rheumatic diseases received PT services. Several individual and contextual factors that may influence the utilisation could be identified. In conclusion, evidence exists for wide variations in the utilisation of PT services and an underuse of such services among patients with rheumatic diseases in Germany. By contrast, little evidence exists on the utilisation of SHG. PMID:23133502

  8. Personality and alcohol/substance-use disorder patient relapse and attendance at self-help group meetings.

    PubMed

    Janowsky, D S; Boone, A; Morter, S; Howe, L

    1999-01-01

    This study evaluated the role of personality in the short-term outcome of alcohol/substance-use disorder patients. Detoxifying alcohol/substance-use disorder patients were administered the Myers-Briggs Type Indicator (MBTI), the Tridimensional Personality Questionnaire (TPQ), the Michigan Alcohol Screening Test (MAST), the CAGE Questionnaire, and the Beck Depression Inventory (BDI). These patients were subsequently evaluated over a 1-month period for relapse and attendance at self-help group meetings. High TPQ Persistence scale scores predicted abstinence. When the Thinking and Feeling groups were considered separately, and when these two groups were combined into a single group, high scores for the individual groups and the combined group (i.e. Thinking and Feeling types together) predicted abstinence. High TPQ Persistence scale scores and low Shyness with Strangers and Fear of Uncertainty subscale scores predicted attendance at self-help group meetings. High MBTI Extroversion and high MBTI Thinking scores also predicted attendance at self-help group meetings. When the Extroverted and Introverted types and the Thinking and Feeling types respectively were combined, as with abstinence, high scores predicted attendance at self-help group meetings. Age, gender, CAGE, MAST, and BDI scores did not predict outcome. The above information suggests that specific personality variables may predict abstinence and attendance at self-help group meetings in recently detoxified alcoholics, and this may have prognostic and therapeutic significance. PMID:10414612

  9. Reworking therapeutic landscapes: the spatiality of an 'alternative' self-help group.

    PubMed

    Laws, Jennifer

    2009-12-01

    Since Gesler first introduced the concept in 1992, the language of 'therapeutic landscapes' has attained a core position in the toolkit of health/place studies. Whilst many authors using the term acknowledge that therapeutic landscapes are often also spaces of contestation, few if any have extended this to incorporate a serious critique of therapy itself. In this article, I use the case study of an 'alternative' psychiatric survivor (self-help) group in the north of England to attempt just this. Based on a ten month period of ethnography, I engage with the spaces - meeting places and venues - occupied by the group, focusing on the dilapidated and reputedly dangerous city park where the group hosts its most regular meetings. Three qualities of these spaces were found to be particularly embraced by the group: spaces of agency and appropriation; a space in the world; and a non-technical relation with space. The article uses these three themes to explore how the unconventional spaces of the group are not mere products of marginality but a serious aspect of mobilising the dissident and 'anti-psychiatric' recovery sought by its members. Through attending to what the survivors' found helpful in the park, a more sensitive rendition of 'anti-psychiatry' as it relates to the group is developed. The therapeutic landscapes framework as put forward by Gesler retains currency in highlighting the importance of place to the processes and identity of the group. However, it is also suggested that the 'dissident topophilias' of the survivors express a critique of current therapeutic landscapes thinking, challenging the supposition that it is the planned, the pleasant and the professional that provide the best backdrops for recovery.

  10. Professional Support of Self-Help Groups: A Support Group Project for Chronic Fatigue Syndrome Patients.

    ERIC Educational Resources Information Center

    Carlsen, Benedicte

    2003-01-01

    Study follows a collaborative support group project between a team of health professionals and a Chronic Fatigue Syndrome patients' group. While advantageous for professionals to decide upon the aim of a joint intervention in dialogue with participants, simply asking participants what their aims are does not guarantee actual agreement. Case study…

  11. Effects of a cognitive-behavioral self-help program on depressed mood for people with peripheral arterial disease.

    PubMed

    Garnefski, N; Kraaij, V; Wijers, E; Hamming, J

    2013-06-01

    The aim of the present study was to examine whether a new low-cost psychological self-help intervention program with minimal coaching could be effective in improving depressed mood in people with peripheral arterial disease (PAD). Thirteen persons with PAD and depressive symptoms participated in the self-help program, grounded in cognitive-behavioral therapy. They completed pre-test, post-test and follow-up questionnaires, including the PHQ-9, to measure symptoms of depression. To evaluate changes in depression scores from pre- to post-test to follow-up measurement, non-parametric repeated measures Wilcoxon signed rank tests were performed. The results showed that participants' depression scores significantly improved from pre-test to post-test and that there was no relapse from post-test to follow-up. The cognitive-behavioral self-help intervention could be an effective tool in people with PAD, to reduce symptoms of depression.

  12. Promoting household water treatment through women's self help groups in Rural India: assessing impact on drinking water quality and equity.

    PubMed

    Freeman, Matthew C; Trinies, Victoria; Boisson, Sophie; Mak, Gregory; Clasen, Thomas

    2012-01-01

    Household water treatment, including boiling, chlorination and filtration, has been shown effective in improving drinking water quality and preventing diarrheal disease among vulnerable populations. We used a case-control study design to evaluate the extent to which the commercial promotion of household water filters through microfinance institutions to women's self-help group (SHG) members improved access to safe drinking water. This pilot program achieved a 9.8% adoption rate among women targeted for adoption. Data from surveys and assays of fecal contamination (thermotolerant coliforms, TTC) of drinking water samples (source and household) were analyzed from 281 filter adopters and 247 non-adopters exposed to the program; 251 non-SHG members were also surveyed. While adopters were more likely than non-adopters to have children under 5 years, they were also more educated, less poor, more likely to have access to improved water supplies, and more likely to have previously used a water filter. Adopters had lower levels of fecal contamination of household drinking water than non-adopters, even among those non-adopters who treated their water by boiling or using traditional ceramic filters. Nevertheless, one-third of water samples from adopter households exceeded 100 TTC/100ml (high risk), and more than a quarter of the filters had no stored treated water available when visited by an investigator, raising concerns about correct, consistent use. In addition, the poorest adopters were less likely to see improvements in their water quality. Comparisons of SHG and non-SHG members suggest similar demographic characteristics, indicating SHG members are an appropriate target group for this promotion campaign. However, in order to increase the potential for health gains, future programs will need to increase uptake, particularly among the poorest households who are most susceptible to disease morbidity and mortality, and focus on strategies to improve the correct, consistent

  13. Promoting Household Water Treatment through Women's Self Help Groups in Rural India: Assessing Impact on Drinking Water Quality and Equity

    PubMed Central

    Freeman, Matthew C.; Trinies, Victoria; Boisson, Sophie; Mak, Gregory; Clasen, Thomas

    2012-01-01

    Household water treatment, including boiling, chlorination and filtration, has been shown effective in improving drinking water quality and preventing diarrheal disease among vulnerable populations. We used a case-control study design to evaluate the extent to which the commercial promotion of household water filters through microfinance institutions to women's self-help group (SHG) members improved access to safe drinking water. This pilot program achieved a 9.8% adoption rate among women targeted for adoption. Data from surveys and assays of fecal contamination (thermotolerant coliforms, TTC) of drinking water samples (source and household) were analyzed from 281 filter adopters and 247 non-adopters exposed to the program; 251 non-SHG members were also surveyed. While adopters were more likely than non-adopters to have children under 5 years, they were also more educated, less poor, more likely to have access to improved water supplies, and more likely to have previously used a water filter. Adopters had lower levels of fecal contamination of household drinking water than non-adopters, even among those non-adopters who treated their water by boiling or using traditional ceramic filters. Nevertheless, one-third of water samples from adopter households exceeded 100 TTC/100ml (high risk), and more than a quarter of the filters had no stored treated water available when visited by an investigator, raising concerns about correct, consistent use. In addition, the poorest adopters were less likely to see improvements in their water quality. Comparisons of SHG and non-SHG members suggest similar demographic characteristics, indicating SHG members are an appropriate target group for this promotion campaign. However, in order to increase the potential for health gains, future programs will need to increase uptake, particularly among the poorest households who are most susceptible to disease morbidity and mortality, and focus on strategies to improve the correct, consistent

  14. A neoliberalisation of civil society? Self-help groups and the labouring class poor in rural South India.

    PubMed

    Pattenden, Jonathan

    2010-01-01

    This paper notes the prominence of self-help groups (SHGs) within current anti-poverty policy in India, and analyses the impacts of government- and NGO-backed SHGs in rural North Karnataka. It argues that self-help groups represent a partial neoliberalisation of civil society in that they address poverty through low-cost methods that do not challenge the existing distribution of power and resources between the dominant class and the labouring class poor. It finds that intra-group savings and loans and external loans/subsidies can provide marginal economic and political gains for members of the dominant class and those members of the labouring classes whose insecure employment patterns currently provide above poverty line consumption levels, but provide neither material nor political gains for the labouring class poor. Target-oriented SHG catalysts are inattentive to how the social relations of production reproduce poverty and tend to overlook class relations and socio-economic and political differentiation within and outside of groups, which are subject to interference by dominant class local politicians and landowners.

  15. Mutual Assistance Associations: Refugee Self-Help Groups Play Key Role.

    ERIC Educational Resources Information Center

    Ranard, Donald A.

    1990-01-01

    The history and current status of Indochinese Mutual Assistance Programs (MAAs) is reviewed in the newsletter issue, and a description is provided of the six kinds of MAAs that are found in the United States. They include the following: (1) cultural preservation/social activities; (2) religious services; (3) special constituency groups; (4)…

  16. Burnout in the Helping Professions: Mutual Aid Groups as Self-Help.

    ERIC Educational Resources Information Center

    Spicuzza, Frank J.; De Voe, Marianne W.

    1982-01-01

    Offers some insight and understanding of the stress-producing components of counseling practice. Discusses some of the physical symptoms of burnout and examines why the syndrome is prevalent in the human services. Proposes the development of mutual aid groups as one solution to prevent or minimize burnout. (Author/RC)

  17. [Patient self-help, user perspective and health services research].

    PubMed

    Borgetto, B; von dem Knesebeck, O

    2009-01-01

    Patient's individual responsibility, self-help and active co-operation are essential for the health care system. This paper presents a synopsis of research in self-help groups and self-help organizations. Studies provide evidence that self-help initiatives are an important contribution to population health. Especially self-help groups increase mutual aid and social support, knowledge about the disease and its consequences and possibilities for changing attitudes of the group members and their social environment. They disburden primary networks and families and reinforce an 'intelligent' utilization of professional health care services. There has been as yet hardly any systematic investigation of the activities of self-help organizations, except from counseling services. Self-help groups and organizations increasingly receive financial support from the social security system and have increasingly become part of the health care system. However, the co-operation between self-help initiatives and the professional health care system is characterized by an imbalance between laymen and experts. Given these results, self-help, user perspective and the health-related behavior of laymen should obtain more significance in the conceptualization and definitions of health services research.

  18. Effect of combining a health program with a microfinance-based self-help group on health behaviors and outcomes

    PubMed Central

    Saha, S.; Kermode, M.; Annear, P.L.

    2015-01-01

    Objectives Women's participation in microfinance-based self-help groups (SHGs) and the resultant social capital may provide a basis to address the gap in health attainment for poor women and their children. We investigated the effect of combining a health program designed to improve health behaviours and outcomes with a microfinance-based SHG program. Design A mixed method study was conducted among 34 villages selected from three blocks or district subdivisions of India; one in Gujarat, two in Karnataka. Methods A set of 17 villages representing new health program areas were pair-matched with 17 comparison villages. Two rounds of surveys were conducted with a total of 472 respondents, followed by 17 key informant interviews and 17 focus group discussions. Results Compared to a matched comparison group, women in SHGs that received the health program had higher odds of delivering their babies in an institution (OR: 5.08, 95% CI 1.21–21.35), feeding colostrum to their newborn (OR: 2.83, 95% CI 1.02–5.57), and having a toilet at home (OR: 1.53, 95% CI 0.76–3.09). However, while the change was in the expected direction, there was no statistically significant reduction in diarrhoea among children in the intervention community (OR: 0.86, 95% CI 0.42–1.76), and the hypothesis that the health program would result in decreased out-pocket expenditures on treatment was not supported. Conclusion Our study found evidence that health programs implemented with microfinance-based SHGs is associated with improved health behaviours. With broad population coverage of SHGs and the social capital produced by their activities, microfinance-based SHGs may provide an avenue for addressing the health needs of poor women. PMID:26304181

  19. Internet-Based Self-Help with Therapist Feedback and in Vivo Group Exposure for Social Phobia: A Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Andersson, Gerhard; Carlbring, Per; Holmstrom, Annelie; Sparthan, Elisabeth; Furmark, Tomas; Nilsson-Ihrfelt, Elisabeth; Buhrman, Monica; Ekselius, Lisa

    2006-01-01

    Sixty-four individuals with social phobia (social anxiety disorder) were assigned to a multimodal cognitive-behavioral treatment package or to a waiting list control group. Treatment consisted of a 9-week, Internet-delivered, self-help program that was combined with 2 group exposure sessions in real life and minimal therapist contact via e-mail.…

  20. A Controlled Comparison of Cognitive Therapy and Self-Help Support Groups in the Treatment of Irritable Bowel Syndrome.

    ERIC Educational Resources Information Center

    Payne, Annette; Blanchard, Edward B.

    1995-01-01

    Patients with irritable bowel syndrome (n=34) were randomly assigned to 1 of 3 treatment conditions for 8 weeks: individualized cognitive treatment, support group, or control. Results indicated significantly greater reductions in gastrointestinal symptoms and amelioration of depression and anxiety for the cognitive therapy group, and these results…

  1. [Social participation and activities of daily living of patients with inflammatory rheumatic diseases : support by self-help, exercise therapy and new media].

    PubMed

    Mattukat, K; Thyrolf, A

    2014-02-01

    Rheumatic patients are at risk of social isolation and physical inactivity which can have a significant impact on physical and mental health. Only every seventh patient is organized in a self-help group (SHG), most of them in the German League Against Rheumatism (GLAR). Members of a SHG are socially and physically more active and take part in exercise therapy (ET) more often. Depending on the study, the utilization of ET ranges from 25 % to 71 %. The functional training as the most attended offer of the GLAR showed positive effects at the physical and psychological levels. To motivate difficult to reach patients to engage in self-help and regular exercise, further development of exercise programs with individually tailored intensive strength and endurance elements as well as the increased use of new media seems promising. The Internet provides various opportunities for networking and social participation especially for severely impaired and temporally less flexible patients.

  2. A community-based group-guided self-help intervention for low mood and stress: study protocol for a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Depression is a mental health condition which affects millions of people each year, with worldwide rates increasing. Cognitive behavioral therapy (CBT) is recommended in the National Institute for Health and Clinical Excellence (NICE) guidelines for the treatment of depression. However, waiting lists can cause delays for face-to-face therapy. Also a proportion of people decline to present for help through the health service – the so-called treatment gap. Self-referral to CBT using community-based group interventions delivered by a voluntary sector organization may serve to resolve this problem. The aim of this randomized controlled trial (RCT) is to determine the efficacy of such a guided CBT self-help course, the ‘Living Life to the Full’ (LLTTF) classes delivered by the charity Action on Depression (AOD). The primary outcome is level of depression at 6 months assessed using the patient health questionnaire-9 (PHQ9) depression scale. Secondary measures include levels of anxiety and social functioning. Methods/design Participants with symptoms of low mood will be recruited from the community through newspaper adverts and also via the AOD website. Participants will receive either immediate or delayed access to guided CBT self-help classes - the eight session LLTTF course. The primary endpoint will be at 6 months at which point the delayed group will be offered the intervention. Levels of depression, anxiety and social functioning will be assessed and an economic analysis will be carried out. Discussion This RCT will test whether the LLTTF intervention is effective and/or cost-effective. If the LLTTF community-based classes are found to be cost effective, they may be helpful as both an intervention for those already seeking care in the health service, as well as those seeking help outside that setting, widening access to psychological therapy. Trial registration Current Controlled Trials ISRCTN86292664 PMID:24252475

  3. Improving Self-Help E-Therapy for Depression and Anxiety Among Sexual Minorities: An Analysis of Focus Groups With Lesbians and Gay Men

    PubMed Central

    Lyons, Anthony; Pitts, Marian; Mitchell, Anne; Christensen, Helen

    2015-01-01

    Background E-therapies for depression and anxiety rarely account for lesbian and gay users. This is despite lesbians and gay men being at heightened risk of mood disorders and likely to benefit from having access to tailored self-help resources. Objective We sought to determine how e-therapies for depression and anxiety could be improved to address the therapeutic needs of lesbians and gay men. Methods We conducted eight focus groups with lesbians and gay men aged 18 years and older. Focus groups were presented with key modules from the popular e-therapy “MoodGYM”. They were asked to evaluate the inclusiveness and relevance of these modules for lesbians and gay men and to think about ways that e-therapies in general could be modified. The focus groups were analyzed qualitatively using a thematic analysis approach to identify major themes. Results The focus groups indicated that some but not all aspects of MoodGYM were suitable, and suggested ways of improving e-therapies for lesbian and gay users. Suggestions included avoiding language or examples that assumed or implied users were heterosexual, improving inclusiveness by representing non-heterosexual relationships, providing referrals to specialized support services and addressing stigma-related stress, such as “coming out” and experiences of discrimination and harassment. Focus group participants suggested that dedicated e-therapies for lesbians and gay men should be developed or general e-therapies be made more inclusive by using adaptive logic to deliver content appropriate for a user’s sexual identity. Conclusions Findings from this study offer in-depth guidance for developing e-therapies that more effectively address mental health problems among lesbians and gay men. PMID:25761775

  4. [More power for patients: the patients' forum--a joint platform for the medical profession and patient self-help groups].

    PubMed

    Sänger, S; Engelbrecht, J; Litschel, A; Englert, G; Hagelskamp, J; Nachtigäller, C

    2001-08-01

    New ways of cooperation between doctors and representatives of patients are followed with the help of the patients' forum which was founded on the initiative of the German Medical Association. Members of the German Association 'Help for the Handicapped People', the 'Forum of the Chronic Ill and Handicapped People' of the 'Equal Charitable Organisation' (Paritätischer Wohlfahrtsverband), the 'German Association of Self-Help Groups' as well as representatives of the committees and the management of the German Medical Association and the National Association of Statutory Health Insurance Physicians form the patients' forum. The major aim of this cooperation is to discuss the possibilities and the ways to improve the quality in health care. A direct participation of patients' representatives is for the moment planned in the evaluation of the quality of medical information for the lay public. In cooperation with the Agency for Quality in Medicine--a joint institution of the German Medical Association and the National Association of Statutory Health Insurance Physicians--the quality of information on health care that is published in the internet should be examined. The patients' information service which was developed by the Agency for Quality in Medicine and is found under www.patienten-information.de is the basis for this examination.

  5. Self-Help Program Components and Linkage to Aftercare Following Inpatient Detoxification

    PubMed Central

    Frydrych, Lynne M.; Greene, Benjamin J.; Blondell, Richard D.; Purdy, Christopher H.

    2009-01-01

    Many patients fail to initiate aftercare for addictive disease rehabilitation following detoxification. This study of 136 inpatients compared characteristics of those who initiated aftercare (behavior therapy or self-help programs) during the week following discharge with those who did not. Among this group of patients, 77% (91/119) linked to aftercare. Self-help treatment related components were associated with increased aftercare treatment attendance rates and included: having a copy of the “12 Steps” (81% vs. 46%, P = .002), having read self-help literature (73% vs. 42%, P = .007) and having telephone numbers of self-help program members (50% vs. 18%, P = .008). Those who initiated aftercare treatment were also more likely to have remained abstinent from drugs and alcohol (81% vs. 39%, P <.001). Having self-help treatment-related components were associated with increased rates of aftercare attendance following hospital inpatient detoxification. PMID:19197592

  6. An Empowerment Approach for Elders Living With Diabetes: A Pilot Study of a Community-Based Self-Help Group--the Diabetes Club

    ERIC Educational Resources Information Center

    DeCoster, Vaughn A.; George, Lori

    2005-01-01

    Diabetes mellitus is a disabling, deadly disease, affecting one in five of adults over 65. Unfortunately, for the few elders that receive diabetes self-care training it is often taught using traditional didactic methods that are insensitive to their unique needs and immersed in the traditional medical paradigm. Integrating diabetes self-care into…

  7. Botswana's self-help community.

    PubMed

    Endrst, J

    1979-09-01

    Gaborone, the new capital of Botswana, has grown rapidly from 600 inhabitants in 1966 to 30,000 currently. People squatted in what was to have been a temporary labor camp zoned for industrial development. The Naledi camp was illegal until 1975 when the government dropped its zoning category and, with aid from the Canadian International Development Agency, began laying plans for turning 116 hectares of squatter land into 2000 individual plots housing 10,000 people. Naledi is now a suburban housing development that combines modern toilet facilities, street lighting, 2 primary schools, a health clinic, and a community center with traditional Tswana culture. A Certificate of Rights must be obtained for a plot of ground. The owner must construct a house within 12 months and pay a levy for road maintenance, water supply, and trash pickup. The Self-Help Housing Agency provides loans for building materials, payable in 15 years. The first thing a Naledi house-owner does is have it blessed by a minister of 1 of some 40 African churches in the settlement. The community is in the formative stages of organization. There is no single headman and no police. Elders are sometimes called upon to settle disputes. Naledi residents often view their plot as their second home. Many have their primary dwellings, and their head of cattle, in their native villages, living in Gabarone solely for economic reasons.

  8. Integrating self-help books into psychotherapy.

    PubMed

    Campbell, Linda F; Smith, Thomas P

    2003-02-01

    This article describes a systematic and integral method of incorporating self-help books into psychotherapy as a collaborative function. We address the distinctions between self-help and bibliotherapy, consider bibliotherapy as adjunctive or integrative to psychotherapy, and outline the multiple uses of bibliotherapy for clinical purposes. How to apply self-help books in psychotherapy and ways to select books are illustrated by a case example. Indications and contraindications for bibliotherapy in therapy are outlined.

  9. A written self-help intervention for depressed adults comparing behavioural activation combined with physical activity promotion with a self-help intervention based upon behavioural activation alone: study protocol for a parallel group pilot randomised controlled trial (BAcPAc)

    PubMed Central

    2014-01-01

    Background Challenges remain to find ways to support patients with depression who have low levels of physical activity (PA) to overcome perceived barriers and enhance the perceived value of PA for preventing future relapse. There is an evidence-base for behavioural activation (BA) for depression, which focuses on supporting patients to restore activities that have been avoided, but practitioners have no specific training in promoting PA. We aimed to design and evaluate an integrated BA and PA (BAcPAc) practitioner-led, written, self-help intervention to enhance both physical and mental health. Methods/design This study is informed by the Medical Research Council Complex Intervention Framework and describes a protocol for a pilot phase II randomised controlled trial (RCT) to test the feasibility and acceptability of the trial methods to inform a definitive phase III RCT. Following development of the augmented written self-help intervention (BAcPAc) incorporating behavioural activation with physical activity promotion, depressed adults are randomised to receive up to 12 sessions over a maximum of 4 months of either BAcPAc or behavioural activation alone within a written self-help format, which represents treatment as usual. The study is located within two ‘Improving Access to Psychological Therapies’ services in South West England, with both written self-help interventions supported by mental health paraprofessionals. Measures assessed at 4, 9, and 12 month follow-up include the following: CIS-R, PHQ-9, accelerometer recorded (4 months only) and self-reported PA, body mass index, blood pressure, Insomnia Severity Index, quality of life, and health and social care service use. Process evaluation will include analysis of recorded support sessions and patient and practitioner interviews. At the time of writing the study has recruited 60 patients. Discussion The feasibility outcomes will inform a definitive RCT to assess the clinical and cost-effectiveness of the

  10. Cults and zealous self-help movements: a psychiatric perspective.

    PubMed

    Galanter, M

    1990-05-01

    Modern cults and zealous self-help movements exercise an intense group influence and can have a major impact on their members' psychiatric status. On the basis of research findings, the author describes the charismatic group, a generic model for such cohesive, intensely ideological movements. He examines the psychological forces they tap and the way they can both relieve and exacerbate psychopathology. The model is then used to explain the operation of zealous self-help programs that address psychiatric syndromes; these are directed at problems of the medically ill, substance abusers, and relatives of psychiatric patients. PMID:2158240

  11. Self-help therapies for sexual dysfunction.

    PubMed

    van Lankveld, Jacques

    2009-01-01

    Self-help approaches can be relevant for individuals with sexual difficulties who cannot visit a therapist yet have sufficient coping skills and motivation to adhere to the advice and prescriptions included in the self-help method. Self-help can facilitate the transfer of treatment gains to the unassisted situation at home and thus reduce generalization difficulties from therapist setting to the home setting. They may prevent the development of client's codependency on therapist support and can help boost the client's sense of self-efficacy. Several self-help approaches were found to be efficacious, both statistically and clinically, in the treatment of several types of sexual dysfunction. The outcome is qualified by problem type, client characteristics, and delivery format of the self-help. The methods that are offered vary from cookbook-like protocols, which need to be followed in a stepwise and strict fashion, to strategies requiring the user to self-adapt a general problem-solving method to his or her personal situation, thereby enabling the individual to become his or her own therapist.

  12. Employee self-help smoking cessation programs: a review of the literature.

    PubMed

    Windsor, R A; Bartlett, E E

    1984-01-01

    The purpose of this article is to present a review of the literature on employee self-help smoking cessation programs. Included in this discussion are: (1) a rationale for self-help smoking cessation interventions; (2) a synopsis of their applicability to occupational settings; (3) a rational and description of the self-help smoking cessation interventions selected for a large group of employees; and (4) several methodological issues faced in conducting evaluations of smoking cessation programs.

  13. Cyber-Porn Dependence: Voices of Distress in an Italian Internet Self-Help Community

    ERIC Educational Resources Information Center

    Cavaglion, Gabriel

    2009-01-01

    This study analyzes narratives of cyber-porn users and defines major patterns of distress as self-reported by contributors to a self-help group in the Internet. It applies narrative analysis methodology to 2000 messages sent by 302 members of an Italian self-help Internet community for cyber-porn dependents ("noallapornodipendenza"). This paper…

  14. Self-Help and Health in Europe. New Approaches in Health Care.

    ERIC Educational Resources Information Center

    Hatch, Stephen, Ed.; Kickbusch, Ilona, Ed.

    This book brings together 24 contributions (from 13 European countries) about the role of self-help in the overall pattern of health care, dealing with both the practical and the theoretical: (1) "A Reorientation of Health Care?" (Ilona Kickbusch and Stephen Hatch); (2) "Self-help Groups in Primary Health Care" (David Robinson); (3) "Self-care:…

  15. Self-help: What future role in health care for low and middle-income countries?

    PubMed Central

    Nayar, KR; Kyobutungi, Catherine; Razum, Oliver

    2004-01-01

    In the debate on 'Third options' for health care delivery in low- and middle-income countries it is proposed that self-help should play a larger role. Self-help is expected to contribute towards improving population health outcomes and reducing government health care expenditure. We review scope and limitations of self-help groups in Europe and South Asia and assess their potential role in health care within the context of health sector reform. Self-help groups are voluntary unions of peers, formed for mutual assistance in accomplishing a health-related purpose. In Europe, self-help groups developed out of dissatisfaction with a de-personalised health care system. They successfully complement existing social and health services but cannot be instrumentalized to improve health outcomes while reducing health expenditure. In South Asia, with its hierarchical society, instrumental approaches towards self-help prevail in Non-governmental Organizations and government. The utility of this approach is limited as self-help groups are unlikely to be sustainable and effective when steered from outside. Self-help groups are typical for individualistic societies with developed health care systems – they are less suitable for hierarchical societies with unmet demand for regulated health care. We conclude that self-help groups can help to achieve some degree of synergy between health care providers and users but cannot be prescribed to partially replace government health services in low-income countries, thereby reducing health care expenditure and ensuring equity in health care. PMID:15084250

  16. Salivary Cortisol Levels and Depressive Symptomatology in Consumers and Nonconsumers of Self-Help Books: A Pilot Study.

    PubMed

    Raymond, Catherine; Marin, Marie-France; Hand, Anne; Sindi, Shireen; Juster, Robert-Paul; Lupien, Sonia J

    2016-01-01

    The self-help industry generates billions of dollars yearly in North America. Despite the popularity of this movement, there has been surprisingly little research assessing the characteristics of self-help books consumers, and whether this consumption is associated with physiological and/or psychological markers of stress. The goal of this pilot study was to perform the first psychoneuroendocrine analysis of consumers of self-help books in comparison to nonconsumers. We tested diurnal and reactive salivary cortisol levels, personality, and depressive symptoms in 32 consumers and nonconsumers of self-help books. In an explorative secondary analysis, we also split consumers of self-help books as a function of their preference for problem-focused versus growth-oriented self-help books. The results showed that while consumers of growth-oriented self-help books presented increased cortisol reactivity to a psychosocial stressor compared to other groups, consumers of problem-focused self-help books presented higher depressive symptomatology. The results of this pilot study show that consumers with preference for either problem-focused or growth-oriented self-help books present different physiological and psychological markers of stress when compared to nonconsumers of self-help books. This preliminary study underlines the need for additional research on this issue in order to determine the impact the self-help book industry may have on consumers' stress.

  17. Salivary Cortisol Levels and Depressive Symptomatology in Consumers and Nonconsumers of Self-Help Books: A Pilot Study

    PubMed Central

    Raymond, Catherine; Marin, Marie-France; Hand, Anne; Sindi, Shireen; Juster, Robert-Paul; Lupien, Sonia J.

    2016-01-01

    The self-help industry generates billions of dollars yearly in North America. Despite the popularity of this movement, there has been surprisingly little research assessing the characteristics of self-help books consumers, and whether this consumption is associated with physiological and/or psychological markers of stress. The goal of this pilot study was to perform the first psychoneuroendocrine analysis of consumers of self-help books in comparison to nonconsumers. We tested diurnal and reactive salivary cortisol levels, personality, and depressive symptoms in 32 consumers and nonconsumers of self-help books. In an explorative secondary analysis, we also split consumers of self-help books as a function of their preference for problem-focused versus growth-oriented self-help books. The results showed that while consumers of growth-oriented self-help books presented increased cortisol reactivity to a psychosocial stressor compared to other groups, consumers of problem-focused self-help books presented higher depressive symptomatology. The results of this pilot study show that consumers with preference for either problem-focused or growth-oriented self-help books present different physiological and psychological markers of stress when compared to nonconsumers of self-help books. This preliminary study underlines the need for additional research on this issue in order to determine the impact the self-help book industry may have on consumers' stress. PMID:26839713

  18. The Self-Help Clearinghouse of Metropolitan Toronto: reflections on seven years of survival and beyond.

    PubMed

    Fine, R; Hammett, C; Sernick, D; Steinhouse, K

    1995-01-01

    In May of 1987, Health and Welfare Canada awarded the Self-Help Clearinghouse of Metropolitan Toronto a three-year demonstration grant. Today, the Toronto Clearinghouse remains the only free-standing self-help resource of its kind in Canada and is a registered charitable organization whose mandate is to facilitate the growth and development of self-help/mutual-aid groups, networks, and resources. This paper describes the unique Toronto Clearinghouse model which from its earliest beginnings has been a partnership between the self-help community and interested and supportive professionals. The success of this model stems from its strong grassroots origins, respect for a community empowerment approach, and focused goals and objectives. Using information gleaned from the archival history of the Toronto Clearinghouse and through a series of interviews with past and current members of the Clearinghouse board of directors, program staff, and local self-help group members, the paper explains the "roller coaster ride" which has characterized the history of the Clearinghouse to date. Finally, the paper illustrates that while the achievement of financial stability has been an ongoing challenge in the face of variable community and political support, the Toronto Clearinghouse is, today, a strong centre of self-help activity and promotion, involved in a unique exercise to determine the role that self-help can play as a strategic component of an overall health and social services system-and with every reason to be optimistic about its future. PMID:10163396

  19. Content analysis of neurodegenerative and mental diseases social groups.

    PubMed

    Martínez-Pérez, Borja; de la Torre-Díez, Isabel; Bargiela-Flórez, Beatriz; López-Coronado, Miguel; Rodrigues, Joel J P C

    2015-12-01

    This article aims to characterize the different types of Facebook and Twitter groups for different mental diseases, their purposes, and their functions. We focused the search on depressive disorders, dementia, and Alzheimer's and Parkinson's diseases and examined the Facebook (www.facebook.com) and Twitter (www.twitter.com) groups. We used four assessment criteria: (1) purpose, (2) type of creator, (3) telehealth content, and (4) free-text responses in surveys and interviews. We observed a total of 357 Parkinson groups, 325 dementia groups, 853 Alzheimer groups, and 1127 depression groups on Facebook and Twitter. Moreover, we analyze the responses provided by different users. The survey and interview responses showed that many people were interested in using social networks to support and help in the fight against these diseases. The results indicate that social networks are acceptable by users in terms of simplicity and utility. People use them for finding support, information, self-help, advocacy and awareness, and for collecting funds.

  20. [Blood groups and disease].

    PubMed

    Prokop, O

    1986-09-01

    The inquiry for the sense of blood group polymorphisms (enzyme groups and serum groups included) and their significance for the constitution and also disposition to diseases is for the time being absolutely legitimate. But it is shown that the field--scarcely a new hereditary blood factor has been detected--becomes a subject of speculations, possibly of the teleological kind: "For which purpose is the factor existing?", or even "Why has God made up the factor?". The hypotheses developing on that are often extremely suggestive and incorrect hypotheses on the first opportunity sometimes reappear like a "cork-tumbler". Finally only a few hard facts remain. This is shown with the help of the systems AB0, Duffy, HLA, Hp and Pi. PMID:2947391

  1. Reading self-help literature in Russia: governmentality, psychology and subjectivity.

    PubMed

    Salmenniemi, Suvi; Vorona, Mariya

    2014-03-01

    Self-help has become a booming business over the past decades and an increasingly visible part of popular media culture worldwide. The paper analyzes the arrival and effects of this cultural technology in post-Soviet Russia after more than seventy years of socialism. It examines how Russians are engaging with popular psychology self-help as a technology of the self and how they are making it meaningful in their lives. Drawing on a set of one-to-one and focus group interviews conducted with self-help readers, it examines how these individuals negotiate the new ethics and the normative models of personhood put forward by the self-help genre. It argues that popular psychology has offered a new language for making sense of the self and the social world, and highlights how the readers critically engage with the normalizing power of popular psychology by drawing on a number of local historically sedimented discourses.

  2. [Implication of the self-help mechanism in the geriatric club (author's transl)].

    PubMed

    Martincević-Ljumanović, R

    1981-07-01

    In the paper clinical investigations are given of the implication of the self-help mechanism with the 125 members of the Geriatric club of the Clinical hospital "Dr. Mladen Stojanović" in Zagreb during the year 1979. The results show that in this phase of the development of contemporary society and medicine and prevention geriatrics self-help is the only way of care and responsibility for the health of a great number of the population. Self-help is built-in everyday life and activity of the members of the club. Elder persons take part in the permanent care of their own health through the group mechanism of self-help by helping and caring for themselves on te basis of obtained health informations, knowledge and experience with society and public health services. In time they discover factors of risk which in many cases provoke a number of chronic illness and thereby put health in danger. The perspectives of self-help are in the scientific work of various social structures and in finding out specific methods of individual and group self-help for attacking mass chronic sicknesses of contemporary civilisation.

  3. [Implication of the self-help mechanism in the geriatric club (author's transl)].

    PubMed

    Martincević-Ljumanović, R

    1981-07-01

    In the paper clinical investigations are given of the implication of the self-help mechanism with the 125 members of the Geriatric club of the Clinical hospital "Dr. Mladen Stojanović" in Zagreb during the year 1979. The results show that in this phase of the development of contemporary society and medicine and prevention geriatrics self-help is the only way of care and responsibility for the health of a great number of the population. Self-help is built-in everyday life and activity of the members of the club. Elder persons take part in the permanent care of their own health through the group mechanism of self-help by helping and caring for themselves on te basis of obtained health informations, knowledge and experience with society and public health services. In time they discover factors of risk which in many cases provoke a number of chronic illness and thereby put health in danger. The perspectives of self-help are in the scientific work of various social structures and in finding out specific methods of individual and group self-help for attacking mass chronic sicknesses of contemporary civilisation. PMID:6116457

  4. Who uses consumer-run self-help organizations?

    PubMed

    Goering, Paula; Durbin, Janet; Sheldon, Christina Tess; Ochocka, Joanna; Nelson, Geoffrey; Krupa, Terry

    2006-07-01

    A multisite evaluation of community mental health services is used to answer two questions: (a) How do diagnosis, functioning, and self-assessments of consumer/survivor initiative (CSI) and assertive community treatment (ACT) participants compare?, and (b) What other supports/services are CSI and ACT participants using? The sample is from an Ontario evaluation of consumer/survivor peer initiatives in four communities (n=73). The reference group is new (n=48) and ongoing (n=134) clients of four ACT teams. Self-help organizations are serving a broader population of individuals who include a significant subgroup of persons with severe mental illness along with others with a mixed picture of higher functioning and greater instability. There is little overlap in the use of these modes of service delivery, which suggests that maintaining options within systems of care is critical to ensuring coverage and access for the broader population. PMID:16981815

  5. Self-Help Career Assessment: Ethical and Professional Issues.

    ERIC Educational Resources Information Center

    Prince, Jeffrey P.; Most, Robert B.; Silver, Diane G.

    2003-01-01

    Addresses the need for ethical and professional guidelines appropriate to the development and use of self-help career assessments. Discusses strengths and limitations of self-help career assessments. Identifies three criteria for evaluating these assessments (appropriateness, trustworthiness/soundness, emphasis on process) and presents an…

  6. Self-Help and Community Education. Courier No. 28.

    ERIC Educational Resources Information Center

    ASPBAE Courier, 1983

    1983-01-01

    This journal consists of eight articles dealing with self-help and community education. Included in the volume are the following articles: "An Uphill Struggle--Self-Help in Bangladesh," by S. Harrison and Judy Saul; "How Not to Help a Local Community: A Case from South India," by Nora Sammut and Maria Theresa; "The High Cost of Manipulating…

  7. Self-Help Tips for Vulvar Skin Care

    MedlinePlus

    ... Online Patient Tutorial Health Care Provider List Support Services Self-Help Tips Patient Stories Participate in Research Other Resources For Health ... Online Patient Tutorial Health Care Provider List Support Services Self-Help Tips Patient Stories Participate in Research Other Resources Home Self- ...

  8. PHASE: a randomised, controlled trial of supervised self-help cognitive behavioural therapy in primary care.

    PubMed Central

    Richards, Ann; Barkham, Michael; Cahill, Jane; Richards, David; Williams, Chris; Heywood, Phil

    2003-01-01

    BACKGROUND: Common mental health problems account for up to 40% of all general practitioner (GP) consultations. Patients have limited access to evidence-based psychological therapies. Cognitive behavioural therapy self-help strategies offer one potential solution. AIM: To determine differences in clinical outcome, patient satisfaction and costs, between a cognitive behavioural-based self-help package facilitated by practice nurses compared to ordinary care by GPs for mild to moderate anxiety and depression. DESIGN OF STUDY: Randomised controlled trial. SETTING: Seventeen primary healthcare teams. METHOD: Patients presenting to their GP with mild to moderate anxiety and/or depression were recruited to the study and randomised to receive either a self-help intervention facilitated by practice nurses or ordinary care. The self-help intervention consisted of up to three appointments: two 1 week apart and a third 3 months later. There were no restrictions on ordinary care. RESULTS: Intention-to-treat analysis showed that patients treated with practice nurse-supported cognitive behavioural therapy self-help attained similar clinical outcomes for similar costs and were more satisfied than patients treated by GPs with ordinary care. On-treatment analysis showed patients receiving the facilitated cognitive behavioural therapy self-help were more likely to be below clinical threshold at 1 month compared to the ordinary care group (odds ratio [OR] = 3.65, 95% confidence interval [CI] = 1.87 to 4.37). This difference was less well marked at 3 months (OR = 1.36, 95% CI = 0.52 to 3.56). CONCLUSION: Facilitated cognitive behavioural self-help may provide a short-term cost-effective clinical benefit for patients with mild to moderate anxiety and depression. This has the potential to help primary care provide a choice of effective psychological as well as pharmacological treatments for mental health problems. PMID:14601351

  9. Voices of coping in an Italian self-help virtual community of cyberporn dependents.

    PubMed

    Cavaglion, Gabriel

    2008-10-01

    Textual analysis of 2000 messages from 302 participants in an Italian self-help Internet community for cyberporn dependents (noallapornodipendenza) shows that through anonymous sharing, participants form a support community providing emotional involvement and care. Similarities with encounter group strategies for other types of addictions are discussed. PMID:18785822

  10. Health Status of Homeless and Marginally Housed Users of Mental Health Self-Help Agencies.

    ERIC Educational Resources Information Center

    Segal, Steven P.; Gomory, Tomi; Silverman, Carol J.

    1998-01-01

    Investigates the health status of 310 homeless and marginally housed people to determine the usefulness of mental health self-help agencies (SHAs) in addressing their physical health needs. Findings indicated that frequencies of health problems among respondents were similar to those of other homeless or marginally housed groups and that the study…

  11. Rational-Emotive Therapy and Self-Help Therapy.

    ERIC Educational Resources Information Center

    Ellis, Albert

    Unsupervised do-it-yourself therapy constitutes an exceptionally important issue that calls for more empirical and scientific investigation of the validity of publications in this field. Rational-emotive therapy (RET), one of the most popular forms of self-help treatment, has led to several generalizations. (1) Cognitive and cognitive-behavior…

  12. Speaking Out for Yourself: A Self-Help Guide

    MedlinePlus

    ... Self-Help Guide Page 1 Foreword It contains information, ideas, and strategies that people from all over the country have ... the area to help you decide if the information you have found is accurate. Plan your strategy. Now that you know what you want and ...

  13. Self-Help Approach to Rural Transformation in Nigeria.

    ERIC Educational Resources Information Center

    Madu, Ephraim N.; Umebali, Emmanuel E.

    1993-01-01

    A survey of 23 chairpersons of town unions (rural sociocultural organizations) in Nigeria indicated that self-help projects in education and rural development were concentrated in areas lacking infrastructure. Recommendations were made for an organizing framework, leadership training, government assistance, and efforts to encourage active…

  14. Effects of a Cognitive Behavioral Self-Help Program on Emotional Problems for People with Acquired Hearing Loss: A Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Garnefski, Nadia; Kraaij, Vivian

    2012-01-01

    The aim of the study was to examine whether a cognitive-behavioral self-help program was effective in improving depressed mood and anxiety in people with acquired deafness. Participants were 45 persons with acquired deafness, randomly allocated to the Cognitive-Behavioral Self-help (CBS) group or the Waiting List Control (WLC) group. Depression…

  15. The Story of Self-Help Enterprises [SHE]. A History of Self-Help Housing in the San Joaquin Valley.

    ERIC Educational Resources Information Center

    Unwin, Richard

    SHE is a rural California home building corporation founded on the principles of self-help. Lacking sufficient capital to purchase or finance a home by conventional means, a low-income family may elect to "self-construct with SHE". A participant family agrees to invest its labor, up to 1,500 hours, in the supervised construction of its own home…

  16. A randomized trial comparing the effects of self-help materials and proactive telephone counseling on teen smoking cessation.

    PubMed

    Lipkus, Isaac M; McBride, Colleen M; Pollak, Kathryn I; Schwartz-Bloom, Rochelle D; Tilson, Elizabeth; Bloom, Paul N

    2004-07-01

    We conducted a 2-arm randomized trial to test the efficacy of self-help materials with or without proactive telephone counseling to increase cessation among teen smokers. Teen smokers (N = 402) recruited from 11 shopping malls and 1 amusement park in the southeastern United States were randomized to 1 of 2 groups: written self-help material plus video; or written self-help material, video, and telephone counseling. Cessation rates based on 7-day point-prevalent abstinence for the self-help and counseling arms were 11% and 16%, respectively (p = .25), at 4 months postbaseline and 19% and 21%, respectively (p = .80), at 8 months postbaseline. Sustained abstinence, reflecting 7-day abstinence at both time points, in the self-help and counseling arms was 7% and 9% (p = .59). Results suggest that minimal self-help cessation approaches that target youth have comparable success to that shown among adult smokers. However, refinements in telephone-counseling approaches may be needed to achieve the success observed in adult populations.

  17. Revisioning the Self: A Phenomenological Investigation into Self-Help Reading

    ERIC Educational Resources Information Center

    Bruneau, Laura; Bubenzer, Donald L.; McGlothlin, Jason M.

    2010-01-01

    The helpfulness of self-help reading was explored through interviews with 6 female self-help readers. Themes derived through phenomenological data analysis suggested that there is a distinct structure to the self-help reading experience, including self-help reading as a medium for revisioning of self. Implications for counseling practice and…

  18. Self-help interventions for depressive disorders and depressive symptoms: a systematic review

    PubMed Central

    Morgan, Amy J; Jorm, Anthony F

    2008-01-01

    Background Research suggests that depressive disorders exist on a continuum, with subthreshold symptoms causing considerable population burden and increasing individual risk of developing major depressive disorder. An alternative strategy to professional treatment of subthreshold depression is population promotion of effective self-help interventions that can be easily applied by an individual without professional guidance. The evidence for self-help interventions for depressive symptoms is reviewed in the present work, with the aim of identifying promising interventions that could inform future health promotion campaigns or stimulate further research. Methods A literature search for randomised controlled trials investigating self-help interventions for depressive disorders or depressive symptoms was performed using PubMed, PsycINFO and the Cochrane Database of Systematic Reviews. Reference lists and citations of included studies were also checked. Studies were grouped into those involving participants with depressive disorders or a high level of depressive symptoms, or non-clinically depressed participants not selected for depression. A number of exclusion criteria were applied, including trials with small sample sizes and where the intervention was adjunctive to antidepressants or psychotherapy. Results The majority of interventions searched had no relevant evidence to review. Of the 38 interventions reviewed, the ones with the best evidence of efficacy in depressive disorders were S-adenosylmethionine, St John's wort, bibliotherapy, computerised interventions, distraction, relaxation training, exercise, pleasant activities, sleep deprivation, and light therapy. A number of other interventions showed promise but had received less research attention. Research in non-clinical samples indicated immediate beneficial effects on depressed mood for distraction, exercise, humour, music, negative air ionisation, and singing; while potential for helpful longer-term effects

  19. Cultural Adaptation of a Cognitive Behavior Therapy Guided Self-Help Program for Mexican American Women with Binge Eating Disorders

    ERIC Educational Resources Information Center

    Shea, Munyi; Cachelin, Fary; Uribe, Luz; Striegel, Ruth H.; Thompson, Douglas; Wilson, G. Terence

    2012-01-01

    Data on the compatibility of evidence-based treatment in ethnic minority groups are limited. This study utilized focus group interviews to elicit Mexican American women's (N = 12) feedback on a cognitive behavior therapy guided self-help program for binge eating disorders. Findings revealed 6 themes to be considered during the cultural adaptation…

  20. Privacy-Preserving Self-Helped Medical Diagnosis Scheme Based on Secure Two-Party Computation in Wireless Sensor Networks

    PubMed Central

    Wen, Qiaoyan; Zhang, Yudong; Li, Wenmin

    2014-01-01

    With the continuing growth of wireless sensor networks in pervasive medical care, people pay more and more attention to privacy in medical monitoring, diagnosis, treatment, and patient care. On one hand, we expect the public health institutions to provide us with better service. On the other hand, we would not like to leak our personal health information to them. In order to balance this contradiction, in this paper we design a privacy-preserving self-helped medical diagnosis scheme based on secure two-party computation in wireless sensor networks so that patients can privately diagnose themselves by inputting a health card into a self-helped medical diagnosis ATM to obtain a diagnostic report just like drawing money from a bank ATM without revealing patients' health information and doctors' diagnostic skill. It makes secure self-helped disease diagnosis feasible and greatly benefits patients as well as relieving the heavy pressure of public health institutions. PMID:25126107

  1. 77 FR 71609 - Self-Help Homeownership Opportunity Program (SHOP) Grant Monitoring

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-03

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Self-Help Homeownership Opportunity Program (SHOP) Grant Monitoring AGENCY: Office of... following information: Title of Proposed: Self-Help Homeownership Opportunity Program (SHOP)...

  2. Weekly brief phone support in self-help cognitive behavioral therapy for insomnia disorder: Relevance to adherence and efficacy.

    PubMed

    Ho, Fiona Yan-Yee; Chung, Ka-Fai; Yeung, Wing-Fai; Ng, Tommy Ho-Yee; Cheng, Sammy Kin-Wing

    2014-12-01

    Self-help cognitive-behavioral therapy for insomnia (CBT-I) is an acceptable, low-intensity treatment in a stepped care model for insomnia. We tested the application of self-help CBT-I in a Chinese population. 312 participants with self-report of insomnia associated with distress or daytime impairment 3 or more nights per week for at least 3 months were randomized to self-help CBT-I with telephone support (SHS), self-help CBT-I (SH) and waiting-list (WL). The program was Internet-based with treatment materials delivered once per week, and lasted for 6 consecutive weeks, while the telephone support was limited to 15 min weekly. Mixed-effects analyses found significant group by time interaction in sleep and sleep-related cognitions at immediate and 4-week posttreatment. Post-hoc pairwise comparison with WL revealed that both SHS and SH had significantly higher sleep efficiency at immediate (p = .004 and p = .03, respectively) and 4-week posttreatment (p = .002 and p = .02, respectively) and lower insomnia and dysfunctional beliefs scores. The SHS group had additional improvements in sleep onset latency and sleep quality. Benefits with self-help CBT-I were maintained at 12-week posttreatment, but attrition rate was about 35%. Internet-based self-help CBT-I was effective and acceptable for treating insomnia in the Chinese population. A brief telephone support further enhanced the efficacy.

  3. 76 FR 80377 - Notice of Submission of Proposed Information Collection to OMB; Self-Help Homeownership...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-23

    ... URBAN DEVELOPMENT Notice of Submission of Proposed Information Collection to OMB; Self-Help... to OMB may be obtained from Ms. Pollard. Title of Proposal: Self-Help Homeownership Opportunity... Its Proposed Use: The Self-Help Homeownership Opportunity Program (SHOP) is authorized by the...

  4. Public Pedagogy, Private Lives: Self-Help Books and Adult Learning

    ERIC Educational Resources Information Center

    McLean, Scott

    2013-01-01

    Self-help literature has become an important domain of adult learning in North America. Self-help books offer readers advice on how to take charge of their lives and achieve goals such as prosperity, love, happiness, wellness, and self-actualization. Despite the popularity of self-help books, there has been little research about them from scholars…

  5. 7 CFR 1924.262 - Handling complaints involving dwellings constructed by the self-help method.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 12 2010-01-01 2010-01-01 false Handling complaints involving dwellings constructed by the self-help method. 1924.262 Section 1924.262 Agriculture Regulations of the Department of... constructed by the self-help method. When a borrower whose dwelling was constructed by the self-help...

  6. 7 CFR 1924.262 - Handling complaints involving dwellings constructed by the self-help method.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 12 2011-01-01 2011-01-01 false Handling complaints involving dwellings constructed by the self-help method. 1924.262 Section 1924.262 Agriculture Regulations of the Department of... constructed by the self-help method. When a borrower whose dwelling was constructed by the self-help...

  7. Self-help materials for anxiety: a randomized controlled trial in general practice.

    PubMed Central

    Donnan, P; Hutchinson, A; Paxton, R; Grant, B; Firth, M

    1990-01-01

    The efficacy of a self-help package in treating chronic anxiety was evaluated in a randomized controlled trial in which the intervention group received self-help materials in the form of an audiotape and booklet, in addition to their current treatment. The intervention was successful in terms of mean depression scores (P = 0.01), anxiety scores (P = 0.04) and general health questionnaire scores (P = 0.02) which were significantly lower for the intervention group than for the controls. In addition, the depression scores fell faster for the intervention group than for the controls. The overall mean reduction in three months in adjusted depression scores was approximately two points greater for the intervention group than for the controls (P = 0.02). Clinicians welcomed the package as a valuable addition to the therapies available for managing chronic anxiety problems. Further studies should include larger sample sizes, taking into account the non-response to postal questionnaires over time. PMID:1704245

  8. Self-help quit smoking interventions: effects of self-help materials, social support instructions, and telephone counseling.

    PubMed

    Orleans, C T; Schoenbach, V J; Wagner, E H; Quade, D; Salmon, M A; Pearson, D C; Fiedler, J; Porter, C Q; Kaplan, B H

    1991-06-01

    Smokers requesting self-help materials for smoking cessation (N = 2,021) were randomized to receive (a) an experimental self-quitting guide emphasizing nicotine fading and other nonaversive behavioral strategies, (b) the same self-quitting guide with a support guide for the quitter's family and friends, (c) self-quitting and support guides along with four brief counselor calls, or (d) a control guide providing motivational and quit tips and referral to locally available guides and programs. Subjects were predominantly moderate to heavy smokers with a history of multiple previous quit attempts and treatments. Control subjects achieved quit rates similar to those of smokers using the experimental quitting guide, with fewer behavioral prequitting strategies and more outside treatments. Social support guides had no effect on perceived support for quitting or on 8- and 16-month quit rates. Telephone counseling increased adherence to the quitting protocol and quit rates.

  9. Nicotine Gum and Self-Help Behavioral Treatment for Smoking Relapse Prevention: Results from a Trial Using Population-Based Recruitment.

    ERIC Educational Resources Information Center

    Fortmann, Stephen P.; Killen, Joel D.

    1995-01-01

    Smokers were randomized using a factorial design to compare nicotine gum use to no gum use, and self-help materials to no materials. Compared with the no-gum group, relapse occurred at a significantly lower rate in the gum group for the entire 12 months of follow-up. There was no significant main effect for the self-help materials and no…

  10. Randomised controlled trial of a guided self-help treatment on the Internet for binge eating disorder.

    PubMed

    Carrard, I; Crépin, C; Rouget, P; Lam, T; Golay, A; Van der Linden, M

    2011-08-01

    Binge eating disorder (BED) is a common and under-treated condition with major health implications. Cognitive behavioural therapy (CBT) self-help manuals have proved to be efficient in BED treatment. Increasing evidence also support the use of new technology to improve treatment access and dissemination. This is the first randomised controlled study to evaluate the efficacy of an Internet guided self-help treatment programme, based on CBT, for adults with threshold and subthreshold BED. Seventy-four women were randomised into two groups. The first group received the six-month online programme with a six-month follow-up. The second group was placed in a six-month waiting list before participating in the six-month intervention. Guidance consisted of a regular e-mail contact with a coach during the whole intervention. Binge eating behaviour, drive for thinness, body dissatisfaction and interoceptive awareness significantly improved after the Internet self-help treatment intervention. The number of objective binge episodes, overall eating disorder symptoms score and perceived hunger also decreased. Improvements were maintained at six-month follow-up. Dropouts exhibited more shape concern and a higher drive for thinness. Overall, a transfer of CBT-based self-help techniques to the Internet was well accepted by patients, and showed positive results for eating disorders psychopathology.

  11. Analyzing Self-Help Forums with Ontology-Based Text Mining: An Exploration in Kidney Space.

    PubMed

    Burckhardt, Philipp; Padman, Rema

    2015-01-01

    The Internet has emerged as a popular source for health-related information. More than eighty percent of American Internet users have searched for health topics online. Millions of patients use self-help online forums to exchange information and support. In parallel, the increasing prevalence of chronic diseases has become a financial burden for the healthcare system demanding new, cost-effective interventions. To provide such interventions, it is necessary to understand patients' preferences of treatment options and to gain insights into their experiences as patients. We introduce a text-processing algorithm based on semantic ontologies to allow for finer-grained analyses of online forums compared to standard methods. We have applied our method in an analysis of two major Chronic Kidney Disease (CKD) forums. Our results suggest that the analysis of forums may provide valuable insights on daily issues patients face, their choice of different treatment options and interactions between patients, their relatives and clinicians.

  12. Analyzing Self-Help Forums with Ontology-Based Text Mining: An Exploration in Kidney Space

    PubMed Central

    Burckhardt, Philipp; Padman, Rema

    2015-01-01

    The Internet has emerged as a popular source for health-related information. More than eighty percent of American Internet users have searched for health topics online. Millions of patients use self-help online forums to exchange information and support. In parallel, the increasing prevalence of chronic diseases has become a financial burden for the healthcare system demanding new, cost-effective interventions. To provide such interventions, it is necessary to understand patients’ preferences of treatment options and to gain insights into their experiences as patients. We introduce a text-processing algorithm based on semantic ontologies to allow for finer-grained analyses of online forums compared to standard methods. We have applied our method in an analysis of two major Chronic Kidney Disease (CKD) forums. Our results suggest that the analysis of forums may provide valuable insights on daily issues patients face, their choice of different treatment options and interactions between patients, their relatives and clinicians. PMID:26958281

  13. Evaluating professionally operated and self-help programs for the seriously mentally ill.

    PubMed

    Toro, P A

    1990-12-01

    Reviewed a study by Bond et al. (1990) that evaluates assertive community treatment (ACT), an intensive community-based program for the seriously mentally ill. Such programs have been developed at a rapid pace in recent years but lack extensive research support. This randomized study supports the effectiveness of ACT and is a significant contribution to the mixed findings from the existing literature. However, its methodological flaws include (a) differential dropout from the ACT and comparison groups, (b) a relatively short follow-up period (12 months), and (c) limitations of the ACT intervention which prevents rehospitalization but lacks impact in other domains (e.g., social relationships, housing stability, employment). Self-help programs, poorly represented by the comparison group in this research, may offer the sorts of societal niches required by the mentally ill. Further research, giving such programs a "fair shake" against professionally controlled programs, is sorely needed.

  14. Professional and service-user perceptions of self-help in primary care mental health services.

    PubMed

    Pratt, Rebekah; Halliday, Emma; Maxwell, Margaret

    2009-03-01

    Self-help is becoming an increasingly accessible option for addressing mental health problems. Despite this, self-help is subject to a variety of interpretations, little is known about how professionals and service-users conceptualise self-help, or how service-users engage in self-help activities. This study aimed to explore the views of self-help by service-users and health professionals in one area of Scotland, including the perceptions of what constitutes self-help and how it might be used to address mental health problems in primary care. The research involved semistructured interviews with 31 primary care mental health professionals, and in-depth interviews with 34 service-users. We found that professionals and service-users describe self-help in different ways, which has great implications for referral to and implementation of self-help in primary care settings. It also emerged that self-help was not necessarily perceived to be able to address the causes of mental distress, which could leave some professionals defaulting to offering no interventions despite the fairly positive attitude service-users show to self-help strategies. Finally, professionals need to be convinced that interventions are useful, effective and accessible as there are significant barriers in professionals using self-help; if they are not convinced, such approaches will support their therapeutic approach. The research supports the need to develop methods of delivery that offer self-help as part of a broad package of care that also considers social causes of distress.

  15. Evaluation of a Motivation and Psycho-Educational Guided Self-Help Intervention for People with Eating Disorders (MOPED).

    PubMed

    Brewin, Nicola; Wales, Jackie; Cashmore, Rebecca; Plateau, Carolyn R; Dean, Brett; Cousins, Tara; Arcelus, Jon

    2016-05-01

    High dropout rates and poor levels of engagement are well documented for patients with eating disorders. Utilising motivational techniques and providing psycho-education have been suggested as ways to reduce treatment disengagement. This study aimed to evaluate the effect of a newly developed motivational and psycho-educational (MOPED) guided self-help intervention for people with eating disorders on engagement and retention in therapy. Patients who received MOPED pre-treatment (n = 79) were compared with a diagnosis-matched group of patients receiving treatment as usual (TAU; n = 79). The study found that patients receiving MOPED had a higher engagement rate than those within the TAU group. Specifically, patients in the anorexic spectrum were found to present with both higher rates of engagement and completion of therapy when issued with MOPED in comparison with TAU. Self-help packages using motivational style could be a valuable and cost-effective intervention for patients with eating disorders.

  16. Community Health Workers Versus Nurses as Counselors or Case Managers in a Self-Help Diabetes Management Program

    PubMed Central

    Kim, Kim B.; Kim, Miyong T.; Lee, Hochang B.; Nguyen, Tam; Bone, Lee R.; Levine, David

    2016-01-01

    Objectives To confirm the effectiveness of community health workers’ involvement as counselors or case managers in a self-help diabetes management program in 2009 to 2014. Methods Our open-label, randomized controlled trial determined the effectiveness of a self-help intervention among Korean Americans aged 35 to 80 years in the Baltimore-Washington metropolitan area with uncontrolled type 2 diabetes. We measured and analyzed physiological and psychobehavioral health outcomes of the community health worker–counseled (n = 54) and registered nurse (RN)–counseled (n = 51) intervention groups in comparison with the control group (n = 104). Results The community health workers’ performance was comparable to that of the RNs for both psychobehavioral outcomes (e.g., self-efficacy, quality of life) and physiological outcomes. The community health worker–counseled group showed hemoglobin A1C reductions from baseline (−1.2%, −1.5%, −1.3%, and −1.6%, at months 3, 6, 9, and 12, respectively), all of which were greater than reductions in the RN-counseled (−0.7%, −0.9%, −0.9%, and −1.0%) or the control (−0.5%, −0.5%, −0.6%, and −0.7%) groups. Conclusions Community health workers performed as well as or better than nurses as counselors or case managers in a self-help diabetes management program in a Korean American community. PMID:26985607

  17. A Randomized Clinical Trial of Self-Help Intervention for Smoking Cessation: Research Design, Interventions, and Baseline Data

    PubMed Central

    Unrod, Marina; Simmons, Vani N.; Sutton, Steven K.; Meltzer, Lauren R.; Harrell, Paul T.; Meade, Cathy D.; Craig, Benjamin M.; Lee, Ji-Hyun; Brandon, Thomas H.

    2014-01-01

    Tobacco smoking is the leading preventable cause of mortality and morbidity. Although behavioral counseling combined with pharmacotherapy is the most effective approach to aiding smoking cessation, intensive treatments are rarely chosen by smokers, citing inconvenience. In contrast, minimal self-help interventions have the potential for greater reach, with demonstrated efficacy for relapse prevention, but not for smoking cessation. This paper summarizes the design and methods used for a randomized controlled trial to assess the efficacy of a minimal self-help smoking cessation intervention that consists of a set of booklets delivered across time. Baseline participant recruitment data are also presented. Daily smokers were recruited nationally via multimedia advertisements and randomized to one of three conditions. The Usual Care (UC) group received a standard smoking-cessation booklet. The Standard Repeated Mailings (SRM) group received 8 booklets mailed over a 12-month period. The Intensive Repeated Mailings (IRM) group received 10 booklets and additional supplemental materials mailed monthly over 18 months. A total of 2641 smokers were screened, 2349 were randomized, and 1874 provided data for analyses. Primary outcomes will be self-reported abstinence at 6-month intervals up to 30 months. If the self-help booklets are efficacious, this minimal, low cost intervention can be widely disseminated and, hence, has the potential for significant public health impact with respect to reduction in smoking-related illness and mortality. PMID:24865525

  18. A randomized clinical trial of self-help intervention for smoking cessation: research design, interventions, and baseline data.

    PubMed

    Unrod, Marina; Simmons, Vani N; Sutton, Steven K; Meltzer, Lauren R; Harrell, Paul T; Meade, Cathy D; Craig, Benjamin M; Lee, Ji-Hyun; Brandon, Thomas H

    2014-07-01

    Tobacco smoking is the leading preventable cause of mortality and morbidity. Although behavioral counseling combined with pharmacotherapy is the most effective approach to aiding smoking cessation, intensive treatments are rarely chosen by smokers, citing inconvenience. In contrast, minimal self-help interventions have the potential for greater reach, with demonstrated efficacy for relapse prevention, but not for smoking cessation. This paper summarizes the design and methods used for a randomized controlled trial to assess the efficacy of a minimal self-help smoking cessation intervention that consists of a set of booklets delivered across time. Baseline participant recruitment data are also presented. Daily smokers were recruited nationally via multimedia advertisements and randomized to one of three conditions. The Usual Care (UC) group received a standard smoking-cessation booklet. The Standard Repeated Mailings (SRM) group received 8 booklets mailed over a 12-month period. The Intensive Repeated Mailings (IRM) group received 10 booklets and additional supplemental materials mailed monthly over 18months. A total of 2641 smokers were screened, 2349 were randomized, and 1874 provided data for analyses. Primary outcomes will be self-reported abstinence at 6-month intervals up to 30months. If the self-help booklets are efficacious, this minimal, low cost intervention can be widely disseminated and, hence, has the potential for significant public health impact with respect to reduction in smoking-related illness and mortality.

  19. Solution-Focused Self-Help for Improving University Students' Well-Being

    ERIC Educational Resources Information Center

    Pakrosnis, Rytis; Cepukiene, Viktorija

    2015-01-01

    Along with positive developments in psychology, the self-help movement is becoming widespread, based on the belief that people are capable of growing and achieving positive change with only minimal help. This article addresses the potential of a solution-focused self-help tool to improve university students' well-being by comparing its outcome to…

  20. Self-Help Conferences for People Who Stutter: A Qualitative Investigation

    ERIC Educational Resources Information Center

    Trichon, Mitchell; Tetnowski, John

    2011-01-01

    Self-help activities for people who stutter (PWS) have been gaining in popularity; however, there is a scarcity of evidence to support their utility in stuttering management. The purpose of this investigation was to understand the lived experience of individuals who attended a self-help conference(s) for PWS from the perspective of a PWS to learn…

  1. 7 CFR Exhibit D to Subpart I of... - Self-Help Technical Assistance Grant Predevelopment Agreement

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... § 1944.410(d) of 7 CFR part 1944, subpart I, as necessary, to develop a complete program for a self-help... 7 Agriculture 13 2010-01-01 2009-01-01 true Self-Help Technical Assistance Grant Predevelopment... SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) HOUSING...

