Neuropsychological Assessment in Patients with Sickle Cell Disease
|
|
- Sheena Strickland
- 5 years ago
- Views:
Transcription
1 Neurpsychlgical Assessment in Patients with Sickle Cell Disease Dr. Heather Rawle (Cnsultant Clinical/Health Psychlgist, GSTT - Adults) Gary Bridges (Cunselling Psychlgist, KCH - Adults) Dr. Natalie Ck (Clinical Psychlgist, KCH - Paediatrics) Thanks t Dr. Carline Jhnsn (GSTT) and Dr. Hatal Bhatt (GSTT) Why Assess? Individuals with SCD f all ages are at higher risk f cerebrvascular cmplicatins, such as acute ischaemic and haemrrhagic strke and silent cerebral infarcts (SCI) This can result in cgnitive deficits that impact upn their cmmunicatin with prviders, medical adherence, academic and ccupatinal achievement and verall quality f life. 1
2 Strkes in SCD Chances f having first strke by SS SC 20 years f age 11% 2% 30 years 15% 4% 45 years 24% 10% (CSSCD, Ohene-Frempng et al, 1998) 250 times mre cmmn in SCD than in ther children If untreated, risk f recurrence (ischaemic strke) = 50-92% Will ften damage bth grey and white matter Leading cause f mrbidity and mrtality in SCD. Cmmnly encuntered patterns f cgnitive impairment after strke Aphasias - impairments f language Apraxias - impairments that affect limb mvement and speech Visuperceptual and visuspatial disrders - disrders f visual recgnitin (agnsias), visuspatial abilities and visual neglect Memry impairments fr events prir t the strke (retrgrade memry) ability t lay dwn new memries (antergrade memry) the inability t retain and manipulate infrmatin fr a shrt time (wrking memry) 2
3 Cmmnly encuntered patterns f cgnitive impairment after strke Executive dysfunctin impairments in cnceptual reasning, cgnitive flexibility, planning, prblem slving, etc. Attentinal impairments and speed f infrmatin prcessing General intellectual functining (i.e. I.Q) Persnality / behaviur changes Silent Cerebral Infarcts (SCI) Silent cerebral infarcts ( silent strke ) Mst cmmn frm f neurlgical injury in children with SCD Prevalence increases during childhd: 10% in infants 28% by age 5 37% by age 15 Prevalence cntinues t increase thrughut adulthd Typically ccur within small vessels, generally cnfined t deep white matter, and invlve nn-mtr areas f the brain (esp. frntal crtex) Increased risk fr further vert and silent strkes. 3
4 Impact f SCI in SCD Cgnitive difficulties Glbal cgnitive dysfunctin, particularly nn-verbal IQ Prcessing speed Wrking memry Executive functin (planning, prblem slving, rganisatin, inhibitin, respnse mnitring, mental flexibility) Attentin, divided attentin / switching (Berkelhammer et al, 2007; Mackin et al, 2014; Rawle et al, 2010; Vichinsky et al, 2010) In children, difficulties becme mre apparent in later stages f primary educatin, when intellectual demands increase Pr schl/wrk perfrmance Deficits in measures f executive functining and attentin/cncentratin Difficulties with paying attentin, shrt-term memry, rganising and planning schl wrk, initiating tasks and staying fcused n them, regulating emtins, self-mnitring. Impact f SCI in SCD Cgnitive difficulties Cgnitive impairments tend t be mre severe when patients have abnrmal MRIs, but significant cgnitive impairment in sme patients with nrmal MRIs MRIs nt sphisticated enugh t detect sme brain changes; pr perfusin; effects f pain Level f anaemia is mre predictive (Vichinsky et al., 2010). 4
5 Standards f Care Sickle Cell Disease in Childhd: Standards and Guidelines (2006); Standards fr Management f Sickle Cell Disease in Childhd (2008) Regular neurpsychlgical screenings and mnitring f schl attainment shuld be carried ut n a regular basis Patients shuld have access t a neurpsychlgist within the MDT. Standards fr the Clinical Care f Adults with Sickle Cell Disease in the UK (draft 2017); Peer Review Standards fr Sickle Cell Disease (updated draft 2017) Patients shuld have access t neurpsychlgy via a defined pathway What is a neurpsychlgical/ cgnitive assessment Interview Medical, Educatinal, Emplyment, Family, Develpmental, Language, Migratin histry reasns and stressrs Cping, Views f prblems (memry diary) Md, Pain Infrmatin frm ther surces Health/Scial Educatinal recrds/feedback frm schl HCPs and family members Research literature 5
6 What is a neurpsychlgical/ cgnitive assessment Assessment f cgnitive dmains Memry, Attentin, Prcessing Speed, Language, Executive Functin, Visual-Spatial/Perceptin, Intellectual Functining, Wrd Reading, Reading Cmprehensin, Mathematics, Listening Cmprehensin, Spelling Interpretatin and recmmendatin Feedback and liaisn Patient/Family/Carers HCPs Emplyers/Schl/Cllege/SENC Can prvide supprt fr Educatin Health Care Plan (EHCP) Onward referrals Current Service Mdel in Paediatric Sickle Cell & Thalassaemia Service (KCL) Referral t Clinical Psychlgy Psychlgy Assessment Semi-structured interview (90 mins) Liaisn with educatinal services Psychmetric assessment Neurpsychlgical Assessment Cgnitive Ability (2-3 hurs) Schlastic Achievement (1-2 hurs) Further assessment if required Fllw-up F/U appintment ffered t all families t discuss assessment findings Recmmendatins f apprpriate educatinal, psychlgical r medical interventins Liaisn with schl/educatinal services (EHCP) Sign-psting/referral t ther services where apprpriate (e.g. SALT, OT) Discharge 6
