Academic literature on the topic 'Family Therapy – methods – Case Reports'
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Journal articles on the topic "Family Therapy – methods – Case Reports"
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Formiga, Cibelle Kayenne Martins Roberto, Jadiane Dionisio, Carolina Fiorone Ribeiro da Silva, and Eloisa Tudella. "Caregivers and Physical therapists' Perceptions of Telehealth for infants with Down Syndrome during COVID-19: Case reports." Research, Society and Development 10, no. 3 (March 16, 2021): e27710313460. http://dx.doi.org/10.33448/rsd-v10i3.13460.
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The aim of this study is to describe the caregivers and physical therapists’ perceptions of telehealth strategies in two cases of infants with Down syndrome during the COVID-19 pandemic in Brazil. Methodology: The physical therapy intervention program was carried out using synchronous and asynchronous methods according to the social context of each family. Results: The telehealth strategies were positively evaluated by caregivers and physical therapists. Conclusion: The study concluded that telehealth has promoted satisfactory results in infants' physiotherapeutic monitoring, and it could be an additional tool for early intervention after the pandemic.
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Alharbi, Musa, Nahla Ali Mobark, Ali Abdullah O. Balbaid, Fatmah A. Alanazi, Wael Abdel Rahman Aljabarat, Eman A. K. Bakhsh, Murad Turkistani, and Malak Abedalthagafi. "HGG-09. FIRST LINE THERAPY OF PEDIATRIC GLIOBLASTOMA WITH LAROTRECTINIB." Neuro-Oncology 22, Supplement_3 (December 1, 2020): iii345. http://dx.doi.org/10.1093/neuonc/noaa222.299.
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Abstract PURPOSE In this case report, we document new recommendations for the treatment of pediatric glioblastoma based on a genetic understanding of the disease. PATIENTS AND METHODS A Saudi girl aged 18 months presented with a history of right sided weakness and partial seizures. MRI revealed the presence of large complex left frontal tumor. Craniotomy and gross total resection were performed. post-operatively The patient showed excellent recovery with no neurological deficits. Pathology reports confirmed glioblastoma (GBM). Due to the expected poor survival, the patient’s family declined standard therapy, including chemotherapy and/or radiation therapy. RESULTS Molecular analysis showed positive fusion mutations for ETV6-NTRK3 making the patient an ideal candidate for larotrectinib, an oral tyrosine kinase (TRK) inhibitor. Unfortunately, follow-up MRI showed local tumor recurrence at 3-months post-surgery. The family agreed to the initiation of oral larotrectinib as a less invasive therapy. The patient tolerated Larotrectinib very well with no reported side effects. Follow up MRI was performed 8-weeks post-larotrectinib treatment and showed significant tumor regression, indicating an excellent treatment response. CONCLUSION This case highlights how TRK-inhibitors can be integrated as a first-line therapy for pediatric high grade GBMs harboring TRK-fusions. We also highlight the need for the integration of genomic profiling and molecular analysis into the routine histopathologic analyses of pediatric patients with malignant primary intracranial tumors, to detect any genetic mutations that can be targeted with available therapies to avoid the morbidity associated with non-precision conventional therapies.
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Morena, Jonathan, Hera Kamdar, Rabia Yasin, J. Chad Hoyle, Adam Quick, and Stephen Kolb. "Facial Onset Sensory and Motor Neuronopathy: A Case Series and Literature Review." RRNMF Neuromuscular Journal 4, no. 2 (June 19, 2023): 34–42. http://dx.doi.org/10.17161/rrnmf.v4i2.18692.
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Introduction: Facial Onset Sensory and Motor Neuronopathy (FOSMN) typically presents with paresthesias in the trigeminal nerve distribution and weakness that progresses rostro-caudally.
Objective: To present two new cases of FOSMN, summarize the current literature, and address areas for future study.
Methods: Observational data was collected from two patients with FOSMN from our institution. A literature review of FOSMN was completed using PubMed.
Results: We identified 100 cases of FOSMN, including our two new cases. 93% presented with facial paresthesias. 97% had bulbar symptoms. Five had family history of ALS. Abnormal Blink reflex was most common on EMG/NCS. CSF was typically normal, but a rare severe case showed elevated protein. Mutations included: TARDBP, OPMD, D90A-SOD1, CHCHD10, VCP, and SQSTM1. Neuropathological studies showed neurodegenerative changes without inflammation. Some cases have reported transient stabilization or improvement to immunomodulatory therapy.
Case Reports: A 72-year-old man presented with right-sided trigeminal paresthesias that progressed in a rostro-caudal fashion, dysphagia, and hand weakness. He died 4-5 years after symptom onset. A 69-year-old man presented with left-sided jaw paresthesias, dysphagia and dysarthria. He was trialed on IVIG for 1.5 years without improvement and died 2.6 years after symptom onset.
Conclusion: FOSMN is a rare disorder with a unique clinical and electrophysiological phenotype. The pathophysiology has been associated with neurodegeneration and multiple gene mutations have correlated to FOSMN. Some reports suggest transient response to immunomodulatory therapy, though prospective studies are lacking. CSF protein elevation may be seen in severe disease. Future studies will help further elucidate the approach to diagnosis, treatment, and prognostic counseling (biomarkers).
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Hadziahmetovic, Nina, Sabina Alispahic, Djenita Tuce, and Enedina Hasanbegovic-Anic. "Therapist’s interpersonal style and therapy benefit as the determinants of personality self-reports in clients." Vojnosanitetski pregled 73, no. 2 (2016): 135–45. http://dx.doi.org/10.2298/vsp140911141h.
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Background/Aim. In (counter)transference relationship therapist?s interpersonal style, implying the perceived relation of therapist to a client (patient) in terms of control, autonomy, care and positive feedback, has been shown to be important. The aim of our study was to assess the relationship between therapist?s interpersonal style and clients? personality self-reports. Within therapist?s interpersonal style, preliminary validation of the Therapist?s Interpersonal Style Scale has been conducted, which included double translation method, exploratory factor analysis, confirmatory factor analysis, as well as the reliability tests of the derived components. Methods. This research was conducted on a group of 206 clients, attending one of the four psychotherapy modalities: psychoanalysis, gestalt therapy, cognitive-behavioral and systemic family therapy. Beside Therapist?s Interpersonal Style Scale, Big Five Questionnaire and Therapy Benefit Scale were administered, showing good internal consistency. Results. Principal component analysis of therapist?s interpersonal style singled out two components Supportive Autonomy and Ignoring Control, explaining 42% of variance. Two-factor model of the therapist?s styles was better fitted in confirmatory factor analysis than the original 4-factor model. Structural model showing indirect and direct effects of therapist?s interpersonal styles on selfreports in clients indicates good fitness (?2(12) = 8.932, p = 0.709; goodness-of-fit index = 0.989), with Ignoring Control having direct effect on Stability, Supportive Autonomy on Therapy Benefit, and Therapy Benefit on Plasticity. Conclusion. The results of this study indicate the importance of further research on therapist?s interpersonal style, as well as further validation of the instrument that measures this construct. Besides, a client?s perception that the therapy is being helpful could instigate more explorative and approach-oriented behavior, what indirectly might contribute to a client?s stability.
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Dos Santos Barroco, Rui, Antonio Candido de Paula Neto, Douglas Hideki Ikeuti, Letícia Zaccaria Prates de Oliveira, Bruno Rodrigues De Miranda, and Mahmoud Beerens Abdul Ghani Abdul Ghani. "PO 18205 - Case report." Scientific Journal of the Foot & Ankle 13, Supl 1 (November 11, 2019): 45S. http://dx.doi.org/10.30795/scijfootankle.2019.v13.1033.
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Introduction: Anterior tibial tendon ruptures are quite rare. All studies found in the literature refer to the adult population, with no reports of this injury in the pediatric population. The literature on the treatment of this injury is scarce. Objective: To report the case of a child subjected to peroneus brevis tendon transfer for the sequela of a severe anterior tibial and extensor hallucis longus tendon injury. Methods: Male patient, 8 years of age, was run over by a car and sustained an exposed tibial fracture and major soft-tissue injury of the foot. Anterior tibial, posterior tibial and extensor hallucis longus tendon rupture were detected. Damage control, soft-tissue cover and conservative treatment of the anterior tibial and extensor hallucis longus tendons were initially performed; however, the conservative treatment failed, and valgus deformity and pronation developed. Subsequently, tenoplasty (posterior tibial tendon), the Strayer procedure (gastrocnemius recession of the Achilles tendon) and elongation of the peroneus longus and brevis tendons were also performed, but the patient experienced deformity recurrence. Subcutaneous peroneus brevis tendon transfer to the navicular was then chosen, with postoperative use of an ankle-foot orthosis (AFO) and physical therapy. Results: The deformity was improved. The patient progressed with satisfactory gait and strength. He currently walks without support using an AFO. Both the patient and his family were satisfied with the functional outcome of the tendon transfer. Conclusion: Reconstruction of anterior tibial and extensor hallucis longus tendon rupture through peroneus brevis tendon transfer is a viable and reliable treatment option. No complications such as adhesions or correction failure were observed, thus corroborating the viability of this method.