  2. With or without a Therapist: Self-Help Reading for Mental Health

    ERIC Educational Resources Information Center

    McLean, Scott

    2015-01-01

    Objective: To address a critical gap in health education scholarship by exploring the contexts in which self-help reading takes place, the motivations of self-help readers and the processes through which such readers engage with books on mental health. Design: Structured, in-depth interviews conducted with participants recruited through online…

  3. One-year follow-up of guided self-help for parents of preschool children with externalizing behavior.

    PubMed

    Ise, Elena; Kierfeld, Frauke; Döpfner, Manfred

    2015-02-01

    Self-help programs are an effective intervention for parents of children with externalizing behavior. A number of studies have shown that self-administered parent training has positive short-term effects on a child's behavior, but there is little research done on long-term outcomes. This paper reports results from a 1-year follow-up of a randomized controlled prevention trial of self-administered parent training with minimal therapist contact. In the initial prevention trial, we randomly assigned 48 preschool children with elevated levels of externalizing behavior to either a treatment group (TG) or a waitlist control group (WLC). The intervention consisted of written material and brief weekly telephone consultations. Thirty-six families (25 TG families, 11 WLC families) completed the self-help program. Twenty-five of these participated in a follow-up assessment 1 year after the intervention. There were no significant changes from post-test to follow-up on measures of child behavior (e.g., Attention-Deficit/Hyperactivity Disorder and Oppositional Defiant Disorder symptom rating scales) and parental mental health, indicating that gains achieved post-intervention were maintained for at least 1 year. Moreover, the percentage of children with substantial behavior problems was reduced from pre-intervention to follow-up. These findings provide evidence that telephone-assisted self-help programs can be effective in the prevention of disruptive behavior problems. PMID:25331981

  4. Acceptability and Cultural Appropriateness of Self-Help Booklets for Smoking Cessation in Puerto Rico

    PubMed Central

    Menzie, Nicole S.; Simmons, Vani N.; Quinn, Gwendolyn P.; Diaz, Diana B.; Piñeiro, Barbara; Jimenez, Julio; Castro, Eida; Brandon, Thomas H.

    2015-01-01

    Cigarette smoking is associated with a range of cancers and is related to five of seven leading causes of death in Puerto Rico. Minimal self-help interventions have shown promising results in reaching participants and preventing relapse from smoking. Specifically, a collection of 8 self-help booklets has demonstrated efficacy (Brandon et al., 2000; 2004). Those booklets have been transcreated into Spanish, with efforts to make them culturally appropriate across a range of Hispanic cultures. We conducted a pilot study in Ponce, Puerto Rico, to evaluate the Spanish version of our smoking relapse-prevention booklets. Qualitative, semi-structured interviews were conducted with 20 current and former smokers. Interviews were conducted to elicit feedback regarding the booklet’s content, cultural appropriateness, dissemination, and perceived availability of smoking cessation resources in Puerto Rico. Interviews were audio-taped and transcribed verbatim. Transcripts were coded using content analysis, with a priori codes based on the interview guide. Emergent themes were examined. Overall, participants liked the booklets’ content, perceived them to be culturally appropriate, easy to read and understand. Regarding dissemination, it was recommended that the booklets be disseminated by physicians and advertised through television. Most importantly, participants reported the best way to distribute and complement the booklets would be through support groups. Participants also reported having limited knowledge about resources provided in the community to aid smoking cessation. Overall, this pilot study was able to show the cultural acceptability of the booklets and highlights the need for the dissemination of these materials among current and former smokers in Puerto Rico. PMID:25219544

  5. A Self-Help Alternative in Student Legal Services Clinics.

    ERIC Educational Resources Information Center

    Chan, Adrian

    National surveys reveal that citizens of all age groups, from school age to adult, are ignorant about the law and its practical use in daily life. The advocate counseling model is an integrative approach combining the elements of legal research and therapeutic counseling in order to teach and guide individuals or groups with institutional problems…

  6. AIDS: Implications for Homosexual Self-Help and Support Efforts.

    ERIC Educational Resources Information Center

    Toro-Alfonso, Jose

    The Colectivo de Concientizacion Gay, a homosexual and lesbian organization in Puerto Rico, developed a brief analysis of what has happened since symptoms associated with acquired immunodeficiency syndrome (AIDS) were first reported by the Centers for Disease Control in 1981; the analysis also included implications for the gay community. Since…

  7. Self-help parenting interventions for childhood behaviour disorders: a review of the evidence.

    PubMed

    O'Brien, M; Daley, D

    2011-09-01

    The use of self-help interventions for parents of children with behaviour problems is becoming more prevalent. This review critically evaluated the evidence supporting the efficacy of such programmes for children with behaviour problems. Using a systematic literature search, two modes of delivery were evaluated, namely bibliotherapy and multimedia. Programmes that included minimal therapist support were also included. Overall, there is good evidence supporting the efficacy of self-help programmes in improving child behaviour, over the short and longer term. Self-help programmes led to outcomes similar to those achieved with more intensive therapist input. Including minimal levels of therapist support in addition to self-help materials enhances child and parent outcomes. Parents view self-help favourably but significantly less so than programmes including some form of therapist input. The future directions for self-help parent programmes include the need for longer-term follow-ups, the identification of moderators of outcome and economic evaluations of self-help programmes.

  8. Cultural Adaptation of a Cognitive Behavior Therapy Guided Self-Help Program for Mexican American Women With Binge Eating Disorders

    PubMed Central

    Shea, Munyi; Cachelin, Fary; Uribe, Luz; Striegel, Ruth H.; Thompson, Douglas; Wilson, G. Terence

    2013-01-01

    Data on the compatibility of evidence-based treatment in ethnic minority groups are limited. This study utilized focus group interviews to elicit Mexican American women’s (N = 12) feedback on a cognitive behavior therapy guided self-help program for binge eating disorders. Findings revealed 6 themes to be considered during the cultural adaptation process and highlighted the importance of balancing the fidelity and cultural relevance of evidence-based treatment when disseminating it across diverse racial/ethnic groups. PMID:23645969

  9. Validation of the Full and Short-Form Self-Help Involvement Scale Against the Rasch Measurement Model

    PubMed Central

    Conrad, Karen M.; Conrad, Kendon J.; Passetti, Lora L.; Funk, Rodney R.; Dennis, Michael L.

    2015-01-01

    Background Substance use disorders (SUDs) are one of the nation’s most costly problems in terms of dollars, disability, and death. Self-help programs are among the varied recovery support options available to address SUD, and evaluation of these programs depends on good measurement. There exists an unmet need for a psychometrically sound, brief, efficient measure of self-help involvement for individuals with SUD that is valid across different substances and age-groups. Methods Using data from 2,101 persons presenting for SUD treatment, the full 21-item Global Appraisal of Individual Needs Self-Help Involvement Scale (SHIS) and a newly developed 11-item short-form version were validated against the Rasch measurement model and each other. Differential item functioning (DIF) was assessed by primary substance and age. Results Both versions met Rasch psychometric criteria. The full scale had minor misfit with no DIF for alcohol, marijuana, or opioids but a few instances of DIF for amphetamine and cocaine users as well as for age, in that youth tended to endorse several easier items more frequently than did adults. The 11-item short form had neither misfit nor DIF by substance and only minor DIF by age was highly correlated with the full version and was relatively more efficient. Criterion-related validity was supported for both. Conclusions Both the long and short versions of SHIS are psychometrically sound measures of a more comprehensive conceptualization of self-help involvement for SUDs that can be used as part of an in-depth assessment or as a short measure that lessens respondent burden. PMID:26275980

  10. Taking care of business: self-help and sleep medicine in american corporate culture.

    PubMed

    Brown, Megan

    2004-01-01

    This article argues that corporate management in the United States has expanded its scope beyond office walls and encompasses many aspects of workers' daily lives. One new element of corporate training is the micromanagement of sleep; self-help books, newspaper reports, magazine articles, and consulting firms currently advise workers and supervisors on optimizing productivity by cultivating certain sleep habits. Although consultants and self-help books make specific recommendations about sleep, most medical research is inconclusive about sleep's benefits for human performance. Using the ideas of Michel Foucault and Gilles Deleuze as a philosophical backdrop, this article examines the complex and often contradictory links between self-help, medicine, and corporate governance.

  11. Behavioral Consultation to Community Self-Help Organizations.

    ERIC Educational Resources Information Center

    Jason, Leonard A.

    A high priority area for behavioral community psychologists involves working to strengthen informal support systems within communities. A collaborative effort between a community group and academic based psychologists focusses on a community problem--dog litter in an urban area. An original demonstration project was used to influence the political…

  12. Online Cognitive-Restructuring Self-Help: www.SelfHelpSocialAnxiety.com a New Application for Social Anxiety Disorder

    ERIC Educational Resources Information Center

    Egan, Julia

    2010-01-01

    The primary purpose of the present study was to develop an online self-help treatment program for Social Anxiety Disorder, focused on cognitive restructuring. It can be difficult getting socially anxious individuals to commit to treatment since therapy is typically a face to face social interaction (the feared stimulus). Recent research suggests…

  13. Disability self-help organizations in the developing world: a case study from Malaysia.

    PubMed

    Armstrong, M J

    1993-09-01

    Disability self-help organizations have emerged as an important element of response to the advancement of people with disabilities throughout the developing world in recent years. There are now self-help organizations in all regions of the developing world, their memberships are growing, and the scope of their activities is enlarging. This paper draws on field research in Malaysia to present an organization developed by and for people with physical disabilities as a case study of self-help action in the Southeast Asian region. This paper reviews the origins and growth of the organization, describes its current programme of activities, and offers comment about the nature and future of disability self-help in the region and its continued advancement in the developing world generally. A combination of internal factors that relate to organization and programming, and external political and social conditions is indicated as important.

  14. A systematic review of self-help for disfigurement: effectiveness, usability, and acceptability.

    PubMed

    Muftin, Zina; Thompson, Andrew R

    2013-09-01

    Self-help has been found to be efficacious in treating mood disorders, however, little is known about its use, effectiveness, or user satisfaction, in reducing distress associated with disfigurement. This review describes the content and focus of self-help interventions available in this area. A systematic search and appraisal protocol facilitated identification of studies, extraction of data, and appraisal of quality. Clinical trials were included if the primary method of intervention delivery was via self-help. Other types of study were included if they investigated user perspectives of a self-help intervention. Eleven studies covering a range of populations met the inclusion criteria. There is tentative support for the use of self-help to manage anxiety associated with disfigurement but little is known about the management of other psychosocial difficulties. Further research and intervention development is required to examine the effectiveness, acceptability, and utility of self-help in managing the appearance related distress associated with disfigurement. PMID:23962642

  15. 7 CFR Exhibit C to Subpart I of... - Amendment to Self-Help Technical Assistance Grant Agreement

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 13 2010-01-01 2009-01-01 true Amendment to Self-Help Technical Assistance Grant... SERVICE AGENCY, DEPARTMENT OF AGRICULTURE (CONTINUED) PROGRAM REGULATIONS (CONTINUED) HOUSING Self-Help... agency under Public Law 103-354, amends the “Self-Help Technical Assistance Grant Agreement” between...

  16. 76 FR 15991 - HUD's Fiscal Year (FY) 2010 NOFA for the Self-Help Homeownership Opportunity Program (SHOP...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-22

    ... URBAN DEVELOPMENT HUD's Fiscal Year (FY) 2010 NOFA for the Self-Help Homeownership Opportunity Program... technical correction to the FY 2010 NOFA for the Self-Help homeownership Opportunity Program (SHOP). This... the deadline date for the Self-Help homeownership Opportunity Program (SHOP) NOFA until April 18,...

  17. 41 CFR 102-75.550 - What does “self-help housing or housing assistance” mean?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... PROPERTY 75-REAL PROPERTY DISPOSAL Surplus Real Property Disposal Property for Providing Self-Help Housing Or Housing Assistance § 102-75.550 What does “self-help housing or housing assistance” mean? Property for self-help housing or housing assistance (which is separate from the program under Title V of...

  18. 41 CFR 102-75.550 - What does “self-help housing or housing assistance” mean?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... PROPERTY 75-REAL PROPERTY DISPOSAL Surplus Real Property Disposal Property for Providing Self-Help Housing Or Housing Assistance § 102-75.550 What does “self-help housing or housing assistance” mean? Property for self-help housing or housing assistance (which is separate from the program under Title V of...

  19. Taking care of business: self-help and sleep medicine in american corporate culture.

    PubMed

    Brown, Megan

    2004-01-01

    This article argues that corporate management in the United States has expanded its scope beyond office walls and encompasses many aspects of workers' daily lives. One new element of corporate training is the micromanagement of sleep; self-help books, newspaper reports, magazine articles, and consulting firms currently advise workers and supervisors on optimizing productivity by cultivating certain sleep habits. Although consultants and self-help books make specific recommendations about sleep, most medical research is inconclusive about sleep's benefits for human performance. Using the ideas of Michel Foucault and Gilles Deleuze as a philosophical backdrop, this article examines the complex and often contradictory links between self-help, medicine, and corporate governance. PMID:15292702

  20. [Self-help program: a new tool to facilitate the access to treatment for problem gamblers].

    PubMed

    Saeremans, M; Noël, X; Verbanck, P

    2015-01-01

    Shame, fear of stigmatization, denial, accessibility to and the cost of treatment program may explain why only a small proportion of problem gamblers sought clinical treatment. In the hope to overcome these barriers, the Gambling Clinic and Other Behavioral Addictions of C.H.U. Brugmann (Brussels) has developed its own self-help program for excessive gamblers. Our goals were to foster readiness to change gambling behaviors and when appropriate to facilitate the transition from self-help program to classical face-to-face clinical intervention. In a sample of 172 problem gamblers who participated, 40% had never sought help (e.g., clinical treatment) and/or never attempted quit gambling. Interestingly, for some, internet-based self-help treatment preceded their determination for seeking a traditional face-to-face therapeutic setting. Those results led us to discuss this program as a valid clinical tool within a broader health care setting in excessive gamblers. PMID:26164965

  1. Efficacy of a behavioral self-help treatment with or without therapist guidance for co-morbid and primary insomnia -a randomized controlled trial

    PubMed Central

    2012-01-01

    Background Cognitive behavioral therapy is treatment of choice for insomnia, but availability is scarce. Self-help can increase availability at low cost, but evidence for its efficacy is limited, especially for the typical insomnia patient with co-morbid problems. We hypothesized that a cognitive behaviorally based self-help book is effective to treat insomnia in individuals, also with co-morbid problems, and that the effect is enhanced by adding brief therapist telephone support. Methods Volunteer sample; 133 media-recruited adults with insomnia. History of sleep difficulties (mean [SD]) 11.8 [12.0] years. 92.5% had co-morbid problems (e.g. allergy, pain, and depression). Parallel randomized (block-randomization, n ≥ 21) controlled "open label" trial; three groups-bibliotherapy with (n = 44) and without (n = 45) therapist support, and waiting list control (n = 44). Assessments before and after treatment, and at three-month follow-up. Intervention was six weeks of bibliotherapeutic self-help, with established cognitive behavioral methods including sleep restriction, stimulus control, and cognitive restructuring. Therapist support was a 15-minute structured telephone call scheduled weekly. Main outcome measures were sleep diary data, and the Insomnia Severity Index. Results Intention-to-treat analyses of 133 participants showed significant improvements in both self-help groups from pre to post treatment compared to waiting list. For example, treatment with and without support gave shorter sleep onset latency (improvement minutes [95% Confidence Interval], 35.4 [24.2 to 46.6], and 20.6 [10.6 to 30.6] respectively), and support gave a higher remission rate (defined as ISI score below 8; 61.4%), than bibliotherapy alone (24.4%, p's < .001). Improvements were not seen in the control group (sleep onset latency 4.6 minutes shorter [-1.5 to 10.7], and remission rate 2.3%). Self-help groups maintained gains at three-month follow-up. Conclusions Participants receiving self-help

  2. A pilot study of mailed nicotine lozenges with assisted self-help for the treatment of smokeless tobacco users.

    PubMed

    Ebbert, Jon O; Severson, Herbert H; Croghan, Ivana T; Danaher, Brian G; Schroeder, Darrell R

    2010-05-01

    Smokeless tobacco (ST) is associated with adverse health consequences yet treatment resources for ST are not widely available. Cost-effective behavioral interventions incorporating self-help materials and counseling calls have been demonstrated to reduce ST use rates and can be easily disseminated, but the feasibility and effectiveness of incorporating pharmacotherapy into this approach have not been evaluated. We conducted a clinical pilot study randomizing 60 patients to 12 weeks of the 4-mg nicotine lozenge or placebo delivered through the mail. All subjects received an assisted self-help intervention (ASH) with telephone support. At the end of the medication phase, lozenges were being used by 63% of subjects in the 4-mg nicotine lozenge group and 43% in placebo. The nicotine lozenge decreased composite withdrawal symptoms and adverse events were minimal. No significant differences were observed in abstinence rates between the two groups at 3 or 6 months. We conclude that the mailing of nicotine lozenges to ST users is a feasible and safe strategy the efficacy of which needs to be evaluated.

  3. A pilot study of mailed nicotine lozenges with assisted self-help for the treatment of smokeless tobacco users.

    PubMed

    Ebbert, Jon O; Severson, Herbert H; Croghan, Ivana T; Danaher, Brian G; Schroeder, Darrell R

    2010-05-01

    Smokeless tobacco (ST) is associated with adverse health consequences yet treatment resources for ST are not widely available. Cost-effective behavioral interventions incorporating self-help materials and counseling calls have been demonstrated to reduce ST use rates and can be easily disseminated, but the feasibility and effectiveness of incorporating pharmacotherapy into this approach have not been evaluated. We conducted a clinical pilot study randomizing 60 patients to 12 weeks of the 4-mg nicotine lozenge or placebo delivered through the mail. All subjects received an assisted self-help intervention (ASH) with telephone support. At the end of the medication phase, lozenges were being used by 63% of subjects in the 4-mg nicotine lozenge group and 43% in placebo. The nicotine lozenge decreased composite withdrawal symptoms and adverse events were minimal. No significant differences were observed in abstinence rates between the two groups at 3 or 6 months. We conclude that the mailing of nicotine lozenges to ST users is a feasible and safe strategy the efficacy of which needs to be evaluated. PMID:20060229

  4. Efficacy of a Multicomponent Positive Psychology Self-Help Intervention: Study Protocol of a Randomized Controlled Trial

    PubMed Central

    Drossaert, Constance HC; Pieterse, Marcel E; Walburg, Jan A; Bohlmeijer, Ernst T

    2015-01-01

    Background Positive psychology interventions have been found to enhance well-being and decrease clinical symptomatology. However, it is still unknown how flourishing can also be increased. Although multicomponent interventions seem to be necessary for this purpose, different formats can be used. A cost-effective approach could be a positive psychology-based self-help book with tailored email support to reach large target groups and to prevent dropout. Objective This study will evaluate the efficacy of a comprehensive multicomponent self-help intervention with or without email support on well-being and flourishing, and will seek to determine the working mechanisms underlying the intervention. Methods In this 3-armed, parallel, randomized controlled trial, 396 participants with low or moderate levels of well-being and without clinical symptomatology will be randomly assigned to (1) a self-help book condition with weekly email support, (2) a self-help book condition without email support but with a weekly information email, or (3) a waiting list control condition. Online measurements will be assessed at baseline, at post-test (3 months after baseline), and at 6 and 12 months after baseline. Results The primary outcomes are well-being and flourishing (ie, high levels of well-being). Secondary outcomes are the well-being components included in the intervention: positive emotion, use of strengths, optimism, self-compassion, resilience, and positive relations. Other measures include depressive and anxiety symptoms, personality traits, direct medical and non-medical costs, life-events, and client satisfaction. Conclusions This study will add knowledge to the efficacy and cost-effectiveness of a multicomponent positive psychology intervention. We will also explore who can benefit most from this intervention. If the intervention is found to be effective, our results will be especially relevant for public mental health services, governments, and primary care. Trial

  5. Investigation of self-help oil-spill response techniques and equipment

    SciTech Connect

    Enderlin, W I; Downing, J P; Enderlin, C W; Sanquist, T F; Pope, W S

    1992-06-01

    The US Coast Guard commissioned Pacific Northwest Laboratory (PNL) to conduct this study of 45 self-help oil-spill response techniques and equipment for oceangoing tankers and inland tank barges to assess the potential effectiveness of the proposed countermeasure categories. This study considers the hypothetical outflow of oil in the case of side damage and bottom damage to single-hull designs. The results will be considered by the Coast Guard in drafting regulations pertaining to the requirement for tanker vessels to carry oil pollution response equipment (i.e., in response to the oil Pollution Act of 1990). PNL's approach to this investigation included: assessing time-dependent oil outflow in the cases of collision and grounding of both tankers and barges; identifying environmental constraints on self-help countermeasure operation; identifying human factor issues, such as crew performance, safety, and training requirements for the self-help countermeasures considered; and assessing each self-help countermeasure with respect to its potential for minimizing oil loss to the environment. Results from the time-dependent oil outflow, environmental limitations, and human factors requirements were input into a simulation model.

  6. Telepsychology and Self-Help: The Treatment of Fear of Public Speaking

    ERIC Educational Resources Information Center

    Botella, Cristina; Guillen, Veronica; Banos, Rosa M.; Garcia-Palacios, Azucena; Gallego, Maria J.; Alcaniz, Mariano

    2007-01-01

    This work presents a self-help, Internet-based telepsychology program for the treatment of public speaking fears. The system is comprised of 3 parts: The "assessment protocol" gives the patient information about his or her problem (i.e., amount of interference it creates in his or her life, severity, degree of fear and avoidance). The system also…

  7. Music for Elementary Teachers; Self-Help Guide (MUS 370). Adams State College.

    ERIC Educational Resources Information Center

    Stokes, Cloyce

    This self-help guide for the music teacher is one of a series of eight Teacher Education Modules developed by Adams State College Teacher Corps Program. The guide itself consists of 11 modules, the first five of which focus on the mathematical and scientific aspects of music--pitch, tempo, furation, time, and key. These five modules are…

  8. 7 CFR Exhibit D to Subpart I of... - Self-Help Technical Assistance Grant Predevelopment Agreement

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... § 1944.410(d) of 7 CFR part 1944, subpart I, as necessary, to develop a complete program for a self-help... Agreement D Exhibit D to Subpart I of Part 1944 Agriculture Regulations of the Department of Agriculture... Technical Assistance Grants Pt. 1944, Subpt. I, Exh. D Exhibit D to Subpart I of Part...

  9. Experiences in Rural Mental Health. VII: Promoting Self-Help with Educational Programs.

    ERIC Educational Resources Information Center

    Hollister, William G.; And Others

    Based on a North Carolina feasibility study (1967-73) which focused on development of a pattern for providing comprehensive mental health services to rural people, this guide deals with promoting self-help via educational programs in Vance and Franklin counties. Emphasizing both cognitive and affective experiences, this booklet details the…

  10. An Evaluation of the Remarriage and Stepfamily Self-Help Literature

    ERIC Educational Resources Information Center

    Coleman, Marilyn; Nickleberry, Lynette

    2009-01-01

    The purpose of this study was to critique in-print, post-1990 copyrighted stepfamily self-help books in order to provide guidance to helping professionals who work with these complex families. Of the 63 books reviewed, trained coders were able to strongly recommend 13 books for being well organized, for relying on clinical or empirical sources of…

  11. Online Counseling: Prioritizing Psychoeducation, Self-Help, and Mutual Help for Counseling Psychology Research and Practice

    ERIC Educational Resources Information Center

    Chang, Tai

    2005-01-01

    This reaction article extends the research and practice recommendations for online counseling from the Major Contribution to the November 2005 issue of "The Counseling Psychologist" by prioritizing research and practice in online psychoeducation, self-help, and mutual help. Research suggests that tens of millions of Americans use the Internet for…

  12. The Acceptability of an Internet-Based Self-Help Treatment for Fear of Public Speaking

    ERIC Educational Resources Information Center

    Botella, C.; Gallego, M. J.; Garcia-Palacios, A.; Banos, R. M.; Quero, S.; Alcaniz, M.

    2009-01-01

    Several randomised controlled studies have shown the efficacy of Internet-based self-help treatments. These studies have centred their attention on axis I (efficacy) of the Guidelines for Empirically Validated Treatments, although there are a few studies that also take into account axis II (effectiveness). The aim of the present work was to test…

  13. Public Pedagogy from the Learner's Perspective: Women Reading Self-Help Relationship Books

    ERIC Educational Resources Information Center

    Kapell, Brandi M.; McLean, Scott

    2014-01-01

    In recent years, the concept of public pedagogy has increasingly influenced the study of continuing education, drawing attention to ways in which adults access resources from popular culture and learn without the involvement of educational institutions. Reading relationship self-help books has become a prominent component of popular culture. There…

  14. Predictors of dropout from internet-based self-help cognitive behavioral therapy for insomnia.

    PubMed

    Yeung, Wing-Fai; Chung, Ka-Fai; Ho, Fiona Yan-Yee; Ho, Lai-Ming

    2015-10-01

    Dropout from self-help cognitive-behavioral therapy for insomnia (CBT-I) potentially diminishes therapeutic effect and poses clinical concern. We analyzed the characteristics of subjects who did not complete a 6-week internet-based CBT-I program. Receiver operator characteristics (ROC) analysis was used to identify potential variables and cutoff for predicting dropout among 207 participants with self-report insomnia 3 or more nights per week for at least 3 months randomly assigned to self-help CBT-I with telephone support (n = 103) and self-help CBT-I (n = 104). Seventy-two participants (34.4%) did not complete all 6 sessions, while 42 of the 72 (56.9%) dropped out prior to the fourth session. Significant predictors of non-completion are total sleep time (TST) ≥ 6.82 h, Hospital Anxiety and Depression Scale depression score ≥ 9 and Insomnia Severity Index score < 13 at baseline in this ranking order. Only TST ≥ 5.92 h predicts early dropout. Longer TST and less severe insomnia predict dropout in this study of self-help CBT-I, in contrast to shorter TST as a predictor in 2 studies of face-to-face CBT-I, while greater severity of depression predicts dropout in both this study and a study of face-to-face CBT-I. Strategies for minimizing dropout from internet-based CBT-I are discussed. PMID:26226091

  15. From Hospital to Community: A Self-Help Program to Promote the Transition.

    ERIC Educational Resources Information Center

    Kutner, Bernard; And Others

    Vocational placement, social needs, and the lack of proper transportation for disabled persons are major problems to be solved if physically handicapped people are to function in community life. Mobilization for Maturity was a 3-year research and demonstration project which utilized a self-help approach to help disabled people to re-enter…

  16. The current status and future direction of self-help treatments for problem gamblers.

    PubMed

    Raylu, Namrata; Oei, Tian P S; Loo, Jasmine

    2008-12-01

    The self-help treatment (SHT) studies for other psychological problems significantly outweigh those for problem gambling. Currently, very little is published about the application and efficacy of various forms of SHTs for problem gambling. Thus, this paper reviews the self-help literature (using the PsycINFO database--all years up to April 2008) to stimulate further research in this area for problem gambling. The findings show that SHTs in problem gambling are still in their infancy. Although the problem gambling literature has mainly reported on two forms of SHTs with problem gamblers (i.e. use of self-help manuals and audiotapes), the review discuss utilizing a wide range of SHTs with problem gamblers. These include written materials (e.g. self-help books and treatment manuals), audiotapes, videotapes, computer-based SHTs implemented on palmtop computers, desktop computers, via telephone (Interactive Voice Response systems--IVR) or via the Internet and virtual reality applications. These SHTs would suit those problem gamblers who are not accessing professional treatment due to shame, guilt, fear of stigma, privacy concerns or financial difficulties, as well as those living in rural areas or with less severe gambling problems. The review also suggest future protocols for conducting further research in this area with problem gamblers, highlighting a need for a cohesive theory to guide research.

  17. Dealing with the Effects of Trauma: A Self-Help Guide

    MedlinePlus

    ... Self-Help Guide Page 1 Foreword It contains information, ideas, and strategies that people from all over the country have found to be helpful in relieving and preventing troubling feelings and symptoms. The information in this booklet can be used safely along ...

  18. Getting out of Depression: Teens' Self-Help Interventions to Relieve Depressive Symptoms

    ERIC Educational Resources Information Center

    Wisdom, Jennifer P.; Barker, Ellen C.

    2006-01-01

    Most depressed adolescents do not access medical care for symptoms, yet many improve without professional intervention. While several self-help interventions have empirical support, teens' non-directed efforts to reduce symptoms are not documented. We reviewed 14 depressed adolescents' reports of attempts to reduce depressive symptoms. Results…

  19. "Transform Your Child's Behaviour Now": Parent Education as Self-Help Culture and Lifelong Learning

    ERIC Educational Resources Information Center

    Widding, Ulrika

    2011-01-01

    Parents in the Western world today are often said to feel unsure and inadequate and as a consequence there are a plethora of self-help products on the market as well as parent education programmes. This article explores the kinds of research questions that are raised by this state of affairs. The discussion is mainly based on existing studies of…

  20. Specific Psychosocial and Behavioral Outcomes from the Systemic Lupus Erythematosus Self-Help Course.

    ERIC Educational Resources Information Center

    Braden, Carrie Jo; And Others

    1993-01-01

    Data from 104 participants in the Systemic Lupus Erythematosus Self-Help Course showed that patients had significant increases in enabling skills and use of relaxation/exercise and decreases in depression. Amount of time spent in class was correlated with significant changes over time. (SK)

  1. Examination of Predictors and Moderators for Self-Help Treatments of Binge-Eating Disorder

    ERIC Educational Resources Information Center

    Masheb, Robin M.; Grilo, Carlos M.

    2008-01-01

    Predictors and moderators of outcomes were examined in 75 overweight patients with binge-eating disorder (BED) who participated in a randomized clinical trial of guided self-help treatments. Age variables, psychiatric and personality disorder comorbidity, and clinical characteristics were tested as predictors and moderators of treatment outcomes.…

  2. Parents' Training: Effects of the Self-Help Skills Programme with Down's Syndrome Babies

    ERIC Educational Resources Information Center

    Sanz, Maria Teresa; Menendez, Javier

    2010-01-01

    This article reviews studies evaluating the effectiveness of two types of early intervention programmes for babies with Down's syndrome (DS). Evaluation of self-help early intervention programmes was done with two types of training with the parents: in the first the parents learned the training programme from observing the clinician, and in the…

  3. Hypnotic Taper with or without Self-Help Treatment of Insomnia: A Randomized Clinical Trial

    ERIC Educational Resources Information Center

    Belleville, Genevieve; Guay, Catherine; Guay, Bernard; Morin, Charles M.

    2007-01-01

    This study aimed to assess the efficacy of a minimal intervention focusing on hypnotic discontinuation and cognitive-behavioral treatment (CBT) for insomnia. Fifty-three adult chronic users of hypnotics were randomly assigned to an 8-week hypnotic taper program, used alone or combined with a self-help CBT. Weekly hypnotic use decreased in both…

  4. 76 FR 77548 - Notice of Submission of Proposed Information Collection to OMB Self-Help Homeownership...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-13

    ... persons and families. This information collection is to measure performance goals and demonstrate the... families. This information collection is to measure performance goals and demonstrate the success of the... URBAN DEVELOPMENT Notice of Submission of Proposed Information Collection to OMB Self-Help...

  5. Cost-Effectiveness of Guided Self-Help Treatment for Recurrent Binge Eating

    ERIC Educational Resources Information Center

    Lynch, Frances L.; Striegel-Moore, Ruth H.; Dickerson, John F.; Perrin, Nancy; DeBar, Lynn; Wilson, G. Terence; Kraemer, Helena C.

    2010-01-01

    Objective: Adoption of effective treatments for recurrent binge-eating disorders depends on the balance of costs and benefits. Using data from a recent randomized controlled trial, we conducted an incremental cost-effectiveness analysis (CEA) of a cognitive-behavioral therapy guided self-help intervention (CBT-GSH) to treat recurrent binge eating…

  6. Comparison of Six- and Eight-Session Cognitive Guided Self-Help for Bulimia Nervosa

    ERIC Educational Resources Information Center

    Furber, Gareth; Steele, Anna; Wade, Tracey D.

    2004-01-01

    A previous case-series evaluation of a six-session guided self-help (GSH) approach with 15 people with bulimia nervosa (BN) showed significant reductions across all measures, including binge eating, self-induced vomiting, weight concern, shape concern and dietary restraint. However, the reduction of binge eating and self-induced vomiting was…

  7. Cognitive Behavioral Guided Self-Help for the Treatment of Recurrent Binge Eating

    ERIC Educational Resources Information Center

    Striegel-Moore, Ruth H.; Wilson, G. Terence; DeBar, Lynn; Perrin, Nancy; Lynch, Frances; Rosselli, Francine; Kraemer, Helena C.

    2010-01-01

    Objective: Despite proven efficacy of cognitive behavioral therapy (CBT) for treating eating disorders with binge eating as the core symptom, few patients receive CBT in clinical practice. Our blended efficacy-effectiveness study sought to evaluate whether a manual-based guided self-help form of CBT (CBT-GSH), delivered in 8 sessions in a health…

  8. The Uses of Juvenile Fiction and Self-Help Books with Stepfamilies.

    ERIC Educational Resources Information Center

    Coleman, Marilyn; Ganong, Lawrence H.

    1990-01-01

    Advocates use of bibliotherapy as an adjunct to counseling with stepchildren and remarried adults. Information to guide the selection and use of fiction and self-help books for children and adolescents is provided. Also mentioned are other audiences and uses for the adolescent fiction. (Author)

  9. An Evaluation of the Stepfamily Self-Help Literature for Children and Adolescents.

    ERIC Educational Resources Information Center

    Coleman, Marilyn; Ganong, Lawrence

    1987-01-01

    Reviews and critiques 11 stepfamily self-help books for children and adolescents. Codes books on dimensions of appropriate audience, author background, issues, advice, and strengths. Rates general interest and quality of writing of books and assigns categories of recommendation. Discusses use of the books as an adjunct to therapy. (Author/NB)

  10. Ohoyo Training Manual. Leadership: Self Help American Indian-Alaska Native Women.

    ERIC Educational Resources Information Center

    Verble, Sedelta D.; Walton, M. Frances

    The training manual provides self-help in six areas of leadership development for American Indian and Alaska Native women. Following an introduction describing how to use the manual are six chapters focusing on the theories and development of leadership skills, the vulnerability of Indian women to poverty, nontraditional careers for Indian women,…

  11. A randomized trial of a serialized self-help smoking cessation program for pregnant women in an HMO.

    PubMed Central

    Ershoff, D H; Mullen, P D; Quinn, V P

    1989-01-01

    We report the results of a population-based randomized clinical trial that tested the effectiveness of a prenatal self-help smoking cessation program. The intervention consisted predominantly of printed materials received through the mail. The population (n = 242) consisted of a socioeconomically and ethnically diverse group of pregnant women enrolled in a large health maintenance organization (HMO) who reported they were smoking at the time of their first prenatal visit. Biochemical confirmation of continuous abstinence achieved prior to the 20th completed week of pregnancy and lasting through delivery revealed 22.2 per cent of the women in the eight-week serialized program quit versus 8.6 per cent of controls with usual care. The adjusted odds ratio was 2.80 (95 per cent CI = 1.17, 6.69). We conclude that a low-cost prenatal self-help intervention can significantly affect the public health problem of smoking during pregnancy and its associated risks for maternal and child health. PMID:2913837

  12. Randomized Effectiveness Trial of an Internet, Pure Self-Help, Cognitive Behavioral Intervention for Depressive Symptoms in Young Adults

    PubMed Central

    Clarke, Greg; Kelleher, Chris; Hornbrook, Matt; DeBar, Lynn; Dickerson, John; Gullion, Christina

    2008-01-01

    This study evaluated an Internet-delivered, cognitive behavioral skills training program versus a treatment-as-usual (TAU) control condition targeting depression symptoms in youth ages 18 to 24. Potential participants were mailed a recruitment brochure; if interested they accessed the study website to complete an online consent and baseline assessment. Intervention participants could access the website at their own pace and at any time. Reminder postcards were mailed periodically to encourage return use of the intervention. The pure self-help intervention was delivered without contact with a live therapist. The primary depression outcome measure was the Patient Health Questionnaire (PHQ-8), administered at 0, 5, 10, 16, and 32 weeks after enrollment. A small but significant between-group effect was found from week 0 to week 32 for the entire sample (n=160; d=.20, 95% CI=0.00-0.50), with a moderate effect among females (n=128; d=.42, 95% CI=0.09-0.77). Greater depression reduction was associated with two measures of lower website usage, total minutes and total number of page hits. While intervention effects were modest, they were observed against a background of substantial TAU depression pharmacotherapy and psychosocial services. Highly disseminable, low-cost, and self-help interventions such as this have the potential to deliver a significant public health benefit. PMID:19440896

  13. Can mindfulness and acceptance be learnt by self-help?: a systematic review and meta-analysis of mindfulness and acceptance-based self-help interventions.

    PubMed

    Cavanagh, Kate; Strauss, Clara; Forder, Lewis; Jones, Fergal

    2014-03-01

    There is growing evidence that mindfulness and acceptance-based interventions have positive consequences for psychological and physical health. The most well-established of these interventions typically involve relatively large resource commitments, in terms of both the provider and participant. A number of recent studies have begun to explore whether the benefits of such interventions can be generalised to less intensive methods. Methods include pure and guided self-help utilising resources such as books and workbooks, computer programmes and applications and audio-visual materials. This paper presents a systematic review and meta-analysis of studies that have evaluated the effectiveness and acceptability of low-intensity interventions including mindfulness and acceptance-based components. Fifteen RCTs (7 ACT-based, 4 mindfulness-based and 4 multi-component interventions including elements of mindfulness and/or acceptance) were identified and reviewed. Interventions that included mindfulness and/or acceptance-based components produced significant benefits in comparison to control conditions on measures of mindfulness/acceptance, depression and anxiety with small to medium effect sizes. Engagement with the self-help interventions varied but on average two-thirds of participants completed post-intervention measures. Emerging research into low-intensity mindfulness and acceptance-based interventions is hopeful. Recommendations for research and practice are presented.

  14. Self-Care and Self-Help Groups for the Elderly: A Directory.

    ERIC Educational Resources Information Center

    National Inst. on Aging (DHHS/PHS), Bethesda, MD.

    This document notes that, as health care costs continue to rise, the elderly are monitoring themselves as a means of cost containment, and as a way of enhancing their sense of well-being and their ability to lead active lives. It points out that more and more organizations are sponsoring health programs that promote the concept of self-care and…

  15. Women's Empowerment and Education: Panchayats and Women's Self-Help Groups in India

    ERIC Educational Resources Information Center

    Ghosh, Ratna; Chakravarti, Paromita; Mansi, Kumari

    2015-01-01

    While women have made many advances, their inferior status to men continues to be a global phenomenon. At a time of unprecedented economic growth, India is experiencing a dramatic intensification of violence against women and the majority of girls are still not getting equal educational opportunity. In one of the most important steps for the…

  16. Making Self-Help More Helpful: A Randomized Controlled Trial of the Impact of Augmenting Self-Help Materials with Implementation Intentions on Promoting the Effective Self-Management of Anxiety Symptoms

    ERIC Educational Resources Information Center

    Varley, Rachel; Webb, Thomas L.; Sheeran, Paschal

    2011-01-01

    Objective: The effectiveness of self-help materials may be constrained by failures to undertake recommended exercises or to deploy the techniques that one has learned at the critical moment. The present randomized controlled trial investigated whether augmenting self-help materials with if-then plans (or implementation intentions) could overcome…

  17. A comparison of online versus workbook delivery of a self-help positive parenting program.

    PubMed

    Sanders, Matthew R; Dittman, Cassandra K; Farruggia, Susan P; Keown, Louise J

    2014-06-01

    A noninferiority randomized trial design compared the efficacy of two self-help variants of the Triple P-Positive Parenting Program: an online version and a self-help workbook. We randomly assigned families of 193 children displaying early onset disruptive behavior difficulties to the online (N = 97) or workbook (N = 96) interventions. Parents completed questionnaire measures of child behavior, parenting, child maltreatment risk, personal adjustment and relationship quality at pre- and post-intervention and again at 6-month follow up. The short-term intervention effects of the Triple P Online program were not inferior to the workbook on the primary outcomes of disruptive child behavior and dysfunctional parenting as reported by both mothers and fathers. Both interventions were associated with significant and clinically meaningful declines from pre- to post-intervention in levels of disruptive child behavior, dysfunctional parenting styles, risk of child maltreatment, and inter-parental conflict on both mother and father report measures. Intervention effects were largely maintained at 6-month follow up, thus supporting the use of self-help parenting programs within a comprehensive population-based system of parenting support to reduce child maltreatment and behavioral problems in children.

  18. Usability and Utility of a Computerized Cognitive-Behavioral Self-Help Program for Public Speaking Anxiety

    ERIC Educational Resources Information Center

    Anderson, Page; Zimand, Elana; Schmertz, Stefan K.; Ferrer, Mirtha

    2007-01-01

    This study describes the use of a cognitive-behavioral computer-administered self-help program with minimal therapist contact for public speaking anxiety. Participants (N = 10) with social phobia, as measured by a structured clinical interview, completed the self-help program in an open clinical trial. The program was delivered via a CD-ROM during…

  19. Evaluation of a DVD-Based Self-Help Program in Highly Socially Anxious Individuals--Pilot Study

    ERIC Educational Resources Information Center

    Mall, Anna K.; Mehl, Annette; Kiko, Sonja; Kleindienst, Nikolaus; Salize, Hans-Joachim; Hermann, Christiane; Hoffmann, Torsten; Bohus, Martin; Steil, Regina

    2011-01-01

    High social anxiety is a risk factor for the incidence of social anxiety disorder (SAD). Early diagnosis and intervention may prevent more severe psychiatric courses. Self-help programs may be a convenient, accessible, and effective intervention. This study examined the efficacy of a newly developed self-help program for SAD in individuals with…

  20. African Americans and Self-Help Education: The Missing Link in Adult Education. ERIC Digest No. 222.

    ERIC Educational Resources Information Center

    Rowland, Michael L.

    Self-help education and self-help literature is important in the lives of African American adults, but the basic models of learning, development, and program planning in adult education have often been developed with little concern for the unique needs of African Americans. In addition, current theories of adult learning often lack understanding…

  1. Development policy and the evaluation of community self-help: the Harambee school movement in Kenya.

    PubMed

    Keller, E J

    1983-01-01

    This attempt to objectively assess the costs and benefits of involvement in the harambee education movement for individuals and families is directed at policymakers and is an exercise in policy analysis. Evaluative studies of this nature are essential to the improvement of the of the overall quality of policymaking. Despite general agreement that harambee education projects involving secondary schools differ in many ways from types of self-help projects, few attempts have been made to assess the long-term social impact of the harambee education movement. For nearly 2 decades Kenya's harambee movement has flourished and has been largely viewed as a positive contribution to national development. Between 1969-79, the total value of contributions to self-help projects rose from around $6 million to almost $27 million, demostrating the substantial inputs of local communities to the economic growth of the country as a whole. Policymakers, after initial reservations about independent self-help, in recent years have come to rely on such activities as complementary to the government's efforts. Self-help activities aimed at expanding educational opportunity are the most significant in terms of both monetary resources expended and the scope of human involvement. Benefits are difficult to extimate. The growing number of students in harambee schools does not necessarly indicate that the majority of these students are acquiring marketable skills or that their consequent levels of academic training will prepare them to complete successfully in the job market with the average student educated in government-sponsored schools. The evidence, in fact, clearly points in the opposite direction. Yet, politicians, policymakers, and citizens continue to regard harambee activities for expanding educational opportunities atall levels as necessary contributions to Kenya's development program and to individual achievement. The direct cost to government for harambee education can be compared

  2. A Web-Based Self-Help Intervention With and Without Chat Counseling to Reduce Cannabis Use in Problematic Cannabis Users: Three-Arm Randomized Controlled Trial

    PubMed Central

    Wenger, Andreas; Berg, Oliver; Beck, Thilo; Stark, Lars; Buehler, Eveline; Haug, Severin

    2015-01-01

    Background After alcohol and tobacco, cannabis is the most widely used psychoactive substance in many countries worldwide. Although approximately one in ten users develops serious problems of dependency, only a minority attend outpatient addiction counseling centers. A Web-based intervention could potentially reach those users who hesitate to approach such treatment centers. Objective To test the efficacy of a Web-based self-help intervention with and without chat counseling—Can Reduce—in reducing the cannabis use of problematic cannabis users as an alternative to outpatient treatment services. Methods Altogether, 436 participants were recruited by various online and offline media for the Web-based trial. A total of 308 of these were eligible for study participation and were randomly allocated in an unblinded manner to either self-help with chat (n=114), self-help without chat (n=101), or a waiting list control group (n=93). The fully automated self-help intervention consisted of eight modules designed to reduce cannabis use, and was based on the principles of motivational interviewing, self-control practices, and methods of cognitive behavioral therapy. Additional individual chat counseling sessions were based on the same therapeutic principles. The sessions were conducted by trained counselors and addressed participants' personal problems. The main outcomes were the frequency (number of days) and quantity of cannabis use (number of standardized joints) per week, as entered into the consumption diary at baseline and at the 3-month follow-up. Secondary outcomes included self-reported symptoms of cannabis use disorder, severity of cannabis dependence, risky alcohol use, and mental health symptoms. Intervention participation and retention were extracted from the user progress data and the consumption diary, respectively. Results Can Reduce participants were older (U=2.296, P=.02) and reported a greater number of cannabis use days at baseline than patients who

  3. [How could self help support patients and families with anorectal malformations?--Psychosocial help offers of SoMA eV].

    PubMed

    Schwarzer, Nicole

    2010-01-01

    To be born with an anorectal malformation means to suffer from a rare disease. The afflicted viscera and the consequences e. g. incontinence border on a taboo. In most instances it is necessary to have an interdisciplinary and long-term follow up of the patients. Involved children and their families benefit in a special way from the offers of a self-help organization. The feeling not to be alone helps to cope with the strain situation, as do the presented projects and offers which come up with the special needs of the patients. The everyday experience and capacity of the patients can be used to solve problems. On the one hand, self-help represents a pool of knowledge on the other hand it shows to the attending physician or therapist the long-term results achieved. Here a network of the different specialties is crucial. Especially in the psychosocial field where self-help organizations have reached their limits--there is a need for more psychotherapeutical support.

  4. Self-help cognitive-behavioral therapy for insomnia: a meta-analysis of randomized controlled trials.

    PubMed

    Ho, Fiona Yan-Yee; Chung, Ka-Fai; Yeung, Wing-Fai; Ng, Tommy H; Kwan, Ka-Shing; Yung, Kam-Ping; Cheng, Sammy K

    2015-02-01

    Self-help cognitive-behavioral therapy (CBT) is an increasingly popular treatment option for insomnia. The objective of this meta-analysis was to compile an up-to-date evaluation on the efficacy, adherence, acceptability and dropout rate of self-help CBT for insomnia. We systematically searched six key electronic databases up until May 2013. Two researchers independently selected relevant publications, extracted data, and evaluated methodological quality according to the Cochrane criteria. Twenty randomized controlled trials were included; 10 of which were published after the last review up until January 2007. Meta-analysis of self-help CBT vs. waiting-list, routine care or no treatment was performed. Results showed that self-help CBT improved sleep, sleep-related cognitions and anxiety and depressive symptoms. Effect sizes for sleep-diary-derived sleep efficiency, sleep onset latency, and wake after sleep onset at immediate posttreatment were 0.80, 0.66, and 0.55, respectively. The average dropout rate of self-help CBT at immediate posttreatment was 14.5%, which was not significantly different from the 16.7% in therapist-administered CBT. Subgroup analyses supported the added benefit of telephone consultation. In conclusion, self-help CBT is efficacious and acceptable as an entry level of a stepped care model for insomnia. In places where face-to-face treatments are unavailable or too costly, self-help CBT can be considered as a compromise. PMID:25104471

  5. The effects of an Internet based self-help course for reducing panic symptoms - Don't Panic Online: study protocol for a randomised controlled trial

    PubMed Central

    2011-01-01

    Background Internet based self-help for panic disorder (PD) has proven to be effective. However, studies so far have focussed on treating a full-blown disorder. Panic symptoms that do not meet DSM-IV criteria are more prevalent than the full-blown disorder and patients with sub-clinical panic symptoms are at risk of developing PD. This study is a randomised controlled trial aimed to evaluate an Internet based self-help intervention for sub-clinical and mild PD compared to a waiting list control group. Methods Participants with mild or sub-clinical PD (N = 128) will be recruited in the general population. Severity of panic and anxiety symptoms are the primary outcome measures. Secondary outcomes include depressive symptoms, quality of life, loss of production and health care consumption. Assessments will take place on the Internet at baseline and three months after baseline. Discussion Results will indicate the effectiveness of Internet based self-help for sub-clinical and mild PD. Strengths of this design are the external validity and the fact that it is almost completely conducted online. Trial registration Netherlands Trial Register (NTR): NTR1639 The Netherlands Trial Register is part of the Dutch Cochrane Centre. PMID:21396089

  6. Acceptability and feasibility of self-help Cognitive Remediation Therapy for anorexia nervosa delivered in collaboration with carers: a qualitative preliminary evaluation study.

    PubMed

    Lang, Katie; Treasure, Janet; Tchanturia, Kate

    2015-02-28

    Anorexia nervosa (AN) is an eating disorder without a recommended first-line treatment. Cognitive Remediation Therapy (CRT) is showing great promise in helping patients reduce cognitive inflexibility and excessive detail focus, thinking styles that could make engaging in psychological therapies difficult. CRT has shown to be effective, feasible and acceptable in both individual and group formats, and positive qualitative data has been gathered from both service users and clinicians. The aim of the current study was to assess the use of CRT as a self-help treatment for individuals with AN delivered in collaboration with carers. Six families underwent a six-week self-help CRT intervention. Feedback was gathered from qualitative interviews and analysed using thematic analysis. Neuropsychological outcomes were also collected. Participant feedback regarding the intervention was generally positive, with participants describing a number of benefits such as it creating a space for families to spend time together outside of the eating disorder, acting as a 'gateway' for more emotional work and helping participants to gain insight into their cognitive profiles. These preliminary findings suggest that self-help CRT delivered in collaboration with carers is an acceptable form of treatment, and adds to the growing literature supporting CRT for AN.

  7. Qualitative process evaluation of a problem-solving guided self-help manual for family carers of young people with first-episode psychosis

    PubMed Central

    2014-01-01

    Background Caring for a young person experiencing first-episode psychosis is challenging and can affect carers’ well-being adversely. While some face-to-face approaches have achieved promising outcomes, they are costly and resource-intensive to provide, restricting their reach and penetration. Guided self-help in book-form (or bibliotherapy) is an alternative but untested approach in these circumstances. In this study, we aimed to evaluate carers’ beliefs about the usefulness of problem-solving guided self-help manual for primary carers of young people with first-episode psychosis. Methods A qualitative process evaluation nested in a randomised controlled trial, conducted across two early intervention psychosis services in Melbourne, Australia. 124 carers were randomised to problem-solving guided self-help intervention or treatment as usual. We also undertook a qualitative process evaluation, using individual interviews, with a random sample of 24 of the intervention group. A thematic analysis of the qualitative data was undertaken, which is the subject of this paper. Interviews were conducted between January 2009 and September 2010. Results Three themes were abstracted from the data, reflecting carers’ beliefs about the usefulness of the manual: promoting carers’ well-being, increasing carers’ understanding of and support for the young person with first-episode psychosis, and accessibility and delivery modes of the programme. Conclusion This process evaluation highlights that guided self-help is useful in informing and supporting carers of affected young people. While there is scope for broadening the delivery modes, the approach is easy to use and accessible, and can be used as a cost-effective adjunct to standard support provided to carers, by community mental health nurses and other clinicians. Trial registration ACTRN12609000064202 PMID:24906392

  8. A self-help cessation program for smokeless tobacco users: comparison of two interventions.

    PubMed

    Severson, H H; Andrews, J A; Lichtenstein, E; Gordon, J S; Barckley, M; Akers, L

    2000-11-01

    While the use of smokeless tobacco products has increased, there has been a paucity of research evaluating interventions to help users quit. This study is the first large-scale randomized trial evaluating two levels of self-help cessation intervention with adult smokeless tobacco (SLT) users. Smokeless users in five Northwest states were recruited to call a toll-free number and 1069 users were randomized to receive one of two interventions, Manual Only (MAN) or Assisted Self-Help (ASH), who received a video and two support phone calls in addition to the manual. The study demonstrated that low-cost minimal interventions done by mail and phone can help a sizable proportion of SLT users quit both SLT and all tobacco use. Follow-up data at 6 months showed that subjects in the ASH condition had a significantly higher quit rate for both smokeless (23.4% vs. 18.4%, p < 0.05) and all tobacco use (21.1% vs. 16.5%, p < 0.05), using an intent-to-treat model. Further analysis revealed that use of the recommended cessation procedures mediated the effect of intervention condition on outcomes. This may be the result of phone counselors getting subjects to carry out behavioral cessation procedures. Public health implications for this intervention are discussed.

  9. How to implement the Science Fair Self-Help Development Program in schools

    SciTech Connect

    Menicucci, D.

    1994-01-01

    This manual is intended to act as a working guide for setting up a Science Fair Volunteer Support Committee at your school. The Science Fair Volunteer Support Committee, or SFVSC, is the key component of the Science Fair Self-Help program, which was developed by Sandia National Laboratories and is designed to support a school`s science activities. The SFVSC is a team of parents and community volunteers who work in concert with a school`s teaching staff to assist and manage all areas of a school Science and Engineering Fair. The main advantage of creating such a committee is that it frees the science teachers from the organizational aspects of the fair and lets them concentrate on their job of teaching science. This manual is based on information gained through a Self-Help Development pilot program that was developed by Sandia National Laboratories during the 1991--92 school year at three Albuquerque, NM, middle schools. The manual describes the techniques that were successful in the pilot program and discusses how these techniques might be implemented in other schools. This manual also discusses problems that may be encountered, including suggestions for how they might be resolved.

  10. Self-Help Booklets for Preventing Postpartum Smoking Relapse: A Randomized Trial

    PubMed Central

    Simmons, Vani Nath; Meade, Cathy D.; Quinn, Gwendolyn P.; Lopez Khoury, Elena N.; Sutton, Steven K.; Lee, Ji-Hyun

    2012-01-01

    Objectives. We tested a series of self-help booklets designed to prevent postpartum smoking relapse. Methods. We recruited 700 women in months 4 through 8 of pregnancy, who quit smoking for their pregnancy. We randomized the women to receive either (1) 10 Forever Free for Baby and Me (FFB) relapse prevention booklets, mailed until 8 months postpartum, or (2) 2 existing smoking cessation materials, as a usual care control (UCC). Assessments were completed at baseline and at 1, 8, and 12 months postpartum. Results. We received baseline questionnaires from 504 women meeting inclusion criteria. We found a main effect for treatment at 8 months, with FFB yielding higher abstinence rates (69.6%) than UCC (58.5%). Treatment effect was moderated by annual household income and age. Among lower income women (< $30 000), treatment effects were found at 8 and 12 months postpartum, with respective abstinence rates of 72.2% and 72.1% for FFB and 53.6% and 50.5% for UCC. No effects were found for higher income women. Conclusions. Self-help booklets appeared to be efficacious and offered a low-cost modality for providing relapse-prevention assistance to low-income pregnant and postpartum women. PMID:22994170

  11. NO-FEAR Airlines: A Computer-aided Self-help Treatment for Flying Phobia.

    PubMed

    Quero, Soledad; Campos, Daniel; Riera Del Amo, Antonio; Bretón-López, Juana; Tortella-Feliu, Miquel; Baños, Rosa Ma; Botella, Cristina

    2015-01-01

    In vivo exposure is the treatment of choice for specific phobias. However, this treatment is linked to a number of limitations in its implementation. Therefore, it is important to develop strategies for improving treatment adherence, acceptance, and dissemination of evidence-based treatments. Information and Communication Technologies, specifically, computerized programs boast advantages in treating flying phobia. NO-FEAR Airlines is a Computer-aided Self-help Treatment for this problem, which can be self-applied via Internet. NO-FEAR Airlines treatment protocol comprises three therapeutic components: psychoeducation, exposure and overlearning. Exposure is carried out through 6 scenarios that are composed by images and real sounds related to a flight in process. The aim of the present work is to describe NO-FEAR Airlines program. PMID:26799907

  12. 41 CFR 102-75.560 - Who notifies eligible public agencies that real property to be used for self-help housing or...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... public agencies that real property to be used for self-help housing or housing assistance purposes is... DISPOSAL Surplus Real Property Disposal Property for Providing Self-Help Housing Or Housing Assistance § 102-75.560 Who notifies eligible public agencies that real property to be used for self-help...

  13. 41 CFR 102-75.595 - What responsibilities do landholding agencies have concerning properties to be used for self-help...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... landholding agencies have concerning properties to be used for self-help housing or housing assistance use... Real Property Disposal Property for Providing Self-Help Housing Or Housing Assistance § 102-75.595 What responsibilities do landholding agencies have concerning properties to be used for self-help housing or...

  14. 7 CFR Exhibit B-1 to Subpart I of... - Instructions for Preparation of Evaluation Report of Self-Help Technical Assistance Grants

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Self-Help Technical Assistance Grants B Exhibit B-1 to Subpart I of Part 1944 Agriculture Regulations... REGULATIONS (CONTINUED) HOUSING Self-Help Technical Assistance Grants Pt. 1944, Subpt. I, Exh. B-1 Exhibit B-1 to Subpart I of Part 1944—Instructions for Preparation of Evaluation Report of Self-Help...

  15. 41 CFR 102-75.600 - What happens if HUD does not approve any applications for self-help housing or housing assistance...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... not approve any applications for self-help housing or housing assistance use? 102-75.600 Section 102... Disposal Property for Providing Self-Help Housing Or Housing Assistance § 102-75.600 What happens if HUD does not approve any applications for self-help housing or housing assistance use? In the absence of...

  16. 41 CFR 102-75.560 - Who notifies eligible public agencies that real property to be used for self-help housing or...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... public agencies that real property to be used for self-help housing or housing assistance purposes is... DISPOSAL Surplus Real Property Disposal Property for Providing Self-Help Housing Or Housing Assistance § 102-75.560 Who notifies eligible public agencies that real property to be used for self-help...

  17. 41 CFR 102-75.555 - Which Federal agency receives the property assigned for self-help housing or housing assistance...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... receives the property assigned for self-help housing or housing assistance for low-income individuals or... DISPOSAL Surplus Real Property Disposal Property for Providing Self-Help Housing Or Housing Assistance § 102-75.555 Which Federal agency receives the property assigned for self-help housing or...

  18. 41 CFR 102-75.555 - Which Federal agency receives the property assigned for self-help housing or housing assistance...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... receives the property assigned for self-help housing or housing assistance for low-income individuals or... DISPOSAL Surplus Real Property Disposal Property for Providing Self-Help Housing Or Housing Assistance § 102-75.555 Which Federal agency receives the property assigned for self-help housing or...

  19. 7 CFR Exhibit B-1 to Subpart I of... - Instructions for Preparation of Evaluation Report of Self-Help Technical Assistance Grants

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Self-Help Technical Assistance Grants B Exhibit B-1 to Subpart I of Part 1944 Agriculture Regulations... REGULATIONS (CONTINUED) HOUSING Self-Help Technical Assistance Grants Pt. 1944, Subpt. I, Exh. B-1 Exhibit B-1 to Subpart I of Part 1944—Instructions for Preparation of Evaluation Report of Self-Help...

  20. 41 CFR 102-75.595 - What responsibilities do landholding agencies have concerning properties to be used for self-help...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... landholding agencies have concerning properties to be used for self-help housing or housing assistance use... Real Property Disposal Property for Providing Self-Help Housing Or Housing Assistance § 102-75.595 What responsibilities do landholding agencies have concerning properties to be used for self-help housing or...

  1. 41 CFR 102-75.600 - What happens if HUD does not approve any applications for self-help housing or housing assistance...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... not approve any applications for self-help housing or housing assistance use? 102-75.600 Section 102... Disposal Property for Providing Self-Help Housing Or Housing Assistance § 102-75.600 What happens if HUD does not approve any applications for self-help housing or housing assistance use? In the absence of...

  2. 7 CFR Exhibit B-1 to Subpart I of... - Instructions for Preparation of Evaluation Report of Self-Help Technical Assistance Grants

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Self-Help Technical Assistance Grants B Exhibit B-1 to Subpart I of Part 1944 Agriculture Regulations... REGULATIONS (CONTINUED) HOUSING Self-Help Technical Assistance Grants Pt. 1944, Subpt. I, Exh. B-1 Exhibit B-1... Assistance Grants Exhibit B will be used by all Technical Assistance (TA) Grantees obtaining self-help...

  3. 7 CFR Exhibit B-1 to Subpart I of... - Instructions for Preparation of Evaluation Report of Self-Help Technical Assistance Grants

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Self-Help Technical Assistance Grants B Exhibit B-1 to Subpart I of Part 1944 Agriculture Regulations... REGULATIONS (CONTINUED) HOUSING Self-Help Technical Assistance Grants Pt. 1944, Subpt. I, Exh. B-1 Exhibit B-1... Assistance Grants Exhibit B will be used by all Technical Assistance (TA) Grantees obtaining self-help...

  4. The Effect of a Community-Based Self-Help Intervention Korean Americans With Type 2 Diabetes

    PubMed Central

    Kim, Miyong T.; Kim, Kim B.; Huh, Boyun; Nguyen, Tam; Han, Hae-Ra; Bone, Lee R.; Levine, David

    2015-01-01

    Introduction Korean Americans are one of the most underserved ethnic/linguistic minority groups owing to cultural and institutional barriers; there is an urgent need for culturally competent diabetes management programs in the Korean American community for those with type 2 diabetes. The purpose of this study was to test the effectiveness of a community-based, culturally tailored, multimodal behavioral intervention program in an ethnic/linguistic minority group with type 2 diabetes. Design A RCT with waitlist comparison based on the Predisposing, Reinforcing, and Enabling Constructs in Education/environmental Diagnosis and Evaluation (PRECEDE)–Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development (PROCEED) and self-help models. Data were collected between September 2010 and June 2013 and were analyzed in August–December 2014. Statistical significance was set at p<0.05. Setting/participants In a naturally occurring community setting, a total of 250 Korean Americans with type 2 diabetes were randomized into an intervention group (n=120) or a control group (n=130). Intervention The intervention consisted of key self-management skill-building activities through 12 hours of group education sessions, followed by integrated counseling and behavioral coaching by a team of RNs and community health workers. Main outcome measures Primary (clinical) outcomes were hemoglobin A1c, glucose, total cholesterol, and low-density lipoprotein at baseline and 3, 6, 9, and 12 months. Secondary (psychosocial and behavioral) outcomes included diabetes-related quality of life, self-efficacy, adherence to diabetes management regimen, and health literacy. Results During the 12-month project, the intervention group demonstrated 1.0%–1.3% (10.9–14.2 mmol/mol) reductions in hemoglobin A1c, whereas the control group achieved reductions of 0.5%–0.7% (5.5–7.7 mmol/mol). The differences between the two groups were statistically significant. The

  5. Development and preliminary testing of a web-based, self-help application for disaster-affected families.

    PubMed

    Yuen, Erica K; Gros, Kirstin; Welsh, Kyleen E; McCauley, Jenna; Resnick, Heidi S; Danielson, Carla K; Price, Matthew; Ruggiero, Kenneth J

    2016-09-01

    Technology-based self-help interventions have the potential to increase access to evidence-based mental healthcare, especially for families affected by natural disasters. However, development of these interventions is a complex process and poses unique challenges. Usability testing, which assesses the ability of individuals to use an application successfully, can have a significant impact on the quality of a self-help intervention. This article describes (a) the development of a novel web-based multi-module self-help intervention for disaster-affected adolescents and their parents and (b) a mixed-methods formal usability study to evaluate user response. A total of 24 adolescents were observed, videotaped, and interviewed as they used the depressed mood component of the self-help intervention. Quantitative results indicated an above-average user experience, and qualitative analysis identified 120 unique usability issues. We discuss the challenges of developing self-help applications, including design considerations and the value of usability testing in technology-based interventions, as well as our plan for widespread dissemination. PMID:25933798

  6. Development and preliminary testing of a web-based, self-help application for disaster-affected families.

    PubMed

    Yuen, Erica K; Gros, Kirstin; Welsh, Kyleen E; McCauley, Jenna; Resnick, Heidi S; Danielson, Carla K; Price, Matthew; Ruggiero, Kenneth J

    2016-09-01

    Technology-based self-help interventions have the potential to increase access to evidence-based mental healthcare, especially for families affected by natural disasters. However, development of these interventions is a complex process and poses unique challenges. Usability testing, which assesses the ability of individuals to use an application successfully, can have a significant impact on the quality of a self-help intervention. This article describes (a) the development of a novel web-based multi-module self-help intervention for disaster-affected adolescents and their parents and (b) a mixed-methods formal usability study to evaluate user response. A total of 24 adolescents were observed, videotaped, and interviewed as they used the depressed mood component of the self-help intervention. Quantitative results indicated an above-average user experience, and qualitative analysis identified 120 unique usability issues. We discuss the challenges of developing self-help applications, including design considerations and the value of usability testing in technology-based interventions, as well as our plan for widespread dissemination.

