Standards of Psychological Care for Pediatric Patients Awaiting Heart Transplantation and Those Requiring Mechanical Circulatory Support.

Children waiting for a heart transplant who require mechanical circulatory support often experience many months of hospitalization. This has a significant impact on their mental health and their development. Additional risk factors for these disorders are neurologic complications associated with the used treatment. To counteract developmental dysfunctions (despite successful heart transplantation) and possible disability in the sphere of mental health as well as to improve executive functions of children after a neurologic incident, there is a need for comprehensive care provided by a clinical psychologist who is a member of a multidisciplinary medical team taking care of the patient. Based on our own experience, standards of psychological care were developed for pediatric patients awaiting heart transplantation and those requiring mechanical circulatory support.

Sweet, Salty, and Umami Taste Sensitivity and the Hedonic Perception of Taste Sensations in Adolescent Females with Anorexia Nervosa.

OBJECTIVE: The aim of this study was to perform analysis of sensitivity to sweet, salty, and umami tastes based on three measurement methods and of the hedonic perception of taste sensations in adolescent females with anorexia nervosa (AN). The aim of the research was to confirm the results of other authors in terms of the perception of sweet and salty taste in patients with AN, and then develop knowledge about the perception of umami taste, which is still insufficiently studied. METHOD: A total of 110 females with an age ranging from 13 to 19 years, including 50 newly diagnosed patients with a restrictive subtype of AN and 60 healthy controls participated in gustatory research involving analyses of taste perception (recognition thresholds, ability to identify the taste correctly, taste intensity, and hedonic response) applying the sip and spit method. RESULTS: Females with AN showed reduced sensitivity to salty taste and increased sensitivity to umami taste and, more often than healthy controls, wrongly classified the taste of solutions with a low sucrose concentration. Patients with AN assessed the sodium chloride and monosodium glutamate tastes less negatively than did control participants, and they did not show differences in their hedonic assessment of sucrose. CONCLUSIONS: The taste sensitivity alterations in females with AN demonstrated in this paper do not entail decreased hedonic assessment of taste experiences. Based on our results, we cannot consider the observed variation in taste sensitivity in patients with AN to be a factor that increases their negative attitude toward food consumption.

Assessment of Long-Term Treatment Results in Women Suffering from Anorexia Nervosa in Adolescence.

INTRODUCTION: Reports assessing long-term treatment outcomes for anorexia nervosa (AN) are divergent and refer to different populations. They lack long-term observations in AN patients in Poland. AIM OF THE STUDY: Analysis of the recovery, relapse rate, and predictive factors in patients treated due to AN in adolescence. MATERIAL AND METHODS: A total of 201 subjects were given a survey. Ninety-seven women were recruited: 56 reported to the clinic and 41 filled in the survey. RESULTS: The average period from hospitalization to the survey was 7.76 ±4.39 years. Remission was found in 78.4%, 21.6% still pre-sented AN, and 84.2% required a one-off hospitalisation, 10.5% twice. The average BMI was: 20.08 ±3.24 kg/m 2 . The rate of attempted suicides was 6.2%. Predictive factors for poor outcome were as follows: older age of the patient when falling ill, lower SDS-BMI score at the onset of AN, transition from the restrictive type of AN into a binge-eating/purging type, and fail-ure to maintain contact with the mother. CONCLUSIONS: 1. Most girls suffering from the restricting type of AN in adolescence are cured permanently. 2. The severity of symptoms in these girls does not eliminate the chance of recovery and achieving important life goals, com-pleting education, finding a life partner, and having children. 3. Girls with a smaller degree of cachexia at onset of AN, with no binge-eating/purging symptoms, maintaining regular con-tact with their mothers, have a better prognosis for recovery. 4. Six per cent of women treated in their youth for AN face the risk of attempted suicide, which points to the need to monitor their mental state for many years.

Assessment of the frequency of hormonal disorders of the gonads and bone mineral density among women treated for anorexia nervosa in adolescence.

INTRODUCTION: There are very few studies evaluating the activity of gonads in women treated for anorexia nervosa (AN) in adolescence, and reports on the bone mineral density in such patients are divergent. Objective Assessment of the incidence of gonadal hormonal function disorders and reduction of bone mineral density in women treated for AN in adolescence. MATERIAL AND METHODS: Out of 97 women who had participated in a survey study, 56 reported personally to the clinic. Their somatic condition, body weight, and BMI were evaluated, as well as levels of oestradiol, LH, FSH in blood serum were determined and DEXA scans were performed. RESULTS: The average period of hospitalisation until the time of the study was 7.08 ±4.47 years. BMI was as follows: 20.01 ±3.6 kg/m2. 25% women were still sick, 75% were considered cured. In 17.9% of the study subjects hypogonadotropic hy-pogonadism was diagnosed. Abnormal results of the densitometric scan were confirmed in 85.7% of the study subjects. In the group of women with normal body weight only 19% had normal levels of bone mineral density. CONCLUSIONS: 1. In almost 18% of women treated for AN in adolescence, disorders of the hormonal function of gonads persist, despite normal body weight in 50% of them. 2. Bone mineral density is reduced in most women treated for AN, which indicates the need to monitor the condition of the bones, an early introduction of prevention of osteopenia and osteoporosis since the onset of AN in order to prevent bone fractures in adulthood.

