Tag Archive: Clinical

BackgroundIgA nephropathy is an immunopathological diagnosed disease… (Education Papers posted on January 16th, 2015 )

BackgroundIgA nephropathy is an immunopathological diagnosed disease. It is characterized by the deposition of IgA immune complexes in the glomerular mesangial, often accompanied by deposition of complement C3. IgA nephropathy is the most common primary glomerular disease around the world, is also one of the major causes of end stage renal desease (ESRD).Because the pathogenesis of IgA nephropathy isn’t clear yet, there is still a lack of a unified and effective treatment for IgA nephropathy. In order to better guide clinical diagnosis and treatment, in2013, China Society of Integrated Traditional Chinese and Western Medicine for Kidney Disease published a guideline of the diagnosis and TCM syndrome differentiation for IgA nephropathy, which divided IgA nephropathy into two stages, the acute exacerbation and chronic duration stage. Chinese medicine has a certain effect in improving chronic stage patients’immunity, prevent evils, reducerecidivation, remission hematuria, proteinuria and other symptoms.At the same time, the study of clinical and histological risk factors for IgA nephropathy has been a hot spot, a large number of studies have shown that clinical indicators such as24h urine protein>lg, serum creatinine, blood pressure and pathological injury such as glomerulosclerosis, tubular fibrosis are independent risk factors of IgA nephropathy. Hyperuricemia, the deposition of complement C3in the glomerular mesangial also gradually be taken seriously on the long-term prognosis of IgA nephropathy.This study is intended to analyse the chronic duration IgA nephropathy patients’TCM syndrome and find the correlation between TCM syndrome, clinical indicators and renal pathology, in order to better guide clinical treatment and prognosis evaluation.ObjectiveStudy the distribution of chronic duration IgA nephropathy patients’TCM syndrome and find the correlation between TCM syndrome, clinical indicators and renal pathology, in order to better guide clinical treatment and prognosis evaluation.MethodsRetrospective analyze62cases of chronic duration IgA nephropathy patients which was diagnosed by nephrology renal biopsy in Guang An Men Hospital, China Academy of Traditional Chinese Medicine from January2012to December2013. TCM syndrome differentiation references the guidline which was published in2013by China Society of Integrated Traditional Chinese and Western Medicine for Nephropathy. Preliminary study the the correlation between TCM syndrome, clinical indicators and renal pathology of chronic duration IgA nephropathy.Resultsl.The general informationBetween January2012and December2013in Guang An Men Hospital, China Academy of Traditional Chinese Medicine, the total number of chronic stage IgA nephropathy is62cases, accounted for72.94%of all primary IgA nephropathy patients during this period. The male to female ratio is1.296:1, the average age was37.87±1.33years old, the age mainly distributed in30-39years old, accounts for33.87%of the total. The most common complication is hypertension,44cases (70.97%).2. TCM syndrome researchThe most common syndrome is Qi and Yin Deficiency syndrome in20cases (32.26%), followed by Lung and Spleen Deficiency syndrome in17cases (27.42%), Liver and Kidney Yin Deficiency syndrome in13cases(20.97%), Spleen and Kidney Yang Deficiency syndrome in12cases (19.35%).The most common concurrent syndrome is blood stasis syndrome in16cases (25.81%), followed by Damp-Heat syndrome in10cases (16.13%), Damp syndrome in9cases (14.52%), Cold-dampness syndrome in4cases (6.45%), Liver Stagnation syndrome in4cases (6.45%), Phlegm-dampness syndrome in3patients (4.84%), Turbidity-toxin syndrome in3patients (4.84%).3. The relevance between TCM syndrome and clinical indicators3.1The relationship between TCM syndrome and24h Urine Protein24h urine protein between the four groups of TCM syndrome has statistical differences (P=0.005).24h urine protein of Spleen and Kidney Yang Deficiency syndrome is higher than that of Qi and Yin Deficiency syndrome and Lung and Spleen Deficiency syndrome (P=0.018, P=0.018);24h urine protein in Liver and Kidney Yin Deficiency syndrome is higher than it in Lung and Spleen Deficiency syndrome(P=0.038).3.2The relationship between TCM syndrome and Serum Creatinine10cases (16.13%) has increased serum creatinine, including Lung and Spleen Deficiency syndrome1case (5.88%), Qi and Yin Deficiency syndrome3cases (15%), Liver and Kidney Yin Deficiency syndrome2cases (15.4%), Spleen and Kidney Yang Deficiency syndrome4cases (33.3%). The incidence of elevated serum creatinine in Spleen and Kidney Yang Deficiency syndrome is higher than the Lung and Spleen Deficiency syndrome, there are statistically significant differences (P=0.005). 3.3The relationship between TCM syndrome and HypertensionThe incidence of hypertension between different syndromes has no statistical difference (P>0.05).3.4The relationship between TCM syndrome and HyperuricemiaThe incidence of hyperuricemia between different syndromes has no statistical difference (P>0.05).3.5The relationship between TCM syndrome and CKD stageThe chronic kidney disease (CKD) stage between different TCM syndrome has statistically significant differences (P=0.006).3.6The relationship between TCM syndrome and Serum AlbuminSerum albumin between the four groups of TCM syndrome has statistical differences (P=0.046). Serum albumin of Spleen and Kidney Yang Deficiency syndrome is lower than that of Lung and Spleen Deficiency syndrome and Liver and Kidney Yin Deficiency syndrome (P=0.012, P=0.015).3.7The relationship between TCM syndrome and other clinical indicatorsOther clinical indicators, such as hemoglobin, blood uric acid, blood urea nitrogen, total cholesterol, triglyceride and low density lipoprotein cholesterol, compare between the four groups of TCM syndrome, has no statistical difference (P>0.05).4. The relevance between TCM syndrome and Renal Pathology4.1The relationship between TCM syndrome and Renal Pathologic ScoreThe62cases chronic duration IgA nephropathy patients’ renal pathology was scored by Katafuchi semi-quantitative score method, glomerular score between the four groups of TCM syndrome, has statistical differences (P=0.044). Glomerular score of Lung and Spleen Deficiency syndrome is lower than that of Qi and Yin Deficiency syndrome and Spleen and Kidney Yang Deficiency syndrome (P=0.011, P=0.038).4.2The relationship between TCM syndrome and C3depositionThe strength of C3deposition compare between four syndromes, has no statistical difference (P>0.05).5. The relevance between Clinical Indicators and Renal Pathology5.1The relationship between24h Urine Protein and Renal Pathologic ScoreThe score of glomerular, tubulointerstitial, blood vessels and pathology total score in24h urine protein>lg group is higher than24h urine protein<1g group (P<O.05or P<0.01).5.2The relationship between Serum Creatinine and Renal Pathologic Score The score of glomerular, tubulointerstitial, blood vessels and pathology total score in elevated serum creatinine group is higher than normal serum creatinine group (P<0.05or P<0.01).5.3The relationship between Hypertension and Renal Pathologic ScoreThe score of blood vessels in hypertension group is higher than normal blood pressure group, there is statistical difference (P<0.05). The score of glomerular, tubulointerstitial and pathology total score have no statistical differences between the two groups(P>0.05).5.4The relationship between Hyperuricemia and Renal Pathologic ScoreThe score of tubulointerstitial and pathology total score in hyperuricemia group are higher than normal uric acid group (P<0.05). The score of glomerular and blood vessels have no statistical differences between the two groups(P>0.05).5.5Correlation analysisSerum creatinine, blood uric acid, blood urea nitrogen has a positive correlation with all the renal pathologic score.24h urine protein has a positive correlation with the score of tubulointerstitial, blood vessels and pathology total score (P<0.05or.P<0.01).Conclusions1. The TCM syndrome of chronic duration IgA nephropathy patients have certain correlation with clinical and pathological factors. The clinical and pathological manifestations in Lung and Spleen Deficiency syndrome is lighter, in Spleen and Kidney Yang Deficiency syndrome is heavier.2. Chronic duration IgA nephropathy patients’clinical factors such as24h urine protein>lg, elevated serum creatinine, hypertension, hyperuricemia have certain relevance with renal pathology.