  7. Development and preliminary testing of a web-based, self-help application for disaster-affected families

    PubMed Central

    Yuen, Erica K; Gros, Kirstin; Welsh, Kyleen E; McCauley, Jenna; Resnick, Heidi S; Danielson, Carla K; Price, Matthew; Ruggiero, Kenneth J

    2015-01-01

    Technology-based self-help interventions have the potential to increase access to evidence-based mental healthcare, especially for families affected by natural disasters. However, development of these interventions is a complex process and poses unique challenges. Usability testing, which assesses the ability of individuals to use an application successfully, can have a significant impact on the quality of a self-help intervention. This article describes (a) the development of a novel web-based multi-module self-help intervention for disaster-affected adolescents and their parents and (b) a mixed-methods formal usability study to evaluate user response. A total of 24 adolescents were observed, videotaped, and interviewed as they used the depressed mood component of the self-help intervention. Quantitative results indicated an above-average user experience, and qualitative analysis identified 120 unique usability issues. We discuss the challenges of developing self-help applications, including design considerations and the value of usability testing in technology-based interventions, as well as our plan for widespread dissemination. PMID:25933798

  8. Predicting Meaningful Outcomes to Medication and Self-Help Treatments for Binge Eating Disorder in Primary Care: The Significance of Early Rapid Response

    PubMed Central

    Grilo, Carlos M.; White, Marney A.; Masheb, Robin M.; Gueorguieva, Ralitza

    2014-01-01

    Objective We examined rapid response among obese patients with binge-eating disorder (BED) in a randomized clinical trial testing anti-obesity medication and self-help cognitive-behavioral therapy (shCBT), alone and in combination, in primary-care settings. Method 104 obese patients with BED were randomly assigned to one of four treatments: sibutramine, placebo, shCBT+sibutramine, or shCBT+placebo. Treatments were delivered by generalist primary-care physicians and the medications were given double-blind. Independent assessments were performed by trained and monitored doctoral research-clinicians monthly throughout treatment, post-treatment (4 months), and at 6- and 12-month follow-ups (i.e., 16 months after randomization). Rapid response, defined as ≥65% reduction in binge-eating by the fourth treatment week, was used to predict outcomes. Results Rapid response characterized 47% of patients. Rapid response was unrelated to demographic and baseline clinical characteristics. Rapid response was significantly associated prospectively with remission from binge eating at post-treatment (51% versus 9% for non-rapid responders), 6-month (53% vs 23.6%), and 12-month (46.9% vs 23.6%) follow-ups. Mixed effects model analyses revealed rapid response was significantly associated with greater decreases in binge-eating, eating-disorder psychopathology, depression, and percent weight loss. Discussion Our findings, based on a diverse obese patient group receiving medication and self-help CBT treatments for BED in primary care settings, indicate that patients who have a rapid response achieve good clinical outcomes through 12-month follow-ups after ending treatments. Rapid response represents a strong prognostic indicator of clinically meaningful outcomes even in low intensity medication and self-help interventions. Rapid response has important clinical implications for stepped-care treatment models for BED. Clinical Trial Registration clinicaltrials.gov: NCT00537810 PMID

  9. Infectious Disease and Grouping Patterns in Mule Deer

    PubMed Central

    2016-01-01

    Infectious disease dynamics are determined, to a great extent, by the social structure of the host. We evaluated sociality, or the tendency to form groups, in Rocky Mountain mule deer (Odocoileus hemionus hemionus) from a chronic wasting disease (CWD) endemic area in Saskatchewan, Canada, to better understand factors that may affect disease transmission. Using group size data collected on 365 radio-collared mule deer (2008–2013), we built a generalized linear mixed model (GLMM) to evaluate whether factors such as CWD status, season, habitat and time of day, predicted group occurrence. Then, we built another GLMM to determine factors associated with group size. Finally, we used 3 measures of group size (typical, mean and median group sizes) to quantify levels of sociality. We found that mule deer showing clinical signs of CWD were less likely to be reported in groups than clinically healthy deer after accounting for time of day, habitat, and month of observation. Mule deer groups were much more likely to occur in February and March than in July. Mixed-sex groups in early gestation were larger than any other group type in any season. Groups were largest and most likely to occur at dawn and dusk, and in open habitats, such as cropland. We discuss the implication of these results with respect to sociobiology and CWD transmission dynamics. PMID:27007808

  10. Infectious Disease and Grouping Patterns in Mule Deer.

    PubMed

    Mejía Salazar, María Fernanda; Waldner, Cheryl; Stookey, Joseph; Bollinger, Trent K

    2016-01-01

    Infectious disease dynamics are determined, to a great extent, by the social structure of the host. We evaluated sociality, or the tendency to form groups, in Rocky Mountain mule deer (Odocoileus hemionus hemionus) from a chronic wasting disease (CWD) endemic area in Saskatchewan, Canada, to better understand factors that may affect disease transmission. Using group size data collected on 365 radio-collared mule deer (2008-2013), we built a generalized linear mixed model (GLMM) to evaluate whether factors such as CWD status, season, habitat and time of day, predicted group occurrence. Then, we built another GLMM to determine factors associated with group size. Finally, we used 3 measures of group size (typical, mean and median group sizes) to quantify levels of sociality. We found that mule deer showing clinical signs of CWD were less likely to be reported in groups than clinically healthy deer after accounting for time of day, habitat, and month of observation. Mule deer groups were much more likely to occur in February and March than in July. Mixed-sex groups in early gestation were larger than any other group type in any season. Groups were largest and most likely to occur at dawn and dusk, and in open habitats, such as cropland. We discuss the implication of these results with respect to sociobiology and CWD transmission dynamics. PMID:27007808

  11. Infectious Disease and Grouping Patterns in Mule Deer.

    PubMed

    Mejía Salazar, María Fernanda; Waldner, Cheryl; Stookey, Joseph; Bollinger, Trent K

    2016-01-01

    Infectious disease dynamics are determined, to a great extent, by the social structure of the host. We evaluated sociality, or the tendency to form groups, in Rocky Mountain mule deer (Odocoileus hemionus hemionus) from a chronic wasting disease (CWD) endemic area in Saskatchewan, Canada, to better understand factors that may affect disease transmission. Using group size data collected on 365 radio-collared mule deer (2008-2013), we built a generalized linear mixed model (GLMM) to evaluate whether factors such as CWD status, season, habitat and time of day, predicted group occurrence. Then, we built another GLMM to determine factors associated with group size. Finally, we used 3 measures of group size (typical, mean and median group sizes) to quantify levels of sociality. We found that mule deer showing clinical signs of CWD were less likely to be reported in groups than clinically healthy deer after accounting for time of day, habitat, and month of observation. Mule deer groups were much more likely to occur in February and March than in July. Mixed-sex groups in early gestation were larger than any other group type in any season. Groups were largest and most likely to occur at dawn and dusk, and in open habitats, such as cropland. We discuss the implication of these results with respect to sociobiology and CWD transmission dynamics.

  12. Expanding the limits of bibliotherapy for panic disorder: randomized trial of self-help without support but with a clear deadline.

    PubMed

    Nordin, Sara; Carlbring, Per; Cuijpers, Pim; Andersson, Gerhard

    2010-09-01

    Cognitive behavioral bibliotherapy for panic disorder has been found to be less effective without therapist support. In this study, participants were randomized to either unassisted bibliotherapy (n=20) with a scheduled follow-up telephone interview or to a waiting list control group (n=19). Following a structured psychiatric interview, participants in the treatment group were sent a self-help book consisting of 10 chapters based on cognitive behavioral strategies for the treatment of panic disorder. No therapist contact of any kind was provided during the treatment phase, which lasted for 10 weeks. Results showed that the treatment group had, in comparison to the control group, improved on all outcome measures at posttreatment and at 3-month follow-up. The tentative conclusion drawn from these results is that pure bibliotherapy with a clear deadline can be effective for people suffering from panic disorder with or without agoraphobia.

  13. Web-based guided self-help for employees with depressive symptoms (Happy@Work): design of a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Depressive disorders are highly prevalent in the working population and are associated with excessive costs for both society and companies. Effective treatment for employees with depressive symptoms in occupational health care is limited. The purpose of this study is to investigate the effectiveness and cost-effectiveness of an indicated preventive web-based guided self-help course for employees with depressive symptoms. Methods The study is a two-arm randomized controlled trial comparing a web-based guided self-help course with care-as-usual. The self-help course consists of 6 weekly lessons. Weekly support will be provided by a coach via the website. Subjects in the care-as-usual group do not receive any treatment in addition to regular care. 200 white collar workers from several national and international companies in the Netherlands will be recruited via different methods such as banners on the company’s intranet, pamphlets and posters. Subjects will be included when they: have elevated depressive symptoms (score ≥16 on the Center for Epidemiologic Studies Depression scale), are 18 years of age or older, have access to the Internet and can be contacted via e-mail. Exclusion criteria are: partial or full work absenteeism, a legal labor dispute with the employer and receiving treatment from the company’s occupational health care at study entrance. The primary outcome is depressive symptoms. Secondary outcomes include work absenteeism, work performance, burnout, anxiety, quality of life, health care use and production losses. Outcome data will be collected at 8 weeks, 6 months, and 12 months after baseline. Analyses will be based on the intention-to-treat principle. The cost-effectiveness analyses will be performed from a societal and a company’s perspective. A process evaluation will be conducted alongside the study. Discussion This study evaluates the effectiveness and cost-effectiveness of a web-based guided self-help course for employees

  14. Feasibility of Group Voice Therapy for Individuals with Parkinson's Disease

    ERIC Educational Resources Information Center

    Searl, Jeff; Wilson, Kristel; Haring, Karen; Dietsch, Angela; Lyons, Kelly; Pahwa, Rajesh

    2011-01-01

    Purpose: The primary purpose was to demonstrate the feasibility of executing treatment tasks focused on increasing loudness in a group format for individuals with Parkinson's disease (PD). A second purpose was to report preliminary pre-to-post treatment outcomes for individuals with PD immediately after they complete the group program. Methods:…

  15. Support Group Counseling for Caregivers of Alzheimer's Disease Patients.

    ERIC Educational Resources Information Center

    Hinkle, J. Scott

    1991-01-01

    Describes Alzheimer's disease and the burdens that caregivers encounter in dealing with Alzheimer's patients. Presents information concerning support group counseling for caregivers, their particular needs, and special family issues. Emphasizes that relationships between caregivers and support group counselors are crucial to successful…

  16. A Review of Treatments for Deficits in Social Skills and Self-Help Skills in Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Flynn, Lorna; Healy, Olive

    2012-01-01

    Deficits in social skills and self-help skills present significant challenges for individuals diagnosed with autism spectrum disorders (ASD). Much research in Applied Behavior Analysis (ABA) has been devoted to treatments for deficits in social skills and there exist a number of extensive reviews on the research in this area. Some research has…

  17. Reliability and Validity of the SAINT: A Guided Self-Help Tool for People with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Chaplin, Eddie; Chester, Rebecca; Tsakanikos, Elias; McCarthy, Jane; Craig, Tom; Bouras, Nick

    2013-01-01

    This study investigated the main psychometric properties of the Self Assessment and Intervention (SAINT), a unique and recently developed Guided Self-Help tool for people with intellectual disabilities (ID). Fifty-four adults with ID identified with symptoms of anxiety and/or depression completed the study. They were between 18 and 77 years old…

  18. A Decade of Advice for Women and Men in the Best-Selling Self-Help Literature.

    ERIC Educational Resources Information Center

    Zimmerman, Toni Schindler; Holm, Kristen E.; Haddock, Shelley A.

    2001-01-01

    Presents a content analysis of the top ten self-help books on the New York Times best-seller list over a ten year period to determine the degree to which the books empower individuals to resist gender-based socialization messages. The four best sellers contained advice for both genders to behave consistently with traditional gender socialization,…

  19. Self-Help Medical Literature in 19th-Century Canada and the Rhetorical Convention of Plain Language.

    ERIC Educational Resources Information Center

    Connor, Jennifer J.

    1994-01-01

    Examines self-help medical literature in 19th-century Canada. Shows that while authors repeatedly called for "plain" language in contrast to mysterious terminology employed by medical practitioners, comparison of their style with that of medical textbook authors reveals few real differences. Concludes that the posture adopted by Canadian self-help…

  20. Internet-Based Self-Help Career Assessments and Interventions: Challenges and Implications for Evidence-Based Career Counseling

    ERIC Educational Resources Information Center

    Gati, Itamar; Asulin-Peretz, Lisa

    2011-01-01

    A major characteristic of the 21st century with significant implications on career decision making is the growing prevalence of Information and Communication Technologies (ICTs). Challenges involving ICT-based self-assessment and self-help interventions aimed at facilitating career decision making are discussed. Specifically, this article focuses…

  1. 76 FR 67759 - Announcement of Funding Awards for the Self-Help Homeownership Opportunity Program (SHOP) for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-02

    ... URBAN DEVELOPMENT Announcement of Funding Awards for the Self-Help Homeownership Opportunity Program (SHOP) for Fiscal Year 2011 AGENCY: Office of Community Planning and Development, HUD. ACTION... and Urban Development Reform Act of 1989, this announcement notifies the public of funding...

  2. 7 CFR Exhibit C to Subpart I of... - Amendment to Self-Help Technical Assistance Grant Agreement

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 13 2012-01-01 2012-01-01 false Amendment to Self-Help Technical Assistance Grant Agreement C Exhibit C to Subpart I of Part 1944 Agriculture Regulations of the Department of Agriculture... Technical Assistance Grants Pt. 1944, Subpt. I, Exh. C Exhibit C to Subpart I of Part 1944—Amendment to...

  3. 7 CFR Exhibit C to Subpart I of... - Amendment to Self-Help Technical Assistance Grant Agreement

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 13 2011-01-01 2009-01-01 true Amendment to Self-Help Technical Assistance Grant Agreement C Exhibit C to Subpart I of Part 1944 Agriculture Regulations of the Department of Agriculture... Technical Assistance Grants Pt. 1944, Subpt. I, Exh. C Exhibit C to Subpart I of Part 1944—Amendment to...

  4. Randomized Controlled Trial Examining the Effectiveness of a Tailored Self-Help Smoking-Cessation Intervention for Postsecondary Smokers

    ERIC Educational Resources Information Center

    Travis, Heather E.; Lawrance, Kelli-an G.

    2009-01-01

    Objective: Between September 2002 and February 2003, the authors assessed the effectiveness of a new, age-tailored, self-help smoking-cessation program for college students. Participants: College student smokers (N = 216) from 6 Ontario universities participated. Methods: The researchers used a randomized controlled trial with a 3-month telephone…

  5. 75 FR 62849 - Announcement of Funding Awards for the Self-Help Homeownership Opportunity Program (SHOP) for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-13

    ... investment of $15,000 per dwelling unit. Low-income homebuyers contribute a minimum of 100 hours of sweat... self-help housing program. Sweat equity can include, but is not limited to, assisting in the painting... administrative tasks. Donated volunteer labor is also required. The SHOP funds together with the sweat equity...

  6. 76 FR 48876 - Announcement of Funding Awards for the Self-Help Homeownership Opportunity Program (SHOP) for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-09

    ... investment of $15,000 per dwelling unit. Low-income homebuyers contribute a minimum of 100 hours of sweat... self-help housing program. Sweat equity can include, but is not limited to, assisting in the painting... administrative tasks. Donated volunteer labor is also required. The SHOP funds together with the sweat equity...

  7. The Feasibility, Acceptability, and Efficacy of Delivering Internet-Based Self-Help and Guided Self-Help Interventions for Generalized Anxiety Disorder to Indian University Students: Design of a Randomized Controlled Trial

    PubMed Central

    Newman, Michelle G; Ruzek, Josef I; Kuhn, Eric; Manjula, M; Jones, Megan; Thomas, Neil; Abbott, Jo-Anne M; Sharma, Smita; Taylor, C. Barr

    2015-01-01

    Background Generalized anxiety disorder (GAD) is one of the most common mental disorders among university students; however, many students go untreated due to treatment costs, stigma concerns, and limited access to trained mental health professionals. These barriers are heightened in universities in India, where there are scant mental health care services and severe stigma surrounding help seeking. Objective To evaluate the feasibility, acceptability, and efficacy of Internet-based, or “online,” cognitive behavioral therapy (CBT)-based unguided and guided self-help interventions (using the programs GAD Online and Lantern, respectively) to reduce GAD symptoms in students with clinical and subthreshold GAD and, ultimately, reduce the prevalence and incidence of GAD among the student population. Methods Students will be recruited via 3 colleges in Hyderabad, India, and referred for a campus-wide online screening. Self-report data will be collected entirely online. A total of 300 qualifying students will be randomized in a 1:1:1 ratio to receive GAD Online, Lantern, or to be in a wait-list control condition, stratified by clinical and subthreshold GAD symptomatology. Students will complete a postintervention assessment after 3 months and a follow-up assessment 6 months later, at which point students in the wait-list control condition will receive one of the programs. The primary outcome is GAD symptom severity at 3 months postintervention. Secondary outcomes include GAD caseness at 9 months, other anxiety and depression symptoms, self-efficacy, and functional measures (eg, sleep, social functioning) at 3 and 9 months, respectively. Primary analyses will be differences between each of the intervention groups and the wait-list control group, analyzed on an intention-to-treat (ITT) basis using mixed-design ANOVA. Results The study commenced in February 2015. The sample was recruited over a 3-week period at each college. The trial is expected to end in December 2015

  8. Inflammatory bowel disease support groups: a primer for gastroenterology nurses.

    PubMed

    Leshem, Rachel Namdar

    2003-01-01

    This article discusses the importance of a support group for people living with inflammatory bowel disease. The support group provides these patients and their families with a social framework for promoting positive adjustment to the illness and seeks to improve the patients' quality of life. The use of a support group has been described in the literature as a method of helping patients and their families to face living with chronic illness, but relatively little has been written about support groups for people with inflammatory bowel disease and the role of the gastroenterology nurse. In this article, the benefit of support groups and the content of the intervention are discussed including health education, self-efficiency, coping skills, and ways to increase feelings of social acceptance. PMID:14676612

  9. FYI: Services to Poor Families; Controlling Infectious Diseases; Parent Groups.

    ERIC Educational Resources Information Center

    Children Today, 1987

    1987-01-01

    Discusses services and resources available for families, parents, and child care providers. Describes a National Resource Center for Children in Poverty; a guide for controlling infectious diseases among young children in day care; a directory of parent support groups; and reports of a link between household pesticides and childhood leukemia. (BB)

  10. Disease manifestations and pathogenic mechanisms of Group A Streptococcus.

    PubMed

    Walker, Mark J; Barnett, Timothy C; McArthur, Jason D; Cole, Jason N; Gillen, Christine M; Henningham, Anna; Sriprakash, K S; Sanderson-Smith, Martina L; Nizet, Victor

    2014-04-01

    Streptococcus pyogenes, also known as group A Streptococcus (GAS), causes mild human infections such as pharyngitis and impetigo and serious infections such as necrotizing fasciitis and streptococcal toxic shock syndrome. Furthermore, repeated GAS infections may trigger autoimmune diseases, including acute poststreptococcal glomerulonephritis, acute rheumatic fever, and rheumatic heart disease. Combined, these diseases account for over half a million deaths per year globally. Genomic and molecular analyses have now characterized a large number of GAS virulence determinants, many of which exhibit overlap and redundancy in the processes of adhesion and colonization, innate immune resistance, and the capacity to facilitate tissue barrier degradation and spread within the human host. This improved understanding of the contribution of individual virulence determinants to the disease process has led to the formulation of models of GAS disease progression, which may lead to better treatment and intervention strategies. While GAS remains sensitive to all penicillins and cephalosporins, rising resistance to other antibiotics used in disease treatment is an increasing worldwide concern. Several GAS vaccine formulations that elicit protective immunity in animal models have shown promise in nonhuman primate and early-stage human trials. The development of a safe and efficacious commercial human vaccine for the prophylaxis of GAS disease remains a high priority. PMID:24696436

  11. Disease Manifestations and Pathogenic Mechanisms of Group A Streptococcus

    PubMed Central

    Barnett, Timothy C.; McArthur, Jason D.; Cole, Jason N.; Gillen, Christine M.; Henningham, Anna; Sriprakash, K. S.; Sanderson-Smith, Martina L.; Nizet, Victor

    2014-01-01

    SUMMARY Streptococcus pyogenes, also known as group A Streptococcus (GAS), causes mild human infections such as pharyngitis and impetigo and serious infections such as necrotizing fasciitis and streptococcal toxic shock syndrome. Furthermore, repeated GAS infections may trigger autoimmune diseases, including acute poststreptococcal glomerulonephritis, acute rheumatic fever, and rheumatic heart disease. Combined, these diseases account for over half a million deaths per year globally. Genomic and molecular analyses have now characterized a large number of GAS virulence determinants, many of which exhibit overlap and redundancy in the processes of adhesion and colonization, innate immune resistance, and the capacity to facilitate tissue barrier degradation and spread within the human host. This improved understanding of the contribution of individual virulence determinants to the disease process has led to the formulation of models of GAS disease progression, which may lead to better treatment and intervention strategies. While GAS remains sensitive to all penicillins and cephalosporins, rising resistance to other antibiotics used in disease treatment is an increasing worldwide concern. Several GAS vaccine formulations that elicit protective immunity in animal models have shown promise in nonhuman primate and early-stage human trials. The development of a safe and efficacious commercial human vaccine for the prophylaxis of GAS disease remains a high priority. PMID:24696436

  12. Internet-based treatment of social phobia: a randomized controlled trial comparing unguided with two types of guided self-help.

    PubMed

    Berger, Thomas; Caspar, Franz; Richardson, Robert; Kneubühler, Bernhard; Sutter, Daniel; Andersson, Gerhard

    2011-03-01

    Internet-based self-help for social phobia with minimal therapist support via email have shown efficacy in several controlled trials by independent research teams. The role and necessity of therapist guidance is, however, still largely unclear. The present study compared the benefits of a 10-week web-based unguided self-help treatment for social phobia with the same intervention complemented with minimal, although weekly, therapist support via email. Further, a third treatment arm was included, in which the level of support was flexibly stepped up, from no support to email or telephone contact, on demand of the participants. Eighty-one individuals meeting diagnostic criteria for social phobia were randomly assigned to one of the three conditions. Primary outcome measures were self-report measures of symptoms of social phobia. Secondary outcome measures included symptoms of depression, interpersonal problems, and general symptomatology. Measures were taken at baseline, post-treatment, and at 6-month follow-up. Data from a telephone-administered diagnostic interview conducted at post-treatment were also included. Results showed significant symptom reductions in all three treatment groups with large effect sizes for primary social phobia measures (Cohen's d=1.47) and for secondary outcome measures (d=1.16). No substantial and significant between-groups effects were found on any of the measures (Cohen's d=00-.36). Moreover, no difference between the three conditions was found regarding diagnosis-free status, clinically significant change, dropout rates, or adherence measures such as lessons or exercises completed. These findings indicate that Internet-delivered treatment for social phobia is a promising treatment option, whether no support is provided or with two different types of therapist guidance. PMID:21255767

  13. Using Personal Ads and Online Self-Help Groups to Teach Content Analysis in a Research Methods Course

    ERIC Educational Resources Information Center

    Finn, Jerry; Dillon, Caroline

    2007-01-01

    This paper describes methods for teaching content analysis as part of the Research sequence in social work education. Teaching content analysis is used to develop research skills as well as to promote students' knowledge and critical thinking and about new information technology resources that are being increasingly used by the general public. The…

  14. The effect of Self-Help Groups on access to maternal health services: evidence from rural India

    PubMed Central

    2013-01-01

    Introduction The main challenge for achieving universal health coverage in India is ensuring effective coverage of poor and vulnerable communities in the face of high levels of income and gender inequity in access to health care. Drawing on the social capital generated through women’s participation in community organizations like SHGs can influence health outcomes. To date, evidence about the impact of SHGs on health outcomes has been derived from pilot-level interventions, some using randomised controlled trials and other rigorous methods. While the evidence from these studies is convincing, our study is the first to analyse the impact of SHGs at national level. Methods We analyzed the entire dataset from the third national District Level Household Survey from 601 districts in India to assess the impact of the presence of SHGs on maternal health service uptake. The primary predictor variable was presence of a SHG in the village. The outcome variables were: institutional delivery; feeding new-borns colostrum; knowledge about family planning methods; and ever used family planning. We controlled for respondent education, wealth, heard or seen health messages, availability of health facilities and the existence of a village health and sanitation committee. Results Stepwise logistic regression shows respondents from villages with a SHG were 19 per cent (OR: 1.19, CI: 1.13-1.24) more likely to have delivered in an institution, 8 per cent (OR: 1.08, CI: 1.05-1.14) more likely to have fed newborns colostrum, have knowledge (OR: 1.48, CI 1.39 – 1.57) and utilized (OR: 1.19, CI 1.11 – 1.27) family planning products and services. These results are significant after controlling for individual and village-level heterogeneities and are consistent with existing literature that the social capital generated through women’s participation in SHGs influences health outcome. Conclusion The study concludes that the presence of SHGs in a village is associated with higher knowledge of family planning and maternal health service uptake in rural India. To achieve the goal of improving public health nationally, there is a need to understand more fully the benefits of systematic collaboration between the public health community and these grassroots organizations. PMID:23714337

  15. 41 CFR 102-75.620 - What happens if property that was transferred to meet a self-help housing or housing assistance...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... that was transferred to meet a self-help housing or housing assistance use requirement is found to be... PROPERTY 75-REAL PROPERTY DISPOSAL Surplus Real Property Disposal Property for Providing Self-Help Housing Or Housing Assistance § 102-75.620 What happens if property that was transferred to meet a...

  16. 41 CFR 102-75.620 - What happens if property that was transferred to meet a self-help housing or housing assistance...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... that was transferred to meet a self-help housing or housing assistance use requirement is found to be... PROPERTY 75-REAL PROPERTY DISPOSAL Surplus Real Property Disposal Property for Providing Self-Help Housing Or Housing Assistance § 102-75.620 What happens if property that was transferred to meet a...

  17. Scurvy in pediatric age group - A disease often forgotten?

    PubMed

    Agarwal, Anil; Shaharyar, Abbas; Kumar, Anubrat; Bhat, Mohd Shafi; Mishra, Madhusudan

    2015-06-01

    Scurvy is caused by prolonged severe dietary deficiency of vitamin C. Being rare as compared to other nutritional deficiencies, it is seldom suspected and this frequently leads to delayed recognition of this disorder. Children with abnormal dietary habits, mental illness or physical disabilities are prone to develop this disease. The disease spectrum of scurvy is quite varied and includes dermatological, dental, bone and systemic manifestations. Subperiosteal hematoma, ring epiphysis, metaphyseal white line and rarefaction zone along with epiphyseal slips are common radiological findings. High index of suspicion, detailed history and bilateral limb radiographs aids physician in diagnosing this eternal masquerader. We searched Pubmed for recent literature (2009-2014) with search terms "scurvy" "vitamin C deficiency" "ascorbic acid deficiency" "scurvy and children" "scurvy and pediatric age group". There were a total of 36 articles relevant to pediatric scurvy in children (7 reviews and 29 case reports) which were retrieved. The review briefly recapitulates the role of vitamin C, the various disease manifestations and the treatment of scurvy to create awareness of the disease which still is reported from our country, although sporadically. The recent advances related to scurvy and its management in pediatric age group are also incorporated. PMID:25983516

  18. Scurvy in pediatric age group - A disease often forgotten?

    PubMed

    Agarwal, Anil; Shaharyar, Abbas; Kumar, Anubrat; Bhat, Mohd Shafi; Mishra, Madhusudan

    2015-06-01

    Scurvy is caused by prolonged severe dietary deficiency of vitamin C. Being rare as compared to other nutritional deficiencies, it is seldom suspected and this frequently leads to delayed recognition of this disorder. Children with abnormal dietary habits, mental illness or physical disabilities are prone to develop this disease. The disease spectrum of scurvy is quite varied and includes dermatological, dental, bone and systemic manifestations. Subperiosteal hematoma, ring epiphysis, metaphyseal white line and rarefaction zone along with epiphyseal slips are common radiological findings. High index of suspicion, detailed history and bilateral limb radiographs aids physician in diagnosing this eternal masquerader. We searched Pubmed for recent literature (2009-2014) with search terms "scurvy" "vitamin C deficiency" "ascorbic acid deficiency" "scurvy and children" "scurvy and pediatric age group". There were a total of 36 articles relevant to pediatric scurvy in children (7 reviews and 29 case reports) which were retrieved. The review briefly recapitulates the role of vitamin C, the various disease manifestations and the treatment of scurvy to create awareness of the disease which still is reported from our country, although sporadically. The recent advances related to scurvy and its management in pediatric age group are also incorporated.

  19. Kin groups and trait groups: population structure and epidemic disease selection.

    PubMed

    Fix, A G

    1984-10-01

    A Monte Carlo simulation based on the population structure of a small-scale human population, the Semai Senoi of Malaysia, has been developed to study the combined effects of group, kin, and individual selection. The population structure resembles D.S. Wilson's structured deme model in that local breeding populations (Semai settlements) are subdivided into trait groups (hamlets) that may be kin-structured and are not themselves demes. Additionally, settlement breeding populations are connected by two-dimensional stepping-stone migration approaching 30% per generation. Group and kin-structured group selection occur among hamlets the survivors of which then disperse to breed within the settlement population. Genetic drift is modeled by the process of hamlet formation; individual selection as a deterministic process, and stepping-stone migration as either random or kin-structured migrant groups. The mechanism for group selection is epidemics of infectious disease that can wipe out small hamlets particularly if most adults become sick and social life collapses. Genetic resistance to a disease is an individual attribute; however, hamlet groups with several resistant adults are less likely to disintegrate and experience high social mortality. A specific human gene, hemoglobin E, which confers resistance to malaria, is studied as an example of the process. The results of the simulations show that high genetic variance among hamlet groups may be generated by moderate degrees of kin-structuring. This strong microdifferentiation provides the potential for group selection. The effect of group selection in this case is rapid increase in gene frequencies among the total set of populations. In fact, group selection in concert with individual selection produced a faster rate of gene frequency increase among a set of 25 populations than the rate within a single unstructured population subject to deterministic individual selection. Such rapid evolution with plausible rates of

  20. Effects of a sleep education program with self-help treatment on sleeping patterns and daytime sleepiness in Japanese adolescents: A cluster randomized trial.

    PubMed

    Tamura, Norihisa; Tanaka, Hideki

    2016-01-01

    Subjective insufficient sleep and delayed sleep-wake patterns have been reported as the primary causes for daytime sleepiness, a reasonably significant and prevalent problem for adolescents worldwide. Systematic reviews have indicated that the success of sleep education programs has thus far been inconsistent, due to the lack of a tailored approach that allows for evaluation of individual differences in behavior patterns. One way to resolve this problem is to assess the individual sleep behaviors of adolescents by using a checklist containing the recommended behaviors for promoting sleep health. Such self-help education programs have already been implemented for elementary school children, school nurses and the elderly. The present study aimed to verify the effects of a sleep education program with supplementary self-help treatment, based on a checklist of sleep-promoting behaviors, in addition to evaluation of changes in sleeping patterns, sleep-promoting behaviors and daytime sleepiness in adolescents. A cluster randomized controlled trial involving 5 Japanese junior high schools was conducted, and 243 students (sleep education: n = 122; waiting list: n = 121; 50.6% female; 7th grade) were included in the final analysis. The sleep education group was provided with information on proper sleep health and sleep-promoting behaviors. The students in this group were asked to practice one sleep-promoting behavior as a goal for 2 weeks and to monitor their practice using sleep diaries. Both pre- and post-treatment questionnaires were administered to students in order to assess knowledge of sleep-promoting behaviors, sleeping patterns and daytime functioning. Students in the sleep education group showed significant improvement in their knowledge of sleep health (F1,121 = 648.05, p < 0.001) and in their sleep-promoting behaviors (F1,121 = 55.66, p < 0.001). Bedtime on both school nights (F1,121 = 50.86, p < 0.001) and weekends (F1,121 = 15.03, p < 0.001), sleep

  1. Effects of a sleep education program with self-help treatment on sleeping patterns and daytime sleepiness in Japanese adolescents: A cluster randomized trial.

    PubMed

    Tamura, Norihisa; Tanaka, Hideki

    2016-01-01

    Subjective insufficient sleep and delayed sleep-wake patterns have been reported as the primary causes for daytime sleepiness, a reasonably significant and prevalent problem for adolescents worldwide. Systematic reviews have indicated that the success of sleep education programs has thus far been inconsistent, due to the lack of a tailored approach that allows for evaluation of individual differences in behavior patterns. One way to resolve this problem is to assess the individual sleep behaviors of adolescents by using a checklist containing the recommended behaviors for promoting sleep health. Such self-help education programs have already been implemented for elementary school children, school nurses and the elderly. The present study aimed to verify the effects of a sleep education program with supplementary self-help treatment, based on a checklist of sleep-promoting behaviors, in addition to evaluation of changes in sleeping patterns, sleep-promoting behaviors and daytime sleepiness in adolescents. A cluster randomized controlled trial involving 5 Japanese junior high schools was conducted, and 243 students (sleep education: n = 122; waiting list: n = 121; 50.6% female; 7th grade) were included in the final analysis. The sleep education group was provided with information on proper sleep health and sleep-promoting behaviors. The students in this group were asked to practice one sleep-promoting behavior as a goal for 2 weeks and to monitor their practice using sleep diaries. Both pre- and post-treatment questionnaires were administered to students in order to assess knowledge of sleep-promoting behaviors, sleeping patterns and daytime functioning. Students in the sleep education group showed significant improvement in their knowledge of sleep health (F1,121 = 648.05, p < 0.001) and in their sleep-promoting behaviors (F1,121 = 55.66, p < 0.001). Bedtime on both school nights (F1,121 = 50.86, p < 0.001) and weekends (F1,121 = 15.03, p < 0.001), sleep

  2. Scurvy in pediatric age group – A disease often forgotten?

    PubMed Central

    Agarwal, Anil; Shaharyar, Abbas; Kumar, Anubrat; Bhat, Mohd Shafi; Mishra, Madhusudan

    2015-01-01

    Scurvy is caused by prolonged severe dietary deficiency of vitamin C. Being rare as compared to other nutritional deficiencies, it is seldom suspected and this frequently leads to delayed recognition of this disorder. Children with abnormal dietary habits, mental illness or physical disabilities are prone to develop this disease. The disease spectrum of scurvy is quite varied and includes dermatological, dental, bone and systemic manifestations. Subperiosteal hematoma, ring epiphysis, metaphyseal white line and rarefaction zone along with epiphyseal slips are common radiological findings. High index of suspicion, detailed history and bilateral limb radiographs aids physician in diagnosing this eternal masquerader. We searched Pubmed for recent literature (2009–2014) with search terms “scurvy” “vitamin C deficiency” “ascorbic acid deficiency” “scurvy and children” “scurvy and pediatric age group”. There were a total of 36 articles relevant to pediatric scurvy in children (7 reviews and 29 case reports) which were retrieved. The review briefly recapitulates the role of vitamin C, the various disease manifestations and the treatment of scurvy to create awareness of the disease which still is reported from our country, although sporadically. The recent advances related to scurvy and its management in pediatric age group are also incorporated. PMID:25983516

  3. Effectiveness of a Web-Based Guided Self-help Intervention for Outpatients With a Depressive Disorder: Short-term Results From a Randomized Controlled Trial

    PubMed Central

    Cuijpers, Pim; Beekman, Aartjan; van Straten, Annemieke

    2016-01-01

    Background Research has convincingly demonstrated that symptoms of depression can be reduced through guided Internet-based interventions. However, most of those studies recruited people form the general population. There is insufficient evidence for the effectiveness when delivered in routine clinical practice in outpatient clinics. Objective The objective of this randomized controlled trial was to study patients with a depressive disorder (as defined by the Diagnostic and Statistical Manual of Disorders, fourth edition), as assessed by trained interviewers with the Composite International Diagnostic Interview, who registered for treatment at an outpatient mental health clinic. We aimed to examine the effectiveness of guided Internet-based self-help before starting face-to-face treatment. Methods We recruited 269 outpatients, aged between 18 and 79 years, from outpatient clinics and randomly allocated them to Internet-based problem solving therapy (n=136), with weekly student support, or to a control condition, who remained on the waitlist with a self-help booklet (control group; n=133). Participants in both conditions were allowed to take up face-to-face treatment at the outpatient clinics afterward. We measured the primary outcome, depressive symptoms, by Center for Epidemiological Studies Depression scale (CES-D). Secondary outcome measures were the Hospital Anxiety and Depression Scale Anxiety subscale (HADS-A), Insomnia Severity Index questionnaire (ISI), and EuroQol visual analog scale (EQ-5D VAS). All outcomes were assessed by telephone at posttest (8 weeks after baseline). Results Posttest measures were completed by 184 (68.4%) participants. We found a moderate to large within-group effect size for both the intervention (d=0.75) and the control (d=0.69) group. However, the between-group effect size was very small (d=0.07), and regression analysis on posttreatment CES-D scores revealed no significant differences between the groups (b=1.134, 95% CI –2

  4. Re-Evaluation Co-Counseling: A Method of Peer Self Help.

    ERIC Educational Resources Information Center

    Rockman, Ilene F.

    The college and university counseling center traditionally employs standard techniques in helping students, faculty, and staff in overcoming problems of mental stress (Berman, 1972). A technique suitable to both individual and group sessions, but rarely utilized is Re-Evaluation Co-Counseling or R.C. For the past twenty years, R.C. has gained an…

  5. Fighting for life: a qualitative analysis of the process of psychotherapy-assisted self-help in patients with metastatic cancer.

    PubMed

    Cunningham, Alastair J; Phillips, Catherine; Stephen, Joanne; Edmonds, Claire

    2002-06-01

    This exploratory study is an attempt to define psychological attributes related to longer survival in patients with metastatic cancers. Previous published analyses have been limited in two ways. First, they have almost always been carried out on patients not receiving therapy; we have followed people receiving a year of group therapy, on the assumption that if mental qualities are to affect cancer progression, substantial mental change would be needed to alter the established balance between the cancer cells and host regulatory mechanisms. Second, the methods typically used to characterize patients' psychology have been self-report inventories, and many decades of research with such methods have largely failed to produce a consensus on what mental qualities, if any, promote survival. By contrast, we have used qualitative methods, allowing a much more in-depth analysis of the patients, without preliminary assumptions as to what would be important. The present report describes the results of a detailed qualitative analysis of data collected from 22 participants over a year of weekly group therapy. Using grounded methods, categories were derived from the extensive verbal data (comprising patients' written homework and therapists' notes), and linked in a model of change. By applying ratings to some of these categories, and combining these ratings, we derived a quantitative estimate of patients' "involvement in self-help." Rankings on degree of involvement corresponded quite closely with the quality of patients' experience and with their survival duration. There was a great range in degree of involvement, and various subgroupings could be discerned. Nine of the participants were classed as "highly involved," meaning that they devoted regular daily time, often several hours, to such self-help strategies as relaxation, mental imaging, meditation, cognitive monitoring and journalling. All but 1 of these patients enjoyed a good quality of life and lived at least 2 years

  6. Fighting for life: a qualitative analysis of the process of psychotherapy-assisted self-help in patients with metastatic cancer.

    PubMed

    Cunningham, Alastair J; Phillips, Catherine; Stephen, Joanne; Edmonds, Claire

    2002-06-01

    This exploratory study is an attempt to define psychological attributes related to longer survival in patients with metastatic cancers. Previous published analyses have been limited in two ways. First, they have almost always been carried out on patients not receiving therapy; we have followed people receiving a year of group therapy, on the assumption that if mental qualities are to affect cancer progression, substantial mental change would be needed to alter the established balance between the cancer cells and host regulatory mechanisms. Second, the methods typically used to characterize patients' psychology have been self-report inventories, and many decades of research with such methods have largely failed to produce a consensus on what mental qualities, if any, promote survival. By contrast, we have used qualitative methods, allowing a much more in-depth analysis of the patients, without preliminary assumptions as to what would be important. The present report describes the results of a detailed qualitative analysis of data collected from 22 participants over a year of weekly group therapy. Using grounded methods, categories were derived from the extensive verbal data (comprising patients' written homework and therapists' notes), and linked in a model of change. By applying ratings to some of these categories, and combining these ratings, we derived a quantitative estimate of patients' "involvement in self-help." Rankings on degree of involvement corresponded quite closely with the quality of patients' experience and with their survival duration. There was a great range in degree of involvement, and various subgroupings could be discerned. Nine of the participants were classed as "highly involved," meaning that they devoted regular daily time, often several hours, to such self-help strategies as relaxation, mental imaging, meditation, cognitive monitoring and journalling. All but 1 of these patients enjoyed a good quality of life and lived at least 2 years

  7. BOLD delay times using group delay in sickle cell disease

    NASA Astrophysics Data System (ADS)

    Coloigner, Julie; Vu, Chau; Bush, Adam; Borzage, Matt; Rajagopalan, Vidya; Lepore, Natasha; Wood, John

    2016-03-01

    Sickle cell disease (SCD) is an inherited blood disorder that effects red blood cells, which can lead to vasoocclusion, ischemia and infarct. This disease often results in neurological damage and strokes, leading to morbidity and mortality. Functional Magnetic Resonance Imaging (fMRI) is a non-invasive technique for measuring and mapping the brain activity. Blood Oxygenation Level-Dependent (BOLD) signals contain also information about the neurovascular coupling, vascular reactivity, oxygenation and blood propagation. Temporal relationship between BOLD fluctuations in different parts of the brain provides also a mean to investigate the blood delay information. We used the induced desaturation as a label to profile transit times through different brain areas, reflecting oxygen utilization of tissue. In this study, we aimed to compare blood flow propagation delay times between these patients and healthy subjects in areas vascularized by anterior, middle and posterior cerebral arteries. In a group comparison analysis with control subjects, BOLD changes in these areas were found to be almost simultaneous and shorter in the SCD patients, because of their increased brain blood flow. Secondly, the analysis of a patient with a stenosis on the anterior cerebral artery indicated that signal of the area vascularized by this artery lagged the MCA signal. These findings suggest that sickle cell disease causes blood propagation modifications, and that these changes could be used as a biomarker of vascular damage.

  8. Internet-based guided self-help for university students with anxiety, depression and stress: a randomized controlled clinical trial.

    PubMed

    Day, Victor; McGrath, Patrick J; Wojtowicz, Magdalena

    2013-07-01

    Anxiety, depression and stress, often co-occurring, are the psychological problems for which university students most often seek help. Moreover there are many distressed students who cannot, or choose not to, access professional help. The present study evaluated the efficacy of an internet-based guided self-help program for moderate anxiety, depression and stress. The program was based on standard cognitive behavior therapy principles and included 5 core modules, some of which involved options for focusing on anxiety and/or depression and/or stress. Trained student coaches provided encouragement and advice about using the program via e-mail or brief weekly phone calls. Sixty-six distressed university students were randomly assigned to either Immediate Access or a 6-week Delayed Access condition. Sixty-one percent of Immediate Access participants completed all 5 core modules, and 80% of all participants completed the second assessment. On the Depression, Anxiety and Stress Scales-21, Immediate Access participants reported significantly greater reductions in depression (ηp(2)=. 07), anxiety (ηp(2)=. 08) and stress (ηp(2)=. 12) in comparison to participants waiting to do the program, and these improvements were maintained at a six month follow-up. The results suggest that the provision of individually-adaptable, internet-based, self-help programs can reduce psychological distress in university students.

  9. Self-help/mutual aid as active citizenship associations: a case-study of the chronically ill in Italy.

    PubMed

    Giarelli, Guido; Spina, Elena

    2014-12-01

    Contrary to the most widespread conception that considers self-help/mutual aid as a component of the 'third sector', an approach is proposed which assumes, on the basis of the specific nature of the social bond and of the social action that characterizes it, it can be more properly considered as part of the 'new civil society' as it has been configured during the time in Western societies. This implies its location in the public non-state and non-systemic space that it has been created in the specific form of associations of citizenship. An interuniversity research project is then presented which, using this approach, studied the case of self-help/mutual aid associations for the chronically ill in Italy, offering some of the findings regarding the origin, structural characteristics, geographical distribution and activities of these associations in order to at least partially verify the heuristic value of this approach and its implications for the processes of reform of the health systems.

  10. Handheld Devices and Video Modeling to Enhance the Learning of Self-Help Skills in Adolescents With Autism Spectrum Disorder.

    PubMed

    Campbell, Joseph E; Morgan, Michele; Barnett, Veronica; Spreat, Scott

    2015-04-01

    The viewing of videos is a much-studied intervention to teach self-help, social, and vocational skills. Many of the studies to date looked at video modeling using televisions, computers, and other large screens. This study looked at the use of video modeling on portable handheld devices to teach hand washing to three adolescent students with an autism spectrum disorder. Three students participated in this 4-week study conducted by occupational therapists. Baseline data were obtained for the first student for 1 week, the second for 2 weeks, and the third for 3 weeks; videos were introduced when the participants each finished the baseline phase. Given the cognitive and motor needs of the participants, the occupational therapist set the player so that the participants only had to press the play button to start the video playing. The participants were able to hold the players and view at distances that were most appropriate for their individual needs and preferences. The results suggest that video modeling on a handheld device improves the acquisition of self-help skills. PMID:26460472

  11. Invasive Group A streptococcal disease in Ireland, 2004 to 2010.

    PubMed

    Martin, J; Murchan, S; O'Flanagan, D; Fitzpatrick, F

    2011-01-01

    Invasive group A streptococcal infections (iGAS) are a major clinical and public health challenge. iGAS is a notifiable disease in Ireland since 2004. The aim of this paper is to describe the epidemiology of iGAS in Ireland for the first time over the seven-year period from 2004 to 2010. The Irish national electronic infectious disease reporting system was used by laboratories to enter the source of iGAS isolates, and by departments of public health to enter clinical and epidemiological details. We extracted and analysed data from 1 January 2004 to 31 December 2010. Over the study period, 400 iGAS cases were notified. The annual incidence of iGAS doubled, from 0.8 per 100,000 population in 2004 to 1.6 in 2008, and then remained the same in 2009 and 2010. The reported average annual incidence rates were highest among children up to five years of age (2.3/100,000) and adults aged over 60 years (3.2/100,000). The most common risk factors associated with iGAS were skin lesions or wounds. Of the 174 people for whom clinical syndrome information was available, 28 (16%) cases presented with streptococcal toxic shock syndrome and 19 (11%) with necrotising fasciitis. Of the 141 cases for whom seven-day outcomes were recorded, 11 people died with iGAS identified as the main cause of death (seven-day case fatality rate 8%). The notification rate of iGAS in Ireland was lower than that reported in the United Kingdom, Nordic countries and North America but higher than southern and eastern European countries. The reasons for lower notification rates in Ireland compared with other countries may be due to a real difference in incidence, possibly due to prescribing practices, or due to artefacts resulting from the specific Irish case definition and/or low reporting in the early stages of a new surveillance system. iGAS disease remains an uncommon but potentially severe disease in Ireland. Ongoing surveillance is required in order to undertake appropriate control measures and gain a

  12. Treatment of binge eating disorder in racially and ethnically diverse obese patients in primary care: randomized placebo-controlled clinical trial of self-help and medication.

    PubMed

    Grilo, Carlos M; Masheb, Robin M; White, Marney A; Gueorguieva, Ralitza; Barnes, Rachel D; Walsh, B Timothy; McKenzie, Katherine C; Genao, Inginia; Garcia, Rina

    2014-07-01

    The objective was to determine whether treatments with demonstrated efficacy for binge eating disorder (BED) in specialist treatment centers can be delivered effectively in primary care settings to racially/ethnically diverse obese patients with BED. This study compared the effectiveness of self-help cognitive-behavioral therapy (shCBT) and an anti-obesity medication (sibutramine), alone and in combination, and it is only the second placebo-controlled trial of any medication for BED to evaluate longer-term effects after treatment discontinuation. 104 obese patients with BED (73% female, 55% non-white) were randomly assigned to one of four 16-week treatments (balanced 2-by-2 factorial design): sibutramine (N = 26), placebo (N = 27), shCBT + sibutramine (N = 26), or shCBT + placebo (N = 25). Medications were administered in double-blind fashion. Independent assessments were performed monthly throughout treatment, post-treatment, and at 6- and 12-month follow-ups (16 months after randomization). Mixed-models analyses revealed significant time and medication-by-time interaction effects for percent weight loss, with sibutramine but not placebo associated with significant change over time. Percent weight loss differed significantly between sibutramine and placebo by the third month of treatment and at post-treatment. After the medication was discontinued at post-treatment, weight re-gain occurred in sibutramine groups and percent weight loss no longer differed among the four treatments at 6- and 12-month follow-ups. For binge-eating, mixed-models revealed significant time and shCBT-by-time interaction effects: shCBT had significantly lower binge-eating frequency at 6-month follow-up but the treatments did not differ significantly at any other time point. Demographic factors did not significantly predict or moderate clinical outcomes. Our findings suggest that pure self-help CBT and sibutramine did not show long-term effectiveness relative to placebo for treating BED in

  13. Client Self-Management: Promoting Self-Help for Parents of Children in Foster-Care

    PubMed Central

    Angel, Bjørn Øystein

    2016-01-01

    Drawing upon Foucault's concepts of power, this article shows how a course given to parents whose children are in foster-care encourages a particular form of self-management—most notably, that their internal dialogues must be altered so that the parents can view themselves as people in control of their behaviour who are in a position to choose new behaviour. The article is based on a qualitative study conducted in Norway and centres on the support and development of participants in the course. Study results show increased self-confidence and self-respect in the participants, both as individuals and as parents. In addition, significant benefits were stated as finding that they could verbalise and describe difficult events and emotions, experiencing being ‘normal’ within a group and receiving feedback. From the perspective of child protective services, dialogue with parents is central, as it not only commits clients to specific behaviours, but—more importantly—commits them to a particular inner dialogue about parenthood. The course can be seen as a management tool in which the parent's ‘self’ becomes the central object, seeking to contradict the conventional conception of parents with children in foster-care as having nothing to contribute to their children's upbringing. PMID:27559212

  14. Assessing the Availability and Quality of Online Self-Help Videos: A Pilot Study with a Focus on Parkinson's Disease

    ERIC Educational Resources Information Center

    Hammond, Julia; Rennie, Brandon; Seekins, Tom; O'Donnell, Dennis

    2015-01-01

    Objective: The Internet and other electronic media may provide one part of a solution for reducing disparities in the availability of medical services. From a patient-centred perspective, an individual with a chronic, degenerative condition may ask what information is available that I can use to manage changes in my functional capacity over time,…

  15. Telephone-based guided self-help for adolescents with chronic fatigue syndrome: A non-randomised cohort study.

    PubMed

    Lloyd, Samantha; Chalder, Trudie; Sallis, Hannah M; Rimes, Katharine A

    2012-05-01

    The aim of this study was to gain preliminary evidence about the efficacy of a new telephone-based guided self-help intervention, based on cognitive-behavioural principles, which aimed to reduce fatigue and improve school attendance in adolescents with chronic fatigue syndrome (CFS). A non-randomised cohort design was used, with a two-month baseline period. Sixty-three 11-18 year-old participants recruited from a specialist CFS unit received the intervention. Participants received six half-hour fortnightly telephone sessions and two follow-up sessions. Fatigue and school attendance were the main outcomes and the main time point for assessing outcome was 6 months post-treatment. Using multi-level modelling, a significant decrease in fatigue was found between pre-treatment and 6 month follow-up, treatment effect estimate = - 5.68 (-7.63, -3.72), a large effect size (Cohen's d = 0.79). The decrease in fatigue between pre and post-treatment was significantly larger than between baseline and pre-treatment. A significant increase in school attendance was found between pre-treatment and 6 month follow-up, effect estimate = 1.38 (0.76, 2.00), a medium effect size (d = -0.48). univariate logistic regression found baseline perfectionism to be associated with better [corrected] school attendance at six-month follow-up. In conclusion, telephone-based guided self-help is an acceptable minimal intervention which is efficacious in reducing fatigue in adolescents with CFS.

  16. Internet-based intervention for the treatment of online addiction for college students in China: a pilot study of the Healthy Online Self-helping Center.

    PubMed

    Su, Wenliang; Fang, Xiaoyi; Miller, John K; Wang, Yiyuan

    2011-09-01

    Internet addiction among college students has become a serious problem in China. This pilot study involved the development of an online expert system named Healthy Online Self-helping Center (HOSC) as an intervention tool to help those who wish to reduce online usage. The study also explored the effectiveness of HOSC for college students' Internet addiction behavior. Participants (N = 65) were recruited from a university in Beijing, and were randomly assigned to one of four conditions: using HOSC within a laboratory environment, using HOSC within a natural environment, using a noninteractive program, and a control group. All the participants were asked to answer questionnaires at the baseline and at the 1-month follow-up. The questionnaires included the participants' online hours per week, the legitimate ratio of Internet usage, online satisfaction, and the Young's Diagnostic Questionnaire. The results revealed that HOSC under both natural and laboratory environments could effectively reduce the participants' online hours per week as well as their Young's Diagnostic Questionnaire score, and improve online satisfaction at a 1-month follow-up. Participants using a noninteractive program also had similar results. The article concludes with a discussion of the limitations of the study, as well as the implications of the findings and future research directions.

  17. Use of biosimilars in inflammatory bowel disease: Statements of the Italian Group for Inflammatory Bowel Disease.

    PubMed

    Annese, Vito; Vecchi, Maurizio

    2014-11-01

    The introduction of biological therapies, particularly anti-TNFα agents, has revolutionized the management of inflammatory bowel disease in those cases which are refractory to conventional treatment; however these drugs are not risk-free and their use has substantially increased the cost of treatment. As marketing protection expires for original, first-generation biopharmaceuticals, lower-cost "copies" of these drugs produced by competitor companies-referred to as biosimilars-are already entering the market. In September 2013, the European Medicines Agency approved two infliximab biosimilars for treatment of adult and paediatric inflammatory bowel disease patients, a decision based largely on efficacy and safety data generated in studies of patients with ankylosing spondylitis and rheumatoid arthritis. For many clinicians, extrapolation practices and the general question of interchangeability between biosimilars and reference biologics are cause for concern. In the present paper, the Italian Group for inflammatory bowel disease presents its statements on these issues, with emphasis on the peculiar clinical characteristics of inflammatory bowel disease and the importance of providing physicians and patients with adequate information and guarantees on the safety and efficacy of these new drugs in the specific setting of inflammatory bowel disease.

  18. Evaluating the Effectiveness of ACT for Anxiety Disorders in a Self-Help Context: Outcomes From a Randomized Wait-List Controlled Trial.

    PubMed

    Ritzert, Timothy R; Forsyth, John P; Sheppard, Sean C; Boswell, James F; Berghoff, Christopher R; Eifert, Georg H

    2016-07-01

    Rigorous evaluations of cognitive behavioral self-help books for anxiety in pure self-help contexts are lacking. The present study evaluated the effectiveness of an Acceptance and Commitment Therapy (ACT) self-help workbook for anxiety-related concerns, with no therapist contact, in an international sample. Participants (N=503; 94% mental health diagnosis) were randomized to an immediate workbook (n=256) or wait-list condition (n=247). Assessments at pretreatment, 12weeks, 6months, and 9months evaluated anxiety and related symptoms, quality of life, and ACT treatment processes (e.g., psychological flexibility). Participants in the wait-list arm crossed over to the workbook following the 12-week assessment. The workbook condition yielded significant improvements on all assessments from pre- to posttreatment relative to wait-list, and these gains were maintained at follow-ups. The pattern observed in the wait-list condition was virtually identical to the active treatment arm after receiving the workbook, but not before. Attrition was notable, but supplemental analyses suggested dropout did not influence treatment effects for all but one measure. Overall, findings provide preliminary support for the effectiveness of this self-help workbook and suggest ACT-based self-help bibliotherapy might be a promising low-cost intervention for people experiencing significant anxiety-related concerns. PMID:27423162

  19. A review of technology-assisted self-help and minimal contact therapies for drug and alcohol abuse and smoking addiction: is human contact necessary for therapeutic efficacy?

    PubMed

    Newman, Michelle G; Szkodny, Lauren E; Llera, Sandra J; Przeworski, Amy

    2011-02-01

    Technology-based self-help and minimal contact therapies have been proposed as effective and low-cost interventions for addictive disorders, such as nicotine, alcohol, and drug abuse and addiction. The present article reviews the literature published before 2010 on computerized treatments for drug and alcohol abuse and dependence and smoking addiction. Treatment studies are examined by disorder as well as amount of therapist contact, ranging from self-administered therapy and predominantly self-help interventions to minimal contact therapy where the therapist is actively involved in treatment but to a lesser degree than traditional therapy and predominantly therapist-administered treatments involving regular contact with a therapist for a typical number of sessions. In the treatment of substance use and abuse it is concluded that self-administered and predominantly self-help computer-based cognitive and behavioral interventions are efficacious, but some therapist contact is important for greater and more sustained reductions in addictive behavior. PMID:21095051

  20. Evaluation of Telephone Support Groups for Persons with HIV Disease.

    ERIC Educational Resources Information Center

    Rounds, Kathleen A.; And Others

    1995-01-01

    Describes the development and testing of a telephone support group project for persons with HIV. Examined five outcomes: self-efficacy, social isolation, social support, coping with HIV, and evaluation of the group experience. Found significant positive changes only in some aspects of self-efficacy and in social isolation. Participants rated the…

  1. 41 CFR 102-75.565 - Is the requirement for self-help housing or housing assistance use of the property by an eligible...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Is the requirement for self-help housing or housing assistance use of the property by an eligible public agency or non-profit... of the property by an eligible public agency or non-profit organization contingent upon the...

  2. 41 CFR 102-75.565 - Is the requirement for self-help housing or housing assistance use of the property by an eligible...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... agency's approval of an assignment recommendation from the Department of Housing and Urban Development... of Housing and Urban Development (HUD)? 102-75.565 Section 102-75.565 Public Contracts and Property... self-help housing or housing assistance use of the property by an eligible public agency or...

  3. A Randomized Controlled Trial of a Novel Self-Help Technique for Impulse Control Disorders: A Study on Nail-Biting

    ERIC Educational Resources Information Center

    Moritz, Steffen; Treszl, Andras; Rufer, Michael

    2011-01-01

    Nail-biting is currently classified as an impulse control disorder not otherwise specified. Although seldom targeted as a primary symptom, nail-biting is often associated with somatic complications and decreased quality of life. The present study assessed the effectiveness of an innovative self-help technique, titled decoupling (DC). DC aims at…

  4. "Helpful People in Touch" Consumer Led Self Help Programs for People with Multiple Disorders, Mental Illness, Drug Addiction, and Alcoholism (MIDAA).

    ERIC Educational Resources Information Center

    Sciacca, Kathleen

    This paper describes the consumer program, "Helpful People in Touch," a self-help treatment program for people with the multiple disorders of mental illness, drug addiction, and/or alcoholism. First, the terms, "Mentally Ill Chemical Abusers and Addicted" (MICAA) and "Chemical Abusing Mentally Ill" (CAMI) are defined and differentiated, with…

  5. Development and Testing of a Science and Engineering Fair Self-Help Development Program: Results of the Pilot Program in Three Middle Schools.

    ERIC Educational Resources Information Center

    Menicucci, David F.

    In seven chapters, this report details the Science Fair Self-Help Development Program, which was initiated in a pilot project at three middles schools in Albuquerque, New Mexico, during school year 1991-1992. The purpose of the program was to provide guidance to schools in developing their own parental and community resources into a sustainable…

  6. [Blood groups - minuses and pluses. Do the blood group antigens protect us from infectious diseases?].

    PubMed

    Czerwiński, Marcin

    2015-06-25

    Human blood can be divided into groups, which is a method of blood classification based on the presence or absence of inherited erythrocyte surface antigens that can elicit immune response. According to the International Society of Blood Transfusion, there are 341 blood group antigens collected in 35 blood group systems. These antigens can be proteins, glycoproteins or glycosphingolipids, and function as transmembrane transporters, ion channels, adhesion molecules or receptors for other proteins. The majority of blood group antigens is present also on another types of cells. Due to their localization on the surface of cells, blood group antigens can act as receptors for various pathogens or their toxins, such as protozoa (malaria parasites), bacteria (Helicobacter pylori, Vibrio cholerae and Shigella dysenteriae) and viruses (Noroviruses, Parvoviruses, HIV). If the presence of group antigen (or its variant which arised due to mutation) is beneficial for the host (e.g. because pathogens are not able to bind to the cells), the blood group may become a selection trait, leading to its dissemination in the population exposed to that pathogen. There are thirteen blood group systems that can be related to pathogen resistance, and it seems that the particular influence was elicit by malaria parasites. It is generally thought that the high incidence of blood groups such as O in the Amazon region, Fy(a-b-) in Africa and Ge(-) in Papua-New Guinea is the result of selective pressure from malaria parasite. This review summarizes the data about relationship between blood groups and resistance to pathogens.

  7. Chronic Diseases in the Pediatric Age Group. Matrix No. 7.

    ERIC Educational Resources Information Center

    Katz, Michael

    This paper briefly outlines current problems associated with chronic diseases in children and youth and provides indications for the types of future research and analysis needed to facilitate the development of solutions. In general, these problems are associated with the following: malignancies, hereditary anemias, cystic fibrosis, other chronic…

  8. Promoting self-help activities for people living with HIV / AIDS in Ho Chi Minh City, Vietnam.

    PubMed

    Le Truong Giang; Nguyen Huu Luyen; Le Thuy Lan Thao; Narimani, P

    1999-01-01

    The rising epidemic of HIV/AIDS in Ho Chi Minh City presents new challenges for sexually transmitted disease/HIV prevention in Vietnam. Most HIV/AIDS cases are found south of the country and this puts a burden on the Ho Chi Minh City AIDS Committee. Building on experiences from other countries, the AIDS Committee successfully implemented measures such as needle-exchange programs, condom distribution, peer education, and outreach activities. It also established a meeting place, the Cafe Hy Vong, for female sex workers and intravenous drug users. From the beginning, the Committee regarded meeting the special needs of people living with HIV/AIDS (PHA) as important prevention activities, and encouraged PHA to discuss their concerns with the committee. The PHA formed the Friend-to-Friend group in October 1995, where the Ho Chi Minh AIDS Committee gave its full support. The group organizes meetings and social gatherings where they can share their feelings and experiences, as well as get information and counseling.

  9. [Blood groups - minuses and pluses. Do the blood group antigens protect us from infectious diseases?].

    PubMed

    Czerwiński, Marcin

    2015-01-01

    Human blood can be divided into groups, which is a method of blood classification based on the presence or absence of inherited erythrocyte surface antigens that can elicit immune response. According to the International Society of Blood Transfusion, there are 341 blood group antigens collected in 35 blood group systems. These antigens can be proteins, glycoproteins or glycosphingolipids, and function as transmembrane transporters, ion channels, adhesion molecules or receptors for other proteins. The majority of blood group antigens is present also on another types of cells. Due to their localization on the surface of cells, blood group antigens can act as receptors for various pathogens or their toxins, such as protozoa (malaria parasites), bacteria (Helicobacter pylori, Vibrio cholerae and Shigella dysenteriae) and viruses (Noroviruses, Parvoviruses, HIV). If the presence of group antigen (or its variant which arised due to mutation) is beneficial for the host (e.g. because pathogens are not able to bind to the cells), the blood group may become a selection trait, leading to its dissemination in the population exposed to that pathogen. There are thirteen blood group systems that can be related to pathogen resistance, and it seems that the particular influence was elicit by malaria parasites. It is generally thought that the high incidence of blood groups such as O in the Amazon region, Fy(a-b-) in Africa and Ge(-) in Papua-New Guinea is the result of selective pressure from malaria parasite. This review summarizes the data about relationship between blood groups and resistance to pathogens. PMID:26206987

  10. Positive Psychological Wellbeing Is Required for Online Self-Help Acceptance and Commitment Therapy for Chronic Pain to be Effective.

    PubMed

    Trompetter, Hester R; Bohlmeijer, Ernst T; Lamers, Sanne M A; Schreurs, Karlein M G

    2016-01-01

    -based self-help ACT may not be allocated to chronic pain sufferers experiencing low levels of mental resilience resources such as self-acceptance, goals in life, and environmental mastery. Other subgroups are identified that potentially need specific tailoring of (web-based) ACT. Emotional and psychological wellbeing should receive much more attention in subsequent studies on chronic pain and illness. PMID:27014159

  11. Positive Psychological Wellbeing Is Required for Online Self-Help Acceptance and Commitment Therapy for Chronic Pain to be Effective.

    PubMed

    Trompetter, Hester R; Bohlmeijer, Ernst T; Lamers, Sanne M A; Schreurs, Karlein M G

    2016-01-01

    -based self-help ACT may not be allocated to chronic pain sufferers experiencing low levels of mental resilience resources such as self-acceptance, goals in life, and environmental mastery. Other subgroups are identified that potentially need specific tailoring of (web-based) ACT. Emotional and psychological wellbeing should receive much more attention in subsequent studies on chronic pain and illness.

  12. Acceptability of Online Self-Help to People With Depression: Users’ Views of MoodGYM Versus Informational Websites

    PubMed Central

    Sarrami Foroushani, Pooria; Grime, Paul; Thornicroft, Graham

    2014-01-01

    Background Little is known about the factors that influence acceptability of and adherence to online psychological interventions. Evidence is needed to guide further development of promising programs. Objective Our goal was to investigate users’ views of two online approaches to self-help for depression: computerized cognitive behavior therapy (cCBT) and informational websites, in a workplace context. Computerized CBT offers an inexpensive and accessible alternative to face-to-face therapy, and employers have an interest in reducing the working time lost to depression or stress. Yet little is known about how employees, who have actual experience of using online approaches, judge the intervention as a process. Methods The qualitative data reported here were collected within an online randomized controlled trial whose participants had diagnosable depression. The experimental intervention was a 5-week cCBT program called MoodGYM, and the control condition was five informational websites about mental health. Data were collected via online questionnaires. There was no evidence of the superiority of either in terms of treatment outcomes. In parallel, using brief rating scales and open-ended questions designed for this purpose, we examined the relative acceptability of each approach over time, including perceptions of cCBT compared to seeing a health care professional. Results At least 60% of participants held online therapy to be at least as acceptable as seeing a professional about mental health issues, and they were more likely to retain this opinion over time if they used the interactive program, MoodGYM, rather than informational websites alone. Barriers to cCBT use fell into four categories: intrinsic, intrapersonal problems; extrinsic technical problems; generic issues mostly pertaining to perceptions of cCBT; and specific issues about the intervention or control condition. These indicate strategies for improving engagement. Conclusions As first-aid for mild to

  13. Positive Psychological Wellbeing Is Required for Online Self-Help Acceptance and Commitment Therapy for Chronic Pain to be Effective

    PubMed Central

    Trompetter, Hester R.; Bohlmeijer, Ernst T.; Lamers, Sanne M. A.; Schreurs, Karlein M. G.

    2016-01-01

    -based self-help ACT may not be allocated to chronic pain sufferers experiencing low levels of mental resilience resources such as self-acceptance, goals in life, and environmental mastery. Other subgroups are identified that potentially need specific tailoring of (web-based) ACT. Emotional and psychological wellbeing should receive much more attention in subsequent studies on chronic pain and illness. PMID:27014159

  14. African American Adolescents with Sickle Cell Disease: Support Groups and Psychological Well-Being.

    ERIC Educational Resources Information Center

    Gardner, Marilyn M.; Telfair, Joseph

    1999-01-01

    Studied the impact of support groups on the psychological well-being of adolescents with sickle cell disease (SCD). Response of 79 adolescent SCD group members show that psychological well-being was best predicted by fewer physical symptoms and greater satisfaction with the group. Findings suggest the beneficial effects of SCD support groups. (SLD)

  15. Prevention of Early-onset Neonatal Group B Streptococcal Disease

    PubMed Central

    Marió, M. J. Soto; Valenzuela, I; Vásquez, A. E; Illanes, S. E

    2013-01-01

    Streptococcus agalactiae, also known as Group B Streptococcus (GBS), is an opportunistic pathogen that colonizes the gastrointestinal and genitourinary tracts of up to 50% of healthy adults and newborns; it is responsible for significant morbidity and mortality. Early detection can be used to establish the use of antibiotic prophylaxis to significantly reduce neonatal sepsis. This article reviews methods of detection and prevention of GBS infection in the neonate. PMID:24358406

  16. Participation and outcome in manualized self-help for bulimia nervosa and binge eating disorder - a systematic review and metaregression analysis.

