Newspaper Coverage of Alzheimer's Disease: Comparing Online Newspapers in Hebrew and Arabic across Time.

The aim of the present study was to examine the objective characteristics and the portrayal of Alzheimer's disease and of persons with Alzheimer's disease in Hebrew and Arabic online newspapers across time. The sample included 180 articles published in seven national online newspapers between 2010-2011 and 2014-2015 and dealing specifically with the topic. The majority of the articles in both periods and languages were published in the Health section of the newspapers, had a neutral tone, and experts or researchers as the main sources of information. Stigmatizing elements were infrequent. While small differences were found across time, significant differences were found between Hebrew and Arabic online newspapers, with Arabic newspapers concentrating more on objective, health-related and expert-based information. As the use of online newspapers increases, policy makers should consider the use of this media as a viable way for improving knowledge and awareness about AD and dementia.

Low trabecular bone score in adolescent female inpatients with anorexia nervosa.

BACKGROUND & AIMS: Trabecular bone score (TBS) is an emerging technology that provides information regarding bone microarchitecture. A recent study showed that in healthy girls normal TBS (≥1.35) was achieved within the first year post-menarche. The aims of our study was to assess TBS in adolescents with anorexia nervosa (AN) and to evaluate correlations with clinical, laboratory and densitometric variables. METHODS: A cohort study of 208 adolescent females (mean age 15.6 ± 1.8 y) hospitalized because of AN between 2003 and 2017 was retrospectively assessed. Demographic and clinical data, including age, weight, height, body mass index (BMI), laboratory parameters and bone mineral density (BMD) measurements by dual-energy X-ray absorptiometry (DXA) were retrieved from the medical charts. Bone mineral apparent density (BMAD) was calculated for each participant. TBS was assessed by reanalyzing DXA spinal images. RESULTS: Mean TBS was 1.308 ± 0.083, lower than the values previously described in healthy adolescents (p < 0.001). Compromised microarchitecture was found in 17 participants (8.2%) and partially compromised in 123 (59.1%). TBS was significantly correlated with age, weight standard deviation score (SDS), BMI SDS, BMD measurements of the lumbar spine and total body, BMAD, BMAD Z-score, luteinizing hormone (LH) and 17b-estradiol (E2) level, and was negatively correlated with cortisol (p = 0.017). Participants with regular menstruation or secondary amenorrhea had higher TBS than participants who were pre-menarche or with primary amenorrhea (p < 0.001). A stepwise linear regression analysis identified BMD L1-4 Z-score and log E2 as independent predictors of TBS. CONCLUSION: TBS of adolescent females with AN was found to be lower than TBS of healthy adolescents. Prospective longitudinal studies should be undertaken to investigate whether recovery may result in correction of bone microarchitecture.

Self-Stigma and Age-Related Hearing Loss: A Qualitative Study of Stigma Formation and Dimensions.

PURPOSE: This study explored experiences of self-stigma among older persons with age-related hearing loss (ARHL) using Corrigan's conceptualization of self-stigma process formation and the attribution model as its theoretical framework. METHOD: In-depth semistructured interviews were conducted with 11 older persons (mean age = 81 years) with ARHL. RESULTS: Self-stigma was present in the lives of the participants. Analysis revealed the existence of 3 stages of self-stigma in which the 3 core dimensions of stigma (cognitive attributions: being old, stupid, and crippled; emotional reactions: shame, pity, and feeling ridiculed; and behavioral reactions: concealment, distancing, and adapting to hearing aids) were observed. Hearing devices emerged as having a significant influence on stigmatic experiences in all stages and dimensions of self-stigma. CONCLUSION: The study contributes to the theoretical and practical understanding of self-stigma regarding ARHL as well as to the understanding of the role of hearing devices in the development of this stigma.

Hyponatremia and decreased bone density in adolescent inpatients diagnosed with anorexia nervosa.