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Drapkina, O. M., S. A. Boytsov, V. V. Omelyanovskiy, A. V. Kontsevaya, M. M. Loukianov, V. I. Ignatieva, and E. V. Derkach. "Socio-economic impact of heart failure in Russia." Russian Journal of Cardiology 26, no. 6 (July 16, 2021): 4490. http://dx.doi.org/10.15829/1560-4071-2021-4490.
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Heart failure (HF) significantly worsens the patient quality of life and leads to the disability of their significant part, as well as increases the risk of death, which in turn causes economic damage.Aim. To assess the annual socio-economic impact of HF in Russia.Material and methods. To assess the socio-economic impact of HF, a model was developed, which assessed the number of HF patients seeking medical care (data from the epidemiological studies), the number of those with disabilities and the mortality rate among them. We also evaluated the costs of drug therapy (data from the government procurement reports) and hospitalization (data from the compulsory health insurance tariffs), social benefits due to disability, and death impact on the gross domestic product. Data on the prescription rate, hospitalizations and mortality was obtained from Russian registries of patients with cardiovascular diseases. Using the foreign study, the costs of family caregiving were also calculated.Results. According to modeling data, there are 7,1 million people with HF seeking medical care in Russia. In this case, the annual economic impact of HF in the context of government spending, is RUB 81,86 billion, including medical costs of RUB 18,6 billion, direct nonmedical costs of RUB 47,1 billion, and indirect costs of RUB 16,2 billion. The impact of family caregiving is RUB 72,4 billion. In the structure of medical expenses, 73,6% is hospitalization costs, while the main costs of drug therapy are borne by patients, since only a part of them (19,6%) receive the necessary medications within assistance programs. In patients with HF with reduced ejection fraction, medical costs are 56% higher than in patients with HF with preserved ejection fraction.Conclusion. HF causes significant economic burden to the state. Improving the healthcare system for this category of patients, including preferential drug provision, will reduce HF-related mortality, the healthcare system costs and, accordingly, reduce the economic impact on the state and society.
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Jiang, Chuang, Jiabi Qian, Wenge Hao, Wei LIU, Shuhong Shen, Hua Jiang, and Hui Zhang. "Novel MEIS1-FOXO1 Fusion Gene in a Case of Pediatric B-Cell Precursor Acute Lymphoblastic Leukemia." Blood 132, Supplement 1 (November 29, 2018): 5283. http://dx.doi.org/10.1182/blood-2018-99-116354.
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Abstract Background: Thanks to the total therapy and systemic basic-translation research, the overall survival rate in children with acute lymphoblastic leukemia (ALL) has dramatically improved to almost 90% over these past few decades. FOXO1 gene belongs to the forkhead family of transcription factors, which play roles in myogenic growth and differentiation. Translocation of FOXO1 with PAX3 has been reported in pediatric alveolar rhabdomyosarcoma. In B-cell precursor ALL, two cases with FOXO1 fusions have been identified already, while its function on ALL remains unknown. Here, we report a novel MEIS1-FOXO1 fusion gene in a case with B-ALL. Methods: Flowcytometery, karyotype, RT-PCR and fluorescence in were employed, MEIS1-FOXO1 was identified as novel fusion gene in a case of pediatric BCP-ALL. Using IL-3 dependent BaF3 cells as study model to test the leukemia transformation potential of MEIS1-FOXO1. Results: A novel MEIS1-FOXO1 fusion was identified in one cease of pediatric B-ALL. Panel next generation sequencing (NGS) showed that the leukemia clone had concurrent NRASG12D, TP53R273H, WHSC1E1099K, ABCC1R1166X, PHGR1H37P, HOXA3P219L and DSTP4606L somatic mutation. This patient was enrolled in CCCG-ALL2015 clinical trial (ChiCTR-IPR-14005706) and achieved completed remission and low minimal residual disease (MRD) level (MRD<0.01%) at day 19 from induction therapy. Functional study showed that MEIS1-FOXO1 fusion gene can potentiate BaF3 cells growth independent of IL3 supplement, as compared to those without MEIS1-FOXO1 fusion transduction. In the meanwhile, we have found that MEIS1-FOXO1 fusion gene can drive cells into S-phase with concurrent decreased G0/G1 phase, which might be its oncogenic role in leukemogenesis. Using qPCR methods, we have found that MEIS1-FOXO1 fusion gene altered the cell cycle related genes expression. Conclusions: Integrating the FOXO1-fusion reports, our data have added more evidence to underline the role of FOXO1 deregulation in the pathogenesis of acute lymphoblastic leukemia. Novel fusion of MEIS1-FOXO1 can potentiate B-ALL via cell cycle entry. Detailed mechanisms involved into the MEIS1-FOXO1 should be further investigated. Figure. Figure. Disclosures No relevant conflicts of interest to declare.
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Zhylka, Nadiya Ya, Nataliya Yu Pedachenko, Olena S. Shcherbinska, Tetyana St Gruzieva, and Lyudmyla V. Pakharenko. "IMPROVEMENT OF THE HEALTH SERVICES FOR THE PREVENTION OF HIV TRANSMISSION FROM MOTHER TO CHILD AT THE LEVEL OF PRIMARY HEALTH CARE." Wiadomości Lekarskie 75, no. 10 (2022): 2507–13. http://dx.doi.org/10.36740/wlek202210136.
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The aim: To analyze the problems of PMTCT of HIV and to clarify the ways for their solving through the increasing their obstetrical and gynecological services at the primary health care level. Materials and methods: Bibliosemantic, statistical and method of structural and logical analysis. The research materials are the data of the statistical reports for the period 2016-2020. Conclusions: The analysis of the problems of PMTCT for HIV demonstrated that in Ukraine there is insufficient availability of pregnant women for HIV testing, the excessive duration of the existing algorithm for testing pregnant women for HIV, the imperfect system of referrals of pregnant women for timely diagnosis, as a result, late and therefore less effective the prophylactic antiretroviral therapy (ART), defects in the effectiveness of standardization of health care for the prevention of mother-to-child transmission (PMTCT) of HIV with the participation of primary healthcare specialists, the main representative of which is a general practitioner – family medicine (GP-FD).
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AlShatnawi, Mohammad, Mohammad Sunoqrot, Basil AlBakri, Mohammad AlOqaily, and Saif Aldeen AlRyalat. "A Systematic Review of Subacute Thyroiditis Related to COVID-19." New Emirates Medical Journal 3, no. 1 (April 2022): 35–41. http://dx.doi.org/10.2174/02666211213151545.
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Background: The novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which belongs to the family Coronaviridae, is the cause of COVID-19 infection. Its outbreak was declared a pandemic on March 11, 2020. COVID-19 does not involve the respiratory system solely, but other systems were also noted to be affected, including the endocrine, cardiovascular, and gastrointestinal systems. Several case reports and series have been published regarding SAT related to COVID-19 infection, yet management and clinical outcomes of the disease have not been discussed in detail. Methods: This is a systematic review of cases that have been reported to have subacute thyroiditis induced by COVID-19 infection. A systematic search was conducted throughout multiple databases, including PubMed, Google Scholar, and MeSH network. Results: The total number of reported subacute thyroiditis cases attributed to COVID-19 is 24. There was a female predominance (18 females and 6 males) with a female to male ratio of 3:1. Ages ranged from 18 to 69 years (mean = 38.67). Twenty-four symptoms related to thyroiditis were reported, the most common of which being neck pain (95.83%, n=23), palpitations (79.17%, n=19), and fever (66.67%, n=16). The outcome was complete resolution in 70% of cases. Conclusion: The endocrine complications of COVID-19 and their management have been disregarded by most as they are rare. Our knowledge of COVID-19 and its complications is growing rapidly. More favourable outcomes were linked with the use of corticosteroid therapy. Until larger studies can be conducted, the management of SAT caused by COVID-19 remains to be based on each individual case. However, the treatment regimen should include corticosteroid therapy.
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Leong, Wei Cheng, and Jyh Jong Tang. "Scalp psoriasis and Dermatology Life Quality Index: A retrospective study based on 12-year data from the Malaysian Psoriasis Registry." Malaysian Family Physician 17, no. 3 (October 20, 2022): 84–88. http://dx.doi.org/10.51866/oa.146.
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Introduction: Psoriasis affects approximately 2–3% of the population worldwide, although the overall prevalence in Asia is <0.5%. Scalp psoriasis is a common initial presentation of psoriasis, which affects almost 80% of patients with psoriasis. Methods: This retrospective descriptive study investigated 1,671 patients with psoriasis with scalp involvement registered with the Malaysian Psoriasis Registry (MPR) from January 2007 to December 2018. Results: A total of 21,859 patients with psoriasis were registered with the MPR during the study period; among them, scalp involvement was seen in 7.6% (n=1,671). Female sex preponderance (61%) was observed in the majority of Malay patients (58.5%), followed by the Chinese (16.9%), Indian (17.1%) and other ethnic patients (7.5%). A positive family history of psoriasis was identified in 22.7% (n=380). Approximately 34.8% (n=581) and 11% (n=172) of the patients had nail changes and psoriatic arthropathy, respectively. The mainstay treatment modality was topical treatment (93.6%), followed by systemic therapy (10%) and phototherapy (0.5%). The comorbidities found among the patients with scalp psoriasis included hypertension (27.9%), obesity (26%), dyslipidaemia (21%), diabetes mellitus (18.4%), ischaemic heart disease (5.4%) and cerebrovascular disease (1.3%). Approximately 23% reported a Dermatology Life Quality Index (DLQI) of >10, which indicated moderate-to-severe impairment. Conclusion: The proportion of patients with psoriasis with scalp involvement in our study (7.6%) is much lower than previous reports. Scalp psoriasis markedly negatively impacts the DLQI.