7 Tests used with Adults IQ: WAIS-IV UK; WAIS-III UK; shrtened versins Premrbid IQ TOPF; WTAR Memry WMS-IV UK; WMS-III UK; RBMT Executive Functining: Hayling and Brixtn; Verbal & Categry Fluency; BADs key search, z map; Trail Making Test (TMT A&B): DKEFS Trails Visuspatial: VOSP Attentin: WAIS subtests; Test f Everyday Attentin Tests f Effrt: WAIS subtests Tests used with Children & Adlescents Cgnitive ability/iq: WPPSI (age range: 2:6 7:7) WISC-V; WISC-IV (age range: 6:0 16:11) WAIS-IV UK (age range: 17:0+) Schlastic Achievement WIAT-II (age range: 4:0 16:11) WIAT-III (age range: 4:0 25:11) Further assessment NEPSY-II (age range: 3:0 16:11) Attentin and executive functining; Language; Memry and Learning; Sensrimtr; Scial Perceptin; Visuspatial Prcessing Children s Memry Scale (age range: 5:0 16:11) D-KEFS (age range: 8:0 89:00) Psychmetric assessment: Cnnrs 3 rd Editin (Selfreprt/Parent/Teacher versins) Behaviur Rating f Executive Functin (BRIEF) (Parent/Teacher versins) Strengths and difficulties questinnaire (SDQ) (Selfreprt/Parent/Teacher versins) Revised Children's Anxiety and Depressin Scale (RCADS) (Selfreprt/Parent) 7
8 Cmplexities SCD and strke Duble time fr interview: Language, culture, educatin Hw SCD affects persn pain, fatigue, expectatins Strkes: Hemiparesis/plegia, sensry, arusal, dysphasia, dysarthria, apraxia, ataxia, fatigue, sleep, epilepsy, pain, cgnitive impairments SCD: Cultural, educatinal backgrund, language Multiple strkes/silent strkes ver time Pain, medicatin, depressin, anxiety Lack f inf frm thers as ften islated Premrbid IQ? (lack f inf) Impact f SCD n schl ach; expectatins f self Csts and time Neurpsychlgical testing is a scarce resurce Nt widely available and time cnsuming Therefre has nt regularly been integrated int rutine clinical care fr patients with sickle cell disease The Vichinsky et al (2010) study invlved a 6-hur neurpsychlgical battery, administered by a trained neurpsychlgist Future? Cmputerised testing NIH Tlbx - Cgnitin Battery (NIHTB-CB) ( Need t ensure this cntributes t a meaningful assessment when using it in clinical setting Q-Interactive testing ( using ipads Create unique, client-centric batteries at bth the instrument and subtest levels Imprves administratin accuracy and speed, prvides real time scring, and allws fr flexibility in just a few simple taps. 8
9 T screen r nt t screen If strke histry and reprting cncerns: Indicates cmprehensive assessment (s screen nt required) SCD patients tend t be yunger strke screening measures culd still lack sensitivity (risk false negatives) If silent strkes/n strke histry: Lack f sensitivity (risk false negatives) Nt in cntext f cgnitive assessment meaningless Dn t have enugh infrmatin t frmulate why patient is presenting as they are cannt make meaningful recmmendatins Ethical dilemma What happens if they have a pr scre, but n service fr a cmprehensive assessment? Self fulfilling prphecy Lw scre anxiety perfrm wrse Factrs affecting screening scres e.g. why may the patient present with a lw prcessing speed scre? Fatigue Lw md Anxiety Trauma Pain Analgesia Other medicatins Effects n brain f strke/silent strke Part f glbal picture f lwer scres e.g. Learning disability Malingering 9
10 Cnclusins Clinicians shuld be aware f the risk f cgnitive impairment in patients with SCD, even amng thse with nrmal MRI scans this may impact n patient s understanding, decisin-making, and adherence t treatments Neurpsychlgical assessments fr patients with SCD are useful t highlight cgnitive impairments that may therwise be unnticed by clinicians, and be a useful way f identifying thse wh require supprt (e.g. at schl, university, wrk) Simple screening tls are nt apprpriate fr clinical use in this ppulatin. Questins? 10
Psychological aspects of breast cancer. Dr Caroline Dancyger & Dr Esther Hansen
Psychlgical aspects f breast cancer Dr Carline Dancyger & Dr Esther Hansen Cmmn acrss all cancers Adjustment as the nrm Diagnsis End f active treatment r Discharge Palliative Care Recurrence distress t
More informationThe Interface Between Theory of Mind and Language Impairment
The Interface Between Thery f Mind and Language Impairment By Lauren Lwry Hanen Certified SLP and Clinical Staff Writer When mst f us hear the term thery f mind we usually think abut children with autism
More informationSwindon Joint Strategic Needs Assessment Bulletin
Swindn Jint Strategic Needs Assessment Bulletin Swindn Diabetes 2017 Key Pints: This JSNA gives health facts abut peple with diabetes r peple wh might get diabetes in Swindn. This helps us t plan fr medical
More informationPROVIDER ALERT. Comprehensive Diagnostic Evaluation (CDE) Guidelines to Access the Applied Behavior Analysis (ABA) Benefit.