Computer aided math learning as a tool to assess and increase motivation in learning math by visually impaired students.

PURPOSE: Effective teaching and learning mathematics is important to achieve good results during an academic and professional career. This is especially difficult for visually impaired students because of difficulties in managing structural information included in maths formulae. METHODS: The extended multimedia alternative method, including the problem of decomposition and knowledge vector, were presented and compared to the classical teaching method. A qualitative method to evaluate motivation during the process of teaching and learning maths for impaired students, which includes eleven detailed motivators, has been developed. RESULTS: The alternative teaching method offers statistically significant improvements in four of the eleven proposed assessment categories: success in progress - adjusting the difficulties of learning, presentation of the material, approval: group/individual and alternative presentation of mathematic materials. The experiments carried out allowed the authors to increase the knowledge about the limitations and challenges occurring in the process of maths education among visually impaired students and their motivation. CONCLUSIONS: Based on the experiments and research results, it can be concluded that applying the proposed method of decomposition together with evaluation procedure based on the vector of knowledge in the process of teaching and learning of mathematics by visually impaired may increase their motivation positively.Implications for RehabilitationThe key aspects of the alternative method of presenting math formulae are included in the bellow points:• It increases the availability of materials containing structured information (mathematical formulae) for the blind.• It limits the importance of communication barriers in math education: the possibility of self-study, reducing costs - by reducing the number of individual tutorials.• It contributes to the development of universal rules for the structural presentation of information• It increases the independence of the student from the teacher.

Computer-aided therapeutic diagnosis for anorexia.

BACKGROUND: Anorexia nervosa is a clinical disorder syndrome of the wide spectrum without a fully recognized etiology. The necessary issue in the clinical diagnostic process is to detect the causes of this disease (e.g., my body image, food, family, peers), which the therapist gradually comes to by verifying assumptions using proper methods and tools for diagnostic process. When a person is diagnosed with anorexia, a clinician (a doctor, a therapist or a psychologist) proposes a therapeutic diagnosis and considers the kind of treatment that should be applied. This process is also continued during therapeutic diagnosis. In both cases, it is recommended to apply computer-aided tools designed for testing and confirming the assumptions made by a psychologist. The paper aims to present the computer-aided therapeutic diagnosis method for anorexia. The proposed method consists of 4 stages: free statements of a patient about his/her body image, the general sentiment analysis of statement based on Recurrent Neural Network, assessment of the intensity of five basic emotions: happiness, anger, sadness, fear and disgust (using the Nencki Affective Word List and conversion of words to their basic form), and the assessment of particular areas of difficulties-the sentiment analysis based on the dictionary approach was applied. RESULTS: The sentiment analysis of a document achieved 72% and 51% of effectiveness, respectively, for RNN and dictionary-based methods. The intensity of sadness (emotion) occurring within the dictionary method is differentiated between control and research group at the level of 10%. CONCLUSION: The quick access to the sentiment analysis of a statement on the image of patient's body, emotions experienced by the patient and particular areas of difficulties of people prone to the anorexia nervosa disorders, may help to establish the diagnosis in a very short time and start an immediate therapy. The proposed automatic method helps to avoid patient's aversions towards the therapy, which may include avoiding patient-therapist communication, talking about less essential topics, coming late for the sessions. These circumstances can guarantee promising prognosis for recovering.

Factors influencing the process of learning mathematics among visually impaired and blind people.

Effective instruction and comprehension of mathematics are important for achieving academic and professional success but are especially difficult for visually impaired individuals because of the inherent difficulty in managing structural information included in math formulae. An evaluation of an alternative for computer-aided math instruction and comprehension among visually impaired students was developed, and the evaluation included seven detailed categories of factors: behavioral, emotional, cognitive, social, distracting, motivational, and modeling factors. Then, the proposed method was used to compare the alternative teaching method, including problem decomposition and vector knowledge, to the classical teaching method with a teacher. The assessment of the impact of the developed approach on improving the process of teaching mathematics in a group of blind and visually impaired students was carried out by the completion of a questionnaire prepared by a psychologist. The alternative teaching method achieved significantly better results in six of the seven proposed assessment categories. These experiments extend the knowledge base on the limitations and challenges associated with teaching and learning mathematics among blind people.

Computer aided sentiment analysis of anorexia nervosa patients' vocabulary.