Dissertations / Theses on the topic "Family Therapy – methods – Case Reports"
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Bouthillier, Shelby. "The impact of therapeutic riding: a mixed methods case study of families' social connectedness." Thesis, 2019. http://hdl.handle.net/1828/11201.
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In 2018, the Cowichan Therapeutic Riding Association (CTRA) connected with the University of Victoria to initiate a research project focusing on social connectedness. Social connectedness is the psychosocial process of belonging that can be developed within a community context. Feelings of social connectedness can reduce depressive symptoms and suicidal thoughts, lessens violence, health compromising behaviours, and the impact of stress and trauma, and is linked to high self-esteem. The aim of this mixed methods case study was to understand the social connectedness of families participating in a community therapeutic riding program.
An explanatory sequential mixed methods design was used to investigate social connectedness at the CTRA. Three different perspectives were sought to explore social connectedness at the CTRA; guardians, children, and instructors. Participants completed the quantitative Connectedness to Treatment Setting Scale (CTSS) in Phase 1, and qualitative semi-structured interviews in Phase 2 to follow-up and expand upon findings from Phase 1. Fifteen participants (guardians (n = 12) and instructors (n = 3)) participated in Phase 1 of the study whereas five guardians (including a guardian and child dyad) and two instructors participated in Phase 2 of the study.
The CTSS comprised of 10 questions assessed on a 6-point scale (from 1 = Totally disagree to 6 = Totally agree). Frequencies were computed for each question and overall mean scores (+ SD) were computed for guardians and instructors separately. The interview transcripts were coded twice. Initially, a deductive orientational approach guided by seven attributes of social connectedness was used. Then, an inductive approach was used to examine how social connectedness was experienced, fostered, or hindered at the CTRA, as well as suggestions for improvement.
The CTSS scores revealed that the vast majority of guardians and instructors felt highly socially connected at the CTRA. The overall mean score of the guardians was 55.3 (SD = 4.5) and 56.7 (SD = 3.1) among the instructors. All seven attributes of social connectedness were represented in the guardians and instructors’ responses however, trust, caring, and reciprocity were the most evident attributes. Two themes emerged from the inductive analysis: effective communication equates with social connectedness and expectations of services. Guardians reported that communication as a team with their instructor, volunteer(s), and the animals positively influenced their families’ social connectedness. The results suggested that social connectedness might be mediating relationships between negative factors preceding a therapeutic riding session and the experience of that lesson. Although the instructors and majority of families were socially connected at the CTRA, guardians had high expectations of the program and wanted the CTRA to foster connections beyond their son/daughters therapeutic riding lesson by organizing opportunities for peer and family relationships.
The people and animals at the CTRA contributed heavily to family’s sense of social connectedness. Most families had a desire to connect and form relationships with the people and animals at the CTRA. The CTRA provides a community context that supports the development of social connectedness.Graduate
Books on the topic "Family Therapy – methods – Case Reports"
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Lynn, Hoffman, ed. Techniques of family therapy. Northvale, N.J: Aronson, 1994.
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Haynes, John M. Mediating divorce: Casebook of strategies for successful family negotiations. San Francisco: Jossey-Bass, 1989.
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McFarlane, Penny. Drama therapy and family therapy in education: Essential pieces of the multi-agency jigsaw. London: Jessica Kingsley Publishers, 2012.
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Marian, Birch, ed. Finding hope in despair: Clinical studies in infant mental health. Washington, DC: ZTT Press, 2008.
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S, McKnight Marilyn, ed. Family mediation casebook: Theory and process. New York: Brunner/Mazel, 1988.
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McGuire, Deborah Killough. Linking parents to play therapy. Northvale, N.J: J. Aronson, 1998.
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McGuire, Deborah Killough. Linking parents to play therapy: A parents' guide. Philadelphia, PA: Brunner-Routledge, 2000.
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E, McGuire Donald, ed. Linking parents to play therapy: A practical guide with applications, interventions, and case studies. Philadelphia, PA: Brunner/Routledge, 2000.
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Peter, Titelman, ed. Clinical applications of Bowen family systems theory. New York: Haworth Press, 1998.
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Berg, Insoo Kim. Family-based services: A solution-focused approach. New York: W.W. Norton, 1994.
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D’Onofrio, Grazia, Annamaria Petito, Antonella Calvio, Giusi Antonia Toto, and Pierpaolo Limone. "Robot Assistive Therapy Strategies for Children with Autism." In Psychology, Learning, Technology, 103–16. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-15845-2_7.
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AbstractBackground: Autism spectrum disorder (ASD) is a category of neurodevelopmental disorder characterized by persistent deficits in social communication and social interaction across multiple contexts as well as restricted, repetitive patterns of behaviour, interests, or activities. Social robots offer clinicians new ways to interact and work with people with ASD. Robot-Assisted Training (RAT) is a growing body of research in HRI, which studies how robots can assist and enhance human skills during a task-centred interaction. RAT systems have a wide range of application for children with ASD.Aims: In a pilot RCT with an experimental group and a control group, research aims will be: to assess group differences in repetitive and maladaptive behaviours (RMBs), affective states and performance tasks across sessions and within each group; to assess the perception of family relationships between two groups before and post robot interaction; to develop a robotic app capable to run Raven’s Progressive Matrices (RPM), a test typically used to measure general human intelligence and to compare the accuracy of the robot to capture the data with that run by psychologists.Material and Methods: Patients with mild or moderate level of ASD will be enrolled in the study which will last 3 years. The sample size is: 60 patients (30 patients will be located in the experimental group and 30 patients will be located in the control group) indicated by an evaluation of the estimated enrolment time. Inclusion criteria will be the following: eligibility of children confirmed using the Autism Diagnostic Observation Schedule −2; age ≥ 7 years; clinician judgment during a clinical psychology evaluation; written parental consent approved by the local ethical committee. The study will be conducted over 10 weeks for each participant, with the pretest and post test conducted during the first and last weeks of the study. The training will be provided over the intermediate eight weeks, with one session provided each week, for a total of 8 sessions. Baseline and follow-up evaluation include: socioeconomic status of families will be assessed using the Hollingshead scale; Social Communication Questionnaire (SCQ) will be used to screen the communication skills and social functioning in children with ASD; Vineland Adaptive Behavior Scale, 2nd edition (VABS) will be used to assess the capabilities of children in dealing with everyday life; severity and variety of children’s ripetitive behaviours will be also assessed using Repetitive Behavior Scale-Revised (RBS-R). Moreover, the perception of family relationships assessment will be run by Portfolio for the validation of parental acceptance and refusal (PARENTS).Expected Results: 1) improbe communication skills; 2) reduced repetitive and maladaptive behaviors; 3) more positive perception of family relationships; 4) improved performance.Conclusions: Robot-Assisted Training aims to train and enhance user (physical or cognitive) skills, through the interaction, and not assist users to complete a task thus a target is to enhance user performance by providing personalized and targeted assistance towards maximizing training and learning effects. Robotics systems can be used to manage therapy sessions, gather and analyse data and like interactions with the patient and generate useful information in the form of reports and graphs, thus are a powerful tool for the therapist to check patient’s progress and facilitate diagnosis.
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Blaise, Didier, and Sabine Fürst. "Post-CAR-T Cell Therapy (Consolidation and Relapse): Lymphoma." In The EBMT/EHA CAR-T Cell Handbook, 169–71. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-94353-0_33.