Cmprehensive Diagnstic Evaluatin (CDE) Guidelines t Access the Applied Behavir Analysis (ABA) Benefit May 5, 2017 Clinical infrmatin that utlines medical necessity is required t supprt the need fr initial
More informationPSYCHOSEXUAL ASSESSMENTS for Children and Adolescents with Problematic Sexual Behavior. Who is qualified to conduct a psychosexual evaluation?
PSYCHOSEXUAL ASSESSMENTS fr Children and Adlescents with Prblematic Sexual Behavir When a child r adlescent is suspected r bserved t have engaged in what may be sexually inapprpriate r sexually aggressive
More informationModule 6: Goal Setting
Mdule 6: Gal Setting Objectives T understand the cncept f gal setting in Brief CBT T acquire skills t set feasible and apprpriate gals in Brief CBT What is gal setting, and why is it imprtant t set gals
More informationManaging the Symptoms of Stroke
Unit 26: Recgnising and Managing the Symptms f Strke Unit reference number: F/616/7312 Level: 2 Unit type: Optinal Credit value: 3 Guided learning hurs: 28 Unit summary A strke can be a life-threatening
More informationIssues in Student-Athlete Mental Health: How Can Student Affairs Help? Shawn Zeplin, Psy.D. Staff/ Sport Psychologist ISU SCS Redbird Athletics
Issues in Student-Athlete Mental Health: Hw Can Student Affairs Help? Shawn Zeplin, Psy.D. Staff/ Sprt Psychlgist ISU SCS Redbird Athletics Intrductin Wh am I? Why are we here? Overview: What d I d? What
More informationof Communication and Interactions with Individuals who have Dementia
Unit 15: Understanding the Rle f Cmmunicatin and Interactins with Individuals wh have Dementia Unit reference number: H/616/7299 Level: 3 Unit type: Optinal Credit value: 3 Guided learning hurs: 26 Unit
More informationTable 3: Neurodevelopmental domains: criteria for severe impairment
Table 3: Neurdevelpmental dmains: criteria fr severe impairment 1. Brain Structure / neurlgy Definitin Direct/indirect assessment Cnsideratins Brain structure and neurlgy includes: Abnrmal ccipitfrntal
More informationABOUT ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)
ABOUT ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) Many tddlers and yung children are restless and excitable. This is nrmal, as they have lts f energy and are cnstantly learning abut the wrld and mving
More informationIll Health. Unit reference number: L/616/7295 Level: 3. Credit value: 3 Guided learning hours: 16. Unit summary
Unit 11: Understand Mental Ill Health Unit reference number: L/616/7295 Level: 3 Unit type: Optinal Credit value: 3 Guided learning hurs: 16 Unit summary Mental ill health culd be ne f the mst serius health
More informationIowa Early Periodic Screening, Diagnosis and Treatment Care for Kids Program Provider Training
Iwa Early Peridic Screening, Diagnsis and Treatment Care fr Kids Prgram Prvider Training The Early Peridic Screening, Diagnsis and Treatment (EPSDT) Care fr Kids prgram is Iwa s Medicaid prgram fr children.
More informationCOPING WITH STRESS IN PARENTS OF CHILDREN AFTER RENAL TRANSPLANTATION
COPING WITH STRESS IN PARENTS OF CHILDREN AFTER RENAL TRANSPLANTATION Mgr. Lucia Lukackva Mgr. Zuzana Kcabva University Hspital Mtl Sectin fr Pediatric Nephrlgy Prague, Czech Republic Research gals pint
More informationEXPLORING THE PROCESS OF ASSESSMENT AND OTHER RELATED CONCEPTS
1 SECTION 1 INTRODUCTION: EXPLORING THE PROCESS OF ASSESSMENT AND OTHER RELATED CONCEPTS The Nature Of Assessment The Definitin Of Assessment The Difference Between Testing, Measurement And Evaluatin Characteristics
More informationBreast Cancer Awareness Month 2018 Key Messages (as of June 6, 2018)
Breast Cancer Awareness Mnth 2018 Key Messages (as f June 6, 2018) In this dcument there are tw sectins f messages in supprt f Cancer Care Ontari s Breast Cancer Awareness Mnth 2018: 1. Campaign key messages
More informationDepression in Dementia and Vice Versa
Depressin in Dementia and Vice Versa Practical suggestins t imprve quality f life in peple with dementia and their carers. Dr Sfia Rbleda, Clinical Psychlgist Overview Brief verview f nrmal ageing prcesses
More informationPsychology Class 11 Syllabus
Psychlgy Class 11 Syllabus Curse Structure Unit Tpic Marks I What is Psychlgy? 7 II Methds f Enquiry in Psychlgy 10 III The Bases f Human Behaviur 8 IV Human Develpment 6 V Sensry, Attentinal and Perceptual
More informationMemory Screening Site s PROGRAM HANDBOOK
Memry Screening Site s PROGRAM HANDBOOK 866-232-8484 www.alzfdn.rg/memry-screening/ Table f Cntents Page 3 Page 5 Page 6 Page 7 Page 8 Page 10 Page 12 Page 13 All Abut the Natinal Memry Screening Prgram
More informationChronic Fatigue Syndrome
Chrnic Fatigue Syndrme (Als knwn as Myalgic encephalmyelitis/encephalmyelpathy) What is CFS/ME? CFS/ME cmprises a range f symptms that include fatigue, malaise, headaches, sleep disturbances, difficulties
More informationPET FORM Planning and Evaluation Tracking ( Assessment Period)
Divisin f: Behaviral Studies PET FORM Planning and Evaluatin Tracking (2010 2011 Assessment Perid) Persn Respnsible fr this Divisin: Jerry Mller Department f: Behaviral Sciences Persn Respnsible fr this
