Benign Paroxysmal Positional Vertigo After Use of Handheld Massage Gun.

This report describes 2 cases of benign paroxysmal positional vertigo symptoms in middle-aged patients who experienced onset after using a handheld massage gun.

Deep learning in magnetic resonance enterography for Crohn's disease assessment: a systematic review.

Crohn's disease (CD) poses significant morbidity, underscoring the need for effective, non-invasive inflammatory assessment using magnetic resonance enterography (MRE). This literature review evaluates recent publications on the role of deep learning in improving MRE for CD assessment. We searched MEDLINE/PUBMED for studies that reported the use of deep learning algorithms for assessment of CD activity. The study was conducted according to the PRISMA guidelines. The risk of bias was evaluated using the QUADAS-2 tool. Five eligible studies, encompassing 468 subjects, were identified. Our study suggests that diverse deep learning applications, including image quality enhancement, bowel segmentation for disease burden quantification, and 3D reconstruction for surgical planning are useful and promising for CD assessment. However, most of the studies are preliminary, retrospective studies, and have a high risk of bias in at least one category. Future research is needed to assess how deep learning can impact CD patient diagnostics, particularly when considering the increasing integration of such models into hospital systems.

Sex-Specific Differences in the Association Between Race/Ethnicity and NAFLD Among US Population.

Non-alcoholic fatty liver disease (NAFLD) is spreading worldwide, with a racial/ethnic disparity. We examined the gender role in the racial/ethnic difference in NAFLD in the US population. We analyzed data for 3,292 individuals ≥18 years old from NHANES 2017-2018, a representative sample of the non-institutionalized adult population in the US. Exclusions were subjects with elevated transferrin level, chronic hepatitis B or C, excessive alcohol use, or prescription medications that might cause hepatic steatosis. NAFLD was diagnosed by FibroScan® using controlled attenuation parameter (CAP) values: S0 <238, S1 = 238-259, S2 = 260-290, S3 >290. Data were analyzed using Chi square and multinomial regression. The overall prevalence of NAFLD was 47.9% [S2 = 16.1%, and S3 = 31.8%]. The prevalence of S3 was highest among Mexican Americans (46%), lowest among Blacks (22.7%), 29.9% in other Hispanics and 32.1% in Whites (p < 0.05). It was higher among Mexican American males (54.1%) compared to Mexican American females (37.7%) (p < 0.05). In the adjusted model, Mexican Americans were two times more likely than Whites to have S2 and S3 (p < 0.05). Only male Mexican Americans had higher odds of S2 and S3 relative to male White (p < 0.05). Males had higher odds of S3 relative to non-menopausal females (p < 0.05). There was no difference in the odds of S2 or S3 NAFLD among the menopausal females with or without hormone therapy relative to non-menopausal females (p > 0.05). While Mexican Americans had the highest prevalence of severe NAFLD relative to the other racial/ethnic groups, only male Mexican Americans, but not females, had higher likelihood of both moderate and severe NAFLD relative to Whites. Interventions that specifically target Mexican American males are needed to increase awareness about NAFLD and its prevention.

Reassessment of the Hispanic Disparity: Hepatic Steatosis Is More Prevalent in Mexican Americans Than Other Hispanics.

Hepatic steatosis (HS) is a growing problem in adults worldwide, with racial/ethnic disparity in the prevalence of the disease. The purpose of this study was to characterize the racial/ethnic prevalence of the stages (normal/mild [S0/S1], moderate [S2], and severe [S3]) of HS in Mexican Americans and other Hispanics compared to other racial/ethnic groups. We analyzed data for 5,492 individuals 12 years and older from the newly released National Health and Nutrition Examination Survey 2017-2018, which is a representative sample of the US adult population. HS was diagnosed by FibroScan using controlled attenuation parameter values: S0, <238; S1, 238-259; S2, 260-290; S3, >290. We analyzed the data using the bivariate chi-squared test and multinomial regression. The prevalence of HS overall was 46.9% (S2,16.6%; S3, 30.3%). The prevalence of S3 was highest among Mexican Americans (42.8%), lowest among Blacks (21.6%), 27.6% in other Hispanics, and 30.6% in Whites (P < 0.05). Mexican Americans were about 2 times more likely than Whites to have S2 and S3, while other Hispanics showed no difference from Whites. In an adjusted model, the common risk factors of S2 and S3 were male sex, older ages, high waist-to-hip ratio, body mass index ≥25, and high triglycerides (P < 0.05). Other risk factors for S3 were hemoglobin A1c ≥5.7 and highly sensitive C-reactive protein ≥10 mg/dL (P < 0.05). Conclusion: Our study challenges the paradigm that HS is higher in Hispanics overall; rather, our data show that HS is higher in Mexican Americans and not non-Mexican American Hispanics.

