Evidence-Base Practice: Screening for Depression and Suicidality in High Functioning Autistic Spectrum Disorder Adolescents

Research regarding assessing for suicide and depression in high-functioning autistic spectrum disorders (HFASDs) is very limited. An extensive literature review focusing on HFASDs was conducted, which resulted in adolescents with HFASDs are likely to experience depression and suicidality compared to those who are neurotypical or those not diagnosed with an autistic spectrum disorder (ASD) because of limited social and communication skills. These deficits put these individuals at risk for depression, therefore, suicidality. PubMed, SCOPUS, PsychiatryOnline. and Cumulative Index to Nursing and Allied Health Literature (C1NAHL) were used to research information for this independent study. Implications for psychiatric nurse practitioners and other clinicians are to screen HFASDs adolescents more often for depression and suicidality because of the complication of having limited communication and social skills as well as. difficulty developing meaningful relationships

Validation of a method to partition the base deficit in meningococcal sepsis: a retrospective study

INTRODUCTION: The base deficit is a useful tool for quantifying total acid–base derangement, but cannot differentiate between various aetiologies. The Stewart–Fencl equations for strong ions and albumin have recently been abbreviated; we hypothesised that the abbreviated equations could be applied to the base deficit, thus partitioning this parameter into three components (the residual being the contribution from unmeasured anions). METHODS: The two abbreviated equations were applied retrospectively to blood gas and chemistry results in 374 samples from a cohort of 60 children with meningococcal septic shock (mean pH 7.31, mean base deficit -7.4 meq/L). Partitioning required the simultaneous measurement of plasma sodium, chloride, albumin and blood gas analysis. RESULTS: After partitioning for the effect of chloride and albumin, the residual base deficit was closely associated with unmeasured anions derived from the full Stewart–Fencl equations (r(2 )= 0.83, y = 1.99 – 0.87x, standard error of the estimate = 2.29 meq/L). Hypoalbuminaemia was a common finding; partitioning revealed that this produced a relatively consistent alkalinising effect on the base deficit (effect +2.9 ± 2.2 meq/L (mean ± SD)). The chloride effect was variable, producing both acidification and alkalinisation in approximately equal proportions (50% and 43%, respectively); furthermore the magnitude of this effect was substantial in some patients (SD ± 5.0 meq/L). CONCLUSION: It is now possible to partition the base deficit at the bedside with enough accuracy to permit clinical use. This provides valuable information on the aetiology of acid–base disturbance when applied to a cohort of children with meningococcal sepsis