Academic literature on the topic 'Cumulative Illness Rating Scale'

The use and the choice of standardized assessment tools are necessary for improving identification of negative symptoms and for testing new efficient therapies. Most of the scales on negative symptoms are based on observer rating. Compared to these scales, self-assessments have been overlooked. Nevertheless, they are quite relevant since they are generally simple; they allow the patients to report their own symptoms and so are complementary to the evaluations based on observer ratings; they require the patient’s participation and so improve their involvement in the treatment; they are time-efficient and can be very useful for identification of negative symptoms at the onset of illness. Among the self-assessments, we can distinguish those designed and validated in patients with schizophrenia and others that can be used in schizophrenia while they have been validated in other populations. Among the first group, two recent scales have supplanted old scales, the Motivation and Pleasure Scale–Self-Report (MAP–SR) and the Self-evaluation of Negative Symptoms (SNS). The last one presents all the psychometric properties required. Among the second group, the most used scales are focused on anhedonia and apathy which assess these dimensions in schizophrenia but also in various psychiatric and neurological disorders; the most well-known are the Social Anhedonia Scale (SAS), the Physical Anhedonia Scale (PAS), and more recently are, on the one hand, the Self-reported Apathy Evaluation Scale (AES-S) and on the other, the Temporal Experience of Pleasure Scale (TEPS) and the Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS) which distinguish anticipation and consummatory pleasures.

The treatment of unipolar major depression with antidepressant medication is well established on the basis of scores of randomized placebo-controlled trials involving thousands of patients. Tricyclic antidepressants (TCAs) were the first to be studied extensively; meta-analyses of placebo-controlled trials show them to be consistently and significantly more efficacious than a placebo. Because of a narrow safety margin and significant drug-induced adverse side effect problems, TCAs have now largely been replaced as the first-line treatment of depression by selective serotonin reuptake inhibitors (SSRIs)—fluoxetine, sertraline, paroxetine, citalopram, and escitalopram; serotonin norepinephrine reuptake inhibitors (SNRIs)—venlafaxine and duloxetine; as well as other compounds, including, for example, bupropion and mirtazapine. Each of these agents has been shown to be superior to a placebo and as effective as comparator TCAs or SSRIs in controlled trials. Clinical trials consistently show them to be better tolerated than TCAs, and they clearly have a wider margin of safety. However, there is a controversy concerning whether TCAs are more effective than SSRIs for the treatment of the most severely ill depressed patients. Monoamine oxidase inhibitors (MAOIs), while also more effective than placebo, have generally been reserved for treatment-refractory patients; however, a recently released transdermally delivered selegiline may be used in less refractory patients. It is now generally recognized that patients with recurrent major depression benefit from continued antidepressant treatment, and there is evidence that TCAs, SSRIs, SNRIs, and so forth are all effective for the long-term management of recurrent major depression. An important issue in evaluating the antidepressant literature is to distinguish between response rated as a reduction in the level of symptoms on a rating scale and response rated as true remission from illness.

The National Institute of Standards and Technology (NIST), in conjunction with Virginia Tech, has developed a rating methodology for residential-scale stationary fuel cell systems. The methodology predicts the cumulative electrical production, thermal energy delivery, and fuel consumption on an annual basis. The annual performance is estimated by representing the entire year of climate and load data into representative winter, spring/fall, and summer days for six different U.S. climatic zones. It prescribes a minimal number of steady state and simulated use tests, which provide the necessary performance data for the calculation procedure that predicts the annual performance. The procedure accounts for the changes in performance resulting from changes in ambient temperature, electrical load, and, if the unit provides thermal as well as electrical power, thermal load. The rating methodology addresses four different types of fuel cell systems: grid-independent electrical load following, grid-connected constant power, grid-connected thermal load following, and grid-connected water heating. This paper will describe a partial validation of the rating methodology for a grid-connected thermal load following fuel cell system. The rating methodology was validated using measured data from tests that subjected the fuel cell system to domestic hot water and space heating thermal loads for each of the three representative days. The simplification of a full year’s load and climate data into three representative days was then validated by comparing the rating methodology predictions with the prediction of each hour over the full year in each of the six cities.

There is growing interest in using cannabis or specific cannabinoids (e.g., THC, CBD) as therapeutic agents for various stress-related psychiatric disorders (e.g., PTSD, anxiety). While beliefs about a drug, such as expecting to feel a certain way, have strong influences over the actual effects experienced by individuals, they are rarely evaluated in clinical research. In the present exploratory report, we sought to (1) evaluate the extent to which individuals believe that cannabis relieves stress, and (2) examine whether individual characteristics (i.e., age, sex, psychiatric illness, cannabis use frequency) are related to these beliefs. A sample of 234 adults (54.7% female; Mean age=31.37, SD=11.03, 19-69 years old) from the Halifax Regional Municipality community took part in a brief telephone screening interview to assess their eligibility for a larger study (in progress). Information was gathered about the frequency of current (i.e., past month) cannabis use (days per week), the presence of current psychiatric disorder(s) ("yes"/"no"), and the extent to which they believed that cannabis was an effective stress reliever (rating scale from 1 (“not at all”) to 10 (“extremely”)). Subjects reported a mean belief rating of 6.39 (SD=2.26). A multiple regression analysis was run to evaluate whether the belief that cannabis relieves stress was related to age, sex, psychiatric illness, and frequency of current cannabis use. Overall, the model significantly predicted cannabis belief ratings (p<.001, adjusted R2=.17). Among all variables, only frequency of cannabis use contributed significantly to this prediction (B=.544, 95% CI: [.387, .701], p<.001). In general, the present sample of community-recruited adults believed that cannabis was somewhat effective at relieving stress. Additionally, cannabis use frequency was the only variable that predicted the strength of this belief, such that more frequent use was associated with higher belief ratings. This is consistent with prior research indicating that heavier cannabis use is linked to positive cannabis expectancies. Given that stimulus expectancies influence substance-related responses, such findings would further the case for evaluating and controlling for these expectancies in clinical work with cannabis for stress-related conditions. Indeed, clinical cannabis research evaluating samples of heavy or frequent cannabis users may be subject to bias due to higher positive expectancies.