Prevalence and Predictors of Nonalcoholic Steatohepatitis Using Multiple Non-Invasive Methods: Data from NHANES III.

Objective: Patients with nonalcoholic steatohepatitis (NASH) are at risk for developing cirrhosis and hepatic cancer. Currently, the definitive gold-standard method of diagnosing NASH is a liver biopsy, an invasive and costly method. Our objective was to compare three non-invasive methods of identifying NASH by using data on 10,007 subjects from NHANES III (1988-1994) to determine the prevalence and variables associated with NASH, as defined by each non-invasive method. Methods: We used ultrasound data to identify subjects with moderate-to-severe hepatic steatosis, of whom we identified the NASH population using either the HAIR score, the NASH liver fat score, or the Gholam score, each of which had been validated with liver biopsy. We performed multinomial logistic regression to compare each NASH population to the normal population (those with no-to-mild hepatic steatosis). Results: We identified 1136 (9.5%) subjects as having NASH by at least one method and 219 (1.8%) were identified by all 3 methods. Independent of the non-invasive method used, Mexican-Americans (MA) had the highest prevalence of NASH. All three methods identified significant risk factors for NASH (p<0.05), including: elevated waist-to-hip ratio, elevated levels of C-peptide, total cholesterol, or C-reactive protein (CRP). Conclusion: We conclude that the combined non-invasive methods can help identify candidates with a high likelihood of being diagnosed with NASH. Health care providers can screen people with the combined non-invasive methods for the risk factors and identify candidates for interventions, including exercise and/or referral to biopsy.

Understanding the social context of adolescent nonsuicidal self-injury.

OBJECTIVE: Research investigating the social context of adolescent nonsuicidal self-injury (NSSI) has been limited. We therefore examined social characteristics of NSSI, such as knowledge of friends' NSSI and the role friends play in continuing NSSI, and their relationships to other known NSSI correlates, such as suicidality. METHOD: We assessed NSSI characteristics, including social features, in a community sample of 89 self-injuring adolescents. We also assessed psychosocial correlates of NSSI, including impulsivity, self-concept, and psychiatric symptoms. RESULTS: Knowledge of friends' NSSI was relatively common among self-injurers. In addition, knowledge of friends' NSSI was associated with use of more NSSI methods, cutting behaviors, and suicidal ideation, but not with other NSSI correlates. However, teaching or encouragement of NSSI by friends was rare. CONCLUSIONS: Knowledge of friends' NSSI may serve as marker of increased severity among adolescent self-injurers. These findings have implications for identifying and intervening with high-risk self-injuring youth.

Validation of the Hebrew and Arabic Versions of the Outcome Questionnaire (OQ-45).

BACKGROUND: Measuring the progress of mental health treatment aids in assessment and monitoring of psychotherapeutic outcomes. The OQ-45 is a widely accepted measure of such outcomes. The aim of this study was to validate the Hebrew and Arabic versions of the OQ-45. METHOD: Data were collected from three samples: non patient university students (n=189), university mental health clinic patients (n=37), and outpatient mental health clinic patients (n=135). Subjects completed the OQ-45 as well as the BSI and PHQ-9 questionnaires. RESULTS: Test-retest and internal reliability, and concurrent and discriminative validity of both OQ-45 versions were satisfactory. Sensitivity of the Hebrew and Arabic versions was 0.70 and 0.80, respectively, and the specificity was 0.69and 0.93, respectively. Sensitivity-to-change was noted only for the Symptom Distress (SD) subscale. LIMITATIONS: Sensitivity-to-change was not demonstrated for the total OQ-45, possibly due to a too-short follow-up period. CONCLUSIONS: Adequate psychometric properties of the Hebrew and Arabic OQ-45 suggest that they can serve as useful measures of mental health treatment in Israel.Further research is necessary to confirm norms, cut-off scores and sensitivity-to-change using a larger representative population and diverse types of treatment over a longer period of time.

Is non-suicidal self-injury an "addiction"? A comparison of craving in substance use and non-suicidal self-injury.