BACKGROUND: Diagnosing and treating anorexia nervosa is an important challenge for modern psychiatry. Taking into account a connection between the mental state of a person and the characteristics of their language, this paper presents developed and tested method for analyzing the written statements of patients with anorexia nervosa and healthy individuals, including the identification of keywords. METHODS: Due to the short nature of the texts, which is related to the difficulty of expressing oneself about one's body when suffering from anorexia, the bag of words approach was used for documents' information representation. The document is represented as a vector, where its various elements indicate the number of individual words. Then, a rule-based model was created, where as a collection of rules, dictionary files were used corresponding to three groups of positive, negative and neutral sounds for each subcategory. Next in the analyzed texts were searched and counted keywords. Based on the keywords found, each of the documents was categorized into one of the groups in every subcategory. RESULTS: It is possible to indicate a set of characteristics sentiment for every person. Additionally, the results of specific patient could be analyzed in six specific subcategories: self-esteem, acceptance of the assessment of the environment, emotions, autoimmune, functioning of the body and body image. CONCLUSIONS: The described analysis indicates the existence of a relationship between the mental state of the author's textual health and the vocabulary he or she uses. It is possible to indicate a set of characteristic sentiment terms specific to a given group of people. Their presence is related to the author's mental state and their body image. It could help focus on specific topics during therapy.

Assessment of serum levels resistin in girls with anorexia nervosa. Part II. Relationships between serum levels of resistin and thyroid, adrenal and gonadal hormones.

OBJECTIVES: Thyroid, adrenal glands and gonadal hormones play a role in maintaining metabolic homeostasis of the body via the receptors located in the adipose tissue. The correlations between serum resistin (RES) and function of other hormonal axes in patients with AN have not been established, yet. Therefore, the aim of this study is: 1) assessment of concentrations of thyroid hormones (FT4, TSH), adrenal hormones (ACTH, cortisol), sex hormones (LH, FSH, estradiol, testosterone); 2) establishing their relationship with BMI and 3) analysis of correlations between examined hormones and RES serum concentrations in adolescent female patients with AN. DESIGN AND SETTING: Serum RES (ELISA) and fT4, TSH, ACTH, LH, FSH, estradiol and testosterone (ECLIA) concentrations have been assayed in 195 adolescent girls: 87 with restrictive AN, 17 with not otherwise specified eating disorders (NOS), 30 with simple obesity (OB) and 61 healthy (H) subjects. RESULTS: Mean serum FT4, LH and estradiol concentrations were significantly lower (p=0.015; p<0.0001; p<0.0001, respectively) in AN than in OB group, and cortisol increased (p<0.001) compared to OB and H subjects. In all examined subjects BMI correlated positively (p<0.0001) with LH (r=0.61) and estradiol (r=0.30), and negatively with cortisol (r=-0.35; p=0.008). Also the significant positive relationship between serum RES and FT4 (r=0.34), LH (r=0.57) as well as estradiol (r=0.28) was observed, whereas serum cortisol correlated negatively with RES (r=-0.40). CONCLUSION: Changes in resistin serum concentrations in eating disorders may be involved in the altered regulation of hypothalamic-pituitary-adrenal, thyroid and gonadal axes.

Assessment of serum levels resistin in girls with anorexia nervosa. Part I. Relationship between resistin and body mass index.

OBJECTIVES: There are only few studies available on blood resistin (RES) levels in patients with anorexia nervosa (AN), which revealed scarce results, however it has been demonstrated that RES mRNA expression in adipose tissue of these patients is increased. The aim of this study is: 1) the evaluation of serum resistin levels in girls with AN and determination a threshold value differentiating these patients from healthy subjects; 2) analysis of the relationship between serum resistin levels and BMI in examined subjects. DESIGN AND SETTING: Serum RES concentration has been assayed using ELISA kit in 195 adolescent girls: 87 with restrictive AN (mean BMI-SDS: -2.65 ± 0.2), 17 with not otherwise specified eating disorders (NOS) (mean BMI-SDS: -1.4 ± 0.68), 30 with simple obesity (OB) (mean BMI-SDS: 6.91 ± 1.23) and 61 healthy (mean BMI-SDS: -0.18 ± 0.54). RESULTS: Mean serum RES concentration in AN (2.8 ± 0.6 ng/ml) and NOS (3.1 ± 0.9 ng/ml) were significantly lower (p<0.0001) than in OB and H groups (4.8 ± 0.5 and 4.1 ± 0.4 ng/ml respectively). After corrected for BMI, RES values in AN were similar as in H subjects, but significantly higher (p<0.005) in comparison to OB group. ROC curve analysis revealed that 3.87 ng/ml is the threshold value of RES serum concentration differentiating AN from H girls (specificity 100%, sensitivity 80%). No significant correlations between BMI and serum resistin concentration are found in AN group, although a significant positive correlation has been established for all examined subjects. CONCLUSION: Additional adaptive mechanisms may be involved in regulation of RES levels in adolescent girls with AN.