Addressing challenges in the evidence base for bipolar disorders: Diagnostic accuracy and attrition

2021 ◽  
Vol 23 (4) ◽  
pp. 321-323
Author(s):  
Priyanka Desai ◽  
Snežana Urošević ◽  
Mary Butler
Keyword(s):  
Diagnostic Accuracy ◽  
Bipolar Disorders ◽  
Evidence Base

Paediatric mood disorders

2012 ◽  
pp. 1669-1680
Author(s):  
David Brent ◽  
Boris Birmaher
Keyword(s):  
Risk Factors ◽  
Mood Disorders ◽  
Bipolar Disorders ◽  
Evidence Base ◽  
Future Research ◽  
Psychosocial Treatments

In this chapter, we describe the nosology and epidemiology of paediatric unipolar and bipolar disorders, risk factors and predictors of course, and the evidence base for pharmacological and psychosocial treatments. We conclude this chapter by suggesting areas for future research.

scholarly journals Utility of Lung Ultrasound in COVID-19: A Systematic Scoping Review

2020 ◽  
Author(s):  
Michael M Trauer ◽  
Ashley Matthies ◽  
Nick Mani ◽  
Cian Mcdermott ◽  
Robert Jarman
Keyword(s):  
Diagnostic Accuracy ◽  
Scoping Review ◽  
Lung Ultrasound ◽  
Evidence Base ◽  
Observer Agreement ◽  
Future Research ◽  
High Quality Research ◽  
Specific Test ◽  
Operator Experience ◽  
Role Based

ABSTRACTLung ultrasound (LUS) has an established evidence base and has proven useful in previous viral epidemics. An understanding of the utility of LUS in COVID-19 is crucial to determine its most suitable role based on local circumstances. A scoping review was thus undertaken to explore the utility of LUS in COVID-19 and guide future research.33 studies were identified which represent a rapidly expanding evidence base for LUS in COVID-19. The quality of the included studies was relatively low. However LUS appears to be a highly sensitive and fairly specific test for COVID-19 in all ages and in pregnancy and is almost certainly more sensitive than CXR. The precise diagnostic accuracy of LUS may be influenced by various factors including disease severity, pre-existing lung disease, scanning protocol, operator experience, disease prevalence and the reference standard.High quality research is needed in various fields including: diagnostic accuracy in undifferentiated patients; triage and prognostication; monitoring progression and guiding interventions; persistence of residual LUS findings; inter-observer agreement; and the role of contrast-enhanced LUS.

Couple and family interventions for depressive and bipolar disorders: Evidence base update (2010–2019)

2021 ◽  
Author(s):  
Andrea K. Wittenborn ◽  
Sarah B. Woods ◽  
Jacob B. Priest ◽  
Preston C. Morgan ◽  
Chi‐Fang Tseng ◽  
...  
Keyword(s):  
Bipolar Disorders ◽  
Evidence Base ◽  
Family Interventions

JS01-04 - Rational optimization of bipolar disorders’ treatment

2011 ◽  
Vol 26 (S2) ◽  
pp. 1998-1998
Author(s):  
E. Vieta
Keyword(s):  
Bipolar Disorder ◽  
Healthy Lifestyle ◽  
Bipolar Depression ◽  
Treatment Options ◽  
Bipolar Disorders ◽  
Mood Stabilizer ◽  
Evidence Base ◽  
Term Therapy ◽  
Depressive Episodes