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AbstractEven after a decade of use, CAR-T cell therapy for non-Hodgkin lymphoma (NHL) is still evolving, and disease control is now the main concern in the majority of experienced centres. Indeed, despite highly appealing objective response (OR) rates in refractory patients, the long-term overall survival (OS) of this population has only slightly improved. Pivotal studies have suggested that 2-year OS rates do not surpass 30%, even though results improve when complete response (CR) is achieved within the first 3 months after treatment (Wang et al. 2020; Schuster et al. 2019; Neelapu et al. 2017). Although achieving this exceptionally high level of OR is praiseworthy, similar improvements have not been made regarding OS, and current OS probabilities are not satisfactory. Of course, there are multiple reasons for this; a substantial proportion of patients either do not achieve an initial response or experience progression very soon after treatment, with poor OS (Chow et al. 2019). Both populations present with disease burden or aggressive cancer prior to CAR-T cell therapy, possibly having been referred too late in the course of treatment or waited too long before CAR-T cells were processed for them. Both of these issues have potential solutions, such as more widely publicizing the efficacy of CAR-T cells, which may increase referrals at an earlier stage, and developing methods, which are already being heavily investigated, for shortening the manufacturing process (Rafiq et al. 2020). In the latter case, the use of allogeneic lymphocytes could allow for already prepared cells to be readily used when needed and would most likely be the most efficient strategy as long as the risk of graft-versus host disease is offset (Graham and Jozwik 2018). Thus, achieving CR is a crucial step in increasing OS, as patients with partial response (PR) or stable disease (SD) present with lower OS, while currently, recurrence appears to be rare when CR is maintained for more than 6 months (Komanduri 2021). However, the disease will likely recur in more than half of patients in the months following treatment, possibly due to issues such as the poor persistence of CAR-T cells (which may not be as crucial as once thought for acute lymphoblastic leukaemia (Komanduri 2021)) or the loss of target antigen expression (which has been regularly documented (Rafiq et al. 2020)). Both of these mechanisms could potentially be used to develop methods that reduce recurrence after CAR-T cell therapy. In fact, the most popular approaches currently being investigated are attempting to either use two CAR-T cell types that each target different antigens or to create CAR-T cell constructs that target either multiple antigens or an antigen other than CD19 (Shah et al. 2020). The concomitant infusion of CAR-T cells with targeted therapies is also being explored in other B-cell malignancies and appears to both increase the CR rate and decrease recurrence (Gauthier et al. 2020). When recurrence does occur, patient OS is rather dismal, and the best remaining option would most likely be inclusion in a clinical trial. If this option is not available, salvage therapy may be attempted, although cytotoxic treatments are extremely limited given that most diseases have been refractory to numerous lines of treatment prior to immunotherapy. A few case reports and studies with a small patient population receiving anti-PD-1 antibodies, ibrutinib, or ImiDs have been reported with largely anecdotal supporting evidence (Byrne et al. 2019). However, even in the case of a new objective response (OR), the subsequent risk of recurrence is substantial and may invite further consolidation with allogeneic haematopoietic stem cell transplantation (Byrne et al. 2019), which has already been performed in patients treated for acute lymphoblastic leukaemia (Hay et al. 2019). However, the efficacy of this strategy remains to be validated in NHL patients in clinical trials. Further supporting evidence, although limited, has recently been reported concerning an additional treatment with CAR-T cells inducing an OR. Of the 21 NHL patients included in the study, the OR rate after the second infusion was 52% (CR, n = 4; PR, n = 7), with some durable responses inviting further investigations (Gauthier et al. 2021). Overall, with such poor outcomes after recurrence, current efforts are also focused on predicting the patients most likely to experience disease progression and that are potential candidates for preemptive consolidation therapy, although there is no doubt that patients who do not achieve a rapid CR should be the first candidates. Additionally, immune monitoring should encompass not only CAR-T cell survival but also the detection of circulating tumour DNA (Komanduri 2021) because this could aid in detecting subclinical recurrence and in deciding whether consolidation or maintenance therapy should be administered. However, currently, all these approaches are highly speculative and require further clinical study.
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"Single-Case Research with Couples and Families." In Advanced Methods in Family Therapy Research, 218–29. Routledge, 2013. http://dx.doi.org/10.4324/9780203084526-22.
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Fink MD, Max. "Pediatric ECT." In Electroconvulsive Therapy. Oxford University Press, 2010. http://dx.doi.org/10.1093/oso/9780195365740.003.0013.
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The role of ECT in the treatment of adolescents and children is not well understood. The experience is limited and poorly documented, especially in pre-pubescent children. For much of the twentieth century, child and adolescent psychiatrists believed that the mental disorders of children and adolescents are psychologically, not biologically, determined. Psychological attitudes and family interactions were considered the cause of the pathology of the disorders. In the past two decades interest has shifted to biological causes and treatments. Depression and mania, autism, anorexia nervosa, and attention deficit hyperactivity disorder (ADHD) are now recognized in children and adolescents with increasing frequency. These shifts in attitude encourage greater interest in medication trials, and with these, increasing tolerance for trials with ECT. The renewed interest in the role of ECT in pediatric patients was shown at a 1994 conference when experts reported an additional 62 case reports beyond the 94 that had been described in publications. Patients between 14 and 20 years of age with major depressive syndromes, delirious mania, catatonia, or acute delusional psychoses had been successfully treated with ECT, usually after other treatments had failed. No reports of harm to age-related faculties, such as impaired maturation, growth, and the capacity to learn, were presented. On the contrary, the resolution of their mental disorders encouraged the young people to complete school and continue their education. No adjustments to the adult ECT protocol were required except that close attention was given to energy dosing. Adolescents require very little energy to induce an effective seizure. No reporter described instances of uncontrolled seizures. Some clinicians, faced with seriously ill adolescents with features that would encourage ECT if the features were seen in adults, now recommend ECT. Examples of the successful treatment of melancholia, psychosis, mania, and catatonia dot the literature. Efficacy is reported in patients with severe mental retardation and in those with self-injurious repetitive behavior and catatonia grafted onto various forms of autism. These reports are sufficiently encouraging to loosen the usual injunctions against the use of ECT in adolescents. In 2004, the American Academy of Child and Adolescent Psychiatry offered official practice guidelines for the use of ECT in adolescents that closely follow the guidelines for treatment in adults.
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Whiteside, Stephen P. H., Thomas H. Ollendick, and Bridget K. Biggs. "Imaginal and Interoceptive Exposure Case Examples." In Exposure Therapy for Child and Adolescent Anxiety and OCD, edited by Stephen P. H. Whiteside, Thomas H. Ollendick, and Bridget K. Biggs, 137—C8.P78. Oxford University PressNew York, 2020. http://dx.doi.org/10.1093/med-psych/9780190862992.003.0008.
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Abstract This chapter presents case examples to more fully illustrate how to implement exposure therapy with a variety of presenting problems. The case presentations in this chapter focus on the less commonly used and less intuitive methods of imaginal and interoceptive exposure. The cases demonstrate the application of exposure to obsessions and compulsions, general anxiety and worry, as well as panic. Each case example begins with a brief description of the case and then conceptualizes the case using the model presented previously in this book. The examples then describe family involvement, discuss the creation of a fear ladder, present a detailed exposure, and comment on the course of treatment. Each case illustrates a broader point related to the implementation of exposure, which is discussed last.
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Abrams, Richard. "Efficacy of Electroconvulsive Therapy." In Electroconvulsive Therapy, 17–42. Oxford University PressNew York, NY, 2002. http://dx.doi.org/10.1093/oso/9780195148206.003.0002.
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Abstract It is axiomatic that rigorous experimental methods are required to demonstrate the efficacy of a medical treatment. Whether the comparison is with placebo (sham treatment) or with an alternative active therapy, a prospective design with random assignment of consecutive patients to treatment groups and blind assessment of outcome using objective measures are absolute requirements. Both the diagnostic criteria and the precise treatment parameters must be specified, and appropriate statistical analyses must be employed (or the data presented in sufficient detail for readers to perform their own calculations). Scrupulous adherence to these rules is especially crucial when studying an emotionally charged and physiologically active treatment such as ECT, for it is often used for illnesses (depression, mania) with a high spontaneous remission rate. The first part of this chapter assesses the efficacy of ECT by reviewing the evidence from controlled trials in the three disorders for which such data are available: depression, schizophrenia, and mania. The results of uncontrolled or otherwise methodologically weak studies, anecdotal reports, and case history studies are referred to in the second part.
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Henrique das Neves Martins Pires, Paulo. "Reducing Disease Burden in Rural Populations: Case Studies in Europe and Africa." In Rural Health [Working Title]. IntechOpen, 2021. http://dx.doi.org/10.5772/intechopen.96559.
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In 1984, Portugal was a middle-income country, developing the primary health care system, based on family doctors, health centres and health posts, reaching almost all population, with infectious diseases as one of the main health problems. In 2006, Mozambique was a low-income country, with a national health service attaining 60% of the population (40% in rural areas), with a double burden of disease (infectious and non-communicable diseases). Working in primary health care in Europe and Africa, we compare several experiences of family medicine practice in rural populations, different in context, time, and methods: Portugal 1984–2006 and Mozambique 2007–2020, all with a strong component of community health education. Our descriptive case studies, summarise strategies, interventions, and results, reviewing reports and articles. Population’ health indicators, and quality of life have improved, in different contexts with culturally tailored approaches. Participative societal diagnosis and multidisciplinary interventions are necessary to improve rural population health. Different rural populations and cultures are ready to learn and to participate in health promotion; empowering rural populations on health issues is an affordable strategy to better health indicators and services. Family Medicine is effective to extend primary health care to all rural populations, aiming universal health cover.
Conference papers on the topic "Family Therapy – methods – Case Reports"
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Silva, Gustavo Figueiredo da, Caroline Figueiredo da Silva, Washigton Luiz Gomes de Medeiros Junior, and Marcus Vinícius Magno Gonçalves. "Anti -Iglon5 Syndrome: What we know so far? A non-systematic review." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.237.
