scholarly journals A quick and reliable waiting room checklist for symptoms of disinhibited social engagement disorder

2021 ◽  
pp. 251610322110507
Author(s):  
Genevieve McMorran-Young ◽  
Kate Moran ◽  
David Young ◽  
Glyn Batchelor ◽  
Helen Minnis
Keyword(s):  
Social Engagement ◽  
Child Neglect ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Autism Spectrum ◽  
Reference Ranges ◽  
Typically Developing ◽  
Waiting Room ◽  
Social Agenda ◽  
Disinhibited Social Engagement Disorder

Background: Disinhibited social engagement disorder (DSED) is a psychosocial disorder, associated with child neglect, characterised by indiscriminate friendliness towards strangers. Some behavioural overlap between DSED and autism spectrum disorder (ASD) – a neurodevelopmental condition whose core symptoms include impaired communication – has been observed. Since DSED is associated with a maltreatment history and ASD is not, differential diagnosis is important. We aimed to establish norms and reference ranges for a clinic waiting room checklist (WRO) for the observation of DSED symptoms, and to examine its discrimination between DSED and ASD. Methods: Norms are provided for the WRO based on 56 children aged 5–12 with DSED and 151 typically developing controls, for whom a reference range is also provided. We modified the WRO based on both quantitative examination of discrimination between DSED and ASD ( n = 16) and qualitative observations of typically developing children ( n = 7), children with DSED ( n = 5) and ASD ( n = 6). Results: A WRO score >6 may indicate the need for a multi-informant assessment for DSED. In a waiting room, children from both atypical groups (ASD and DSED) were more likely to approach strangers than controls; however, while children with DSED symptoms appeared to take control of the social aspects of the situation, children with ASD followed a non-social agenda, with the stranger appearing irrelevant. Conclusion: The WRO is an efficient tool that, along with information from parents and teacher, can contribute to clinical decision-making regarding children who have difficulties with social relationships.

Psychiatric disorders in C9orf72 kindreds

Neurology ◽  
2018 ◽  
Vol 91 (16) ◽  
pp. e1498-e1507 ◽  
Author(s):  
Emma M. Devenney ◽  
Rebekah M. Ahmed ◽  
Glenda Halliday ◽  
Olivier Piguet ◽  
Matthew C. Kiernan ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Clinical Decision Making ◽  
Late Onset ◽  
Family Members ◽  
Positive Association ◽  
Clinical Decision ◽  
Autism Spectrum ◽  
Psychiatric Disease ◽  
Relative Risk Ratio ◽  
Lateral Sclerosis

ObjectiveThe aim of this study was to determine in a systematic manner if the C9orf72 phenotype might extend beyond frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS) to include psychiatric disease.MethodsA validated semistructured family history interview was conducted in a large cohort of patients with FTD and ALS (n = 89), with and without the C9orf72 expansion (n = 29 and n = 60, respectively), encompassing 1,414 first- and second-degree relatives. Statistical analyses used both the hazard ratio (HR) and the relative risk ratio to determine the risk profiles within families.ResultsA significant HR of 4.9 (95% confidence interval [CI]: 1.9–13.9, p = 0.003) confirmed a higher probability of developing schizophrenia for relatives of C9orf72 carriers compared with noncarriers. In addition, 8 relatives of C9orf72 carriers experienced an episode of late-onset psychosis unrelated to schizophrenia, in comparison to one noncarrier (HR = 17.9, 95% CI: 2.2–143.2, p = 0.007). The probability of suicide was also significantly higher for family members of C9orf72 carriers (HR = 2.7, 95% CI: 1.2–6.2, p = 0.02). An HR of 2.7 (95% CI: 1.1–6.9, p = 0.03) indicated a higher probability of autism spectrum disorder (ASD) in family members of C9orf72 carriers, and this risk extended to FTD. Furthermore, there was a positive association between psychosis in probands and mental health disorders, including ASD in their family members (p = 0.04).ConclusionOverall, the results from this study suggest that a psychiatric phenotype exists within C9orf72 kindreds. Further studies should attempt to delineate the risk of psychiatric disorders in C9orf72 kindreds to aid in clinical decision making, particularly regarding genetic counseling, through collaborations between neurology and psychiatry.