More informationAwareness of Autistic Spectrum Conditions
Unit 21: Awareness f Autistic Spectrum Cnditins Unit reference number: H/616/7304 Level: 2 Unit type: Optinal Credit value: 2 Guided learning hurs: 17 Unit summary This unit intrduces yu t autistic spectrum
More informationAdvantage EAP Employee Assistance Program
Advantage EAP Emplyee Assistance Prgram July 2014 In This Issue What might we face? Symptms f SAD Seasnal changes in biplar disrder Tips fr cmbating summer truble When t seek help Tips fr helping thse
More informationChapter 6: Impact Indicators
Overview Chapter 6: Impact Indicatrs The best measure f the lng-term impact f all HIV preventin activities is the HIV incidence rate, namely the number f new cases f HIV infectin per year divided by the
More informationApproaches to the Care and Support of Individuals with Dementia
Unit 14: Persn-centred Appraches t the Care and Supprt f Individuals with Dementia Unit reference number: H/601/2879 Level: 2 Unit type: Optinal Credit value: 2 Guided learning hurs: 17 Unit summary Understanding
More informationEMDR EUROPE ACCREDITED PRACTITIONER COMPETENCY BASED FRAMEWORK
EMDR EUROPE ACCREDITED PRACTITIONER COMPETENCY BASED FRAMEWORK Guidelines fr Accreditatin as an EMDR Eurpe Accredited Practitiner Applicants must have cmpleted EMDR Basic training by a recgnised EMDR Eurpe
More informationFOUNDATIONS OF DECISION-MAKING...
Table f Cntents FOUNDATIONS OF DECISION-MAKING... Errr! Bkmark nt Describe the decisin-making prcess pp.62-66... Errr! Bkmark nt Explain the three appraches managers can use t make decisins pp.67-70 Errr!
More informationIndividual Assessments for Couples Treatment with HFCA
Individual Assessments fr Cuples Treatment with HFCA Jennifer S. Ripley, Ph.D. Many appraches t cuples therapy include an individual assessment whenever a cuple cmes fr treatment. Therapists shuld be aware
More informationMeeting the Nutritional Requirements of Individuals with Dementia
Unit 15: Understanding and Meeting the Nutritinal Requirements f Individuals with Dementia Unit reference number: D/616/7124 Level: 3 Unit type: Optinal Credit value: 3 Guided learning hurs: 26 Unit summary
More informationFor our protection, we require verification that you have received this notice. Therefore, please sign below.
PATIENT INFORMATION Dear Patient: Sleep prblems are extremely cmmn. Public health and safety are threatened by the increasing prevalence f bstructive sleep apnea, which nw afflicts at least 25 millin adults
More informationMEASURE #10: PLAN OF CARE FOR MIGRAINE OR CERVICOGENIC HEADACHE DEVELOPED OR REVIEWED Headache
MEASURE #10: PLAN OF CARE FOR MIGRAINE OR CERVICOGENIC HEADACHE DEVELOPED OR REVIEWED Headache Measure Descriptin All patients diagnsed with migraine headache r cervicgenic headache wh had a headache management
More informationThe principles of evidence-based medicine
The principles f evidence-based medicine By the end f this mdule yu shuld be able t: Describe what evidence based medicine is Knw where t find quality evidenced based medicine n the internet Be able t
More informationAssessment Field Activity Collaborative Assessment, Planning, and Support: Safety and Risk in Teams
Assessment Field Activity Cllabrative Assessment, Planning, and Supprt: Safety and Risk in Teams OBSERVATION Identify a case fr which a team meeting t discuss safety and/r safety planning is needed r scheduled.
More informationFIGHT DEMENTIA ACTION PLAN
FIGHT DEMENTIA ACTION PLAN DEMENTIA IS A HEALTH PRIORITY Dementia will be the majr health prblem f this century. Over ne millin Australians are already affected by the disease themselves r are caring fr
More information2012 Indiana Parent/Family Needs Assessment Survey
Reprt t the Legislative Cmmissin n Autism: 2012 2012 Indiana Parent/Family Needs Assessment Survey Cnducted By: Cathy Pratt, Ph.D., BCBA-D Directr Sctt Bellini, Ph.D. Prfessr, Schl f Educatin Indiana Resurce
More informationTrue Patient & Partner Engagement How is it done? How can I do it?
True Patient & Partner Engagement Hw is it dne? Hw can I d it? GROUP TECHNICAL ASSISTANCE JANUARY 18, 2017 COLORADO FOUNDATION FOR PUBLIC HEALTH AND THE ENVIRONMENT Webinar Objectives 1. Describe patient
More informationCSHCN Services Program Benefits to Change for Outpatient Behavioral Health Services Information posted November 10, 2009
CSHCN Services Prgram Benefits t Change fr Outpatient Behaviral Health Services Infrmatin psted Nvember 10, 2009 Effective fr dates f service n r after January 1, 2010, benefit criteria fr utpatient behaviral
More informationHospital Preparedness Checklist
Hspital Preparedness Checklist http://pandemicflu.gv Preparedness Subject 1. Structure fr planning and decisin making An internal, multidisciplinary planning cmmittee fr influenza preparedness has been
More informationACSQHC National Consensus Statement: Essential Elements for High Quality End-oflife Care in Acute Hospitals.
