Physiological interpretation of pressure waveforms
John Edward Boland, David W. M. Muller in Interventional Cardiology and Cardiac Catheterisation, 2019
Most patients with mitral stenosis present with dyspnoea on effort and these patients have elevated PAW pressures and, more importantly, elevated pulmonary capillary pressure which causes the symptoms. Pulmonary artery pressures are often only mildly elevated (passive pulmonary hypertension). At times these symptoms are replaced by listlessness and fatigue. Haemodynamically the latter patients have much higher PA pressures, higher pulmonary vein resistance and slightly higher PAW and LA pressures, with a much lower cardiac output. Such patients develop what Grossman refers to as ‘second stenosis’ from pulmonary vascular disease affecting distal arterioles and the capillary bed (active pulmonary hypertension).8 The cause of these reactive changes is uncertain. The latter group shows clinically and on the electrocardiogram (ECG) the signs of pulmonary hypertension and right ventricular pressure overload. When the active pulmonary hypertension becomes severe, prognosis is worsened.
Test of time and test of treatment
Caroline J Rodgers, Richard Harrington in Helping Hands: An Introduction to Diagnostic Strategy and Clinical Reasoning, 2019
Red flags are: Poor oral intake or decreased urine output (decreased frequency of wet nappies).Persistent listlessness, drowsiness and reduced interaction.A non-blanching rash, neck stiffness, photophobia, headache, and a bulging fontanelle in babies.Laboured breathing, wheezing or stridor.Continuous crying, or a weak cry in babies.Significant parental concern.
Posttraumatic Personality Disorders
Rolland S. Parker in Concussive Brain Trauma, 2016
Mood disorder symptoms overlap with those of TBI. They are frequent complications of TBI, and influence recovery, but are often overlooked. Post-TBI symptoms of major depression cluster in the domains of low mood, distorted self-representation, lack of motivation and anhedonia, subjective cognitive complaints, and hyperactive and disinhibited behavior (the latter activity findings seem to differ from the frequent fatigability and reduced activity of persons with lesser degrees of TBI). Other studies determined these characteristics of depression: depressed mood, lack of energy, feelings of worthlessness, suicidal ideas, fatigue, frustration, poor concentration, boredom (and in a group of moderate-to-severe injuries) distractibility, irritability, hopelessness, inability to enjoy activities, trouble falling asleep, restlessness, and weakness (Jorge & Starkstein, 2005). Depression may have evolved as a useful conservation strategy: The functions of a low mood would be the reassessment of major life strategies, replace lost resources, secure help from kin, stop pursuing unavailable goals, and so forth (Gardner, 2001). In patients with TBI, depression is associated with poorer social functioning, decline in activities of daily living in patients of varied age, failure to return to work, and financial stress, and long-term outcome. The clinician capability for appropriate treatment will follow assessment of depression’s many possible etiologies.
Can sensory discrimination ability in children with low functioning autism be used as an index of cognitive ability—an exploratory study
Published in International Journal of Developmental Disabilities, 2023
Subsequent analysis of the coded behaviours revealed that in the context of the research question, the behaviours displayed by the children with LFA can be pigeon-holed into 3 categories—(a) behaviours reflecting an interest to explore the stimulus, (b) behaviours reflecting that the stimulus is perceived to be obnoxious and (c) behaviours displaying a listlessness akin to indifference towards the stimulus. Congruent with our initial theoretical considerations, the afore-mentioned behaviours were conceptualized under three paradigms, viz.ApproachWithdrawalApathetic
“We all need Purpose and Reason to be here.”: A Qualitative Investigation of howmembers of Alcoholics Anonymous with Long-term Recovery Experience Aging
Published in Alcoholism Treatment Quarterly, 2022
Kevin McInerney, Gulcan Garip, Tony Benson
Theoretically, the present study considers the participants’ narratives from a logotherapeutic perspective (Frankl, 2014). Logotherapy is an existential and spiritual, meaning-centered psychotherapy. According to Holmes (1991) AA is essentially logotherapy because it addresses four of Frankl’s (2014) major concepts: the spiritual dimension, existential frustration, freedom and responsibility. Whereas Adlerian psychology and Freudian psychoanalysis, respectively, advance the notions of the will to power and the will to pleasure, as the fundamental forces that drive human beings, Frankl (1963) proposes that the individual’s “primary motivation” is “the will to meaning” (p. 105). In other words, there is a deep-rooted instinct within every human being to find purpose and meaning in life. Frankl (2014) further proposes that when this primary need is not satisfied, people “suffer from a sense of meaningless and emptiness,” which he conceptualized as an “existential vacuum,” a phenomenon born out of boredom and apathy (p. 61). Equally central to logotherapy is the spiritual aspect of humanness, which, in logotherapy is contextualized as what it means to be human. All of which, is particularly relevant to the elderly demographic in the current paper, who are likely to experience major late-life events (e.g., bereavement of a partner, retirement, social isolation) that may cause them to question the purpose and meaning of their existence.
Evaluating an engaging and coach-assisted online cognitive behavioral therapy for depression among adolescent and young adult cancer survivors: A pilot feasibility trial
Published in Journal of Psychosocial Oncology, 2023
Anao Zhang, Addie Weaver, Emily Walling, Brad Zebrack, Nina Jackson Levin, Beth Stuchell, Joseph Himle
Finally, high dropout rates and low engagement of existing tCBTs, also likely relate to a lack of treatment tailoring and customization for specific client groups, settings, and contexts. In fact, most, if not all, of the currently available tCBTs are not customizable.36 This is of concern, given literature consistently suggesting that treatment tailoring and customization is associated with increased engagement and improved treatment outcomes. Without customization, a range of patient populations receive the same tCBT without the necessary tailoring of content to meet patient-specific needs.36 For example, to our knowledge, none of the existing tCBT treatment options has content specifically customized to meet the unique developmental and medical needs of AYAs diagnosed with cancer. This would likely lead to AYA cancer survivors finding these available platforms less relevant due to their perception of these options being designed for older people or for people without cancer.37–39 Consequently, they are likely to disengage in these treatment options due to boredom or low relevance. Implementing technology-assisted CBT with limited support from a human clinician, as is sometimes done, may provide tailoring to a certain extent.40 However, the lack of platform-based customization poses significant challenges for tCBT implementation and treatment uptake.41,42
Related Knowledge Centers
- Apathy
- Attention
- Disgust
- Emotion
- Depression
- Psychology
- Affect
- Interest
- Positive Psychology
- Absent-Mindedness