    PubMed

    Beintner, Ina; Jacobi, Corinna; Schmidt, Ulrike H

    2014-03-01

    There is a growing body of research on manualized self-help interventions for bulimia nervosa (BN) and binge eating disorder (BED). Study and treatment dropout and adherence represent particular challenges in these studies. However, systematic investigations of the relationship between study, intervention and patient characteristics, participation, and intervention outcomes are lacking. We conducted a systematic literature review using electronic databases and hand searches of relevant journals. In metaregression analyses, we analyzed study dropout as well as more specific measures of treatment participation in manualized self-help interventions, their association with intervention characteristics (e.g. duration, guidance, intervention type [bibliotherapy, CD-ROM or Internet based intervention]) and their association with treatment outcomes. Seventy-three publications reporting on 50 different trials of manualized self-help interventions for binge eating and bulimia nervosa published through July 9th 2012 were identified. Across studies, dropout rates ranged from 1% to 88%. Study dropout rates were highest in CD-ROM interventions and lowest in Internet-based interventions. They were higher in samples of BN patients, samples of patients with higher degrees of dietary restraint at baseline, lower age, and lower body mass index. Between 6% and 88% of patients completed the intervention to which they had been assigned. None of the patient, study and intervention characteristics predicted intervention completion rates. Intervention outcomes were moderated by the provision of personal guidance by a health professional, the number of guidance sessions as well as participants' age, BMI, and eating disorder related attitudes (Restraint, Eating, Weight and Shape Concerns) at baseline (after adjusting for study dropout and intervention completion rates). Guidance particularly improved adherence and outcomes in samples of patients with bulimia nervosa; specialist guidance led

  17. The association between blood group and the risk of vascular disease in Quebec blood donors

    PubMed Central

    Blais, Claudia; Germain, Marc; Delage, Gilles; Grégoire, Yves

    2016-01-01

    Background The association between antigens A and B and arterial thrombosis, such as coronary heart disease, cerebrovascular disease or peripheral vascular disease, is still unclear. We evaluated the association between blood groups and thrombotic events in a cohort of blood donors from the province of Quebec, Canada. Material and methods Among all whole blood donors aged ≥18 years in Quebec between June 1990 and March 2009, a study sample with known blood groups was linked with the provincial hospitalisation and death records to count vascular events. All hospital admissions and deaths with codes for primary and relevant secondary diagnoses of coronary, cerebrovascular or peripheral diseases, including coronary heart disease interventions, were included. Cox regression was used to evaluate the hazard ratio associated between blood groups and these events adjusted for other baseline characteristics. Results Among the blood donors, 64,686 had a known blood group and were linked with the provincial health databases. The mean age of these donors was 38 years. The Cox multivariate adjusted hazard ratio for coronary, cerebrovascular or peripheral diseases was 1.19 (95% confidence interval: 1.01–1.40) for subjects with blood group AB compared to those with blood group O. There were no statistically significant associations with other blood groups. Only among women aged ≥40 years did those with blood group A have a higher hazard ratio for coronary heart disease (1.40 [1.01–1.92]) than those with blood group O, after adjusting for other characteristics. Discussion When compared to blood group O, only blood group AB was associated with a higher risk of hospitalisation or death because of thrombotic events such as coronary, cerebrovascular or peripheral diseases. However, the associations differed according to age and sex because only females aged ≥40 years with blood group A had a higher risk of coronary heart disease. PMID:27177404

  18. Human Endogenous Retrovirus Group E and Its Involvement in Diseases

    PubMed Central

    Le Dantec, Christelle; Vallet, Sophie; Brooks, Wesley H.; Renaudineau, Yves

    2015-01-01

    Human endogenous retrovirus group E (HERV-E) elements are stably integrated into the human genome, transmitted vertically in a Mendelian manner, and are endowed with transcriptional activity as alternative promoters or enhancers. Such effects are under the control of the proviral long terminal repeats (LTR) that are organized into three HERV-E phylogenetic subgroups, namely LTR2, LTR2B, and LTR2C. Moreover, HERV-E expression is tissue-specific, and silenced by epigenetic constraints that may be disrupted in cancer, autoimmunity, and human placentation. Interest in HERV-E with regard to these conditions has been stimulated further by concerns regarding the capacity of HERV-E elements to modify the expression of neighboring genes and/or to produce retroviral proteins, including immunosuppressive env peptides, which in turn may induce (auto)-antibody (Ab) production. Finally, better understanding of HERV-E elements may have clinical applications for prevention, diagnosis, prognosis, and therapy. PMID:25785516

  19. High-Mobility Group Box 1, Oxidative Stress, and Disease

    PubMed Central

    Kang, Rui; Zeh, Herbert J.

    2011-01-01

    Abstract Oxidative stress and associated reactive oxygen species can modify lipids, proteins, carbohydrates, and nucleic acids, and induce the mitochondrial permeability transition, providing a signal leading to the induction of autophagy, apoptosis, and necrosis. High-mobility group box 1 (HMGB1) protein, a chromatin-binding nuclear protein and damage-associated molecular pattern molecule, is integral to oxidative stress and downstream apoptosis or survival. Accumulation of HMGB1 at sites of oxidative DNA damage can lead to repair of the DNA. As a redox-sensitive protein, HMGB1 contains three cysteines (Cys23, 45, and 106). In the setting of oxidative stress, it can form a Cys23-Cys45 disulfide bond; a role for oxidative homo- or heterodimerization through the Cys106 has been suggested for some of its biologic activities. HMGB1 causes activation of nicotinamide adenine dinucleotide phosphate oxidase and increased reactive oxygen species production in neutrophils. Reduced and oxidized HMGB1 have different roles in extracellular signaling and regulation of immune responses, mediated by signaling through the receptor for advanced glycation end products and/or Toll-like receptors. Antioxidants such as ethyl pyruvate, quercetin, green tea, N-acetylcysteine, and curcumin are protective in the setting of experimental infection/sepsis and injury including ischemia-reperfusion, partly through attenuating HMGB1 release and systemic accumulation. Antioxid. Redox Signal. 14, 1315–1335. PMID:20969478

  20. [Eating disorders on the internet: an experimental study on the effects of pro-eating disorders websites and self-help websites].

    PubMed

    Theis, Florian; Wolf, Markus; Fiedler, Peter; Backenstrass, Matthias; Kordy, Hans

    2012-02-01

    Pro-eating disorders (ED) websites are assumed to have a negative impact on internet users because these sites promote ED as a lifestyle, and present an extreme thin ideal as well as extreme weight loss measures. We tested the impact of reading pro-ED contents in a sample of 421 women. The participants were randomly assigned to one of 3 conditions in which they were exposed to either a pro-ED blog, a self-help blog, or a neutral control blog. Post-exposure negative affect was higher in participants of the pro-ED and the self-help conditions compared to the neutral blog condition. Participants with an elevated risk for developing an ED had a lower appearance self esteem after exposure to the pro-ED, or the self-help blog. According to the study, a subgroup of high risk individuals might be affected by ED-related internet content. The implications of this study are discussed in the context of the ongoing controversy around pro-ED websites.

  1. Minimal Residual Disease and Childhood Leukemia: Standard of Care Recommendations From the Pediatric Oncology Group of Ontario MRD Working Group.

    PubMed

    Athale, Uma H; Gibson, Paul J; Bradley, Nicole M; Malkin, David M; Hitzler, Johann

    2016-06-01

    Minimal residual disease (MRD) is an independent predictor of relapse risk in children with leukemia and is widely used for risk-adapted treatment. This article summarizes current evidence supporting the use of MRD, including clinical significance, current international clinical practice, impact statement, and recommended indications. The proposed MRD recommendations have been endorsed by the MRD Working Group of the Pediatric Oncology Group of Ontario and provide the foundation for a strategy that aims at equitable access to MRD evaluation for children with leukemia.

  2. Infectious disease and group size: more than just a numbers game

    PubMed Central

    Nunn, Charles L.; Jordán, Ferenc; McCabe, Collin M.; Verdolin, Jennifer L.; Fewell, Jennifer H.

    2015-01-01

    Increased risk of infectious disease is assumed to be a major cost of group living, yet empirical evidence for this effect is mixed. We studied whether larger social groups are more subdivided structurally. If so, the social subdivisions that form in larger groups may act as barriers to the spread of infection, weakening the association between group size and infectious disease. To investigate this ‘social bottleneck’ hypothesis, we examined the association between group size and four network structure metrics in 43 vertebrate and invertebrate species. We focused on metrics involving modularity, clustering, distance and centralization. In a meta-analysis of intraspecific variation in social networks, modularity showed positive associations with network size, with a weaker but still positive effect in cross-species analyses. Network distance also showed a positive association with group size when using intraspecific variation. We then used a theoretical model to explore the effects of subgrouping relative to other effects that influence disease spread in socially structured populations. Outbreaks reached higher prevalence when groups were larger, but subgrouping reduced prevalence. Subgrouping also acted as a ‘brake’ on disease spread between groups. We suggest research directions to understand the conditions under which larger groups become more subdivided, and to devise new metrics that account for subgrouping when investigating the links between sociality and infectious disease risk. PMID:25870397

  3. Development of a Self-Help Web-Based Intervention Targeting Young Cancer Patients With Sexual Problems and Fertility Distress in Collaboration With Patient Research Partners

    PubMed Central

    Obol, Claire Micaux; Lampic, Claudia; Eriksson, Lars E; Pelters, Britta; Wettergren, Lena

    2016-01-01

    Background The Internet should be suitable for delivery of interventions targeting young cancer patients. Young people are familiar with the technologies, and this patient group is small and geographically dispersed. Still, only few psycho-educational Web-based interventions are designed for this group. Young cancer patients consider reproductive health, including sexuality, an area of great importance and approximately 50% report sexual problems and fertility-related concerns following cancer treatment. Therefore, we set out to develop a self-help Web-based intervention, Fex-Can, to alleviate such problems. To improve its quality, we decided to involve patients and significant others as research partners. The first 18 months of our collaboration are described in this paper. The intervention will subsequently be tested in a feasibility study followed by a randomized controlled trial. Objective The study aims to describe the development of a Web-based intervention in long-term collaboration with patient research partners (PRPs). Methods Ten former cancer patients and two significant others participated in building the Web-based intervention, using a participatory design. The development process is described according to the design step in the holistic framework presented by van Gemert-Pijnen et al and evaluates the PRPs’ impact on the content, system, and service quality of the planned intervention. Results The collaboration between the research group and the PRPs mainly took place in the form of 1-day meetings to develop the key components of the intervention: educational and behavior change content, multimedia (pictures, video vignettes, and audios), interactive online activities (eg, self-monitoring), and partial feedback support (discussion forum, tailored feedback from experts). The PRPs influenced the intervention’s content quality in several ways. By repeated feedback on prototypes, the information became more comprehensive, relevant, and understandable

  4. Internet Therapy versus Internet Self-Help versus No Treatment for Problematic Alcohol Use: A Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Blankers, Matthijs; Koeter, Maarten W. J.; Schippers, Gerard M.

    2011-01-01

    Objective: Problematic alcohol use is the third leading contributor to the global burden of disease, partly because the majority of problem drinkers are not receiving treatment. Internet-based alcohol interventions attract an otherwise untreated population, but their effectiveness has not yet been established. The current study examined the…

  5. Increasing Antenatal Care and HIV Testing among Rural Pregnant Women with Conditional Cash Transfers to Self-Help Groups: An Evaluation Study in Rural Mysore, India.

    PubMed

    Madhivanan, Purnima; NiranjanKumar, Bhavana; Shaheen, Reshma; Jaykrishna, Poornima; Ravi, Kavitha; Gowda, Savitha; Srinivas, Vijaya; Arun, Anjali; Krupp, Karl

    2013-01-01

    Background. We describe a one-year evaluation study comparing SCIL intervention of mobile provision of integrated ANC/ HIV testing with an enhanced (SCIL+) intervention of community mobilization strategy providing conditional cash transfers (CCT) to women's SHG for identifying and accompanying pregnant women to mobile clinics. Methods. Twenty pairs of villages matched on population, socioeconomic status, access to medical facilities, and distance from Mysore city were divided between SCIL and SCIL+ interventions. The primary study outcome was the proportion of total pregnancies in these villages who received ANC and HIV testing. Results. Between April 2011 and March 2012, 552 pregnant women participated in SCIL or SCIL+ interventions. Among women who were pregnant at the time of intervention delivery, 181 of 418 (43.3%) women pregnant at the time of intervention delivery received ANC in the SCIL arm, while 371 of 512 (72.5%) received ANC in the SCIL+ arm (P < 0.001); 175 (97%) in the SCIL and 366 (98.6%) in the SCIL+ arm consented to HIV testing (P < 0.001). HIV prevalence of 0.6% was detected among SCIL clinic, and 0.9% among attending SCIL+ clinic attendees. Conclusion. Provision of CCT to women's microeconomic SHG appears to significantly increase uptake of ANC/HIV testing services in rural Mysore villages.

  6. Barriers to Community Participation in Development Planning: Lessons from the Mutengene (Cameroon) Self-Help Water Project.

    ERIC Educational Resources Information Center

    Njoh, Ambe J.

    2002-01-01

    A community water supply project in Cameroon illustrates the following constraints on community participation in development: paternalistic authorities, prescriptive role of the state, selective participation, bias toward "hard" issues, inattention to negative results, group conflicts, gatekeeping, pressure for immediate results, population size,…

  7. Philanthropy, Self Help, and Social Control: The New York Manumission Society and Free Blacks, 1785-1810.

    ERIC Educational Resources Information Center

    Rury, John L.

    1985-01-01

    Examines the attempts of the New York Manumission Society, a white anti-slavery group, to monitor and influence the behavior of free blacks in the decades following the Revolution. Identifies chief characteristics of the Society's relationship to New York's black community. Argues that the Society's wealthy white leadership probably imposed its…

  8. [Risk factors of ischemic heart disease in various occupational groups. II. Complex analysis of risk factors].

    PubMed

    Gałuszka, Z; Kolarzyk, E; Stepniewski, M; Salwińska-Ciećkiewicz, B; Szpak, D

    1991-01-01

    Four hundred four men aged 30 to 59 years, belonging to one of 4 occupational groups were investigated in a standard clinical conditions. Two from those groups were characteristic for steel mill professions: 121 blast furnace workers; exerting strenuous physical effort and working in hot microclimate. 131 operators (the second group) performed work in comfort microclimate conditions not demanding much effort. The third group comprised 73 executives of industry. The fourth group consisted of 79 monks. For all subjects of investigations 8 selected risk factors of ischemic heart disease were evaluated. They included: age, sex, family history, habit of smoking, systolic blood pressure, fasting blood cholesterol level, obesity index and professional physical activity. The level of each risk factor had numerical value in a span from "0" to "8". The sum of all points was decisive to which of 3 groups of risk given man should be accounted. Those 3 groups were arbitrary divided into "low, intermediate and high risk". The highest risk was found for the executives group, and the lowest for blast furnace workers. From the risk factors under investigation highest overall influence on incidence of ischemic heart disease had habit of smoking and obesity. Described here point classification system seems to be very simple and useful for estimation of risk of ischemic heart disease in a given population. PMID:1845321

  9. Coping with mental health issues: subjective experiences of self-help and helpful contextual factors at the start of mental health treatment

    PubMed Central

    Biringer, Eva; Davidson, Larry; Sundfør, Bengt; Lier, Haldis Ø.; Borg, Marit

    2016-01-01

    Abstract Background: Self-help strategies and various contextual factors support recovery. However, more in-depth knowledge is needed about how self-help strategies and supportive environments facilitate the recovery process. Aims: To explore what individuals who have recently been referred to a specialist Community Mental Health Center experience as helpful and what they do to help themselves. Method: Ten service users participated in in-depth interviews within a collaborative-reflexive framework. A hermeneutic-phenomenological approach was used. Results: Participants described a variety of helpful strategies and environmental supports. Four relevant main themes were identified: helpful activities, helpful people and places, self-instruction and learning about mental problems and medication and self-medication. Conclusions: The process of recovery is initiated before people become users of mental health services. This study confirms that recovery takes place within the person’s daily life context and involves the interplay of contextual factors, such as family, friends, good places, work and other meaningful activities. The coping strategies reported may represent an important focus for attention and clinical intervention. PMID:26484831

  10. Vaccines for prevention of group B meningococcal disease: Not your father's vaccines.

    PubMed

    Harrison, Lee H

    2015-11-27

    For decades, there was no licensed vaccine for prevention of endemic capsular group B meningococcal disease, despite the availability of vaccines for prevention of the other most common meningococcal capsular groups. Recently, however, two new vaccines have been licensed for prevention of group B disease. Although immunogenic and considered to have an acceptable safety profile, there are many scientific unknowns about these vaccines, including effectiveness against antigenically diverse endemic meningococcal strains; duration of protection; whether they provide any herd protection; and whether there will be meningococcal antigenic changes that will diminish effectiveness over time. In addition, these vaccines present societal dilemmas that could influence how they are used in the U.S., including high vaccine cost in the face of a historically low incidence of meningococcal disease. These issues are discussed in this review. PMID:26116255

  11. Vaccines for Prevention of Group B Meningococcal Disease: Not Your Father's Vaccines.

    PubMed

    Harrison, Lee H

    2015-12-01

    For decades, there was no licensed vaccine for prevention of endemic capsular group B meningococcal disease, despite the availability of vaccines for prevention of the other most common meningococcal capsular groups. Recently, however, two new vaccines have been licensed for prevention of group B disease. Although immunogenic and considered to have an acceptable safety profile, there are many scientific unknowns about these vaccines, including effectiveness against antigenically diverse endemic meningococcal strains; duration of protection; whether they provide any herd protection; and whether there will be meningococcal antigenic changes that will diminish effectiveness over time. In addition, these vaccines present societal dilemmas that could influence how they are used in the U.S., including high vaccine cost in the face of a historically low incidence of meningococcal disease. These issues are discussed in this review.

  12. Vaccines for prevention of group B meningococcal disease: Not your father's vaccines.

    PubMed

    Harrison, Lee H

    2015-11-27

    For decades, there was no licensed vaccine for prevention of endemic capsular group B meningococcal disease, despite the availability of vaccines for prevention of the other most common meningococcal capsular groups. Recently, however, two new vaccines have been licensed for prevention of group B disease. Although immunogenic and considered to have an acceptable safety profile, there are many scientific unknowns about these vaccines, including effectiveness against antigenically diverse endemic meningococcal strains; duration of protection; whether they provide any herd protection; and whether there will be meningococcal antigenic changes that will diminish effectiveness over time. In addition, these vaccines present societal dilemmas that could influence how they are used in the U.S., including high vaccine cost in the face of a historically low incidence of meningococcal disease. These issues are discussed in this review.

  13. Impact of GOLD groups of chronic pulmonary obstructive disease on surgical complications

    PubMed Central

    Kim, Hyung-Jun; Lee, Jinwoo; Park, Young Sik; Lee, Chang-Hoon; Lee, Sang-Min; Yim, Jae-Joon; Yoo, Chul-Gyu; Kim, Young Whan; Han, Sung Koo; Choi, Sun Mi

    2016-01-01

    Purpose Chronic obstructive pulmonary disease (COPD) is associated with increased postoperative complications. Recently, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classified COPD patients into four groups based on spirometry results and the severity of symptoms. The objective of this study was to evaluate the impact of GOLD groups on postoperative complications. Patients and methods We reviewed the medical records of COPD patients who underwent preoperative spirometry between April and August 2013 at a tertiary hospital in Korea. We divided the patients into GOLD groups according to the results of spirometry and self-administered questionnaires that assessed the symptom severity and exacerbation history. GOLD groups, demographic characteristics, and operative conditions were analyzed. Results Among a total of 405 COPD patients, 70 (17.3%) patients experienced various postoperative complications, including infection, wound, or pulmonary complications. Thoracic surgery, upper abdominal surgery, general anesthesia, large estimated blood loss during surgery, and longer anesthesia time were significant risk factors for postoperative complications. Patients in high-risk group (GOLD groups C or D) had an increased risk of postoperative complications compared to those in low-risk group (GOLD groups A or B). Conclusion COPD patients in GOLD groups representing a high exacerbation risk have an increased risk of postoperative complications compared to those with low risk. PMID:26929613

  14. Organizational technologies of chronic disease management programs in large rural multispecialty group practice systems.

    PubMed

    Gamm, Larry; Bolin, Jane Nelson; Kash, Bita A

    2005-01-01

    Four large rural multispecialty group practice systems employ a mix of organizational technologies to provide chronic disease management with measurable impacts on their patient populations and costs. Four technologies-administrative, clinical, information, and social-are proposed as key dimensions for examining disease management programs. The benefits of disease management are recognized by these systems despite marked variability in the organization of the programs. Committees spanning health plans and clinics in the 4 systems and electronic medical records and/or other disease management information systems are important coordinating mechanisms. Increased reliance on nurses for patient education and care coordination in all 4 systems reflects significant extension of clinical and social technologies in the management of patient care. The promise of disease management as offered by these systems and other auspices are considered.

  15. Multimodal Guided Self-Help Exercise Program to Prevent Speech, Swallowing, and Shoulder Problems Among Head and Neck Cancer Patients: A Feasibility Study

    PubMed Central

    Cnossen, Ingrid C; van Uden-Kraan, Cornelia F; Rinkel, Rico NPM; Aalders, IJke J; de Goede, Cees JT; de Bree, Remco; Doornaert, Patricia; Rietveld, Derek HF; Langendijk, Johannes A; Witte, Birgit I; Leemans, C Rene

    2014-01-01

    Background During a 6-week course of (chemo)radiation many head and neck cancer patients have to endure radiotherapy-induced toxicity, negatively affecting patients’ quality of life. Pretreatment counseling combined with self-help exercises could be provided to inform patients and possibly prevent them from having speech, swallowing, and shoulder problems during and after treatment. Objective Our goal was to investigate the feasibility of a multimodal guided self-help exercise program entitled Head Matters during (chemo)radiation in head and neck cancer patients. Methods Head and neck cancer patients treated with primary (chemo)radiation or after surgery were asked to perform Head Matters at home. This prophylactic exercise program, offered in three different formats, aims to reduce the risk of developing speech, swallowing, shoulder problems, and a stiff neck. Weekly coaching was provided by a speech and swallowing therapist. Patients filled out a diary to keep track of their exercise activity. To gain insight into possible barriers and facilitators to exercise adherence, reports of weekly coaching sessions were analyzed by 2 coders independently. Results Of 41 eligible patients, 34 patients were willing to participate (83% uptake). Of participating patients, 21 patients completed the program (64% adherence rate). The majority of participants (58%) had a moderate to high level of exercise performance. Exercise performance level was not significantly associated with age (P=.50), gender (P=.42), tumor subsite (P=1.00) or tumor stage (P=.20), treatment modality (P=.72), or Head Matters format (Web-based or paper) (P=1.00). Based on patients’ diaries and weekly coaching sessions, patients’ perceived barriers to exercise were a decreased physical condition, treatment-related barriers, emotional problems, lack of motivation, social barriers, and technical problems. Patients’ perceived facilitators included an increased physical condition, feeling motivated, and

  16. A content analysis of chronic diseases social groups on Facebook and Twitter.

    PubMed

    De la Torre-Díez, Isabel; Díaz-Pernas, Francisco Javier; Antón-Rodríguez, Míriam

    2012-01-01

    Research on the use of social networks for health-related purposes is limited. This study aims to characterize the purpose and use of Facebook and Twitter groups concerning colorectal cancer, breast cancer, and diabetes. We searched in Facebook ( www.facebook.com ) and Twitter ( www.twitter.com ) using the terms "colorectal cancer," "breast cancer," and "diabetes." Each important group has been analyzed by extracting its network name, number of members, interests, and Web site URL. We found 216 breast cancer groups, 171 colorectal cancer groups, and 527 diabetes groups on Facebook and Twitter. The largest percentage of the colorectal cancer groups (25.58%) addresses prevention, similarly to breast cancer, whereas diabetes groups are mainly focused on research issues (25.09%). There are more social groups about breast cancer and diabetes on Facebook (around 82%) than on Twitter (around 18%). Regarding colorectal cancer, the difference is less: Facebook had 62.23%, and Twitter 31.76%. Social networks are a useful tool for supporting patients suffering from these three diseases. Regarding the use of these social networks for disease support purposes, Facebook shows a higher usage rate than Twitter, perhaps because Twitter is newer than Facebook, and its use is not so generalized.

  17. Estimating the contribution of genetic variants to difference in incidence of disease between population groups.

    PubMed

    Moonesinghe, Ramal; Ioannidis, John P A; Flanders, W Dana; Yang, Quanhe; Truman, Benedict I; Khoury, Muin J

    2012-08-01

    Genome-wide association studies have identified multiple genetic susceptibility variants to several complex human diseases. However, risk-genotype frequency at loci showing robust associations might differ substantially among different populations. In this paper, we present methods to assess the contribution of genetic variants to the difference in the incidence of disease between different population groups for different scenarios. We derive expressions for the contribution of a single genetic variant, multiple genetic variants, and the contribution of the joint effect of a genetic variant and an environmental factor to the difference in the incidence of disease. The contribution of genetic variants to the difference in incidence increases with increasing difference in risk-genotype frequency, but declines with increasing difference in incidence between the two populations. The contribution of genetic variants also increases with increasing relative risk and the contribution of joint effect of genetic and environmental factors increases with increasing relative risk of the gene-environmental interaction. The contribution of genetic variants to the difference in incidence between two populations can be expressed as a function of the population attributable risks of the genetic variants in the two populations. The contribution of a group of genetic variants to the disparity in incidence of disease could change considerably by adding one more genetic variant to the group. Any estimate of genetic contribution to the disparity in incidence of disease between two populations at this stage seems to be an elusive goal.

  18. Treatment of Depression and Anxiety in Parkinson's Disease: A Pilot Study Using Group Cognitive Behavioural Therapy

    ERIC Educational Resources Information Center

    Feeney, Farah; Egan, Sarah; Gasson, Natalie

    2005-01-01

    Depression and anxiety affect up to 50% of people with Parkinson's Disease (PD) (Marsh, 2000; Murray, 1996), however, few studies have examined the effectiveness of psychological treatment. This study examined the effectiveness of group cognitive behaviour therapy (CBT) in treating depression and anxiety in PD. Four participants, aged between 56…

  19. Teaching Direct Practice Techniques for Work with Elders with Alzheimer's Disease: A Simulated Group Experience.

    ERIC Educational Resources Information Center

    Kane, Michael N.

    2003-01-01

    A role-play exercise about Alzheimer's disease was designed to teach group work with memory-impaired elders. Written comments from 26 social work students revealed four outcomes: demystifying practical knowledge, respect for diversity among memory-impaired individuals, increased awareness of elders' internal states, and awareness of the challenges…

  20. Synonymy of strains of Center for Disease Control group DF-1 with species of Capnocytophaga.

    PubMed

    Williams, B L; Hollis, D; Holdeman, L V

    1979-10-01

    Of eight strains of Center for Disease Control group DF-1 examined, seven had 62 to 87% deoxyribonucleic acid homology with the neotype strain of Capnocytophaga ochracea and one had 72% deoxyribonucleic acid homology with the type strain of C. gingivalis. Deoxyribonucleic acid homology of four strains of Bacteroides ochraceus with the neotype strain of C. ochrecea was 76 to 86%.

  1. Procedures for prevention of perinatal group B streptococcal diseases: a multicenter questionnaire survey of hospitals in the Kyoto Neonatal Disease Study Group, Japan.

    PubMed

    Matsubara, Kousaku; Kawai, Masahiko; Nakahata, Tatsutoshi; Kato, Fumihide; Tsukahara, Hirokazu; Yamakawa, Masaru; Hashimoto, Kazuhiro; Shimada, Seiichi; Maeda, Shinji; Okumura, Mitsuyoshi; Kanaoka, Hiroo

    2007-02-01

    To explore clinical protocols for the prevention of early-onset group B Streptococcus (EOGBS) disease of the newborn in Japan, we conducted a multicenter questionnaire survey. Of 32 regional centers participating in the Kyoto Neonatal Study Group, 28 provided usable data concerning prevention practices undertaken between 2000 and 2004. Twenty-three (82%) of the 28 hospitals implemented bacteriological screening to identify maternal GBS carriage, and all 23 hospitals administered intrapartum antibiotics to all screening-positive pregnant women. There were no institutes that used risk-based strategies. In the 23 hospitals, bacteriological screening was conducted mostly by lower vaginal swab alone (n = 18). Eighteen hospitals performed screening once during pregnancy, either before 34 weeks' gestation (n = 6) or between 35 and 37 weeks' gestation (n = 12). Oral antepartum antibiotics, when carriage was identified, were administered at 12 (52%) hospitals. Twenty institutes used penicillins for intrapartum prophylaxis. However, the loading dose for chemoprophylaxis ranged from 0.5 to 2 g, and the interval between repeat administrations ranged from 4 to 12 h. Although the results indicated that more than 80% of the hospitals surveyed had introduced some screening-based prevention practices, the timing of the bacteriological screening during the pregnancy, the number of screenings, and the screening sites, as well as the antibiotics used, and their dosage, varied widely. Because of these highly variable methods, the efficacy of the implementation of preventive practices could not be determined. This study is the first to have described preventive practices for EOGBS disease in Japan in the era of Centers for Disease Control and Prevention guidelines. In light of the above results, a larger study under a unifying protocol would be warranted.

  2. Prevention of perinatal group B streptococcal disease--revised guidelines from CDC, 2010.

    PubMed

    Verani, Jennifer R; McGee, Lesley; Schrag, Stephanie J

    2010-11-19

    Despite substantial progress in prevention of perinatal group B streptococcal (GBS) disease since the 1990s, GBS remains the leading cause of early-onset neonatal sepsis in the United States. In 1996, CDC, in collaboration with relevant professional societies, published guidelines for the prevention of perinatal group B streptococcal disease (CDC. Prevention of perinatal group B streptococcal disease: a public health perspective. MMWR 1996;45[No. RR-7]); those guidelines were updated and republished in 2002 (CDC. Prevention of perinatal group B streptococcal disease: revised guidelines from CDC. MMWR 2002;51[No. RR-11]). In June 2009, a meeting of clinical and public health representatives was held to reevaluate prevention strategies on the basis of data collected after the issuance of the 2002 guidelines. This report presents CDC's updated guidelines, which have been endorsed by the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, the American College of Nurse-Midwives, the American Academy of Family Physicians, and the American Society for Microbiology. The recommendations were made on the basis of available evidence when such evidence was sufficient and on expert opinion when available evidence was insufficient. The key changes in the 2010 guidelines include the following: • expanded recommendations on laboratory methods for the identification of GBS, • clarification of the colony-count threshold required for reporting GBS detected in the urine of pregnant women, • updated algorithms for GBS screening and intrapartum chemoprophylaxis for women with preterm labor or preterm premature rupture of membranes, • a change in the recommended dose of penicillin-G for chemoprophylaxis, • updated prophylaxis regimens for women with penicillin allergy, and • a revised algorithm for management of newborns with respect to risk for early-onset GBS disease. Universal screening at 35-37 weeks' gestation for maternal GBS

  3. Behavioural activation versus mindfulness-based guided self-help treatment administered through a smartphone application: a randomised controlled trial

    PubMed Central

    Ly, Kien Hoa; Trüschel, Anna; Jarl, Linnea; Magnusson, Susanna; Windahl, Tove; Johansson, Robert; Carlbring, Per; Andersson, Gerhard

    2014-01-01

    Objectives Evaluating and comparing the effectiveness of two smartphone-delivered treatments: one based on behavioural activation (BA) and other on mindfulness. Design Parallel randomised controlled, open, trial. Participants were allocated using an online randomisation tool, handled by an independent person who was separate from the staff conducting the study. Setting General community, with recruitment nationally through mass media and advertisements. Participants 40 participants diagnosed with major depressive disorder received a BA treatment, and 41 participants received a mindfulness treatment. 9 participants were lost at the post-treatment. Intervention BA: An 8-week long behaviour programme administered via a smartphone application. Mindfulness: An 8-week long mindfulness programme, administered via a smartphone application. Main outcome measures The Beck Depression Inventory-II (BDI-II) and the nine-item Patient Health Questionnaire Depression Scale (PHQ-9). Results 81 participants were randomised (mean age 36.0 years (SD=10.8)) and analysed. Results showed no significant interaction effects of group and time on any of the outcome measures either from pretreatment to post-treatment or from pretreatment to the 6-month follow-up. Subgroup analyses showed that the BA treatment was more effective than the mindfulness treatment among participants with higher initial severity of depression from pretreatment to the 6-month follow-up (PHQ-9: F (1, 362.1)=5.2, p<0.05). In contrast, the mindfulness treatment worked better than the BA treatment among participants with lower initial severity from pretreatment to the 6-month follow-up (PHQ-9: F (1, 69.3)=7.7, p<0.01); BDI-II: (F(1, 53.60)=6.25, p<0.05). Conclusions The two interventions did not differ significantly from one another. For participants with higher severity of depression, the treatment based on BA was superior to the treatment based on mindfulness. For participants with lower initial severity, the

  4. Guided self-help as intervention for traumatic stress in parents of children with cancer: conceptualization, intervention strategies, and a case study.

    PubMed

    Cernvall, Martin; Carlbring, Per; Ljungman, Gustaf; von Essen, Louise

    2013-01-01

    Being a parent of a child diagnosed with cancer poses an enormous stressor. Indeed, several parents have difficulties adjusting to such a situation and react with symptoms of traumatic stress, depression, and reduced quality of life. However, there is little conceptual work on behavioral mechanisms that contribute to suboptimal adaptation in these parents. The authors present a conceptualization in which experiential avoidance and rumination are suggested to contribute to increased levels of traumatic stress and suboptimal adaption. Based on this conceptualization, a recently developed intervention for parents of children with cancer, in the form of guided self-help, is presented. Finally, the authors present a successful case study as an example of the application of this intervention. Clinical implications and suggestions for future research are discussed.

  5. Chronic Disease Self-Management and Health Literacy in Four Ethnic Groups

    PubMed Central

    SHAW, SUSAN J.; ARMIN, JULIE; TORRES, CRISTINA HUEBNER; ORZECH, KATHRYN M.; VIVIAN, JAMES

    2012-01-01

    Research from several fields has explored health literacy as a multidimensional construct. The authors’ multimethod study, “The Impact of Cultural Differences on Health Literacy and Chronic Disease Outcomes,” assessed health literacy and chronic disease self-management among 296 patients from four ethnic groups (Vietnamese, African American, White, Latino) at a Massachusetts community health center between 2006 and 2010. Health literacy was assessed using the short form of the Test of Functional Health Literacy in Adults (S-TOFHLA), the Rapid Estimate of Adult Literacy in Medicine (REALM), and the Short Assessment of Health Literacy for Spanish-speaking Adults (SAHLSA) measures. Qualitative research methods, including in-depth interviews (n = 34), home visits (n = 12), chronic disease diaries (n = 15), and focus groups (n = 47), were completed with a subset of participants. Qualitative interviews indicated a wide range of interpretations of S-TOFHLA questions in which participants substituted their own illness or health care experiences for the abstract examples offered in the instrument, at times leading to incorrect responses. Situating these responses in a broader social and cultural context, this article describes examples of the wide range of chronic disease self-management abilities among participants with limited education and/or low health literacy. It also discusses the culturally variable health beliefs identified among participants interviewed that may play important roles in their chronic disease self-management practices. PMID:23030562

  6. Trade-offs in group living: transmission and disease resistance in leaf-cutting ants.

    PubMed Central

    Hughes, William O H; Eilenberg, Jørgen; Boomsma, Jacobus J

    2002-01-01

    Sociality can be associated with significant costs due to the increased risk of disease transmission. However, in some organisms the costs may be offset by benefits due to improvements in defences against parasites. To examine this possible trade-off between infection risk and disease resistance, we used Acromyrmex leaf-cutting ants and the entomopathogenic fungus Metarhizium anisopliae as the model system. Ants exposed to the parasite were found to have substantially improved survival when they were kept with nest-mates, while the cost of being in a group in terms of increased disease transmission was very low. The efficiency of transmission is described by the transmission parameter, which decreased with increasing host density showing that transmission rates are inversely density dependent. Both grooming and antibiotic secretions appeared to be important in resistance against the parasite, with the defences of small workers being particularly effective. The results indicate that leaf-cutting ant colonies may have much greater resistance to disease than would be predicted from the high densities of host individuals within them. Unlike most organisms, group living in these ants may actually be associated with a net benefit in terms of disease dynamics. PMID:12350269

  7. Risk groups for yellow fever vaccine-associated viscerotropic disease (YEL-AVD).

    PubMed

    Seligman, Stephen J

    2014-10-01

    Although previously considered as the safest of the live virus vaccines, reports published since 2001 indicate that live yellow fever virus vaccine can cause a severe, often fatal, multisystemic illness, yellow fever vaccine-associated viscerotropic disease (YEL-AVD), that resembles the disease it was designed to prevent. This review was prompted by the availability of a listing of the cumulative cases of YEL-AVD, insights from a statistical method for analyzing risk factors and re-evaluation of previously published data. The purpose of this review is to identify and analyze risk groups based on gender, age, outcome and predisposing illnesses. Using a passive surveillance system in the US, the incidence was reported as 0.3 to 0.4 cases per 100,000. However, other estimates range from 0 to 12 per 100,000. Identified and potential risk groups for YEL-AVD include elderly males, women between the ages of 19 and 34, people with a variety of autoimmune diseases, individuals who have been thymectomized because of thymoma, and infants and children ≤11 years old. All but the last group are supported by statistical analysis. The confirmed risk groups account for 77% (49/64) of known cases and 76% (32/42) of the deaths. The overall case fatality rate is 66% (42/64) with a rate of 80% (12/15) in young women, in contrast to 50% (13/26) in men ≥56 years old. Recognition of YEL-AVD raises the possibility that similar reactions to live chimeric flavivirus vaccines that contain a yellow fever virus vaccine backbone could occur in susceptible individuals. Delineation of risk groups focuses the search for genetic mutations resulting in immune defects associated with a given risk group. Lastly, identification of risk groups encourages concentration on measures to decrease both the incidence and the severity of YEL-AVD.

  8. The Association between Invasive Group A Streptococcal Diseases and Viral Respiratory Tract Infections

    PubMed Central

    Herrera, Andrea L.; Huber, Victor C.; Chaussee, Michael S.

    2016-01-01

    Viral infections of the upper respiratory tract are associated with a variety of invasive diseases caused by Streptococcus pyogenes, the group A streptococcus, including pneumonia, necrotizing fasciitis, toxic shock syndrome, and bacteremia. While these polymicrobial infections, or superinfections, are complex, progress has been made in understanding the molecular basis of disease. Areas of investigation have included the characterization of virus-induced changes in innate immunity, differences in bacterial adherence and internalization following viral infection, and the efficacy of vaccines in mitigating the morbidity and mortality of superinfections. Here, we briefly summarize viral-S. pyogenes superinfections with an emphasis on those affiliated with influenza viruses. PMID:27047460

  9. The Association between Invasive Group A Streptococcal Diseases and Viral Respiratory Tract Infections.

    PubMed

    Herrera, Andrea L; Huber, Victor C; Chaussee, Michael S

    2016-01-01

    Viral infections of the upper respiratory tract are associated with a variety of invasive diseases caused by Streptococcus pyogenes, the group A streptococcus, including pneumonia, necrotizing fasciitis, toxic shock syndrome, and bacteremia. While these polymicrobial infections, or superinfections, are complex, progress has been made in understanding the molecular basis of disease. Areas of investigation have included the characterization of virus-induced changes in innate immunity, differences in bacterial adherence and internalization following viral infection, and the efficacy of vaccines in mitigating the morbidity and mortality of superinfections. Here, we briefly summarize viral-S. pyogenes superinfections with an emphasis on those affiliated with influenza viruses. PMID:27047460

  10. The Role of Support Groups in the Treatment of Eating Disorders.

    ERIC Educational Resources Information Center

    Enright, Amy Baker; Tootell, Colleen

    1986-01-01

    Discusses the benefits of support, the format and design of existing self-help and support groups for individuals with eating disorders, and current controversies on the use of these groups. (Author/ABB)

  11. Raised serum activity of phospholipase A2 immunochemically related to group II enzyme in inflammatory bowel disease: its correlation with disease activity of Crohn's disease and ulcerative colitis.

    PubMed Central

    Minami, T; Tojo, H; Shinomura, Y; Tarui, S; Okamoto, M

    1992-01-01

    Calcium dependent phospholipase A2 activity in the mixed micelles of 1-palmitoyl-2-oleoyl-phosphatidylglycerol and cholate was measured in sera of 39 patients with Crohn's disease, 40 patients with ulcerative colitis, and 40 healthy controls. The phospholipase A2 activity was significantly raised in those sera of the patients with active Crohn's disease and those with moderate and severe ulcerative colitis. The major phospholipase A2 activity derived from the sera was separated into two peaks by reverse phase high performance liquid chromatography. The phospholipase A2 active fractions were immunochemically characterised using specific antibody directed against human group II phospholipase A2 purified from rheumatoid synovial fluid. The results suggest that raised serum phospholipase A2 activity in patients with Crohn's disease and ulcerative colitis was mainly attributed to the two forms of phospholipase A2 immunochemically related to group II enzyme. In patients with Crohn's disease, serum phospholipase A2 activity decreased in parallel with clinical improvement, and correlated with serum C-reactive protein and erythrocyte sedimentation rate. The results suggest that serum phospholipase A2 activity may serve as an additional indicator of disease activity. Serum phospholipase A2 activity in patients with ulcerative colitis tends to increase in relation with endoscopic severity, and may be a more sensitive laboratory index than serum C-reactive protein and erythrocyte sedimentation rate to evaluate disease activity. Images Figure 3 PMID:1644331

  12. Effect of Duration of Disease on Ventilatory Function in an Ethnic Saudi Group of Diabetic Patients

    PubMed Central

    Meo, Sultan A.; Al Drees, Abdul Majeed; Ahmed, Jehangeer; Ahmed Shah, Sayed Fayaz; Al-Regaiey, Khalid; Husain, Ashraf; Al-Rubean, Khalid

    2007-01-01

    Background Diabetes mellitus is a leading cause of illness and death across the world and is responsible for a growing proportion of global health care expenditures. The present study was designed to observe the effect of diabetes mellitus on lung function in patients with diabetes belonging to a specific ethnic group, namely Saudis. Method In this study, a group of 47 apparently healthy volunteer male Saudi patients with diabetes was randomly selected. Their ages ranged from 20 to 70 years. The patients were matched with another group of 50 healthy male control subjects in terms of age, height, weight, ethnicity, and socioeconomic status. Both groups met exclusion criteria as per standard. Spirometry was performed with an electronic spirometer (Schiller AT-2 Plus, Switzerland), and results were compared by a Student's t test. Results Subjects with diabetes showed a significant reduction in forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) relative to their matched controls. However, there were no significant differences in the forced expiratory ratio (FEV1/FVC%) and the middle half of the FVC (FEF25–75%) between the groups. We observed a significantly negative correlation between duration of disease and pulmonary function, as measured by FEV1 (r = 0.258, p = 0.04), FVC (r = 0.282, p = 0.28), and the middle half of the FVC (FEF25–75%) (r = 0.321, p = 0.014). Conclusions Pulmonary function in a specific ethnic group of patients with diabetes was impaired as evidenced by a decrease in FVC and FEV1 compared to pulmonary function in matched controls. Stratification of results by years of disease revealed a significant correlation between duration of disease and a decline in pulmonary function. PMID:19885139

  13. Detection of Alzheimer's disease using group lasso SVM-based region selection

    NASA Astrophysics Data System (ADS)

    Sun, Zhuo; Fan, Yong; Lelieveldt, Boudewijn P. F.; van de Giessen, Martijn

    2015-03-01

    Alzheimer's disease (AD) is one of the most frequent forms of dementia and an increasing challenging public health problem. In the last two decades, structural magnetic resonance imaging (MRI) has shown potential in distinguishing patients with Alzheimer's disease and elderly controls (CN). To obtain AD-specific biomarkers, previous research used either statistical testing to find statistically significant different regions between the two clinical groups, or l1 sparse learning to select isolated features in the image domain. In this paper, we propose a new framework that uses structural MRI to simultaneously distinguish the two clinical groups and find the bio-markers of AD, using a group lasso support vector machine (SVM). The group lasso term (mixed l1- l2 norm) introduces anatomical information from the image domain into the feature domain, such that the resulting set of selected voxels are more meaningful than the l1 sparse SVM. Because of large inter-structure size variation, we introduce a group specific normalization factor to deal with the structure size bias. Experiments have been performed on a well-designed AD vs. CN dataset1 to validate our method. Comparing to the l1 sparse SVM approach, our method achieved better classification performance and a more meaningful biomarker selection. When we vary the training set, the selected regions by our method were more stable than the l1 sparse SVM. Classification experiments showed that our group normalization lead to higher classification accuracy with fewer selected regions than the non-normalized method. Comparing to the state-of-art AD vs. CN classification methods, our approach not only obtains a high accuracy with the same dataset, but more importantly, we simultaneously find the brain anatomies that are closely related to the disease.

  14. Peer Interaction and Group Education for Adaptation to Disease in Adolescents with Type 1 Diabetes Mellitus

    PubMed Central

    Altundag, Sebahat; Bayat, Meral

    2016-01-01

    Objective: To evaluate the effects of group interaction and training in the adaptation process to disease in adolescents with type 1 diabetes mellitus (T1DM). Methods: This experimental study with pre- and post-test control groups was conducted in the pediatric endocrine clinic at a university hospital. The data were collected through descriptive data form, social support assessment scale, self-esteem inventory and information form. The data collection forms were administered four times with 3-month intervals to the study and control groups. Training, peer interaction and social support attempts were provided to the study group. Results: After the training and peer interaction, it was determined that there was a decrease in HbA1c levels and an increase in self-esteem (p<0.001) and mean scores of social support (p<0.05), and significant increase in knowledge levels (p<0.001). As for the adolescents in the control group, it was determined that there was no change in their HbA1c levels (p>0.05), and that there was no difference in their self-esteem scores, mean knowledge levels (p>0.05) in comparison with their pre-test scores. Conclusion: The training and peer interaction in adolescents were found to be effective in the adaptation process to the disease. PMID:27648058

  15. Peer Interaction and Group Education for Adaptation to Disease in Adolescents with Type 1 Diabetes Mellitus

    PubMed Central

    Altundag, Sebahat; Bayat, Meral

    2016-01-01

    Objective: To evaluate the effects of group interaction and training in the adaptation process to disease in adolescents with type 1 diabetes mellitus (T1DM). Methods: This experimental study with pre- and post-test control groups was conducted in the pediatric endocrine clinic at a university hospital. The data were collected through descriptive data form, social support assessment scale, self-esteem inventory and information form. The data collection forms were administered four times with 3-month intervals to the study and control groups. Training, peer interaction and social support attempts were provided to the study group. Results: After the training and peer interaction, it was determined that there was a decrease in HbA1c levels and an increase in self-esteem (p<0.001) and mean scores of social support (p<0.05), and significant increase in knowledge levels (p<0.001). As for the adolescents in the control group, it was determined that there was no change in their HbA1c levels (p>0.05), and that there was no difference in their self-esteem scores, mean knowledge levels (p>0.05) in comparison with their pre-test scores. Conclusion: The training and peer interaction in adolescents were found to be effective in the adaptation process to the disease.

  16. Neonatal group B streptococcus disease in developing countries: are we ready to deploy a vaccine?

    PubMed

    Iroh Tam, Pui-Ying; Delair, Shirley F; Obaro, Stephen K

    2015-01-01

    Group B streptococcus (GBS) disease is the leading cause of neonatal sepsis in developed countries and has high case fatality rates. In developing countries, however, the burden of GBS is less clear; this is due to a lack of studies using optimal diagnostic, clinical and laboratory techniques and is complicated by the wide availability of non-prescription antibiotics to the general population and in peripartum patients. There is an urgent need for prospective, population-based surveillance to provide an accurate assessment of neonatal GBS disease burden in developing countries, which remains largely unrecognized, and consequently obscures the potential relevance of GBS vaccination in these populations. Preliminary data on GBS vaccines are promising as a preventive tool for neonatal GBS infection, more so than any other currently available public health initiative. However, how do we assess the true impact of a GBS vaccine without accurate surveillance data on the real burden of disease? PMID:26289974

  17. Neonatal group B streptococcus disease in developing countries: are we ready to deploy a vaccine?

    PubMed

    Iroh Tam, Pui-Ying; Delair, Shirley F; Obaro, Stephen K

    2015-01-01

    Group B streptococcus (GBS) disease is the leading cause of neonatal sepsis in developed countries and has high case fatality rates. In developing countries, however, the burden of GBS is less clear; this is due to a lack of studies using optimal diagnostic, clinical and laboratory techniques and is complicated by the wide availability of non-prescription antibiotics to the general population and in peripartum patients. There is an urgent need for prospective, population-based surveillance to provide an accurate assessment of neonatal GBS disease burden in developing countries, which remains largely unrecognized, and consequently obscures the potential relevance of GBS vaccination in these populations. Preliminary data on GBS vaccines are promising as a preventive tool for neonatal GBS infection, more so than any other currently available public health initiative. However, how do we assess the true impact of a GBS vaccine without accurate surveillance data on the real burden of disease?

  18. Absence of Multiple Sclerosis and Demyelinating Diseases among Lacandonians, a Pure Amerindian Ethnic Group in Mexico.

    PubMed

    Flores, Jose; González, Silvia; Morales, Ximena; Yescas, Petra; Ochoa, Adriana; Corona, Teresa

    2012-01-01

    Multiple Sclerosis (MS) is a highly polymorphic disease characterized by different neurologic signs and symptoms. In MS, racial and genetic factors may play an important role in the geographic distribution of this disease. Studies have reported the presence of several protective alleles against the development of autoimmune disorders. In the case of MS, however, they help define MS as a complex disease, and confirm the importance of environmental agents as an independent variable not associated with ethnicity. We carried out an on-site epidemiological study to confirm the absence of MS or NMO among Lacandonians, a pure Amerindian ethnic group in Mexico. We administered a structured interview to 5,372 Lacandonians to assess by family background any clinical data consistent with the presence of a prior demyelinating event. Every participating subject underwent a comprehensive neurological examination by a group of three members of the research team with experience in the diagnosis and treatment of demyelinating disorders to detect clinical signs compatible with a demyelinating disease. We did not find any clinical signs compatible with multiple sclerosis among study participants.

  19. Absence of Multiple Sclerosis and Demyelinating Diseases among Lacandonians, a Pure Amerindian Ethnic Group in Mexico

    PubMed Central

    Flores, Jose; González, Silvia; Morales, Ximena; Yescas, Petra; Ochoa, Adriana; Corona, Teresa

    2012-01-01

    Multiple Sclerosis (MS) is a highly polymorphic disease characterized by different neurologic signs and symptoms. In MS, racial and genetic factors may play an important role in the geographic distribution of this disease. Studies have reported the presence of several protective alleles against the development of autoimmune disorders. In the case of MS, however, they help define MS as a complex disease, and confirm the importance of environmental agents as an independent variable not associated with ethnicity. We carried out an on-site epidemiological study to confirm the absence of MS or NMO among Lacandonians, a pure Amerindian ethnic group in Mexico. We administered a structured interview to 5,372 Lacandonians to assess by family background any clinical data consistent with the presence of a prior demyelinating event. Every participating subject underwent a comprehensive neurological examination by a group of three members of the research team with experience in the diagnosis and treatment of demyelinating disorders to detect clinical signs compatible with a demyelinating disease. We did not find any clinical signs compatible with multiple sclerosis among study participants. PMID:22973516

  20. Graded Exercise Therapy Guided Self-Help Trial for Patients with Chronic Fatigue Syndrome (GETSET): Protocol for a Randomized Controlled Trial and Interview Study

    PubMed Central

    McCrone, Paul; Ridge, Damien; Cheshire, Anna; Vergara-Williamson, Mario; Pesola, Francesca; White, Peter D

    2016-01-01

    Background Chronic fatigue syndrome, also known as myalgic encephalomyelitis (CFS/ME), is characterized by chronic disabling fatigue and other symptoms, which are not explained by an alternative diagnosis. Previous trials have suggested that graded exercise therapy (GET) is an effective and safe treatment. GET itself is therapist-intensive with limited availability. Objective While guided self-help based on cognitive behavior therapy appears helpful to patients, Guided graded Exercise Self-help (GES) is yet to be tested. Methods This pragmatic randomized controlled trial is set within 2 specialist CFS/ME services in the South of England. Adults attending secondary care clinics with National Institute for Health and Clinical Excellence (NICE)-defined CFS/ME (N=218) will be randomly allocated to specialist medical care (SMC) or SMC plus GES while on a waiting list for therapist-delivered rehabilitation. GES will consist of a structured booklet describing a 6-step graded exercise program, supported by up to 4 face-to-face/telephone/Skype™ consultations with a GES-trained physiotherapist (no more than 90 minutes in total) over 8 weeks. The primary outcomes at 12-weeks after randomization will be physical function (SF-36 physical functioning subscale) and fatigue (Chalder Fatigue Questionnaire). Secondary outcomes will include healthcare costs, adverse outcomes, and self-rated global impression change scores. We will follow up all participants until 1 year after randomization. We will also undertake qualitative interviews of a sample of participants who received GES, looking at perceptions and experiences of those who improved and worsened. Results The project was funded in 2011 and enrolment was completed in December 2014, with follow-up completed in March 2016. Data analysis is currently underway and the first results are expected to be submitted soon. Conclusions This study will indicate whether adding GES to SMC will benefit patients who often spend many months

  1. International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma.

    PubMed

    Kumar, Shaji; Paiva, Bruno; Anderson, Kenneth C; Durie, Brian; Landgren, Ola; Moreau, Philippe; Munshi, Nikhil; Lonial, Sagar; Bladé, Joan; Mateos, Maria-Victoria; Dimopoulos, Meletios; Kastritis, Efstathios; Boccadoro, Mario; Orlowski, Robert; Goldschmidt, Hartmut; Spencer, Andrew; Hou, Jian; Chng, Wee Joo; Usmani, Saad Z; Zamagni, Elena; Shimizu, Kazuyuki; Jagannath, Sundar; Johnsen, Hans E; Terpos, Evangelos; Reiman, Anthony; Kyle, Robert A; Sonneveld, Pieter; Richardson, Paul G; McCarthy, Philip; Ludwig, Heinz; Chen, Wenming; Cavo, Michele; Harousseau, Jean-Luc; Lentzsch, Suzanne; Hillengass, Jens; Palumbo, Antonio; Orfao, Alberto; Rajkumar, S Vincent; San Miguel, Jesus; Avet-Loiseau, Herve

    2016-08-01

    Treatment of multiple myeloma has substantially changed over the past decade with the introduction of several classes of new effective drugs that have greatly improved the rates and depth of response. Response criteria in multiple myeloma were developed to use serum and urine assessment of monoclonal proteins and bone marrow assessment (which is relatively insensitive). Given the high rates of complete response seen in patients with multiple myeloma with new treatment approaches, new response categories need to be defined that can identify responses that are deeper than those conventionally defined as complete response. Recent attempts have focused on the identification of residual tumour cells in the bone marrow using flow cytometry or gene sequencing. Furthermore, sensitive imaging techniques can be used to detect the presence of residual disease outside of the bone marrow. Combining these new methods, the International Myeloma Working Group has defined new response categories of minimal residual disease negativity, with or without imaging-based absence of extramedullary disease, to allow uniform reporting within and outside clinical trials. In this Review, we clarify several aspects of disease response assessment, along with endpoints for clinical trials, and highlight future directions for disease response assessments. PMID:27511158

  2. Multistimulation group therapy in Alzheimer's disease promotes changes in brain functioning.

    PubMed

    Baglio, Francesca; Griffanti, Ludovica; Saibene, Francesca Lea; Ricci, Cristian; Alberoni, Margherita; Critelli, Raffaella; Villanelli, Fabiana; Fioravanti, Raffaella; Mantovani, Federica; D'amico, Alessandra; Cabinio, Monia; Preti, Maria Giulia; Nemni, Raffaello; Farina, Elisabetta

    2015-01-01

    Background. The growing social emergency represented by Alzheimer's disease (AD) and the lack of medical treatments able to modify the disease course have kindled the interest in nonpharmacological therapies. Objective. We introduced a novel nonpharmacological approach for people with AD (PWA) named Multidimensional Stimulation group Therapy (MST) to improve PWA condition in different disease domains: cognition, behavior, and motor functioning. Methods. Enrolling 60 PWA in a mild to moderate stage of the disease, we evaluated the efficacy of MST with a randomized-controlled study. Neuropsychological and neurobehavioral measures and functional magnetic resonance imaging (fMRI) data were considered as outcome measures. Results. The following significant intervention-related changes were observed: reduction in Neuropsychiatric Inventory scale score, improvement in language and memory subscales of Alzheimer's Disease Assessment Scale-Cognitive subscale, and increased fMRI activations in temporal brain areas, right insular cortex, and thalamus. Conclusions. Cognitive-behavioral and fMRI results support the notion that MST has significant effects in improving PWA cognitive-behavioral status by restoring neural functioning.

  3. Stroke in Children With Cardiac Disease: Report From the International Pediatric Stroke Study Group Symposium

    PubMed Central

    Sinclair, Adriane J.; Fox, Christine K.; Ichord, Rebecca N.; Almond, Christopher S.; Bernard, Timothy J.; Beslow, Lauren A.; Chan, Anthony K.C.; Cheung, Michael; deVeber, Gabrielle; Dowling, Michael M.; Friedman, Neil; Giglia, Therese M.; Guilliams, Kristin P.; Humpl, Tilman; Licht, Daniel J.; Mackay, Mark T.; Jordan, Lori C.

    2016-01-01

    BACKGROUND Cardiac disease is a leading cause of stroke in children, yet limited data support the current stroke prevention and treatment recommendations. A multidisciplinary panel of clinicians was convened in February 2014 by the International Pediatric Stroke Study group to identify knowledge gaps and prioritize clinical research efforts for children with cardiac disease and stroke. RESULTS Significant knowledge gaps exist, including a lack of data on stroke incidence, predictors, primary and secondary stroke prevention, hyperacute treatment, and outcome in children with cardiac disease. Commonly used diagnostic techniques including brain computed tomography and ultrasound have low rates of stroke detection, and diagnosis is frequently delayed. The challenges of research studies in this population include epidemiologic barriers to research such as small patient numbers, heterogeneity of cardiac disease, and coexistence of multiple risk factors. Based on stroke burden and study feasibility, studies involving mechanical circulatory support, single ventricle patients, early stroke detection strategies, and understanding secondary stroke risk factors and prevention are the highest research priorities over the next 5-10 years. The development of large-scale multicenter and multispecialty collaborative research is a critical next step. The designation of centers of expertise will assist in clinical care and research. CONCLUSIONS There is an urgent need for additional research to improve the quality of evidence in guideline recommendations for cardiogenic stroke in children. Although significant barriers to clinical research exist, multicenter and multispecialty collaboration is an important step toward advancing clinical care and research for children with cardiac disease and stroke. PMID:25532775

  4. International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma.

    PubMed

    Kumar, Shaji; Paiva, Bruno; Anderson, Kenneth C; Durie, Brian; Landgren, Ola; Moreau, Philippe; Munshi, Nikhil; Lonial, Sagar; Bladé, Joan; Mateos, Maria-Victoria; Dimopoulos, Meletios; Kastritis, Efstathios; Boccadoro, Mario; Orlowski, Robert; Goldschmidt, Hartmut; Spencer, Andrew; Hou, Jian; Chng, Wee Joo; Usmani, Saad Z; Zamagni, Elena; Shimizu, Kazuyuki; Jagannath, Sundar; Johnsen, Hans E; Terpos, Evangelos; Reiman, Anthony; Kyle, Robert A; Sonneveld, Pieter; Richardson, Paul G; McCarthy, Philip; Ludwig, Heinz; Chen, Wenming; Cavo, Michele; Harousseau, Jean-Luc; Lentzsch, Suzanne; Hillengass, Jens; Palumbo, Antonio; Orfao, Alberto; Rajkumar, S Vincent; San Miguel, Jesus; Avet-Loiseau, Herve

    2016-08-01

    Treatment of multiple myeloma has substantially changed over the past decade with the introduction of several classes of new effective drugs that have greatly improved the rates and depth of response. Response criteria in multiple myeloma were developed to use serum and urine assessment of monoclonal proteins and bone marrow assessment (which is relatively insensitive). Given the high rates of complete response seen in patients with multiple myeloma with new treatment approaches, new response categories need to be defined that can identify responses that are deeper than those conventionally defined as complete response. Recent attempts have focused on the identification of residual tumour cells in the bone marrow using flow cytometry or gene sequencing. Furthermore, sensitive imaging techniques can be used to detect the presence of residual disease outside of the bone marrow. Combining these new methods, the International Myeloma Working Group has defined new response categories of minimal residual disease negativity, with or without imaging-based absence of extramedullary disease, to allow uniform reporting within and outside clinical trials. In this Review, we clarify several aspects of disease response assessment, along with endpoints for clinical trials, and highlight future directions for disease response assessments.

  5. Demographics and Disease Prevalence of Two New Refugee Groups in San Francisco

    PubMed Central

    McCaw, Brigid R.; DeLay, Paul

    1985-01-01

    Of all the Ethiopian (N=110) and Afghan (N=59)refugees seen at the Refugee Screening Clinic at San Francisco General Hospital Medical Center between May 1982 and July 1983, most were young men and more than 80% of each group were unable to speak English. The most frequently noted medical conditions in both groups were pathogenic parasites, dental caries and skin disorders. Most had positive PPD tests, but only a few cases of class A or class B tuberculosis were found. Among the Ethiopians two active cases each of Plasmodium vivax malaria and trachoma were diagnosed. Although a wide range of diseases were seen, most were common rather than exotic. In addition to the need for translators, traditional beliefs and customs must be sensitively considered when providing health care to these groups. PMID:4036130

  6. Group comparison of spatiotemporal dynamics of intrinsic networks in Parkinson's disease.

    PubMed

    Madhyastha, Tara M; Askren, Mary K; Zhang, Jing; Leverenz, James B; Montine, Thomas J; Grabowski, Thomas J

    2015-09-01

    right insula, an area implicated in network shifting and associated with cognitive impairment in Parkinson's disease, was more highly correlated with both these networks in Parkinson's disease than in controls. In Parkinson's disease, increased correlation of the insula with the default mode network was related to lower attentional accuracy. We demonstrated that in an omnibus sense, correlations among network kernels describe biological impact of pathophysiological processes (through correlation with cerebrospinal fluid biomarkers) and clinical status (by classification of patient group). At a greater level of detail, we demonstrate aberrant involvement of the insula in the default mode network and the frontal frontoparietal task control network kernel. Network kernel analysis holds promise as a sensitive method for detecting biologically and clinical relevant changes to specific networks that support cognition and are impaired in Parkinson's disease. PMID:26173859

  7. Group comparison of spatiotemporal dynamics of intrinsic networks in Parkinson's disease.

    PubMed

    Madhyastha, Tara M; Askren, Mary K; Zhang, Jing; Leverenz, James B; Montine, Thomas J; Grabowski, Thomas J

    2015-09-01

    right insula, an area implicated in network shifting and associated with cognitive impairment in Parkinson's disease, was more highly correlated with both these networks in Parkinson's disease than in controls. In Parkinson's disease, increased correlation of the insula with the default mode network was related to lower attentional accuracy. We demonstrated that in an omnibus sense, correlations among network kernels describe biological impact of pathophysiological processes (through correlation with cerebrospinal fluid biomarkers) and clinical status (by classification of patient group). At a greater level of detail, we demonstrate aberrant involvement of the insula in the default mode network and the frontal frontoparietal task control network kernel. Network kernel analysis holds promise as a sensitive method for detecting biologically and clinical relevant changes to specific networks that support cognition and are impaired in Parkinson's disease.

  8. Selling an Energy Efficiency Loan Portfolio in Oregon: Resale of the Craft3 loan portfolio to Self-Help Credit Union

    SciTech Connect

    Thompson, Peter; Borgeson, Merrian; Kramer, Chris; Zimring, Mark; Goldman, Charles

    2014-05-30

    Under the Clean Energy Works (CEW) program, Craft3 developed a loan product that widened access to financing for homeowners, offered long term funding, and collected repayments through the customer?s utility bill. The program?s success led Craft3 to pursue the sale of the loan portfolio to both mitigate its own risks and replenish funds for lending. This sale breaks new ground for energy efficiency finance and is notable as it was completed even with many novel program design elements. It replenished Craft3?s program capital and uncovered some valuable lessons that may facilitate future transactions. However, the lack of data history and the unproven nature of the loan portfolio meant that Craft3 had to limit the risk of losses to Self-Help, the purchaser of the portfolio. It remains to be seen whether this experience will pave the way for more sales of on-bill energy efficiency loan portfolios. This case study illustrates how certain program design decisions can sometimes both facilitate programmatic objectives and possibly present challenges for the sale of a portfolio of energy efficiency loans.

  9. Internet-based guided self-help intervention for chronic pain based on Acceptance and Commitment Therapy: a randomized controlled trial.

    PubMed

    Trompetter, Hester R; Bohlmeijer, Ernst T; Veehof, Martine M; Schreurs, Karlein M G

    2015-02-01

    Acceptance-based psychological interventions can potentially minimize the burden of chronic pain. This randomized controlled trial evaluated an internet-delivered, guided self-help intervention based on Acceptance and Commitment Therapy (ACT). A total of 238 chronic pain sufferers from the general population were randomly allocated to either ACT (n = 82), an internet-based control condition Expressive Writing (n = 79) or a waiting list condition (n = 77). Participants completed measures at baseline, posttreatment (3 months) and at a 3-month follow-up. At follow-up, ACT participants had improved in pain interference in daily life (primary outcome) compared to participants in Expressive Writing (Cohen's d = .47), but not compared to waiting list participants (p value = .11). Those who adhered to the ACT-intervention (48%) did improve significantly compared to waiting list participants (d = .49). ACT-participants also showed superior improvement on depression, pain intensity, psychological inflexibility and pain catastrophizing (d: .28-.60). Significant clinical improvement was present. Especially, 28% of ACT-participants showed general clinically relevant improvement in pain interference, as well as in pain intensity and depression (vs. Expressive Writing and waiting list 5%). Given these findings, internet-based ACT programs may be a promising treatment modality for chronic pain.

  10. Serotype IV and invasive group B Streptococcus disease in neonates, Minnesota, USA, 2000-2010.

    PubMed

    Ferrieri, Patricia; Lynfield, Ruth; Creti, Roberta; Flores, Aurea E

    2013-04-01

    Group B Streptococcus (GBS) is a major cause of invasive disease in neonates in the United States. Surveillance of invasive GBS disease in Minnesota, USA, during 2000-2010 yielded 449 isolates from 449 infants; 257 had early-onset (EO) disease (by age 6 days) and 192 late-onset (LO) disease (180 at age 7-89 days, 12 at age 90-180 days). Isolates were characterized by capsular polysaccharide serotype and surface-protein profile; types III and Ia predominated. However, because previously uncommon serotype IV constitutes 5/31 EO isolates in 2010, twelve type IV isolates collected during 2000-2010 were studied further. By pulsed-field gel electrophoresis, they were classified into 3 profiles; by multilocus sequence typing, representative isolates included new sequence type 468. Resistance to clindamycin or erythromycin was detected in 4/5 serotype IV isolates. Emergence of serotype IV GBS in Minnesota highlights the need for serotype prevalence monitoring to detect trends that could affect prevention strategies.

  11. [Late-onset Group B Streptococcus disease in twins delivered by caesarean section].