27 March 2014 Prfessr Debra Picne Chief Executive Officer Australian Cmmissin n Safety and Quality in Health Care c/ Ms Jennifer Hill, Senir Prject Officer Level 5, 255 Elizabeth Street SYDNEY NSW 2000
More informationStrategic Plan Publication No: EO-SP
Strategic Plan 2017-2019 Publicatin N: EO-SP-170223 +61 2 9036 5002 www.pcg.rg.au pcg.ffice@sydney.edu.au This dcument was prepared by the PCG Executive Office PCG Publicatin number: EO-SP-170223 Psych-nclgy
More informationHarold P. Adams, Jr., MD Department of Neurology Carver College of Medicine UIHC Comprehensive Stroke Center University of Iowa
Harld P. Adams, Jr., MD Department f Neurlgy Carver Cllege f Medicine UIHC Cmprehensive Strke Center University f Iwa D nt receive persnal cmpensatin frm cmmercial interests D receive grant supprt frm
More informationDEMENTIA. DESCRIPTION: a progressive, degenerative disease of the brain, which causes impairment of thinking and memory
DEMENTIA Dementia a syndrme cnsisting f a number f symptms including lss f memry, judgment and reasning, and changes in md and behavir the changes may affect a persn's ability t functin at wrk, in scial
More information23/11/2015. Introduction & Aims. Methods. Methods. Survey response. Patient Survey (baseline)
Intrductin & Aims Drug and Alchl Cnsultatin Liaisn (AOD CL) services aim t imprve identificatin and treatment f patients with AOD mrbidity. The csts and cnsequences f targeting AOD patients presenting
More informationFor our protection, we require verification that you have received this notice. Therefore, please sign below.
PATIENT INFORMATION Dear Patient: Sleep prblems are extremely cmmn. Public health and safety are threatened by the increasing prevalence f bstructive sleep apnea, which nw afflicts at least 25 millin adults
More informationUS Public Health Service Clinical Practice Guidelines for PrEP
Webcast 1.3 US Public Health Service Clinical Practice Guidelines fr PrEP P R E S ENTED BY: M A R K T H R U N, M D A S S O C I AT E P R O F E S S O R, U N I V E R S I T Y O F C O L O R A D O, D I V I S
More informationContinuous Quality Improvement: Treatment Record Reviews. Third Thursday Provider Call (August 20, 2015) Wendy Bowlin, QM Administrator
Cntinuus Quality Imprvement: Treatment Recrd Reviews Third Thursday Prvider Call (August 20, 2015) Wendy Bwlin, QM Administratr Gals f the Presentatin Review the findings f Treatment Recrd Review results
More informationTopic PHOBIAS. (Student name) (Department name) (Professor name) (Date)
Tpic PHOBIAS (Student name) (Department name) (Prfessr name) (Date) Phbias: hw peple develp phbias and why? What is a Phbia? Phbia may be defined as an irresistibly unreasnable feeling f fear anything
More informationSensory Loss. Unit reference number: M/616/7368 Level: 3. Credit value: 3 Guided learning hours: 21. Unit summary
Unit 18: Understanding Sensry Lss Unit reference number: M/616/7368 Level: 3 Unit type: Optinal Credit value: 3 Guided learning hurs: 21 Unit summary Sensry lss can affect individuals in different ways.
More informationPennsylvania Guidelines on the Use of Opioids to Treat Chronic Noncancer Pain
Pennsylvania Guidelines n the Use f Opiids t Treat Chrnic Nncancer Pain Chrnic pain is a majr health prblem in the United States, ccurring with a pintprevalence f abut ne-third f the US ppulatin.(1) Mre
More informationChapter 5 Anxiety Disorders
Test Review 2 Chapter 5 Anxiety Disrders Mst cmmn and effective frm f treatment = Expsure Anxiety Disrders Mst cmmn psychiatric disrders Phbias mst cmmn f the anxiety disrders Often Cmrbid with Majr Depressin
More informationSay Goodbye to Test Anxiety. Kortschak Center for Learning and Creativity University of Southern California Presented by: Eliza Peña
Say Gdbye t Test Anxiety Krtschak Center fr Learning and Creativity University f Suthern Califrnia Presented by: Eliza Peña 1 Learning Objective By the end f this wrkshp, students will be able t: Recgnize
More informationEDPS 475: Instructional Objectives for Midterm Exam Behaviorism
EDPS 475: Instructinal Objectives fr Midterm Exam Behavirism 1. Given a nvel example t chse frm, identify the characteristics f classical cnditining. General mdel: Stimulus (S) elicits >Respnse (R) Based
More informationHSC 106 Personal Health Plan for Learning Activities & Assessment linked to Michigan Teacher Preparation Standards
HSC 106 Persnal Health Plan fr Learning Activities & Assessment linked t Michigan Teacher Preparatin Standards Standard 1 Cmpetency 1.1 Understand basic health cntent as it relates t schl health educatin.