The impact of assay quality and reference ranges on clinical decision making in the diagnosis of androgen disorders

Steroids ◽  
2008 ◽  
Vol 73 (13) ◽  
pp. 1311-1317 ◽  
Author(s):  
Shalender Bhasin ◽  
Anqi Zhang ◽  
Andrea Coviello ◽  
Ravi Jasuja ◽  
Jagadish Ulloor ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Reference Ranges ◽  
The Impact

scholarly journals Reference equations for tidal breathing parameters using structured light plethysmography

2021 ◽  
pp. 00050-2021
Author(s):  
Shayan Motamedi-Fakhr ◽  
Richard Iles ◽  
Nicki Barker ◽  
John Alexander ◽  
Brendan G. Cooper
Keyword(s):  
Duty Cycle ◽  
Clinical Decision Making ◽  
Structured Light ◽  
Methodological Approach ◽  
Clinical Decision ◽  
Reference Ranges ◽  
Breathing Patterns ◽  
Inspiratory Time ◽  
Tidal Breathing ◽  
Reference Equations

Tidal breathing measurements can be used to identify changes in respiratory status. Structured light plethysmography (SLP) is a non-contact tidal breathing measurement technique. Lack of reference equations for SLP parameters makes clinical decision-making difficult. We have developed a set of growth adjusted reference equations for seven clinically pertinent parameters of respiratory rate (RR), inspiratory time (Ti), expiratory time (Te), duty cycle (Ti/Total-breath-time), phase (thoraco-abdominal asynchrony or TAA), relative thoracic contribution (RTC) and IE50 (tidal inspiratory/expiratory flow at 50% volume).Reference equations were developed based on a cohort of 198 seated healthy subjects (age 2–75 years, height 82 cm–194 cm, 108 Male). We adopted the same methodological approach as the global lung function initiative (GLI) report on spirometric reference equations [1]. Five minutes of tidal breathing was recorded per subject. Parameters were summarised with their medians. The online supplement provided is an integral part of this work and a reference range calculator is also provided therein.We found predicted RR to decrease with age and height rapidly in the first 20 years and slowly thereafter. Expected Ti, Te and RTC followed the opposite trend. RTC was 6.7% higher in females. Duty cycle increased with age, peaked at 13 and decreased after. TAA was high and variable in early life and declined rapidly with age. Predicted IE50 was constant as it did not correlate with growth.These reference ranges for seven key measures ensure clinicians and researchers can identify tidal breathing patterns in disease and better understand and interpret SLP and tidal breathing data.

Case Studies: Stahl's Essential Psychopharmacology

2011 ◽  
Author(s):  
Stephen M. Stahl ◽  
Nancy Muntner
Keyword(s):  
Clinical Decision Making ◽  
Real Life ◽  
Clinical Decision ◽  
Clinical Encounter ◽  
Waiting Room ◽  
Clinical Scenarios ◽  
The Everyday ◽  
Representative Selection ◽  
User Friendly ◽  
Selection Of

Designed with the distinctive, user-friendly presentation Dr Stahl's audience know and love, this new stream of Stahl books capitalize on Dr Stahl's greatest strength - the ability to address complex issues in an understandable way and with direct relevance to the everyday experience of clinicians. The book describes a wide-ranging and representative selection of clinical scenarios, making use of icons, questions/answers and tips. It follows these cases through the complete clinical encounter, from start to resolution, acknowledging all the complications, issues, decisions, twists and turns along the way. The book is about living through the treatments that work, the treatments that fail, and the mistakes made along the journey. This is psychiatry in real life – these are the patients from your waiting room – this book will reassure, inform and guide better clinical decision making.

scholarly journals Reference Ranges for Lymphocyte Subsets among Healthy Hong Kong Chinese Adults by Single-Platform Flow Cytometry

2013 ◽  
Vol 20 (4) ◽  
pp. 602-606 ◽  
Author(s):  
W. S. Wong ◽  
A. W. I. Lo ◽  
L. P. Siu ◽  
J. N. S. Leung ◽  
S. P. Tu ◽  
...  
Keyword(s):  
Flow Cytometry ◽  
Hong Kong ◽  
Clinical Decision Making ◽  
Lymphocyte Subsets ◽  
Local Population ◽  
Suppressor Cells ◽  
Clinical Decision ◽  
Hong Kong Chinese ◽  
Reference Ranges ◽  
Chinese Adults

ABSTRACTRace, age, sex, and environmental conditions have significant impacts on lymphocyte subset values. It is important to establish the local reference ranges from healthy and non-HIV-positive adults in the local population for clinical decision making. In this study, the reference ranges for lymphocyte subsets among Chinese adults were established by analysis by single-platform flow cytometry of the lymphocyte compositions of 273 healthy adult blood donors between 17 and 59 years of age. The 95% reference ranges for CD3+T cells, CD3+CD4+T helper cells, and CD3+CD8+T suppressor cells are 723 to 2,271 cells/μl, 396 to 1,309 cells/μl, and 224 to 1,014 cells/μl, respectively. The 95% reference ranges for CD19+B cells and CD56+NK cells are 118 to 645 cells/μl and 61 to 607 cells/μl, respectively. Significant gender and age differences in the lymphocyte subsets have been demonstrated. Our results have also shown that the T-lymphocyte compositions in Hong Kong Chinese were comparable to those of other Asian populations but were different from those of Caucasians.