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Background: The first report of Anti-IgLON5 syndrome was in 2014. AntiIgLON5 antibodies have a prevalence of 12 in 150,000 patients per year. However, considering the unreported patients, the prevalence can be much higher. Objectives: Provide an overview of the current knowledge of Anti- IgLON5 syndrome. Design and setting: Narrative review. Methods: Non- systematic review on Pubmed database. Results: The IgLON proteins are a family of cell adhesion molecules and the presence of antibodies against IgLON5 is crucial for the AntiIgLON5 Syndrome diagnosis. This syndrome has an expanded clinical spectrum that involves prominent sleep disorder, progressive bulbar dysfunction, gait instability with abnormal eye movements reminiscent, and cognitive deterioration sometimes associated with chorea. The main neuropathological finding is the neuronal loss with hyperphosphorylated tau protein accumulation at the hypothalamus, brainstem tegmentum, hippocampus, periaqueductal gray matter, medulla oblongata, and upper cervical cord. The exact pathogenesis is still unclear and involves a neurodegenerative process and autoimmune response. Early diagnosis is important to avoid unnecessary tests and prevent complications. Important resources for diagnosis are the antibody testing of serum and cerebrospinal fluid for IgLON5-IgG. The Anti-IgLON5 syndrome mortality is high and new studies published described a good response to immune therapy, however, depends on some clinical and analytical characteristics. Conclusions: The Anti-Iglon5 syndrome is a pathology still poorly studied and described in the medical literature (only in case series, for example), being a syndrome probably underdiagnosed. Future studies are needed to thoroughly analyze the aspects of pathogenesis and treatment of this important pathological syndrome.
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"Case series: Breast and ovarian cancer syndrome." In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685364.
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Aims and Objectives: To report a series of cases with breast and ovarian carcinomas either in same patient or in a family and identifying the importance of BRCA 1, 2 genetic testing in such individuals. Materials and Methods: The medical records of breast and ovarian cancer patients operated over past 3 years at a single institute were reviewed retrospectively and their clinical profile, family history, final pathological reports and follow up data was collected. Results: 8 patients were found to have breast and ovarian malignancies, out of which 3 had synchronous breast and ovarian cancers, 4 had metachronous and 1 patient with ovarian cancer had history of breast cancer in family. Median age of presentation to the hospital was 47 years and median time interval in metachronous disease patients was 5.5 years. Conclusion: About 5% of people who have breast cancer and about 10% of women who have ovarian cancer have HBOC, caused by germline mutation in BRCA 1, 2 gene. These individuals have increased risk of developing breast cancer at younger age, TNBC, or developing a second primary in breast or ovary plus an overall risk of breast/ovarian/prostate/pancreatic malignancies in other family members due to inheritable mutation. Identification of BRCA mutation in such individuals can help family members to undergo genetic counseling and follow different screening and prevention guidelines from general population thus reducing the cancer risks.
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"Case series: Breast and ovarian cancer syndrome." In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685348.
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Aims and Objectives: To report a series of cases with breast and ovarian carcinomas either in same patient or in a family and identifying the importance of BRCA 1,2 genetic testing in such individuals. Materials and Methods: The medical records of breast and ovarian cancer patients operated over past 3 years at a single institute were reviewed retrospectively and their clinical profile, family history, final pathological reports and follow up data was collected. Results: 8 patients were found to have breast and ovarian malignancies, out of which 3 had synchronous breast and ovarian cancers, 4 had metachronous and 1 patient with ovarian cancer had history of breast cancer in family. Median age of presentation to the hospital was 47 years and median time interval in metachronous disease patients was 5.5 years. Conclusion: About 5% of people who have breast cancer and about 10% of women who have ovarian cancer have HBOC, caused by germline mutation in BRCA1, 2 gene. These individuals have increased risk of developing breast cancer at younger age, TNBC, or developing a second primary in breast or ovary plus an overall risk of breast/ovarian/prostate/pancreatic malignancies in other family members due to inheritable mutation. Identification of BRCA mutation in such individuals can help family members to undergo genetic counseling and follow different screening and prevention guidelines from general population thus reducing the cancer risks.
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Iegoroff, Renan, Rafael Herlan Terceros Vaca, Gustavo Araújo Pinheiro, Alvaro Marcelo Huchani Huanca, Matheus Henrique de Souza Coradini, and Leonardo Mariano Inácio Medeiros. "Cadasil, atypical and familial presentation – family case report." In XIV Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2023. http://dx.doi.org/10.5327/1516-3180.141s1.318.
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Introduction: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), is a non-atherosclerotic, nonamyloid, hereditary cerebral disease of small vessels and capillaries caused by mutations in the NOTCH-3 gene located on chromosome 19. The presence of granular osmophilic material (GOM) deposition in the smooth muscle cells of vessel walls is the pathological hallmark of arteriopathy in CADASIL. GOM deposits in the basal lamina of smooth muscle of small vessels are pathognomonic for CADASIL. The presence of GOM in capillary blood vessels of the skin and muscle in biopsy and genetic studies (NOTCH-3 analysis) plays a key diagnostic role. Biopsy tests have high specificity (up to 100%) and low sensitivity (less than 50%). The NOTCH-3 test has been proposed as the primary diagnostic approach, allowing detection of 90% of affected individuals. CADASIL has an estimated prevalence between 2 and 5 in 100,000, and the phenotypic study demonstrates different clinical symptoms in the course of the disease within the same family. The average age of onset of clinical symptoms varies between 48.3 years in men and 52.2 years in women. Characteristic symptoms of migraine, stroke or TIA (transient ischemic attack), behavioral changes, early and progressive cognitive changes associated with leukoencephalopathy on imaging studies. The large association of symptoms often causes the diagnosis of CADASIL to be delayed. In this case, we had an association of gait ataxia within the framework of motor alterations, demonstrating the wide range of symptomatology of the pathology. This case report presents a familial course that started outside the most prevalent age group in the studies described and with an atypical presentation in an affected generation. Case reports: Case 01: woman, 68 years old, started progressively forgetting to perform household activities after the age of fifty, associated with primarily generalized myoclonic epileptic seizures, evolving rapidly within five years to walking apraxia with the use of a wheelchair and tonic-tonic epileptic seizures. bilateral clonic disorders, comprehension aphasia and bradypsychism. Relatives report previous migraine without chronic aura and REM (rapid eye movement sleep) sleep behavior disorder (RMSD). On neurological examination, severe ataxia with bilateral dysdiadochokinesia associated with bilateral hypometric index-index. Bilateral ROT 4+/4+ with bilateral Hoffman and Babinski signs. MMSS and MMII with FGM 4/5 proximal and distal. Case 02: woman, 36 years old, pastry chef, had episodes of forgetting about everyday activities of her work, progressive in the last three years (cake recipes, budget accounts, orders placed) associated with confusion for spatial location on the way home/ work, evolving to apraxia in writing letters and words and difficulty with calculations associated with monoparesis of the right lower limb for twelve months with progression to paresis of the lower limbs after six months and evolution to paresthesia of the upper limbs for three months. Associated with the condition, he has migraine without chronic aura and RMSD. The neurological examination showed Mini-Mental State Examination 22/30 (expected score of 29), list of animals in one minute: 09 animals; list of words starting with “F”: 03 words; clock test: 2/4; difficulty with calculations and digital agnosia with right/left apraxia; Upper limbs: eutrophic, FMG 4/5, bilateral distal; FMG 5/5 bilateral proximal; Lower limbs: eutrophic, bilateral FMG 4/5 distal and proximal with positive Mingazini; atypical gait with evidenced weakness in heel, toe and tandem gait; Bilateral dysdiadochokinesia with eumetric, slowed indexindex; ROT 4+/4+ in the right side with positive Hoffman and Babinski signs. MRI Brain (17/09/2020): extensive area of hypersignal on T2 and FLAIR (T2- weighted-Fluid-Attenuated Inversion Recovery) involving the periventricular white matter in all lobes without atrophic or expansive effect; Case 03: woman, 45 years old, started behavioral arrest epileptic seizures at the age of thirty-two, progressing to focal dysperceptive seizures with progression to bilateral tonic clonic seizures after eight months and multiple episodes of anterograde amnesia, presenting forgetfulness related to everyday work activities (exchanged worksheets , payments, calculation errors and budgets); associated with the condition presented migraine without chronic aura and RMSD. Genetic Test (04/06/2017): Heterozygous alteration in exon 8 of the NOTHC – 3 gene. Discussion: CADASIL presents a rare cause of cognitive decline and is often overlooked in diagnosis, except in cases of high clinical suspicion in a familial course. Access to imaging tests becomes fundamental for the diagnostic segment and the primordial genetic test for etiological elucidation and family planning, in the report described the family presentation with the same course of satellite symptoms (migraine without aura, and RMSD) associated with cognitive alteration with anticipation of age of onset are hallmarks of clinical thinking. Cases described in the literature show that the clinical symptomatology is not necessarily related to the level of brain injury observed in the imaging exam, which could be explained by personal factors and which exon is affected. The NOTCH-3 gene has 24 exons, in which the literature reports exon 4 as the most common mutation, followed by 3, 5 and 6, mainly in the Caucasian population. In an Asian population, the most affected exon is 4 and 11, which is also found in Italian descendants. The mutation in exon 8, described in the clinical case, is found in a population of Portuguese origin, being the second most common mutation in this nationality, behind the mutation in exon 4. Brain MRI studies have tried to elucidate the most affected brain regions, aiming to trace a line of evolution. Involvement of the temporal lobe, external capsule and corpus callosum are described as probable markers of CADASIL, and can be used as an aid in the diagnosis due to its specificity of 86% and sensitivity of 89%. Studies also show that the frontoparietal area has frequent findings of hyperintensity (100%), followed by the temporal lobe (83%), less frequently affecting the brainstem, occipital lobe and cerebellum. Despite the great advances in the specialized literature, the causes of the important cognitive dysfunction presented in the course of the evolution of CADASIL remain unclear. However, studies have suggested that the process of cognitive decline is more related to the loss of cortico-subcortical connections than to brain atrophy itself, with these disconnections resulting from repeated transient ischemic accidents. Science has been looking for ways to change the prognosis of CADASIL, recent studies in gene therapy and neurogenetics show the importance of thinking about this pathology as a genetic disease of great importance to change the prognosis of this pathology.