OBJECTIVE: Recent studies demonstrated an association between low serum sodium levels and reduced bone density. Patients with anorexia nervosa (AN) are at greater risk for osteoporosis as well as for hyponatremia. The aim of the present study was to assess the association between hyponatremia and bone mineral density (BMD) in a large cohort of adolescent inpatients with AN. METHODS: A historic cohort study of 174 adolescent females (mean age 15.7 ± 1.8 y) hospitalized because of AN between 2003 and 2013. Demographic and clinical data, including age, psychiatric comorbidity, anthropometric measurements, laboratory tests, and BMD scores were obtained from the patients' medical charts. RESULTS: Mean lumbar spine BMD z-score of the patients was lower than expected in the normal population (mean -1.5 ± 1.2) and positively correlated with body mass index standard deviation score (r = 0.42, P < 0.0001). Sixty-four participants (36.8%) had at least one episode of hyponatremia during the year preceding the BMD measurement. These participants had a significantly lower lumbar spine BMD z-score (-1.8 ± 1.2 versus -1.3 ± 1.2, P = 0.01) compared with participants with no hyponatremia. Lumbar spine BMD z-score was also positively correlated with the levels of free triiodothyronine (r = 0.16, P = 0.038), 17 b-estradiol (r = 0.23, P = 0.005), and luteinizing hormone (r = 0.25, P = 0.001), and negatively correlated with cortisol levels (r = 0.33, P < 0.0001). Having at least one episode of hyponatremia, BMI z-score and cortisol levels were identified as independent predictors of BMD z-score (P < 0.001, P < 0.001, and P = 0.034, respectively). CONCLUSIONS: Hyponatremia may be associated with decreased bone density in adolescent females with AN. Additional studies are required to evaluate whether the correction of hyponatremia will improve BMD.

Pre-Morbid Developmental Vulnerabilities in Children With Newly Diagnosed Acute Lymphoblastic Leukemia (ALL).

BACKGROUND: Not all children with acute lymphoblastic leukemia (ALL) were developing in a typical manner prior to diagnosis. Pre-existing developmental vulnerabilities (DV) may be related to long-term neuropsychological sequelae following ALL treatment, yet little is known about the prevalence or nature of prior DV in this population. PROCEDURE: Children with newly diagnosed ALL aged 2-18 years (n = 115) were screened for DV by asking parents about the child's prior developmental history and with the Developmental Profile-3 (DP-3). RESULTS: Twenty-six participants (23% of total sample) screened positive for prior DV, with one or more of the following: delayed early motor and/or language milestones that required intervention (n = 17), prior diagnosis of Down syndrome (n = 3), prior diagnosis of autism spectrum disorder (n = 1), prior diagnosis of attention-deficit/hyperactivity disorder and/or learning disability (n = 6), or prior neurological conditions (n = 5). CONCLUSIONS: A sizable proportion of children with newly diagnosed ALL have pre-morbid DV that could potentially make them more vulnerable to reduced educational opportunities during treatment and neurotoxic late effects following treatment. Identification of the subset of children with ALL and DV is essential to direct early interventions and to study their long-term outcomes.

Relationship of speech-language pathology inpatient rehabilitation interventions and patient characteristics to outcomes following spinal cord injury: the SCIRehab project.

BACKGROUND/OBJECTIVE: Describe associations of patient characteristics and speech-language pathology (SLP) interventions provided during impatient rehabilitation for spinal cord injury (SCI) to outcomes at discharge and 1-year post-injury. METHODS: Speech-language pathologists at six inpatient rehabilitation centers documented details of treatment provided. Least squares regression modeling was used to predict outcomes at discharge and 1-year injury anniversary. Cognitive, participation, and mood outcomes for a subsample of patients with traumatic brain injury (TBI) and cognitive-communication limitations (CCLs) were examined. RESULTS: SLP treatment factors explain a small amount of variation in cognitive Functional Independence Measure (FIM), participation, and mood. Variation explained by treatment factors for cognitive outcomes at the time of discharge increased when the patient group was more homogeneous (patients with TBI and CCLs). More time in SLP cognitive-communication interventions had a negative relationship, while longer length of stay was positive. The added explanatory power was not seen for similar outcomes at 1-year post-injury. CONCLUSION: Patients with SCI who have the greatest need for interventions to address cognitive limitations due to TBI receive the most SLP cognitive-communication treatment and show the greatest amount of improvement during rehabilitation. Their cognitive functioning remained impaired at discharge; this likely accounts for the consistent finding that more hours of SLP cognitive-communication treatment is associated with lower cognitive FIM scores at discharge. Future research on individuals with dual SCI and TBI should include more comprehensive assessment of individual differences in cognitive performance in order to better examine the complex relationships between SLP treatments and outcomes. Note: This is the fifth of nine articles in this SCIRehab series.

The SCIRehab project: treatment time spent in SCI rehabilitation. Speech-language pathology treatment time during inpatient spinal cord injury rehabilitation: the SCIRehab project.