scholarly journals Machine Learning based Autism Grading for Clinical Decision Making

2019 ◽  
Vol 8 (4) ◽  
pp. 7443-7446
Keyword(s):  
Machine Learning ◽  
Decision Making ◽  
Autism Spectrum Disorder ◽  
Clinical Decision Making ◽  
Prediction Models ◽  
Clinical Decision ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Diagnostic Process ◽  
Manhattan Distance

Autism spectrum disorder is a pervasive developmental disorder that affects the behavioral and communication function of the children. It shows poor performance in communication, social and cognitive abilities, which are generally characterized by developmental delays and abnormal activities in their regular work. Early intervention can reduce the autism spectrum disorders. Machine learning techniques are used to detect autistic features in childhood. The prediction models are implemented as classification problem in which model is constructed by using real-time autism dataset. The proposed work is use Backpropagation and learning vector quantization with different distance measures like Euclidean Distance, Manhattan Distance, and City Block Distance to predict whether a child has autism spectrum disorder and also defines the grade of the autism. So that it can be supported for the clinical decision making. It enables automated clinical autism spectrum disorder diagnostic process using machine learning models.

Toddlers' Verb Lexicon Diversity and Grammatical Outcomes

2016 ◽  
Vol 47 (1) ◽  
pp. 44-58 ◽  
Author(s):  
Pamela A. Hadley ◽  
Matthew Rispoli ◽  
Ning Hsu
Keyword(s):  
Language Impairment ◽  
Linear Growth ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Parent Report ◽  
Typically Developing ◽  
Lexical Diversity ◽  
Communicative Development ◽  
Archival Database ◽  
Verb Lexicon

Purpose The goals of this study were to quantify longitudinal expectations for verb lexicon growth and to determine whether verb lexicon measures were better predictors of later grammatical outcomes than noun lexicon measures. Method Longitudinal parent-report measures from the MacArthur-Bates Communicative Development Inventory (Fenson et al., 2007) from ages 21 to 30 months from an archival database were used to model growth in common noun and verb lexicon size for 45 typically developing toddlers. Communicative Development Inventory growth coefficients and 24-month measures of lexical diversity from spontaneous language samples were used to predict 30-month grammatical outcomes on the Index of Productive Syntax (Scarborough, 1990). Results Average verb growth was characterized by 50.57 verbs at 24 months, with linear growth of 8.29 verbs per month and deceleration overall. Children with small verb lexicons or slow linear growth at 24 months accelerated during this developmental period. Verb lexicon measures were better predictors of grammatical outcomes than noun lexicon measures, accounting for 47.8% of the variance in Index of Productive Syntax scores. Lexical verb diversity in spontaneous speech emerged as the single best predictor. Conclusion Measures of verb lexicon size and diversity should be included as part of early language assessment to guide clinical decision making with young children at risk for language impairment.

scholarly journals Determination of Haematological Reference Ranges in Healthy Adults in Three Regions in Ghana

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Otchere Addai-Mensah ◽  
Daniel Gyamfi ◽  
Richard Vikpebah Duneeh ◽  
Kwabena O. Danquah ◽  
Max E. Annani-Akollor ◽  
...  
Keyword(s):  
Reference Values ◽  
Clinical Decision Making ◽  
Geographical Area ◽  
Clinical Decision ◽  
Specific Reference ◽  
Guidance Document ◽  
Reference Ranges ◽  
Cross Sectional ◽  
Study Sites ◽  
The Individual

Laboratory results interpretation for diagnostic accuracy and clinical decision-making in this period of evidence-based medicine requires cut-off values or reference ranges that are reflective of the geographical area where the individual resides. Several studies have shown significant differences between and within populations, emphasizing the need for population-specific reference ranges. This cross-sectional experimental study sought to establish the haematological reference values in apparently healthy individuals in three regions in Ghana. Study sites included Nkenkaasu, Winneba, and Nadowli in the Ashanti, Central, and Upper West regions of Ghana, respectively. A total of 488 healthy participants were recruited using the Clinical and Laboratory Standards Institute (United States National Consensus Committee on Laboratory Standards, NCCLS) Guidance Document C28A2. Medians for haematological parameters were calculated and reference values determined at2.5thand97.5thpercentiles and compared with Caucasian values adopted by our laboratory as reference ranges and values from other African and Western countries. RBC count, haemoglobin, and haematocrit (HCT) were significantly higher in males compared to females. There were significant intraregional and interregional as well as international variations of haematological reference ranges in the populations studied. We conclude that, for each geographical area, there is a need to establish geography-specific reference ranges if accurate diagnosis and concise clinical decisions are to be made.

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