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Sgrott, Francine Fischer, Jaqueline Munaretto Tim Baiocchi, and Francilma Catão. "PHOTOBIOMODULATION AND MANUAL LYMPH DRAINAGE FOR THE TREATMENT OF NIPPLE NECROSIS IN BREAST CANCER PATIENT: TWO CASE REPORTS." In Brazilian Breast Cancer Symposium 2022. Mastology, 2022. http://dx.doi.org/10.29289/259453942022v32s2092.
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Introduction: Breast cancer is the most common malignant neoplasm among women in the world and in Brazil, accounting for approximately 28% new cases each year. Recently, breast reconstruction after mastectomy with preservation of the nipple has been an alternative breast cancer treatment. However, despite its efficacy and esthetic superiority, the preservation of the nipple has been associated with several complications in the postoperative period. The therapy of photobiomodulation, formerly known as low-level laser therapy, has been demonstrated to promote repair of tissues by cellular repair biostimulation, angiogenesis, and anti-inflammatory effects. These characteristics suggest a potential role for the repair of chronic wounds and may be applicable in the treatment of necrosis. Objective: This study aimed to observe the effects of physiotherapeutic intervention through photobiomodulation therapy in two patients with nipple necrosis after mastectomy. Methods: Two Brazilian females with necrosis of more than 40% of the nipple on the right breast after breast mastectomy and reconstruction were referred to physical therapy (PT). PT sessions were composed of manual lymph drainage, manual therapy, and exercises of strength and flexibility, followed by photobiomodulation. Patient 1 received laser therapy with a laser at 660 nm, 3 joules per point every 1 cm. The device used was the Laser Therapy DMC, with a power output of 100 mw. The therapy was implemented 12 times in total, and a reevaluation was performed monthly until 12 months of follow-up. Patient 2 received led therapy at 660 and 850 nm, 3 joules per point every 2 cm. The device used was the Ledtherapy Cosmedical, with a power output of 5 mW, for a total of 24 treatments, and follow-up was performed until 6 months post-therapy. Conclusion: Photobiomodulation was helpful for wound healing. Confirmation of the sustained effects of photobiomodulation was shown in a 6-month follow-up.
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Dias, Alice Estevo, Bruna Helena Sciarini, Juliana Aparecida Rhein Telles, Ibis Ariana, Carlos Monteiro, and Talita Dias da Silva. "A case study on dysarthria present in coexisting autoimmune diseases." In XIV Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2023. http://dx.doi.org/10.5327/1516-3180.141s1.655.
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Introduction: Autoimmune diseases are characterized by immune dysfunction, autoantibody production and chronic inflammation. The aim is to describe dysarthria in a case that combines autoimmune diseases. Case report: This study reports the case of a 43-year-old woman with complaints of speech difficulties and a diagnosis of dysarthria due to Multiple Sclerosis, Sjögren’s Syndrome, Raynaud’s Phenomenon, Systemic Lupus Erythematosus and Hashimoto’s Thyroiditis. Assessments were performed using the GRBASI scale, Praat software and Voice Related Quality of Life Protocol for six years consecutive. During the period, the patient sought speech therapy support annually and reported symptoms of low and hoarse voice, slurred speech and tiredness when speaking. Negative impact on quality of life was self-reported in the presence of speech difficulties, with mean scores in the VRQOL domains: total = 75, physical = 71, and socioemotional = 82. The most frequent signs were a breathy and asthenic hoarse voice with marked instability, and reduced intensity (56 decibels), slowed speech, and imprecise articulation, characterizing mixed dysarthria. The signs and symptoms did not always occur simultaneously with the expressions of the diseases and had intermittent, heterogeneous manifestations of varying severity. Conclusion: This study shows that dysarthria affects verbal communication, family, social and professional interaction and compromises quality of life. Considering the complexity of these chronic diseases, periodic specialized speech therapy monitoring is recommended for analysis of speech subsystems, guidelines and personalized approaches.
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Diniz, Maria Ondina Machado, Jordana Gaudie Gurian, Amanda Nascimento Bispo, Aline Boaventura Ferreira, Paulo Sérgio Machado Diniz, and Marco Túlio Araújo Pedatella. "Vertebral arterial dissection in a young patient, case report." In XIV Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2023. http://dx.doi.org/10.5327/1516-3180.141s1.356.
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Introduction: Cervical artery dissection accounts for 1–2% of all ischemic strokes and is a common cause of stroke in young people, in which it represents 10–25%. Some studies have reported an increased risk of stroke in patients who present with a dissection, with most occurring soon after the onset of symptoms. Objectives: To report a case of Vertebral Arterial Dissection in a young patient after Direct Trauma, treated at the Hospital Geral de Goiânia. Methods: Information was obtained through clinical follow-up in a Neurology ward and outpatient clinic. Results: Patient, female, 45 years old, reports direct trauma in the right cervical, frontal and left occipital regions. After one day, he suddenly presented right hemiparesis, right peripheral facial paresis, diplopia, vertigo and nausea, dysarthria. On examination, right horizontal gaze palsy, diplopia, right peripheral facial paresis, right curtain sign, tongue deviation to the left. Complete hemiparesis provided grade 3 on the right, tetrasegmental hyperreflexia, Trommer, Hoffman and Babinski on the right. Evidenced on Brain Magnetic Resonance Imaging recent ischemia in the base and pontine tegment lower right and higher left. Cervical Magnetic Resonance Angiography with signs of dissection of segment V3 of the Right Vertebral Artery. Antiplatelets therapy was proposed, evolving with good recovery of the deficits. Conclusion: The literature shows that patients with arterial dissection have head or neck pain, stroke and Horner’s syndrome. Vertebral artery dissection is believed to be a multifactorial process, intrinsic factors present in the setting of an exacerbating extrinsic factor (low-speed car accident, direct trauma, heavy lifting, or a rotational sports injury). As for therapy, more research is needed, there is no evidence of superiority of anticoagulation or antiplatelets therapy.
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Freitas, Laura Rabelo de, Lilian Cristina Silva da Costa, Maria Gabriela Ferreira da Silva, Luiza Rodrigues Batista, and Rafael Henrique Szywanski Machado. "EPIDEMIOLOGICAL CHARACTERISTICS AND INCIDENCE OF BREAST CANCER IN MALE PATIENTS IN A TERTIARY HEALTH INSTITUTION." In XXIV Congresso Brasileiro de Mastologia. Mastology, 2022. http://dx.doi.org/10.29289/259453942022v32s1030.
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Introduction: Despite the rare incidence of malignant breast pathologies in men, it is extremely important to pay attention to any complaints related to breast alterations in men. Benign and malignant breast diseases are uncommon in men. In addition, most of the male population can be careless when it comes to their own health, especially in breast diseases, commonly seen as an exclusive condition for women. Objective: The aim of this study was to analyze the epidemiological profile of male patients treated at the Mastology Clinic in Rio de Janeiro, Lagoa’s Federal Hospital (HFL), a tertiary health institution. Methods: In total, 40 medical records of patients who were assisted during 2020 and 2021 were evaluated. Results: The majority of patients were between 30 and 70 years old, and the major complaints (97%) were related to a tumor or to breast volume increase. Sixty percent of the patients were diagnosed with gynecomastia and, as a consequence, have been regularly observed throughout appointments since then. Some of these patients (12.5%) have reported the use of anabolic substances before the discovery. The breast cancer incidence in this male population was 22.5% during this period, and the patients affected by malignant tumors were between 47 and 74 years old. Most patients with breast cancer smoked (55%) and drank alcohol (22%). No patient had breast cancer in family history and only one patient was related to a family history of prostate cancer. A total of 66.6% of the male breast cancer in this study population was positive for hormone receptors, and the papillary carcinoma of the breast was the predominant histological type (44.4%). Conclusion: As other studies indicate, all of the patients were in an advanced stage of the disease since the first appointment at HFL. Low educational level, no knowledge about possible male breast cancer, insecurity, shyness and fear of possible social judgments about breast increase (especially in older patients), and carelessness when it comes to their own health were the preponderant factors for a clinically advanced disease among the patients at HFL. These factors were also relevant for a bad adaptation to the treatment, as well as emotional shakiness during therapy and follow-up: some patients showed symptoms such as apathy, deep sadness, and even depression. The male population assisted by the Mastology Clinic at HFL has similar features as the ones in equivalent studies. This research confirms the necessity of an increase in male’s Health Care Education, family participation during treatment, and interdisciplinary care, considering the physical and emotional consequences of such diagnosis.
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Menezes, João Lucas Pordeus de, João Victor Bezerra Ramos, Louyse Jerônimo de Morais, and Maurus Marques de Almeida Holanda. "Regression of Tumor in the Pineal Gland after Exclusive Radiotherapy: Case Report." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.569.
