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Ortiz A.,Dalhousie University | Bradler K.,Saint Mary's University, Halifax | Garnham J.,Capital Health District Authority | Slaney C.,Capital Health District Authority | And 2 more authors.
Bipolar Disorders | Year: 2015

Objectives: We sought to study the underlying dynamic processes involved in mood regulation in subjects with bipolar disorder and healthy control subjects using time-series analysis and to then analyze the relation between anxiety and mood using cross-correlation techniques. Methods: We recruited 30 healthy controls and 30 euthymic patients with bipolar disorder. Participants rated their mood, anxiety, and energy levels using a paper-based visual analog scale; and they also recorded their sleep and any life events. Information on these variables was provided over a three-month period on a daily basis, twice per day. We analyzed the data using Box-Jenkins time series analysis to obtain information on the autocorrelation of the series (for mood) and cross-correlation (mood and anxiety series). Results: Throughout the study, we analyzed 10,170 data points. Self-ratings for mood, anxiety, and energy were normally distributed in both groups. Autocorrelation functions for mood in both groups were governed by the autoregressive integrated moving average (ARIMA) (1,1,0) model, which means that current values in the series were related to one previous point only. We also found a negative cross-correlation between mood and anxiety. Conclusions: Mood can be considered a memory stochastic process; it is a flexible, dynamic process that has a 'short memory' both in healthy controls and euthymic patients with bipolar disorder. This process may be quite different in untreated patients or in those acutely ill. Our results suggest that nonlinear measures can be applied to the study of mood disorders. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Cox A.,Health Science Center | Breau L.,Dalhousie University | Connor L.,Capital Health District Authority | McNeely P.D.,Dalhousie University | And 2 more authors.
Journal of Urology | Year: 2011

Purpose: Transitioning care of patients with spina bifida to adult centers poses a challenge. We sought patient and parent perspectives on the transition process at our center and correlated these perspectives with medical outcomes. Materials and Methods: Patients who attended the adult spina bifida clinic at our institution were invited to complete SF-36®, the Ambulatory Care Experience Survey and a Transition of Care Survey. Urological and neurosurgical medical outcomes were correlated with health status, clinic experience and perspectives on the transition process. Statistical analysis was done using SPSS®, version 16.0. Results: Of 105 patients with spina bifida 24 participated in the study. SF-36 results showed that the physical health domain correlated with lack of employment (p = 0.006). Patients whose parents completed the surveys on their behalf were more likely to have physical limitations than the patients who completed surveys (p = 0.011). Urological and neurosurgical outcomes did not significantly affect SF-36, Ambulatory Care Experience Survey or Transition of Care Survey scores in this patient population. Patients and caregivers identified similar key elements and barriers in the transition process. Satisfaction with care at the pediatric center was higher than at the adult center. Conclusions: Transitioning care of patients with spina bifida from pediatric to adult care poses challenges for the health care system. Medical outcomes do not impact the patient perspective of the transition process. To optimize the transition of care we must address the barriers identified by patients and their caregivers. © 2011 American Urological Association Education and Research, Inc.

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