BACKGROUND/OBJECTIVE: Following spinal cord injury (SCI), speech-language pathologists (SLPs) perform assessments and provide treatment for swallowing, motor speech, voice, and cognitive-communication disorders that result from the SCI and/or co-occurring brain injuries. This paper describes the nature and distribution of speech-language pathology (SLP) activities delivered during inpatient SCI rehabilitation and discusses predictors (patient and injury characteristics) of the amount of time spent in specific SLP treatment activities. METHODS: Six rehabilitation centers enrolled 600 patients with traumatic SCI for an observational study of acute inpatient rehabilitation treatment (SCIRehab). SLPs documented the details of assessment and treatment and time spent on each of a set of specific SLP activities during each patient encounter. Patterns of time use are described for all patients by neurological injury category. Ordinary least squares stepwise regression models are used to identify patient and injury characteristics predictive of treatment time in the specific SLP activities identified. RESULTS: SLP consults were requested for 40% of SCIRehab patients. Fifty-seven percent of these patients received intense therapy (defined as more than five sessions during the rehabilitation stay); the remainder received primarily evaluation or less intense services (one to five sessions). The patients who participated in intense treatment received a mean total of 16.1 hours (range 2.5-105.2 hours, standard deviation (SD) 16.5, median 9.7 hours) of SLP; significant differences were seen in the amount of time spent in each activity among neurological injury groups. Cognitive-communication and swallowing therapy were the most common SLP activities. Patients with motor levels of injury at C1-C4 spent the highest percentage of their therapy time working on swallowing therapy while patients with low tetraplegia and paraplegia, and those classified as AIS D (regardless of motor level of injury) focused the greatest percentage of time on cognitive-communication work. Patient and injury characteristics explained a portion of the variation in time spent on cognitive-communication therapy but did not explain the variation in time spent on swallowing and other SLP treatment activities. CONCLUSION: The need for swallowing and cognitive treatment by SLP is common during inpatient rehabilitation due to dysfunction resulting from use of artificial airways and feeding approaches, as well as secondary brain injuries. The large amount of variability seen in SLP treatment time, which is not explained well by patient and injury characteristics, sets the stage for future analyses to associate treatments with outcomes.

Genetic and epigenetic biomarkers for early detection, therapeutic effectiveness and relapse monitoring in bladder cancer.

Urinary bladder cancer is the fifth most common cancer in the Western world and is responsible for about 3% of all cancer-related deaths. Because most advanced invasive or metastatic cancers have low cure rates, risk assessment and early detection of the clinically occult premalignant phases of neoplasia are a particular importance. Many tumor biomarkers for bladder cancer have been evaluated for use in detecting and monitoring bladder cancers tissue specimens, bladder washes, and urine specimens but, none of the biomarkers reported to date has shown sufficient sensitivity and specificity to detect the entire spectrum of bladder cancers in routine clinical practice. The limitations of established prognostic markers requires us to identify better molecular parameters that could be of interest in predicting the prognosis of bladder cancer patients, in particular, the high-risk patient groups that are at risk of progression and recurrence. Methylation is an important molecular mechanism in the development of bladder cancer and could be used as a prognostic and diagnostic biomarker, because hypermethylation of several gene promoters was detected in urine sediment DNA from bladder cancer patients. Aberrant patterns of epigenetic modification could be, in the near future, crucial indicators in cancer diagnosis, prognosis, and additionally could be good targets for developing novel therapies while maintaining quality of life.

The importance of clinical application of molecular biomarkers in bladder cancer detection.

It is known that high throughput technologies facilitate the identification of new molecular targets and biomarkers specific for bladder cancer.The new field of molecular medicine promises that clinical outcomes will be improved by directing therapy toward the molecular mechanisms and targets associated with the growth of the patient's tumor.The great challenge remains to improve the measurement of these targets and to translate this wealth of discovery into clinical management of bladder cancer.

SCIRehab Project series: the speech language pathology taxonomy.

INTRODUCTION: Outcomes research for speech language pathology (SLP) interventions for acute traumatic spinal cord injury (SSC) rehabilitation in the US is difficult because of the lack of a treatment classification system (taxonomy). OBJECTIVE: To describe a taxonomy developed by speech language pathologists (SLPs) to examine the effects of SLP interventions on SCI rehabilitation outcomes. METHODS: The SCIRehab study uses practice-based evidence, a rigorous observational methodology that examines treatment processes without specifying or requiring specific therapeutic interventions. Speech language pathology lead clinicians and researchers at 6 US SCI centers developed a detailed SLP taxonomy documentation process that is comprehensive of SLP interventions for patients with SCI. RESULTS: The SLP taxonomy consists of 7 intervention categories that address deficits (speech production for patients with artificial airway, motor speech and voice, swallowing, cognitive-communication, and communication) and the associated exercises and tasks that patients perform. Time is recorded for each category, and supplementary information focuses on cueing needs and family involvement that helps to describe and guide intervention selection. The SCIRehab project is enrolling 1,500 patients with acute traumatic SCI at 6 inpatient rehabilitation facilities. CONCLUSIONS: Speech language pathology taxonomy information is being captured for the SCIRehab patients who are referred for SLP services; this may be the first attempt to document the many details of the SLP rehabilitation process for patients with SCI in the US.