-
PloS One 2024To inform interventions focused on safely reducing urgent paediatric short stay admissions (SSAs) for convulsions.
OBJECTIVE
To inform interventions focused on safely reducing urgent paediatric short stay admissions (SSAs) for convulsions.
METHODS
Routinely acquired administrative data from hospital admissions in Scotland between 2015-2017 investigated characteristics of unscheduled SSAs (an urgent admission where admission and discharge occur on the same day) for a diagnosis of febrile and/or afebrile convulsions. Semi-structured interviews to explore perspectives of health professionals (n = 19) making referral or admission decisions about convulsions were undertaken. Interpretation of mixed methods findings was complemented by interviews with four parents with experience of unscheduled SSAs of children with convulsion.
RESULTS
Most SSAs for convulsions present initially at hospital emergency departments (ED). In a subset of 10,588 (11%) of all cause SSAs with linked general practice data available, 72 (37%) children with a convulsion contacted both the GP and ED pre-admission. Within 30 days of discharge, 10% (n = 141) of children admitted with afebrile convulsions had been readmitted to hospital with a further convulsion. Interview data suggest that panic and anxiety, through fear that the situation is life threatening, was a primary factor driving hospital attendance and admission. Lengthy waits to speak to appropriate professionals exacerbate parental anxiety and can trigger direct attendance at ED, whereas some children with complex needs had direct access to convulsion professionals.
CONCLUSIONS
SSAs for convulsions are different to SSAs for other conditions and our findings could inform new efficient convulsion-specific pre and post hospital pathways designed to improve family experiences and reduce admissions and readmissions.
Topics: Humans; Child; Critical Pathways; Hospitalization; Seizures; Fever; Hospitals; Emergency Service, Hospital
PubMed: 38557817
DOI: 10.1371/journal.pone.0301071 -
Sensors (Basel, Switzerland) Mar 2024Cruise ships and other naval vessels include automated Internet of Things (IoT)-based evacuation systems for the passengers and crew to assist them in case of...
Cruise ships and other naval vessels include automated Internet of Things (IoT)-based evacuation systems for the passengers and crew to assist them in case of emergencies and accidents. The technical challenges of assisting passengers and crew to safety during emergencies include various aspects such as sensor failures, imperfections in the sound or display systems that are used to direct evacuees, the timely selection of optimum evacuation routes for the evacuees, as well as computation and communication delays that may occur in the IoT infrastructure due to intense activities during an emergency. In addition, during an emergency, the evacuees may be confused or in a panic, and may make mistakes in following the directions offered by the evacuation system. Therefore, the purpose of this work is to analyze the effect of two important aspects that can have an adverse effect on the passengers' evacuation time, namely (a) the computer processing and communication delays, and (b) the errors that may be made by the evacuees in following instructions. The approach we take uses simulation with a representative existing cruise ship model, which dynamically computes the best exit paths for each passenger, with a deadline-driven Adaptive Navigation Strategy (ANS). Our simulation results reveal that delays in the evacuees' reception of instructions can significantly increase the total time needed for passenger evacuation. In contrast, we observe that passenger behavior errors also affect the evacuation duration, but with less effect on the total time needed to evacuate passengers. These findings demonstrate the importance of the design of passenger evacuation systems in a way that takes into account all realistic features of the ship's indoor evacuation environment, including the importance of having high-performance data processing and communication systems that will not result in congestion and communication delays.
PubMed: 38544113
DOI: 10.3390/s24061850 -
Materials (Basel, Switzerland) Mar 2024This study aimed to compare the effectiveness of adsorption and photocatalysis techniques at removing the herbicide clomazone (CLO) and the antidepressant known as...
This study aimed to compare the effectiveness of adsorption and photocatalysis techniques at removing the herbicide clomazone (CLO) and the antidepressant known as amitriptyline (AMI) from water. This study employed kinetic models to analyze the removal processes and assess the potential toxicity of the treated water. The structure and morphology of the prepared multi-walled carbon nanotubes were characterized as adsorbents by transmission electron microscopy, X-ray diffraction, Fourier transform infrared techniques, and Raman spectroscopy. The adsorption kinetics of CLO and AMI were studied on the pristine and functionalized multi-walled carbon nanotubes. Kinetic studies were performed by modeling the obtained experimental data using three kinetic models: pseudo-first-order, pseudo-second-order, and Elovich kinetic models. On the other hand, the efficiency of CLO and AMI photodegradation was examined as a function of the type of irradiation (UV and simulated solar irradiation) and type of TiO photocatalyst (Aeroxide and Kronos). Under the experimental conditions employed, the reaction followed pseudo-first-order kinetics. Additionally, in order to assess the toxicity of water containing CLO, AMI, and their intermediates, toxicity assessments were conducted using human fetal lung fibroblast cells. The results obtained indicate the effectiveness of both methods and provide valuable insights into their removal mechanisms, contributing to the advancement of sustainable water treatment strategies.