There is debate among researchers regarding the most appropriate conceptual model of non-suicidal self-injury (NSSI). Some argue that NSSI is best viewed within an addictions framework. Because craving of substances is a key concept in the addictions literature, we sought to compare the nature of craving in NSSI and substance use. Measures of NSSI, substance use, and craving were administered to a sample of adolescents (n=58) receiving psychiatric treatment. It was found that total craving scores were significantly lower for NSSI than for substances. Item-level analyses suggested that substances are craved in a variety of contexts, whereas NSSI is typically craved in the context of negative emotions. The pattern of results remained the same when analyses were limited to patients who engaged in both NSSI and substance use. Thus, findings appear to be due to differences in the nature of the behaviors themselves rather than to individual differences between those who engage in NSSI or use substances. We conclude that, while both behaviors have powerful reinforcement contingencies, NSSI appears to be almost exclusively maintained by negative reinforcement (e.g., the reduction of aversive emotions). Findings are more consistent with emotion regulation than addiction models of NSSI.

[Psychotherapy--outcome studies and guidelines for evidence-based care policy in Israel].

Psychotherapy is one of the major methods of treatment in the mental health field. A review of the literature suggests that some forms of psychotherapy are evidence-based. Findings from hundreds of meta-analytic studies indicate that psychotherapy can often achieve outcomes that are clinically meaningful and may also contribute to cost savings. This review contains findings pertaining to the main psychotherapy approaches: the psychodynamic, the cognitive-behavioral (CBT) and the dialectical-behavioral (DBT). The findings suggest that there is ample evidence on the effectiveness of CBT in the treatment of various mental disorders. There is also an accumulating body of evidence suggesting that short-term psychodynamic psychotherapy is effective in the treatment of mental disorders except for psychosis and schizophrenia. On the other hand, there are only preliminary findings supporting the effectiveness of DBT and questions remain concerning the cost-effectiveness of this labor-intensive treatment technique. Similarly, there are only preliminary results that long-term psychodynamic psychotherapy is effective in the treatment of complex mental disorders. Recent technological advances in the measurement of psychotherapy outcome were reviewed. These include methods of tracking changes throughout the course of treatment and computer-assisted programs designed to generate on-going feedback to the therapist. These techniques are designed to improve outcome by focusing the psychotherapy on clearly defined objectives and by the use of measures aimed at reducing negative reactions to treatment and lowering the risk of premature termination of treatment by clients. The authors conclude by proposing guidelines for evidence-based care policy for the public sector based outpatient psychotherapy in Israel.

Sacred moments: implications on well-being and stress.

This research provides a theoretical, empirical, and qualitative examination of the role of cultivating sacred moments in daily life on subjective well-being (SWB), psychological well-being (PWB), and stress. Seventy-three participants were randomly assigned to two groups: (a) a 3-week intervention group where members were instructed in cultivating sacred moments, or (b) a 3-week control group where members were instructed in writing about daily activities. Findings indicate that the intervention was equally as effective as an adapted therapeutic writing intervention. There were significant effects over time across multiple assessments related to SWB, PWB, stress, and daily spiritual experiences after the 3-week intervention and again 6 weeks later. Qualitative analysis complemented and enriched the findings of these results. This study introduces a new intervention into the field of clinical psychology and extends the findings of prior research.

[Mental health reform in Israel: how to increase the opportunities and reduce the threats].

Since the publication in 1990 of the Netanyahu Commission Report on Health Reform in Israel the issue of Mental Health Reform (MHR) has been discussed extensively. As steps toward the implementation of the MHR progressed, concerns were increasingly voiced that it would adversely affect the accessibility, availability and quality of mental health services. The main source of threat is attributed to the mechanisms of Managed Behavioral Health Care (MBHC) expected to be applied by the Health Funds. The authors review recent evaluation studies of MBHC in the US with a special reference to issues pertaining to ambulatory treatment of those suffering from mental illness and to outpatient psychotherapy. The findings reviewed suggest that the key to the success of MBHC systems is a strategy endeavoring to bring together the professional and the economic management mechanisms of the service system in a mutually supporting effort to bring about a paradigmatic change in the organization, payment methods and evaluation of the services. The authors also refer to recent studies of outpatient psychotherapy that provide information about trends and utilization patterns and provide support for its overall effectiveness. The authors discuss the implications of the findings reviewed to the implementation of the MHR in Israel.

A Need-based model for determining staffing needs for the public sector outpatient mental health service system.

This article proposes a need-based model for determining staffing needs for regional or national public sector outpatient mental health services. It constitutes a spreadsheet method involving a sequence of calculations relating demographic variables, workers' productivity, anticipated demand, and standards pertaining to annual visits per client distributed among the core mental health professions. The authors demonstrate the application of the model to national planning of adult outpatient mental health services using standards based on both expert consensus and existing staffing patterns while they note the need for more rigorously derived and empirically based standards. It is suggested that by using clearly stated assumptions and quantifiable variables, the model can facilitate constructive negotiations among various agencies and community organizations involved in policymaking and in budget allocations.