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1.
Psych J ; 11(2): 149-162, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35001544

RESUMO

Attention to affect is theoretically a precursor to one's ideal affect (i.e., preference for feeling low- and high-arousal positive and negative affect) and emotion regulation (ER). In schizotypy, there have been mixed findings regarding abnormalities in attention to affect. At the same time, little is known about ideal affect in schizotypy or whether differences in ideal affect or ER difficulties in schizotypy are driven by attention to affect. Thus, this study aimed to identify shared and unique abnormalities in attention to affect, ideal affect, and ER difficulties in schizotypy, and to test whether attention to affect underlies differences in ideal affect and ER difficulties. Using groups of individuals with either extreme levels of social anhedonia (SocAnh; n = 181), extreme levels of perceptual aberrations/magical ideation (PerMag; n = 105), or individuals low on both (i.e., controls; n = 531), we tested group differences in attention to affect, ideal affect, and ER difficulties. Our findings suggest both shared and unique affective abnormalities; compared to controls, the SocAnh group paid the least attention to positive affect. Only PerMag had heightened attention to negative affect compared to controls. Additionally, we found unique abnormalities relating to ideal affect but mostly shared difficulties in ER in schizotypy. Abnormalities in ideal affect and ER remain largely consistent after accounting for attention to affect for PerMag, suggesting that attention to affect is not the primary mechanism driving these abnormalities. However, we found evidence that attention to affect underlies some SocAnh-control group differences in ideal affect and ER difficulties. Our work helps to clarify prior work and contributes to the understanding of shared and unique affective abnormalities in schizotypy. Future research may consider longitudinal approaches to test causal mechanisms of affective abnormalities in schizotypy.


Assuntos
Regulação Emocional , Transtorno da Personalidade Esquizotípica , Anedonia , Emoções , Humanos , Processos Mentais , Transtorno da Personalidade Esquizotípica/psicologia
2.
J Contin Educ Nurs ; 52(7): 309-311, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34166157

RESUMO

To continue nursing leadership development experiences in a virtual world requires planning and perseverance. Given the current landscape of health care, a view toward healthy work environment experiences is critical to maintain participant engagement while meeting educational objectives. This article outlines the steps and key points important in developing healthy work environment nursing leadership experiences. [J Contin Educ Nurs. 2021;52(7):309-311.].


Assuntos
Enfermeiras Administradoras , Cuidados de Enfermagem , Currículo , Educação Continuada em Enfermagem , Humanos , Liderança , Local de Trabalho
3.
Healthc (Amst) ; 9(3): 100545, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33901987

RESUMO

OBJECTIVE: We sought to determine the feasibility of the Practical Alternative to Hospitalization (PATH) program, an intervention that offers ED clinicians an outpatient care pathway for patients initially designated for inpatient admission or observation. METHODS: We evaluated a novel care delivery model that was piloted at a tertiary academic medical center in December 2019. An advanced practice provider screened patients designated for inpatient admission or observation and identified eligible participants. Outpatient services were customized for each patient but primarily included care coordination and monitoring through telemedicine and home health services. The primary feasibility outcome was the proportion of eligible patients who were enrolled in the program, as well as patient outcomes after discharge including return ED visits and averted ED boarding time. RESULTS: A total of 199 patients were designated for inpatient admission or observation during PATH program hours. Of 52 eligible patients, 30 (58%) were enrolled. The mean participant age was 62.5 years (SD 17.5), and 25 (83%) had non-Hispanic Black race/ethnicity. The most common disease conditions were chest pain, heart failure, and hyperglycemia. 4 (13%) enrolled patients returned to an ED within 30 days. We estimate that ED boarding time was reduced by 8.2 h (SD 8.1) per patient. CONCLUSION: Emergency physicians and patients were willing to use a novel service that provided an alternative disposition to hospitalization. IMPLICATIONS: alternative payment models that seek to reduce hospital utilization and cost may consider strengthening systems to monitor and coordinate care for patients after ED discharge.


Assuntos
Serviço Hospitalar de Emergência , Hospitalização , Assistência Ambulatorial , Estudos de Viabilidade , Humanos , Pessoa de Meia-Idade , Alta do Paciente
4.
Artigo em Inglês | MEDLINE | ID: mdl-24455450

RESUMO

BACKGROUND: Tremors may be difficult to classify. CASE REPORT: An 83-year-old male presented with an unusual left wrist tremor. The tremor could be reproducibly elicited by making a fist or carrying a weighted object (e.g., a shopping bag, bottle of water) of approximately 1 lb or more, and it intensified with heavier weights. The tremor was difficult to classify, although it shared features with isometric tremor. DISCUSSION: This specific presentation of tremor has not been reported previously. We hope that the detailed description we provide will aid other neurologists who encounter this or similar tremors in their clinics.