PubMed: 38541522
DOI: 10.3390/ma17061369 -
Medicina (Kaunas, Lithuania) Feb 2024: The aim of this study was to determine the prevalence of mental disorders in a group of patients with multiple sclerosis (MS) during outpatient treatment....
: The aim of this study was to determine the prevalence of mental disorders in a group of patients with multiple sclerosis (MS) during outpatient treatment. Additionally, an attempt was made to assess the influence of parameters related to patients and their clinical status on the prevalence of mental disorders. : This study was conducted between 2017 and 2018 in a group of 103 patients with MS who underwent treatment at the Outpatient Clinic of Neurology at the Clinical Hospital No. 1 in Zabrze, Poland. Sociodemographic data were collected, and the course of the underlying disease and comorbidities underwent assessment. The Mini International Neuropsychiatric Interview (MINI) and psychiatric examination were used to assess the occurrence of mental disorders. : In this study, female subjects accounted for 67.96% of patients (mean age: 43 years). Of all patients, 67% of subjects were clinically diagnosed with mental disorders during their lifetime. The results of the MINI Questionnaire showed that 33% of MS patients had a history of a major depressive episode, while 8.7% of patients met the criteria for a depressive episode. The same number of patients were treated for recurrent depressive disorders. Generalized anxiety disorder was diagnosed in 10.7% of patients, agoraphobia in 8.7% and panic disorder in 7.8%. Most patients (94.2%) had a low risk of suicide, according to the MINI Questionnaire. This study did not show a significant influence of age, sex, duration of MS symptoms or severity of symptoms as expressed by the Expanded Disability Status Score (EDSS) on the prevalence of mental disorders ( = 0.05). However, a significantly higher median EDSS score was found in patients with a history of mental disorders ( = 0.03). Additionally, a significant negative correlation was found between having a family and a psychiatric diagnosis ( = 0.01). A statistically significant negative correlation was found between the level of education and the suicide risk as assessed by the MINI Questionnaire ( = 0.03). : This study showed a high prevalence of mental disorders in patients with MS, of which depressive episodes and anxiety disorders were the most commonly reported. There may exist a relationship between the degree of disability of MS patients and a higher prevalence of mental disorders. Patients with MS who do not have a family may be more susceptible to mental disorders. In turn, patients with a lower level of education may show a higher risk of suicide. This suggests the need for psychological and psychiatric support for patients with MS, with particular consideration given to those who are alone, those with more severe disability and patients with a lower level of education.
Topics: Humans; Female; Adult; Poland; Depressive Disorder, Major; Multiple Sclerosis; Mental Disorders; Comorbidity; Risk Factors; Prevalence
PubMed: 38541102
DOI: 10.3390/medicina60030376 -
Foods (Basel, Switzerland) Mar 2024The coronavirus has wreaked havoc on the global economy before the eyes of the entire world. Due to evolving consumer needs and expectations during the pandemic, the... (Review)
Review
The coronavirus has wreaked havoc on the global economy before the eyes of the entire world. Due to evolving consumer needs and expectations during the pandemic, the supply and demand for various goods and services varied from the pre-COVID-19 period. This article aims to understand the changes in purchasing and food choices, focusing particularly on meat and meat products, made by consumers and households in response to the crisis caused by the COVID-19 pandemic. The study also indicates the impact directions of these changes and assesses the magnitude of the contribution of various determinants that influenced them. The literature review from 2020 to 2023 was conducted using Scopus and the Web of Science scientific databases. The study identified sociodemographic and individual factors as the main determinants influencing consumers' purchasing or eating behavior. Positive shifts (e.g., implementing strategies to better manage food at home through activities like creating shopping lists, the average increase in consumer spending during store visits, and decrease in visit frequencies) or negative changes (e.g., shortages of food products in stores due to consumer panic buying, unusually high demand resulting from stockpiling, purchasing fewer fresh products, increased consumption of unhealthy foods and snacking, among other factors) during isolation were influenced by various individual factors (e.g., motivation, mental state) or sociodemographic factors (e.g., gender, age, income level, education). While individual factors had a greater impact on changes in consumer behavior in the early stages of the COVID-19 pandemic, socio-demographic factors became more important as the pandemic progressed.
