Child psychiatry in primary care

This article aims to give a brief summary of child psychiatric practice in a primary care setting. Five types of common childhood psychopathology are described, these include anxiety disorders, antisocial behaviour, enuresis, hyperactivity, and child abuse. The emphasis is on the recognition of the disturbance and practical advice on early treatment strategies. The epidemiological aspects of child psychiatric disturbances in primary care setting and referral practices reported in the West are summarised. Throughout the article, references to data relevant to the local context are made.published_or_final_versio

Management of children refusing to eat

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利用三碘甲狀腺氨酸強化療法治療對於三環抗抑鬱藥物無效的濫用藥物病人

We report on two substance misusers with depression resistant to tricyclic antidepressant treatment who responded to triiodothyronine augmentation. The management of resistant depression, augmentation strategies with particular reference to triiodothyronine, and the possible mechanism of action of triiodothyronine are discussed.published_or_final_versio

Numerical modeling of transient characteristics of photovoltage in Schottky contacts

Numerical modeling of the transient characteristics of the photovoltage at metal-semiconductor interfaces has been carried out with a simple model in which the contributions of different current transport processes including thermionic emission, tunneling, carrier recombination, and leakage current have been taken into account. The simulation gives the detailed dependence of the transient characteristics on temperature, doping concentration, Schottky barrier height, and leakage resistance. © 1994 American Institute of Physics.published_or_final_versio

Prediction of hip fracture in post-menopausal women using artificial neural network approach

© 2017 IEEE. Hip fracture is one of the most serious health problems among post-menopausal women with osteoporosis. It is very difficult to predict hip fracture, because it is affected by multiple risk factors. Existing statistical models for predicting hip fracture risk yield area under the receiver operating characteristic curve (AUC) ∼0.7-0.85. In this study, we trained an artificial neural network (ANN) to predict hip fracture in one cohort, and validated its predictive performance in another cohort. The data for training and validation included age, bone mineral density (BMD), clinical factors, and lifestyle factors which had been obtained from a longitudinal study that involved 1167 women aged 60 years and above. The women had been followed up for up to 10 years, and during the period, the incidence of new hip fractures was ascertained. We applied feed-forward neural networks to learn from the data, and then used the learning for predicting hip fracture. Results of prediction showed that the accuracy of model I (which included only lumbar spine and femoral neck BMD) and model II (which included non-BMD factors) was 82% and 84%, respectively. When both BMD and non-BMD factors were combined (Model III), the accuracy increased to 87%. The AUC for model III was 0.94. These findings indicate that ANNs are able to predict hip fracture more accurately than any existing statistical models, and that ANNs can help stratify individuals for clinical management

Depth profiling of Si nanocrystals in Si-implanted SiO2 films by spectroscopic ellipsometry

An approach to determine depth profiles of silicon nanocrystals in silica films was developed. In the spectral fittings, the dielectric function of silicon nanocrystal was calculated based on two different models for the band-gap expansion due to the nanocrystal size reduction. The fitting yielded the nanocrystal depth profile and the nanocrystal size.published_or_final_versio

The development of complex physiological loading profiles for the study of the intervertebral disc

This is the author accepted manuscript.Engineering and Physical Sciences Research Council (EPSRC

The prognosis of allocentric and egocentric neglect : evidence from clinical scans

We contrasted the neuroanatomical substrates of sub-acute and chronic visuospatial deficits associated with different aspects of unilateral neglect using computed tomography scans acquired as part of routine clinical diagnosis. Voxel-wise statistical analyses were conducted on a group of 160 stroke patients scanned at a sub-acute stage. Lesion-deficit relationships were assessed across the whole brain, separately for grey and white matter. We assessed lesions that were associated with behavioural performance (i) at a sub-acute stage (within 3 months of the stroke) and (ii) at a chronic stage (after 9 months post stroke). Allocentric and egocentric neglect symptoms at the sub-acute stage were associated with lesions to dissociated regions within the frontal lobe, amongst other regions. However the frontal lesions were not associated with neglect at the chronic stage. On the other hand, lesions in the angular gyrus were associated with persistent allocentric neglect. In contrast, lesions within the superior temporal gyrus extending into the supramarginal gyrus, as well as lesions within the basal ganglia and insula, were associated with persistent egocentric neglect. Damage within the temporo-parietal junction was associated with both types of neglect at the sub-acute stage and 9 months later. Furthermore, white matter disconnections resulting from damage along the superior longitudinal fasciculus were associated with both types of neglect and critically related to both sub-acute and chronic deficits. Finally, there was a significant difference in the lesion volume between patients who recovered from neglect and patients with chronic deficits. The findings presented provide evidence that (i) the lesion location and lesion size can be used to successfully predict the outcome of neglect based on clinical CT scans, (ii) lesion location alone can serve as a critical predictor for persistent neglect symptoms, (iii) wide spread lesions are associated with neglect symptoms at the sub-acute stage but only some of these are critical for predicting whether neglect will become a chronic disorder and (iv) the severity of behavioural symptoms can be a useful predictor of recovery in the absence of neuroimaging findings on clinical scans. We discuss the implications for understanding the symptoms of the neglect syndrome, the recovery of function and the use of clinical scans to predict outcome

Situational versus pervasive hyperactivity in a community sample

Groups of home and school situational hyperactive primary schoolboys identified from the community were compared with pervasive hyperactive and non-hyperactive controls on a wide range of measures. The hyperactive groups tended to persist in the same category over a half-year period. Both situational hyperactive groups had lower measured activity levels than the pervasive hyperactive group and only the latter differed from non-hyperactive controls. Home hyperactivity was characterized by poor family relationships and was not distinguishable from non-hyperactive home-antisocial controls. School hyperactive boys had specific correlates of low intelligence, motor clumsiness, poor reading and academic abilities. Pervasive hyperactive subjects differed from both situational groups in showing a higher percentage of delayed language development. While home hyperactivity has dubious identity, the distinct pattern of external correlates in school and pervasive hyperactivity speak for the need to regard these as separate entities.published_or_final_versio