5.
J Child Neurol ; 27(10): 1316-9, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22408141

RESUMO

Friedreich ataxia is a neurodegenerative disease characterized by gait abnormalities, cardiomyopathy, and diabetes. Congestive heart failure was recently reported as the most frequent cause of Friedreich ataxia mortality. Cardiac dysfunction is suspected to result from a frataxin deficiency that leads to oxidative damage in cardiac tissues and possible metabolic syndrome characteristics. In this report, we describe 2 patient cases whose cardiac function worsened dramatically in the presence of underlying endocrinopathies. We report on one Friedreich ataxia teenager with previously undiagnosed diabetes that resulted in diabetic ketoacidosis and rapid progression to severe left ventricular dysfunction. We also describe a Friedreich ataxia teenager whose underlying Graves disease led to rapid worsening of known cardiomyopathy. Cardiac management and treatment for the endocrinopathies returned cardiac function to baseline. We conclude that screening for and awareness of underlying endocrinopathies in Friedreich ataxia may provide novel therapeutic targets for preventing Friedreich ataxia-associated cardiac dysfunction.


Assuntos
Cardiomiopatias/complicações , Ataxia de Friedreich/complicações , Disfunção Ventricular/etiologia , Adolescente , Complicações do Diabetes/tratamento farmacológico , Eletrocardiografia , Ataxia de Friedreich/tratamento farmacológico , Doença de Graves/etiologia , Humanos , Insulina/uso terapêutico , Masculino
6.
Artigo em Inglês | MEDLINE | ID: mdl-23440401

RESUMO

Essential tremor (ET) is one of the most common tremor disorders in the world. Despite this, only two medications have received Level A recommendations from the American Academy of Neurology to treat it (primidone and propranolol). Even though these medications provide relief to a large group of ET patients, up to 50% of patients are non-responders. Additional medications to treat ET are needed. This review discusses some of the methodological issues that should be addressed for quality clinical drug development in ET.

7.
Am J Cardiol ; 109(3): 401-5, 2012 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-22078220

RESUMO

Although Friedreich ataxia (FA) is associated with cardiomyopathy, the severity and evolution of cardiac disease is poorly understood. To identify factors predicting cardiomyopathy in FA, we assessed echocardiograms from a large heterogenous cohort and their relation to disease traits. The most recent echocardiograms from 173 subjects with FA were analyzed in a core laboratory to determine their relation to disease duration, subject age, age of onset, functional disability score, and GAA repeat length. Mean age of the cohort was 19.7 years, mean age of disease onset was 10.6 years, and mean shorter GAA length was 681 repeats. Echocardiograms collectively illustrated systolic dysfunction, diastolic dysfunction, and hypertrophy. Measurements of hypertrophy correlated moderately with each other (r = 0.39 to 0.79) but not with measurements of diastolic dysfunction (r <0.35). Diastolic measurements correlated poorly with each other, although 26% of the cohort had multiple diastolic abnormalities. The most common diastolic dysfunction classification was pseudonormalization. Classification of diastolic dysfunction was predicted by GAA repeat length but not by age or gender. Ejection fraction was below normal in 20% of the cohort. In linear regression analysis, increasing age predicted decreasing ejection fraction. Functional disability score, a measurement of neurologic ability, did not predict any echocardiographic measurements. In conclusion, hypertrophy and diastolic and systolic dysfunctions occur in FA and are substantially independent; diastolic dysfunction is the most common abnormality with most patients having an assigned diastolic dysfunction class of pseudonormalization.


Assuntos
Ecocardiografia Doppler/métodos , Ataxia de Friedreich/diagnóstico por imagem , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Contração Miocárdica/fisiologia , Volume Sistólico , Disfunção Ventricular Esquerda/diagnóstico por imagem , Adolescente , Criança , Diástole , Progressão da Doença , Feminino , Seguimentos , Ataxia de Friedreich/complicações , Ataxia de Friedreich/fisiopatologia , Humanos , Hipertrofia Ventricular Esquerda/complicações , Hipertrofia Ventricular Esquerda/fisiopatologia , Masculino , Prognóstico , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Disfunção Ventricular Esquerda/etiologia , Disfunção Ventricular Esquerda/fisiopatologia , Adulto Jovem
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