Objective-To determine the relationship between disease severity and patient characteristics in endometriosis.Design-Cross-sectional study of self-reported survey data. Setting-Academic research setting. Patient(s)-One thousand women in the Oxford Endometriosis Gene (OXEGENE) study. Intervention(s)-None.Main Outcome Measure(s)-Participants were assigned to one of two groups with predominantly revised AFS stage I-II (group I, n = 423) or III-IV disease (group II, n = 517). Their characteristics were compared by disease extent.Result(s)-Most participants were white (96%) and of reproductive age (81%). Women in group I were significantly younger on entering the study (39.9 ± 0.5 vs. 44.5 ± 0.4 years). Overall time to diagnosis did not differ between groups. The most common symptoms leading to a diagnosis were dysmenorrhea (79%) and pelvic pain (69%). In group II, subfertility (21.5% vs. 30.0%) and an ovarian mass (7.3% vs. 29.4%) more commonly led to a diagnosis, whereas dyspareunia (51.1% vs. 39.5%) was significantly more common in group I. Subfertility (41.5% vs. 53.4%) remained more common in group II throughout reproductive life, although birth and miscarriage rates were similar. Conclusion(s)-Pelvicpain is common to all with endometriosis and those with more extensive disease report higher rates of subfertility. Remarkably, the time to diagnosis was similar among women. KeywordsEndometriosis; patient characteristics; extent of disease; pelvic pain; subfertility Chronic pelvic pain, defined as persistent pain in the pelvis, is the most common symptom associated with endometriosis, yet there is no clear relationship between the severity of the Reprint requests: Ninet Sinaii, Ph.D., 10 Center Drive, Building 10, Room 2N-228, Bethesda, MD 20892-1871 (FAX: 301-496-0457; sinaiin@mail.nih.gov NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript pain experienced and the extent of disease, irrespective of which classification system is used.Researchers have found either no association between pain symptoms and disease stage (1-3) or observed a degree of association between pain and the presence of adnexal adhesions, rectal and vaginal infiltration, ovarian involvement, or endometriomas (2,4,5). The failure of many women with minimal endometriosis to respond to surgical treatment has led some investigators to question whether this is even a cause of pain (6), especially as it may be an incidental finding in asymptomatic women (7,8).The relationship between subfertility and disease stage is similarly uncertain. Some researchers have found no association between stage and subfertility (1), whereas others report that fertility decreases with increasing disease severity (9).Although studies have reported an increased risk of other diseases among women with endometriosis (10-12), evidence is lacking as to how these other conditions are influenced by stage of disease. Women with endometriosis, regardless of stage, appear to have similar ages at menarche and menstrual patterns (13). Health and li...

This study investigated the effects of infant and maternal sensory processing on sleep, fussing, and crying in a sample of 55 firstborn, 4- to 7-month-old infants and their mothers. Mothers completed self-report questionnaires to assess maternal and infant sensory processing styles and a 4-day diary of infant behavior, including sleep, fussing, and crying. Higher levels of infant Sensation Avoiding were associated with less sleep, more fussing, and more crying whereas higher levels of Sensory Sensitivity were associated with less sleep and more fussing. The positive association between infant Sensation Avoiding and crying was strengthened by lower levels of Low Registration in mothers. The effect of infant Sensory Sensitivity on reducing total sleep also was strengthened by lower levels of maternal Low Registration. Assessment of infant sensory processing as well as the moderating effect of maternal sensory processing on the relationship between infant sensory processing and infant regulatory capacities need to be considered when assessing and designing interventions for families in which infant regulation is problematic.