    PubMed

    Escolano Serrano, S; Ruiz Alcántara, I; Alfonso Diego, J; González Muñoz, A; Gastaldo Simeón, E

    2015-01-01

    Group B Streptococcus (GBS) is a commensal pathogen of the gut microflora with a well-established role in the aetiology of early and late onset GBS infections in the newborn. The incidence of early onset infections by vertical transmission has been drastically reduced in recent decades with the use of intravenous intrapartum prophylaxis. Progress in risk factor detection and prophylaxis of late-onset infection has however remained static. The ongoing modifications and improvements of the guidelines regarding prophylaxis, risk factors and prevention of the early-onset GBS disease have not addressed late-onset GBS infection in detail. The following cases illustrate the presence of grey areas in current guidelines and in the knowledge of the pathogenesis of late-onset disease.

  12. Variation in reported neonatal group B streptococcal disease incidence in developing countries.

    PubMed

    Dagnew, Alemnew F; Cunnington, Marianne C; Dube, Queen; Edwards, Morven S; French, Neil; Heyderman, Robert S; Madhi, Shabir A; Slobod, Karen; Clemens, Sue Ann Costa

    2012-07-01

    Group B Streptococcus (GBS) is a leading cause of neonatal sepsis in developed countries. Its burden in the developing world is less clear. Studies reporting neonatal GBS disease incidence from developing countries were identified from 5 literature databases. Studies were assessed with respect to case finding and culture methods. Only 20 studies were identified. The GBS incidence ranged 0-3.06 per 1000 live births with variation within and between geographic regions. All but 1 study identified GBS cases within a hospital setting, despite the potential for births in the community. Possible case under-ascertainment was only discussed in 2 studies. A higher GBS incidence was reported when using automated culture methods. Prospective, population-based surveillance is urgently needed in developing countries to provide an accurate assessment of the neonatal GBS disease burden. This will be crucial for the design of interventions, including novel vaccines, and the understanding of their potential to impact mortality from neonatal sepsis. PMID:22523262

  13. [Schizophrenia or a group of endogenous diseases? The past and the present].

    PubMed

    Smulevich, A B

    2015-01-01

    A critical analysis of the main concepts of schizophrenia (from the Kraepelin paradigm to the current studies attempted to «destruct» schizophrenia as nosologically independent disease) is presented. In author's opinion, the elimination of schizophrenia may lead to negative consequences as in aspect of clinical practice (the diagnosis of schizophrenia provides information about disease course, clinical and social outcomes) as well as in aspect of denial of autochthonous (endogenous) origin of mental disorders that fall under this definition. Based on the current level of knowledge, manifestation of these disorders can't be well explained by the adverse effects of situational, psychogenic or somatogenic factors. The restriction of the definition of schizophrenia («process» schizophrenia) should be brought about by the elimination of a group of schizophrenia spectrum disorders (schizotypal disorder, schizoaffective disorder, delusional psychosis).

  14. [Gaucher disease in Latin America. A report from the Gaucher Disease International Registry and the Latin American Group for Gaucher Disease].

    PubMed

    Drelichman, Guillermo; Linares, Adriana; Villalobos, Jacobo; Cabello, Juan Francisco; Kerstenetzky, Marcelo; Kohan, Regina M; Martins, Ana María

    2012-01-01

    Gaucher disease -due to its low frequency- is considered an orphan disease. In 1991 the International Gaucher Registry was created and in 1992 the first patients from Latin America were enrolled. In 2008 the Latin American Group for Gaucher Disease was initiated. Its main objectives are to promote regional consensus, to stimulate the enrollment of patients into the International Gaucher Registry and the enhancement of knowledge on this disease, and to achieve better care and quality of life of patients in our Region. Until April 2010, 5828 patients have been enrolled all around the world, 911 (15.6%) from Latin America. This is the first comprehensive report of the disease in the Region. In our population there is a predominance of females, the most common clinical form is the type I (95%) and the age at diagnosis is before 20 years in 68% of patients. The most frequent clinical manifestations at diagnosis are splenomegaly (96%) and anemia (49%). Eighty percent of patients had radiographic findings of bone involvement. In our Region, the vast majority of patients (89%) had received enzyme replacement therapy with imiglucerase; with a long follow-up (up to 10 years) they have achieved the therapeutic goals, showing the great effectiveness of therapy. While the percentage of patients with therapy is high, discontinuations are common. The main deficiencies in our Region are: the lack of visceral volumetric evaluations and densitometries as well as molecular analysis for some patients. The main problem is the under-diagnosis of patients. PMID:22892077

  15. ESC Working Group on Valvular Heart Disease Position Paper: assessing the risk of interventions in patients with valvular heart disease

    PubMed Central

    Rosenhek, Raphael; Iung, Bernard; Tornos, Pilar; Antunes, Manuel J.; Prendergast, Bernard D.; Otto, Catherine M.; Kappetein, Arie Pieter; Stepinska, Janina; Kaden, Jens J.; Naber, Christoph K.; Acartürk, Esmeray; Gohlke-Bärwolf, Christa

    2012-01-01

    Aims Risk scores provide an important contribution to clinical decision-making, but their validity has been questioned in patients with valvular heart disease (VHD), since current scores have been mainly derived and validated in adults undergoing coronary bypass surgery. The Working Group on Valvular Heart Disease of the European Society of Cardiology reviewed the performance of currently available scores when applied to VHD, in order to guide clinical practice and future development of new scores. Methods and results The most widely used risk scores (EuroSCORE, STS, and Ambler score) were reviewed, analysing variables included and their predictive ability when applied to patients with VHD. These scores provide relatively good discrimination, i.e. a gross estimation of risk category, but cannot be used to estimate the exact operative mortality in an individual patient because of unsatisfactory calibration. Conclusion Current risk scores do not provide a reliable estimate of exact operative mortality in an individual patient with VHD. They should therefore be interpreted with caution and only used as part of an integrated approach, which incorporates other patient characteristics, the clinical context, and local outcome data. Future risk scores should include additional variables, such as cognitive and functional capacity and be prospectively validated in high-risk patients. Specific risk models should also be developed for newer interventions, such as transcatheter aortic valve implantation. PMID:21406443

  16. Invasive Group B Streptococcal Disease in South Africa: Importance of Surveillance Methodology

    PubMed Central

    Cohen, Cheryl; von Gottberg, Anne; Meiring, Susan; Cutland, Clare L.; Schrag, Stephanie J.; Madhi, Shabir A.

    2016-01-01

    Data on neonatal group B streptococcal (GBS) invasive disease burden are needed to refine prevention policies. Differences in surveillance methods and investigating for cases can lead to varying disease burden estimates. We compared the findings of laboratory-based passive surveillance for GBS disease across South Africa, and for one of the provinces compared this to a real-time, systematic, clinical surveillance in a population-defined region in Johannesburg, Soweto. Passive surveillance identified a total of 799 early-onset disease (EOD, <7 days age) and 818 LOD (late onset disease, 7–89 days age) cases nationwide. The passive surveillance provincial incidence varied for EOD (range 0.00 to 1.23/1000 live births), and was 0.03 to 1.04/1000 live births for LOD. The passive surveillance rates for Soweto, were not significantly different compared to those from the systematic surveillance (EOD 1.23 [95%CI 1.06–1.43] vs. 1.50 [95%CI 1.30–1.71], respectively, rate ratio 0.82 [95%CI 0.67–1.01]; LOD 1.04 [95% CI 0.90–1.23] vs. 1.22 [95%CI 1.05–1.42], rate ratio 0.85 [95% CI 0.68–1.07]). A review of the few cases missed in the passive system in Soweto, suggested that missing key identifiers, such as date of birth, resulted in their omission during the electronic data extraction process. Our analysis suggests that passive surveillance provides a modestly lower estimate of invasive GBS rates compared to real time sentinel-site systematic surveillance, however, this is unlikely to be the reason for the provincial variability in incidence of invasive GBS disease in South Africa. This, possibly reflects that invasive GBS disease goes undiagnosed due to issues related to access to healthcare, poor laboratory capacity and varying diagnostic procedures or empiric antibiotic treatment of neonates with suspected sepsis in the absence of attempting to making a microbiological diagnosis. An efficacious GBS vaccine for pregnant women, when available, could be used as a

  17. Invasive Group B Streptococcal Disease in South Africa: Importance of Surveillance Methodology.

    PubMed

    Quan, Vanessa; Verani, Jennifer R; Cohen, Cheryl; von Gottberg, Anne; Meiring, Susan; Cutland, Clare L; Schrag, Stephanie J; Madhi, Shabir A

    2016-01-01

    Data on neonatal group B streptococcal (GBS) invasive disease burden are needed to refine prevention policies. Differences in surveillance methods and investigating for cases can lead to varying disease burden estimates. We compared the findings of laboratory-based passive surveillance for GBS disease across South Africa, and for one of the provinces compared this to a real-time, systematic, clinical surveillance in a population-defined region in Johannesburg, Soweto. Passive surveillance identified a total of 799 early-onset disease (EOD, <7 days age) and 818 LOD (late onset disease, 7-89 days age) cases nationwide. The passive surveillance provincial incidence varied for EOD (range 0.00 to 1.23/1000 live births), and was 0.03 to 1.04/1000 live births for LOD. The passive surveillance rates for Soweto, were not significantly different compared to those from the systematic surveillance (EOD 1.23 [95%CI 1.06-1.43] vs. 1.50 [95%CI 1.30-1.71], respectively, rate ratio 0.82 [95%CI 0.67-1.01]; LOD 1.04 [95% CI 0.90-1.23] vs. 1.22 [95%CI 1.05-1.42], rate ratio 0.85 [95% CI 0.68-1.07]). A review of the few cases missed in the passive system in Soweto, suggested that missing key identifiers, such as date of birth, resulted in their omission during the electronic data extraction process. Our analysis suggests that passive surveillance provides a modestly lower estimate of invasive GBS rates compared to real time sentinel-site systematic surveillance, however, this is unlikely to be the reason for the provincial variability in incidence of invasive GBS disease in South Africa. This, possibly reflects that invasive GBS disease goes undiagnosed due to issues related to access to healthcare, poor laboratory capacity and varying diagnostic procedures or empiric antibiotic treatment of neonates with suspected sepsis in the absence of attempting to making a microbiological diagnosis. An efficacious GBS vaccine for pregnant women, when available, could be used as a probe to better

  18. Second malignancies complicating Hodgkin's disease: a Southwest Oncology Group 10-year followup

    SciTech Connect

    Coltman, C.A. Jr.; Dixon, D.O.

    1982-04-01

    Thirty-two second malignancies (21 acute leukemias and 11 solid tumors) were identified among 659 patients with all stages of Hodgkin's disease treated by members of the Southwest Oncology Group. There were no leukemias and one solid tumor among 95 patients treated with radiotherapy alone. The actuarial risk of developing acute leukemia at 7 years was 6.2% for chemotherapy alone, 6.4% for combined modality, and 7.7% for salvage chemotherapy. The incidence of acute leukemia was higher (P . 0.002) among those whose treatment began at greater than or equal to 40 years of age. The actuarial risk of leukemia in that group was 20.7% at 7 years. These data are compatible with the hypothesis that chemotherapy alone, combined modality, and salvage chemotherapy have an equivalent oncogenic potential and that patients greater than or equal to 40 years of age have an enhanced susceptibility to these oncogenic stimuli.

  19. International Myeloma Working Group Recommendations for the Treatment of Multiple Myeloma–Related Bone Disease

    PubMed Central

    Terpos, Evangelos; Morgan, Gareth; Dimopoulos, Meletios A.; Drake, Matthew T.; Lentzsch, Suzanne; Raje, Noopur; Sezer, Orhan; García-Sanz, Ramón; Shimizu, Kazuyuki; Turesson, Ingemar; Reiman, Tony; Jurczyszyn, Artur; Merlini, Giampaolo; Spencer, Andrew; Leleu, Xavier; Cavo, Michele; Munshi, Nikhil; Rajkumar, S. Vincent; Durie, Brian G.M.; Roodman, G. David

    2013-01-01

    Purpose The aim of the International Myeloma Working Group was to develop practice recommendations for the management of multiple myeloma (MM) –related bone disease. Methodology An interdisciplinary panel of clinical experts on MM and myeloma bone disease developed recommendations based on published data through August 2012. Expert consensus was used to propose additional recommendations in situations where there were insufficient published data. Levels of evidence and grades of recommendations were assigned and approved by panel members. Recommendations Bisphosphonates (BPs) should be considered in all patients with MM receiving first-line antimyeloma therapy, regardless of presence of osteolytic bone lesions on conventional radiography. However, it is unknown if BPs offer any advantage in patients with no bone disease assessed by magnetic resonance imaging or positron emission tomography/computed tomography. Intravenous (IV) zoledronic acid (ZOL) or pamidronate (PAM) is recommended for preventing skeletal-related events in patients with MM. ZOL is preferred over oral clodronate in newly diagnosed patients with MM because of its potential antimyeloma effects and survival benefits. BPs should be administered every 3 to 4 weeks IV during initial therapy. ZOL or PAM should be continued in patients with active disease and should be resumed after disease relapse, if discontinued in patients achieving complete or very good partial response. BPs are well tolerated, but preventive strategies must be instituted to avoid renal toxicity or osteonecrosis of the jaw. Kyphoplasty should be considered for symptomatic vertebral compression fractures. Low-dose radiation therapy can be used for palliation of uncontrolled pain, impending pathologic fracture, or spinal cord compression. Orthopedic consultation should be sought for long-bone fractures, spinal cord compression, and vertebral column instability. PMID:23690408

  20. Cervical insufficiency: a new issue for guidelines on prevention of perinatal group B streptococcal disease?

    PubMed

    Natale, Fabio; Brunelli, Roberto; Bizzarri, Bianca; Castronovo, Antonella; De Curtis, Mario

    2013-02-01

    The updated Guidelines on Prevention of Perinatal Group B Streptococcal Disease, issued by the Centers for Disease Control and Prevention, actually represent the mainstay in the prevention of neonatal early-onset group B streptococcal (GBS) sepsis. According to these guidelines, patients with possible preterm delivery are screened for GBS colonization and offered intrapartum prophylaxis only if they enter preterm labor or experience preterm premature rupture of the membranes. Nonetheless, the fulfillment of these recommendations seems to be suboptimal in clinical practice, as it is heavily influenced by the knowledge of the colonization status. We report here 2 cases of blood culture-proven, early-onset neonatal GBS sepsis involving preterm infants delivered by mothers who had midtrimester cervical insufficiency and bulging membranes. Midtrimester acute cervical insufficiency strongly predicts preterm delivery. These women are liable to miss intrapartum antibiotic prophylaxis because they typically have shorter labor, and the test results for GBS status are unlikely to be available before delivery. We believe that women with midtrimester cervical insufficiency and bulging membranes should be screened for GBS infection soon after hospital admittance if the gestational age is close to the threshold of fetal viability. A timely diagnosis of GBS colonization may not only increase the number of patients receiving targeted intrapartum antibiotic prophylaxis but would also allow consideration of the administration of antepartum antibiotic prophylaxis. Indeed, as further outlined in this report, GBS intraamniotic infection may dramatically occur before the onset of preterm labor or preterm premature rupture of the membranes.

  1. Efficacy of an internet-based self-help intervention to reduce co-occurring alcohol misuse and depression symptoms in adults: study protocol of a three-arm randomised controlled trial

    PubMed Central

    Schaub, Michael P; Blankers, Matthijs; Lehr, Dirk; Boss, Leif; Riper, Heleen; Dekker, Jack; Goudriaan, Anna E; Maier, Larissa J; Haug, Severin; Amann, Manuel; Dey, Michelle; Wenger, Andreas; Ebert, David D

    2016-01-01

    Introduction In the general population, alcohol use disorder and depression more often occur together than any other combination of a mental illness with a substance use disorder. It is important to have a cost-effective intervention that is able to reach at-risk individuals in the early stages of developing alcohol use disorders and depression disorders. Methods and analysis This paper presents the protocol for a 3-arm multicentre randomised controlled trial (RCT) to test the efficacy and cost-effectiveness of the combined internet-based self-help intervention Take Care of You (TCOY) to reduce alcohol misuse and depression symptoms in comparison with a waiting list control group and a comparable intervention focusing on problematic alcohol use only. The active interventions consist of modules designed to reduce alcohol use, based on the principles of motivational interviewing and methods of cognitive behavioural therapy, together with additional modules in the combined study arm to reduce symptoms of depression. Data will be collected at baseline, as well as at 3 and 6 months postrandomisation. The primary outcome is the quantity of alcohol used in the past 7 days. A number of secondary outcome measures will be studied. These include the Centre of Epidemiologic Studies of Depression Scale (CES-D) and a combined measure with the criteria of values below the cut-off for severe alcohol use disorder and for CES-D. Data analysis will follow the intention-to-treat principle using (generalised) linear mixed models. In order to investigate the interventions’ cost-utility and cost-effectiveness, a full economic evaluation will be performed. Ethics and dissemination This RCT will be executed in compliance with the Helsinki Declaration and has been approved by 2 local Ethics Committees. Results will be reported at conferences and in peer-reviewed publications. Participant-friendly summaries of trial findings will be published on the TCOY websites. Trial registration

  2. Health Social Networks as Online Life Support Groups for Patients With Cardiovascular Diseases

    PubMed Central

    Medina, Edhelmira Lima; Loques, Orlando; Mesquita, Cláudio Tinoco

    2013-01-01

    The number of patients who use the internet in search for information that might improve their health conditions has increased. Among them, those looking for virtual environments to share experiences, doubts, opinions, and emotions, and to foster relationships aimed at giving and getting support stand out. Therefore, there is an increasing need to assess how those environments can affect the patients' health. This study was aimed at identifying scientific studies on the proliferation and impact of virtual communities, known as health social networks or online support groups, directed to cardiovascular diseases, which might be useful to patients with certain conditions, providing them with information and emotional support. A systematic review of the literature was conducted with articles published from 2007 to 2012, related to cardiovascular diseases and collected from the following databases: PubMed; Association for Computing Machinery(ACM); and Institute of Electrical and Electronics Engineers (IEEE). Four articles meeting the inclusion criteria were selected. The results were interesting and relevant from the health viewpoint, identifying therapeutic benefits, such as provision of emotional support, greater compliance to treatment, and information sharing on diseases and on life experiences. PMID:24030085

  3. Participants' Evaluation of Educational/Support Groups for Families of Patients with Alzheimer's Disease and Other Dementias.

    ERIC Educational Resources Information Center

    Glosser, Guila; Wexler, Debra

    1985-01-01

    Participants (N=54) of seven eight-week educational/support groups for relatives of patients with Alzheimer's disease and other dementias evaluated the helpfulness of their group experience. The supportive aspects of the group and the information provided about medical and behavioral management of the patient were most highly rated. (Author/NRB)

  4. Synthesis of organophosphates with fluorine-containing leaving groups as serine esterase inhibitors with potential for Alzheimer disease therapeutics.

    PubMed

    Makhaeva, Galina F; Aksinenko, Alexey Y; Sokolov, Vladimir B; Serebryakova, Olga G; Richardson, Rudy J

    2009-10-01

    Acetylcholinesterase and butyrylcholinesterase inhibitors are potential cognition enhancers in Alzheimer disease. O,O-Dialkylphosphate inhibitors with 1-substituted 2,2,2-trifluoroethoxy leaving groups were synthesized by phosphonate-phosphate rearrangement. Substituents in the 1-position of the leaving group along with the O-alkyl groups modulated potency and selectivity against acetylcholinesterase, butyrylcholinesterase, and carboxylesterase.

  5. URBAN COMMUNITY DEVELOPMENT AND THE INDIAN SLUM, A CASE STUDY (IN SLUMS AND COMMUNITY DEVELOPMENT, EXPERIMENTS IN SELF-HELP, BY MARSHALL B. CLINARD. NEW YORK, THE FREE PRESS, 1966/139-278).

    ERIC Educational Resources Information Center

    CLINARD, MARSHALL B.

    THE DELHI PILOT PROJECT IN URBAN COMMUNITY DEVELOPMENT, DESIGNED TO STIMULATE CITIZEN PARTICIPATION, INDIGENOUS LEADERSHIP, AND SELF- HELP ACTIVITIES TO ALLEVIATE SLUM CONDITIONS, WAS INITIATED BY THE MUNICIPAL GOVERNMENT (AIDED BY FORD FOUNDATION GRANTS) IN 1958. SLUM DWELLERS WERE ORGANIZED INTO--(1) VIKAS SUBHAS (ZONE COUNCILS) OF 15-100…

  6. Quantitative Amyloid Imaging in Autosomal Dominant Alzheimer's Disease: Results from the DIAN Study Group.

    PubMed

    Su, Yi; Blazey, Tyler M; Owen, Christopher J; Christensen, Jon J; Friedrichsen, Karl; Joseph-Mathurin, Nelly; Wang, Qing; Hornbeck, Russ C; Ances, Beau M; Snyder, Abraham Z; Cash, Lisa A; Koeppe, Robert A; Klunk, William E; Galasko, Douglas; Brickman, Adam M; McDade, Eric; Ringman, John M; Thompson, Paul M; Saykin, Andrew J; Ghetti, Bernardino; Sperling, Reisa A; Johnson, Keith A; Salloway, Stephen P; Schofield, Peter R; Masters, Colin L; Villemagne, Victor L; Fox, Nick C; Förster, Stefan; Chen, Kewei; Reiman, Eric M; Xiong, Chengjie; Marcus, Daniel S; Weiner, Michael W; Morris, John C; Bateman, Randall J; Benzinger, Tammie L S

    2016-01-01

    Amyloid imaging plays an important role in the research and diagnosis of dementing disorders. Substantial variation in quantitative methods to measure brain amyloid burden exists in the field. The aim of this work is to investigate the impact of methodological variations to the quantification of amyloid burden using data from the Dominantly Inherited Alzheimer's Network (DIAN), an autosomal dominant Alzheimer's disease population. Cross-sectional and longitudinal [11C]-Pittsburgh Compound B (PiB) PET imaging data from the DIAN study were analyzed. Four candidate reference regions were investigated for estimation of brain amyloid burden. A regional spread function based technique was also investigated for the correction of partial volume effects. Cerebellar cortex, brain-stem, and white matter regions all had stable tracer retention during the course of disease. Partial volume correction consistently improves sensitivity to group differences and longitudinal changes over time. White matter referencing improved statistical power in the detecting longitudinal changes in relative tracer retention; however, the reason for this improvement is unclear and requires further investigation. Full dynamic acquisition and kinetic modeling improved statistical power although it may add cost and time. Several technical variations to amyloid burden quantification were examined in this study. Partial volume correction emerged as the strategy that most consistently improved statistical power for the detection of both longitudinal changes and across-group differences. For the autosomal dominant Alzheimer's disease population with PiB imaging, utilizing brainstem as a reference region with partial volume correction may be optimal for current interventional trials. Further investigation of technical issues in quantitative amyloid imaging in different study populations using different amyloid imaging tracers is warranted.

  7. Quantitative Amyloid Imaging in Autosomal Dominant Alzheimer’s Disease: Results from the DIAN Study Group

    PubMed Central

    Su, Yi; Blazey, Tyler M.; Owen, Christopher J.; Christensen, Jon J.; Friedrichsen, Karl; Joseph-Mathurin, Nelly; Wang, Qing; Hornbeck, Russ C.; Ances, Beau M.; Snyder, Abraham Z.; Cash, Lisa A.; Koeppe, Robert A.; Klunk, William E.; Galasko, Douglas; Brickman, Adam M.; McDade, Eric; Ringman, John M.; Thompson, Paul M.; Saykin, Andrew J.; Ghetti, Bernardino; Sperling, Reisa A.; Johnson, Keith A.; Salloway, Stephen P.; Schofield, Peter R.; Masters, Colin L.; Villemagne, Victor L.; Fox, Nick C.; Förster, Stefan; Chen, Kewei; Reiman, Eric M.; Xiong, Chengjie; Marcus, Daniel S.; Weiner, Michael W.; Morris, John C.; Bateman, Randall J.; Benzinger, Tammie L. S.

    2016-01-01

    Amyloid imaging plays an important role in the research and diagnosis of dementing disorders. Substantial variation in quantitative methods to measure brain amyloid burden exists in the field. The aim of this work is to investigate the impact of methodological variations to the quantification of amyloid burden using data from the Dominantly Inherited Alzheimer’s Network (DIAN), an autosomal dominant Alzheimer’s disease population. Cross-sectional and longitudinal [11C]-Pittsburgh Compound B (PiB) PET imaging data from the DIAN study were analyzed. Four candidate reference regions were investigated for estimation of brain amyloid burden. A regional spread function based technique was also investigated for the correction of partial volume effects. Cerebellar cortex, brain-stem, and white matter regions all had stable tracer retention during the course of disease. Partial volume correction consistently improves sensitivity to group differences and longitudinal changes over time. White matter referencing improved statistical power in the detecting longitudinal changes in relative tracer retention; however, the reason for this improvement is unclear and requires further investigation. Full dynamic acquisition and kinetic modeling improved statistical power although it may add cost and time. Several technical variations to amyloid burden quantification were examined in this study. Partial volume correction emerged as the strategy that most consistently improved statistical power for the detection of both longitudinal changes and across-group differences. For the autosomal dominant Alzheimer’s disease population with PiB imaging, utilizing brainstem as a reference region with partial volume correction may be optimal for current interventional trials. Further investigation of technical issues in quantitative amyloid imaging in different study populations using different amyloid imaging tracers is warranted. PMID:27010959

  8. Quantitative Amyloid Imaging in Autosomal Dominant Alzheimer's Disease: Results from the DIAN Study Group.

    PubMed

    Su, Yi; Blazey, Tyler M; Owen, Christopher J; Christensen, Jon J; Friedrichsen, Karl; Joseph-Mathurin, Nelly; Wang, Qing; Hornbeck, Russ C; Ances, Beau M; Snyder, Abraham Z; Cash, Lisa A; Koeppe, Robert A; Klunk, William E; Galasko, Douglas; Brickman, Adam M; McDade, Eric; Ringman, John M; Thompson, Paul M; Saykin, Andrew J; Ghetti, Bernardino; Sperling, Reisa A; Johnson, Keith A; Salloway, Stephen P; Schofield, Peter R; Masters, Colin L; Villemagne, Victor L; Fox, Nick C; Förster, Stefan; Chen, Kewei; Reiman, Eric M; Xiong, Chengjie; Marcus, Daniel S; Weiner, Michael W; Morris, John C; Bateman, Randall J; Benzinger, Tammie L S

    2016-01-01

    Amyloid imaging plays an important role in the research and diagnosis of dementing disorders. Substantial variation in quantitative methods to measure brain amyloid burden exists in the field. The aim of this work is to investigate the impact of methodological variations to the quantification of amyloid burden using data from the Dominantly Inherited Alzheimer's Network (DIAN), an autosomal dominant Alzheimer's disease population. Cross-sectional and longitudinal [11C]-Pittsburgh Compound B (PiB) PET imaging data from the DIAN study were analyzed. Four candidate reference regions were investigated for estimation of brain amyloid burden. A regional spread function based technique was also investigated for the correction of partial volume effects. Cerebellar cortex, brain-stem, and white matter regions all had stable tracer retention during the course of disease. Partial volume correction consistently improves sensitivity to group differences and longitudinal changes over time. White matter referencing improved statistical power in the detecting longitudinal changes in relative tracer retention; however, the reason for this improvement is unclear and requires further investigation. Full dynamic acquisition and kinetic modeling improved statistical power although it may add cost and time. Several technical variations to amyloid burden quantification were examined in this study. Partial volume correction emerged as the strategy that most consistently improved statistical power for the detection of both longitudinal changes and across-group differences. For the autosomal dominant Alzheimer's disease population with PiB imaging, utilizing brainstem as a reference region with partial volume correction may be optimal for current interventional trials. Further investigation of technical issues in quantitative amyloid imaging in different study populations using different amyloid imaging tracers is warranted. PMID:27010959

  9. 75 FR 55793 - Cooperative Agreement to Support the Foodborne Disease Burden Epidemiology Reference Group of the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-14

    ... to Estimate the Global Burden of Foodborne Diseases--Foodborne Disease Burden Epidemiology Reference... in specific areas: Infectious diseases, chemicals and toxins, source attribution, and country burden..., the projected, and the averted burden of foodborne disease estimates; conduct epidemiological...

  10. THE BURDEN OF INVASIVE NEONATAL GROUP B STREPTOCOCCAL (GBS) DISEASE IN THAILAND AND THE PHILIPPINES.

    PubMed

    Villanueva-Uy, Ma Esterlita; Wongsiridej, Pimol; Sangtawesin, Varaporn; Chiu, Vivina; Tallo, Veronica; Nazaire-Bermal, Nancy; Bock, Hans; Cunnington, Marianne; Nan, Cassandra; Boudville, Irving

    2015-07-01

    Group B Streptococcus (GBS) is a leading cause of meningitis and sepsis in infancy, but burden of disease data are scarce for Asia. We performed two hospital-based, prospective, descriptive, observational studies using similar protocols in the Philippines and Thailand to evaluate neonatal GBS disease epidemiology. Infants aged <90 days with a GBS-positive culture from normally sterile sites using routine microbiological standards were eligible for inclusion. Awareness of GBS symptoms was raised by informing all women at delivery and follow-up for 90 days post-delivery. Infections were classified as early onset disease (EOD) if they occurred within 6 days of birth and late Onset disease (LOD) if they occurred 7-89 days after birth. Due to ethical requirements in Thailand, consent for study participation, including periodic post-discharge telephone calls, was obtained at delivery. Parents in the Philippines gave consent for study participation at case identification. The clinical outcomes of GBS infections were recorded. During the 6-month study period, two cases (one fatal) of EOD were identified among 8,409 live births at the study hospitals in Thailand and three cases (two fatal) of EOD were identified among 11,768 live births reported at the study hospitals in the Philippines. Incidence rates per 1,000 live births were 0.2 (95% CI: 0.0-0.8) and 0.3 (95% CI: 0.1-0.8) in Thailand and the Philippines, respectively. There were no cases of reported LOD. The low number of cases precluded analysis of serotype distribution and case fatality rates. Large epidemiological studies are needed to better understand the factors influencing GBS infection incidence in Asia.

  11. THE BURDEN OF INVASIVE NEONATAL GROUP B STREPTOCOCCAL (GBS) DISEASE IN THAILAND AND THE PHILIPPINES.

    PubMed

    Villanueva-Uy, Ma Esterlita; Wongsiridej, Pimol; Sangtawesin, Varaporn; Chiu, Vivina; Tallo, Veronica; Nazaire-Bermal, Nancy; Bock, Hans; Cunnington, Marianne; Nan, Cassandra; Boudville, Irving

    2015-07-01

    Group B Streptococcus (GBS) is a leading cause of meningitis and sepsis in infancy, but burden of disease data are scarce for Asia. We performed two hospital-based, prospective, descriptive, observational studies using similar protocols in the Philippines and Thailand to evaluate neonatal GBS disease epidemiology. Infants aged <90 days with a GBS-positive culture from normally sterile sites using routine microbiological standards were eligible for inclusion. Awareness of GBS symptoms was raised by informing all women at delivery and follow-up for 90 days post-delivery. Infections were classified as early onset disease (EOD) if they occurred within 6 days of birth and late Onset disease (LOD) if they occurred 7-89 days after birth. Due to ethical requirements in Thailand, consent for study participation, including periodic post-discharge telephone calls, was obtained at delivery. Parents in the Philippines gave consent for study participation at case identification. The clinical outcomes of GBS infections were recorded. During the 6-month study period, two cases (one fatal) of EOD were identified among 8,409 live births at the study hospitals in Thailand and three cases (two fatal) of EOD were identified among 11,768 live births reported at the study hospitals in the Philippines. Incidence rates per 1,000 live births were 0.2 (95% CI: 0.0-0.8) and 0.3 (95% CI: 0.1-0.8) in Thailand and the Philippines, respectively. There were no cases of reported LOD. The low number of cases precluded analysis of serotype distribution and case fatality rates. Large epidemiological studies are needed to better understand the factors influencing GBS infection incidence in Asia. PMID:26867393

  12. Patient perspectives on the impact of Crohn’s disease: results from group interviews

    PubMed Central

    Norton, Beth-Ann; Thomas, Rosemarie; Lomax, Kathleen G; Dudley-Brown, Sharon

    2012-01-01

    Aim To understand the impact of Crohn’s disease (CD) on various aspects of daily life from the perspective of patients living with CD. Awareness of the disease and biologic therapies, patient satisfaction and adherence, and physician (provider) relationships were also assessed. Background CD is a chronic, inflammatory, autoimmune disorder of the gastrointestinal tract that substantially impacts patients’ physical and emotional well-being. For patients eligible for biologic therapy, anti-tumor necrosis factor agents represent an important addition to the available therapies for CD. Methods The study sample included biologic-naïve and biologic-experienced patients who had self-reported moderate to severe CD, were under the care of a specialist, and agreed to film a video diary and participate in a focus group. Data from the videos and group interviews were collected from May to June of 2009 and summarized qualitatively by grouping similar answers and quotations. Results Of the 44 participants who submitted video diaries, 23 were biologic-experienced and 21 were biologic-naïve. Participants stated that CD caused fear and embarrassment, that they were reluctant to share the full impact of CD with family and providers, and that they relied on their provider for treatment decisions. Many participants accepted a new state of normalcy if their current medication helped their most bothersome symptoms without providing sustained remission. Participants receiving biologic therapy generally were more informed, more satisfied, and more likely to adhere to treatment regimens. Conclusion Participants’ responses suggest a need for more patient education and more collaborative relationships between patients and providers (physicians) regarding treatment decisions. PMID:22879737

  13. Binding of Rabbit Hemorrhagic Disease Virus to Antigens of the ABH Histo-Blood Group Family

    PubMed Central

    Ruvoën-Clouet, Nathalie; Ganière, Jean Pierre; André-Fontaine, Geneviève; Blanchard, Dominique; Le Pendu, Jacques

    2000-01-01

    The ability of rabbit hemorrhagic disease virus to agglutinate human erythrocytes and to attach to rabbit epithelial cells of the upper respiratory and digestive tracts was shown to depend on the presence of ABH blood group antigens. Indeed, agglutination was inhibited by saliva from secretor individuals but not from nonsecretors, the latter being devoid of H antigen. In addition, erythrocytes of the rare Bombay phenotype, which completely lack ABH antigens, were not agglutinated. Native viral particles from extracts of infected rabbit liver as well as virus-like particles from the recombinant virus capsid protein specifically bound to synthetic A and H type 2 blood group oligosaccharides. Both types of particles could attach to adult rabbit epithelial cells of the upper respiratory and digestive tracts. This binding paralleled that of anti-H type 2 blood group reagents and was inhibited by the H type 2-specific lectin UEA-I and polyacrylamide-conjugated H type 2 trisaccharide. Young rabbit tissues were almost devoid of A and H type 2 antigens, and only very weak binding of virus particles could be obtained on these tissues. PMID:11090195

  14. High Mobility Group Box Protein-1 Correlates with Renal Function in Chronic Kidney Disease (CKD)

    PubMed Central

    Bruchfeld, Annette; Qureshi, Abdul Rashid; Lindholm, Bengt; Barany, Peter; Yang, LiHong; Stenvinkel, Peter; Tracey, Kevin J

    2008-01-01

    Chronic kidney disease (CKD) is associated with inflammation and malnutrition and carries a markedly increased risk of cardiovascular disease (CVD). High Mobility Group Box Protein-1 (HMGB-1) is a 30-kDa nuclear and cytosolic protein known as a transcription and growth factor, recently identified as a proinflammatory mediator of tissue injury. Recent data implicates HMGB-1 in endotoxin lethality, rheumatoid arthritis, and atherosclerosis. The aim of this post-hoc, cross-sectional study was to determine whether HMGB-1 serum levels are elevated in CKD patients. The study groups were categorized as follows: 110 patients starting dialysis defined as CKD 5; 67 patients with moderately to severely reduced renal function or CKD 3–4; and 48 healthy controls. High-sensitivity C-reactive-protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor (TNF), serum-albumin (S-albumin), hemoglobin A1c (HbA1c), hemoglobin, subjective global nutritional assessment (SGA), and glomerular filtration rate (GFR) were analyzed. Kruskal-Wallis test was used to compare groups and Spearman’s rank correlation test was used for continuous variables. HMGB-1, measured by Western blot, was significantly (P < 0.001) elevated in CKD 5 (146.7 ± 58.6 ng/mL) and CKD 3–4 (85.6 ± 31.8) compared with controls (10.9 ± 10.5). HMGB-1 levels were correlated positively with TNF (Rho = 0.52; P < 0.001), hs-CRP (Rho = 0.38; P < 0.001), IL-6 (Rho = 0.30; P < 0.001), HbA1c (Rho = 0.14; P = 0.02) and SGA (Rho = 0.21; P = 0.002) and negatively correlated with GFR (Rho = –0.69; P = 0.0001), Hb (Rho = –0.60; P < 0.001), S-albumin (Rho = –0.31; P < 0.001). The current study has revealed that HMGB-1 is elevated significantly in CKD patients and correlates with GFR as well as markers of inflammation and malnutrition. Future studies may delineate whether HMGB-1 is also a marker of disease activity and severity as well as a predictor of outcome in CKD. PMID:18317568

  15. Evaluation of strategies for the control of canola and lupin seedling diseases caused by Rhizoctonia anastomosis groups

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Several methods with potential for the management of Rhizoctonia diseases of canola and lupin including several methods with potential for the management of Rhizoctonia plant resistance, fungicide seed treatment and biological control using binucleate Rhizoctonia anastomosis groups (AGs) were evalua...

  16. The Norwegian Voice Handicap Index (VHI-N) patient scores are dependent on voice-related disease group.

    PubMed

    Karlsen, Tom; Heimdal, John-Helge; Grieg, Anne Rita Hella; Aarstad, Hans Jørgen

    2015-10-01

    The aim of this study is to determine to what extent the Voice Handicap Index-Norwegian (VHI-N) is scored depending on specific laryngological disease. In a multi-center study, 126 healthy subjects and 355 patients with different voice-related diseases answered the VHI-N. The VHI-N scores showed high Cronbach's alpha. Analyses of variance were performed with VHI-N dependent and specific voice-related disease as independent variable, and showed highly significant dependence by group allocation (F(7,461) = 28.0; p < 0.001). When studying post hoc analyses secondary to this ANOVA analysis, we have shown that the control group scored lower than the entire patient groups (all p < 0.001) except the dysplasia group. Aphonic patients scored higher than all the other groups (all p < 0.001) except those with spasmodic dysphonia. The cancer patient group furthermore scored lower than patient groups with recurrent palsy, dysfunctional disease or spasmodic dysphonia (all p < 0.001). In addition, patients with recurrent palsy scored higher than patients with degenerative/inflammatory disease (p < 0.001). No influences of patient age, gender, or smoking were observed in the VHI-N scores. The VHI-N is a psychometrically well-functioning instrument, also at disease-specific levels and discriminates well between health and voice diseases, as well as between different voice-related diseases. The VHI-N may be recommended to be used when monitoring voice-related disease treatment.

  17. RECIST 1.1 - Standardisation and disease-specific adaptations: Perspectives from the RECIST Working Group.

    PubMed

    Schwartz, Lawrence H; Seymour, Lesley; Litière, Saskia; Ford, Robert; Gwyther, Stephen; Mandrekar, Sumithra; Shankar, Lalitha; Bogaerts, Jan; Chen, Alice; Dancey, Janet; Hayes, Wendy; Hodi, F Stephen; Hoekstra, Otto S; Huang, Erich P; Lin, Nancy; Liu, Yan; Therasse, Patrick; Wolchok, Jedd D; de Vries, Elisabeth

    2016-07-01

    Radiologic imaging of disease sites plays a pivotal role in the management of patients with cancer. Response Evaluation Criteria in Solid Tumours (RECIST), introduced in 2000, and modified in 2009, has become the de facto standard for assessment of response in solid tumours in patients on clinical trials. The RECIST Working Group considers the ability of the global oncology community to implement and adopt updates to RECIST in a timely manner to be critical. Updates to RECIST must be tested, validated and implemented in a standardised, methodical manner in response to therapeutic and imaging technology advances as well as experience gained by users. This was the case with the development of RECIST 1.1, where an expanded data warehouse was developed to test and validate modifications. Similar initiatives are ongoing, testing RECIST in the evaluation of response to non-cytotoxic agents, immunotherapies, as well as in specific diseases. The RECIST Working Group has previously outlined the level of evidence considered necessary to formally and fully validate new imaging markers as an appropriate end-point for clinical trials. Achieving the optimal level of evidence desired is a difficult feat for phase III trials; this involves a meta-analysis of multiple prospective, randomised multicentre clinical trials. The rationale for modifications should also be considered; the modifications may be proposed to improve surrogacy, to provide a more mechanistic imaging technique, or be designed to improve reproducibility of the imaging biomarker. Here, we present the commonly described modifications of RECIST, each of which is associated with different levels of evidence and validation. PMID:27237360

  18. The prevalence of hematologic and metabolic abnormalities during chronic kidney disease stages in different ethnic groups.

    PubMed

    Barbour, S J; Er, L; Djurdjev, O; Karim, M A; Levin, A

    2008-07-01

    We conducted an observational cross-sectional study to determine if the prevalence of hematologic and metabolic abnormalities in chronic kidney disease (CKD) varied in different ethnic groups. We used a CKD provincial database where a complete data set at the time of registration was available as well as an estimated glomerular filtration rate (eGFR), which showed using the abbreviated MDRD formula that the patients had CKD of stages 3-5. We included patients with self-reported race of Caucasian, Oriental Asian, or South Asian. Primary outcomes were the prevalence of at least one of the following: anemia, hypocalcemia, hyperphosphatemia, hyperparathyroidism, hypoalbuminemia, and three or more laboratory abnormalities. All definitions were consistent with K/DOQI guidelines. When compared with Caucasians, Oriental Asians and South Asians had a higher prevalence of many of the metabolic abnormalities during most stages of CKD and were more likely to have any abnormality at all levels of eGFR. The prevalence of three or more laboratory abnormalities was higher in Oriental Asians at all stages and in South Asians at some levels of eGFR. These results were unchanged or exaggerated when controlled for age, gender, diabetes, and a primary diagnosis of renal disease. Hence, it appears that South Asians and Oriental Asians have more laboratory abnormalities compared with Caucasians at most levels of eGFR.

  19. Report of the National Heart, Lung, and Blood Institute Working Group: An Integrated Network for Congenital Heart Disease Research.

    PubMed

    Pasquali, Sara K; Jacobs, Jeffrey P; Farber, Gregory K; Bertoch, David; Blume, Elizabeth D; Burns, Kristin M; Campbell, Robert; Chang, Anthony C; Chung, Wendy K; Riehle-Colarusso, Tiffany; Curtis, Lesley H; Forrest, Christopher B; Gaynor, William J; Gaies, Michael G; Go, Alan S; Henchey, Paul; Martin, Gerard R; Pearson, Gail; Pemberton, Victoria L; Schwartz, Steven M; Vincent, Robert; Kaltman, Jonathan R

    2016-04-01

    The National Heart, Lung, and Blood Institute convened a working group in January 2015 to explore issues related to an integrated data network for congenital heart disease research. The overall goal was to develop a common vision for how the rapidly increasing volumes of data captured across numerous sources can be managed, integrated, and analyzed to improve care and outcomes. This report summarizes the current landscape of congenital heart disease data, data integration methodologies used across other fields, key considerations for data integration models in congenital heart disease, and the short- and long-term vision and recommendations made by the working group.

  20. Communication and Huntington's Disease: Qualitative Interviews and Focus Groups with Persons with Huntington's Disease, Family Members, and Carers

    ERIC Educational Resources Information Center

    Hartelius, Lena; Jonsson, Maria; Rickeberg, Anneli; Laakso, Katja

    2010-01-01

    Background: As an effect of the cognitive, emotional and motor symptoms associated with Huntington's disease, communicative interaction is often dramatically changed. No study has previously included the subjective reports on this subject from individuals with Huntington's disease. Aims: To explore the qualitative aspects of how communication is…

  1. Venous thromboembolism in Croatia – Croatian Cooperative Group for Hematologic Diseases (CROHEM) study

    PubMed Central

    Pulanić, Dražen; Gverić-Krečak, Velka; Nemet-Lojan, Zlatka; Holik, Hrvoje; Coha, Božena; Babok-Flegarić, Renata; Komljenović, Mili; Knežević, Dijana; Petrovečki, Mladen; Zupančić Šalek, Silva; Labar, Boris; Nemet, Damir

    2015-01-01

    Aim To analyze the incidence and characteristics of venous thromboembolism (VTE) in Croatia. Methods The Croatian Cooperative Group for Hematologic Diseases conducted an observational non-interventional study in 2011. Medical records of patients with newly diagnosed VTE hospitalized in general hospitals in 4 Croatian counties (Šibenik-Knin, Koprivnica-Križevci, Brod-Posavina, and Varaždin County) were reviewed. According to 2011 Census, the population of these counties comprises 13.1% of the Croatian population. Results There were 663 patients with VTE; 408 (61.54%) had deep vein thrombosis, 219 (33.03%) had pulmonary embolism, and 36 (5.43%) had both conditions. Median age was 71 years, 290 (43.7%) were men and 373 (56.3%) women. Secondary VTE was found in 57.3% of participants, idiopathic VTE in 42.7%, and recurrent VTE in 11.9%. There were no differences between patients with secondary VTE and patients with idiopathic VTE in disease recurrence and sex. The most frequent causes of secondary VTE were cancer (40.8%), and trauma, surgery, and immobilization (38.2%), while 42.9% patients with secondary VTE had ≥2 causes. There were 8.9% patients ≤45 years; 3.3% with idiopathic or recurrent VTE. Seventy patients (10.6%) died, more of whom had secondary (81.4%) than idiopathic (18.6%) VTE (P < 0.001), and in 50.0% VTE was the main cause of death. Estimated incidence of VTE in Croatia was 1.185 per 1000 people. Conclusion Characteristics of VTE in Croatia are similar to those reported in large international studies. Improved thromboprophylaxis during the presence of risk factors for secondary VTE might substantially lower the VTE burden. PMID:26718761

  2. Acquired cystic kidney disease in children undergoing continuous ambulatory peritoneal dialysis. Kyushu Pediatric Nephrology Study Group.

    PubMed

    1999-08-01

    Our cross-sectional study aims to elucidate the prevalence of acquired cystic kidney disease (ACKD), time of occurrence of ACKD, relationship between the prevalence of ACKD and duration of dialysis, progression of cysts, and ACKD-related complications in 54 children undergoing continuous ambulatory peritoneal dialysis (CAPD). ACKD was defined as four or more cysts detected in each kidney by ultrasonography, computed tomography (CT), or magnetic resonance imaging. The presence of less than four cysts was diagnosed as solitary cysts (SCs). Noncystic primary disease was present as glomerulonephritis in 23 patients (42.6%); hypoplastic kidney, 7 patients (13.0%); reflux nephropathy, 6 patients (11.1%); and other, 18 patients (33.3%). ACKD was evident in 16 patients (29.6%) during the 57.9 +/- 39.8 months after the start of CAPD. Nine patients (16. 7%) had SCs. SCs and ACKD were detected initially in patients with 1 and 3 years of CAPD, respectively. The mean duration of CAPD for patients with ACKD (96.1 +/- 36.6 months) differed from that of patients with SCs (49.8 +/- 29.9 months) and no cysts (38.3 +/- 25.8 months). The groups were classified according to time after the start of CAPD: 0 to 4 years (n = 33), 5 to 9 years (n = 16), and longer than 10 years (n = 5). The prevalence of ACKD among these three groups was 9.1%, 50%, and 80%, respectively, and this prevalence increased significantly with increasing duration of CAPD. Of 15 patients examined two to four times by ultrasonography or CT, the number and size of cysts increased in 7 patients with ACKD and 2 patients with SC. Two patients with many and large cysts experienced gross hematuria, and one of those patients had intracystic and retroperitoneal bleeding caused by cyst rupture. No solid mass lesion was found by imaging diagnostic modalities in the 54 patients. In conclusion, the prevalence of ACKD in children undergoing CAPD is just as high as that in adults. The prevalence of ACKD and number and size of

  3. Distribution and Determinants of Non Communicable Diseases among Elderly Uyghur Ethnic Group in Xinjiang, China

    PubMed Central

    Wang, Xihua; Hu, Zhi; Ma, Ying; Tang, Weiming; Ben, Yanli; Mahapatra, Tanmay; Cao, Xiaolin; Mahapatra, Sanchita; Ling, Min; Gou, Anshuan; Wang, Yanmei; Xiao, Jiangqin; Hou, Ming; Wang, Xiuli; Lin, Bo; Wang, Faxing

    2014-01-01

    Background Non-communicable diseases (NCDs) are showing an increasing trend globally as well as in China. Elderly population are more prone to these NCDs. Situation in China is worse owing to the higher proportion of geriatric population. Burden of NCDs and the role of their socio-demographic and behavioral predictors among these elderly and more so among the ethnic minority groups among them, need to be investigated specifically, owing to their distinct genetic background, lifestyles and behavior. Methods A cross-sectional study was conducted among 1329 randomly selected persons of Uyghur ethnicity, aged 60 years or more in Xinjiang, the largest administrative division in China to measure the burden of NCDs, understand the distribution of socio-demographic, behavioral and life event-related potential correlates of them and to estimate the association of the NCDs with these correlates. Results Among these participants 54.2% were female, 86.8% were married and more than half had only attended elementary school or less. 41.46% was suffering from at least one NCD. 20.22% had one NCD, 12.11% had two and 8.58% had three or more. 27.3% had hypertension, 4.06% had diabetes, 6.02% had hyperlipidemia, 7.37% had angina, 14.52% had cardiovascular diseases, 11.59% had any kind of cancers and 9.78% had chronic obstructive pulmonary diseases. Rural residents (OR = 1.45, 95% CI: 1.17–1.80, AOR = 2.00, 95% CI: 1.53–2.61) and current smokers had higher odds of having more NCDs (AOR = 1.53, 95% CI: 1.00–2.34). Additionally not being satisfied with current life, not being able to take care of self in daily life, currently not being involved in farm work, less intake of fresh vegetables, fruits and garlic, too less or too much salt intake, not having hobbies were found to be positively associated with having more NCDs. Conclusion Implementation of effective intervention strategies to promote healthy life styles among the Uyghur elderly population of China seems

  4. Inborn errors of the Krebs cycle: a group of unusual mitochondrial diseases in human.

    PubMed

    Rustin, P; Bourgeron, T; Parfait, B; Chretien, D; Munnich, A; Rötig, A

    1997-08-22

    Krebs cycle disorders constitute a group of rare human diseases which present an amazing complexity considering our current knowledge on the Krebs cycle function and biogenesis. Acting as a turntable of cell metabolism, it is ubiquitously distributed in the organism and its enzyme components encoded by supposedly typical house-keeping genes. However, the investigation of patients presenting specific defects of Krebs cycle enzymes, resulting from deleterious mutations of the considered genes, leads to reconsider this simple envision by revealing organ-specific impairments, mostly affecting neuromuscular system. This often leaves aside organs the metabolism of which strongly depends on mitochondrial energy metabolism as well, such as heart, kidney or liver. Additionally, in some patients, a complex pattern of tissue-specific enzyme defect was also observed. The lack of functional additional copies of Krebs cycle genes suggests that the complex expression pattern should be ascribed to tissue-specific regulations of transcriptional and/or translational activities, together with a variable cell adaptability to Krebs cycle functional defects.

  5. Screening for celiac disease in the general population and in high-risk groups

    PubMed Central

    Card, Timothy R; Kaukinen, Katri; Bai, Julio; Zingone, Fabiana; Sanders, David S; Murray, Joseph A

    2015-01-01

    Background Celiac disease (CD) occurs in approximately 1% of the Western population. It is a lifelong disorder that is associated with impaired quality of life (QOL) and an excessive risk of comorbidity and death. Objectives To review the literature on screening for CD in relation to the current World Health Organization (WHO) criteria for mass screening. Methods We performed a PubMed search to identify indexed papers on CD screening with a publication date from 1900 until 1 June 2014. When we deemed an abstract relevant, we read the corresponding paper in detail. Results CD fulfills several WHO criteria for mass screening (high prevalence, available treatment and difficult clinical detection), but it has not yet been established that treatment of asymptomatic CD may reduce the excessive risk of severe complications, leading to higher QOL nor that it is cost-effective. Conclusions Current evidence is not sufficient to support mass screening for CD, but active case-finding may be appropriate, as we recognize that most patients with CD will still be missed by this strategy. Although proof of benefit is still lacking, screening for CD may be appropriate in high-risk groups. PMID:25922671

  6. High burden of invasive group A streptococcal disease in the Northern Territory of Australia.

    PubMed

    Boyd, R; Patel, M; Currie, B J; Holt, D C; Harris, T; Krause, V

    2016-04-01

    Although the incidence of invasive group A streptococcal disease in northern Australia is very high, little is known of the regional epidemiology and molecular characteristics. We conducted a case series of Northern Territory residents reported between 2011 and 2013 with Streptococcus pyogenes isolates from a normally sterile site. Of the 128 reported episodes, the incidence was disproportionately high in the Indigenous population at 69·7/100 000 compared to 8·8/100 000 in the non-Indigenous population. Novel to the Northern Territory is the extremely high incidence in haemodialysis patients of 2205·9/100 000 population; and for whom targeted infection control measures could prevent transmission. The incidences in the tropical north and semi-arid Central Australian regions were similar. Case fatality was 8% (10/128) and streptococcal toxic shock syndrome occurred in 14 (11%) episodes. Molecular typing of 82 isolates identified 28 emm types, of which 63 (77%) were represented by four emm clusters. Typing confirmed transmission between infant twins. While the diverse range of emm types presents a challenge for effective coverage by vaccine formulations, the limited number of emm clusters raises optimism should cluster-specific cross-protection prove efficacious. Further studies are required to determine effectiveness of chemoprophylaxis for contacts and to inform public health response. PMID:26364646

  7. High burden of invasive group A streptococcal disease in the Northern Territory of Australia.

    PubMed

    Boyd, R; Patel, M; Currie, B J; Holt, D C; Harris, T; Krause, V

    2016-04-01

    Although the incidence of invasive group A streptococcal disease in northern Australia is very high, little is known of the regional epidemiology and molecular characteristics. We conducted a case series of Northern Territory residents reported between 2011 and 2013 with Streptococcus pyogenes isolates from a normally sterile site. Of the 128 reported episodes, the incidence was disproportionately high in the Indigenous population at 69·7/100 000 compared to 8·8/100 000 in the non-Indigenous population. Novel to the Northern Territory is the extremely high incidence in haemodialysis patients of 2205·9/100 000 population; and for whom targeted infection control measures could prevent transmission. The incidences in the tropical north and semi-arid Central Australian regions were similar. Case fatality was 8% (10/128) and streptococcal toxic shock syndrome occurred in 14 (11%) episodes. Molecular typing of 82 isolates identified 28 emm types, of which 63 (77%) were represented by four emm clusters. Typing confirmed transmission between infant twins. While the diverse range of emm types presents a challenge for effective coverage by vaccine formulations, the limited number of emm clusters raises optimism should cluster-specific cross-protection prove efficacious. Further studies are required to determine effectiveness of chemoprophylaxis for contacts and to inform public health response.

  8. Sing Your Lungs Out: a qualitative study of a community singing group for people with chronic obstructive pulmonary disease (COPD)

    PubMed Central

    McNaughton, Amanda; Aldington, Sarah; Williams, Gayle; Levack, William M M

    2016-01-01

    Objective To explore the ways in which participation in a community singing group contributed to the health and well-being of patients with chronic obstructive pulmonary disease (COPD). Design Qualitative description, based on transcripts from individual interviews and a focus group meeting with people with COPD participating in the singing group, regarding their experience. Setting Urban community, Wellington, New Zealand. Participants 23 people (13 women and 10 men), 51–91 years with COPD (21) or interstitial lung disease (2). Results The weekly singing group was a well-attended activity, with self-reported benefits to health and well-being. 4 key themes were identified: being in the ‘right space’, connection, purpose and growth, and participation in a meaningful physical activity. Conclusions This study helps us to better understand how participation in a community singing group can benefit the health and well-being of patients with COPD. Trial registration number ACTRN12615000736549; Results. PMID:27650768

  9. Different Risk of Common Gastrointestinal Disease Between Groups Undergoing Hemodialysis or Peritoneal Dialysis or With Non-End Stage Renal Disease: A Nationwide Population-Based Cohort Study.

    PubMed

    Lee, Yi-Che; Hung, Shih-Yuan; Wang, Hsi-Hao; Wang, Hao-Kuang; Lin, Chi-Wei; Chang, Min-Yu; Ho, Li-Chun; Chen, Yi-Ting; Wu, Ching-Fang; Chen, Ho-Ching; Wang, Wei-Ming; Sung, Junne-Ming; Chiou, Yuan-Yow; Lin, Sheng-Hsiang

    2015-09-01

    Peritoneal dialysis (PD) is one type of renal replacement therapy, but potential peritoneal damage and gastrointestinal (GI) tract adverse effects during long-term exposure to bio-incompatible dialysate remain a concern. Although GI disease frequently occurs in dialysis patients, whether the risk of GI diseases differs among PD and hemodialysis (HD) or non-uremic groups is still uncertain.In this retrospective cohort study, data were obtained from the National Health Insurance Research Database, which includes almost all dialysis patients in Taiwan. Between 2000 and 2009, a total of 1791 PD and 8955 HD incident patients were enrolled and matched for age and sex or for propensity score. In addition, a comparison cohort of 8955 non-uremic patients was also selected. Individuals were monitored for the occurrence of common GI diseases until 2010, and data were analyzed using several different models.Generally speaking, the results showed that the risk of gastroesophageal reflux, intestinal obstruction or adhesions, and abdominal hernia was significantly higher in the PD group, whereas the risk of peptic ulcer disease and lower GI diverticula and bleeding was significantly greater in the HD group. Meanwhile, the risk of mesenteric ischemia, liver cirrhosis, and acute pancreatitis was higher in dialysis patients, but was not significantly different between the PD and HD groups; moreover, the risk of appendicitis in the PD group appeared to be lower than that in the HD group.In conclusion, dialysis patients have a higher risk of most common GI diseases, and PD and HD modalities are associated with different GI diseases.

  10. Costs of Neisseria meningitidis Group A Disease and Economic Impact of Vaccination in Burkina Faso

    PubMed Central

    Colombini, Anaïs; Trotter, Caroline; Madrid, Yvette; Karachaliou, Andromachi; Preziosi, Marie-Pierre

    2015-01-01

    Background. Five years since the successful introduction of MenAfriVac in a mass vaccination campaign targeting 1- to 29-year-olds in Burkina Faso, consideration must be given to the optimal strategies for sustaining population protection. This study aims to estimate the economic impact of a range of vaccination strategies in Burkina Faso. Methods. We performed a cost-of-illness study, comparing different vaccination scenarios in terms of costs to both households and health systems over a 26-year time horizon. These scenarios are (1) reactive vaccination campaign (baseline comparator); (2) preventive vaccination campaign; (3) routine immunization at 9 months; and (4) a combination of routine and an initial catchup campaign of children under 5. Costs were estimated from a literature review, which included unpublished programmatic documents and peer-reviewed publications. The future disease burden for each vaccination strategy was predicted using a dynamic transmission model of group A Neisseria meningitidis. Results. From 2010 to 2014, the total costs associated with the preventive campaign targeting 1- to 29-year-olds with MenAfriVac were similar to the estimated costs of the reactive vaccination strategy (approximately 10 million US dollars [USD]). Between 2015 and 2035, routine immunization with or without a catch-up campaign of 1- to 4-year-olds is cost saving compared with the reactive strategy, both with and without discounting costs and cases. Most of the savings are accrued from lower costs of case management and household costs resulting from a lower burden of disease. After the initial investment in the preventive strategy, 1 USD invested in the routine strategy saves an additional 1.3 USD compared to the reactive strategy. Conclusions. Prevention strategies using MenAfriVac will be significantly cost saving in Burkina Faso, both for the health system and for households, compared with the reactive strategy. This will protect households from

  11. High mobility group box-1 (HMGB1) participates in the pathogenesis of alcoholic liver disease (ALD).

    PubMed

    Ge, Xiaodong; Antoine, Daniel J; Lu, Yongke; Arriazu, Elena; Leung, Tung-Ming; Klepper, Arielle L; Branch, Andrea D; Fiel, Maria Isabel; Nieto, Natalia

    2014-08-15

    Growing clinical and experimental evidence suggests that sterile inflammation contributes to alcoholic liver disease (ALD). High mobility group box-1 (HMGB1) is highly induced during liver injury; however, a link between this alarmin and ALD has not been established. Thus, the aim of this work was to determine whether HMGB1 contributes to the pathogenesis of ALD. Liver biopsies from patients with ALD showed a robust increase in HMGB1 expression and translocation, which correlated with disease stage, compared with healthy explants. Similar findings were observed in chronic ethanol-fed wild-type (WT) mice. Using primary cell culture, we validated the ability of hepatocytes from ethanol-fed mice to secrete a large amount of HMGB1. Secretion was time- and dose-dependent and responsive to prooxidants and antioxidants. Selective ablation of Hmgb1 in hepatocytes protected mice from alcohol-induced liver injury due to increased carnitine palmitoyltransferase-1, phosphorylated 5'AMP-activated protein kinase-α, and phosphorylated peroxisome proliferator-activated receptor-α expression along with elevated LDL plus VLDL export. Native and post-translationally modified HMGB1 were detected in humans and mice with ALD. In liver and serum from control mice and in serum from healthy volunteers, the lysine residues within the peptides containing nuclear localization signals (NLSs) 1 and 2 were non-acetylated, and all cysteine residues were reduced. However, in livers from ethanol-fed mice, in addition to all thiol/non-acetylated isoforms of HMGB1, we observed acetylated NLS1 and NLS2, a unique phosphorylation site in serine 35, and an increase in oxidation of HMGB1 to the disulfide isoform. In serum from ethanol-fed mice and from patients with ALD, there was disulfide-bonded hyperacetylated HMGB1, disulfide-bonded non-acetylated HMGB1, and HMGB1 phosphorylated in serine 35. Hepatocytes appeared to be a major source of these HMGB1 isoforms. Thus, hepatocyte HMGB1 participates in

  12. Changing Emergence of Shigella Sero-Groups in Bangladesh: Observation from Four Different Diarrheal Disease Hospitals

    PubMed Central

    Das, Sumon Kumar; Ahmed, Shahnawaz; Ferdous, Farzana; Farzana, Fahmida Dil; Chisti, Mohammod Jobayer; Leung, Daniel T.; Malek, Mohammad Abdul; Talukder, Kaisar Ali; Bardhan, Pradip Kumar; Salam, Mohammed Abdus; Faruque, Abu Syed Golam; Raqib, Rubhana

    2013-01-01

    Background Shigellosis continues to be a public health challenge for developing countries, including Bangladesh. The aim of the study is to demonstrate recent changes in Shigella sero-groups and their geographical diversity. Methods Data were extracted from data archive of four diarrheal disease surveillance systems. A 2% sub sample from urban Dhaka Hospital (2008–2011; n = 10,650), and 10% from urban Mirpur Treatment Centre (2009–2011; n = 3,585), were enrolled systematically; whereas, all patients coming from the Health and Demographic Surveillance System area in rural Matlab (2008–2011; n = 6,399) and rural Mirzapur (2010–2011; n = 2,812) were included irrespective of age, sex, and disease severity. A fresh stool specimen was collected for identification of Shigella spp. Of them, 315 (3%) were positive for Shigella in Dhaka, 490 (8%) from Matlab, 109 (3%) from Mirpur and 369 (13%) from Mirzapur and considered as analyzable sample size. Results Among all Shigella isolates regardless of age, significant decreases in percentage of S. flexneri over time was observed in Mirpur (55→29%; p value of χ2-for trend = 0.019) and Mirzapur (59→47%; p = 0.025). A non-significant decrease was also seen in Dhaka (58→48%), while in Matlab there was a non-significant increase (73→81%). Similar patterns were observed among under-5 children at all sites. Emergence of S. sonnei was found in Dhaka (8→25%; p<0.001) and Mirpur (10→33%; p = 0.015), whereas it decreased in Mirzapur (32→23%; p = 0.056). The emergence of S. boydii was seen in all ages in Mirzapur [(3→28%; p<0.001); (3→27%; p<0.001)]. On the other hand, we saw non-significant percent reductions in S. boydii in Dhaka [overall (25→16%); under-5 (16→9%)]. Decreasing rates of Shigella dysenteriae were observed in Matlab, Mirpur and Mirzapur; whereas, in Dhaka it remained unchanged. Conclusion and Significance Emergence of S. sonnei and S. boydii as important

  13. High mobility group box-1 (HMGB1) participates in the pathogenesis of alcoholic liver disease (ALD).

    PubMed

    Ge, Xiaodong; Antoine, Daniel J; Lu, Yongke; Arriazu, Elena; Leung, Tung-Ming; Klepper, Arielle L; Branch, Andrea D; Fiel, Maria Isabel; Nieto, Natalia

    2014-08-15

    Growing clinical and experimental evidence suggests that sterile inflammation contributes to alcoholic liver disease (ALD). High mobility group box-1 (HMGB1) is highly induced during liver injury; however, a link between this alarmin and ALD has not been established. Thus, the aim of this work was to determine whether HMGB1 contributes to the pathogenesis of ALD. Liver biopsies from patients with ALD showed a robust increase in HMGB1 expression and translocation, which correlated with disease stage, compared with healthy explants. Similar findings were observed in chronic ethanol-fed wild-type (WT) mice. Using primary cell culture, we validated the ability of hepatocytes from ethanol-fed mice to secrete a large amount of HMGB1. Secretion was time- and dose-dependent and responsive to prooxidants and antioxidants. Selective ablation of Hmgb1 in hepatocytes protected mice from alcohol-induced liver injury due to increased carnitine palmitoyltransferase-1, phosphorylated 5'AMP-activated protein kinase-α, and phosphorylated peroxisome proliferator-activated receptor-α expression along with elevated LDL plus VLDL export. Native and post-translationally modified HMGB1 were detected in humans and mice with ALD. In liver and serum from control mice and in serum from healthy volunteers, the lysine residues within the peptides containing nuclear localization signals (NLSs) 1 and 2 were non-acetylated, and all cysteine residues were reduced. However, in livers from ethanol-fed mice, in addition to all thiol/non-acetylated isoforms of HMGB1, we observed acetylated NLS1 and NLS2, a unique phosphorylation site in serine 35, and an increase in oxidation of HMGB1 to the disulfide isoform. In serum from ethanol-fed mice and from patients with ALD, there was disulfide-bonded hyperacetylated HMGB1, disulfide-bonded non-acetylated HMGB1, and HMGB1 phosphorylated in serine 35. Hepatocytes appeared to be a major source of these HMGB1 isoforms. Thus, hepatocyte HMGB1 participates in

  14. Reinforcement Learning and Dopamine in Schizophrenia: Dimensions of Symptoms or Specific Features of a Disease Group?