Objective: To observe the broth Yu patients with liver cirrhosis wit… (Education Papers posted on January 9th, 2015 )

Objective: To observe the broth Yu patients with liver cirrhosis with diuretic on urinary sodium, urine potassium, ALT, TBIL, A / G prothrombin time, and to explore the clinical efficacy of Yu soup.Methods: from 2009 to 2010 of Traditional Chinese Medicine Hospital and clinic met the diagnostic criteria of liver cirrhosis patients with liver cirrhosis in patients with typeⅡ60 cases were randomly divided into treatment group (30 cases) and control group (30 cases), respectively, broth for Yu alone with diuretics and diuretic therapy for 21 days before and after treatment were observed in patients with clinical symptoms and the ALT, TBIL, A / G prothrombin time, urinary potassium, urinary sodium change.Results: Clinical symptoms was significantly higher than the control group (P <0.05); the treatment group, patients with ALT, TBIL, A / G prothrombin time, urine potassium, urine sodium decreased significantly than that before treatment (P<0.05 ); ALT, TBIL, A / G prothrombin time compared with the control group there were significant differences (P <0.05).Conclusion: The clinical observation showed that: treatment group used in the treatment of ascites due to cirrhosis of Integrative Medicine is effective and, in improving symptoms, signs, ALT, TBIL, A / G prothrombin time, urine potassium, urine sodium is superior to the control group, survival improved quality of life, and security, Economic, clinical treatment of liver cirrhosis for us to provide a useful reference.

