The Triad of Idiopathic Normal-Pressure Hydrocephalus A Clinical Practice Case Report

An 89-year-old white male presented with memory impairment, slowness in responsiveness, and frequent falls over a two-year duration. Six months earlier, the patient was believed to have had a “dementia with parkinsonian features,” but showed no response to incrementing doses of both donepezil and carbidopa-levodopa. Urinary urgency was believed to have been due to prostate hypertrophy. A head CT with contrast revealed moderate ventriculomegaly in the setting of mild diffuse cortical atrophy. A diagnosis of idiopathic normal-pressure hydrocephalus (INPH) was made

Aggressive fibromatosis of the head and neck: a new classification based on a literature review over 40 years (1968-2008)

BACKGROUND: Fibromatosis is an aggressive fibrous tumor of unknown etiology that is, in some cases, lethal. Until now, there has been no particular classification for the head and neck. Therefore, the aim of the present study was to review the current literature in order to propose a new classification for future studies. METHODS: An evidence-based literature review was conducted from the last 40 years regarding aggressive fibromatosis in the head and neck. Studies that summarized patients' data without including individual data were excluded. RESULTS: Between 1968 and 2008, 179 cases with aggressive fibromatosis of the head and neck were published. The male to female ratio was 91 to 82 with a mean age of 16.87 years, and 57.32% of the described cases that involved the head and neck were found in patients under 11 years. The most common localization was the mandible, followed by the neck. All together, 143 patients were followed up, and in 43 (30.07%), a recurrence was seen. CONCLUSION: No clear prognostic factors for recurrence (age, sex, or localization) were observed. A new classification with regard to hormone receptors and bone involvement could improve the understanding of risk factors and thereby assist in future studies

Analysis of question text properties for equality monitoring.

INTRODUCTION: Ongoing monitoring of cohort demographic variation is an essential part of quality assurance in medical education assessments, yet the methods employed to explore possible underlying causes of demographic variation in performance are limited. Focussing on properties of the vignette text in single-best-answer multiple-choice questions (MCQs), we explore here the viability of conducting analyses of text properties and their relationship to candidate performance. We suggest that such analyses could become routine parts of assessment evaluation and provide an additional, equality-based measure of an assessment's quality and fairness. METHODS: We describe how a corpus of vignettes can be compiled, followed by examples of using Microsoft Word's native readability statistics calculator and the koRpus text analysis package for the R statistical analysis environment for estimating the following properties of the question text: Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (Grade), word count, sentence count, and average words per sentence (WpS). We then provide examples of how these properties can be combined with equality and diversity variables, and the process automated to provide ongoing monitoring. CONCLUSIONS: Given the monitoring of demographic differences in assessment for assurance of equality, the ability to easily include textual analysis of question vignettes provides a useful tool for exploring possible causes of demographic variations in performance where they occur. It also provides another means of evaluating assessment quality and fairness with respect to demographic characteristics. Microsoft Word provides data comparable to the specialized koRpus package, suggesting routine use of word processing software for writing items and assessing their properties is viable with minimal burden, but that automation for ongoing monitoring also provides an additional means of standardizing MCQ assessment items, and eliminating or controlling textual variables as a possible contributor to differential attainment between subgroups

Embodiment and body awareness in meditators

[EN] Mindfulness practice consists of focusing attention in an intentional way on the experience of the present moment, including bodily sensations, thoughts or feelings, and the environment, with an attitude of acceptance and without judging. The body and, especially, body awareness are key elements in mindfulness. Embodiment or the feeling of being located within one's physical body is a related concept, and it is composed of the sense of ownership, location, and agency of the body. The rubber hand illusion (RHI) is an experimental paradigm that has been used to understand the mechanisms of embodiment, and evidence shows that body awareness modulates this illusion. To our knowledge, no studies have analyzed embodiment processes in meditators. The aim of this study is to use the RHI to analyze the mechanisms of embodiment and its relationship with body awareness and mindfulness in meditators and non-meditators. The sample was composed of long-term meditators (n = 15) and non-meditators (n = 15). Objective and self-report measures for embodiment with the RHI and self-report questionnaires of body awareness and mindfulness were administered. One-way ANOVA revealed significant differences between groups in sense of agency in the rubber hand. Meditators experienced less sense of agency in the rubber hand than non-meditators. Pearson's correlations showed that this lower sense of agency in the rubber hand was associated with higher body awareness and mindfulness. Results highlight the role of body awareness and mindfulness in embodiment mechanisms. This study has clinical implications, especially in psychopathological disorders that can be influenced by disturbances in these processes.The authors would like to acknowledge the "BODYTA" project (Spanish Ministry of Economy and Competitiveness, PSI2014-51928-R), "PROMOSAM" (Spanish Ministry of Economy and Competitiveness, PSI2014-56303-REDT), and "Excellence Research Program PROMETEO II" (Generalitat Valenciana, Conselleria de Educacion, Cultura y Deporte, PROMETEOII/2013/003). CIBERobn is an initiate of the ISCIII. PROMOSAM Excellence in Research Program (PSI2014-56303-REDT), MINECO, Spain.Cebolla, A.; Miragall, M.; Palomo, P.; Llorens Rodríguez, R.; Soler, J.; Demarzo, M.; García Campayo, J.... (2016). Embodiment and body awareness in meditators. Mindfulness. 7(6):1297-1305. https://doi.org/10.1007/s12671-016-0569-xS1297130576Aguado, J., Luciano, J. V., Cebolla, A., Serrano-Blanco, A., Soler, J., & García-Campayo, J. (2015). 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Understanding adolescent and young adult use of family physician services: a cross-sectional analysis of the Canadian Community Health Survey

BACKGROUND: Primary health care is known to have positive effects on population health and may reduce at-risk behavior and health problems in adolescence. Yet little is known about the factors that are associated with adolescent and young adult utilization of family physician services. It is critical to determine the factors associated with utilization to inform effective primary health care policy. We address this gap in the primary health care literature by examining three issues concerning adolescent and young adult family physician use: inequity; the unique developmental stage of adolescence; and the distinction between utilization (users versus non-users) and intensity (high users versus low users). METHODS: We conducted nested logistic regressions for two outcomes: utilization and intensity of family physician services for early adolescence, middle adolescence, and young adulthood using the 2005 Canadian Community Health Survey. RESULTS: Chronic conditions were associated with utilization in early and middle adolescence and intensity in all age groups. Respondents from Quebec had lower odds of utilization. Those without a regular medical doctor had much lower odds of being users. The factors associated with use in early and middle adolescence were in keeping with parental involvement while the factors in young adulthood show the emerging independence of this group. CONCLUSIONS: We highlight key messages not known previously for adolescent and young adult use of family physician services. There is inequity concerning regional variation and for those who do not have a regular medical doctor. There is variation in factors associated with family physician services across the three age groups of adolescence. Health care and health care policies aimed at younger adolescents must consider that parents are still the primary decision-maker while older adolescents are more autonomous. There is variation in the factors associated with the two outcomes of utilization and intensity of services. Factors associated with utilization must be understood when considering the equitability of access to primary health care while factors associated with intensity must be understood when considering appropriate use of resources. The understanding gained from this study can inform health care policy that is responsive to the critical developmental stage of adolescence and young adulthood