    PubMed Central

    Deserno, Lorenz; Boehme, Rebecca; Heinz, Andreas; Schlagenhauf, Florian

    2013-01-01

    Abnormalities in reinforcement learning are a key finding in schizophrenia and have been proposed to be linked to elevated levels of dopamine neurotransmission. Behavioral deficits in reinforcement learning and their neural correlates may contribute to the formation of clinical characteristics of schizophrenia. The ability to form predictions about future outcomes is fundamental for environmental interactions and depends on neuronal teaching signals, like reward prediction errors. While aberrant prediction errors, that encode non-salient events as surprising, have been proposed to contribute to the formation of positive symptoms, a failure to build neural representations of decision values may result in negative symptoms. Here, we review behavioral and neuroimaging research in schizophrenia and focus on studies that implemented reinforcement learning models. In addition, we discuss studies that combined reinforcement learning with measures of dopamine. Thereby, we suggest how reinforcement learning abnormalities in schizophrenia may contribute to the formation of psychotic symptoms and may interact with cognitive deficits. These ideas point toward an interplay of more rigid versus flexible control over reinforcement learning. Pronounced deficits in the flexible or model-based domain may allow for a detailed characterization of well-established cognitive deficits in schizophrenia patients based on computational models of learning. Finally, we propose a framework based on the potentially crucial contribution of dopamine to dysfunctional reinforcement learning on the level of neural networks. Future research may strongly benefit from computational modeling but also requires further methodological improvement for clinical group studies. These research tools may help to improve our understanding of disease-specific mechanisms and may help to identify clinically relevant subgroups of the heterogeneous entity schizophrenia. PMID:24391603

  15. ABO blood group system and the coronary artery disease: an updated systematic review and meta-analysis.

    PubMed

    Chen, Zhuo; Yang, Sheng-Hua; Xu, Hao; Li, Jian-Jun

    2016-03-18

    ABO blood group system, a well-known genetic risk factor, has clinically been demonstrated to be linked with thrombotic vascular diseases. However, the relationship between ABO blood group and coronary artery disease (CAD) is still controversial. We here performed an updated meta-analysis of the related studies and tried to elucidate the potential role of ABO blood group as a risk factor for CAD. All detectable case-control and cohort studies comparing the risk of CAD in different ABO blood groups were collected for this analysis through searching PubMed, Embase, and the Cochrane Library. Ultimately, 17 studies covering 225,810 participants were included. The combined results showed that the risk of CAD was significantly higher in blood group A (OR = 1.14, 95% CI = 1.03 to 1.26, p = 0.01) and lower in blood group O (OR = 0.85, 95% CI = 0.78 to 0.94, p = 0.0008). Even when studies merely about myocardial infarction (MI) were removed, the risk of CAD was still significantly higher in blood group A (OR = 1.05, 95% CI = 1.00 to 1.10, p = 0.03) and lower in blood group O (OR = 0.89, 95% CI = 0.85 to 0.93, p < 0.00001). This updated systematic review and meta-analysis indicated that both blood group A and non-O were the risk factors of CAD.

  16. Groups in Latin America: Comunidades Eclesial de Base as Mutual Support Groups.

    ERIC Educational Resources Information Center

    McWhirter, Benedict T.; And Others

    1988-01-01

    Describes Comunidades Eclesial de Base (CEBs) or base communities which are self-help and mutual aid groups that assist in alleviating the effects of poverty and powerlessness in Latin America. Discusses two potential problems of CEBs - that they may encourage either passivity or increased violence. (Author/NB)

  17. Internet-based preventive intervention for reducing eating disorder risk: A randomized controlled trial comparing guided with unguided self-help.

    PubMed

    Kass, Andrea E; Trockel, Mickey; Safer, Debra L; Sinton, Meghan M; Cunning, Darby; Rizk, Marianne T; Genkin, Brooke H; Weisman, Hannah L; Bailey, Jakki O; Jacobi, Corinna; Wilfley, Denise E; Taylor, C Barr

    2014-12-01

    Student Bodies, an internet-based intervention, has successfully reduced weight/shape concerns and prevented eating disorders in a subset of college-age women at highest risk for an eating disorder. Student Bodies includes an online, guided discussion group; however, the clinical utility of this component is unclear. This study investigated whether the guided discussion group improves program efficacy in reducing weight/shape concerns in women at high risk for an eating disorder. Exploratory analyses examined whether baseline variables predicted who benefitted most. Women with high weight/shape concerns (N = 151) were randomized to Student Bodies with a guided discussion group (n = 74) or no discussion group (n = 77). Regression analyses showed weight/shape concerns were reduced significantly more among guided discussion group than no discussion group participants (p = 0.002; d = 0.52); guided discussion group participants had 67% lower odds of having high-risk weight/shape concerns post-intervention (p = 0.02). There were no differences in binge eating at post-intervention between the two groups, and no moderators emerged as significant. Results suggest the guided discussion group improves the efficacy of Student Bodies in reducing weight/shape concerns in college students at high risk for an eating disorder. PMID:25461783

  18. Internet-based preventive intervention for reducing eating disorder risk: A randomized controlled trial comparing guided with unguided self-help

    PubMed Central

    Kass, Andrea E.; Trockel, Mickey; Safer, Debra L.; Sinton, Meghan M.; Cunning, Darby; Rizk, Marianne T.; Genkin, Brooke H.; Weisman, Hannah L.; Bailey, Jakki O.; Jacobi, Corinna; Wilfley, Denise E.; Taylor, C. Barr

    2014-01-01

    Student Bodies, an internet-based intervention, has successfully reduced weight/shape concerns and prevented eating disorders in a subset of college-age women at highest risk for an eating disorder. Student Bodies includes an online, guided discussion group; however, the clinical utility of this component is unclear. This study investigated whether the guided discussion group improves program efficacy in reducing weight/shape concerns in women at high risk for an eating disorder. Exploratory analyses examined whether baseline variables predicted who benefitted most. Women with high weight/shape concerns (N=151) were randomized to Student Bodies with a guided discussion group (n=74) or no discussion group (n=77). Regression analyses showed weight/shape concerns were reduced significantly more among guided discussion group than no discussion group participants (p = 0.002; d = 0.52); guided discussion group participants had 67% lower odds of having high-risk weight/shape concerns post-intervention (p = 0.02). There were no differences in binge eating at post-intervention between the two groups, and no moderators emerged as significant. Results suggest the guided discussion group improves the efficacy of Student Bodies in reducing weight/shape concerns in college students at high risk for an eating disorder. PMID:25461783

  19. Marital Discord and Coronary Artery Disease: A Comparison of Behaviorally Defined Discrete Groups

    ERIC Educational Resources Information Center

    Smith, Timothy W.; Uchino, Bert N.; Berg, Cynthia A.; Florsheim, Paul

    2012-01-01

    Objective: Marital difficulties can confer risk of coronary heart disease, as in a study of outwardly healthy couples (T. W. Smith et al., 2011) where behavioral ratings of low affiliation and high control during marital disagreements were associated with asymptomatic coronary artery disease (CAD). However, taxometric studies suggest that marital…

  20. Complications in Working with AIDS Patients in Group Psychotherapy.

    ERIC Educational Resources Information Center

    Tunnell, Gil

    Numerous research studies have documented that for patients coping with chronic illness, social support is extremely important in facilitating adjustment to the illness. The support may come from organized therapy and self-help groups or from interpersonal relationships outside a group. However, Acquired Immune Deficiency Syndrome (AIDS) is a…

  1. Consensus Statement on medication use in multiple sclerosis by the Spanish Society of Neurology's study group for demyelinating diseases.

    PubMed

    García-Merino, A; Fernández, O; Montalbán, X; de Andrés, C; Oreja-Guevara, C; Rodríguez-Antigüedad, A; Arbizu, T

    2013-01-01

    Treatments for multiple sclerosis therapy are rapidly evolving. It is believed that new drugs will be approved in the near future, thereby changing current indications for treatment. In this context, the Spanish Society of Neurology's study group on demyelinating diseases, which evaluates medication use in MS, has decided to draw up a consensus statement on the current indications and guidelines for multiple sclerosis treatment.

  2. Heart disease education and prevention program targeting immigrant Latinos: using focus group responses to develop effective interventions.

    PubMed

    Moreno, C; Alvarado, M; Balcazar, H; Lane, C; Newman, E; Ortiz, G; Forrest, M

    1997-12-01

    Although research has provided considerable knowledge concerning the positive effects of behavioral change on morbidity and mortality from heart disease and related risk factors, some segments of the population have not benefited equitably from this information. In April 1995, the National Heart, Lung, and Blood Institute (NHLBI) conducted seven focus groups to determine knowledge and attitudes about heart disease and associated risk factors, identify media usage and preferences, and assess publications usage and preferences among Spanish-speaking Latino immigrants residing in the Washington, D.C., metropolitan area. This information was gathered to assist in the development of key messages and strategies for the NHLBI Latino Community Cardiovascular Disease Prevention and Outreach Initiative, Salud para su Corazón--a heart disease prevention and education campaign. Findings from these focus groups indicate that Latinos may not benefit from heart disease prevention messages developed for the general population because of language and cultural differences. The researchers concluded that health education and disease prevention programs targeting the Latino community should develop educational materials and interventions that address language preferences and cultural values. Furthermore, to be effective, these programs should show people how to make positive behavioral changes based on their current circumstances, while remaining sensitive to the fact that Latino immigrants face major life adjustments and many are still greatly influenced by their country of origin.

  3. Emerging Research Directions in Adult Congenital Heart Disease: A Report From an NHLBI/ACHA Working Group.

    PubMed

    Gurvitz, Michelle; Burns, Kristin M; Brindis, Ralph; Broberg, Craig S; Daniels, Curt J; Fuller, Stephanie M P N; Honein, Margaret A; Khairy, Paul; Kuehl, Karen S; Landzberg, Michael J; Mahle, William T; Mann, Douglas L; Marelli, Ariane; Newburger, Jane W; Pearson, Gail D; Starling, Randall C; Tringali, Glenn R; Valente, Anne Marie; Wu, Joseph C; Califf, Robert M

    2016-04-26

    Congenital heart disease (CHD) is the most common birth defect, affecting about 0.8% of live births. Advances in recent decades have allowed >85% of children with CHD to survive to adulthood, creating a growing population of adults with CHD. Little information exists regarding survival, demographics, late outcomes, and comorbidities in this emerging group, and multiple barriers impede research in adult CHD. The National Heart, Lung, and Blood Institute and the Adult Congenital Heart Association convened a multidisciplinary working group to identify high-impact research questions in adult CHD. This report summarizes the meeting discussions in the broad areas of CHD-related heart failure, vascular disease, and multisystem complications. High-priority subtopics identified included heart failure in tetralogy of Fallot, mechanical circulatory support/transplantation, sudden cardiac death, vascular outcomes in coarctation of the aorta, late outcomes in single-ventricle disease, cognitive and psychiatric issues, and pregnancy.

  4. Midterm cost-effectiveness of the liver transplantation program of England and Wales for three disease groups.

    PubMed

    Longworth, Louise; Young, Tracey; Buxton, Martin J; Ratcliffe, Julie; Neuberger, James; Burroughs, Andrew; Bryan, Stirling

    2003-12-01

    Liver transplantation has never been the subject of a randomized controlled trial, and there remains uncertainty about the magnitude of benefit and cost-effectiveness for specific patient groups. This article reports the results of an economic evaluation of adult liver transplantation in England and Wales. Patients placed on the waiting list for a liver transplant were observed over 27 months. The costs and health benefits of a comparison group, representing experience in the absence of liver transplantation, were estimated using a combination of observed data from patients waiting for a transplant and published prognostic models. The analysis focuses on three disease groups, for each of which prognostic models were available: primary biliary cirrhosis (PBC), alcoholic liver disease (ALD), and primary sclerosing cholangitis (PSC). A higher proportion of patients with ALD were assessed for a transplant but not placed on the waiting list. The estimated gain in quality-adjusted life-years from transplantation was positive for each of the disease groups. The mean incremental cost per quality-adjusted life-year (95% bootstrap confidence intervals) from time of listing to 27 months for patients with PBC, ALD, and PSC are pound 29,000 (pounds 1,000 to pounds 59,000), pounds 48,000 (pounds 12,000 to pounds 83,000) and pounds 21,000 (-pounds 23,000 to pounds 60,000), respectively. In conclusion, liver transplantation increases the survival and health-related quality of life of patients with each of three end-stage liver diseases. However, the extent of this increase differs between different disease groups. Cost-effectiveness estimates were poorer for patients with ALD over the 27-month period than for patients with PBC or PSC. This in part reflects the costs of the higher number of ALD patients assessed for each transplant.

  5. Improving the Care of Patients with Chronic Kidney Disease Using Group Visits: A Pilot Study to Reflect an Emphasis on the Patients Rather Than the Disease.

    PubMed

    Montoya, Vicki; Sole, Mary Lou; Norris, Anne E

    2016-01-01

    This two-group, repeated-measures experimental study assessed the efficacy of a nurse practitioner-facilitated chronic kidney disease (CKD) group visit (GV) model versus usual nephrology care for patients with Stage 4 CKD. The study enrolled patients from two sites of an outpatient nephrology practice (n = 30) and randomized subjects to usual care (n = 14) or to the GV model (n = 16). Data regarding CKD knowledge, self-efficacy/disease self-management, and physiologic measures were collected at baseline, 6 months, and 9 months. Satisfaction was obtained at 6 months and 9 months. Usual nephrology office visit components were maintained during six monthly GVs, with group discussions of CKD-related topies. Results indicated a statistical improvement in CKD knowledge for both groups (F[1.498, 34.446] = 6.363, p = 0.008). An upward trend in mean scores for self-management subscales and self-efficacy scores was demonstrated in the GV patients, with no improvement found in the usual care group. Twenty-six of 30 patients completed the study, with 92% attendance in the GV group. GV satisfaction was high. PMID:27501629

  6. Electronic disease surveillance for sensitive population groups - the diabetics case study.

    PubMed

    Botsis, Taxiarchis; Hejlesen, Ole; Bellika, Johan Gustav; Hartvigsen, Gunnar

    2008-01-01

    Diabetics are quite susceptible to infectious diseases and can easily spread them under certain circumstances. Their blood glucose levels are increased after infection and this can cause a hyperglycemic crisis. Our study indicates that this increase results in glucosylated hemoglobin elevation, even when a diabetic is monitored closely and his/her blood glucose is under tight control. Thus, it is important to detect infections at the very early stages of disease progression in order to aid the patient. For this purpose, an electronic Disease Surveillance System could be developed to collect and analyze blood glucose data. Generally, we could extend the use of blood glucose data to the implementation of disease surveillance systems for the general population.

  7. Antimicrobial Use Guidelines for Treatment of Urinary Tract Disease in Dogs and Cats: Antimicrobial Guidelines Working Group of the International Society for Companion Animal Infectious Diseases

    PubMed Central

    Weese, J. Scott; Blondeau, Joseph M.; Boothe, Dawn; Breitschwerdt, Edward B.; Guardabassi, Luca; Hillier, Andrew; Lloyd, David H.; Papich, Mark G.; Rankin, Shelley C.; Turnidge, John D.; Sykes, Jane E.

    2011-01-01

    Urinary tract disease is a common reason for use (and likely misuse, improper use, and overuse) of antimicrobials in dogs and cats. There is a lack of comprehensive treatment guidelines such as those that are available for human medicine. Accordingly, guidelines for diagnosis and management of urinary tract infections were created by a Working Group of the International Society for Companion Animal Infectious Diseases. While objective data are currently limited, these guidelines provide information to assist in the diagnosis and management of upper and lower urinary tract infections in dogs and cats. PMID:21776346

  8. Costs and benefits of group living with disease: a case study of pneumonia in bighorn lambs (Ovis canadensis)

    PubMed Central

    Manlove, Kezia R.; Cassirer, E. Frances; Cross, Paul C.; Plowright, Raina K.; Hudson, Peter J.

    2014-01-01

    Group living facilitates pathogen transmission among social hosts, yet temporally stable host social organizations can actually limit transmission of some pathogens. When there are few between-subpopulation contacts for the duration of a disease event, transmission becomes localized to subpopulations. The number of per capita infectious contacts approaches the subpopulation size as pathogen infectiousness increases. Here, we illustrate that this is the case during epidemics of highly infectious pneumonia in bighorn lambs (Ovis canadensis). We classified individually marked bighorn ewes into disjoint seasonal subpopulations, and decomposed the variance in lamb survival to weaning into components associated with individual ewes, subpopulations, populations and years. During epidemics, lamb survival varied substantially more between ewe-subpopulations than across populations or years, suggesting localized pathogen transmission. This pattern of lamb survival was not observed during years when disease was absent. Additionally, group sizes in ewe-subpopulations were independent of population size, but the number of ewe-subpopulations increased with population size. Consequently, although one might reasonably assume that force of infection for this highly communicable disease scales with population size, in fact, host social behaviour modulates transmission such that disease is frequency-dependent within populations, and some groups remain protected during epidemic events. PMID:25377464

  9. Costs and benefits of group living with disease: a case study of pneumonia in bighorn lambs (Ovis canadensis).

    PubMed

    Manlove, Kezia R; Cassirer, E Frances; Cross, Paul C; Plowright, Raina K; Hudson, Peter J

    2014-12-22

    Group living facilitates pathogen transmission among social hosts, yet temporally stable host social organizations can actually limit transmission of some pathogens. When there are few between-subpopulation contacts for the duration of a disease event, transmission becomes localized to subpopulations. The number of per capita infectious contacts approaches the subpopulation size as pathogen infectiousness increases. Here, we illustrate that this is the case during epidemics of highly infectious pneumonia in bighorn lambs (Ovis canadensis). We classified individually marked bighorn ewes into disjoint seasonal subpopulations, and decomposed the variance in lamb survival to weaning into components associated with individual ewes, subpopulations, populations and years. During epidemics, lamb survival varied substantially more between ewe-subpopulations than across populations or years, suggesting localized pathogen transmission. This pattern of lamb survival was not observed during years when disease was absent. Additionally, group sizes in ewe-subpopulations were independent of population size, but the number of ewe-subpopulations increased with population size. Consequently, although one might reasonably assume that force of infection for this highly communicable disease scales with population size, in fact, host social behaviour modulates transmission such that disease is frequency-dependent within populations, and some groups remain protected during epidemic events.

  10. Costs and benefits of group living with disease: a case study of pneumonia in bighorn lambs (Ovis canadensis)

    USGS Publications Warehouse

    Manlove, Kezia R.; Cassirer, E. Frances; Cross, Paul C.; Plowright, Raina K.; Hudson, Peter J.

    2014-01-01

    Group living facilitates pathogen transmission among social hosts, yet temporally stable host social organizations can actually limit transmission of some pathogens. When there are few between-subpopulation contacts for the duration of a disease event, transmission becomes localized to subpopulations. The number of per capita infectious contacts approaches the subpopulation size as pathogen infectiousness increases. Here, we illustrate that this is the case during epidemics of highly infectious pneumonia in bighorn lambs (Ovis canadensis). We classified individually marked bighorn ewes into disjoint seasonal subpopulations, and decomposed the variance in lamb survival to weaning into components associated with individual ewes, subpopulations, populations and years. During epidemics, lamb survival varied substantially more between ewe-subpopulations than across populations or years, suggesting localized pathogen transmission. This pattern of lamb survival was not observed during years when disease was absent. Additionally, group sizes in ewe-subpopulations were independent of population size, but the number of ewe-subpopulations increased with population size. Consequently, although one might reasonably assume that force of infection for this highly communicable disease scales with population size, in fact, host social behaviour modulates transmission such that disease is frequency-dependent within populations, and some groups remain protected during epidemic events.

  11. Transmission of group II heteronymous pathways is enhanced in rigid lower limb of de novo patients with Parkinson's disease.

    PubMed

    Simonetta Moreau, M; Meunier, S; Vidailhet, M; Pol, S; Galitzky, M; Rascol, O

    2002-09-01

    A potent heteronymous excitation of quadriceps motoneurones via common peroneal group II afferents has recently been demonstrated in normal subjects. The aim of this study was to investigate whether this group II excitation contributes to rigidity in Parkinson's disease. The early and late facilitations of the quadriceps H reflex elicited by a conditioning volley to the common peroneal nerve (CPN) at twice motor threshold, attributed to non-monosynaptic group I and group II excitations, respectively, were investigated. The comparison was drawn between results obtained in 20 "de novo" patients with Parkinson's disease (hemiparkinsonian, 17; bilateral, three) and 20 age-matched normal subjects. There was no statistically significant effect of "group" (patients/controls), "duration", "global severity" [Unified Parkinson's Disease Rating Scale (UPDRS)] or "side" (unilaterally versus bilaterally affected) factors on either group I or group II facilitations. To further the analysis, the factors of status (affected or non-affected limb), akinesia (lower limb akinesia score) and rigidity (lower limb rigidity score) were entered in a general linear model to explain the variations of the quadriceps H reflex facilitation. Rigidity was the only factor useful in predicting the value of the group II facilitation of the quadriceps H reflex (P < 0.007). Group I and group II facilitation was then compared between the rigid, non-rigid and control lower limbs [multivariate analysis of variance (MANOVA)]. Results are represented as mean +/- SEM (standard error of the mean). Group II facilitation was enhanced in the rigid lower limb of unilaterally affected patients (153.2 +/- 7% of control H reflex) compared with non-rigid lower limbs (124 +/- 4% of control H reflex; P < 0.007) or control lower limbs (126.1 +/- 4.1%; P < 0.01). There was no difference between the non-rigid lower limbs of the unilaterally affected patients and the control lower limbs, but a difference was observed

  12. Experimental infectious respiratory disease in groups of calves:Lobar distribution, variance, and sample-size requirements for vaccine evaluation

    PubMed Central

    2004-01-01

    Abstract The distribution and variance of respiratory disease produced with aerosols of bovine herpesvirus 1 (BHV-1) and Mannheimia haemolytica in control (183 calves in 44 experiments) and vaccinated calves were studied in experiments conducted at the Animal Diseases Research Institute, Lethbridge, Alberta, from 1975 to 1989. All calves had been born and raised at this institute and exposed similarly for 5 min by means of a face mask to viral and bacterial aerosols produced by a Collison atomizer (particles < 3 μm in diameter). We summarized the macroscopic pathological responses of pneumonia (main end point), tonsillitis, tracheitis, and other microbiologic and experimental variables. We also summarized the lobar distribution of pneumonia in 202 control and 192 vaccinated calves with this disease model and in calves similarly exposed to parainfluenza 3 virus/M. haemolytica or BHV-1/Pasteurella multocida. Pneumonia in control calves began in ventral tissues of all lobes, with lobar preferences, and progressed dorsally, the dorsal parts of both large caudal lobes being least affected. A high variance of pneumonia was evident within and among experiments. From the magnitude of variance observed in the control groups, the number of calves per group required in vaccine-challenge studies using this BHV-1/M. haemolytica disease model was estimated. Such estimates are required for any disease model used in vaccine-challenge studies. PMID:15188956

  13. Climate change and infectious diseases in the Arctic: establishment of a circumpolar working group.

    PubMed

    Parkinson, Alan J; Evengard, Birgitta; Semenza, Jan C; Ogden, Nicholas; Børresen, Malene L; Berner, Jim; Brubaker, Michael; Sjöstedt, Anders; Evander, Magnus; Hondula, David M; Menne, Bettina; Pshenichnaya, Natalia; Gounder, Prabhu; Larose, Tricia; Revich, Boris; Hueffer, Karsten; Albihn, Ann

    2014-01-01

    The Arctic, even more so than other parts of the world, has warmed substantially over the past few decades. Temperature and humidity influence the rate of development, survival and reproduction of pathogens and thus the incidence and prevalence of many infectious diseases. Higher temperatures may also allow infected host species to survive winters in larger numbers, increase the population size and expand their habitat range. The impact of these changes on human disease in the Arctic has not been fully evaluated. There is concern that climate change may shift the geographic and temporal distribution of a range of infectious diseases. Many infectious diseases are climate sensitive, where their emergence in a region is dependent on climate-related ecological changes. Most are zoonotic diseases, and can be spread between humans and animals by arthropod vectors, water, soil, wild or domestic animals. Potentially climate-sensitive zoonotic pathogens of circumpolar concern include Brucella spp., Toxoplasma gondii, Trichinella spp., Clostridium botulinum, Francisella tularensis, Borrelia burgdorferi, Bacillus anthracis, Echinococcus spp., Leptospira spp., Giardia spp., Cryptosporida spp., Coxiella burnetti, rabies virus, West Nile virus, Hantaviruses, and tick-borne encephalitis viruses.

  14. At the bedside: the emergence of group 2 innate lymphoid cells in human disease.

    PubMed

    Peebles, R Stokes

    2015-03-01

    ILC2s have been primarily identified at environmental-mucosal interfaces and can be activated quickly by environmental antigens and pathogens to produce large quantities of IL-5 and IL-13. As a result of the production of these cytokines, ILC2s have been implicated in the host response to allergens, viruses, and parasites. However, the exact role of ILC2s in any human disease state is presently unknown, as specifically eliminating these cells is not possible, given that potentially targetable cell-surface markers are shared with other immune cells. Likewise, selectively and completely inhibiting ILC2 activation is also not currently possible, as several activating cytokines, IL-25, IL-33, and TSLP, act in redundancy or are not specific for ILC2 stimulation. Therefore, at this point, we can only identify the relative abundance of ILC2s in organs and tissue identified as being involved in specific diseases, and the contribution of ILC2s in human disease can only be inferred from mouse studies. Given these limitations, in this article, we will review the studies that have examined the presence of ILC2s in human disease states and speculate on their possible role in disease pathogenesis. The intent of the review is to identify priority areas for basic research based on clinical research insights.

  15. Climate change and infectious diseases in the Arctic: establishment of a circumpolar working group

    PubMed Central

    Parkinson, Alan J.; Evengard, Birgitta; Semenza, Jan C.; Ogden, Nicholas; Børresen, Malene L.; Berner, Jim; Brubaker, Michael; Sjöstedt, Anders; Evander, Magnus; Hondula, David M.; Menne, Bettina; Pshenichnaya, Natalia; Gounder, Prabhu; Larose, Tricia; Revich, Boris; Hueffer, Karsten; Albihn, Ann

    2014-01-01

    The Arctic, even more so than other parts of the world, has warmed substantially over the past few decades. Temperature and humidity influence the rate of development, survival and reproduction of pathogens and thus the incidence and prevalence of many infectious diseases. Higher temperatures may also allow infected host species to survive winters in larger numbers, increase the population size and expand their habitat range. The impact of these changes on human disease in the Arctic has not been fully evaluated. There is concern that climate change may shift the geographic and temporal distribution of a range of infectious diseases. Many infectious diseases are climate sensitive, where their emergence in a region is dependent on climate-related ecological changes. Most are zoonotic diseases, and can be spread between humans and animals by arthropod vectors, water, soil, wild or domestic animals. Potentially climate-sensitive zoonotic pathogens of circumpolar concern include Brucella spp., Toxoplasma gondii, Trichinella spp., Clostridium botulinum, Francisella tularensis, Borrelia burgdorferi, Bacillus anthracis, Echinococcus spp., Leptospira spp., Giardia spp., Cryptosporida spp., Coxiella burnetti, rabies virus, West Nile virus, Hantaviruses, and tick-borne encephalitis viruses. PMID:25317383

  16. ABO blood group system and the coronary artery disease: an updated systematic review and meta-analysis

    PubMed Central

    Chen, Zhuo; Yang, Sheng-Hua; Xu, Hao; Li, Jian-Jun

    2016-01-01

    ABO blood group system, a well-known genetic risk factor, has clinically been demonstrated to be linked with thrombotic vascular diseases. However, the relationship between ABO blood group and coronary artery disease (CAD) is still controversial. We here performed an updated meta-analysis of the related studies and tried to elucidate the potential role of ABO blood group as a risk factor for CAD. All detectable case-control and cohort studies comparing the risk of CAD in different ABO blood groups were collected for this analysis through searching PubMed, Embase, and the Cochrane Library. Ultimately, 17 studies covering 225,810 participants were included. The combined results showed that the risk of CAD was significantly higher in blood group A (OR = 1.14, 95% CI = 1.03 to 1.26, p = 0.01) and lower in blood group O (OR = 0.85, 95% CI = 0.78 to 0.94, p = 0.0008). Even when studies merely about myocardial infarction (MI) were removed, the risk of CAD was still significantly higher in blood group A (OR = 1.05, 95% CI = 1.00 to 1.10, p = 0.03) and lower in blood group O (OR = 0.89, 95% CI = 0.85 to 0.93, p < 0.00001). This updated systematic review and meta-analysis indicated that both blood group A and non-O were the risk factors of CAD. PMID:26988722

  17. International Primary Care Respiratory Group (IPCRG) Guidelines: management of chronic obstructive pulmonary disease (COPD).

    PubMed

    Bellamy, David; Bouchard, Jacques; Henrichsen, Svein; Johansson, Gunnar; Langhammer, Arnulf; Reid, Jim; van Weel, Chris; Buist, Sonia

    2006-02-01

    COPD is a common and under-diagnosed disease which is increasing in prevalence worldwide. A more aggressive and optimistic approach must be adopted towards its management in primary care. This IPCRG Guideline on the management of COPD in primary care is fully consistent with GOLD guidelines. It highlights the goals of COPD treatment and the need for spirometric testing to make the diagnosis. It covers the classification of the disease according to disease severity, non-pharmacologic therapy including smoking cessation, avoidance of risk factors, patient education, pharmacologic therapy including the use of oxygen treatment, the management of exacerbations, the role of pulmonary rehabilitation, and the need for monitoring and ongoing care for COPD patients. PMID:16701758

  18. Phylogenetic groups and cephalosporin resistance genes of Escherichia coli from diseased food-producing animals in Japan

    PubMed Central

    2011-01-01

    A total of 318 Escherichia coli isolates obtained from different food-producing animals affected with colibacillosis between 2001 and 2006 were subjected to phylogenetic analysis: 72 bovine isolates, 89 poultry isolates and 157 porcine isolates. Overall, the phylogenetic group A was predominant in isolates from cattle (36/72, 50%) and pigs (101/157, 64.3%) whereas groups A (44/89, 49.4%) and D (40/89, 44.9%) were predominant in isolates from poultry. In addition, group B2 was not found among diseased food-producing animals except for a poultry isolate. Thus, the phylogenetic group distribution of E. coli from diseased animals was different by animal species. Among the 318 isolates, cefazolin resistance (minimum inhibitory concentrations: ≥32 μg/ml) was found in six bovine isolates, 29 poultry isolates and three porcine isolates. Of them, 11 isolates (nine from poultry and two from cattle) produced extended spectrum β-lactamase (ESBL). The two bovine isolates produced blaCTX-M-2, while the nine poultry isolates produced blaCTX-M-25 (4), blaSHV-2 (3), blaCTX-M-15 (1) and blaCTX-M-2 (1). Thus, our results showed that several types of ESBL were identified and three types of β-lactamase (SHV-2, CTX-M-25 and CTX-M-15) were observed for the first time in E. coli from diseased animals in Japan. PMID:21989155

  19. APOE Genotype in the Ethnic Majority and Minority Groups of Laos and the Implications for Non-Communicable Diseases

    PubMed Central

    Midorikawa, Kaoru; Soukaloun, Douangdao; Akkhavong, Kongsap; Southivong, Bouavanh; Rattanavong, Oudayvone; Sengkhygnavong, Vikham; Pyaluanglath, Amphay; Sayasithsena, Saymongkhonh; Nakamura, Satoshi; Midorikawa, Yutaka; Murata, Mariko

    2016-01-01

    Background Increasing age is associated with elevated risk of non-communicable diseases, including dementia and Alzheimer’s disease (AD). The apolipoprotein E (APOE) ε4 allele is a risk factor not only for AD, but also for cognitive decline, depressive symptoms, stroke, hypertension, coronary heart disease, cardiovascular disease, and diabetes. The Lao People’s Democratic Republic (Laos) is undergoing development; consequently, life expectancy has risen. To evaluate the future risk of non-communicable diseases, we investigated APOE genotypes and anthropometric characteristics in the Laotian population. Methodology/Principal Findings Subjects were 455 members of the Lao Loum majority and 354 members of ethnic minorities. APOE genotypes, anthropometric characteristics, blood pressure, and blood glucose were recorded. To compare individual changes, health examination data collected 5 years apart were obtained from a subset of Lao Loum subjects. APOE ε4 allele frequencies were higher among minorities (31.3%) than among Lao Loum (12.6%). In Lao Loum, but not in minorities, mean waist circumference and blood pressure increased significantly across age groups. Comparisons of health conditions between the beginning and end of the 5-year period revealed significant increases in obesity and blood glucose levels in Lao Loum. APOE ε4 carriers exhibited significant increases in resting heart rate in both ethnic groups. Conclusions/Significance A higher ε4 allele frequency was observed in Laotian minorities than in the Laotian majority. Furthermore, higher obesity, blood pressure and blood glucose were observed in the middle-aged ethnic majority. Therefore, given these genetic and non-communicable disease risk factors, it seems likely that as the Laotian population ages, elevated rates of non-communicable aging-related diseases, such as dementia, will also become more prevalent. PMID:27168072

  20. Help for Self-Help at the Grassroots: Non-Governmental Organizations for Development Assistance in the Federal Republic of Germany.

    ERIC Educational Resources Information Center

    Mensing, Friedhelm

    1988-01-01

    It is estimated that there are over 10,000 non-governmental groups and initiatives in West Germany devoted to improving the quality of life of people in the developing countries. Many of these projects consist of churches helping churches, such as Misereor, the charity organization of German Catholics, or Brot fur die Welt (Bread for the World),…

  1. An investigation of long-term effects of group music therapy on agitation levels of people with Alzheimer's Disease.

    PubMed

    Ledger, Alison J; Baker, Felicity A

    2007-05-01

    This study aimed to investigate the long-term effects of group music therapy on agitation manifested by nursing home residents with Alzheimer's disease. A non-randomised experimental design was employed with one group receiving weekly music therapy (n = 26) and another group receiving standard nursing home care (n = 19). Agitation levels were measured five times over one year using the Cohen-Mansfield Agitation Inventory (Cohen-Mansfield, J. (1989). Agitation in the elderly. In N. Billig & P. V. Rabins (Eds.), Issues in geriatric psychiatry (pp. 101-113). Basel, Switzerland: Karger). Although music therapy participants showed short-term reductions in agitation, there were no significant differences between the groups in the range, frequency, and severity of agitated behaviours manifested over time. Multiple measures of treatment efficacy are necessary to better understand the long-term effects music therapy programs have on this population.

  2. A Group Intervention Model for Speech and Communication Skills in Patients with Parkinson's Disease: Initial Observations

    ERIC Educational Resources Information Center

    Manor, Yael; Posen, Jennie; Amir, Ofer; Dori, Nechama; Giladi, Nir

    2005-01-01

    Various speech and voice disorders affect 70% to 85% of individuals with Parkinson's disease (PD). Speech treatment is generally conducted on an individual basis, with family member involvement. Clinical experience indicates that many patients do not practice treatments at home or apply the learned techniques in everyday situations. An…

  3. Project CARE: A Randomized Controlled Trial of a Behavioral Intervention Group for Alzheimer's Disease Caregivers

    ERIC Educational Resources Information Center

    Gonyea, Judith G.; O'Connor, Maureen K.; Boyle, Patricia A.

    2006-01-01

    Purpose: The neuropsychiatric symptoms associated with Alzheimer's disease are a major contributor to caregiver distress and burden. Despite recent efforts to teach caregivers skills to manage neuropsychiatric symptoms and reduce burden, there continues to be limited evidence that these strategies have helped caregivers of individuals with…

  4. [Structural and functional changes of external and intracranial arteries in elderly patients of different ethnic groups with ischemic heart disease].

    PubMed

    Fedorets, V N; Abramov, E A; Bartosh-Zelenaia, S Iu; Naĭden, T V

    2014-01-01

    The present article discusses the problem of structural and functional changes in extra-and intracranial arteries in elderly patients with ischemic heart disease (CHD) belonging to different ethnic groups before the upcoming coronary arteriography research and planned operative intervention. We examined 120 elderly patients with ischemic heart disease, including 50 patients of Korean nationality and 70 patients of Slavic ethnicity. Average values of IMT of the right and left CCA patients of South Asian group were significantly lower than those of Slavic ethnicity. Elderly patients with CHD the violation of cerebral circulation were due to atherosclerotic lesions of the extracranial vessels and local hemodynamic disturbances in their area of pathological tortuosity. Korean ethnicity elderly patients with CHD were observed more pronounced signs of stenosis and deformation of the main arteries of the neck, as well as lower collateral reserve of cerebral circulation.

  5. [Chagas disease in France: estimated number of infected persons and cardiac diseases in 2009, by risk groups].

    PubMed

    Dejour Salamanca, D; La Ruche, G; Tarantola, A; Degail, M A; Jeannel, D; Gastellu-Etchegorry, M

    2009-12-01

    An estimation of the number of Trypanosoma cruzi infected individuals and expected number of Chagasic cardiomyopathies in France (excluding French Guyana) was conducted in June, 2009 by InVS. Different risk groups were identified: Latino-Americans (LA) from endemic area (naturalized, legal and illegal migrants, adopted children), children born from LA's mother, French Guyanese living in Metropolitan France, expatriated and travellers from endemic countries. Prevalence rates by country of origin were applied to official data on risk populations obtained from the International Adoption Agency, Tourism Direction and French ministries (Finances, Foreign Affairs and Migrations). Around 157,000 individuals were potentially exposed. It is estimated than 1,464 [895-2,619] are infected by T. cruzi, of which 63 to 555 may evolve towards a chronic cardiomyopathy. This figure is within the range of earlier estimations of InVS and Guerri-Guttenberg. Taking into account illegal immigrants, the expected number of infected individuals in France should increase greatly this estimation.

  6. Dermatological disease in the older age group: a cross-sectional study in aged care facilities

    PubMed Central

    Deo, Maneka S; Vandal, Alain C; Jarrett, Paul

    2015-01-01

    Objectives To estimate the prevalence of dermatological disease in aged care facilities, and the relationship between cognitive or physical disability and significant disease. Setting 2 large aged care facilities in Auckland, New Zealand, each providing low and high level care. Participants All 161 residents of the facilities were invited to participate. The only exclusion criterion was inability to obtain consent from the individual or designated guardian. 88 participants were recruited—66 females (75%), 22 males (25%) with average age 87.1 years (SD 5.5 years). Primary and secondary outcome measures Primary—presence of significant skin disease (defined as that which in the opinion of the investigators needed treatment or was identified as a patient concern) diagnosed clinically on full dermatological examination by a dermatologist or dermatology trainee. Secondary—functional and cognitive status (Rehabilitation Complexity Scale and Abbreviated Mental Test Score). Results 81.8% were found to have at least one significant condition. The most common disorders were onychomycosis 42 (47.7%), basal cell carcinoma 13 (14.8%), asteototic eczema 11 (12.5%) and squamous cell carcinoma in situ 9 (10.2%). Other findings were invasive squamous cell carcinoma 7 (8%), bullous pemphigoid 2 (2.3%), melanoma 2 (2.3%), lichen sclerosus 2 (2.3%) and carcinoma of the breast 1 (1.1%). Inflammatory disease was more common in those with little physical disability compared with those with serious physical disability (OR 3.69; 95% CI 1.1 to 12.6, p=0.04). No significant association was found between skin disease and cognitive impairment. Conclusions A high rate of dermatological disease was found. Findings ranged from frequent but not life-threatening conditions (eg, onychomycosis), to those associated with a significant morbidity (eg, eczema, lichen sclerosus and bullous pemphigoid), to potentially life-threatening (eg, squamous cell carcinoma, melanoma and breast cancer

  7. A Simple, Semiselective Medium for Anaerobic Isolation of Anginosus Group Streptococci from Patients with Chronic Lung Disease

    PubMed Central

    Waite, Richard D.; Wareham, David W.; Gardiner, Samuel

    2012-01-01

    The anaerobic isolation of anginosus group streptococci (AGS) from respiratory specimens containing diverse microbiota using a semiselective blood agar medium incorporating nalidixic acid and sulfamethazine (NAS) is described. AGS were detected in 60% of tested sputa from patients with cystic fibrosis, chronic obstructive pulmonary disease, and bronchiectasis. This demonstrates NAS to be a diagnostic tool for detecting AGS within the complex microbial communities associated with chronic lung disorders. PMID:22238446

  8. Group A Streptococcus: a re-emergent pathogen. Infectious Diseases and Immunization Committee, Canadian Paediatric Society.

    PubMed Central

    1993-01-01

    Rheumatic fever is still rare in North America but must continue to be considered in the appropriate clinical setting. Invasive or severe GABHS disease remains unusual and is unlikely to be missed by the practitioner; however, it is essential that GABHS infection be considered as a possible cause of a severe sepsis-like syndrome. Currently the routine management of GABHS infection is unchanged; however, heightened awareness of the infection's rare, more serious complications is needed. PMID:8500028

  9. At the bench: understanding group 2 innate lymphoid cells in disease.

    PubMed

    Doherty, Taylor A

    2015-03-01

    The conventional paradigm of type 2 inflammatory responses is characterized by activation of CD4(+) Th2 cells that produce IL-4, IL-5, and IL-13, resulting in tissue eosinophil infiltration, mucus metaplasia, AHR, and IgE production. However, the recent discovery of ILC2s in mice and humans has brought forth a novel pathway in type 2 immunity that may work independent of, or in concert with, adaptive Th2 responses. ILC2s were described initially as lineage-negative lymphocytes that produce high levels of Th2 cytokines IL-5 and IL-13 in response to IL-25 and IL-33 and promote protection against helminth infections. More recent investigations have identified novel upstream regulators, as well as novel ILC2 products. ILC2s are found in mucosal surfaces, including respiratory tract and skin, and studies from experimental asthma and atopic dermatitis models support a role for ILC2s in promoting type 2 inflammatory responses. There are many unanswered questions about the role of ILC2s in chronic allergic diseases, including how ILC2s or upstream pathways can be targeted for therapy. As ILC2s are not antigen specific and may be activated after exposures to a variety of infectious agents and irritants thought to contribute to respiratory and skin diseases, future strategies to target ILC2 function in human disease may be promising. Our intent is to identify priority areas for ILC2 translational research based on basic research insights.

  10. Early Gut Microbiota Perturbations Following Intrapartum Antibiotic Prophylaxis to Prevent Group B Streptococcal Disease

    PubMed Central

    Ross, R. Paul; Biavati, Bruno; Corvaglia, Luigi T.; Faldella, Giacomo; Stanton, Catherine

    2016-01-01

    The faecal microbiota composition of infants born to mothers receiving intrapartum antibiotic prophylaxis with ampicillin against group B Streptococcus was compared with that of control infants, at day 7 and 30 of life. Recruited newborns were both exclusive breastfed and mixed fed, in order to also study the effect of dietary factors on the microbiota composition. Massive parallel sequencing of the V3-V4 region of the 16S rRNA gene and qPCR analysis were performed. Antibiotic prophylaxis caused the most marked changes on the microbiota in breastfed infants, mainly resulting in a higher relative abundance of Enterobacteriaceae, compared with control infants (52% vs. 14%, p = 0.044) and mixed-fed infants (52% vs. 16%, p = 0.13 NS) at day 7 and in a lower bacterial diversity compared to mixed-fed infants and controls. Bifidobacteria were also particularly vulnerable and abundances were reduced in breastfed (p = 0.001) and mixed-fed antibiotic treated groups compared to non-treated groups. Reductions in bifidobacteria in antibiotic treated infants were also confirmed by qPCR. By day 30, the bifidobacterial population recovered and abundances significantly increased in both breastfed (p = 0.025) and mixed-fed (p = 0.013) antibiotic treated groups, whereas Enterobacteriaceae abundances remained highest in the breastfed antibiotic treated group (44%), compared with control infants (16%) and mixed-fed antibiotic treated group (28%). This study has therefore demonstrated the short term consequences of maternal intrapartum antibiotic prophylaxis on the infant faecal microbial population, particularly in that of breastfed infants. PMID:27332552

  11. New type of exfoliatin obtained from staphylococcal strains, belonging to phage groups other than group II, isolated from patients with impetigo and Ritter's disease.

    PubMed

    Kondo, I; Sakurai, S; Sarai, Y

    1974-10-01

    Four strains of Staphylococcus aureus of a phage type other than the second group, isolated from patients with impetigo and Ritter's disease, were found to produce an exotoxin similar to those reported by Melish et al. (1972), Kapral and Miller (1971), and Arbuthnott et al. (1973). This toxin could elicit a general exfoliation of the epidermis with the so-called Nikolsky sign when subcutaneously inoculated into neonatal mice within 4 days after birth. The new toxin was serologically different from exfoliatin produced by the phage group II staphylococci previously reported (Kondo et al., 1973) and showed an electrophoretic pattern corresponding to that of the B-type toxin of the latter in acrylamide disc electrophoresis. It had the same molecular weight as that of the latter, which was estimated to be about 24,000. It was thermolabile and lost its toxic activity by heating at 60 C for 30 min; in addition, most of the toxicity was lost within 1 month of storage even at -30 C. We propose to designate the old typical heat-stable exfoliatin as S. aureus exfoliatin A and the new heat-susceptible exfoliatin as S. aureus exfoliatin B. PMID:4139120

  12. Application of Whole-Genome Sequencing to an Unusual Outbreak of Invasive Group A Streptococcal Disease

    PubMed Central

    Galloway-Peña, Jessica; Clement, Meredith E.; Sharma Kuinkel, Batu K.; Ruffin, Felicia; Flores, Anthony R.; Levinson, Howard; Shelburne, Samuel A.; Moore, Zack; Fowler, Vance G.

    2016-01-01

    Whole-genome analysis was applied to investigate atypical point-source transmission of 2 invasive group A streptococcal (GAS) infections. Isolates were serotype M4, ST39, and genetically indistinguishable. Comparison with MGAS10750 revealed nonsynonymous polymorphisms in ropB and increased speB transcription. This study demonstrates the usefulness of whole-genome analyses for GAS outbreaks. PMID:27006966

  13. Tracking Parkinson’s Disease over One Year with Multimodal Magnetic Resonance Imaging in a Group of Older Patients with Moderate Disease

    PubMed Central

    Melzer, Tracy R.; Myall, Daniel J.; MacAskill, Michael R.; Pitcher, Toni L.; Livingston, Leslie; Watts, Richard; Keenan, Ross J.; Dalrymple-Alford, John C.; Anderson, Tim J.

    2015-01-01

    Background & Objectives Cross-sectional magnetic resonance imaging (MRI) suggests that Parkinson’s disease (PD) is associated with changes in cerebral tissue volume, diffusion tensor imaging metrics, and perfusion values. Here, we performed a longitudinal multimodal MRI study—including structural, diffusion tensor imaging (DTI), and perfusion MRI—to investigate progressive brain changes over one year in a group of older PD patients at a moderate stage of disease. Methods Twenty-three non-demented PD (mean age (SD) = 69.5 (6.4) years, disease duration (SD) = 5.6 (4.3) years) and 23 matched control participants (mean age: 70.6 (6.8)) completed extensive neuropsychological and clinical assessment, and multimodal 3T MRI scanning at baseline and one year later. We used a voxel-based approach to assess change over time and group-by-time interactions for cerebral structural and perfusion metrics. Results Compared to controls, in PD participants there was localized grey matter atrophy over time in bilateral inferior and right middle temporal, and left orbito-frontal cortices. Using a voxel-based approach that focused on the centers of principal white matter tracts, the PD and control cohorts exhibited similar levels of change in DTI metrics. There was no significant change in perfusion, cognitive, or motor severity measures. Conclusions In a cohort of older, non-demented PD participants, macrostructural MRI detected atrophy in the PD group compared with the control group in temporal and orbito-frontal cortices. Changes in diffusion MRI along principal white matter tracts over one year were found, but this was not differentially affected by PD. PMID:26714266

  14. Women's knowledge about heart disease: Differences among ethnic and cultural groups in the Israeli Women's Health in Midlife Study.

    PubMed

    Blumstein, Tzvia; Benyamini, Yael; Boyko, Valentina; Lerner-Geva, Liat

    2016-01-01

    The current investigation aimed to assess levels of knowledge about risk factors for heart disease among midlife Israeli women, and to evaluate the relationship of knowledge to personal risk factors and vulnerability to heart disease. Face-to-face interviews with women aged 45-64 years were conducted during 2004-2006 within three population groups: long-term Jewish residents (LTR), immigrants from the former Soviet Union, and Arab women. The survey instrument included six knowledge statements relating to: the risk after menopause, family history, elevated cholesterol level, diabetes, obesity, and warning signs of a heart attack. The findings showed wide disparities in knowledge by educational level and between immigrants and LTR, after taking into account personal risk factors and education. Personal risk factors were not significantly related to the knowledge items, except for personal history of cardiovascular disease, which was associated with knowledge about "warning signs of a heart attack" and "family history." Women who perceived themselves as more vulnerable to heart disease were more likely to identify several risk factors correctly. These findings stress the need to increase knowledge about heart disease, especially among less educated and minority women, and to emphasize the risk of patients' personal status by health providers.

  15. Blood thicker than water: kinship, disease prevalence and group size drive divergent patterns of infection risk in a social mammal

    PubMed Central

    Delahay, Richard J.

    2016-01-01

    The importance of social- and kin-structuring of populations for the transmission of wildlife disease is widely assumed but poorly described. Social structure can help dilute risks of transmission for group members, and is relatively easy to measure, but kin-association represents a further level of population sub-structure that is harder to measure, particularly when association behaviours happen underground. Here, using epidemiological and molecular genetic data from a wild, high-density population of the European badger (Meles meles), we quantify the risks of infection with Mycobacterium bovis (the causative agent of tuberculosis) in cubs. The risk declines with increasing size of its social group, but this net dilution effect conceals divergent patterns of infection risk. Cubs only enjoy reduced risk when social groups have a higher proportion of test-negative individuals. Cubs suffer higher infection risk in social groups containing resident infectious adults, and these risks are exaggerated when cubs and infectious adults are closely related. We further identify key differences in infection risk associated with resident infectious males and females. We link our results to parent–offspring interactions and other kin-biased association, but also consider the possibility that susceptibility to infection is heritable. These patterns of infection risk help to explain the observation of a herd immunity effect in badgers following low-intensity vaccination campaigns. They also reveal kinship and kin-association to be important, and often hidden, drivers of disease transmission in social mammals. PMID:27440666

  16. Blood thicker than water: kinship, disease prevalence and group size drive divergent patterns of infection risk in a social mammal.

    PubMed

    Benton, Clare H; Delahay, Richard J; Robertson, Andrew; McDonald, Robbie A; Wilson, Alastair J; Burke, Terry A; Hodgson, Dave

    2016-07-27

    The importance of social- and kin-structuring of populations for the transmission of wildlife disease is widely assumed but poorly described. Social structure can help dilute risks of transmission for group members, and is relatively easy to measure, but kin-association represents a further level of population sub-structure that is harder to measure, particularly when association behaviours happen underground. Here, using epidemiological and molecular genetic data from a wild, high-density population of the European badger (Meles meles), we quantify the risks of infection with Mycobacterium bovis (the causative agent of tuberculosis) in cubs. The risk declines with increasing size of its social group, but this net dilution effect conceals divergent patterns of infection risk. Cubs only enjoy reduced risk when social groups have a higher proportion of test-negative individuals. Cubs suffer higher infection risk in social groups containing resident infectious adults, and these risks are exaggerated when cubs and infectious adults are closely related. We further identify key differences in infection risk associated with resident infectious males and females. We link our results to parent-offspring interactions and other kin-biased association, but also consider the possibility that susceptibility to infection is heritable. These patterns of infection risk help to explain the observation of a herd immunity effect in badgers following low-intensity vaccination campaigns. They also reveal kinship and kin-association to be important, and often hidden, drivers of disease transmission in social mammals. PMID:27440666

  17. Evaluation of a disease management program for COPD using propensity matched control group

    PubMed Central

    George, Pradeep Paul; Heng, Bee Hoon; Lim, Tow Keang; Abisheganaden, John; Ng, Alan Wei Keong; Lim, Fong Seng

    2016-01-01

    Background Disease management programs (DMPs) have proliferated recently as a means of improving the quality and efficiency of care for patients with chronic illness. These programs include education about disease, optimization of evidence-based medications, information and support from case managers, and institution of self-management principles. Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in Singapore and worldwide. DMP aims to reduce mortality, hospitalizations, and average length of stay in such patients. This study assesses the outcomes of the DMP, comparing the propensity score matched DMP patients with controls. Methods DMP patients were compared with the controls, who were COPD patients fulfilling the DMP’s inclusion criteria but not included in the program. Control patients were identified from Operations Data Store (ODS) database. The outcomes of interest were average length of stay, number of days admitted to hospital per 100 person days, readmission, and mortality rates per person year. The risk of death and readmission was estimated using Cox, and competing risk regression respectively. Propensity score was estimated to identify the predictors of DMP enrolment. DMP patients and controls were matched on their propensity score. Results There were 170 matched DMP patients and control patients having 287 and 207 hospitalizations respectively. Program patient had lower mortality than the controls (0.12 vs. 0.27 per person year); cumulative 1-year survival was 91% among program patient and 76% among the control patients. Readmission, and hospital days per 100 person-days was higher for the program patients (0.36 vs. 0.17 per person year), and (2.19 vs. 1.88 per person year) respectively. Conclusions Participation in “DMP” was associated with lower all-cause mortality when compared to the controls. This survival gain in the program patients was paradoxically associated with an increase in readmission rate and

  18. [Clinical and epidemiologic characteristics of ischemic heart disease in a group of physically handicapped individuals (blind and mute)].

    PubMed

    Stanić, R

    1993-01-01

    Our long clinical experience, with observations of some authors as well, indicate that the epidemic data of the prevalence of ischaemic heart disease (I.H.D.) is significantly reduced in some physically handicapped people (the blind and the deaf-mute) if we compare them with the similar ones who have not such anomalies. With no regard to patho-physiologic mechanism of such condition, 233 examinees of both sex, chosen by the method of accidental choice, were examined by clinical, ECG, and laboratory (non- invasive) methods and divided into three groups: the blind 81 (34.76%), the deaf-mute 76 (32.61%), and industrial workers 76 (32.61%) who were taken a as control group. The obtained results show that the incidence of I.H.D. (4,56%), and the control group 11 (8,36%), which, from the point of statistics, offer a significant piece of information.

  19. The prevention of early-onset neonatal group B streptococcal disease.

    PubMed

    Money, Deborah; Allen, Victoria M

    2013-10-01

    Objectif : Analyser les données issues de la littérature et formuler des recommandations sur la prise en charge des parturientes en vue de prévenir l’infection néonatale à streptocoques du groupe B d’apparition précoce. Parmi les révisions clés que renferme la présente directive clinique mise à jour, on trouve des modifications quant aux recommandations en ce qui concerne les schémas posologiques d’antibioprophylaxie, les épreuves de sensibilité et la prise en charge des femmes présentant une rupture prématurée des membranes. Issues : Parmi les issues maternelles évaluées, on trouvait l’exposition aux antibiotiques au cours de la grossesse et du travail, ainsi que les complications associées à l’administration d’antibiotiques. Les issues néonatales associées aux taux d’infection néonatale à streptocoques du groupe B d’apparition précoce ont été évaluées. Résultats : La littérature publiée a été récupérée par l’intermédiaire de recherches menées dans PubMed, CINAHL et The Cochrane Library entre janvier 1980 et juillet 2012, au moyen d’un vocabulaire contrôlé et de mots clés appropriés (« Group B streptococcus », « antibiotic therapy », « infection », « prevention »). Les résultats ont été restreints aux analyses systématiques, aux essais comparatifs randomisés / essais cliniques comparatifs et aux études observationnelles. Aucune restriction n’a été appliquée en matière de date ou de langue. Les recherches ont été mises à jour de façon régulière et intégrées à la directive clinique jusqu’en mai 2013. La littérature grise (non publiée) a été identifiée par l’intermédiaire de recherches menées dans les sites Web d’organismes s’intéressant à l’évaluation des technologies dans le domaine de la santé et d’organismes connexes, dans des collections de directives cliniques, dans des registres d’essais cliniques et auprès de sociétés de sp

  20. High prevalence of Escherichia coli belonging to the B2+D phylogenetic group in inflammatory bowel disease

    PubMed Central

    Kotlowski, Roman; Bernstein, Charles N; Sepehri, Shadi; Krause, Denis O

    2007-01-01

    Background It is not clear which species of bacteria may be involved in inflammatory bowel disease (IBD). One way of determining which bacteria might be likely candidates is to use culture‐independent methods to identify microorganisms that are present in diseased tissues but not in controls. Aims (1) To assess the diversity of microbial communities of biopsy tissue using culture‐independent methods; (2) to culture the bacteria found in the tissues of patients with IBD but not in the controls; (3) to identify potential virulence factors associated with cultured bacteria. Methods 84 biopsy specimens were collected from 15 controls, 13 patients with Crohn's disease (CD) and 19 patients with ulcerative colitis (UC) from a population‐based case–control study. Ribosomal intergenic spacer analysis (RISA) was conducted to identify unique DNA bands in tissues from patients with CD and UC that did not appear in controls. Results RISA followed by DNA sequencing identified unique bands in biopsy specimens from patients with IBD that were classified as Escherichia coli. Targeted culture showed a significantly (p<0.05) higher number of Enterobacteriaceae in specimens from patients with IBD. The B2+D phylogenetic group, serine protease autotransporters (SPATE) and adherence factors were more likely to be associated with tissues from patients with UC and CD than with controls. Conclusions The abundance of Enterobacteriaceae is 3–4 logs higher in tissues of patients with IBD and the B2+D phylogenetic groups are more prevalent in patients with UC and CD. The B2+D phylogenetic groups are associated with SPATE and adherence factors and may have a significant role in disease aetiology. PMID:17028128

  1. Refractoriness of the western fence lizard (Sceloporus occidentalis) to the Lyme disease group spirochete Borrelia bissettii.

    PubMed

    Lane, R S; Mun, J; Eisen, L; Eisen, R J

    2006-08-01

    The western fence lizard, Sceloporus occidentalis, is refractory to experimental infection with Borrelia burgdorferi sensu stricto, one of several Lyme disease spirochetes pathogenic for humans. Another member of the Lyme disease spirochete complex, Borrelia bissettii, is distributed widely throughout North America and a similar, if not identical, spirochete has been implicated as a human pathogen in southern Europe. To determine the susceptibility of S. occidentalis to B. bissettii, 6 naïve lizards were exposed to the feeding activities of Ixodes pacificus nymphs experimentally infected with this spirochete. None of the lizards developed spirochetemias detectable by polymerase chain reaction for up to 8 wk post-tick feeding, infected nymphs apparently lost their B. bissettii infections within 1-2 wk after engorgement, and xenodiagnostic L. pacificus larvae that co-fed alongside infected nymphs did not acquire and maintain spirochetes. In contrast, 3 of 4 naïve deer mice (Peromyscus maniculatus) exposed similarly to feeding by 1 or more B. bissettii-infected nymphs developed patent infections within 4 wk. These and previous findings suggest that the complement system of S. occidentalis typically destroys B. burgdorferi sensu lato spirochetes present in tissues of attached and feeding I. pacificus nymphs, thereby potentially reducing the probability of transmission of these bacteria to humans or other animals by the resultant adult ticks. PMID:16995383

  2. Tete a Tete: Reading Groups and Peer Learning

    ERIC Educational Resources Information Center

    Finlay, Sara-Jane; Faulkner, Guy

    2005-01-01

    This project was inspired by an awareness of the lack of engagement with the research literature by our students. The project consisted of self-help reading groups that centralized student discussion with three research objectives: to encourage students to engage with a broader range of literature, to encourage critical thinking around subject…

  3. Low-temperature isolation of disease-suppressive bacteria and characterization of a distinctive group of pseudomonads.

    PubMed

    Johansson, P Maria; Wright, Sandra A I

    2003-11-01

    The influence of environmental factors during isolation on the composition of potential biocontrol isolates is largely unknown. Bacterial isolates that efficiently suppressed wheat seedling blight caused by Fusarium culmorum were found by isolating psychrotrophic, root-associated bacteria and by screening them in a bioassay that mimicked field conditions. The impact of individual isolation factors on the disease-suppressive index (DSI) of almost 600 isolates was analyzed. The bacteria originated from 135 samples from 62 sites in Sweden and Switzerland. The isolation factors that increased the probability of finding isolates with high DSIs were sampling from arable land, Swiss origin of samples, and origination of isolates from plants belonging to the family Brassicaceae. The colony morphology of the isolates was characterized and compared to DSIs, which led to identification of a uniform morphological group containing 57 highly disease-suppressive isolates. Isolates in this group were identified as Pseudomonas sp.; they were fluorescent on King's medium B and had characteristic crystalline structures in their colonies. These isolates were morphologically similar to seven strains that had previously been selected for suppression of barley net blotch caused by Drechslera teres. Members of this morphological group grow at 1.5 degrees C and produce an antifungal polyketide (2,3-deepoxy-2,3-didehydrorhizoxin [DDR]). They have similar two-dimensional polyacrylamide gel electrophoresis protein profiles, phenotypic characteristics, and in vitro inhibition spectra of pathogens. In summary, in this paper we describe some isolation factors that are important for obtaining disease-suppressive bacteria in our system, and we describe a novel group of biocontrol pseudomonads.

  4. Low-Temperature Isolation of Disease-Suppressive Bacteria and Characterization of a Distinctive Group of Pseudomonads

    PubMed Central

    Johansson, P. Maria; Wright, Sandra A. I.

    2003-01-01

    The influence of environmental factors during isolation on the composition of potential biocontrol isolates is largely unknown. Bacterial isolates that efficiently suppressed wheat seedling blight caused by Fusarium culmorum were found by isolating psychrotrophic, root-associated bacteria and by screening them in a bioassay that mimicked field conditions. The impact of individual isolation factors on the disease-suppressive index (DSI) of almost 600 isolates was analyzed. The bacteria originated from 135 samples from 62 sites in Sweden and Switzerland. The isolation factors that increased the probability of finding isolates with high DSIs were sampling from arable land, Swiss origin of samples, and origination of isolates from plants belonging to the family Brassicaceae. The colony morphology of the isolates was characterized and compared to DSIs, which led to identification of a uniform morphological group containing 57 highly disease-suppressive isolates. Isolates in this group were identified as Pseudomonas sp.; they were fluorescent on King's medium B and had characteristic crystalline structures in their colonies. These isolates were morphologically similar to seven strains that had previously been selected for suppression of barley net blotch caused by Drechslera teres. Members of this morphological group grow at 1.5°C and produce an antifungal polyketide (2,3-deepoxy-2,3-didehydrorhizoxin [DDR]). They have similar two-dimensional polyacrylamide gel electrophoresis protein profiles, phenotypic characteristics, and in vitro inhibition spectra of pathogens. In summary, in this paper we describe some isolation factors that are important for obtaining disease-suppressive bacteria in our system, and we describe a novel group of biocontrol pseudomonads. PMID:14602601

  5. Antioxidant status in a group of institutionalised elderly people with chronic obstructive pulmonary disease.

    PubMed

    Rodríguez-Rodríguez, Elena; Ortega, Rosa M; Andrés, Pedro; Aparicio, Aránzazu; González-Rodríguez, Liliana G; López-Sobaler, Ana M; Navia, Beatriz; Perea, José M; Rodríguez-Rodríguez, Paula

    2016-05-28

    Chronic obstructive pulmonary disease (COPD) is one of the most important and prevalent diseases suffered by the elderly. Evidence exists that its onset and severity might be conditioned by antioxidant status. The aim of the present study was to investigate the relationship between antioxidant status and COPD in institutionalised elderly people. In all, 183 elderly people aged >65 years (twenty-one had COPD and 160 healthy controls) were studied. The subjects' diets were investigated via the use of precise individual weighing for 7 d. Body weight, height, and biceps and triceps skinfold thickness were measured, and body fat (kg) and BMI (kg/m2) were calculated. Serum retinol, α-tocopherol, β-carotene and vitamin C levels were determined. Subjects with COPD ate less fruits than healthy controls (117 (sd 52) v. 192 (sd 161) g/d), their coverage of the recommended intake of vitamin C was smaller (150 (sd 45) v. 191 (sd 88) %; note that both exceeded 100 %) and their diets had a lower antioxidant capacity (6558 (sd 2381) v. 9328 (sd 5367) mmol trolox equivalent/d). Those with COPD had lower serum vitamin C and α-tocopherol concentrations than healthy controls (32·4 (sd 15·3) v. 41·5 (sd 14·8) µmol/l and 12·1 (sd 3·2) v. 13·9 (sd 2·8) µmol/l, respectively). In addition, subjects with α-tocopherol <14·1µmol/l (50th percentile) were at 6·43 times greater risk of having COPD than those subjects with ≥14·1µmol/l (OR 6·43; 95 % CI 1·17, 35·24; P<0·05), taking sex, age, use of tobacco, body fat and vitamin E intake as covariables. Subjects with COPD had diets of poorer antioxidant quality, especially with respect to vitamins C and E, compared with healthy controls. PMID:27002926

  6. Antioxidant status in a group of institutionalised elderly people with chronic obstructive pulmonary disease.

    PubMed

    Rodríguez-Rodríguez, Elena; Ortega, Rosa M; Andrés, Pedro; Aparicio, Aránzazu; González-Rodríguez, Liliana G; López-Sobaler, Ana M; Navia, Beatriz; Perea, José M; Rodríguez-Rodríguez, Paula

    2016-05-28

    Chronic obstructive pulmonary disease (COPD) is one of the most important and prevalent diseases suffered by the elderly. Evidence exists that its onset and severity might be conditioned by antioxidant status. The aim of the present study was to investigate the relationship between antioxidant status and COPD in institutionalised elderly people. In all, 183 elderly people aged >65 years (twenty-one had COPD and 160 healthy controls) were studied. The subjects' diets were investigated via the use of precise individual weighing for 7 d. Body weight, height, and biceps and triceps skinfold thickness were measured, and body fat (kg) and BMI (kg/m2) were calculated. Serum retinol, α-tocopherol, β-carotene and vitamin C levels were determined. Subjects with COPD ate less fruits than healthy controls (117 (sd 52) v. 192 (sd 161) g/d), their coverage of the recommended intake of vitamin C was smaller (150 (sd 45) v. 191 (sd 88) %; note that both exceeded 100 %) and their diets had a lower antioxidant capacity (6558 (sd 2381) v. 9328 (sd 5367) mmol trolox equivalent/d). Those with COPD had lower serum vitamin C and α-tocopherol concentrations than healthy controls (32·4 (sd 15·3) v. 41·5 (sd 14·8) µmol/l and 12·1 (sd 3·2) v. 13·9 (sd 2·8) µmol/l, respectively). In addition, subjects with α-tocopherol <14·1µmol/l (50th percentile) were at 6·43 times greater risk of having COPD than those subjects with ≥14·1µmol/l (OR 6·43; 95 % CI 1·17, 35·24; P<0·05), taking sex, age, use of tobacco, body fat and vitamin E intake as covariables. Subjects with COPD had diets of poorer antioxidant quality, especially with respect to vitamins C and E, compared with healthy controls.