Unemployment in Kenya relates closely to under skilling of learners arising specifically from teachers whose research potential has not been well harnessed through the present education system. In any teaching situation, the faculty’s role is to facilitate, guide, and motivate the learning process— training students to be lifelong learners and critical thinkers. Because information in the world is constantly changing, there is need to learn how to evaluate, integrate, and apply information, not simply memorizing accepted facts and theories. It is for these reasons that this study sought show how that undergraduate research skills lead to lifelong learning for teachers. This project used a quasi-experimental design (Pre-test/Post-test Design), with 3rd year Mathematics students of Maseno in the experimental cohort (Taken through an online facilitated research course but supervised face to face in both cohorts) of students and same cohort students from Kenyatta University in the control group (Taken through the face-to-face course without online follow up). The population consisted of 600 3rd year Math students, 55, 60 & 5 school of Education lecturers from Maseno, Kenyatta and Linnaeus Universities respectively. A sample of 200 students and 55 lecturers from both Kenyatta and Maseno University were drawn through the stratified random method, with stratification based on the University of each participant’s origin. Saturated sampling was applied for the Linnaeus lecturers. Data was collected through student and teacher questionnaires, online forum discussions and documentary analysis. The paired sample T-test was used to analyse the quantitative data. Preliminary findings indicated that a higher number of students who received the treatment (online support from supervisors) completed and submitted research reports (25%) as compared to only 15% from the control cohort. However, the final cumulative rating of the reports based on a qualitative scale by an independent team of researchers from Linnaeus university indicated that students who received treatment (taken through a facilitated online support area during the research course) performed much better (80% pass rate) as compared to students who did not receive the treatment (not facilitated through a taught research Course) with a 20% pass rate. These results show that training in research and creation of a community of practice in research is linked to performance in the field (Industry). Preliminary report further indicated that at least 2% of students in the facilitated research cohort are already directly benefiting from the research training received as an undergraduate.

Background. Untreated maternal mental health disorders can have devastating sequelae for the mother and child. For women who are currently or planning to become pregnant or are breastfeeding, a critical question is whether the benefits of treating psychiatric illness with pharmacologic interventions outweigh the harms for mother and child. Methods. We conducted a systematic review to assess the benefits and harms of pharmacologic interventions compared with placebo, no treatment, or other pharmacologic interventions for pregnant and postpartum women with mental health disorders. We searched four databases and other sources for evidence available from inception through June 5, 2020 and surveilled the literature through March 2, 2021; dually screened the results; and analyzed eligible studies. We included studies of pregnant, postpartum, or reproductive-age women with a new or preexisting diagnosis of a mental health disorder treated with pharmacotherapy; we excluded psychotherapy. Eligible comparators included women with the disorder but no pharmacotherapy or women who discontinued the pharmacotherapy before pregnancy. Results. A total of 164 studies (168 articles) met eligibility criteria. Brexanolone for depression onset in the third trimester or in the postpartum period probably improves depressive symptoms at 30 days (least square mean difference in the Hamilton Rating Scale for Depression, -2.6; p=0.02; N=209) when compared with placebo. Sertraline for postpartum depression may improve response (calculated relative risk [RR], 2.24; 95% confidence interval [CI], 0.95 to 5.24; N=36), remission (calculated RR, 2.51; 95% CI, 0.94 to 6.70; N=36), and depressive symptoms (p-values ranging from 0.01 to 0.05) when compared with placebo. Discontinuing use of mood stabilizers during pregnancy may increase recurrence (adjusted hazard ratio [AHR], 2.2; 95% CI, 1.2 to 4.2; N=89) and reduce time to recurrence of mood disorders (2 vs. 28 weeks, AHR, 12.1; 95% CI, 1.6 to 91; N=26) for bipolar disorder when compared with continued use. Brexanolone for depression onset in the third trimester or in the postpartum period may increase the risk of sedation or somnolence, leading to dose interruption or reduction when compared with placebo (5% vs. 0%). More than 95 percent of studies reporting on harms were observational in design and unable to fully account for confounding. These studies suggested some associations between benzodiazepine exposure before conception and ectopic pregnancy; between specific antidepressants during pregnancy and adverse maternal outcomes such as postpartum hemorrhage, preeclampsia, and spontaneous abortion, and child outcomes such as respiratory issues, low Apgar scores, persistent pulmonary hypertension of the newborn, depression in children, and autism spectrum disorder; between quetiapine or olanzapine and gestational diabetes; and between benzodiazepine and neonatal intensive care admissions. Causality cannot be inferred from these studies. We found insufficient evidence on benefits and harms from comparative effectiveness studies, with one exception: one study suggested a higher risk of overall congenital anomalies (adjusted RR [ARR], 1.85; 95% CI, 1.23 to 2.78; N=2,608) and cardiac anomalies (ARR, 2.25; 95% CI, 1.17 to 4.34; N=2,608) for lithium compared with lamotrigine during first- trimester exposure. Conclusions. Few studies have been conducted in pregnant and postpartum women on the benefits of pharmacotherapy; many studies report on harms but are of low quality. The limited evidence available is consistent with some benefit, and some studies suggested increased adverse events. However, because these studies could not rule out underlying disease severity as the cause of the association, the causal link between the exposure and adverse events is unclear. Patients and clinicians need to make an informed, collaborative decision on treatment choices.