More informationInstructions regarding referral of patients to the Persistent Pain Service
Prtsmuth Persistent Pain Service Lng Term Cnditins Suite Grund Flr, Blck A St Mary s Cmmunity Health Campus Miltn Rad Prtsmuth Hampshire PO3 6AD Tel: 23 9268 485 Fax: 23 9268 21 Dear GP Instructins regarding
More informationEXECUTIVE SUMMARY INNOVATION IS THE KEY TO CHANGING THE PARADIGM FOR THE TREATMENT OF PAIN AND ADDICTION TO CREATE AN AMERICA FREE OF OPIOID ADDICTION
EXECUTIVE SUMMARY INNOVATION IS THE KEY TO CHANGING THE PARADIGM FOR THE TREATMENT OF PAIN AND ADDICTION TO CREATE AN AMERICA FREE OF OPIOID ADDICTION The Bitechnlgy Innvatin Organizatin (BIO) and ur member
More informationWeight Assessment and Counseling for Children and Adolescents (NQF 0024)
Weight Assessment and Cunseling fr Children and Adlescents (NQF 0024) EMeasure Name Weight Assessment and EMeasure Id Pending Cunseling fr Children and Adlescents Versin Number 1 Set Id Pending Available
More informationCompleting the NPA online Patient Safety Incident Report form: 2016
Cmpleting the NPA nline Patient Safety Incident Reprt frm: 2016 The infrmatin cntained within this dcument is in line with the current Data Prtectin Act (DPA) requirements. This infrmatin may be subject
More informationCastilion Primary School. Spiritual Moral Social and Cultural Education Policy
Spiritual Mral Scial and Cultural Educatin Plicy Intrductin recgnises that the persnal develpment f pupils, spiritually, mrally, scially and culturally, plays a significant part in their ability t learn
More informationImproving Surveillance and Monitoring of Self-harm in Irish Prisons
HSE Mental Health Divisin Stewart s Hspital, Palmerstwn, Dublin 20 Tel: 01 6201670 Email: inf@nsp.ie www.nsp.ie Imprving Surveillance and Mnitring f Self-harm in Irish Prisns Prject Scpe Dcument 8 th June
More information2. As a caregiver, it s important to build a team/ support network around you (choose one):
Test Questins (Part 1, Chapter 1) 1. Of thse affected by dementia: 50% are nt aware they are changing and 50% are aware they are changing. Of the 50% wh are aware, they will always respnd by becming anxius
More informationConcept paper on the need for revision of the guideline on clinical investigation of medicinal products in the treatment of depression
1 2 3 10 Nvember 2016 EMA/CHMP/183826/2016 Cmmittee fr Medicinal Prducts fr Human Use (CHMP) 4 5 6 7 Cncept paper n the need fr revisin f the guideline n clinical investigatin f medicinal prducts in the
More informationHumanities and Social Sciences Division. o Work Experience, General. o Open Entry/Exit. Distance (Hybrid Online) for online supported courses
SECTION A - Curse Infrmatin 1. Curse ID: 2. Curse Title: 3. Divisin: 4. Department: 5. Subject: 6. Shrt Curse Title: 7. Effective Term:: SIGN 108 Fingerspelling Humanities and Scial Sciences Divisin Sign
More informationWho is eligible for LifeCare? What services are available?
Wh is eligible fr LifeCare? What services are available? LifeCare is an emplyer prvided wrk/life benefit frm The University f Texas at Austin available t all benefits eligible emplyees and their husehld
More informationHealth for Life Chiropractic At Cloverdale Mall Unit # The East Mall Etobicoke, ON, M9B 3Y
Health fr Life Chirpractic At Clverdale Mall Unit #143-250 The East Mall Etbicke, ON, M9B 3Y8 416-232-1822 416-232-0060 Child and Adlescent Health Questinnaire Name:_ Birth date: Address:_ Telephne: Medical
More informationMedication Assisted Treatment for Opioid Use Disorder in Rural Colorado
Medicatin Assisted Treatment fr Opiid Use Disrder in Rural Clrad Why is piid use disrder getting s much attentin? Opiid Use Disrder (OUD) has seen an epidemic rise in the United States ver the past decade.
