Internet Gaming Disorder and the DSM-5: Conceptualization, Debates, and Controversies

Scientific interest in behavioral addictions (such as Internet gaming disorder [IGD]) has risen considerably over the last two decades. Moreover, the inclusion of IGD in Section 3 of DSM-5 will most likely stimulate such research even more. Although the inclusion of IGD appears to have been well received by most of the researchers and clinicians in the field, there are several controversies and concerns surrounding its inclusion. The present paper aims to discuss the most important of these issues: (i) the possible effects of accepting IGD as an addiction; (ii) the most important critiques regarding certain IGD criteria (i.e., preoccupation, tolerance, withdrawal, deception, and escape); and (iii) the controversies surrounding the name and content of IGD. In addition to these controversies, the paper also provides a brief overview of the recent findings in the assessment and prevalence of IGD, the etiology of the disorder, and the most important treatment methods

A Public Health Framework for Screening Mammography: Evidence-Based Versus Politically Mandated Care

This Viewpoint highlights the societal risks of politically motivated mandates relating to public health guidelines. Although the Affordable Care Act mandated insurance coverage for U.S. Preventive Services Task Force (USPSTF)-recommended preventive services, it went further for mammography screening. Instead of relying on the most recent USPSTF guidelines, Congress amended the ACA to require the Department of Health and Human Services (DHHS) to use its 2002 guidelines, which recommended screening every 1-2 years starting at age 40. The FY 2016 Consolidated Appropriations Act instructs DHHS to interpret any reference to “current” USPSTF breast cancer screening recommendations to mean those issued “before 2009” — in other words, its 2002 recommendations. Essentially, Congress is requiring health insurers to ignore modern scientific assessments, and instead use 14-year-old guidance. The ACA improved the public’s health by guaranteeing that insurers provide uniform, cost-free access to preventive services based on modern evidence of effectiveness. The public’s health is best served when women’s personal decisions about screening are informed by evidence rather than political considerations. The Congress’s paternalistic response to USPSTF mammography-screening recommendations vividly illuminate the social costs of politically mandated care. Rather than benefiting women, political interference with science can discourage shared decision-making, increase harms from screening, and sow public doubt about the value and integrity of science

Disseminated Nocardia cyriacigeorgia causing pancreatitis in a haploidentical stem cell transplant recipient.

We report the first published case of acute pancreatitis secondary to disseminated nocardiosis in a hematopoietic stem cell transplant (HSCT) recipient on chronic immunosuppression for graft-versus-host disease (GVHD). Nocardiosis in the HSCT population is relatively rare, and has not yet been described in haploidentical HSCT recipients. Our patient is a 28-year-old male with a history of haploidentical HSCT and GVHD of the skin and lung who was admitted to the hospital with acute pancreatitis. The workup for the etiology of his pancreatitis was initially unrevealing. He subsequently developed worsening sepsis and respiratory failure despite broad spectrum antimicrobials. After multiple bronchoscopies and pancreatic fluid sampling, he was found to have disseminated nocardiosis with Nocardia cyriacigeorgia

Use of Standardized Patient Scenarios to Train Medical Assistants in an Ambulatory Rehabilitation Medicine Clinic

Objectives: To improve the efficiency of our outpatient Rehabilitation Medicine clinic without sacrificing high value/quality patient care. To clarify the responsibilities of the MA and identify areas of redundancy in the rooming process. To demonstrate the utility of in-situ simulation for MA training. To reduce the time it takes for MAs to complete all assigned tasks to 10 minutes or less per encounter in at least 50% of patient encounters within two months from the time of intervention. To potentially highlight other areas in which to improve clinic efficiency and overall patient satisfaction (e.g. front desk registration process, resident and attending physician encounters, clinic and exam room accessibility).https://jdc.jefferson.edu/patientsafetyposters/1051/thumbnail.jp

Naloxone Administration Route in Opioid Overdose: A Review of Vermont EMS Data

Objective: Emergency Medical System (EMS) personnel administer the direct opioid antagonist naloxone in cases of opioid overdose via intramuscular (IM), intravenous (IV), subcutaneous (SQ), intraosseous (IO), or intranasal (IN) routes. Some early studies suggest that the intranasal route of administration is of similar effectiveness to injectable routes. The main objective of our study was to compare the efficacy of intravenous and intraosseous (IV/IO) routes of naloxone administration to the intranasal (IN) route in suspected opioid overdoses in Vermont. Methods: We reviewed retrospective data from Vermont EMS Statewide Incident Reporting Network (SIREN) between April 2014 and August 2016. We included all patients that were entered into SIREN and administered naloxone during the study period. Predictor variables were route of administration, medication dosage, crew member level, and cardiac arrest (yes or no). We conducted a binary logistic regression in SPSS to predict improvement in patient condition. Results: Our sample consisted of 1139 cases of first-dose naloxone administration. 1076 cases contained sufficient data to be analyzed. Patients who experienced a cardiac arrest were less likely to respond to naloxone (OR 10.8, 95% CI (5.908-19.694)). Route of administration, crew member level, and dosage (in the normal therapeutic range of 0.1-2mg) did not have a statistically significant effect on patient response to naloxone. Conclusions: Our findings, in conjunction with other recent research, suggest that intranasal administration is a safe and effective route when compared with intravenous and intraosseous routes. Intranasal administration has several distinct advantages over injectable routes, including the potential to reduce the risk of needle-stick injuries and blood-borne pathogen transmissions and to be handled by individuals with less medical training. In cases of cardiac arrest, we recommend that providers focus on treatments with proven benefit, including CPR and proper ventilation and oxygenation