  7. High Incidence of Invasive Group A Streptococcus Disease Caused by Strains of Uncommon emm Types in Thunder Bay, Ontario, Canada

    PubMed Central

    Athey, Taryn B. T.; Teatero, Sarah; Sieswerda, Lee E.; Gubbay, Jonathan B.; Marchand-Austin, Alex; Li, Aimin; Wasserscheid, Jessica; Dewar, Ken; McGeer, Allison; Williams, David

    2015-01-01

    An outbreak of type emm59 invasive group A Streptococcus (iGAS) disease was declared in 2008 in Thunder Bay District, Northwestern Ontario, 2 years after a countrywide emm59 epidemic was recognized in Canada. Despite a declining number of emm59 infections since 2010, numerous cases of iGAS disease continue to be reported in the area. We collected clinical information on all iGAS cases recorded in Thunder Bay District from 2008 to 2013. We also emm typed and sequenced the genomes of all available strains isolated from 2011 to 2013 from iGAS infections and from severe cases of soft tissue infections. We used whole-genome sequencing data to investigate the population structure of GAS strains of the most frequently isolated emm types. We report an increased incidence of iGAS in Thunder Bay compared to the metropolitan area of Toronto/Peel and the province of Ontario. Illicit drug use, alcohol abuse, homelessness, and hepatitis C infection were underlying diseases or conditions that might have predisposed patients to iGAS disease. Most cases were caused by clonal strains of skin or generalist emm types (i.e., emm82, emm87, emm101, emm4, emm83, and emm114) uncommonly seen in other areas of the province. We observed rapid waxing and waning of emm types causing disease and their replacement by other emm types associated with the same tissue tropisms. Thus, iGAS disease in Thunder Bay District predominantly affects a select population of disadvantaged persons and is caused by clonally related strains of a few skin and generalist emm types less commonly associated with iGAS in other areas of Ontario. PMID:26491184

  8. A Sharing Experience: Development of a Group for Families Affected by HIV Infection.

    ERIC Educational Resources Information Center

    Melvin, Diane; Appleby, Sue

    1995-01-01

    Describes the establishment and development of a support group for the parents of children infected and/or affected by HIV infection. The group is hospital-based, meeting monthly since April 1992, facilitated by professionals but with a self-help and peer support emphasis. Explains the planning, setting, and running of the group. Identifies…

  9. Web-based self-help intervention reduces alcohol consumption in both heavy-drinking and dependent alcohol users: A pilot study.

    PubMed

    Andrade, André Luiz Monezi; de Lacerda, Roseli Boerngen; Gomide, Henrique Pinto; Ronzani, Telmo Mota; Sartes, Laisa Marcorela Andreoli; Martins, Leonardo Fernandes; Bedendo, André; Souza-Formigoni, Maria Lucia Oliveira

    2016-12-01

    As part of a multicenter project supported by the World Health Organization, we developed a web-based intervention to reduce alcohol use and related problems. We evaluated the predictors of adherence to, and the outcomes of the intervention. Success was defined as a reduction in consumption to low risk levels or to <50% of the baseline levels of number of drinks. From the 32,401 people who accessed the site, 3389 registered and 929 completed the full Alcohol Use Disorders Identification Test (AUDIT), a necessary condition to be considered eligible to take part in the intervention. Based on their AUDIT scores, these participants were classified into: low risk users (LRU; n=319) harmful/hazardous users (HHU; n=298) or suggestive of dependence users (SDU; n=312). 29.1% of the registered users (LRU=42; HHU=90; SDU=82) completed the evaluation form at the end of the six-week period, and 63.5% reported low-risk drinking levels. We observed a significant reduction in alcohol consumption in the HHU (62.5%) and SDU (64.5%) groups in relation to baseline. One month after the intervention, in the follow-up, 94 users filled out the evaluation form, and their rate of success was similar to the one observed in the previous evaluation. Logistic regression analyses indicated that HHU participants presented higher adherence than LRU. Despite a relatively low adherence to the program, its good outcomes and low cost, as well as the high number of people that can be reached by a web-based intervention, suggest it has good cost-effectiveness. PMID:27424165

  10. Web-based self-help intervention reduces alcohol consumption in both heavy-drinking and dependent alcohol users: A pilot study.

    PubMed

    Andrade, André Luiz Monezi; de Lacerda, Roseli Boerngen; Gomide, Henrique Pinto; Ronzani, Telmo Mota; Sartes, Laisa Marcorela Andreoli; Martins, Leonardo Fernandes; Bedendo, André; Souza-Formigoni, Maria Lucia Oliveira

    2016-12-01

    As part of a multicenter project supported by the World Health Organization, we developed a web-based intervention to reduce alcohol use and related problems. We evaluated the predictors of adherence to, and the outcomes of the intervention. Success was defined as a reduction in consumption to low risk levels or to <50% of the baseline levels of number of drinks. From the 32,401 people who accessed the site, 3389 registered and 929 completed the full Alcohol Use Disorders Identification Test (AUDIT), a necessary condition to be considered eligible to take part in the intervention. Based on their AUDIT scores, these participants were classified into: low risk users (LRU; n=319) harmful/hazardous users (HHU; n=298) or suggestive of dependence users (SDU; n=312). 29.1% of the registered users (LRU=42; HHU=90; SDU=82) completed the evaluation form at the end of the six-week period, and 63.5% reported low-risk drinking levels. We observed a significant reduction in alcohol consumption in the HHU (62.5%) and SDU (64.5%) groups in relation to baseline. One month after the intervention, in the follow-up, 94 users filled out the evaluation form, and their rate of success was similar to the one observed in the previous evaluation. Logistic regression analyses indicated that HHU participants presented higher adherence than LRU. Despite a relatively low adherence to the program, its good outcomes and low cost, as well as the high number of people that can be reached by a web-based intervention, suggest it has good cost-effectiveness.

  11. Geographic distribution, evolution, and disease importance of species within the Neotropical Anopheles albitarsis Group (Diptera, Culicidae)

    PubMed Central

    Linton, Yvonne-Marie; Ruiz-Lopez, J. Freddy; Conn, Jan E.; Sallum, Maria Anice M.; Póvoa, Marinete M.; Bergo, Eduardo S.; Oliveira, Tatiane M. P.; Sucupira, Izis; Wilkerson, Richard C.

    2015-01-01

    The Anopheles albitarsis group of mosquitoes comprises eight recognized species and one mitochondrial lineage. Our knowledge of malaria vectorial importance and the distribution and evolution of these taxa is incomplete. We constructed ecological niche models (ENMs) for these taxa and used hypothesized phylogenetic relationships and ENMs to investigate environmental and ecological divergence associated with speciation events. Two major clades were identified, one north (Clade 1) and one south (Clade 2) of the Amazon River that likely is or was a barrier to mosquito movement. Clade 1 species occur more often in higher average temperature locations than Clade 2 species, and taxon splits within Clade 1 corresponded with a greater divergence of variables related to precipitation than was the case within Clade 2. Comparison of the ecological profiles of sympatric species and sister species support the idea that phylogenetic proximity is related to ecological similarity. Anopheles albitarsis I, An. janconnae, and An. marajoara ENMs had the highest percentage of their predicted suitable habitat overlapping distribution models of Plasmodium falciparum and P. vivax, and warrant additional studies of the transmission potential of these species. Phylogenetic proximity may be related to malaria vectorial importance within the Albitarsis Group. PMID:24820570

  12. Molecular Characterization of Disease-Associated Streptococci of the Mitis Group That Are Optochin Susceptible▿

    PubMed Central

    Balsalobre, Luz; Hernández-Madrid, Antonia; Llull, Daniel; Martín-Galiano, Antonio J.; García, Ernesto; Fenoll, Asunción; de la Campa, Adela G.

    2006-01-01

    Eight optochin-susceptible (Opts) alpha-hemolytic (viridans) streptococcus isolates were characterized at the molecular level. These isolates showed phenotypic characteristics typical of both viridans streptococci and Streptococcus pneumoniae. Comparison of the sequence of housekeeping genes from these isolates with those of S. pneumoniae, Streptococcus mitis, Streptococcus oralis, and Streptococcus pseudopneumoniae suggested that the Opts isolates corresponded to streptococci of the mitis group. Besides, the Opts streptococci were negative by a Gen-Probe AccuProbe pneumococcus test and hybridized with specific pneumococcal probes (lytA and ply) but also with ant, a gene not present in most S. pneumoniae strains. Moreover, the isolates were insoluble in 1% sodium deoxycholate but completely dissolved in 0.1% deoxycholate. Sequence analysis of the lytA gene revealed that the Opts streptococci carried lytA alleles characteristic of those present in nonpneumococcal streptococci of the mitis group. The determination of the partial nucleotide sequence embracing the atp operon encoding the FoF1 H+-ATPase indicated that the optochin susceptibility of the isolates was due to the acquisition of atpC, atpA, and part of atpB from S. pneumoniae by horizontal gene transfer. PMID:16971639

  13. Geographic distribution, evolution, and disease importance of species within the Neotropical Anopheles albitarsis Group (Diptera, Culicidae).

    PubMed

    Foley, Desmond H; Linton, Yvonne-Marie; Ruiz-Lopez, J Freddy; Conn, Jan E; Sallum, Maria Anice M; Póvoa, Marinete M; Bergo, Eduardo S; Oliveira, Tatiane M P; Sucupira, Izis; Wilkerson, Richard C

    2014-06-01

    The Anopheles albitarsis group of mosquitoes comprises eight recognized species and one mitochondrial lineage. Our knowledge of malaria vectorial importance and the distribution and evolution of these taxa is incomplete. We constructed ecological niche models (ENMs) for these taxa and used hypothesized phylogenetic relationships and ENMs to investigate environmental and ecological divergence associated with speciation events. Two major clades were identified, one north (Clade 1) and one south (Clade 2) of the Amazon River that likely is or was a barrier to mosquito movement. Clade 1 species occur more often in higher average temperature locations than Clade 2 species, and taxon splits within Clade 1 corresponded with a greater divergence of variables related to precipitation than was the case within Clade 2. Comparison of the ecological profiles of sympatric species and sister species support the idea that phylogenetic proximity is related to ecological similarity. Anopheles albitarsis I, An. janconnae, and An. marajoara ENMs had the highest percentage of their predicted suitable habitat overlapping distribution models of Plasmodium falciparum and P. vivax, and warrant additional studies of the transmission potential of these species. Phylogenetic proximity may be related to malaria vectorial importance within the Albitarsis Group.

  14. Clonal Complex 17 Group B Streptococcus strains causing invasive disease in neonates and adults originate from the same genetic pool

    PubMed Central

    Teatero, Sarah; Ramoutar, Erin; McGeer, Allison; Li, Aimin; Melano, Roberto G.; Wasserscheid, Jessica; Dewar, Ken; Fittipaldi, Nahuel

    2016-01-01

    A significant proportion of group B Streptococcus (GBS) neonatal disease, particularly late-onset disease, is associated with strains of serotype III, clonal complex (CC) 17. CC17 strains also cause invasive infections in adults. Little is known about the phylogenetic relationships of isolates recovered from neonatal and adult CC17 invasive infections. We performed whole-genome-based phylogenetic analysis of 93 temporally and geographically matched CC17 strains isolated from both neonatal and adult invasive infections in the metropolitan region of Toronto/Peel, Canada. We also mined the whole-genome data to reveal mobile genetic elements carrying antimicrobial resistance genes. We discovered that CC17 GBS strains causing neonatal and adult invasive disease are interspersed and cluster tightly in a phylogenetic tree, signifying that they are derived from the same genetic pool. We identified limited variation due to recombination in the core CC17 genome. We describe that loss of Pilus Island 1 and acquisition of different mobile genetic elements carrying determinants of antimicrobial resistance contribute to CC17 genetic diversity. Acquisition of some of these mobile genetic elements appears to correlate with clonal expansion of the strains that possess them. Our results provide a genome-wide portrait of the population structure and evolution of a major disease-causing clone of an opportunistic pathogen. PMID:26843175

  15. Guidelines for the assessment and management of chronic obstructive pulmonary disease. Canadian Thoracic Society Workshop Group.

    PubMed Central

    1992-01-01

    Chronic obstructive pulmonary disease (COPD) is the fifth commonest cause of death in North America and is the only leading cause of death that is increasing in prevalence. Early detection and prevention through smoking cessation are essential to stem this epidemic. Once COPD is diagnosed there is a compelling rationale for vaccination against influenza and possibly pneumococcal pneumonia, although proof of efficacy is lacking. If airways obstruction is present, inhaled quaternary anticholinergic bronchodilators or inhaled beta 2 agonists or both may be of benefit, the former agents showing fewer side effects and often greater efficacy in elderly patients. Theophylline may enhance the effect or increase the duration of the bronchodilatation produced by an inhaled agent and may offer added nonbronchodilatory effects such as improved respiratory muscle endurance and ventilatory stimulation. If significant airflow obstruction persists, an objectively monitored trial of oral steroid therapy is required. Limitation of activity despite optimum medical therapy may be alleviated in selected patients by a supervised exercise rehabilitation program. If hypoxemia is present supplemental oxygen therapy will improve the patient's survival and quality of life. Additional therapies, from respiratory stimulants to lung transplantation, remain under investigation. PMID:1498754

  16. Electroencephalographic coherence in Alzheimer's disease: comparisons with a control group and population norms.

    PubMed

    Knott, V; Mohr, E; Mahoney, C; Ilivitsky, V

    2000-01-01

    Previous research from independent laboratories has shown reduced electroencephalographic coherence in patients diagnosed with dementia of the Alzheimer type (DAT). This study added to this work by comparing interhemispheric and intrahemispheric coherence in nonmedicated DAT patients (n = 35) with that of a normal control group (n = 30), as well as with a data bank of population norms. Raw and Z-score transformed values showed reduced coherence, interhemispherically (in delta, theta, alpha, and beta bands) and intrahemispherically (delta and theta bands) in DAT patients with both comparison procedures. Discriminant analysis correctly classified 73% to 75% of patients. The results are discussed in relation to earlier research, "trait" versus "state" factors, the cholinergic system, and cognitive processes in dementia.

  17. Pelvic inflammatory disease following induced first-trimester abortion. Risk groups, prophylaxis and sequelae.

    PubMed

    Heisterberg, L

    1988-02-01

    An analysis of published studies of the effect of antibiotic prophylaxis associated with vacuum aspiration abortion includes an examination of risk factors for pelvic inflammatory disease (PID), cervical and vaginal flora present in early pregnancy and in PID, the effect of surgical scrub and of prophylaxis on flora, principles of antibiotic prophylaxis, and economic costs of PID. From several prospective studies, it is clear that nulliparas, women with a history of PID, those bearing Chlamydia trachomatis are at risk of post-abortion infection. No risk was associated with pelvic pain, dysmenorrhea, social class, insertion of an IUD, or timing of resumption of coitus. After an extensive enumeration of microbes found in nonpregnant, pregnant, and PID female genital tracts, it was concluded that only C. trachomatis and N. gonorrheae are clearly associated with PID, while the importance of several other microbes is unclear. Quantitative counts of organisms in any condition are lacking. PID is polymicrobial; different organisms probably account for noniatrogenic PID and post-surgical PID. There is evidence that surgical cleansing of the vagina has no bearing on incidence of post-abortal PID, since the responsible organisms come from the endocervix. 5 controlled clinical trials demonstrated that antibiotic prophylaxis is warranted; that penicillin/ampicillin selectively reduced PID in women with PID history; that imidazoles preferentially reduce PID in the general population without PID history. No lasting side effects or emergence of resistant organisms was reported. The treatment was cost effective, cutting health costs and labor losses 5-8%, and reducing the incidence of spontaneous abortion, secondary infertility, and chronic pain. PMID:3277798

  18. A skin disease, a blood disease or something in between? An exploratory focus group study of patients' experiences with porphyria cutanea tarda*

    PubMed Central

    Andersen, J; Gjengedal, E; Sandberg, S; Råheim, M

    2015-01-01

    Background Porphyria cutanea tarda (PCT) is characterized by fragile skin with blistering on sun-exposed areas. Symptoms typically develop in late adulthood and can be triggered by iron overload, alcohol intake, oestrogens and various liver diseases. Treatment consists of phlebotomy to reduce iron, or increasing urinary porphyrin excretion by administering chlorochin. To optimize patient care, health personnel need to understand the subjective experiences of PCT. Objectives To explore the experiences of persons with PCT with regard to symptoms, treatment, follow-up and prevention of the disease. Methods Interpretive description was used as a qualitative approach. Twenty-one participants attended three focus groups. All participants had experienced PCT symptoms during the last 5 years. Results Participants' experiences varied from trivializing symptoms and fragile skin to what was described as a desperate situation, with huge blisters, skin falling off and feeling as if one was in a ‘horror movie’. For some, itching was very troublesome, preventing sleep and delaying skin healing. In managing PCT a shift in focus from skin to blood was described. PCT was perceived as a chronic and systemic disease causing a range of health problems. Strategies for preventing symptoms ranged from doing nothing to frequent controls and check-ups. Conclusions Participants had a systemic perception of PCT, and a tendency to attribute a range of health problems to the condition. This study adds insight into the experiences patients have with PCT. PMID:24958197

  19. Ethical and social issues in presymptomatic testing for Huntington's disease: a European Community collaborative study. European Community Huntington's Disease Collaborative Study Group.

    PubMed Central

    1993-01-01

    An analysis of social and ethical aspects of presymptomatic testing for Huntington's disease has been carried out, based on data on linked DNA markers, from four major testing centres in different European Community countries (Belgium, Italy, Netherlands, and United Kingdom). Information was available on 603 applicants, with 213 final results given, of which 32% gave an increased risk. A series of specific issues and problems were documented systematically for all applicants, results being given on frequency of occurrence and illustrated by individual case histories. The principal issues could be grouped as problems of inappropriate referral, problems involving relatives, and problems relating to disclosure of results. At least one important problem was encountered in 46% of applicants, emphasising the importance of expert counselling, preparation, and support of applicants, and of close liaison between clinical, counselling, and laboratory staff. The extensive and detailed information available for Huntington's disease from this and other studies will be of considerable value in relation to genetic testing for other late onset genetic disorders and will be even more relevant to Huntington's disease now that specific mutation analysis is possible for this disorder. PMID:8133502

  20. [PCR study of the human herpes virus type 6 and other viruses of the herpes group in eye diseases].

    PubMed

    Slepowa, O S; Svetlova, E V; Kovaleva, L A; Makarov, P V; Kugusheva, A E; Denisova, E V; Vahova, E S; Zaharova, G Yu; Kondrat'eva, Yu A; Andryushin, A E; Demkin, V V

    2015-01-01

    To study the role of the HHV-6 type in the development of eye diseases PCR tests of blood (152), cornea biopsies (61), and intraocular fluids (11) for HHV-6 and other viruses of the herpes group (HSV type 1 and 2, CMV, EBV) were conducted. It was found that the HHV-6, along with other representatives of the Herpesviridae, can be detected in patients with different clinical forms of ophthalmopathology (174 patients were surveyed). Viral DNA was detected in blood, cornea, and in the anterior chamber fluid. The obtained data allow that the HHV-6 to be suggested as a possible cause of the ophthalmic herpes along with the other viruses of this group. It makes finding the virus DNA an essential step towards setting the etiologic diagnosis of the ophthalmological patients. PMID:27024918

  1. Characterization of a Large Group of Individuals with Huntington Disease and Their Relatives Enrolled in the COHORT Study

    PubMed Central

    Dorsey, E. Ray

    2012-01-01

    Background Careful characterization of the phenotype and genotype of Huntington disease (HD) can foster better understanding of the condition. Methods We conducted a cohort study in the United States, Canada, and Australia of members of families affected by HD. We collected demographic and clinical data, conducted the Unified Huntington's Disease Rating Scale and Mini-Mental State Examination, and determined Huntingtin trinucleotide CAG repeat length. We report primarily on cross-sectional baseline data from this recently completed prospective, longitudinal, observational study. Results As of December 31, 2009, 2,318 individuals enrolled; of these, 1,985 (85.6%) were classified into six analysis groups. Three groups had expanded CAG alleles (36 repeats or more): individuals with clinically diagnosed HD [n = 930], and clinically unaffected first-degree relatives who had previously pursued [n = 248] or not pursued [n = 112] predictive DNA testing. Three groups lacked expanded alleles: first-degree relatives who had previously pursued [n = 41] or not pursued [n = 224] genetic testing, and spouses and caregivers [n = 430]. Baseline mean performance differed across groups in all motor, behavioral, cognitive, and functional measures (p<0.001). Clinically unaffected individuals with expanded alleles weighed less (76.0 vs. 79.6 kg; p = 0.01) and had lower cognitive scores (28.5 vs. 29.1 on the Mini Mental State Examination; p = 0.008) than individuals without expanded alleles. The frequency of “high normal” repeat lengths (27 to 35) was 2.5% and repeat lengths associated with reduced penetrance (36 to 39) was 2.7%. Conclusion Baseline analysis of COHORT study participants revealed differences that emerge prior to clinical diagnosis. Longitudinal investigation of this cohort will further characterize the natural history of HD and genetic and biological modifiers. Trial Registration Clinicaltrials.gov NCT00313495 PMID:22359536

  2. Blood pressure categories and long-term risk of cardiovascular disease according to age group in Japanese men and women.

    PubMed

    Fujiyoshi, Akira; Ohkubo, Takayoshi; Miura, Katsuyuki; Murakami, Yoshitaka; Nagasawa, Shin-Ya; Okamura, Tomonori; Ueshima, Hirotsugu

    2012-09-01

    Blood pressure (BP) categories defined by systolic BP (SBP) and diastolic BP (DBP) are commonly used. However, the BP category-specific risk of cardiovascular disease (CVD) has not been thoroughly investigated in different age groups. The aim of this study was to assess long-term CVD risk and its impact according to BP categories and age group. Pooling individual data from 10 cohorts, we studied 67 309 Japanese individuals (40-89 years old) who were free of CVD at baseline: we categorized them as belonging to three age groups: 'middle-aged' (40-64 years), 'elderly' (65-74 years) and 'very elderly' (75-89 years). BP was classified according to the 2009 Japanese Society of Hypertension Guidelines. Cox models were used to estimate adjusted hazard ratios for CVD deaths. We observed 1944 CVD deaths over a mean follow-up of 10.2 years. In all age groups, the overall relationship between BP category and CVD risk was positive, with a greater strength observed for younger age groups. We observed a trend of increased risk from SBP/DBP ≥ 130/85 mm Hg in the very elderly, and a significant increase from SBP/DBP ≥ 120/80 mm Hg in the other age groups. The population attributable fractions (PAFs) of CVD death in reference to the SBP/DBP<120/80 mm Hg category ranged from 23.4% in the very elderly to 60.3% in the middle-aged. We found an overall graded increase in CVD risk with higher BP category in the very elderly. The PAFs suggest that keeping BP levels low is an important strategy for primary CVD prevention, even in an elderly population.

  3. Group motivational intervention in overweight/obese patients in primary prevention of cardiovascular disease in the primary healthcare area

    PubMed Central

    2010-01-01

    Background The global mortality caused by cardiovascular disease increases with weight. The Framingham study showed that obesity is a cardiovascular risk factor independent of other risks such as type 2 diabetes mellitus, dyslipidemia and smoking. Moreover, the main problem in the management of weight-loss is its maintenance, if it is achieved. We have designed a study to determine whether a group motivational intervention, together with current clinical practice, is more efficient than the latter alone in the treatment of overweight and obesity, for initial weight loss and essentially to achieve maintenance of the weight achieved; and, secondly, to know if this intervention is more effective for reducing cardiovascular risk factors associated with overweight and obesity. Methods This 26-month follow up multi-centre trial, will include 1200 overweight/obese patients. Random assignment of the intervention by Basic Health Areas (BHA): two geographically separate groups have been created, one of which receives group motivational intervention (group intervention), delivered by a nurse trained by an expert phsychologist, in 32 group sessions, 1 to 12 fortnightly, and 13 to 32, monthly, on top of their standard program of diet, exercise, and the other (control group), receiving the usual follow up, with regular visits every 3 months. Discussion By addressing currently unanswered questions regarding the maintenance in weight loss in obesity/overweight, upon the expected completion of participant follow-up in 2012, the IMOAP trial should document, for the first time, the benefits of a motivational intervention as a treatment tool of weight loss in a primary care setting. Trial Registration ClinicalTrials.gov Identifier: NCT01006213 PMID:20298557

  4. Patterns of cardiovascular disease in a group of HIV-infected adults in Yaoundé, Cameroon

    PubMed Central

    Menanga, Alain Patrick; Ngomseu, Christelle Kougang; Jingi, Ahmadou M.; Mfangam, Brigitte Molu; Gweth, Marie Ntep; Blackett, Kathleen Ngu; Kingue, Samuel

    2015-01-01

    Background Cardiovascular disease is an increasingly important issue in human immunodeficiency viral (HIV)-infected individuals. There is dearth of information on the patterns of cardiovascular disease especially in sub-Saharan Africa (SSA) patients. This study reports on the clinical, biological, electrocardiographic and echocardiographic characteristics of a group of HIV-infected patients presenting with symptoms of heart disease in Yaoundé, Cameroon. Methods This was a cross-sectional study conducted at the Yaoundé Central Hospital and Jamot Hospital. Consenting HIV-infected adults aged ≥18 years with symptoms suggestive of heart disease were consecutively recruited between February and July 2014. All participants underwent a complete clinical examination; biological analyses including CD4 cell counts, fasting blood glucose, and serum lipids, resting electrocardiography and cardiac ultrasound, and a venous ultrasound where necessary. Results Forty four subjects (21 men) were included. Their mean age was 48 (SD 13) years. Thirty patients (68.2%) were in WHO clinical stages 3 and 4 of HIV infection, 27 (61.4%) had a CD4 cell count <200/mm3, and 31 (70.5%) were on antiretroviral therapy (ART). Hypertension (43.2%, n=19) was the most frequent cardiovascular risk factor; and dyslipidemia which was found in 17 subjects (38.6%) was significantly associated with ART (48.4% vs. 15.4%, P=0.04). Only men where smokers (23% vs. 0%, P=0.019). Exertional dyspnea (86.4%, n=38) and cough (59.1%, n=26) were the most frequent symptoms, and the clinical presentation was dominated by heart failure (75%, n=33). The most frequent echocardiographic abnormalities were pericardial effusion (45.5%, n=20) and dilated cardiomyopathy (22.7%, n=10). Dilated cardiomyopathy was significantly associated with CD4 cell counts <200/mm3 (100%, P=0.003). Primary pulmonary hypertension (PH) rate was 11.4% (n=5) and all cases occurred at CD4 cell counts ≥200/mm3 (P=0.005). The most frequent

  5. A best practice position statement on pregnancy in chronic kidney disease: the Italian Study Group on Kidney and Pregnancy.

    PubMed

    Cabiddu, Gianfranca; Castellino, Santina; Gernone, Giuseppe; Santoro, Domenico; Moroni, Gabriella; Giannattasio, Michele; Gregorini, Gina; Giacchino, Franca; Attini, Rossella; Loi, Valentina; Limardo, Monica; Gammaro, Linda; Todros, Tullia; Piccoli, Giorgina Barbara

    2016-06-01

    Pregnancy is increasingly undertaken in patients with chronic kidney disease (CKD) and, conversely, CKD is increasingly diagnosed in pregnancy: up to 3 % of pregnancies are estimated to be complicated by CKD. The heterogeneity of CKD (accounting for stage, hypertension and proteinuria) and the rarity of several kidney diseases make risk assessment difficult and therapeutic strategies are often based upon scattered experiences and small series. In this setting, the aim of this position statement of the Kidney and Pregnancy Study Group of the Italian Society of Nephrology is to review the literature, and discuss the experience in the clinical management of CKD in pregnancy. CKD is associated with an increased risk for adverse pregnancy-related outcomes since its early stage, also in the absence of hypertension and proteinuria, thus supporting the need for a multidisciplinary follow-up in all CKD patients. CKD stage, hypertension and proteinuria are interrelated, but they are also independent risk factors for adverse pregnancy-related outcomes. Among the different kidney diseases, patients with glomerulonephritis and immunologic diseases are at higher risk of developing or increasing proteinuria and hypertension, a picture often difficult to differentiate from preeclampsia. The risk is higher in active immunologic diseases, and in those cases that are detected or flare up during pregnancy. Referral to tertiary care centres for multidisciplinary follow-up and tailored approaches are warranted. The risk of maternal death is, almost exclusively, reported in systemic lupus erythematosus and vasculitis, which share with diabetic nephropathy an increased risk for perinatal death of the babies. Conversely, patients with kidney malformation, autosomal-dominant polycystic kidney disease, stone disease, and previous upper urinary tract infections are at higher risk for urinary tract infections, in turn associated with prematurity. No risk for malformations other than those

  6. A best practice position statement on pregnancy in chronic kidney disease: the Italian Study Group on Kidney and Pregnancy.

    PubMed

    Cabiddu, Gianfranca; Castellino, Santina; Gernone, Giuseppe; Santoro, Domenico; Moroni, Gabriella; Giannattasio, Michele; Gregorini, Gina; Giacchino, Franca; Attini, Rossella; Loi, Valentina; Limardo, Monica; Gammaro, Linda; Todros, Tullia; Piccoli, Giorgina Barbara

    2016-06-01

    Pregnancy is increasingly undertaken in patients with chronic kidney disease (CKD) and, conversely, CKD is increasingly diagnosed in pregnancy: up to 3 % of pregnancies are estimated to be complicated by CKD. The heterogeneity of CKD (accounting for stage, hypertension and proteinuria) and the rarity of several kidney diseases make risk assessment difficult and therapeutic strategies are often based upon scattered experiences and small series. In this setting, the aim of this position statement of the Kidney and Pregnancy Study Group of the Italian Society of Nephrology is to review the literature, and discuss the experience in the clinical management of CKD in pregnancy. CKD is associated with an increased risk for adverse pregnancy-related outcomes since its early stage, also in the absence of hypertension and proteinuria, thus supporting the need for a multidisciplinary follow-up in all CKD patients. CKD stage, hypertension and proteinuria are interrelated, but they are also independent risk factors for adverse pregnancy-related outcomes. Among the different kidney diseases, patients with glomerulonephritis and immunologic diseases are at higher risk of developing or increasing proteinuria and hypertension, a picture often difficult to differentiate from preeclampsia. The risk is higher in active immunologic diseases, and in those cases that are detected or flare up during pregnancy. Referral to tertiary care centres for multidisciplinary follow-up and tailored approaches are warranted. The risk of maternal death is, almost exclusively, reported in systemic lupus erythematosus and vasculitis, which share with diabetic nephropathy an increased risk for perinatal death of the babies. Conversely, patients with kidney malformation, autosomal-dominant polycystic kidney disease, stone disease, and previous upper urinary tract infections are at higher risk for urinary tract infections, in turn associated with prematurity. No risk for malformations other than those

  7. Hope, optimism, and self-care among Better Breathers Support Group members with chronic obstructive pulmonary disease.

    PubMed

    Alberto, June; Joyner, Barry

    2008-11-01

    The objective of this study was to determine the levels of hope, optimism, and self-care of persons with chronic obstructive pulmonary disease (COPD) who attend community-based Better Breathers Support Group (BBSG) meetings. A convenience sample of 68 BBSG members from 14 groups in three southeastern states participated. The data were collected with a questionnaire set composed of a demographic form and three previously tested research instruments: the Herth Hope Index (HHI), the Alberto Chronic Obstructive Pulmonary Disease Self-care Behavior Inventory (COPDSC), and the Life Orientation Test--Revised (LOT-R). The findings (n = 68) include a significant and positive relationship between the HHI and COPDSC (r = .39; p > .01), between the LOT-R and COPDSC (r = .41; p > .001), and between the LOT-R and HHI (r = .59; p > .001). So, those participants with higher Hope and Optimism have higher levels of Self-care. We concluded the participants were fairly optimistic (LOT-R average = 23.75+/-4.49) and hopeful (HHI average 39.47+/-5.61). The average score on the COPDSC was 141.57 (+/-14.76) indicating a high level of self-care.

  8. The Effect of Online Chronic Disease Personas on Activation: Within-Subjects and Between-Groups Analyses

    PubMed Central

    2015-01-01

    Background Although self-management of chronic disease is important, engaging patients and increasing activation for self-care using online tools has proven difficult. Designing more tailored interventions through the application of condition-specific personas may be a way to increase engagement and patient activation. Personas are developed from extensive interviews with patients about their shared values and assumptions about their health. The resulting personas tailor the knowledge and skills necessary for self-care and guide selection of the self-management tools for a particular audience. Objective Pre-post changes in self-reported levels of activation for self-management were analyzed for 11 chronic health personas developed for 4 prevalent chronic diseases. Methods Personas were created from 20 to 25 hour-long nondirected interviews with consumers with a common, chronic disease (eg, diabetes). The interviews were transcribed and coded for behaviors, feelings, and beliefs using the principles of grounded theory. A second group of 398 adults with self-reported chronic disease were recruited for online testing of the personas and their impact on activation. The activation variables, based on an integrated theory of health behavior, were knowledge of a given health issue, perceived self-management skills, confidence in improving health, and intention to take action in managing health. Pre-post changes in activation were analyzed with a mixed design with 1 within-subjects factor (pre-post) and 1 between-group factor (persona) using a general linear model with repeated measures. Results Sixteen pre-post changes for 4 measures of activation were analyzed. All but 2 of the within-subjects effects were statistically significant and all changes were in the direction of increased activation scores at posttest. Five significant differences between personas were observed, showing which personas performed better. Of low activation participants, 50% or more shifted to high

  9. Group 3 innate lymphoid cells accumulate and exhibit disease-induced activation in the meninges in EAE.

    PubMed

    Hatfield, Julianne K; Brown, Melissa A

    2015-10-01

    Innate lymphoid cells are immune cells that reside in tissues that interface with the external environment and contribute to the first line defense against pathogens. However, they also have roles in promoting chronic inflammation. Here we demonstrate that group 3 ILCs, (ILC3s - CD45+Lin-IL-7Rα+RORγt+), are normal residents of the meninges and exhibit disease-induced accumulation and activation in EAE. In addition to production of the pro-inflammatory cytokines IL-17 and GM-CSF, ILC3s constitutively express CD30L and OX40L, molecules required for memory T cell survival. We show that disease-induced trafficking of transferred wild type T cells to the meninges is impaired in ILC3-deficient Rorc-/- mice. Furthermore, lymphoid tissue inducer cells, a c-kit+ ILC3 subset that promotes ectopic lymphoid follicle development, a hallmark of many autoimmune diseases, are reduced in the meninges of EAE-resistant c-kit mutant Kit(W/Wv) mice. We propose that ILC3s sustain neuroinflammation by supporting T cell survival and reactivation in the meninges.

  10. Better Housing Through Self-Help

    ERIC Educational Resources Information Center

    Opat, Ellen-Jane

    1976-01-01

    Three case studies describe successful squatter settlements in Panama City, Panama, San Salvador, El Salvador and Lusaka, Zambia and show how governments have improved the condition of squatters by utilizing government loans, sites and services projects, foreign technical and financial aid and private non-profit developers, instead of eliminating…

  11. Associations between food and beverage groups and major diet-related chronic diseases: an exhaustive review of pooled/meta-analyses and systematic reviews.

    PubMed

    Fardet, Anthony; Boirie, Yves

    2014-12-01

    Associations between food and beverage groups and the risk of diet-related chronic disease (DRCD) have been the subject of intensive research in preventive nutrition. Pooled/meta-analyses and systematic reviews (PMASRs) aim to better characterize these associations. To date, however, there has been no attempt to synthesize all PMASRs that have assessed the relationship between food and beverage groups and DRCDs. The objectives of this review were to aggregate PMASRs to obtain an overview of the associations between food and beverage groups (n = 17) and DRCDs (n = 10) and to establish new directions for future research needs. The present review of 304 PMASRs published between 1950 and 2013 confirmed that plant food groups are more protective than animal food groups against DRCDs. Within plant food groups, grain products are more protective than fruits and vegetables. Among animal food groups, dairy/milk products have a neutral effect on the risk of DRCDs, while red/processed meats tend to increase the risk. Among beverages, tea was the most protective and soft drinks the least protective against DRCDs. For two of the DRCDs examined, sarcopenia and kidney disease, no PMASR was found. Overweight/obesity, type 2 diabetes, and various types of cardiovascular disease and cancer accounted for 289 of the PMASRs. There is a crucial need to further study the associations between food and beverage groups and mental health, skeletal health, digestive diseases, liver diseases, kidney diseases, obesity, and type 2 diabetes.

  12. The role of ABO blood groups in Crohn’s disease and in monitoring response to infliximab treatment

    PubMed Central

    Yu, Qiao; Wang, Lingyun; Zhang, Shenghong; Feng, Ting; Li, Li; Chen, Baili; Chen, Minhu

    2016-01-01

    Background The variation in ABO blood groups is reported to be associated with multiple diseases. Infliximab (IFX) has been widely used in the treatment of Crohn’s disease (CD). We aim to investigate the distribution of ABO blood groups in Chinese patients with CD and to explore its impact on response to IFX. Materials and methods Patients with CD were consecutively recruited to the study between 2007 and 2014. CD patients receiving IFX therapy were followed for at least two years. Results In 293 patients with CD, most patients (40.6%) had blood type O (119/293). The odds ratio (OR) of CD in blood type O patients was 1.06 (95%CI: 0.6–1.86; p=0.84) compared to all other blood types. Among those CD patients, 107 patients received IFX treatment. One year after the first course of IFX, a significant association was found between the overall ABO system and outcomes of IFX treatment (p<0.001). CD patients with blood type AB (OR=4.42, 95% CI: 1.04–18.76; p=0.044) were more likely to achieve mucosal healing, while CD patients with blood type A had a high risk of losing response (OR=0.38, 95% CI: 0.15–0.96; p=0.040). Discussion ABO blood groups are not associated with prevalence of CD. Patients with blood type AB had a better response to IFX while those with blood type A appeared to have a risk of losing response to IFX. PMID:27136434

  13. Identification and molecular characterization of serological group C streptococci isolated from diseased pigs and monkeys in Indonesia.

    PubMed Central

    Soedarmanto, I; Pasaribu, F H; Wibawan, I W; Lämmler, C

    1996-01-01

    The present study was designed to comparatively investigate 34 beta-hemolytic streptococci isolated from infected pigs and monkeys from various islands in Indonesia. According to the serological and biochemical data, all 34 isolates were Lancefield's serological group C streptococci and could be identified as Streptococcus equi subsp. zooepidemicus. Of the 34 group C streptococci investigated, 28 grew on solid media in large, mucoid colonies, in fluid media at a uniform turbidity, and in soft agar in diffuse colonies. A decapsulation test with a hyaluronidase-producing Staphylococcus aureus strain revealed the hyaluronic acid nature of the capsular material. The remaining six streptococci grew on solid media in small, nonmucoid colonies, in fluid media as sediment with clear supernatant, and in soft agar in compact colonies. Determination of surface hydrophobicity by salt aggregation revealed a hydrophilic surface for the encapsulated bacteria and a hydrophobic surface for the unencapsulated group C streptococci. To further analyze the epidemiological relationships, all 34 mucoid and nonmucoid isolates from pigs and monkeys were subjected to protein and DNA fingerprinting. The latter was performed by pulsed-field gel electrophoresis. The protein profiles of all 34 isolates and the DNA profiles of 32 isolates appeared to be identical, with the DNA profiles of 2 isolates being closely related, indicating that a single virulent clone is responsible for this disease outbreak in Indonesia. PMID:8862585

  14. Frequencies of Blood Group Systems MNS, Diego, and Duffy and Clinical Phases of Carrion's Disease in Amazonas, Peru

    PubMed Central

    Solano, Luis; Escobar, Jorge; Fernandez, Miguel; Solano, Carlos

    2014-01-01

    Carrion's disease (CD), is a human bartonellosis, that is, endemic in the Andes of Peru, Ecuador, and Colombia. Bartonella bacilliformis, a native hemotrophic bacteria, is the causative agent of CD, and the interaction with the host could have produced changes in the gene frequencies of erythrocyte antigens. The goal here is to investigate the relationship between allele frequencies of blood group systems MNS, Diego, and Duffy and the clinical phases of CD, within a genetic context. In this associative and analytical study, 76 individuals from Bagua Grande, the province of Utcubamba, and the department of Amazonas in Peru, were enrolled. Forty of them resided in Tomocho-Collicate-Vista Hermosa area (high prevalence of cases in chronic phase, verrucous, or eruptive phase, without previous acute phase). Thirty-six individuals were from the area of Miraflores (high prevalence of cases in acute phase only) and were evaluated for blood group systems MNS, Diego, and Duffy. This study constitutes one of the first attempts at evaluating the genetic factors and clinical phases of CD. No significant statistical differences (P > 0.05) between allele frequencies of blood groups MNS, Diego, and Duffy and the prevalence of chronic and acute phases were detected in the two areas of Amazonas, Peru. PMID:24847360

  15. PGMA-Based Star-Like Polycations with Plentiful Hydroxyl Groups Act as Highly Efficient miRNA Delivery Nanovectors for Effective Applications in Heart Diseases.

    PubMed

    Li, Rui-Quan; Wu, Yina; Zhi, Ying; Yang, Xinchao; Li, Yulin; Xua, Fu-Jian; Du, Jie

    2016-09-01

    Poly(glycidyl methacrylate)-based star-like polycations with rich hydrophilic hydroxyl groups can efficiently transfer miRNA into primary cardiac fibroblasts for effective applications in cardiac diseases, such as inhibition of cardiac fibrosis and hypertrophy.

  16. Cervical neuro-muscular syndrome: discovery of a new disease group caused by abnormalities in the cervical muscles.

    PubMed

    Matsui, Takayoshi; Ii, Kunio; Hojo, Shuntaro; Sano, Keiji

    2012-01-01

    Our previous study of whiplash injury found that abnormalities in the cervical muscles cause autonomic dystonia. Further research has found that abnormalities in the cervical muscles cause headache, chronic fatigue syndrome, vertigo, and dizziness. We named this group of diseases cervical neuro-muscular syndrome. Patients treated within a 2-year period from April 1, 2002 to March 31, 2004 reported good outcomes in 83.8% for headache, 88.4% for vertigo and dizziness, 84.5% for chronic fatigue syndrome, 88.0% for autonomic dystonia, and 83.7% for whiplash-associated disorder. A large number of outpatients present with general malaise, including many general physical complaints without identifiable cause. We propose that treatment of the cervical muscle is effective for general malaise.

  17. Expressed Sense of Self by People With Alzheimer's Disease in a Support Group Interpreted in Terms of Agency and Communion.

    PubMed

    Hedman, Ragnhild; Hansebo, Görel; Ternestedt, Britt-Marie; Hellström, Ingrid; Norberg, Astrid

    2016-04-01

    The self is constructed in cooperation with other people and social context influences how people perceive and express it. People with Alzheimer's disease (AD) often receive insufficient support in constructing their preferred selves, but little is known about how they express themselves together with other people with AD. In accordance with Harré's social constructionist theory of self, this study aimed to describe how five people with mild and moderate AD express their Self 2 (i.e., their personal attributes and life histories) in a support group with a facilitator experienced in communicating with people with AD. The participants' expressions of their Self 2 were analyzed with qualitative abductive content analysis and interpreted in terms of agency and communion and a lack of agency and communion. The findings highlight the importance of supporting a sense of agency and communion when assisting people with AD in constructing their self.

  18. The dynamic nature of group A streptococcal epidemiology in tropical communities with high rates of rheumatic heart disease.

    PubMed

    McDonald, M I; Towers, R J; Andrews, R; Benger, N; Fagan, P; Currie, B J; Carapetis, J R

    2008-04-01

    Prospective surveillance was conducted in three remote Aboriginal communities with high rates of rheumatic heart disease in order to investigate the epidemiology of group A beta-haemolytic streptococci (GAS). At each household visit, participants were asked about sore throat. Swabs were taken from all throats and any skin sores. GAS isolates were emm sequence and pattern-typed using standard laboratory methods. There were 531 household visits; 43 different emm types and subtypes (emmST) were recovered. Four epidemiological patterns were observed. Multiple emmST were present in the population at any one time and household acquisition rates were high. Household acquisition was most commonly via 5- to 9-year-olds. Following acquisition, there was a 1 in 5 chance of secondary detection in the household. Throat detection of emmST was brief, usually <2 months. The epidemiology of GAS in these remote Aboriginal communities is a highly dynamic process characterized by emmST diversity and turnover.

  19. Evaluation of a Group-Based Behavioral Intervention to Promote Adherence in Adolescents with Inflammatory Bowel Disease

    PubMed Central

    Hommel, Kevin A.; Hente, Elizabeth A.; Odell, Shannon; Herzer, Michele; Ingerski, Lisa M.; Guilfoyle, Shanna M.; Denson, Lee A.

    2011-01-01

    Objective To pilot test the feasibility and acceptability of a family-based group behavioral intervention to improve medication adherence in adolescents diagnosed with Inflammatory Bowel Disease (IBD). Methods Participants were 40 adolescents age 11-18 years diagnosed with IBD and their primary caregivers, who were randomized to either a 4-session Family-Based Group Behavioral Treatment or Usual Care over a 6-week period. Adherence was measured using a mutli-method, multi-informant assessment involving caregiver- and patient-report, pill count data, and electronic monitoring. Results Adherence rates ranged from 66-89% for 6-MP/azathioprine and 51-93% for mesalamine across assessment methods. The intervention was feasible, as evidenced by the 99% treatment session attendance rate, and acceptable based on patient and caregiver report. Repeated measures ANOVA tests revealed nonsignificant differences between the conditions from baseline to post-treatment assessments for pill count, electronic monitor, and primary caregiver-reported adherence (p's> .05). There was a statistically significant improvement in patient-reported mesalamine adherence represented by a significant main effect for Condition (F = 22.24, p< .01; δ = .79) and Condition X Time interaction (F = 13.32, p< .05; δ = .69). Conclusions Findings suggest potential for use of behavioral intervention to improve medication adherence in this population. This intervention may be more effective with more complex regimens (e.g., multiple doses per day) such as those prescribed with mesalamine. Further research is needed to examine this type of intervention in more diverse samples with more active disease. Use of alternative adherence measurement approaches, including electronic pill boxes and/or real-time self-report (e.g., via text messaging, electronic diaries, etc.) is also recommended. PMID:21989119

  20. Working Group Guidelines on the nursing roles in caring for patients with Crohn's disease and ulcerative colitis in Poland

    PubMed Central

    Kurek, Marzena; Poteralska, Aneta; Bieniek, Ewa; Marynka, Anna; Pabich, Grażyna; Liebert, Ariel; Kłopocka, Maria; Rydzewska, Grażyna

    2014-01-01

    Inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, present a major challenge for present-day gastroenterology due to their increasing incidence, chronic nature, risk of permanent worsening of quality of life of patients, and the costs of conservative and invasive treatment. Basic and advanced nursing care are important parts of the multidisciplinary care for patients. The developed guidelines on the nursing care, which are compliant with the European guidelines published by Nurses-European Crohn's & Colitis Organisation (N-ECCO), were adjusted to the current situation in Poland. Significant issues that are important for nursing teams have been identified, with particular emphasis on the specificity of working in centres specialising in the care of IBD patients. The Working Group paid attention to the conditions that should be satisfied in order to optimise the nursing care for IBD patients, and the necessity to develop professional and scientific cooperation with European centres within European Crohn's & Colitis Organisation (ECCO) and N-ECCO. PMID:25276248

  1. Multi-Family Psychoeducational Support Group Therapy for Families with a Member Afflicted with Irreversible Brain Syndrome (Alzheimer's Disease): Report of a Pilot Study.

    ERIC Educational Resources Information Center

    Paley, Evelyn S.; And Others

    Alzheimers Disease (AD), an incurable disability which afflicts older adults, can have devastating emotional consequences for the victim and the family. In an attempt to determine the effectiveness of multifamily psychoeducational support, group therapy (MFPSGT), 22 persons (13 families) from the Alzheimer's Disease and Related Disorders…

  2. Acute clinical events in 299 homozygous sickle cell patients living in France. French Study Group on Sickle Cell Disease.

    PubMed

    Neonato, M G; Guilloud-Bataille, M; Beauvais, P; Bégué, P; Belloy, M; Benkerrou, M; Ducrocq, R; Maier-Redelsperger, M; de Montalembert, M; Quinet, B; Elion, J; Feingold, J; Girot, R

    2000-09-01

    A subset of 299 patients with homozygous sickle cell anaemia, enrolled in the cohort of the French Study Group on sickle cell disease (SCD), was investigated in this study. The majority of patients were children (mean age 10.1 +/- 5.8 yr) of first generation immigrants from Western and Central Africa, the others originated from the French West Indies (20.2%). We report the frequency of the main clinical events (mean follow-up 4.2 +/- 2.2 yr). The prevalence of meningitis-septicaemia and osteomyelitis was, respectively, 11.4% and 12% acute chest syndrome was observed in 134 patients (44.8%). Twenty patients (6.7%) developed stroke with peak prevalence at 10-15 yr of age. One hundred and seventy-two patients (58%) suffered from one or more painful sickle cell crises, while the others (42.5%) never suffered from pain. The overall frequency of acute anaemic episodes was 50.5%, (acute aplastic anaemia 46%; acute splenic sequestration 26%). A group of 27 patients were asymptomatic (follow-up > 3 yr). Epistatic mechanisms influencing SCD were studied. Coinherited alpha-thalassemia strongly reduced the risk of stroke (p <0.001) and increased that of painful crises (p < 0.02). There was a low prevalence of Senegal and Bantu (CAR) betas-chromosomes in patients with meningitis (p <0.04) and osteomyelitis (p < 0.03). Prevalence of Senegal betas-chromosomes was lower in the asymptomatic group of 27 patients (p < 0.02). The patients come from a population of unmixed immigrants in whom the beta-globin gene haplotype strongly reflects the geographic origin and identifies subgroups with a homogenous genetic background. Thus the observed effects might result more from differences in as yet unidentified determinants in the genetic background than from the direct linkage with differences in the beta-globin gene locus.

  3. Lack of association between Behçet's disease and major histocompatibility complex class II antigens in an ethnically diverse North American Caucasoid patient group.

    PubMed

    Moore, S B; O'Duffy, J D

    1986-08-01

    A group of 25 North American Caucasoid patients with well defined Behcet's disease were serologically typed for HLA-DR and DQw antigens. No significant associations were seen when results were compared with a group of 73 normal Caucasoid controls tested concomitantly. PMID:3772926

  4. Causes of death after therapy for early stage Hodgkin's disease entered on EORTC protocols. EORTC Lymphoma Cooperative Group.

    PubMed

    Henry-Amar, M; Hayat, M; Meerwaldt, J H; Burgers, M; Carde, P; Somers, R; Noordijk, E M; Monconduit, M; Thomas, J; Cosset, J M

    1990-11-01

    The risk of dying from different causes after Hodgkin's disease (HD) therapy has been quantified from a series of 1,449 patients with early stages included in four successive clinical trials conducted by the European Organization for Research and Treatment of Cancer (EORTC) Lymphoma Cooperative Group since 1963. Overall, 240 patients died and the 15-year survival rate was 69% whereas the expected rate was 95%. The standardized mortality ratio (SMR) technique was used to quantify excess deaths as a function of time since first therapy. At each interval, SMR was significantly increased, giving: 0-3 year, 8.86 (p less than 0.001); 4-6 year, 9.25 (p less than 0.001); 7-9 year, 7.08 (p less than 0.001); 10-12 year, 9.53 (p less than 0.001); 13-15 year, 4.37 (p less than 0.01); and 16+ years, 3.80 (p less than 0.05). While the proportion of deaths as a consequence of HD progression, treatment side-effect, and intercurrent disease decreased with time, that of second cancer and cardiac failure peaked during the 10-12 year post-treatment interval. After 15 years of follow-up, the risk of dying from causes other than HD continued to increase. These findings indicate that although probably cured from HD, patients are at higher risk for death than expected, a risk that might be a consequence of therapy. PMID:2254106

  5. Sequence type 1 group B Streptococcus, an emerging cause of invasive disease in adults, evolves by small genetic changes.

    PubMed

    Flores, Anthony R; Galloway-Peña, Jessica; Sahasrabhojane, Pranoti; Saldaña, Miguel; Yao, Hui; Su, Xiaoping; Ajami, Nadim J; Holder, Michael E; Petrosino, Joseph F; Thompson, Erika; Margarit Y Ros, Immaculada; Rosini, Roberto; Grandi, Guido; Horstmann, Nicola; Teatero, Sarah; McGeer, Allison; Fittipaldi, Nahuel; Rappuoli, Rino; Baker, Carol J; Shelburne, Samuel A

    2015-05-19

    The molecular mechanisms underlying pathogen emergence in humans is a critical but poorly understood area of microbiologic investigation. Serotype V group B Streptococcus (GBS) was first isolated from humans in 1975, and rates of invasive serotype V GBS disease significantly increased starting in the early 1990s. We found that 210 of 229 serotype V GBS strains (92%) isolated from the bloodstream of nonpregnant adults in the United States and Canada between 1992 and 2013 were multilocus sequence type (ST) 1. Elucidation of the complete genome of a 1992 ST-1 strain revealed that this strain had the highest homology with a GBS strain causing cow mastitis and that the 1992 ST-1 strain differed from serotype V strains isolated in the late 1970s by acquisition of cell surface proteins and antimicrobial resistance determinants. Whole-genome comparison of 202 invasive ST-1 strains detected significant recombination in only eight strains. The remaining 194 strains differed by an average of 97 SNPs. Phylogenetic analysis revealed a temporally dependent mode of genetic diversification consistent with the emergence in the 1990s of ST-1 GBS as major agents of human disease. Thirty-one loci were identified as being under positive selective pressure, and mutations at loci encoding polysaccharide capsule production proteins, regulators of pilus expression, and two-component gene regulatory systems were shown to affect the bacterial phenotype. These data reveal that phenotypic diversity among ST-1 GBS is mainly driven by small genetic changes rather than extensive recombination, thereby extending knowledge into how pathogens adapt to humans. PMID:25941374

  6. Sequence type 1 group B Streptococcus, an emerging cause of invasive disease in adults, evolves by small genetic changes

    PubMed Central

    Flores, Anthony R.; Galloway-Peña, Jessica; Sahasrabhojane, Pranoti; Saldaña, Miguel; Yao, Hui; Su, Xiaoping; Ajami, Nadim J.; Holder, Michael E.; Petrosino, Joseph F.; Thompson, Erika; Margarit Y Ros, Immaculada; Rosini, Roberto; Grandi, Guido; Horstmann, Nicola; Teatero, Sarah; McGeer, Allison; Fittipaldi, Nahuel; Rappuoli, Rino; Baker, Carol J.; Shelburne, Samuel A.

    2015-01-01

    The molecular mechanisms underlying pathogen emergence in humans is a critical but poorly understood area of microbiologic investigation. Serotype V group B Streptococcus (GBS) was first isolated from humans in 1975, and rates of invasive serotype V GBS disease significantly increased starting in the early 1990s. We found that 210 of 229 serotype V GBS strains (92%) isolated from the bloodstream of nonpregnant adults in the United States and Canada between 1992 and 2013 were multilocus sequence type (ST) 1. Elucidation of the complete genome of a 1992 ST-1 strain revealed that this strain had the highest homology with a GBS strain causing cow mastitis and that the 1992 ST-1 strain differed from serotype V strains isolated in the late 1970s by acquisition of cell surface proteins and antimicrobial resistance determinants. Whole-genome comparison of 202 invasive ST-1 strains detected significant recombination in only eight strains. The remaining 194 strains differed by an average of 97 SNPs. Phylogenetic analysis revealed a temporally dependent mode of genetic diversification consistent with the emergence in the 1990s of ST-1 GBS as major agents of human disease. Thirty-one loci were identified as being under positive selective pressure, and mutations at loci encoding polysaccharide capsule production proteins, regulators of pilus expression, and two-component gene regulatory systems were shown to affect the bacterial phenotype. These data reveal that phenotypic diversity among ST-1 GBS is mainly driven by small genetic changes rather than extensive recombination, thereby extending knowledge into how pathogens adapt to humans. PMID:25941374

  7. Causes of death after therapy for early stage Hodgkin's disease entered on EORTC protocols. EORTC Lymphoma Cooperative Group.

    PubMed

    Henry-Amar, M; Hayat, M; Meerwaldt, J H; Burgers, M; Carde, P; Somers, R; Noordijk, E M; Monconduit, M; Thomas, J; Cosset, J M

    1990-11-01

    The risk of dying from different causes after Hodgkin's disease (HD) therapy has been quantified from a series of 1,449 patients with early stages included in four successive clinical trials conducted by the European Organization for Research and Treatment of Cancer (EORTC) Lymphoma Cooperative Group since 1963. Overall, 240 patients died and the 15-year survival rate was 69% whereas the expected rate was 95%. The standardized mortality ratio (SMR) technique was used to quantify excess deaths as a function of time since first therapy. At each interval, SMR was significantly increased, giving: 0-3 year, 8.86 (p less than 0.001); 4-6 year, 9.25 (p less than 0.001); 7-9 year, 7.08 (p less than 0.001); 10-12 year, 9.53 (p less than 0.001); 13-15 year, 4.37 (p less than 0.01); and 16+ years, 3.80 (p less than 0.05). While the proportion of deaths as a consequence of HD progression, treatment side-effect, and intercurrent disease decreased with time, that of second cancer and cardiac failure peaked during the 10-12 year post-treatment interval. After 15 years of follow-up, the risk of dying from causes other than HD continued to increase. These findings indicate that although probably cured from HD, patients are at higher risk for death than expected, a risk that might be a consequence of therapy.

  8. Evaluating the impact of a disease management program for chronic complex conditions at two large northeast health plans using a control group methodology.

    PubMed

    Schwerner, Henry; Mellody, Timothy; Goldstein, Allan B; Wansink, Daryl; Sullivan, Virginia; Yelenik, Stephan N; Charlton, Warwick; Lloyd, Kelley; Courtemanche, Ted

    2006-02-01

    The objective of this study was to observe trends in payer expenditures for plan members with one of 14 chronic, complex conditions comparing one group with a disease management program specific to their condition (the intervention group) and the other with no specific disease management program (the control group) for these conditions. The authors used payer claims and membership data to identify members eligible for the program in a 12-month baseline year (October 2001 to September 2002) and a subsequent 12-month program year (October 2002 to September 2003). Two payers were analyzed: one health plan with members primarily in New Jersey (AmeriHealth New Jersey [AHNJ]), where the disease management program was offered, and one affiliated large plan with members primarily in the metro Philadelphia area, where the program was not offered. The claims payment policy for both plans is identical. Intervention and control groups were analyzed for equivalence. The analysis was conducted in both groups over identical time periods. The intervention group showed statistically significant (p < 0.01) differences in total paid claims trend and expenditures when compared to the control group. Intervention group members showed a reduction in expenditures of -8%, while control group members showed an increase of +10% over identical time periods. Subsequent analyses controlling for outliers and product lines served to confirm the overall results. The disease management program is likely responsible for the observed difference between the intervention and control group results. A well-designed, targeted disease management program offered by a motivated, supportive health plan can play an important role in cost improvement strategies for members with complex, chronic conditions.

  9. [Nutrition and IBD-Consensus of the Austrian Working Group of IBD (Inflammatory Bowel Diseases) of the ÖGGH].

    PubMed

    Fuchssteiner, H; Nigl, K; Mayer, A; Kristensen, B; Platzer, R; Brunner, B; Weiß, I; Haas, T; Benedikt, M; Gröchenig, H P; Eisenberger, A; Hillebrand, P; Reinisch, W; Vogelsang, H

    2014-04-01

    This is a consensus of the Austrian working group of IBD (inflammatory bowel diseases) of the ÖGGH on nutrition in IBD. Malnutrition should be assessed in case of IBD (in 20 - 70 % of Crohn's patients) and weight loss(> 5 % within 3 months) or nutritional deficiencies or after extensive bowel resection and afterwards also treated. Malnutrition should be treated with medical therapy of IBD and also adequate - as far as possible - with oral nutritional therapy particularly because of reduced life quality, risk of opportunistic infections, osteopenia/osteoporosis, longer hospitalisations and higher mortality. Iron homeostasis, serum levels of Vitamin B12- and folic acid, 25-hydroxyvitamin D and zinc should be checked. Therapy with enteral liquid diets is only indicated as therapy of first choice in children and adolescents, but only in rare situations in adults with IBD. There is - up to now - no proven oral diet for maintenance of remission in IBD. Probiotics as E. coli Nissle could be used as alternative to mesalazine for maintenance of remission in patients with ulcerative colitis. A specific dietary counselling is mandatory in patients with ileostoma or short bowel syndrome. Malnutrition of short bowel patients is particularly dependent on the function and length of the remaining bowel, therefore the most effective medical therapy should be administered. PMID:24718944

  10. Genomic Recombination Leading to Decreased Virulence of Group B Streptococcus in a Mouse Model of Adult Invasive Disease

    PubMed Central

    Teatero, Sarah; Lemire, Paul; Dewar, Ken; Wasserscheid, Jessica; Calzas, Cynthia; Mallo, Gustavo V.; Li, Aimin; Athey, Taryn B.T.; Segura, Mariela; Fittipaldi, Nahuel

    2016-01-01

    Adult invasive disease caused by Group B Streptococcus (GBS) is increasing worldwide. Whole-genome sequencing (WGS) now permits rapid identification of recombination events, a phenomenon that occurs frequently in GBS. Using WGS, we described that strain NGBS375, a capsular serotype V GBS isolate of sequence type (ST)297, has an ST1 genomic background but has acquired approximately 300 kbp of genetic material likely from an ST17 strain. Here, we examined the virulence of this strain in an in vivo model of GBS adult invasive infection. The mosaic ST297 strain showed intermediate virulence, causing significantly less systemic infection and reduced mortality than a more virulent, serotype V ST1 isolate. Bacteremia induced by the ST297 strain was similar to that induced by a serotype III ST17 strain, which was the least virulent under the conditions tested. Yet, under normalized bacteremia levels, the in vivo intrinsic capacity to induce the production of pro-inflammatory cytokines was similar between the ST297 strain and the virulent ST1 strain. Thus, the diminished virulence of the mosaic strain may be due to reduced capacity to disseminate or multiply in blood during a systemic infection which could be mediated by regulatory factors contained in the recombined region. PMID:27527222

  11. Writing Groups: History, Theory, and Implications: Studies in Writing and Rhetoric.

    ERIC Educational Resources Information Center

    Gere, Anne Ruggles

    Drawing on previously unpublished archival materials as well as historical accounts of American education and the self-help tradition of education in the United States, this book examines the origins, theoretical bases, and implications of writing groups. Following an introduction that points out the varied circumstances under which writing groups…

  12. The Devil Has Slippery Shoes. A Biased Biography of the Child Development Group of Mississippi.

    ERIC Educational Resources Information Center

    Greenberg, Polly

    This book provides an insider's account of the attempts of the Child Development Group of Mississippi (CDGM) to introduce self-help educational innovations into the Black community of Mississippi. It documents the efforts of one of the first OEO-financed Head Start projects designed to help the Black people of Mississippi overcome economic,…

  13. Activation of group II metabotropic glutamate receptors underlies microglial reactivity and neurotoxicity following stimulation with chromogranin A, a peptide up-regulated in Alzheimer's disease.

    PubMed

    Taylor, D L; Diemel, L T; Cuzner, M L; Pocock, J M

    2002-09-01

    Regulation of microglial reactivity and neurotoxicity is critical for neuroprotection in neurodegenerative diseases. Here we report that microglia possess functional group II metabotropic glutamate receptors, expressing mRNA and receptor protein for mGlu2 and mGlu3, negatively coupled to adenylate cyclase. Two different agonists of these receptors were able to induce a neurotoxic microglial phenotype which was attenuated by a specific antagonist. Chromogranin A, a secretory peptide expressed in amyloid plaques in Alzheimer's disease, activates microglia to a reactive neurotoxic phenotype. Chromogranin A-induced microglial activation and subsequent neurotoxicity may also involve an underlying stimulation of group II metabotropic glutamate receptors since their inhibition reduced chromogranin A-induced microglial reactivity and neurotoxicity. These results show that selective inhibition of microglial group II metabotropic glutamate receptors has a positive impact on neuronal survival, and may prove a therapeutic target in Alzheimer's disease. PMID:12358765

  14. Relationship between Serum Level of Interleukin-2 in Patients with Systemic Lupus Erythematosus and Disease Activity in Comparison with Control Group

    PubMed Central

    Aghaei, Mehrdad; Musavi, Sara; Nomali, Mahin

    2014-01-01

    Background: Despite the large number of surveys, there are not any validated biomarkers for SLE disease activity till now. This study aimed to evaluate the relationship between serum level of IL-2 in patients with SLE and disease activity in comparison with control group. Materials and Methods: In this case-control study, 73 patients with lupus and 73 healthy subjects referred to the rheumatology clinic of 5 Azar Hospital in Gorgan (North of Iran).They were studied via convenience sampling during 2011-2012. Blood samples were taken from both groups and serum levels of interleukin -2 measured by Avi Bion Human IL-2 ELISA kit. Serum Level of IL-2 greater than 15 pg/ml defined positive and lesser than this amount defined negative. Disease activity evaluated with SLE disease activity index. Score greater than or equal to three or four defined as active disease. Data analysis conducted by SPSS software (version 16) and by using descriptive statistics and statistical tests. Results: Serum level of IL-2 was positive in 45.2% of sample studied and negative in 54.8% in case group, while in control group, serum level of IL-2 only in 11% of sample studied was positive and in 89% was negative. Statistical analysis indicated a significant relationship between serum level of IL-2 and the SLE disease activity index (p=0.025). Conclusion: This study showed the relationship between serum levels of IL-2 and disease activity, so this biomarker can be used as a clinical indicator for assessing disease activity in patients with SLE. PMID:25177590

  15. Association of ABO Blood Group and Rh factor with Periodontal Disease in a Population of Virajpet, Karnataka: A Cross-Sectional Study

    PubMed Central

    Vivek, S; Jain, Jithesh; Simon, Sequiera Peter; Battur, Hemanth; Supreetha, S; Haridas, Reshmi

    2013-01-01

    Background: The purpose of the present study was to determine whether there was an association between periodontal diseases and ABO blood groups. Materials & Methods: An epidemiological study was was carried out on 220 subjects who were randomly selected from individuals referred for periodontal treatment or for other reasons regarding Oral health at Coorg Institute of Dental Sciences. Results: The findings of our study revealed that subject’s blood group O (65.8) and Rh positive (73.33%) had a greater propensity for periodontitis. Conclusion: The results of the present study revealed blood groups and Rh factor can act as a determinant of periodontitis. How to cite this article: Vivek S, Jain J, Simon SP, Battur H, Supreetha S, Haridas R. Association of ABO Blood Group and Rh factor with Periodontal Disease in a Population of Virajpet, Karnataka: A Cross-Sectional Study. J Int Oral Health 2013; 5(4):30-34. PMID:24155617

  16. Host group formation decreases exposure to vector-borne disease: a field experiment in a ‘hotspot’ of West Nile virus transmission

    PubMed Central

    Krebs, Bethany L.; Anderson, Tavis K.; Goldberg, Tony L.; Hamer, Gabriel L.; Kitron, Uriel D.; Newman, Christina M.; Ruiz, Marilyn O.; Walker, Edward D.; Brawn, Jeffrey D.