More informationState Health Improvement Plan Choosing Priorities, Creating a Plan. DHHS DPH - SHIP Priorities (Sept2016) 1
State Health Imprvement Plan 2017-2021 Chsing Pririties, Creating a Plan DHHS DPH - SHIP Pririties (Sept2016) 1 Creating a Plan: 2017-2021 SHIP Welcme! Wh s here? What is the State Health Imprvement Plan
More informationStructured Assessment using Multiple Patient. Scenarios (StAMPS) Exam Information
Structured Assessment using Multiple Patient Scenaris (StAMPS) Exam Infrmatin 1. Preparing fr the StAMPS assessment prcess StAMPS is an assessment mdality that is designed t test higher rder functins in
More informationSub-Topic: Massage for Depression, Anxiety, and Sleep Disorders Level 1 Knowledge: Attain and Comprehend Skills: Observe and Imitate
Nte: Feedback frm prfessin stakehlders n the first draft f the Entry-Level Massage Educatin Blueprint indicated that this sub-tpic was beynd entry-level r unnecessary fr safe and cmpetent practice. The
More informationReferral Criteria: Inflammation of the Spine Feb
Referral Criteria: Inflammatin f the Spine Feb 2019 1 5.7. Inflammatin f the Spine Backgrund Ankylsing spndylitis and axial spndylarthrpathy are fund in arund 0.3-1.2% f the ppulatin. Spndylarthritis encmpasses
More informationThe Psychology of. Thinking Grey about Testing
The Psychlgy f Testing Thinking Grey abut Testing I am: The Test Practice Manager fr the New Zealand Department f A hlder f an Hnurs Internal Degree Affairs in Cgnitive Psychlgy and Philsphy N, we are
More informationManagement of autism
MANAGEMENT OF AUTISM Autism Develpmental disrder Lifelng disability Spectrum disrder Impairement in three majr areas Language and cmmunicatin Scial skills Flexibility f thinking Sensry issues Autism Sund
More informationCDC Influenza Division Key Points MMWR Updates February 20, 2014
CDC Influenza Divisin Key Pints MMWR Updates In this dcument: Summary Key Messages Seasnal Influenza Vaccine Effectiveness: Interim Adjusted Estimates Influenza Surveillance Update: September 29, 2013-February
More informationSTAKEHOLDER IN-DEPTH INTERVIEW GUIDE
STAKEHOLDER IN-DEPTH INTERVIEW GUIDE PURPOSE The Stakehlder In-Depth Interview Guide cntributes t understanding the scale-up prcess by asking key stakehlders t evaluate what has been achieved in scaleup,
More informationPILI Ohana Facilitator s Guide
Previus Versin: September 10, 2007 Updated Versin: Octber 2, 2007 PILI Ohana Facilitatr s Guide Lessn 5: Managing and Reducing Negative Thughts and Emtins. Questin/Tpic Script Reminder/Activity Welcming
More informationLecture 17 (03/28/2011) (Lateralization in the Brain) PSY 215. Lecture 17 Topic: Lateralization in the Brain Chapter 14.
PSY 215 Lecture 17 (03/28/2011) (Lateralizatin in the Brain) Dr. Achtman PSY 215 Lecture 17 Tpic: Lateralizatin in the Brain Chapter 14.1, pages 404-413 Crrectins: Nne needed Annuncements: Wednesday will
More informationCnsideratin fr Optimizatin: Optimizatin is a prgram transfrmatin technique, which tries t imprve the cde by making it cnsume fewer resurces (i.e. CPU, Memry) and deliver high speed. In ptimizatin, high-level
More informationPreventing Suicide: Review of Safety Protocol for Suicidal Students. Maureen Cooper Jamie Anderson
Preventing Suicide: Review f Safety Prtcl fr Suicidal Students Maureen Cper Jamie Andersn Fast Facts abut Suicide 2013, students in grades 9-12: 17% seriusly cnsidered attempting suicide in the previus
More informationDATA RELEASE: UPDATED PRELIMINARY ANALYSIS ON 2016 HEALTH & LIFESTYLE SURVEY ELECTRONIC CIGARETTE QUESTIONS
DATA RELEASE: UPDATED PRELIMINARY ANALYSIS ON 216 HEALTH & LIFESTYLE SURVEY ELECTRONIC CIGARETTE QUESTIONS This briefing has been specifically prepared fr the Ministry f Health t prvide infrmatin frm this
More informationCode of employment practice on infant feeding
Cde f emplyment practice n infant feeding An Emplyer s guide t: Sectin 69Y f the Emplyment Relatins Act 2000 Frewrd As Minister f Labur, I am pleased t publish the Cde f Emplyment Practice n Infant Feeding.
More informationBariatric Surgery FAQs for Employees in the GRMC Group Health Plan
Bariatric Surgery FAQs fr Emplyees in the GRMC Grup Health Plan Gergia Regents Medical Center and Gergia Regents Medical Assciates emplyees and eligible dependents wh are in the GRMC Grup Health Plan (Select
More informationAccessibility Customer Service Volunteer Guide
Accessibility Custmer Service Vlunteer Guide Accessibility Ontari Disability Act (AODA) and Serve-Ability & Integrated Accessibility Standards Regulatin (IASR) Training "The Exchange is a beautiful place
More informationBRCA1 and BRCA2 Mutations
BRCA1 and BRCA2 Mutatins ROBERT LEVITT, MD JESSICA BERGER-WEISS, MD ADRIENNE POTTS, MD HARTAJ POWELL, MD, MPH COURTNEY LEVENSON, MD LAUREN BURNS, MSN, RN, WHNP OBGYNCWC.COM v Cancer is a cmplex disease
More informationPSYCHOLOGICAL AND NEUROPSYCHOLOGICAL TESTING GUIDELINES
OPTUM PSYCHOLOGICAL NEUROPSYCHOLOGICAL TESTING GUIDELINES PSYCHOLOGICAL NEUROPSYCHOLOGICAL TESTING GUIDELINES Guideline Number: BH727PNTG_022018 Effective Date: February, 2018 Table f Cntents Page INTRODUCTION...1
More informationHumanities and Social Sciences Division. o Work Experience, General. o Open Entry/Exit. Distance (Hybrid Online) for online supported courses
SECTION A - Curse Infrmatin 1. Curse ID: 2. Curse Title: 3. Divisin: 4. Department: 5. Subject: 6. Shrt Curse Title: 7. Effective Term:: PSYC 14 Develpmental Psychlgy Humanities and Scial Sciences Divisin
More informationBehaviour Management: Some Ideas revisited
Behaviur Management: Sme Ideas revisited Tmrrw I will walk int yur classrm I must learn t read, write, calculate, and spell... But my greatest need is lve I wn t be easy t teach and I wn t be easy t lve.