A comparative study of school-based interventions for students with emotional disabilities, specific learning disabilities, and other health impairments (Education Papers posted on May 13th, 2014 )

The purpose of special Education is to provide students with effective interventions in order to ensure they perform up to their potential while enrolled in school and are prepared upon exiting school. The current study aimed to examine and compare school-based interventions, and the behavioral and psychological functioning of students with emotional disabilities (ED), specific learning disabilities (SLD), and other Health impairments (OHI) category. Using secondary summary data on students served under the ED, SLD, and OHI categories from the National Longitudinal Transition Study-2 (NLTS2), this study used multiple significance tests to examine differences in interventions and functioning among students served under the three special Education categories. The results indicated that students in the ED and OHI categories received significantly more behavioral interventions than their peers with SLD; students with ED received significantly more mental Health interventions than their peers in the SLD and OHI categories; and students with ED, SLD, and OHI received similar rates of academic interventions. Findings also indicated that students with ED and OHI share similar behavioral profiles. Further research is needed to determine whether distinct behavioral profiles exist among students with ADHD served under the ED category and students with ADHD served under OHI.

Incorporating culture into substance abuse treatment: The associations among acculturation and acculturative stress and treatment outcomes for Latino adolescents (Education Papers posted on May 13th, 2014 )

Substance use disorders are prevalent among adolescents and there is a need to develop and test empirically supported interventions that target these disorders specifically. However, to date, much of the empirically supported intervention research in this arena has neglected the needs of ethnic minority youth. Recent research efforts support the notion of cultural adaptation/accommodation modifying interventions to increase cultural congruence) of standard interventions to better serve ethnic minority clients. However, few studies have examined the efficacy of cultural adaptations in direct comparison studies. Direct comparisons studies would allow for an examination of relative efficacy as well as moderating effects. These types of studies will help researchers determine when a cultural adaptation is likely to be most helpful for a particular client. This study aimed to understand the associations between acculturation and acculturative stress and treatment outcomes for Latino adolescents participating in a substance abuse treatment program. A total of 70 Latino adolescents participated in a randomized-controlled trial designed to directly compare an empirically supported, standard cognitive behavioral group-based intervention with a culturally accommodated cognitive behavioral intervention. Adolescents participated in 12 weeks of active treatment as well as pre- and posttreatment assessments. Results provided evidence for relative efficacy of the culturally accommodated intervention, as adolescents in both treatment conditions reported significant decreases in their substance use. There were no significant differences between the two treatment conditions. In addition to examining relative efficacy, this study also examined for the presence of interaction effects between cultural variables and treatment outcomes. It was hypothesized that adolescents who were matched to the most appropriate intervention i.e., less acculturated adolescent matched to accommodated intervention) would report the largest reduction in substance use. Results did not reveal any significant three-way interactions, indicating the specific cultural variables did not moderate treatment outcomes by treatment condition. Despite these null findings, future studies should continue to exam the role of cultural variables on treatment outcomes.

Les effets d’un programme d’equitation therapeutique sur le controle de soi et les humeurs depressives chez des adolescentes en troubles de comportement (Education Papers posted on April 11th, 2014 )

Cette &eacute;tude &agrave; cas unique de type A-B-A vise &agrave; v&eacute;rifier, &agrave; laide quels sont les effets dun programme d&eacute;quitation th&eacute;rapeutique de dix 10) s&eacute;ances sur les humeurs d&eacute;pressives et le contr&ocirc;le de soi chez des adolescentes en troubles de comportement et si ces effets se maintiennent apr&egrave;s la fin du programme. Les sujets s&eacute;lectionn&eacute;s sont trois 3) adolescentes de 16 et 17 ans, h&eacute;berg&eacute;es en Centre de r&eacute;adaptation Estrie du Centre jeunesse de lEstrie pour troubles de comportement. L&eacute;valuation, dune dur&eacute;e de quinze 15) semaine, se fit &agrave; laide de la version fran&ccedil;aise du Beck Depression Inventory-II BDI-II) pour mesurer les humeurs d&eacute;pressives, les &eacute;chelles de comportements ext&eacute;rioris&eacute;s et de probl&egrave;mes dattention de la version autorapport&eacute;e pour adolescent du Achenbach version YSR) pour le contr&ocirc;le de soi et un questionnaire maison pour calculer les variations de lhumeur avant et apr&egrave;s les s&eacute;ances d&eacute;quitation th&eacute;rapeutique. Mots cl&eacute;s : &eacute;quitation th&eacute;rapeutique, &eacute;quith&eacute;rapie, programme dintervention, trouble de comportement, adolescent, d&eacute;pression,

