scholarly journals Memory and cognitive effects of ECT: informing and assessing patients†

2006 ◽  
Vol 12 (3) ◽  
pp. 228-237 ◽  
Author(s):  
Harold Robertson ◽  
Robin Pryor
Keyword(s):  
Adverse Effects ◽  
Cognitive Disability ◽  
Cognitive Effects ◽  
National Guidelines ◽  
The Past ◽  
Permanent Memory ◽  
Policy Statements ◽  
The Uk ◽  
Research And Policy

Over the past few years electroconvulsive therapy (ECT) has come under increased scrutiny in the UK, with the first systematic review of patients' experiences and new national guidelines. Our aim in this article is to translate recent and sometimes confusing research and policy statements into practical guidance that benefits patients. We examined the evidence on the permanent memory and cognitive effects of ECT, with a focus on delineating their nature, understanding how ECT may cause them, informing prospective patients about them, and assessing their impact on former patients. We describe a simple and effective method for assessing retrograde amnesia. Data do not exist at this time to confirm the mechanisms by which ECT exerts its adverse effects, but clinicians should fully inform patients of the possible permanent adverse effects of the treatment, which include amnesia, memory disability and cognitive disability, and should provide follow-up testing using relevant instruments.

Elder abuse and neglect: an update

1997 ◽  
Vol 7 (2) ◽  
pp. 177-182 ◽  
Author(s):  
Rosalie Wolf
Keyword(s):  
Elder Abuse ◽  
Specific Reference ◽  
Elder Abuse And Neglect ◽  
The Past ◽  
Abuse And Neglect ◽  
The World ◽  
The Status ◽  
The Uk ◽  
National Governments ◽  
Research And Policy

For those of us who have been working in the elder abuse movement for a decade or more, progress towards understanding and prevention of elder abuse has been exceptionally slow. This situation may be attributed as much to the complexities of elder abuse as to the importance given to the problem by national governments. However, one trend in the past five years is particularly noteworthy. The increased awareness of elder abuse among the nations of the world, underscored by an ‘“explosion” of interest’ in the UK, has been the most salutary accomplishment. The purpose of this paper is to review the status of the field with specific reference to the past five years. Of necessity, this review is selective and thus may omit worthy research and policy achievements. As with an earlier paper (see Rev Clin Gerontol 1992; 2: 269-76), this review is limited to elder abuse in domestic settings.

scholarly journals General hospital services in the UK for adults presenting after self-harm: little evidence of progress in the past 25 years

2020 ◽  
Vol 217 (6) ◽  
pp. 661-662
Author(s):  
Allan House ◽  
David Owens
Keyword(s):  
Public Health ◽  
Effective Action ◽  
Health Concern ◽  
Hospital Services ◽  
Public Health Concern ◽  
Services Research ◽  
The Past ◽  
Self Harm ◽  
The Uk ◽  
Research And Policy

SummarySelf-harm remains a serious public health concern, not least because of its strong link with suicide. Twenty-five years ago we lamented the deficits in UK services, research and policy. Since then, there has not been nearly enough effective action in any of these three domains. It is time for action.

scholarly journals Assertive outreach teams in London: Patient characteristics and outcomes

2003 ◽  
Vol 183 (2) ◽  
pp. 148-154 ◽  
Author(s):  
Stefan Priebe ◽  
Walid Fakhoury ◽  
Joanna Watts ◽  
Paul Bebbington ◽  
Tom Burns ◽  
...  
Keyword(s):  
Substance Misuse ◽  
Patient Characteristics ◽  
Violent Behaviour ◽  
Assertive Outreach ◽  
The Past ◽  
Outreach Services ◽  
Wide Range ◽  
The Uk ◽  
Team Types