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Background: Brain tumors are the most common solid neoplasia and the main cause of death from malignancy in children. Germ cell tumors (GCT) of the central nervous system (CNS) are rare. In pediatrics, the main location is close to the pineal gland and germinomas are the most common intracranial GCTs. Objectives and Methods: To describe the case of a patient with a possible germinoma treated exclusively with radiotherapy. The case was studied and came from a referral hospital – João Pesssoa, PB. Results: Reports “impaired failure”, disorientation and headache. Computed tomography: Hydrocephalus and strong tumor suspicion in the pineal region. Alpha-fetoprotein (AFP) and beta-gonadotropin (betaHCG) measurements: Normal. Treatment can be based on radiotherapy or chemotherapy followed by radiotherapy. In this case, radiotherapy was performed at a dosage of 10 Gy, with control, after one month, by means of magnetic resonance imaging that revealed regression of the lesion. The treatment corroborated the hypothesis of a germinoma, which is extremely radiosensitive. However, the regression made it impossible to perform the anatomopathological exam for diagnostic conclusion. Conclusions: It can be seen, then, that primary CNG GCTs are part of a heterogeneous group of extremely rare lesions, with germinoma therapy still controversial. The case shows regression of a possible germinoma only with the use of radiotherapy.
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Baldoni, Gabriela, Gabriela Iribarren, Claudia Garbasz, Pablo Striebeck, Micaela Mayer Wolf, Liliana Fernandez Canigia, and Patricia Galarza. "Persistent and recurrent urethritis due to macrolide-resistant Mycoplasma genitalium: first reports in Argentina." In XIII Congresso da Sociedade Brasileira de DST - IX Congresso Brasileiro de AIDS - IV Congresso Latino Americano de IST/HIV/AIDS. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/dst-2177-8264-202133p044.
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Introduction: Mycoplasma genitalium (MG) is responsible for 15%-20% nongonococcal urethritis in men. In Argentina, the diagnosis is only performed by few laboratories. Single-dose 1 g azithromycin (AZM1D) treatment leads to emergence of macrolide resistance (mutations at 23S rRNA gene, region V, position 2058 or 2059). Recommendations include 5-day AZM (AZM5D) regimen, moxifloxacin as second-line therapy. Doxycycline is only 30% effective. Test of Cure (ToC) is advisable. Objective: The aim of this study was to describe the first two clinical cases of persistent and recurrent urethritis due to macrolide-resistant MG in Argentina. Methods: End point polymerase chain reaction (PCR) for diagnosis and ToC. Sanger sequencing analysis of mutations. Results: Case 1: A 26-year-old male patient with occasional heterosexual contacts and no history of sexually transmitted infections (STIs) complained urethral thick purulent discharge and dysuria (January 2018), with negative microbiological cultures and Chlamydia trachomatis PCR. The patient received ceftriaxone/AZM1D. However, symptoms persisted (April 2018). Later, doxycycline was prescribed for 1 month. Five days after treatment, the sample was referred to the STI national reference laboratory (NRL) and results were found positive for MG. The patient was given AZM5D. As a result, symptoms disappeared, posterior ToC was found negative, and retrospectively, sequencing 23S rRNA gene showed A2058G transition. Case 2: An 18-year-old male patient with stable heterosexual relationship complained of previous gonococcal urethritis and urethral serous exudate with inflammatory reaction (September 2017), with negative microbiological cultures. The patient received ceftriaxone and AZM1D as initial treatment. Later, he was given doxycycline for 10 days. On February 2018, symptoms reappeared and sample referred to the NRL was positive for MG (negative for other STIs). With AZM1D treatment, symptoms disappeared. After 1 month, the symptoms recurred. Results showed a new MG-positive sample (April 2018). AZM5D administration induced 2 weeks symptoms free and recurrence, requiring moxifloxacin treatment. Symptoms disappeared completely. Posterior ToC is negative. Subsequently, sequencing both samples referred to the NRL showed A2059G transition. Conclusion: The clinical cases presented notified the importance of early and accurate diagnosis of MG infections and use of adequate treatment schemes. We emphasized the relevance of monitoring and surveillance prevalence of macrolide-resistant MG in Argentina.
Reports on the topic "Family Therapy – methods – Case Reports"
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McEntee, Alice, Sonia Hines, Joshua Trigg, Kate Fairweather, Ashleigh Guillaumier, Jane Fischer, Billie Bonevski, James A. Smith, Carlene Wilson, and Jacqueline Bowden. Tobacco cessation in CALD communities. The Sax Institute, June 2022. http://dx.doi.org/10.57022/sneg4189.
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Background Australia is a multi-cultural society with increasing rates of people from culturally and linguistically diverse (CALD) backgrounds. On average, CALD groups have higher rates of tobacco use, lower participation in cancer screening programs, and poorer health outcomes than the general Australian population. Lower cancer screening and smoking cessation rates are due to differing cultural norms, health-related attitudes, and beliefs, and language barriers. Interventions can help address these potential barriers and increase tobacco cessation and cancer screening rates among CALD groups. Cancer Council NSW (CCNSW) aims to reduce the impact of cancer and improve cancer outcomes for priority populations including CALD communities. In line with this objective, CCNSW commissioned this rapid review of interventions implemented in Australia and comparable countries. Review questions This review aimed to address the following specific questions: Question 1 (Q1): What smoking cessation interventions have been proven effective in reducing or preventing smoking among culturally and linguistically diverse communities? Question 2 (Q2): What screening interventions have proven effective in increasing participation in population cancer screening programs among culturally and linguistically diverse populations? This review focused on Chinese-, Vietnamese- and Arabic-speaking people as they are the largest CALD groups in Australia and have high rates of tobacco use and poor screening adherence in NSW. Summary of methods An extensive search of peer-reviewed and grey literature published between January 2013-March 2022 identified 19 eligible studies for inclusion in the Q1 review and 49 studies for the Q2 review. The National Health and Medical Research Council (NHMRC) Levels of Evidence and Joanna Briggs Institute’s (JBI) Critical Appraisal Tools were used to assess the robustness and quality of the included studies, respectively. Key findings Findings are reported by components of an intervention overall and for each CALD group. By understanding the effectiveness of individual components, results will demonstrate key building blocks of an effective intervention. Question 1: What smoking cessation interventions have been proven effective in reducing or preventing smoking among culturally and linguistically diverse communities? Thirteen of the 19 studies were Level IV (L4) evidence, four were Level III (L3), one was Level II (L2), none were L1 (highest level of evidence) and one study’s evidence level was unable to be determined. The quality of included studies varied. Fifteen tobacco cessation intervention components were included, with most interventions involving at least three components (range 2-6). Written information (14 studies), and education sessions (10 studies) were the most common components included in an intervention. Eight of the 15 intervention components explored had promising evidence for use with Chinese-speaking participants (written information, education sessions, visual information, counselling, involving a family member or friend, nicotine replacement therapy, branded merchandise, and mobile messaging). Another two components (media campaign and telephone follow-up) had evidence aggregated across CALD groups (i.e., results for Chinese-speaking participants were combined with other CALD group(s)). No intervention component was deemed of sufficient evidence for use with Vietnamese-speaking participants and four intervention components had aggregated evidence (written information, education sessions, counselling, nicotine replacement therapy). Counselling was the only intervention component to have promising evidence for use with Arabic-speaking participants and one had mixed evidence (written information). Question 2: What screening interventions have proven effective in increasing participation in population cancer screening programs among culturally and linguistically diverse populations? Two of the 49 studies were Level I (L1) evidence, 13 L2, seven L3, 25 L4 and two studies’ level of evidence was unable to be determined. Eighteen intervention components were assessed with most interventions involving 3-4 components (range 1-6). Education sessions (32 studies), written information (23 studies) and patient navigation (10 studies) were the most common components. Seven of the 18 cancer screening intervention components had promising evidence to support their use with Vietnamese-speaking participants (education sessions, written information, patient navigation, visual information, peer/community health worker, counselling, and peer experience). The component, opportunity to be screened (e.g. mailed or handed a bowel screening test), had aggregated evidence regarding its use with Vietnamese-speaking participants. Seven intervention components (education session, written information, visual information, peer/community health worker, opportunity to be screened, counselling, and branded merchandise) also had promising evidence to support their use with Chinese-speaking participants whilst two components had mixed (patient navigation) or aggregated (media campaign) evidence. One intervention component for use with Arabic-speaking participants had promising evidence to support its use (opportunity to be screened) and eight intervention components had mixed or aggregated support (education sessions, written information, patient navigation, visual information, peer/community health worker, peer experience, media campaign, and anatomical models). Gaps in the evidence There were four noteworthy gaps in the evidence: 1. No systematic review was captured for Q1, and only two studies were randomised controlled trials. Much of the evidence is therefore based on lower level study designs, with risk of bias. 2. Many studies provided inadequate detail regarding their intervention design which impacts both the quality appraisal and how mixed finding results can be interpreted. 3. Several intervention components were found to have supportive evidence available only at the aggregate level. Further research is warranted to determine the interventions effectiveness with the individual CALD participant group only. 4. The evidence regarding the effectiveness of certain intervention components were either unknown (no studies) or insufficient (only one study) across CALD groups. This was the predominately the case for Arabic-speaking participants for both Q1 and Q2, and for Vietnamese-speaking participants for Q1. Further research is therefore warranted. Applicability Most of the intervention components included in this review are applicable for use in the Australian context, and NSW specifically. However, intervention components assessed as having insufficient, mixed, or no evidence require further research. Cancer screening and tobacco cessation interventions targeting Chinese-speaking participants were more common and therefore showed more evidence of effectiveness for the intervention components explored. There was support for cancer screening intervention components targeting Vietnamese-speaking participants but not for tobacco cessation interventions. There were few interventions implemented for Arabic-speaking participants that addressed tobacco cessation and screening adherence. Much of the evidence for Vietnamese and Arabic-speaking participants was further limited by studies co-recruiting multiple CALD groups and reporting aggregate results. Conclusion There is sound evidence for use of a range of intervention components to address tobacco cessation and cancer screening adherence among Chinese-speaking populations, and cancer screening adherence among Vietnamese-speaking populations. Evidence is lacking regarding the effectiveness of tobacco cessation interventions with Vietnamese- and Arabic-speaking participants, and cancer screening interventions for Arabic-speaking participants. More research is required to determine whether components considered effective for use in one CALD group are applicable to other CALD populations.