The terror of forced termination: An integration of forced termination and death anxiety to assist the student-clinician (Education Papers posted on April 11th, 2014 )

This dissertation explores the impact of forced termination on doctoral student-clinicians of psychology through the use of a death anxiety lens. Frequently overlooked in clinical theory, forced termination is a common occurrence for student-clinicians in psychodynamic-oriented outpatient clinics and poses emotional problems for both the patient and student-clinician. In this paper, Terror Management Theory and Firestone’s Separation Theory, both death anxiety theories, are intertwined in order to make them more easily applicable to forced termination. These death anxiety theories, which are also frequently overlooked in psychodynamic theory, are integrated with the forced termination literature in order to assist the student-clinician in gaining a clearer understanding of the forced termination phenomenon. The author claims that death anxiety is present during the forced termination phase of treatment and that comprehension of the denial-based psychological impact of death anxiety can serve as a guidepost for student-clinicians during premature phases of termination.

Parental criticism and eating disturbance in adolescent females: Implications for a multifaceted eating disorder prevention program (Education Papers posted on March 26th, 2013 )

Unhealthy eating patterns, attitudes, and behaviors affect up to 15% of young women. Certain familial characteristics have been identified as risk factors for developing an eating disorder and include parents who are highly critical of their daughters weight and appearance, have unhealthy eating behaviors themselves, or put pressure on or encourage their daughters to diet and lose weight. Multifaceted prevention programs have been recommended; however, based on a recent literature review only one study has included parents as a part of the intervention. The current study built upon the Student Bodies prevention intervention, which targets high school-aged females and their parents. The relationship between parental criticism and risk factors for the development of an eating disorder was examined as well as the effectiveness of the parental portion of the intervention. One hundred and seventy-five adolescent girls aged 14–16, 136 mothers, and 112 fathers participated. Participants were randomly assigned to either the treatment or comparison group and were assessed pre- and post-intervention. Adolescents completed the Eating Disorder Inventory – 2 EDI-2) Perfectionism subscale, the Eating Disorder Examination – Questionnaire EDE-Q), the Weight Concerns Scale WCS), and the Parental Criticism Questionnaire – Adolescent PCQ-A). Parents completed the Parental Attitudes and Criticism Scale PACS) and the Parental Criticism Questionnaire – Parent PCQ-P). Results indicated a significant relationship between parental criticism and risk factors for an eating disorder. Both mothers and fathers criticism of attractiveness predicted adolescents eating disordered behaviors, and their general criticism predicted perfectionism. Fathers general criticism also predicted eating disordered behaviors. Mothers in the treatment group had a significantly greater decrease in rates of criticism and unhealthy attitudes and behaviors than fathers; however, there was not a significant difference between the treatment and comparison group. The current study did not find the parent intervention to significantly decrease parental criticism, but it did support that parental criticism is related to weight concerns in adolescents as well as contribute to a deeper understanding of what types of parental criticism are predictive of different risk factors for the development of an eating disorder.

Application of sport psychology to music performance: A study based on a review of sport psychology literature and selected interviews with professional musicians (Education Papers posted on March 26th, 2013 )