Pathological video game playing in Spanish and British adolescents: towards the exploration of Internet Gaming Disorder symptomatology

Research into problematic video gaming has increased greatly over the last decade and many screening instruments have been developed to identify such behaviour. This study re-examined the Problematic Videogame Playing [PVP] Scale. The objectives of the study were to (i) examine its psychometric properties in two European countries, (ii) estimate the prevalence of potential pathological gaming among adolescents in both countries, and (iii) assess the classification accuracy of the PVP Scale based on its symptomatology as a way of exploring its relationship with both the behavioural component model of addiction and the proposed Internet Gaming Disorder. The data were collected via a survey administered to 2,356 adolescents aged between 11 and 18 years from Spain (n=1,132) and Great Britain (n=1,224). Results indicated that the reliability of both versions was adequate, and the factorial and construct validity were good. Findings also showed that the prevalence of pathological gamers estimated with a rigorous cut-off point was 7.7% for Spanish and 14.6% for British adolescents. The scale showed adequate sensitivity, specificity and classification accuracy in both countries, and was able to differentiate between social and potential pathological gamers, and from their addictive symptomatology. The implications of these findings are discussed

Why do you dance? Development of the Dance Motivation Inventory (DMI)

Dancing is a popular form of physical exercise and studies have show that dancing can decrease anxiety, increase self-esteem, and improve psychological wellbeing. The aim of the current study was to explore the motivational basis of recreational social dancing and develop a new psychometric instrument to assess dancing motivation. The sample comprised 447 salsa and/or ballroom dancers (68% female; mean age 32.8 years) who completed an online survey. Eight motivational factors were identified via exploratory factor analysis and comprise a new Dance Motivation Inventory: Fitness, Mood Enhancement, Intimacy, Socialising, Trance, Mastery, Self-confidence and Escapism. Mood Enhancement was the strongest motivational factor for both males and females, although motives differed according to gender. Dancing intensity was predicted by three motivational factors: Mood Enhancement, Socialising, and Escapism. The eight dimensions identified cover possible motives for social recreational dancing, and the DMI proved to be a suitable measurement tool to assess these motives. The explored motives such as Mood Enhancement, Socialising and Escapism appear to be similar to those identified in other forms of behaviour such as drinking alcohol, exercise, gambling, and gaming

A Novel Real-Time Non-invasive Hemoglobin Level Detection Using Video Images from Smartphone Camera

Hemoglobin level detection is necessary for evaluating health condition in the human. In the laboratory setting, it is detected by shining light through a small volume of blood and using a colorimetric electronic particle counting algorithm. This invasive process requires time, blood specimens, laboratory equipment, and facilities. There are also many studies on non-invasive hemoglobin level detection. Existing solutions are expensive and require buying additional devices. In this paper, we present a smartphone-based non-invasive hemoglobin detection method. It uses the video images collected from the fingertip of a person. We hypothesized that there is a significant relation between the fingertip mini-video images and the hemoglobin level by laboratory gold standard. We also discussed other non-invasive methods and compared with our model. Finally, we described our findings and discussed future works

Zoom-in-Net: Deep Mining Lesions for Diabetic Retinopathy Detection

We propose a convolution neural network based algorithm for simultaneously diagnosing diabetic retinopathy and highlighting suspicious regions. Our contributions are two folds: 1) a network termed Zoom-in-Net which mimics the zoom-in process of a clinician to examine the retinal images. Trained with only image-level supervisions, Zoomin-Net can generate attention maps which highlight suspicious regions, and predicts the disease level accurately based on both the whole image and its high resolution suspicious patches. 2) Only four bounding boxes generated from the automatically learned attention maps are enough to cover 80% of the lesions labeled by an experienced ophthalmologist, which shows good localization ability of the attention maps. By clustering features at high response locations on the attention maps, we discover meaningful clusters which contain potential lesions in diabetic retinopathy. Experiments show that our algorithm outperform the state-of-the-art methods on two datasets, EyePACS and Messidor.Comment: accepted by MICCAI 201