Background and aims A high rate of children in mental health services have poor language skills, but little evidence exists on how mental health support is delivered to and received by children with language needs. This study looked at parental experiences, asking parents of children with speech, language and communication needs (SLCN) about their experiences seeking help for their children's mental health. We were particularly interested on the experiences of parents of children with Developmental Language Disorder (DLD), a specific SLCN that remains relatively unknown to the general public. Methods We conducted an online survey of 74 parents of children with speech, language and communication needs (SLCN). Survey respondents included parents of children with a range of difficulties, including DLD, autism, verbal dyspraxia, global intellectual delay, a history of hearing problems, and SLCN without a primary diagnosis. Survey respondents were asked what sources of support they had accessed for their child's mental health and to provide comments on what was good and what was not good about this support. We then conducted 9 semi-structured interviews of parents of children with DLD about their experiences. These were parents of children with DLD aged 7 to 17 years, from across a range of educational settings, and with a range of present mental health concerns. Results Content analyses of the survey responses from parents of children with SLCN highlighted three broad factors of importance to parents’ experiences: relational aspects of care, organisational aspects of care, and professionals’ knowledge. Thematic analyses of the interviews of parents of children with DLD identified 5 themes: the effects of language problems on the presentation of distress; the role of the school environment; the role of key professionals; standard approaches to mental health support might not be appropriate; and the role and impact on parents. Parents expressed concerns that their children's mental health problems and need for support would not be recognised, and felt interventions were not accessible, or delivered in a manner that was not comfortable for their children due to high reliance on oral language skills. Some parents were left feeling that there was no provision suitable for their children. Conclusions Parents of children with SLCN face barriers accessing support for their children's mental health, including a lack of professional knowledge about their children's language needs. Parents argued that language and communication needs can significantly affect the delivery and success of psychological therapies and interventions. Systematic research is needed to understand how to successfully adapt services to make them accessible to children and young people with language needs, and to ensure that mental health problems are detected in children with language difficulties. Increased knowledge about language disorders such as DLD, and access to speech and language therapy expertise, is needed amongst professionals who work to support children's mental health.

Background & aims: A high rate of children in mental health services have poor language skills, but little evidence exists on how mental health support is delivered to and received by children with language needs. This study looked at parental experiences, asking parents of children speech, language and communication needs (SLCN) about their experiences seeking help for their children’s mental health. We were particularly interested on the experiences of parents of children with Developmental Language Disorder (DLD), a specific SLCN that remains relatively unknown to the general public. Methods: We conducted an online survey of 74 parents of children with speech, language and communication needs (SLCN). Survey respondents included parents of children with a range of difficulties, including DLD, autism, verbal dyspraxia, global intellectual delay, a history of hearing problems, and SLCN without a primary diagnosis. Survey respondents were asked what sources of support they had accessed for their child’s mental health and to provide comments on what was good and what was not good about this support. We then conducted 9 semi-structured interviews of parents of children with DLD about their experiences. These were parents of children with DLD aged 7 to 17 years, from across a range of educational settings, and with a range of present mental health concerns. Results: Content analyses of the survey responses from parents of children with SLCN highlighted three broad factors of importance to parents’ experiences: relational aspects of care, organisational aspects of care, and professionals’ knowledge. Thematic analyses of the interviews of parents of children with DLD identified 5 themes: the effects of language problems on the presentation of distress; the role of the school environment; the role of key professionals; standard approaches to mental health support might not be appropriate; and the role and impact on parents. Parents expressed concerns that their children’s mental health problems and need for support would not be recognised, and felt interventions were not accessible, or delivered in a manner that was not comfortable for their children due to high reliance on oral language skills. Some parents were left feeling that there was no provision suitable for their children.Conclusions: Parents of children with SLCN face barriers accessing support for their children’s mental health, including a lack of professional knowledge about their children’s language needs. Parents argued that language and communication needs can significantly affect the delivery and success of psychological therapies and interventions.

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People who attend mental health services have more risk factors for tuberculosis (TB) than the general population. Currently, TB-specific screening is not part of the admission process in mental health services in South East London, an area with particularly high TB prevalence. The authors evaluated the effectiveness of verbal screening in identifying clients in an acute setting who may have active disease.

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