Sport psychology is a booming field. Specialists in all areas of sports are now aware that mental preparation of athletes is as important as physical preparation because what makes the difference between two equally skilled athletes in a competition is his or her mental readiness to perform. The principles of sport psychology translate very well to the field of music performance because the highly competitive field of music performance involves a similar pressure to perform well at a given time when the pressure is on. Playing a musical instrument or singing also demands a high degree of muscular control and coordination that can either be facilitated or inhibited by the musicians mental disposition. This study takes advantage of the extensive research and rapid advancement of sport psychology by applying its concepts to music performance. After surveying the major sport psychology literature, the author formulated a set of interview questions. Six performing musicians from different areas of music performance, different cultural backgrounds, and different career stages were interviewed. The sample of musicians included an orchestra musician, a singer, a collaborative pianist and a conductor. They also represented the United States, France, Puerto Rico and Quebec. In this paper the author describes the main principles of sport psychology: goal setting, pre-event routines, visualization, focus, arousal regulation energy levels), and optimal performance. Then, based on the interviews, the author applies these principles to music performance. The interviews allow the author to explore the extent to which selected professional musicians apply sport psychology principles. It also helps to determine how the concepts can be adapted to best serve musicians and can be use as a basis for further studies. The document is organized into seven chapters: I) Introduction; II) Structure of the Preparation—for a competition or a performance—topics covered: Goal Setting, Organization of the Practice Sessions and Pre-Event Routine); III) Tools for Enhancement this includes all the different types of imagery or visualization); IV) Interference; V) Psychological Skills leading to Optimal Performance topics covered: Energy Level Regulation and Focus); VI) Optimal Performance includes the concept: “being in the zone”); and VII) Conclusion.

High school climate: Perceived safety and belonging of students, faculty, and parents (Education Papers posted on March 24th, 2013 )

Schools are experiencing increasing incidences of violence Bower, 2001; Mayer, 2001; Mayer & Leone, 1999; Owen, 1999; Skiba & Peterson, 2000). This national problem prompted the author to study public high school students perception of school safety. School safety was defined as protection from violence, threats, unfair treatment, and alienation. The author investigated what constitutes school safety through quantitative and qualitative procedures. She examined how students perceptions of school climate features, such as fairness, positive relationships, belonging, and disruptive behaviors, were related to their understanding of safety/security. The study was a secondary analysis of archived survey data on school climate Roysircar, 2001) completed in 2001-2002 by students, teachers, and parents of a regional New England high school. The variables Safety/Security, Positive Relationships, and Fairness correlated positively with each other and negatively with Disruptive Behaviors all correlations at p &lt; .01). Student data n = 399) were examined for differences by sex, grade, and sending school. Ninth grade girls perceived the highest degree of safety p &lt; .05), and girls overall experienced less physical aggression than boys p &lt; .05). No significant differences were found by sending school i.e., rural versus town). Qualitative data from 3 open-ended questions from students n = 20), teachers n = 20), and parents n = 20) elicited various meanings about school climate, as construed by the 3 school constituencies. The short answers, analyzed with the Consensual Qualitative Research CQR) method Hill, Thompson, & Williams, 1997), fell in 9 broad domains: Safety/Security, Morale, Communication, Physical Environment, Well-Being, Belonging/Not Belonging, Curriculum, Organizational Policies, and Diversity/Sensitivity. The majority preferred tougher enforcement of rules and more security personnel to increase safety. More than half of the participants thought morale, communication, and physical environment were important to school climate. Administrative concerns, well-being, belonging/not belonging, and diversity were endorsed by fewer than half of the participants as important. Using the studys findings, the archived survey, and the current literature, a revised School Climate Questionnaire for Middle/High School Students, Sections I and II was developed by the author and is included in the dissertation. Recommendations are proposed for improving school climate, i.e., adding communication and Social skills courses to the curriculum, enforcing school rules consistently, embracing diversity, and increasing parent involvement. Implications for future research are suggested.

Predicting cultural adjustment outcomes from nonverbal communication skills, cultural variables, and acculturative stress (Education Papers posted on March 21st, 2013 )

The purpose of the current study was to determine whether international students’ nonverbal communication skills; cultural behaviors, beliefs, and values; and acculturative stress levels are related to various aspects of cultural adjustment (Social difficulties, academic achievement, and psychological functioning). The first goal of the study was to ascertain whether nonverbal decoding ability is associated with cross-cultural adaptation difficulties in these domains. The second goal of the study was to examine Triandis” (1995) model of acculturation, which suggests that the greater the cultural distance, i.e., the more differences between people’s home and host culture, the greater the level of difficulty that individuals will have during cultural adjustment. The third goal of the study was an empirical test of several acculturation models, which indicate that cultural adjustment is a stressful process; the present study evaluated whether acculturative stress functions as a mediator of the relationship between cultural variables and adjustment outcomes. A total of 193 international students from North and South America, Europe, South Asia, and East Asia completed the study. Results suggest that cultural variables and acculturative stress are strongly linked to psychological functioning and Social difficulties, while emotion recognition skills are weakly or indirectly correlated with adjustment outcomes. Further, acculturative stress serves as a mediator between acculturation variables and cultural adjustment outcomes.