Bipolar disorder is difficult to treat. There are several options to treat acute mania, but combination of two or more drugs is the rule rather than the exception, indicating the limitations of currently available therapies. The evidence base for the treatment of bipolar depression is much weaker, and again combination is the rule. Although patients with bipolar disorder may experience resolution of symptoms with acute treatment, many will continue to experience impaired functioning due to the episodic, chronic, and progressive nature of the illness. Maintenance therapy is needed for a variety of reasons, including prevention of relapse, reduction of subthreshold symptoms, decreasing the risk of suicide, and reducing the frequency of rapid cycling and mood instability. Although long-term therapy is usually required to maintain or improve functioning and quality of life, it has been a significant challenge to identify clinically effective treatments for long-term management. There are few currently-available, well-tolerated treatment options that are effective in all phases of bipolar disorder and which prevent recurrence of manic and/or depressive episodes. Questions concerning when to discontinue one of the drugs when two or more are used, or how to switch from one mood stabilizer to another, have not been addressed in clinical trials. Electroconvulsive therapy may be effective in treatment resistant cases and can be used as maintenance when pharmacotherapy is not enough. Psychoeducation may help to enhance treatment adherence and healthy lifestyle. A rational combination of the above mentioned strategies may help to optimize the outcome of this challenging condition.

Classifying Disfluencies in Preschool- and School-Age Spanish–English Bilinguals Who Do Not Stutter: An Exploratory Study

2020 ◽  
Vol 5 (1) ◽  
pp. 119-130
Author(s):  
Raúl Rojas ◽  
Farzan Irani
Keyword(s):  
Exploratory Study ◽  
Evidence Base ◽  
Medium Effect ◽  
Bilingual Children ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Total Percentage ◽  
Narrative Production ◽  
Language Measures ◽  
Mean Length Of Utterance

Purpose This exploratory study examined the language skills and the type and frequency of disfluencies in the spoken narrative production of Spanish–English bilingual children who do not stutter. Method A cross-sectional sample of 29 bilingual students (16 boys and 13 girls) enrolled in grades prekindergarten through Grade 4 produced a total of 58 narrative retell language samples in English and Spanish. Key outcome measures in each language included the percentage of normal (%ND) and stuttering-like (%SLD) disfluencies, percentage of words in mazes (%MzWds), number of total words, number of different words, and mean length of utterance in words. Results Cross-linguistic, pairwise comparisons revealed significant differences with medium effect sizes for %ND and %MzWds (both lower for English) as well as for number of different words (lower for Spanish). On average, the total percentage of mazed words was higher than 10% in both languages, a pattern driven primarily by %ND; %SLDs were below 1% in both languages. Multiple linear regression models for %ND and %SLD in each language indicated that %MzWds was the primary predictor across languages beyond other language measures and demographic variables. Conclusions The findings extend the evidence base with regard to the frequency and type of disfluencies that can be expected in bilingual children who do not stutter in grades prekindergarten to Grade 4. The data indicate that %MzWds and %ND can similarly index the normal disfluencies of bilingual children during narrative production. The potential clinical implications of the findings from this study are discussed.

Bang for Your Buck: A Single-Case Experimental Design Study of Practice Amount and Distribution in Treatment for Childhood Apraxia of Speech

2019 ◽  
Vol 62 (9) ◽  
pp. 3160-3182 ◽  
Author(s):  
Edwin Maas ◽  
Christina Gildersleeve-Neumann ◽  
Kathy Jakielski ◽  
Nicolette Kovacs ◽  
Ruth Stoeckel ◽  
...  
Keyword(s):  
Single Case ◽  
Evidence Base ◽  
Distributed Practice ◽  
Single Subject ◽  
Single Subject Design ◽  
Apraxia Of Speech ◽  
Childhood Apraxia Of Speech ◽  
Opposite Pattern ◽  
Massed Practice ◽  
Treatment Conditions

Purpose The aim of this study was to examine 2 aspects of treatment intensity in treatment for childhood apraxia of speech (CAS): practice amount and practice distribution. Method Using an alternating-treatments single-subject design with multiple baselines, we compared high versus low amount of practice, and massed versus distributed practice, in 6 children with CAS. Conditions were manipulated in the context of integral stimulation treatment. Changes in perceptual accuracy, scored by blinded analysts, were quantified with effect sizes. Results Four children showed an advantage for high amount of practice, 1 showed an opposite effect, and 1 showed no condition difference. For distribution, 4 children showed a clear advantage for massed over distributed practice post treatment; 1 showed an opposite pattern, and 1 showed no clear difference. Follow-up revealed a similar pattern. All children demonstrated treatment effects (larger gains for treated than untreated items). Conclusions High practice amount and massed practice were associated with more robust speech motor learning in most children with CAS, compared to low amount and distributed practice, respectively. Variation in effects across children warrants further research to determine factors that predict optimal treatment conditions. Finally, this study adds to the evidence base supporting the efficacy of integral stimulation treatment for CAS. Supplemental Material https://doi.org/10.23641/asha.9630599