More informationPrescribing Safely to Prevent Misuse & Diversion
Patient-Prvider Agreement fr Onging Use f Cntrlled Medicatin BIRTHDATE: NAME: The use f the fllwing medicine(s) (list medicine names) Is nly ne part f my treatment fr. Primary Prescribing Dctr: What shuld
More informationDr Mark Selikowitz. BA (Hons) MBChB (Hons) MRCP DCH FRACP
Dr Mark Selikwitz The Children s Clinic BA (Hns) MBChB (Hns) MRCP DCH FRACP Suite 312, 3 Waverley St Cnsultant Develpmental Paediatrician Bndi Junctin 2022 Prvider Number: 468439Y Telephne: (02) 9369 5757
More informationCardiac Rehabilitation Services
Dcumentatin Guidance N. DG1011 Cardiac Rehabilitatin Services Revisin Letter A 1.0 Purpse The Centers fr Medicare and Medicaid Services (CMS) has detailed specific dcumentatin requirements fr Cardiac Rehabilitatin
More informationPROCEDURAL SAFEGUARDS NOTICE PARENTAL RIGHTS FOR PRIVATE SCHOOL SPECIAL EDUCATION STUDENTS
PROCEDURAL SAFEGUARDS NOTICE PARENTAL RIGHTS FOR PRIVATE SCHOOL SPECIAL EDUCATION STUDENTS INTRODUCTION This ntice prvides an verview f the parental special educatin rights, smetimes called prcedural safeguards
More informationSocial Learning Theories
Scial Learning Theries - Careful scientific prcedures and methdlgy that characterize the behaviurist apprach Albert Bandura - Brn in small twn Alberta - Plish decent - Only sn with 5 sisters - Interested
More informationNational Imaging Associates, Inc. (NIA) Frequently Asked Questions (FAQs) For Louisiana Healthcare Connections Providers
Natinal Imaging Assciates, Inc. (NIA) Frequently Asked Questins (FAQs) Fr Luisiana Healthcare Cnnectins Prviders Questin GENERAL Why did Luisiana Healthcare Cnnectins implement a Medical Prgram? Answer
More informationIn their own words: an exploratory study of bonafide Group leaders
In their wn wrds: an explratry study f bnafide Grup leaders Wikipedia: Bna Fide Grups is a theretical perspective f cmmunicatin in small grups that was initially develped by Linda L. Putnam and Cynthia
More informationPRESIDENT. June 18, President St. Rita School for the Deaf Search managed by Catholic Recruiter Associates
PRESIDENT June 18, 2018 1 CLIENT BACKGROUND St. Rita Schl fr the Deaf (http://www.srsdeaf.rg) is a Cathlic, c-educatinal, pre K-12 grade, in additin t a Career 2 prgram serving students up t age 22. Fr
More informationDOMAIN II: SAFE and EFFECTIVE CLINICAL PRACTICE
DOMAIN II: SAFE and EFFECTIVE CLINICAL PRACTICE Definitin Dentists are required t ensure that they are capable f prviding apprpriate care fr their patients, whilst als effectively managing and leading
More informationCognitive Processing for Interpreters. Humanities and Social Sciences Division. o Work Experience, General. o Open Entry/Exit
SECTION A - Curse Infrmatin 1. Curse ID: 2. Curse Title: 3. Divisin: 4. Department: SIGN 227 Cgnitive Prcessing fr Interpreters Humanities and Scial Sciences Divisin Sign Language Department 5. Subject:
More informationo Procedures performed o Diagnoses Identified o Certain devices/equipment/supplies acquired for patient
Image Surce: https://s-media-cache-ak0.pinimg.cm/736x/7c/29/91/7c2991805f004e1ca05e42a79883f4a7.jpg 6/30/2017 Curse Objectives A Practical Guide t Cding fr Audilgists in 2017 Megan Keirans, AuD University
More informationNational Imaging Associates, Inc. (NIA) Frequently Asked Questions (FAQ s) For PA Health & Wellness Providers
Natinal Imaging Assciates, Inc. (NIA) Frequently Asked Questins (FAQ s) Fr PA Health & Wellness Prviders Questin GENERAL Why is PA Health & Wellness implementing a Medical Specialty Slutins Prgram? Answer
More informationQ 5: Is relaxation training better (more effective than/as safe as) than treatment as usual in adults with depressive episode/disorder?
updated 2012 Relaxatin training Q 5: Is relaxatin training better (mre effective than/as safe as) than treatment as usual in adults with depressive episde/disrder? Backgrund The number f general health
More informationNational Imaging Associates, Inc. (NIA) Frequently Asked Questions (FAQs) For Managed Health Services (MHS)
Questin GENERAL Why did MHS implement a Medical Specialty Slutins Prgram? Natinal Imaging Assciates, Inc. (NIA) Frequently Asked Questins (FAQs) Fr Managed Health Services (MHS) Answer Effective Nvember
More informationFebruary 28, 2018 Community Presentation Ottawa County Fillmore Complex
2017 February 28, 2018 Cmmunity Presentatin Ottawa Cunty Fillmre Cmplex Tday s Agenda Welcme Study Findings 2015 CHIP Prgress 2018 CHIP Launch 2.0 Backgrund & Methds What is a CHNA? A cmmunity health needs
More information