Understanding the Acceptability and Effect of Psychiatric Care via Telemedicine as an Alternative Option for Patients Living with Intellectual Disabilities in Group Homes

Telemedicine has become a popular alternative to in-person clinic visits in the field of psychiatry, but few studies examine the impact of telemedicine mental healthcare provided to patients with intellectual disabilities living in group homes. Our study aims to fill this gap in the literature. A ten-question survey was designed to evaluate the effect of telemedicine services on access to care, quality of care, and patient and caregiver stress. This survey was distributed to caregivers of patients living in group homes who received care at the University of Alabama Medical Center. The majority of respondents indicated that telemedicine visits improved access to care, did not result in lower quality care compared to in-person visits, and adequately addressed the needs of the patient. Our findings suggest that telemedicine is an acceptable method of delivery of healthcare for a significant proportion of caregivers of patients surveyed

Aspects of the breeding biology of Janaira gracilis Moreira & Pires (Crustacea, Isopoda, Asellota)

The biological aspects of incubating females of Janaira gracilis Mbreira & Pires, are described. The marsupium is formed by 4 pairs of oostegites arising from pereopods I-IV. The oostegites appear for the first time at the post-marsupial stage 7 (preparatory stage 1), growing successively at each moult until stage 9 (brooding stage 1), when they reach fully development. The sizes of the eggs increase with the body size of the females. The number of eggs, per female, is a linear function of the body volume, i.e., the fecundity increases with the female's body size. The number of eggs, embryos and juveniles decrease during the marsupial development. This decrease in brood number is higher between the last two marsupial stages, i.e., from stage C to D, than between the preceding marsupial stages. The average and overall brood mortality rate is of 38.95%.São descritos, no presente trabalho, vários aspectos relacionados à biologia de fêmeas grávidas de Janaira gracilis Moreira & Pires. O marsúpio é formado por 4 pares de oostégitos, que partem dos pereópodos I-IV. Os oostégitos, que surgem pela primeira vez no estádio 7 do desenvolvimento pós-marsupial (estágio preparatório 1), crescem nas sucessivas mudas, atingindo no estágio 9 (estágio reprodutor 1) seu pleno desenvolvimento. O tamanho dos ovos é proporcional ao tamanho das fêmeas. O número de ovos, por fêmeas, e proporcional ao volume das fêmeas, isto é, a fecundidade é mais elevada nos exemplares de maior comprimento. O número de ovos, embriões e jovens decresce com o desenvolvimento marsupial, sendo este decréscimo maior entre os dois últimos estágios marsupials (i.é., entre os estágios C e D) do que entre os estágios precedentes. A taxa média de mortalidade marsupial é de 38.95%

Factor analysis of the Zung self-rating depression scale in a large sample of patients with major depressive disorder in primary care

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to examine the symptomatic dimensions of depression in a large sample of patients with major depressive disorder (MDD) in the primary care (PC) setting by means of a factor analysis of the Zung self-rating depression scale (ZSDS).</p> <p>Methods</p> <p>A factor analysis was performed, based on the polychoric correlations matrix, between ZSDS items using promax oblique rotation in 1049 PC patients with a diagnosis of MDD (DSM-IV).</p> <p>Results</p> <p>A clinical interpretable four-factor solution consisting of a <it>core depressive </it>factor (I); a <it>cognitive </it>factor (II); an <it>anxiety </it>factor (III) and a <it>somatic </it>factor (IV) was extracted. These factors accounted for 36.9% of the variance on the ZSDS. The 4-factor structure was validated and high coefficients of congruence were obtained (0.98, 0.95, 0.92 and 0.87 for factors I, II, III and IV, respectively). The model seemed to fit the data well with fit indexes within recommended ranges (GFI = 0.9330, AGFI = 0.9112 and RMR = 0.0843).</p> <p>Conclusion</p> <p>Our findings suggest that depressive symptoms in patients with MDD in the PC setting cluster into four dimensions: <it>core depressive, cognitive, anxiety </it>and <it>somatic</it>, by means of a factor analysis of the ZSDS. Further research is needed to identify possible diagnostic, therapeutic or prognostic implications of the different depressive symptomatic profiles.</p

The McKenzie method for the management of acute non-specific low back pain: design of a randomised controlled trial [ACTRN012605000032651]

BACKGROUND: Low back pain (LBP) is a major health problem. Effective treatment of acute LBP is important because it prevents patients from developing chronic LBP, the stage of LBP that requires costly and more complex treatment. Physiotherapists commonly use a system of diagnosis and exercise prescription called the McKenzie Method to manage patients with LBP. However, there is insufficient evidence to support the use of the McKenzie Method for these patients. We have designed a randomised controlled trial to evaluate whether the addition of the McKenzie Method to general practitioner care results in better outcomes than general practitioner care alone for patients with acute LBP. METHODS/DESIGN: This paper describes the protocol for a trial examining the effects of the McKenzie Method in the treatment of acute non-specific LBP. One hundred and forty eight participants who present to general medical practitioners with a new episode of acute non-specific LBP will be randomised to receive general practitioner care or general practitioner care plus a program of care based on the McKenzie Method. The primary outcomes are average pain during week 1, pain at week 1 and 3 and global perceived effect at week 3. DISCUSSION: This trial will provide the first rigorous test of the effectiveness of the McKenzie Method for acute non-specific LBP