BackgroundAlthough the model of assertive outreach has been widely adopted, it is unclear who receives assertive outreach in practice and what outcomes can be expected under routine conditions.AimsTo assess patient characteristics and outcome in routine assertive outreach services in the UK.MethodPatients (n=580) were sampled from 24 assertive outreach teams in London. Outcomes – days spent in hospital and compulsory hospitalisation – were assessed over a 9-month follow-up.ResultsThe 6-month prevalence rate of substance misuse was 29%, and 35% of patients had been physically violent in the past 2 years. During follow-up, 39% were hospitalised and 25% compulsorily admitted. Outcome varied significantly between team types. These differences did not hold true when baseline differences in patient characteristics were controlled for.ConclusionsRoutine assertive outreach serves a wide range of patients with significant rates of substance misuse and violent behaviour. Over a 9-month period an average of 25% of assertive outreach patients can be expected to be hospitalised compulsorily. Differences in outcome between team types can be explained by differences in patient characteristics.

Early Occupational Aspirations and Fractured Transitions: A Study of Entry into ‘NEET’ Status in the UK

2010 ◽  
Vol 40 (3) ◽  
pp. 513-534 ◽  
Author(s):  
SCOTT YATES ◽  
ANGEL HARRIS ◽  
RICARDO SABATES ◽  
JEREMY STAFF
Keyword(s):  
Labour Market ◽  
Educational Expectations ◽  
Occupational Aspirations ◽  
The Past ◽  
Youth Labour Market ◽  
British Cohort Study ◽  
Employment Education ◽  
The Uk ◽  
Research And Policy ◽  
Youth Labour

AbstractThere has been significant recent research and policy interest in issues of young people's occupational aspirations, transitions to employment and the antecedents of NEET (not in employment, education or training) status. Many have argued that changes to the youth labour market over the past 30 years have led to transitions to work becoming more individualised, complex and troublesome for many, particularly those from poorer backgrounds. However, little research has examined the connection between early uncertainty or misalignment in occupational aspirations and entry into NEET status. This paper draws on the British Cohort Study to investigate these issues, and finds that young people with uncertain occupational aspirations or ones misaligned with their educational expectations are considerably more likely to become NEET by age 18. Uncertainty and misalignment are both more widespread and more detrimental for those from poorer backgrounds. These findings are discussed in the context of recent research and debates on emerging adulthood and the youth labour market.

scholarly journals Oral corticosteroid prescription patterns for asthma in France, Germany, Italy and the UK

2020 ◽  
Vol 55 (6) ◽  
pp. 1902363 ◽  
Author(s):  
Trung N. Tran ◽  
Elizabeth King ◽  
Rajiv Sarkar ◽  
Cassandra Nan ◽  
Annalisa Rubino ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Primary Care Physicians ◽  
Western Europe ◽  
Uncontrolled Asthma ◽  
The United Kingdom ◽  
Asthma Exacerbations ◽  
Oral Corticosteroids ◽  
Baseline Characteristics ◽  
The Uk

Oral corticosteroids (OCS) are used to manage asthma exacerbations and severe, uncontrolled asthma, but OCS use is associated with adverse effects. We aimed to describe the patterns of OCS use in the real-world management of patients with asthma in western Europe.We used electronic medical records from databases in France, Germany, Italy and the United Kingdom from July 2011 through February 2018. Patients aged ≥12 years with an asthma diagnosis, at least one non-OCS asthma medication within ±6 months of diagnosis, and available data ≥6 months prior to and ≥90 days after cohort entry were included. High OCS use was defined as OCS ≥450 mg prescribed in a 90-day window during follow-up. Baseline characteristics and OCS use during follow-up were described overall and by OCS use status.Of 702 685 patients with asthma, 14–44% were OCS users and 6–9% were high OCS users at some point during follow-up. Annual prevalence of high OCS use across all countries was ∼3%. High OCS users had a mean of between one and three annual OCS prescriptions, with an average daily OCS dosage of 1.3–2.2 mg. For patients who continued to meet the high-use definition, daily OCS exposure was generally stable at 5.5–7.5 mg for ≥2 years, increasing the risk of adverse effects.Our study demonstrates that OCS use is relatively common across the four studied European countries. Data from this study may provide decisive clinical insights to inform primary care physicians and specialists involved in the management of severe, uncontrolled asthma.