PubMed: 38540923
DOI: 10.3390/foods13060933 -
Behavioral Sciences (Basel, Switzerland) Mar 2024Panic buying poses significant challenges for individuals and societies. This paper provides a literature review on the process by which a pandemic crisis evolves into... (Review)
Review
Panic buying poses significant challenges for individuals and societies. This paper provides a literature review on the process by which a pandemic crisis evolves into panic buying behavior. The review offers a comprehensive perspective on studies related to panic buying and mitigation efforts, categorizing them based on their contributions in three stages: factors influencing panic buying, the process of transforming panic into increased demand and stockpiling, and applicable intervention strategies to mitigate panic situations. The paper introduces the Socio-Economic Framework of Panic (SEFP) to illustrate the interaction between demand and supply during a panic. The review identifies a lack of quantitative models explicitly correlating influencing factors with panic and estimating panic demand. Additionally, it reveals that suggested intervention strategies often lack practical implementation guidelines. Using the SEFP, the importance of considering interventions at various stages is highlighted, ranging from controlling influencing factors and panic demands to overseeing stockpiling and supply-related activities. The paper also identifies research gaps in both qualitative and quantitative modeling, policymaking, and governance.
PubMed: 38540525
DOI: 10.3390/bs14030222 -
Behavioral Sciences (Basel, Switzerland) Feb 2024Patients with panic disorder (PD) may experience increased vulnerability to dissociative and anxious phenomena in the presence of repeated traumatic events, and these...
BACKGROUND
Patients with panic disorder (PD) may experience increased vulnerability to dissociative and anxious phenomena in the presence of repeated traumatic events, and these may be risk factors for the development of complex post-traumatic stress disorder (cPTSD). The present study aims to find out whether the presence of cPTSD exacerbates anxiety symptoms in patients suffering from panic disorder and whether this is specifically associated with the occurrence of dissociative symptoms.
METHODS
One-hundred-and-seventy-three patients diagnosed with PD were recruited and divided into two groups based on the presence (or absence) of cPTSD using the International Trauma Questionnaire (ITQ) scale. Dissociative and anxious symptoms were assessed using the Cambridge Depersonalization Scale (CDS) and Hamilton Anxiety Scale (HAM-A), respectively.
RESULTS
Significant differences in re-experienced PTSD ( < 0.001), PTSD avoidance ( < 0.001), PTSD hyperarousal ( < 0.001), and DSO dysregulation ( < 0.001) were found between the cPTSD-positive and cPTSD-negative groups. A statistically significant association between the presence of cPTSD and total scores on the HAM-A ( < 0.001) and CDS ( < 0.001) scales was found using regression analysis.
CONCLUSIONS
This study highlights the potential link between dissociative symptoms and a more severe clinical course of anxiety-related conditions in patients with PD. Early intervention programs and prevention strategies are needed.
PubMed: 38540469
DOI: 10.3390/bs14030166 -
BMJ Paediatrics Open Mar 2024The reported prevalence rate of anxiety disorder in the paediatric population varies widely between different counties. Currently, there is no national epidemiological...
BACKGROUND
The reported prevalence rate of anxiety disorder in the paediatric population varies widely between different counties. Currently, there is no national epidemiological survey anxiety disorder in China. This study aims to investigate the national prevalence of anxiety disorder, the distribution profiles of different subtypes and its comorbidity rates among school students.
METHODS
A nationwide epidemiological survey of mental disorders in school students aged 6-16 years was conducted. Participants were randomly recruited from five provinces in China. The Child Behavior Checklist was used to screen students at high risk for mental disorders. The final diagnosis was made based on the Diagnostic and Statistical Manual-IV. The point prevalence and comorbidity rate of anxiety disorder were calculated, and the difference between age, sex and socioeconomic status groups was also compared.
RESULTS
Generalised anxiety disorder (GAD) was the most common anxiety disorder in school-attending children and adolescents, with a prevalence rate of 1.3% (95% CI: 1.2 to 1.3). Separation anxiety and specific phobia were more common in children than in adolescents. Girls had a higher prevalence of panic disorder (0.3% vs 0.2%, χ=14.6, p<0.001) and agoraphobia (0.9% vs 0.8%, χ=4.3, p=0.03) than that of boys. We found no significant difference between developed and less developed areas. Girls were more likely to have panic disorder and GAD than boys, with ratios of 2.13:1 and 1.01:1, respectively. The co-occurrence of anxiety disorder and attention-deficit and disruptive behaviour disorder was very common, ranging from 40% to 85%.