Clausal Density Between Ages 4 and 9 Years for the Edmonton Narrative Norms Instrument: Reference Data and Psychometric Properties

2020 ◽  
pp. 1-15
Author(s):  
Ling-Yu Guo ◽  
Phyllis Schneider ◽  
William Harrison
Keyword(s):  
Diagnostic Accuracy ◽  
Psychometric Properties ◽  
Language Impairment ◽  
Reference Data ◽  
Reliability And Validity ◽  
Correlation Coefficients ◽  
Criterion Validity ◽  
Likelihood Ratios ◽  
Generation Task ◽  
Sensitivity Specificity

Purpose This study provided reference data and examined psychometric properties for clausal density (CD; i.e., number of clauses per utterance) in children between ages 4 and 9 years from the database of the Edmonton Narrative Norms Instrument (ENNI). Method Participants in the ENNI database included 300 children with typical language (TL) and 77 children with language impairment (LI) between the ages of 4;0 (years;months) and 9;11. Narrative samples were collected using a story generation task, in which children were asked to tell stories based on six picture sequences. CD was computed from the narrative samples. The split-half reliability, concurrent criterion validity, and diagnostic accuracy were evaluated for CD by age. Results CD scores increased significantly between ages 4 and 9 years in children with TL and those with LI. Children with TL produced higher CD scores than those with LI at each age level. In addition, the correlation coefficients for the split-half reliability and concurrent criterion validity of CD scores were all significant at each age level, with the magnitude ranging from small to large. The diagnostic accuracy of CD scores, as revealed by sensitivity, specificity, and likelihood ratios, was poor. Conclusions The finding on diagnostic accuracy did not support the use of CD for identifying children with LI between ages 4 and 9 years. However, given the attested reliability and validity for CD, reference data of CD from the ENNI database can be used for evaluating children's difficulties with complex syntax and monitoring their change over time. Supplemental Material https://doi.org/10.23641/asha.13172129

Inclusion of Transgender Voice and Communication Training in a University Clinic

2017 ◽  
Vol 2 (10) ◽  
pp. 109-115 ◽  
Author(s):  
Jennifer Oates ◽  
Georgia Dacakis
Keyword(s):  
Training Program ◽  
Clinical Education ◽  
Well Being ◽  
Evidence Base ◽  
Communication Training ◽  
Speech Language Pathology ◽  
Transgender People ◽  
Language Pathology ◽  
Effectiveness Of Training ◽  
Negative Impacts

Because of the increasing number of transgender people requesting speech-language pathology services, because having gender-incongruent voice and communication has major negative impacts on an individual's social participation and well-being, and because voice and communication training is supported by an improving evidence-base, it is becoming more common for universities to include transgender-specific theoretical and clinical components in their speech-language pathology programs. This paper describes the theoretical and clinical education provided to speech-language pathology students at La Trobe University in Australia, with a particular focus on the voice and communication training program offered by the La Trobe Communication Clinic. Further research is required to determine the outcomes of the clinic's training program in terms of student confidence and competence as well as the effectiveness of training for transgender clients.

1956: Does Increasing the Number of Cores of Prostate Biopsy Improve Diagnostic Accuracy? Indications and Morbidity

2007 ◽  
Vol 177 (4S) ◽  
pp. 649-649
Author(s):  
Ponnambalam Chandrasekar ◽  
Jeremy Raynard ◽  
Abdul Sayed ◽  
Faiyaz Kapasi ◽  
Jaspal S. Virdi ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Prostate Biopsy
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