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Vail, Kylin, Bret Lizundia, David Welch, and Evan Reis. Earthquake Damage Workshop (PEER-CEA Project). Pacific Earthquake Engineering Research Center, University of California, Berkeley, CA, November 2020. http://dx.doi.org/10.55461/plbd5536.
Full textAbstract:
This report is one of a series of reports documenting the methods and findings of a multi-year, multi-disciplinary project coordinated by the Pacific Earthquake Engineering Research Center (PEER and funded by the California Earthquake Authority (CEA). The overall project is titled “Quantifying the Performance of Retrofit of Cripple Walls and Sill Anchorage in Single-Family Wood-Frame Buildings,” henceforth referred to as the “PEER–CEA Project.” The overall objective of the PEER–CEA Project is to provide scientifically based information (e.g., testing, analysis, and resulting loss models) that measure and assess the effectiveness of seismic retrofit to reduce the risk of damage and associated losses (repair costs) of wood-frame houses with cripple wall and sill anchorage deficiencies as well as retrofitted conditions that address those deficiencies. Tasks that support and inform the loss-modeling effort are: (1) collecting and summarizing existing information and results of previous research on the performance of wood-frame houses; (2) identifying construction features to characterize alternative variants of wood-frame houses; (3) characterizing earthquake hazard and ground motions at representative sites in California; (4) developing cyclic loading protocols and conducting laboratory tests of cripple wall panels, wood-frame wall subassemblies, and sill anchorages to measure and document their response (strength and stiffness) under cyclic loading; and (5) the computer modeling, simulations, and the development of loss models as informed by a workshop with claims adjustors. This report is a product of Working Group 6 (WG6): Interaction with Claims Adjustors & Catastrophe Modelers and focuses on a damage workshop effort undertaken to provide repair estimates of representative damaged single-family wood-frame case study buildings to compare the differences in costs between houses with and without retrofits to cripple walls and sill anchorage. At the request of the CEA, 11 experienced claims adjustors from insurance companies volunteered to provide the estimates. Electronic cost estimation files for each case study building were developed by the PEER–CEA Project Team using the Verisk Xactware Xactimate X1 platform and provided to the claims adjustors to complete their estimates. These adjustor estimates served as the baseline for comparison against the FEMA P-58 [FEMA 2012] methodology used on the project for loss estimation. The term “damage workshop effort” is used to emphasize that the scope of work included not just a successful workshop meeting, but the broader development of a damage description package describing case studies and associated Xactimate descriptions before the workshop meeting and revisions after it, two rounds of estimates and survey question responses by adjustors, interpretation and clarification of the estimates for consistency, and synthesizing of estimate findings and survey responses into conclusions and recommendations. Three building types were investigated, each with an unretrofitted and a retrofitted condition. These were then assessed at four levels of damage, resulting in a total of 24 potential scenarios. Because of similarities, only 17 scenarios needed unique Xactimate estimates. Each scenario was typically estimated by three to five adjustors, resulting in a final total of 74 different estimates.
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Mazzoni, Silvia, Nicholas Gregor, Linda Al Atik, Yousef Bozorgnia, David Welch, and Gregory Deierlein. Probabilistic Seismic Hazard Analysis and Selecting and Scaling of Ground-Motion Records (PEER-CEA Project). Pacific Earthquake Engineering Research Center, University of California, Berkeley, CA, November 2020. http://dx.doi.org/10.55461/zjdn7385.
Full textAbstract:
This report is one of a series of reports documenting the methods and findings of a multi-year, multi-disciplinary project coordinated by the Pacific Earthquake Engineering Research Center (PEER) and funded by the California Earthquake Authority (CEA). The overall project is titled “Quantifying the Performance of Retrofit of Cripple Walls and Sill Anchorage in Single-Family Wood-Frame Buildings,” henceforth referred to as the “PEER–CEA Project.” The overall objective of the PEER–CEA Project is to provide scientifically based information (e.g., testing, analysis, and resulting loss models) that measure and assess the effectiveness of seismic retrofit to reduce the risk of damage and associated losses (repair costs) of wood-frame houses with cripple wall and sill anchorage deficiencies as well as retrofitted conditions that address those deficiencies. Tasks that support and inform the loss-modeling effort are: (1) collecting and summarizing existing information and results of previous research on the performance of wood-frame houses; (2) identifying construction features to characterize alternative variants of wood-frame houses; (3) characterizing earthquake hazard and ground motions at representative sites in California; (4) developing cyclic loading protocols and conducting laboratory tests of cripple wall panels, wood-frame wall subassemblies, and sill anchorages to measure and document their response (strength and stiffness) under cyclic loading; and (5) the computer modeling, simulations, and the development of loss models as informed by a workshop with claims adjustors. This report is a product of Working Group 3 (WG3), Task 3.1: Selecting and Scaling Ground-motion records. The objective of Task 3.1 is to provide suites of ground motions to be used by other working groups (WGs), especially Working Group 5: Analytical Modeling (WG5) for Simulation Studies. The ground motions used in the numerical simulations are intended to represent seismic hazard at the building site. The seismic hazard is dependent on the location of the site relative to seismic sources, the characteristics of the seismic sources in the region and the local soil conditions at the site. To achieve a proper representation of hazard across the State of California, ten sites were selected, and a site-specific probabilistic seismic hazard analysis (PSHA) was performed at each of these sites for both a soft soil (Vs30 = 270 m/sec) and a stiff soil (Vs30=760 m/sec). The PSHA used the UCERF3 seismic source model, which represents the latest seismic source model adopted by the USGS [2013] and NGA-West2 ground-motion models. The PSHA was carried out for structural periods ranging from 0.01 to 10 sec. At each site and soil class, the results from the PSHA—hazard curves, hazard deaggregation, and uniform-hazard spectra (UHS)—were extracted for a series of ten return periods, prescribed by WG5 and WG6, ranging from 15.5–2500 years. For each case (site, soil class, and return period), the UHS was used as the target spectrum for selection and modification of a suite of ground motions. Additionally, another set of target spectra based on “Conditional Spectra” (CS), which are more realistic than UHS, was developed [Baker and Lee 2018]. The Conditional Spectra are defined by the median (Conditional Mean Spectrum) and a period-dependent variance. A suite of at least 40 record pairs (horizontal) were selected and modified for each return period and target-spectrum type. Thus, for each ground-motion suite, 40 or more record pairs were selected using the deaggregation of the hazard, resulting in more than 200 record pairs per target-spectrum type at each site. The suites contained more than 40 records in case some were rejected by the modelers due to secondary characteristics; however, none were rejected, and the complete set was used. For the case of UHS as the target spectrum, the selected motions were modified (scaled) such that the average of the median spectrum (RotD50) [Boore 2010] of the ground-motion pairs follow the target spectrum closely within the period range of interest to the analysts. In communications with WG5 researchers, for ground-motion (time histories, or time series) selection and modification, a period range between 0.01–2.0 sec was selected for this specific application for the project. The duration metrics and pulse characteristics of the records were also used in the final selection of ground motions. The damping ratio for the PSHA and ground-motion target spectra was set to 5%, which is standard practice in engineering applications. For the cases where the CS was used as the target spectrum, the ground-motion suites were selected and scaled using a modified version of the conditional spectrum ground-motion selection tool (CS-GMS tool) developed by Baker and Lee [2018]. This tool selects and scales a suite of ground motions to meet both the median and the user-defined variability. This variability is defined by the relationship developed by Baker and Jayaram [2008]. The computation of CS requires a structural period for the conditional model. In collaboration with WG5 researchers, a conditioning period of 0.25 sec was selected as a representative of the fundamental mode of vibration of the buildings of interest in this study. Working Group 5 carried out a sensitivity analysis of using other conditioning periods, and the results and discussion of selection of conditioning period are reported in Section 4 of the WG5 PEER report entitled Technical Background Report for Structural Analysis and Performance Assessment. The WG3.1 report presents a summary of the selected sites, the seismic-source characterization model, and the ground-motion characterization model used in the PSHA, followed by selection and modification of suites of ground motions. The Record Sequence Number (RSN) and the associated scale factors are tabulated in the Appendices of this report, and the actual time-series files can be downloaded from the PEER Ground-motion database Portal (https://ngawest2.berkeley.edu/)(link is external).