CONCLUSIONS
Anxiety disorder was prevalent among school students in China, and comorbidity with attention-deficit and disruptive disorder was very common. The data imply that screening for anxiety disorder is needed in school settings. Policies should be adapted to provide psychological services to children and adolescents. A comprehensive assessment is recommended in clinical practice.
Topics: Male; Female; Child; Humans; Adolescent; Prevalence; Phobic Disorders; Anxiety Disorders; Attention Deficit Disorder with Hyperactivity; Comorbidity
PubMed: 38538104
DOI: 10.1136/bmjpo-2023-001967 -
Neuroradiology Jul 2024We reviewed 33 original research studies assessing brain perfusion, using consensus guidelines from a "white paper" issued by the International Society for Magnetic... (Review)
Review
We reviewed 33 original research studies assessing brain perfusion, using consensus guidelines from a "white paper" issued by the International Society for Magnetic Resonance in Medicine Perfusion Study Group and the European Cooperation in Science and Technology Action BM1103 ("Arterial Spin Labelling Initiative in Dementia"; https://www.cost.eu/actions/BM1103/ ). The studies were published between 2011 and 2023 and included participants with subjective cognitive decline plus; neurocognitive disorders, including mild cognitive impairment (MCI), Alzheimer's disease (AD), frontotemporal lobar degeneration (FTLD), dementia with Lewy bodies (DLB) and vascular cognitive impairment (VCI); as well as schizophrenia spectrum disorders, bipolar and major depressive disorders, autism spectrum disorder, attention-deficit/hyperactivity disorder, panic disorder and alcohol use disorder. Hypoperfusion associated with cognitive impairment was the major finding across the spectrum of cognitive decline. Regional hyperperfusion also was reported in MCI, AD, frontotemporal dementia phenocopy syndrome and VCI. Hypoperfused structures found to aid in diagnosing AD included the precunei and adjacent posterior cingulate cortices. Hypoperfused structures found to better diagnose patients with FTLD were the anterior cingulate cortices and frontal regions. Hypoperfusion in patients with DLB was found to relatively spare the temporal lobes, even after correction for partial volume effects. Hyperperfusion in the temporal cortices and hypoperfusion in the prefrontal and anterior cingulate cortices were found in patients with schizophrenia, most of whom were on medication and at the chronic stage of illness. Infratentorial structures were found to be abnormally perfused in patients with bipolar or major depressive disorders. Brain perfusion abnormalities were helpful in diagnosing most neurocognitive disorders. Abnormalities reported in VCI and the remaining mental disorders were heterogeneous and not generalisable.
Topics: Humans; Spin Labels; Mental Disorders; Magnetic Resonance Imaging; Cerebrovascular Circulation; Cognitive Dysfunction
PubMed: 38536448
DOI: 10.1007/s00234-024-03323-0 -
European Psychiatry : the Journal of... Mar 2024There is heterogeneity in the long-term trajectories of depressive symptoms among patients. To date, there has been little effort to inform the long-term trajectory of... (Clinical Trial)
Clinical Trial
BACKGROUND
There is heterogeneity in the long-term trajectories of depressive symptoms among patients. To date, there has been little effort to inform the long-term trajectory of symptom change and the factors associated with different trajectories. Such knowledge is key to treatment decision-making in primary care, where depression is a common reason for consultation. We aimed to identify distinct long-term trajectories of depressive symptoms and explore pre-treatment characteristics associated with them.
METHODS
A total of 483 patients from the PsicAP clinical trial were included. Growth mixture modeling was used to identify long-term distinct trajectories of depressive symptoms, and multinomial logistic regression models to explore associations between pre-treatment characteristics and trajectories.
RESULTS
Four trajectories were identified that best explained the observed response patterns: "recovery" (64.18%), "late recovery" (10.15%), "relapse" (13.67%), and "chronicity" (12%). There was a higher likelihood of following the recovery trajectory for patients who had received psychological treatment in addition to the treatment as usual. Chronicity was associated with higher depressive severity, comorbidity (generalized anxiety, panic, and somatic symptoms), taking antidepressants, higher emotional suppression, lower levels on life quality, and being older. Relapse was associated with higher depressive severity, somatic symptoms, and having basic education, and late recovery was associated with higher depressive severity, generalized anxiety symptoms, greater disability, and rumination.
CONCLUSIONS
There were different trajectories of depressive course and related prognostic factors among the patients. However, further research is needed before these findings can significantly influence care decisions.
Topics: Humans; Anxiety; Anxiety Disorders; Depression; Longitudinal Studies; Medically Unexplained Symptoms; Primary Health Care
PubMed: 38532731
DOI: 10.1192/j.eurpsy.2024.27