    2014-01-01

    Animals can decrease their individual risk of predation by forming groups. The encounter-dilution hypothesis extends the potential benefits of gregariousness to biting insects and vector-borne disease by predicting that the per capita number of insect bites should decrease within larger host groups. Although vector-borne diseases are common and can exert strong selective pressures on hosts, there have been few tests of the encounter-dilution effect in natural systems. We conducted an experimental test of the encounter-dilution hypothesis using the American robin (Turdus migratorius), a common host species for the West Nile virus (WNV), a mosquito-borne pathogen. By using sentinel hosts (house sparrows, Passer domesticus) caged in naturally occurring communal roosts in the suburbs of Chicago, we assessed sentinel host risk of WNV exposure inside and outside of roosts. We also estimated per capita host exposure to infected vectors inside roosts and outside of roosts. Sentinel birds caged inside roosts seroconverted to WNV more slowly than those outside of roosts, suggesting that social groups decrease per capita exposure to infected mosquitoes. These results therefore support the encounter-dilution hypothesis in a vector-borne disease system. Our results suggest that disease-related selective pressures on sociality may depend on the mode of disease transmission. PMID:25339722

  17. Host group formation decreases exposure to vector-borne disease: a field experiment in a 'hotspot' of West Nile virus transmission.

    PubMed

    Krebs, Bethany L; Anderson, Tavis K; Goldberg, Tony L; Hamer, Gabriel L; Kitron, Uriel D; Newman, Christina M; Ruiz, Marilyn O; Walker, Edward D; Brawn, Jeffrey D

    2014-12-01

    Animals can decrease their individual risk of predation by forming groups. The encounter-dilution hypothesis extends the potential benefits of gregariousness to biting insects and vector-borne disease by predicting that the per capita number of insect bites should decrease within larger host groups. Although vector-borne diseases are common and can exert strong selective pressures on hosts, there have been few tests of the encounter-dilution effect in natural systems. We conducted an experimental test of the encounter-dilution hypothesis using the American robin (Turdus migratorius), a common host species for the West Nile virus (WNV), a mosquito-borne pathogen. By using sentinel hosts (house sparrows, Passer domesticus) caged in naturally occurring communal roosts in the suburbs of Chicago, we assessed sentinel host risk of WNV exposure inside and outside of roosts. We also estimated per capita host exposure to infected vectors inside roosts and outside of roosts. Sentinel birds caged inside roosts seroconverted to WNV more slowly than those outside of roosts, suggesting that social groups decrease per capita exposure to infected mosquitoes. These results therefore support the encounter-dilution hypothesis in a vector-borne disease system. Our results suggest that disease-related selective pressures on sociality may depend on the mode of disease transmission.

  18. Alaska Native and Rural Youths' Views of Sexual Health: A Focus Group Project on Sexually Transmitted Diseases, HIV/AIDS, and Unplanned Pregnancy

    ERIC Educational Resources Information Center

    Leston, Jessica D.; Jessen, Cornelia M.; Simons, Brenna C.

    2012-01-01

    Background: The disparity in rates of sexually transmitted diseases (STDs), HIV/AIDS, and unplanned pregnancy between Alaska Native (AN) and non-AN populations, particularly among young adults and females, is significant and concerning. Focus groups were conducted to better understand the knowledge, attitudes, and beliefs of rural Alaska youth…

  19. Defining risk groups to yellow fever vaccine-associated viscerotropic disease in the absence of denominator data.

    PubMed

    Seligman, Stephen J; Cohen, Joel E; Itan, Yuval; Casanova, Jean-Laurent; Pezzullo, John C

    2014-02-01

    Several risk groups are known for the rare but serious, frequently fatal, viscerotropic reactions following live yellow fever virus vaccine (YEL-AVD). Establishing additional risk groups is hampered by ignorance of the numbers of vaccinees in factor-specific risk groups thus preventing their use as denominators in odds ratios (ORs). Here, we use an equation to calculate ORs using the prevalence of the factor-specific risk group in the population who remain well. The 95% confidence limits and P values can also be calculated. Moreover, if the estimate of the prevalence is imprecise, discrimination analysis can indicate the prevalence at which the confidence interval results in an OR of ∼1 revealing if the prevalence might be higher without yielding a non-significant result. These methods confirm some potential risk groups for YEL-AVD and cast doubt on another. They should prove useful in situations in which factor-specific risk group denominator data are not available.

  20. Acute alcoholic hepatitis, end stage alcoholic liver disease and liver transplantation: an Italian position statement.

    PubMed

    Testino, Gianni; Burra, Patrizia; Bonino, Ferruccio; Piani, Francesco; Sumberaz, Alessandro; Peressutti, Roberto; Giannelli Castiglione, Andrea; Patussi, Valentino; Fanucchi, Tiziana; Ancarani, Ornella; De Cerce, Giovanna; Iannini, Anna Teresa; Greco, Giovanni; Mosti, Antonio; Durante, Marilena; Babocci, Paola; Quartini, Mariano; Mioni, Davide; Aricò, Sarino; Baselice, Aniello; Leone, Silvia; Lozer, Fabiola; Scafato, Emanuele; Borro, Paolo

    2014-10-28

    Alcoholic liver disease encompasses a broad spectrum of diseases ranging from steatosis steatohepatitis, fibrosis, and cirrhosis to hepatocellular carcinoma. Forty-four per cent of all deaths from cirrhosis are attributed to alcohol. Alcoholic liver disease is the second most common diagnosis among patients undergoing liver transplantation (LT). The vast majority of transplant programmes (85%) require 6 mo of abstinence prior to transplantation; commonly referred to as the "6-mo rule". Both in the case of progressive end-stage liver disease (ESLD) and in the case of severe acute alcoholic hepatitis (AAH), not responding to medical therapy, there is a lack of evidence to support a 6-mo sobriety period. It is necessary to identify other risk factors that could be associated with the resumption of alcohol drinking. The "Group of Italian Regions" suggests that: in a case of ESLD with model for end-stage liver disease < 19 a 6-mo abstinence period is required; in a case of ESLD, a 3-mo sober period before LT may be more ideal than a 6-mo period, in selected patients; and in a case of severe AAH, not responding to medical therapies (up to 70% of patients die within 6 mo), LT is mandatory, even without achieving abstinence. The multidisciplinary transplant team must include an addiction specialist/hepato-alcohologist. Patients have to participate in self-help groups.

  1. Acute alcoholic hepatitis, end stage alcoholic liver disease and liver transplantation: An Italian position statement

    PubMed Central

    Testino, Gianni; Burra, Patrizia; Bonino, Ferruccio; Piani, Francesco; Sumberaz, Alessandro; Peressutti, Roberto; Giannelli Castiglione, Andrea; Patussi, Valentino; Fanucchi, Tiziana; Ancarani, Ornella; De Cerce, Giovanna; Iannini, Anna Teresa; Greco, Giovanni; Mosti, Antonio; Durante, Marilena; Babocci, Paola; Quartini, Mariano; Mioni, Davide; Aricò, Sarino; Baselice, Aniello; Leone, Silvia; Lozer, Fabiola; Scafato, Emanuele; Borro, Paolo

    2014-01-01

    Alcoholic liver disease encompasses a broad spectrum of diseases ranging from steatosis steatohepatitis, fibrosis, and cirrhosis to hepatocellular carcinoma. Forty-four per cent of all deaths from cirrhosis are attributed to alcohol. Alcoholic liver disease is the second most common diagnosis among patients undergoing liver transplantation (LT). The vast majority of transplant programmes (85%) require 6 mo of abstinence prior to transplantation; commonly referred to as the “6-mo rule”. Both in the case of progressive end-stage liver disease (ESLD) and in the case of severe acute alcoholic hepatitis (AAH), not responding to medical therapy, there is a lack of evidence to support a 6-mo sobriety period. It is necessary to identify other risk factors that could be associated with the resumption of alcohol drinking. The “Group of Italian Regions” suggests that: in a case of ESLD with model for end-stage liver disease < 19 a 6-mo abstinence period is required; in a case of ESLD, a 3-mo sober period before LT may be more ideal than a 6-mo period, in selected patients; and in a case of severe AAH, not responding to medical therapies (up to 70% of patients die within 6 mo), LT is mandatory, even without achieving abstinence. The multidisciplinary transplant team must include an addiction specialist/hepato-alcohologist. Patients have to participate in self-help groups. PMID:25356027

  2. Acute alcoholic hepatitis, end stage alcoholic liver disease and liver transplantation: an Italian position statement.

    PubMed

    Testino, Gianni; Burra, Patrizia; Bonino, Ferruccio; Piani, Francesco; Sumberaz, Alessandro; Peressutti, Roberto; Giannelli Castiglione, Andrea; Patussi, Valentino; Fanucchi, Tiziana; Ancarani, Ornella; De Cerce, Giovanna; Iannini, Anna Teresa; Greco, Giovanni; Mosti, Antonio; Durante, Marilena; Babocci, Paola; Quartini, Mariano; Mioni, Davide; Aricò, Sarino; Baselice, Aniello; Leone, Silvia; Lozer, Fabiola; Scafato, Emanuele; Borro, Paolo

    2014-10-28

    Alcoholic liver disease encompasses a broad spectrum of diseases ranging from steatosis steatohepatitis, fibrosis, and cirrhosis to hepatocellular carcinoma. Forty-four per cent of all deaths from cirrhosis are attributed to alcohol. Alcoholic liver disease is the second most common diagnosis among patients undergoing liver transplantation (LT). The vast majority of transplant programmes (85%) require 6 mo of abstinence prior to transplantation; commonly referred to as the "6-mo rule". Both in the case of progressive end-stage liver disease (ESLD) and in the case of severe acute alcoholic hepatitis (AAH), not responding to medical therapy, there is a lack of evidence to support a 6-mo sobriety period. It is necessary to identify other risk factors that could be associated with the resumption of alcohol drinking. The "Group of Italian Regions" suggests that: in a case of ESLD with model for end-stage liver disease < 19 a 6-mo abstinence period is required; in a case of ESLD, a 3-mo sober period before LT may be more ideal than a 6-mo period, in selected patients; and in a case of severe AAH, not responding to medical therapies (up to 70% of patients die within 6 mo), LT is mandatory, even without achieving abstinence. The multidisciplinary transplant team must include an addiction specialist/hepato-alcohologist. Patients have to participate in self-help groups. PMID:25356027

  3. Trinucleotide repeat elongation in the huntingtin gene in Huntington's disease patients from 85 French families. The French HD Research Group.

    PubMed

    Lucotte, G; Aouizérate, A; Loreille, O; Gérard, N; Turpin, J C

    1994-01-01

    IT15 is a new gene encoding a protein named huntingtin; a polymorphic CAG repeat in the proposed open reading frame of IT15 has been characterized, and an elongation of this repeat has been correlated to Huntington's disease (HD). We have investigated the CAG repeat in the huntingtin gene in 85 unrelated French families with Huntington's disease. In 79 patients (from 60 families, where at least one HD DNA was available) we found repeat lengths of 37 to 100 units, in contrast to 11 to 35 CAG's on normal chromosomes. Comparison of repeat length and age at onset of disease symptoms in 71 individuals confirms an inverse correlation (r = -0.51 for p < 10(-4)) between the age at onset and the number of CAG repeat units.

  4. Minimal Disseminated Disease in Childhood T-Cell Lymphoblastic Lymphoma: A Report From the Children's Oncology Group

    PubMed Central

    Coustan-Smith, Elaine; Sandlund, John T.; Perkins, Sherrie L.; Chen, Helen; Chang, Myron; Abromowitch, Minnie; Campana, Dario

    2009-01-01

    Purpose Disease dissemination to the bone marrow is detected at diagnosis in approximately 15% of children with T-cell lymphoblastic lymphoma (T-LL). It is unclear whether the remaining patients have submicroscopic systemic disease and, if so, what is the clinical significance of this finding. Patients and Methods Using a flow cytometric method that can detect one T-LL cell among 10,000 normal cells, we examined bone marrow and peripheral-blood samples collected from 99 children with T-LL at diagnosis, as well as blood samples collected from 42 patients during treatment. Results In 71 (71.7%) of the 99 marrow samples obtained at diagnosis, T-LL cells represented 0.01% to 31.6% (median, 0.22%) of mononuclear cells; 57 of the 71 T-LL–positive samples were from patients with stage II/III disease. Results of studies in bilateral marrow aspirates were highly concordant. Two-year event-free survival (EFS) was 68.1% ± 11.1% (SE) for patients with ≥ 1% T-LL cells in bone marrow versus 90.7% ± 4.4% for those with lower levels of marrow involvement (P = .031); EFS for patients with ≥ 5% lymphoblasts was 51.9% ± 18.0% (P = .009). T-LL cells were as prevalent in blood as in marrow; monitoring residual T-LL cells in blood during remission induction therapy identified patients with slower disease clearance. Conclusion More than two thirds of children with T-LL have disseminated disease at diagnosis, a proportion much higher than previously demonstrated. Measurements of disease dissemination at diagnosis might provide useful prognostic information, which can be further refined by monitoring response to therapy through blood testing. PMID:19546402

  5. Use of Biosimilars in Paediatric Inflammatory Bowel Disease: A Position Statement of the ESPGHAN Paediatric IBD Porto Group.

    PubMed

    de Ridder, Lissy; Waterman, Matti; Turner, Dan; Bronsky, Jiri; Hauer, Almuthe C; Dias, Jorge A; Strisciuglio, Caterina; Ruemmele, Frank M; Levine, Arie; Lionetti, Paolo

    2015-10-01

    Because the patents for biopharmaceutical monoclonal antibodies have or soon will expire, biosimilars are coming to the market. This will most likely lead to decreased drug costs and so easier access to these expensive agents. Extrapolation, however, of the limited available clinical data from adults with rheumatologic diseases to children with inflammatory bowel disease (IBD) should be done with caution and needs some considerations.Postmarketing surveillance programs for efficacy, safety, and immunogenicity should become mandatory in children with IBD using biosimilars, as for all biological drugs. PMID:26154031

  6. A randomised study of adjuvant chemotherapy after mantle radiotherapy in supradiaphragmatic Hodgkin's disease PS IA-IIB: a report from the Manchester lymphoma group.

    PubMed

    Anderson, H; Deakin, D P; Wagstaff, J; Jones, J M; Todd, I D; Wilkinson, P M; James, R D; Steward, W P; Blackledge, G; Scarffe, J H

    1984-06-01

    One hundred and fourteen untreated patients with pathological stage (PS) IA-IIB supradiaphragmatic Hodgkin's Disease were randomised to mantle radiotherapy alone (55) or mantle radiotherapy followed by 6 courses of adjuvant chemotherapy with mustine, vinblastine, prednisolone and procarbazine- MVPP (59). Patients excluded were those outside the age range 16-65 years and those with massive mediastinal disease precluding laparotomy. Bulk disease was defined as a mass of lymph nodes measuring five centimetres or more in any axis. Mediastinal bulk was present if the ratio of the maximum width of mediastinal disease to the maximal chest diameter was more than one third. All patients achieved a complete remission. Median duration of follow-up was 62 months (range 16-97). The relapse free survival (RFS) was 81%; 69% for radiotherapy alone and 93% for adjuvant chemotherapy (P = 0.002). RFS was also shown to be adversely affected by B symptoms (P = 0.0003), bulk disease (P = 0.018), abnormal CXR (P = 0.037), and increasing stage (P = 0.039). Age, sex, histology, and number of sites involved had no significant effect upon RFS. A Cox multivariate analysis showed that only three variables had a significant adverse effect on RFS - radiotherapy alone, the presence of bulk disease, and B symptoms. The overall 5 year survival was 93% with no statistically significant difference between the two treatment groups (P = 0.54). Survival was adversely affected by three variables - B symptoms (P = 0.02), the presence of bulk disease (P = 0.002), and pathological stage (P = 0.05). High risk groups for relapse are those with bulk and B symptoms. This analysis has shown that RFS was significantly improved by adjuvant chemotherapy, but that overall survival was not.

  7. Diet and Exercise Adherence and Practices among Medically Underserved Patients with Chronic Disease: Variation across Four Ethnic Groups

    ERIC Educational Resources Information Center

    Orzech, Kathryn M.; Vivian, James; Huebner Torres, Cristina; Armin, Julie; Shaw, Susan J.

    2013-01-01

    Many factors interact to create barriers to dietary and exercise plan adherence among medically underserved patients with chronic disease, but aspects related to culture and ethnicity are underexamined in the literature. Using both qualitative ("n" = 71) and quantitative ("n" = 297) data collected in a 4-year, multimethod study among patients with…

  8. Caring for Others: Internet Video-Conferencing Group Intervention for Family Caregivers of Older Adults with Neurodegenerative Disease

    ERIC Educational Resources Information Center

    Marziali, Elsa; Donahue, Peter

    2006-01-01

    Purpose: The aim of this pilot feasibility study was to evaluate the effects of an innovative, Internet-based psychosocial intervention for family caregivers of older adults with neurodegenerative disease. Design and Methods: After receiving signed informed consent from each participant, we randomly assigned 66 caregivers to an Internet-based…

  9. Factors affecting the therapeutic choice in patients with multivessel coronary artery disease. The Studio Lombardo Angiografia Multivasali (SLAM) Study Group.

    PubMed Central

    De Servi, S.; Galli, S.; Onofri, M.; Boschetti, E.; Oberti, R.; Niccoli, L.; De Biase, A. M.; Rovelli, G.; Carini, M.; Regalia, F.; Valentini, P.; Bartorelli, A.

    1997-01-01

    OBJECTIVE: To assess how clinical and angiographic findings are related to the decision to carry out coronary angioplasty (PTCA) or coronary bypass grafting in patients with multivessel coronary artery disease. DESIGN: Prospective survey carried out in 14 centres in the Lombardia region of Italy. PATIENTS: 1468 consecutive patients under going coronary arteriography for known or suspected ischaemic heart disease between May and October 1994, who were found to have multivessel coronary artery disease. MAIN OUTCOME MEASURES: Multivariate analysis was undertaken using stepwise logistic regression to identify the clinical and angiographic variables correlated with revascularisation (v medical treatment) in all of patients, and with surgery (v angioplasty) in the subset of revascularised patients. RESULTS: In all patients the clinical decision after coronary arteriography was made by physicians of each participating centre on the basis of their experience and clinical judgment: 53% of patients had bypass surgery, 28% had PTCA, and 19% continued medical treatment. The choice of a revascularisation procedure was directly related to a clinical diagnosis of unstable angina (P < < 0.001), the presence of left anterior descending artery disease (P < < 0.001), and to an ejection fraction > or = 40% (P < < 0.001), and inversely related to history of previous coronary bypass surgery (P < < 0.001). In revascularised patients, bypass surgery was the preferred treatment in patients with left anterior descending artery disease (P < < 0.001), three-vessel disease (P < < 0.001), and in those with at least one occluded vessel (P = 0.008). The choice of PTCA was significantly related to history of previous PTCA (P < < 0.001) or coronary bypass surgery (P < < 0.001), to a clinical diagnosis of non-Q wave myocardial infarction (P = 0.002), and to the possibility of implanting an intracoronary stent (P = 0.01). CONCLUSIONS: Bypass surgery is still the most widely used treatment for

  10. Defining Risk Groups to Yellow Fever Vaccine-Associated Viscerotropic Disease in the Absence of Denominator Data

    PubMed Central

    Seligman, Stephen J.; Cohen, Joel E.; Itan, Yuval; Casanova, Jean-Laurent; Pezzullo, John C.

    2014-01-01

    Several risk groups are known for the rare but serious, frequently fatal, viscerotropic reactions following live yellow fever virus vaccine (YEL-AVD). Establishing additional risk groups is hampered by ignorance of the numbers of vaccinees in factor-specific risk groups thus preventing their use as denominators in odds ratios (ORs). Here, we use an equation to calculate ORs using the prevalence of the factor-specific risk group in the population who remain well. The 95% confidence limits and P values can also be calculated. Moreover, if the estimate of the prevalence is imprecise, discrimination analysis can indicate the prevalence at which the confidence interval results in an OR of ∼1 revealing if the prevalence might be higher without yielding a non-significant result. These methods confirm some potential risk groups for YEL-AVD and cast doubt on another. They should prove useful in situations in which factor-specific risk group denominator data are not available. PMID:24394480

  11. Resting-state BOLD networks versus task-associated functional MRI for distinguishing Alzheimer's disease risk groups.

    PubMed

    Fleisher, Adam S; Sherzai, Ayesha; Taylor, Curtis; Langbaum, Jessica B S; Chen, Kewei; Buxton, Richard B

    2009-10-01

    To assess the ability of resting-state functional magnetic resonance imaging to distinguish known risk factors for AD, we evaluated 17 cognitively normal individuals with a family history of AD and at least one copy of the apolipoprotein e4 allele compared to 12 individuals who were not carriers of the APOE4 gene and did not have a family history of AD. Blood oxygen level dependent fMRI was performed evaluating encoding-associated signal and resting-state default mode network signal differences between the two risk groups. Neurocognitive testing revealed that the high risk group performed worse on category fluency testing, but the groups were equivalent on all other cognitive measures. During encoding of novel face-name pairs, there were no regions of encoding-associated BOLD activations that were different in the high risk group. Encoding-associated deactivations were greater in magnitude in the low risk group in the medial and right lateral parietal cortex, similar to findings in AD studies. The resting-state DMN analysis demonstrated nine regions in the prefrontal, orbital frontal, temporal and parietal lobes that distinguished the two risk groups. Resting-state DMN analysis could distinguish risk groups with an effect size of 3.35, compared to an effect size of 1.39 using encoding-associated fMRI techniques. Imaging of the resting state avoids performance related variability seen in activation fMRI, is less complicated to acquire and standardize, does not require radio-isotopes, and may be more effective at identifying functional pathology associated with AD risk compared to non-resting fMRI techniques.

  12. Association of the consumption of common food groups and beverages with mortality from cancer, ischaemic heart disease and diabetes mellitus in Serbia, 1991–2010: an ecological study

    PubMed Central

    Ilic, Milena; Ilic, Irena; Stojanovic, Goran; Zivanovic-Macuzic, Ivana

    2016-01-01

    Objectives This paper reports association between mortality rates from cancer, ischaemic heart disease and diabetes mellitus and the consumption of common food groups and beverages in Serbia. Design In this ecological study, data on both mortality and the average annual consumption of common food groups and beverages per household's member were obtained from official data-collection sources. The multivariate linear regression analysis was used to determine the strength of the associations between consumption of common food groups and beverages and mortality rates. Results Markedly increasing trends of cancer, ischaemic heart disease and diabetes mellitus mortality rates were observed in Serbia in the period 1991–2010. Mortality rates from cancer were negatively associated with consumption of vegetable oil (p=0.005) and grains (p=0.001), and same was found for ischaemic heart disease (p=0.002 and 0.021, respectively), while consumption of other dairy products showed a significant positive association (p<0.001 and p=0.032, respectively). In men and women, mortality rates from diabetes mellitus showed a significant positive association with consumption of poultry (p=0.014 and 0.004, respectively). Consumption of beef and grains showed a significant negative association with cancer mortality rates in both genders (p=0.002 and p<0.001 in men, and p<0.001 and p=0.014 in women, respectively), while consumption of cheese was negatively associated only in men (p<0.001). Mortality from diabetes mellitus showed a significant positive association with consumption of animal fat and other dairy products only in women (p=0.003 and 0.046, respectively). Conclusions Association between unfavourable mortality trends from cancer, ischaemic heart disease and diabetes mellitus, and common food groups and beverages consumption was observed and should be assessed in future analytical epidemiological studies. Promotion of healthy diet is sorely needed in Serbia. PMID:26733565

  13. Associations of prostate cancer risk variants with disease aggressiveness: results of the NCI-SPORE Genetics Working Group analysis of 18,343 cases.

    PubMed

    Helfand, Brian T; Roehl, Kimberly A; Cooper, Phillip R; McGuire, Barry B; Fitzgerald, Liesel M; Cancel-Tassin, Geraldine; Cornu, Jean-Nicolas; Bauer, Scott; Van Blarigan, Erin L; Chen, Xin; Duggan, David; Ostrander, Elaine A; Gwo-Shu, Mary; Zhang, Zuo-Feng; Chang, Shen-Chih; Jeong, Somee; Fontham, Elizabeth T H; Smith, Gary; Mohler, James L; Berndt, Sonja I; McDonnell, Shannon K; Kittles, Rick; Rybicki, Benjamin A; Freedman, Matthew; Kantoff, Philip W; Pomerantz, Mark; Breyer, Joan P; Smith, Jeffrey R; Rebbeck, Timothy R; Mercola, Dan; Isaacs, William B; Wiklund, Fredrick; Cussenot, Olivier; Thibodeau, Stephen N; Schaid, Daniel J; Cannon-Albright, Lisa; Cooney, Kathleen A; Chanock, Stephen J; Stanford, Janet L; Chan, June M; Witte, John; Xu, Jianfeng; Bensen, Jeannette T; Taylor, Jack A; Catalona, William J

    2015-04-01

    Genetic studies have identified single nucleotide polymorphisms (SNPs) associated with the risk of prostate cancer (PC). It remains unclear whether such genetic variants are associated with disease aggressiveness. The NCI-SPORE Genetics Working Group retrospectively collected clinicopathologic information and genotype data for 36 SNPs which at the time had been validated to be associated with PC risk from 25,674 cases with PC. Cases were grouped according to race, Gleason score (Gleason ≤ 6, 7, ≥ 8) and aggressiveness (non-aggressive, intermediate, and aggressive disease). Statistical analyses were used to compare the frequency of the SNPs between different disease cohorts. After adjusting for multiple testing, only PC-risk SNP rs2735839 (G) was significantly and inversely associated with aggressive (OR = 0.77; 95 % CI 0.69-0.87) and high-grade disease (OR = 0.77; 95 % CI 0.68-0.86) in European men. Similar associations with aggressive (OR = 0.72; 95 % CI 0.58-0.89) and high-grade disease (OR = 0.69; 95 % CI 0.54-0.87) were documented in African-American subjects. The G allele of rs2735839 was associated with disease aggressiveness even at low PSA levels (<4.0 ng/mL) in both European and African-American men. Our results provide further support that a PC-risk SNP rs2735839 near the KLK3 gene on chromosome 19q13 may be associated with aggressive and high-grade PC. Future prospectively designed, case-case GWAS are needed to identify additional SNPs associated with PC aggressiveness.

  14. Prostate disease: management options for the primary healthcare team. Report of a working party of the British Prostate Group.

    PubMed Central

    Chisholm, G. D.; Carne, S. J.; Fitzpatrick, J. M.; George, N. J.; Gingell, J. C.; Keen, J. W.; Kirby, R. S.; Kirk, D.; O'Donoghue, E. P.; Peeling, W. B.

    1995-01-01

    The prostate gland has attracted a remarkable increase in interest in the past few years. The two most common diseases of this gland, benign prostatic hyperplasia and carcinoma of the prostate, have been brought into greater prominence by new diagnostic methods, public interest, and a wider choice of surgical and non-surgical treatments. Uncertainty about the significance of these changes has occurred because of the rapidity of change, the profusion of statements, opinions and promotions, and the relatively little guidance available from the profession. Ten urologists and two general practitioners have reviewed the relevant evidence about these two prostate diseases and the newer diagnostic methods; their conclusions are summarised here. Management options and guidance on clinical practice are also discussed. Because of a number of unresolved diagnostic and management issues, detailed requirements for practice guidelines have not been specified. PMID:7538216

  15. Strategic approach to the management of Hodgkin's disease incorporating salvage therapy with high-dose ifosfamide, etoposide and epirubicin: a Northern Region Lymphoma Group study (UK).

    PubMed

    Proctor, S J; Jackson, G H; Lennard, A; Angus, B; Wood, K; Lucraft, H L; White, J; Windebank, K; Taylor, P R A

    2003-01-01

    The Northern Region Lymphoma Group is a population-based group covering 3.1 million people in Northern England. From 1991 total data collection for all Hodgkin's disease patients for this population has been in place and it has been possible to demonstrate that the overall survival for Hodgkin's disease for younger patients within this population has moved from 80% pre- 1988 to 87% post- 1988. This improvement has been brought about by the introduction of clinical trials for advanced stage disease and effective salvage regimens. This report describes the outcome of 51 patients treated with the ifosfamide, etoposide and epirubicin (IVE)schedule and includes 28 males and 23 females with a median age of 34 years. Overall 43 of 51 patients responded to treatment (84%) with 31 achieving a complete response, four a good partial response and eight a partial response. Thirty-one proceeded to autologous stem-cell transplantation. In total, with a median follow-up of 24 months (range 6-51), 26 patients remain alive and in continuous remission. Haematological toxicity,in particular neutropenia WHO grade 4, was observed in all cases but improved over the three courses of treatment. Non-haematological toxicity was not a major problem, with no significant cardiac, hepatic, renal or neurotoxicity. We conclude that the high-dose ifosfamide-containing regimens should be prospectively evaluated in the various types of non-responsive and relapsing Hodgkin's disease.

  16. Clinical characteristics and public health management of invasive meningococcal group W disease in the East Midlands region of England, United Kingdom, 2011 to 2013.

    PubMed

    Bethea, Jane; Makki, Sophia; Gray, Steve; MacGregor, Vanessa; Ladhani, Shamez

    2016-06-16

    In England and Wales, meningococcal disease caused by group W has historically been associated with outbreaks of disease among travellers to high-risk countries. Following a large outbreak associated with travel to the Hajj in 2000, the number of cases declined and, in 2008, only 19 laboratory-confirmed cases were identified nationally. In 2013, in the East Midlands region of England, eight cases of meningococcal disease caused by this serogroup were recorded, compared with six from 2011 to 2012. To explore this further, data for all cases with a date of onset between 1 January 2011 and 31 December 2013 were collected. Data collected included geographical location, clinical presentation and outcome. Fourteen cases were identified; two died as a result of their illness and two developed long-term health problems. No commonality in terms of geographical location, shared space or activities was identified, suggesting that group W is circulating endemically with local transmission. Clinical presentation was variable. Half presented with symptoms not typical of a classical meningococcal disease, including two cases of cellulitis, which may have implications for clinicians, in terms of timely identification and treatment, and public health specialists, for offering timely antibiotic chemoprophylaxis to close contacts. PMID:27336327

  17. Clinical characteristics and public health management of invasive meningococcal group W disease in the East Midlands region of England, United Kingdom, 2011 to 2013.

    PubMed

    Bethea, Jane; Makki, Sophia; Gray, Steve; MacGregor, Vanessa; Ladhani, Shamez

    2016-06-16

    In England and Wales, meningococcal disease caused by group W has historically been associated with outbreaks of disease among travellers to high-risk countries. Following a large outbreak associated with travel to the Hajj in 2000, the number of cases declined and, in 2008, only 19 laboratory-confirmed cases were identified nationally. In 2013, in the East Midlands region of England, eight cases of meningococcal disease caused by this serogroup were recorded, compared with six from 2011 to 2012. To explore this further, data for all cases with a date of onset between 1 January 2011 and 31 December 2013 were collected. Data collected included geographical location, clinical presentation and outcome. Fourteen cases were identified; two died as a result of their illness and two developed long-term health problems. No commonality in terms of geographical location, shared space or activities was identified, suggesting that group W is circulating endemically with local transmission. Clinical presentation was variable. Half presented with symptoms not typical of a classical meningococcal disease, including two cases of cellulitis, which may have implications for clinicians, in terms of timely identification and treatment, and public health specialists, for offering timely antibiotic chemoprophylaxis to close contacts.

  18. [Consensus statement of an interdisciplinary group of French experts on modalities of diagnosis and medical treatment of Alzheimer's disease at a treatable stage].

    PubMed

    Petit, H; Bakchine, S; Dubois, B; Laurent, B; Montagne, B; Touchon, J; Robert, P; Vellas, B; Vetel, J M; Cogneau, J; Marin La Meslée, R; Sorbé, G

    1998-06-01

    A group of French expert met on the 7th and 8th of February 1998 in order to establish a consensus attitude for Alzheimer's disease diagnosis and treatment. Members were drawn from primary care, geriatrics, neurology and psychiatry. They used the consensus statement of the American Association for Geriatrics, the Alzheimer's Association and the American Geriatrics Society published in JAMA, in October 1997 as a source of data for further consideration. Alzheimer's disease in the most common etiology of dementia. Main clinical features are cognitive impairment and psycho-behavioral disorders. Diagnosis must be one of inclusion and not exclusion. It is based on interviews of informants and family members and office-based clinical assessment. After a physical examination, cognitive function must be evaluated using the Mini-Mental State Examination. A laboratory evaluation should include a complete blood cell count, blood chemistry and determination of thyroid-stimulating hormone. In addition, noncontrast computed tomography head scans are adequate in most cases. Available pharmacologic treatments are not curative but are given to improve quality of life and enhance cognition and behavior. Two cholinesterases inhibitors, tacrine and donepezil, are the only agents officially authorized for treatment of the cognitive impairment in Alzheimer's disease. Mood and behaviour disorder also have to be treated by both pharmacologic and nonpharmacologic strategies. Only pharmacologic treatments will be detailed here. The consensus statements established by this group of experts will be reevaluated each year, considering the new available data on Alzheimer's disease.

  19. A prolonged course of Group A streptococcus-associated nephritis: a mild case of dense deposit disease (DDD)?

    PubMed

    Sawanobori, E; Umino, A; Kanai, H; Matsushita, K; Iwasa, S; Kitamura, H; Oda, T; Yoshizawa, N; Sugita, K; Higashida, K

    2009-06-01

    We herein report the case of a 12-year-old boy with dense deposit disease (DDD) evoked by streptococcal infection. He had been diagnosed to have asymptomatic hematuria syndrome at the age of 6 during school screening. At 12 years of age, he was found to have macrohematuria and overt proteinuria with hypocomplementemia 2 months after streptococcal pharyngitis. Renal biopsy showed endocapillary proliferative glomerulonephritis with double contours of the glomerular basement membrane. Hypocomplementemia and proteinuria were sustained for over 8 weeks. He was suspected to have dense deposit disease due to intramembranous deposits in the first and the second biopsies. 1 month after treatment with methylprednisolone pulse therapy, proteinuria decreased to a normal level. Microscopic hematuria disappeared 2 years later, but mild hypocomplementemia persisted for more than 7 years. Nephritis-associated plasmin receptor (NAPlr), a nephritic antigen for acute poststreptococcal glomerulonephritis, was found to be positive in the glomeruli for more than 8 weeks. DDD is suggested to be caused by dysgeneration of the alternative pathway due to C3NeF and impaired Factor H activity. A persistent deposition of NAPlr might be one of the factors which lead to complement dysgeneration. A close relationship was suggested to exist between the streptococcal infection and dense deposit disease in this case.

  20. Evaluating the predictive power of multivariate tensor-based morphometry in Alzheimer's disease progression via convex fused sparse group Lasso

    NASA Astrophysics Data System (ADS)

    Tsao, Sinchai; Gajawelli, Niharika; Zhou, Jiayu; Shi, Jie; Ye, Jieping; Wang, Yalin; Lepore, Natasha

    2014-03-01

    Prediction of Alzheimers disease (AD) progression based on baseline measures allows us to understand disease progression and has implications in decisions concerning treatment strategy. To this end we combine a predictive multi-task machine learning method1 with novel MR-based multivariate morphometric surface map of the hippocampus2 to predict future cognitive scores of patients. Previous work by Zhou et al.1 has shown that a multi-task learning framework that performs prediction of all future time points (or tasks) simultaneously can be used to encode both sparsity as well as temporal smoothness. They showed that this can be used in predicting cognitive outcomes of Alzheimers Disease Neuroimaging Initiative (ADNI) subjects based on FreeSurfer-based baseline MRI features, MMSE score demographic information and ApoE status. Whilst volumetric information may hold generalized information on brain status, we hypothesized that hippocampus specific information may be more useful in predictive modeling of AD. To this end, we applied Shi et al.2s recently developed multivariate tensor-based (mTBM) parametric surface analysis method to extract features from the hippocampal surface. We show that by combining the power of the multi-task framework with the sensitivity of mTBM features of the hippocampus surface, we are able to improve significantly improve predictive performance of ADAS cognitive scores 6, 12, 24, 36 and 48 months from baseline.

  1. A novel gene containing a trinucleotide repeat that is expanded and unstable on Huntington's disease chromosomes. The Huntington's Disease Collaborative Research Group.

    PubMed

    1993-03-26

    The Huntington's disease (HD) gene has been mapped in 4p16.3 but has eluded identification. We have used haplotype analysis of linkage disequilibrium to spotlight a small segment of 4p16.3 as the likely location of the defect. A new gene, IT15, isolated using cloned trapped exons from the target area contains a polymorphic trinucleotide repeat that is expanded and unstable on HD chromosomes. A (CAG)n repeat longer than the normal range was observed on HD chromosomes from all 75 disease families examined, comprising a variety of ethnic backgrounds and 4p16.3 haplotypes. The (CAG)n repeat appears to be located within the coding sequence of a predicted approximately 348 kd protein that is widely expressed but unrelated to any known gene. Thus, the HD mutation involves an unstable DNA segment, similar to those described in fragile X syndrome, spino-bulbar muscular atrophy, and myotonic dystrophy, acting in the context of a novel 4p16.3 gene to produce a dominant phenotype.

  2. Diseases and their management strategies take top research priority in watermelon research and development group member’s survey

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Watermelon is an important crop grown for its delicious fruit in the U.S. and in many countries across the world. A survey of members of Watermelon Research and Development Group (WRDG) was conducted via email and during WRDG meetings in 2014 and 2015 in an effort to identify and rank important rese...

  3. Ibex-associated malignant catarrhal fever-like disease in a group of bongo antelope (Tragelaphus euryceros)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A private zoological facility experienced an outbreak of fatal malignant catarrhal fever (MCF) in a group of bongo antelope (Tragelaphus euryceros). Three periparturient female bongos exhibited an acute onset of anorexia beginning ~6 weeks after being housed with a Nubian ibex (Capra nubiana). Disea...

  4. High prevalence of NIDDM and impaired glucose tolerance in Indian, Creole, and Chinese Mauritians. Mauritius Noncommunicable Disease Study Group.

    PubMed

    Dowse, G K; Gareeboo, H; Zimmet, P Z; Alberti, K G; Tuomilehto, J; Fareed, D; Brissonnette, L G; Finch, C F

    1990-03-01

    Mauritius, a multiethnic island nation in the southwestern Indian Ocean, has one of the world's highest diabetes mortality rates. The prevalence of both impaired glucose tolerance (IGT) and non-insulin-dependent diabetes mellitus (NIDDM) was investigated in 5080 Muslim and Hindu Indian, Creole (mixed African, European, and Indian origin), and Chinese Mauritian adults aged 25-74 yr who were selected by random cluster sampling. Based on a 75-g oral glucose tolerance test and World Health Organization criteria, the age-standardized prevalence of IGT was significantly greater in women (19.7%, 95% confidence interval [CI] 18.1-21.2) than in men (11.7%, CI 10.5-12.8). By contrast, the prevalence of NIDDM was similar in men (12.1%, CI 10.9-13.4) and women (11.7%, CI 10.5-12.8) for all ethnic groups combined. The sex difference in IGT prevalence was seen in all ethnic groups, but for NIDDM, the sex difference was not consistent across ethnic groups. However, age- and sex-standardized prevalence of IGT and NIDDM was remarkably similar across ethnic groups (16.2 and 12.4% in Hindu Indians, 15.3 and 13.3% in Muslim Indians, 17.5 and 10.4% in Creoles, and 16.6 and 11.9% in Chinese, respectively). Three new cases of diabetes were diagnosed for every two known cases. The high prevalence of abnormal glucose tolerance in Indian subjects is consistent with studies of other migrant Indian communities, but the findings in Creole and, in particular, Chinese subjects are unexpected. Potent environmental factors shared between ethnic groups in Mauritius may be responsible for the epidemic of glucose intolerance.

  5. The KMDS-NATION Study: Korean Movement Disorders Society Multicenter Assessment of Non-Motor Symptoms and Quality of Life in Parkinson's Disease NATION Study Group

    PubMed Central

    Kwon, Do-Young; Koh, Seong-Beom; Lee, Jae Hyeok; Park, Hee Kyung; Kim, Han-Joon; Shin, Hae-Won; Youn, Jinyoung; Park, Kun Woo; Choi, Sun-Ah; Kim, Sang Jin; Choi, Seong-Min; Park, Ji-Yun; Jeon, Beom S.; Kim, Ji Young; Chung, Sun Ju; Lee, Chong Sik; Park, Jeong-Ho; Ahn, Tae-Beom; Kim, Won Chan; Kim, Hyun Sook; Cheon, Sang Myung; Kim, Hee-Tae; Lee, Jee-Young; Kim, Ji Sun; Kim, Eun-Joo; Kim, Jong-Min; Lee, Kwang Soo; Kim, Joong-Seok; Kim, Min-Jeong; Baik, Jong Sam; Park, Ki-Jong; Kim, Hee Jin; Park, Mee Young; Kang, Ji Hoon; Song, Sook Kun; Kim, Yong Duk; Yun, Ji Young; Lee, Ho-Won; Oh, Hyung Geun; Cho, Jinwhan; Song, In-Uk; Sohn, Young H.; Lee, Phil Hyu

    2016-01-01

    Background and Purpose Nonmotor symptoms (NMS) in Parkinson's disease (PD) have multisystem origins with heterogeneous manifestations that develop throughout the course of PD. NMS are increasingly recognized as having a significant impact on the health-related quality of life (HrQoL). We aimed to determine the NMS presentation according to PD status, and the associations of NMS with other clinical variables and the HrQoL of Korean PD patients. Methods We surveyed patients in 37 movement-disorders clinics throughout Korea. In total, 323 PD patients were recruited for assessment of disease severity and duration, NMS, HrQoL, and other clinical variables including demographics, cognition, sleep scale, fatigability, and symptoms. Results In total, 98.1% of enrolled PD subjects suffered from various kinds of NMS. The prevalence of NMS and scores in each NMS domain were significantly higher in the PD group, and the NMS worsened as the disease progressed. Among clinical variables, disease duration and depressive mood showed significant correlations with all NMS domains (p<0.001). NMS status impacted HrQoL in PD (rS=0.329, p<0.01), and the association patterns differed with the disease stage. Conclusions The results of our survey suggest that NMS in PD are not simply isolated symptoms of degenerative disease, but rather exert significant influences throughout the disease course. A novel clinical approach focused on NMS to develop tailored management strategies is warranted to improve the HrQoL in PD patients.

  6. Differences in cognitive ability and hippocampal volume between Alzheimer's disease, amnestic mild cognitive impairment, and healthy control groups, and their correlation.

    PubMed

    Choi, Mi-Hyun; Kim, Hyung-Sik; Gim, Seon-Young; Kim, Woo-Ram; Mun, Kyung-Ryul; Tack, Gye-Rae; Lee, Bongsoo; Choi, Young Chil; Kim, Hyun-Jun; Hong, Seung Hwa; Lim, Dae-Woon; Chung, Soon-Cheol

    2016-05-01

    The study investigated differences in cognitive ability and hippocampal volume between groups of patients with Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI), and healthy control (HC) subjects, and explored the relationship between cognitive ability and hippocampal volume. Among the sub-tests of Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K), the Boston naming test score decreased in the order HC, aMCI, and AD. The hippocampal volumes of subjects with AD and aMCI were relatively smaller than those of HC individuals. There were strongly positive correlations between hippocampal volume and the scores for the Boston naming test. Discriminant analysis identified the Boston naming test as having the highest level of discrimination among the variables used to differentiate the three groups (89.9%). In conclusion, the Boston naming test accurately differentiated the three groups and was correlated with hippocampal volume. These results will be helpful for choosing an accurate and economically feasible test method that efficiently differentiates the three groups.

  7. Expression of Histo-Blood Group A Type 1, 2 and 3 Antigens in Normal Skin and Extramammary Paget’s Disease

    PubMed Central

    Tanaka, Aki; Kimura, Akihiko; Yamamoto, Yuki; Uede, Koji; Furukawa, Fukumi

    2008-01-01

    The distribution of histo-blood group A type 1, 2 and 3 antigens was investigated using immunohistochemistry in normal human skin and extramammary Paget’s disease (EMPD). We used monoclonal antibodies (mAbs) Bioclone-A (BA) and AR-1, which react with histo-blood group A type 1/2, and type 3 antigens, respectively. We found that A type 1, 2 and 3 antigens were expressed in the upper layer of the epidermis. We also found that the duct cells of the eccrine glands expressed A type 1/2 antigens and A type 3 antigens regardless of secretor status. The dark cells of the eccrine glands expressed A type 1, 2 and 3 antigens from A blood group secretors, but not from non-secretors. Apocrine glands, hair follicles and sebaceous glands did not express these antigens. Since these antigens were localized in the eccrine glands, we examined the possibility of a skin tumor marker. Interestingly, 7 out of 16 extramammary Paget’s disease cases were immunopositive for these antigens. Six cases were accompanied by dermal invasion. Five cases without dermal invasion were immunonegative against these antigens. These results suggest that the expression of histo-blood group A antigens in EMPD are associated with a poor histopathological prognosis. PMID:19180201

  8. Recommended curriculum for subspecialty training in transplant infectious disease on behalf of the American Society of Transplantation Infectious Diseases Community of Practice Educational Initiatives Working Group.

    PubMed

    Avery, R; Clauss, H; Danziger-Isakov, L; Davis, J; Doucette, K; van Duin, D; Fishman, J; Gunseren, F; Humar, A; Husain, S; Isada, C; Julian, K; Kaul, D; Kumar, D; Martin, S; Michaels, M; Morris, M; Silveira, F; Subramanian, A

    2010-06-01

    The American Society of Transplantation Infectious Diseases (ID) Community of Practice has established an education workgroup to identify core components of a curriculum for training specialists in transplant ID. Clinical, laboratory, and research training form the triad of components on which an additional year of ID training, dedicated to the care of solid organ and hematopoietic stem cell transplant recipients, should be based. The recommended training environment would have access to adequate numbers of transplant patients, along with qualified faculty committed to teaching specialized fellows in this area. The learning objectives for both inpatient and outpatient clinical training are presented. The laboratory component requires trainees to attain expertize in utilizing and interpreting cutting-edge diagnostics used in transplant medicine. The research component may involve basic science, and translational or clinical research individualized to the trainee. Finally, suggestions for evaluation of both the fellows and the training program are provided.

  9. Results of the 4th scientific workshop of the ECCO (Group II): markers of intestinal fibrosis in inflammatory bowel disease.

    PubMed

    Rieder, Florian; de Bruyn, Jessica R; Pham, Bao Tung; Katsanos, Konstantinos; Annese, Vito; Higgins, Peter D R; Magro, Fernando; Dotan, Iris

    2014-10-01

    The fourth scientific workshop of the European Crohn's and Colitis Organization (ECCO) focused on intestinal fibrosis in inflammatory bowel disease (IBD). The objective was to better understand basic mechanisms and markers of intestinal fibrosis as well as to suggest new therapeutic targets to prevent or treat fibrosis. The results of this workshop are presented in three separate manuscripts. This section describes markers of fibrosis in IBD, identifies unanswered questions in the field and provides a framework for future studies addressing the unmet needs in the field of intestinal fibrosis.

  10. Schistosomiasis: The Social Challenge of Controlling a Man-Made Disease

    ERIC Educational Resources Information Center

    Lemma, Aklilu

    1973-01-01

    There is an indication of a method for curbing or controlling schistosomiasis or bilharziasis. Modern technological advances in applied pharmacology have not provided a satisfactory remedy but a simple natural product, an endod berry, has been used to control the disease on a self-help basis. (EB)

  11. Human intronless genes: Functional groups, associated diseases, evolution, and mRNA processing in absence of splicing

    SciTech Connect

    Grzybowska, Ewa A.

    2012-07-20

    Highlights: Black-Right-Pointing-Pointer Functional characteristics of intronless genes (IGs). Black-Right-Pointing-Pointer Diseases associated with IGs. Black-Right-Pointing-Pointer Origin and evolution of IGs. Black-Right-Pointing-Pointer mRNA processing without splicing. -- Abstract: Intronless genes (IGs) constitute approximately 3% of the human genome. Human IGs are essentially different in evolution and functionality from the IGs of unicellular eukaryotes, which represent the majority in their genomes. Functional analysis of IGs has revealed a massive over-representation of signal transduction genes and genes encoding regulatory proteins important for growth, proliferation, and development. IGs also often display tissue-specific expression, usually in the nervous system and testis. These characteristics translate into IG-associated diseases, mainly neuropathies, developmental disorders, and cancer. IGs represent recent additions to the genome, created mostly by retroposition of processed mRNAs with retained functionality. Processing, nuclear export, and translation of these mRNAs should be hampered dramatically by the lack of splice factors, which normally tightly cover mature transcripts and govern their fate. However, natural IGs manage to maintain satisfactory expression levels. Different mechanisms by which IGs solve the problem of mRNA processing and nuclear export are discussed here, along with their possible impact on reporter studies.

  12. Role of hyperosmolarity in the pathogenesis and management of dry eye disease: proceedings of the OCEAN group meeting.

    PubMed

    Baudouin, Christophe; Aragona, Pasquale; Messmer, Elisabeth M; Tomlinson, Alan; Calonge, Margarita; Boboridis, Kostas G; Akova, Yonca A; Geerling, Gerd; Labetoulle, Marc; Rolando, Maurizio

    2013-10-01

    Dry eye disease (DED), a multifactorial disease of the tears and ocular surface, is common and has a significant impact on quality of life. Reduced aqueous tear flow and/or increased evaporation of the aqueous tear phase leads to tear hyperosmolarity, a key step in the vicious circle of DED pathology. Tear hyperosmolarity gives rise to morphological changes such as apoptosis of cells of the conjunctiva and cornea, and triggers inflammatory cascades that contribute to further cell death, including loss of mucin-producing goblet cells. This exacerbates tear film instability and drives the cycle of events that perpetuate the condition. Traditional approaches to counteracting tear hyperosmolarity in DED include use of hypotonic tear substitutes, which have relatively short persistence in the eye. More recent attempts to counteract tear hyperosmolarity in DED have included osmoprotectants, small organic molecules that are used in many cell types throughout the natural world to restore cell volume and stabilize protein function, allowing adaptation to hyperosmolarity. There is now an expanding pool of clinical data on the efficacy of DED therapies that include osmoprotectants such as erythritol, taurine, trehalose and L-carnitine. Osmoprotectants in DED may directly protect cells against hyperosmolarity and thereby promote exit from the vicious circle of DED physiopathology. PMID:24112228

  13. The Difference Quantity of Urinary Peptides between Two Groups of Type 2 Diabetic Patients with or without Coronary Artery Disease

    PubMed Central

    Fu, Guangzhen; Hu, Mei; Chu, Lina; Zhang, Man

    2015-01-01

    Objectives. We aim to explore urinary biomarkers that could monitor CAD in type 2 diabetic patients. Materials and Methods. Urine samples from two groups, twenty-eight type 2 diabetic patients with coexisting CAD and thirty type 2 diabetic patients without CAD, were purified by MB-WCX and then analyzed by MALDI-TOF-MS. Subsequently, we compared the urinary peptide signatures of the two groups by use of ClinProTools2.1 and evaluated the potential ability of the differently expressed peptides to distinguish type 2 diabetic patients with coexisting CAD from type 2 diabetic patients without CAD by ROC analysis. Finally, the differently expressed peptides were identified by nanoliquid chromatography-tandem mass spectrometry. Results. There were six differently expressed peptides (m/z 1305.2, 1743.9, 2184.9, 2756.1, 3223.2, and 6196.1) between the two groups of subjects, and they were identified as fragments of isoform 1 of fibrinogen alpha chain precursor, prothrombin precursor, and interalpha-trypsin inhibitor heavy chain H4. The diagnostic efficacy of m/z 2756.1 and m/z 3223.2 was better than the other peptides. Area under ROC of the m/z 2756.1, and m/z 3223.2 was 0.98 and 0.93, respectively. Conclusions. These urinary peptides are potential urinary biomarkers for monitoring of type 2 diabetic patients with CAD. PMID:26089891

  14. Alcoholic patients' response to their disease: perspective of patients and family

    PubMed Central

    Lima-Rodríguez, Joaquín Salvador; Guerra-Martín, María Dolores; Domínguez-Sánchez, Isabel; Lima-Serrano, Marta

    2015-01-01

    Objective: to know the perspective of alcoholic patients and their families about the behavioral characteristics of the disease, identifying the issues to modify the addictive behavior and seek rehabilitation. Method: ethnographic research using interpretative anthropology, via participant observation and a detailed interview with alcoholic patients and their families, members of Alcoholics Anonymous (AA) and Alanon in Spain. Results: development of disease behavior in alcoholism is complex due to the issues of interpreting the consumption model as a disease sign. Patients often remain long periods in the pre-contemplation stage, delaying the search for assistance, which often arrives without them accepting the role of patient. This constrains the recovery and is related to the social thought on alcoholism and self-stigma on alcoholics and their families, leading them to deny the disease, condition of the patient, and help. The efforts of self-help groups and the involvement of health professionals is essential for recovery. Conclusion: understanding how disease behavior develops, and the change process of addictive behavior, it may be useful for patients, families and health professionals, enabling them to act in a specific way at each stage. PMID:26626009

  15. Genetic homogeneity of Pelizaeus-Merzbacher disease: tight linkage to the proteolipoprotein locus in 16 affected families. PMD Clinical Group.

    PubMed Central

    Boespflug-Tanguy, O.; Mimault, C.; Melki, J.; Cavagna, A.; Giraud, G.; Pham Dinh, D.; Dastugue, B.; Dautigny, A.

    1994-01-01

    Among the numerous leukodystrophies that have an early onset and no biochemical markers, Pelizaeus-Merzbacher disease (PMD) is one that can be identified using strict clinical criteria and demonstrating an abnormal formation of myelin that is restricted to the CNS in electrophysiological studies and brain magnetic resonance imaging (MRI). In PMD, 12 different base substitutions and one total deletion of the genomic region containing the PLP gene have been reported, but, despite extensive analysis, PLP exon mutations have been found in only 10%-25% of the families analyzed. To test the genetic homogeneity of this disease, we have carried out linkage analysis with polymorphic markers of the PLP genomic region in 16 families selected on strict diagnostic criteria of PMD. We observed a tight linkage of the PMD locus with markers of the PLP gene (cDNA PLP, exon IV polymorphism) and of the Xq22 region (DXS17, DXS94, and DXS287), whereas the markers located more proximally (DXYS1X and DXS3) or distally (DXS11) were not linked to the PMD locus. Multipoint analysis gave a maximal location score for the PMD locus (13.98) and the PLP gene (8.32) in the same interval between DXS94 and DXS287, suggesting that in all families PMD is linked to the PLP locus. Mutations of the extraexonic PLP gene sequences or of another unknown close gene could be involved in PMD. In an attempt to identify molecular defects of this genomic region that are responsible for PMD, these results meant that RFLP analysis could be used to improve genetic counseling for the numerous affected families in which a PLP exon mutation could not be demonstrated. PMID:7915877

  16. Expert Consensus Group report on the use of apomorphine in the treatment of Parkinson's disease--Clinical practice recommendations.

    PubMed

    Trenkwalder, Claudia; Chaudhuri, K Ray; García Ruiz, Pedro J; LeWitt, Peter; Katzenschlager, Regina; Sixel-Döring, Friederike; Henriksen, Tove; Sesar, Ángel; Poewe, Werner; Baker, Mary; Ceballos-Baumann, Andres; Deuschl, Günther; Drapier, Sophie; Ebersbach, Georg; Evans, Andrew; Fernandez, Hubert; Isaacson, Stuart; van Laar, Teus; Lees, Andrew; Lewis, Simon; Martínez Castrillo, Juan Carlos; Martinez-Martin, Pablo; Odin, Per; O'Sullivan, John; Tagaris, Georgios; Wenzel, Karoline

    2015-09-01

    Extensive published evidence supports the use of subcutaneously-administered apomorphine as an effective therapy for Parkinson's disease (PD) but to date no consensus recommendations have been available to guide healthcare professionals in the optimal application of apomorphine therapy in clinical practice. This document outlines best-practice recommendations for selecting appropriate candidates for apomorphine intermittent injection (the pen-injection formulation) or apomorphine continuous infusion (the pump formulation), for initiating patients onto therapy and for managing their ongoing treatment. Apomorphine is a suitable therapeutic option for PD patients who experience troublesome 'off' periods despite optimized treatment with oral PD medications. Due to its speed of onset, apomorphine injection is particularly suited to those patients requiring rapid, reliable relief of both unpredictable and predictable 'off' periods, those who require reliable and fast relief when anticipating an 'off', those with levodopa absorption or gastric emptying problems resulting in delayed or failed 'on', or for rapid relief of early morning dystonia or akinesia. Apomorphine infusion(1) is suited for patients whose 'off' periods can no longer be adequately controlled by standard oral PD treatment or for those in whom rescue doses of apomorphine injection are effective but either needed too frequently (more than 4-6 times per day), or are associated with increasing dyskinesia. In addition to treating motor fluctuations, there is evidence that apomorphine infusion may be effective for the management of specific non-motor symptoms of PD associated with 'off' periods. Apomorphine infusion is less invasive than other non-oral treatment options for advancing disease, intrajejunal levodopa infusion and deep-brain stimulation. PMID:26189414

  17. Genomic Analysis Reveals Multi-Drug Resistance Clusters in Group B Streptococcus CC17 Hypervirulent Isolates Causing Neonatal Invasive Disease in Southern Mainland China

    PubMed Central

    Campisi, Edmondo; Rosini, Roberto; Ji, Wenjing; Guidotti, Silvia; Rojas-López, Maricarmen; Geng, Guozhu; Deng, Qiulian; Zhong, Huamin; Wang, Weidong; Liu, Haiying; Nan, Cassandra; Margarit, Immaculada; Rinaudo, C. D.

    2016-01-01

    Neonatal invasive disease caused by group B Streptococcus (GBS) represents a significant public health care concern globally. However, data related to disease burden, serotype distribution, and molecular epidemiology in China and other Asian countries are very few and specifically relative to confined regions. The aim of this study was to investigate the genetic characteristics of GBS isolates recovered from neonates with invasive disease during 2013–2014 at Guangzhou and Changsha hospitals in southern mainland China. We assessed the capsular polysaccharide type, pilus islands (PIs) distribution and hvgA gene presence in a panel of 26 neonatal clinical isolates, of which 8 were recovered from Early Onset Disease and 18 from Late Onset Disease (LOD). Among 26 isolates examined, five serotypes were identified. Type III was the most represented (15 cases), particularly among LOD strains (n = 11), followed by types Ib (n = 5), V (n = 3), Ia (n = 2) and II (n = 1). We performed whole-genome sequencing analysis and antimicrobial susceptibility testing on the 14 serotype III isolates belonging to the hypervirulent Clonal Complex 17 (serotype III-CC17). The presence of PI-2b alone was associated with 13 out of 14 serotype III-CC17 strains. Genome analysis led us to identify two multi-drug resistance gene clusters harbored in two new versions of integrative and conjugative elements (ICEs), carrying five or eight antibiotic resistance genes, respectively. These ICEs replaced the 16 kb-locus that normally contains the PI-1 operon. All isolates harboring the identified ICEs showed multiple resistances to aminoglycoside, macrolide, and tetracycline antibiotic classes. In conclusion, we report the first whole-genome sequence analysis of 14 GBS serotype III-CC17 strains isolated in China, representing the most prevalent lineage causing neonatal invasive disease. The acquisition of newly identified ICEs conferring multiple antibiotic resistance could in part explain the spread

  18. Metastatic Neuroblastoma Confined to Distant Lymph Nodes (stage 4N) Predicts Outcome in Patients With Stage 4 Disease: A Study From the International Neuroblastoma Risk Group Database

    PubMed Central

    Morgenstern, Daniel A.; London, Wendy B.; Stephens, Derek; Volchenboum, Samuel L.; Hero, Barbara; Di Cataldo, Andrea; Nakagawara, Akira; Shimada, Hiroyuki; Ambros, Peter F.; Matthay, Katherine K.; Cohn, Susan L.; Pearson, Andrew D.J.; Irwin, Meredith S.

    2014-01-01

    Purpose The presence of distant metastases is one of the most powerful predictors of outcome in patients with neuroblastoma. However, the pattern of metastatic spread is not incorporated into current risk stratification systems. Small case series have suggested that patients with neuroblastoma who have metastatic disease limited to distant lymph nodes (4N disease) may have improved outcomes. Patients and Methods We analyzed retrospective data from the International Neuroblastoma Risk Group database for patients diagnosed from 1990 to 2002. 4N patients were compared with the remaining stage 4 patients (non-4N), excluding those with missing metastatic site data. Results In all, 2,250 International Neuroblastoma Staging System stage 4 patients with complete data were identified, of whom 146 (6.5%) had 4N disease. For 4N patients, event-free survival (EFS; 5-year, 77% ± 4%) and overall survival (OS; 5-year, 85% ± 3%) were significantly better than EFS (5-year, 35% ± 1%) and OS (5-year, 42% ± 1%) for non-4N stage 4 patients (P < .001). 4N patients were more likely to be younger (P < .001) and have tumors with favorable characteristics, including absence of MYCN amplification (89% v 69%; P < .001). In a multivariable analysis, 4N disease remained a significant predictor of outcome (hazard ratio for non-4N v 4N: 3.40 for EFS and 3.69 for OS). Within subgroups defined by age at diagnosis and tumor MYCN status, 4N disease was significantly associated with improved outcomes. Conclusion 4N represents a subgroup with better outcome than that of other patients with metastatic disease. These findings suggest that the biology and treatment response of 4N tumors differ from other stage 4 tumors, and less intensive therapy should be considered for this cohort. Future exploration of biologic factors determining the pattern of metastatic spread is warranted. PMID:24663047

  19. Genomic Analysis Reveals Multi-Drug Resistance Clusters in Group B Streptococcus CC17 Hypervirulent Isolates Causing Neonatal Invasive Disease in Southern Mainland China.

    PubMed

    Campisi, Edmondo; Rosini, Roberto; Ji, Wenjing; Guidotti, Silvia; Rojas-López, Maricarmen; Geng, Guozhu; Deng, Qiulian; Zhong, Huamin; Wang, Weidong; Liu, Haiying; Nan, Cassandra; Margarit, Immaculada; Rinaudo, C D

    2016-01-01

    Neonatal invasive disease caused by group B Streptococcus (GBS) represents a significant public health care concern globally. However, data related to disease burden, serotype distribution, and molecular epidemiology in China and other Asian countries are very few and specifically relative to confined regions. The aim of this study was to investigate the genetic characteristics of GBS isolates recovered from neonates with invasive disease during 2013-2014 at Guangzhou and Changsha hospitals in southern mainland China. We assessed the capsular polysaccharide type, pilus islands (PIs) distribution and hvgA gene presence in a panel of 26 neonatal clinical isolates, of which 8 were recovered from Early Onset Disease and 18 from Late Onset Disease (LOD). Among 26 isolates examined, five serotypes were identified. Type III was the most represented (15 cases), particularly among LOD strains (n = 11), followed by types Ib (n = 5), V (n = 3), Ia (n = 2) and II (n = 1). We performed whole-genome sequencing analysis and antimicrobial susceptibility testing on the 14 serotype III isolates belonging to the hypervirulent Clonal Complex 17 (serotype III-CC17). The presence of PI-2b alone was associated with 13 out of 14 serotype III-CC17 strains. Genome analysis led us to identify two multi-drug resistance gene clusters harbored in two new versions of integrative and conjugative elements (ICEs), carrying five or eight antibiotic resistance genes, respectively. These ICEs replaced the 16 kb-locus that normally contains the PI-1 operon. All isolates harboring the identified ICEs showed multiple resistances to aminoglycoside, macrolide, and tetracycline antibiotic classes. In conclusion, we report the first whole-genome sequence analysis of 14 GBS serotype III-CC17 strains isolated in China, representing the most prevalent lineage causing neonatal invasive disease. The acquisition of newly identified ICEs conferring multiple antibiotic resistance could in part explain the spread of

  20. Identification of a High-Risk Group Among Patients With Oral Cavity Squamous Cell Carcinoma and pT1-2N0 Disease

    SciTech Connect

    Liao, Chun-Ta; Lin, Chien-Yu; Fan, Kang-Hsing; Wang, Hung-Ming; Ng, Shu-Hang; Lee, Li-Yu; Hsueh, Chuen; Chen, I-How; Huang, Shiang-Fu; Kang, Chung-Jan; and others

    2012-01-01

    Purpose: In the American Joint Committee on Cancer 2010 classification system, pT1-2N0 oral cavity squamous cell carcinoma (OSCC) is considered an early-stage cancer treatable with surgery alone (National Comprehensive Cancer Network 2010 guidelines). Our aim was to evaluate the feasibility of surgery alone for pT1-2N0 OSCC patients. Methods and Materials: Among 1279 previously untreated OSCC patients referred to our hospital between January 1996 and May 2008, we identified 457 consecutive patients with pT1-2N0 disease. All had radical tumor excision with neck dissection. A total of 387 patients showing pathologic margins greater than 4 mm and treated by surgery alone were included in the final analysis. All were followed up for at least 24 months after surgery or until death. The 5-year rates of control, distant metastasis, and survival were the main outcome measures. Results: The 5-year rates in the entire group of pT1-2N0 patients were as follows: local control, 91%; neck control, 92%; distant metastases, 1%; disease-free survival, 85%; disease-specific survival, 93%; and overall survival, 84%. Multivariate analysis identified poor differentiation and pathologic tumor depth of 4 mm or greater as independent risk factors for neck control, disease-free survival, and disease-specific survival. A scoring system using poor differentiation and tumor depth was formulated to define distinct prognostic groups. The presence of both poorly differentiated tumors and a tumor depth of 4 mm or greater resulted in significantly poorer 5-year neck control (p < 0.0001), disease-free (p < 0.0001), disease-specific (p < 0.0001), and overall survival (p = 0.0046) rates. Conclusion: The combination of poor differentiation and pathologic tumor depth of 4 mm or greater identified a subset of pT1-2N0 OSCC patients with poor outcome, who may have clinical benefit from postoperative adjuvant radiotherapy.