scholarly journals Characteristics of teams, staff and patients: associations with outcomes of patients in assertive outreach

2004 ◽  
Vol 185 (4) ◽  
pp. 306-311 ◽  
Author(s):  
Stefan Priebe ◽  
Walid Fakhoury ◽  
Ian White ◽  
Joanna Watts ◽  
Paul Bebbington ◽  
...  
Keyword(s):  
Patient Characteristics ◽  
Favourable Outcome ◽  
Assertive Outreach ◽  
The Past ◽  
Eleven Patient ◽  
Team Working ◽  
Outreach Services ◽  
Burn Out ◽  
The Uk

BackgroundLittle is known about what characteristics of teams, staff and patients are associated with a favourable outcome of severe mental illness managed by assertive outreach.AimsTo identify predictors of voluntary and compulsory admissions in routine assertive outreach services in the UK.MethodNine features of team organisation and policy, five variables assessing staff satisfaction and burn-out and eleven patient characteristics taken from the baseline data of the Pan-London Assertive Outreach Study were tested as predictors of voluntary and compulsory admissions within a 9-month follow-up period.ResultsWeekend working, staff burn-out and lack of contact of the patient with other services were associated independently with a higher probability of both voluntary and compulsory admission. In addition, admissions in the past predicted further voluntary and compulsory admissions, and teams not working extended hours predicted compulsory admissions in the follow-up period.ConclusionsCharacteristics of team working practice, staff burn-out and patients' history are associated independently with outcome. Patient contact with other services is a positive prognostic factor.

Psychological sequelae of female sterilization: short-term outcome in a prospective controlled study: A report from the UK Field Research Centre of a WHO Collaborative Project

1984 ◽  
Vol 14 (2) ◽  
pp. 379-390 ◽  
Author(s):  
K. D. Bledin ◽  
J. E. Cooper ◽  
S. Mackenzie ◽  
B. Brice
Keyword(s):  
Abdominal Pain ◽  
Adverse Effects ◽  
Physical Health ◽  
Field Research ◽  
Research Centre ◽  
Controlled Study ◽  
Term Outcome ◽  
State Present ◽  
The Uk

SynopsisHealthy multiparous women having elective interval (N= 69) or postpartum (N= 69) sterilization were interviewed pre-operatively and 6 weeks and 6 months post-operatively, using standardized instruments. They did not differ significantly from control samples of comparable non-sterilized women with respect to mental state (Present State Examination) or subjectively-assessed mental or physical health or abdominal pain. More sterilization subjects than control subjects reported subjectively experienced improvement in sexual satisfaction at the later follow-up. Reports of poor physical health and abdominal pain increased over time within both the sterilization and the control groups. Reports of adverse effects at follow-up were often associated with higher PSE scores initially. Regrets and wish for reversal were rare and were also associated with higher initial PSE scores. Since the adverse effects were more common among postpartum subjects, it is suggested that subjectively experienced sequelae of sterilization may sometimes be attributable to ‘normal’ postnatal events.

Dowagers, Debs, Nuns and Babies: The Politics of Nostalgia and the Older Woman in the British Sunday Night Television Serial

2013 ◽  
Vol 10 (4) ◽  
pp. 769-784 ◽  
Author(s):  
Estella Tincknell
Keyword(s):  
Older Women ◽  
Social Role ◽  
Mature Female ◽  
Older Woman ◽  
Distinctive Features ◽  
The Past ◽  
Political Position ◽  
The Social ◽  
The Uk ◽  
Popular Television

The extensive commercial success of two well-made popular television drama serials screened in the UK at prime time on Sunday evenings during the winter of 2011–12, Downton Abbey (ITV, 2010–) and Call the Midwife (BBC, 2012–), has appeared to consolidate the recent resurgence of the period drama during the 1990s and 2000s, as well as reassembling something like a mass audience for woman-centred realist narratives at a time when the fracturing and disassembling of such audiences seemed axiomatic. While ostensibly different in content, style and focus, the two programmes share a number of distinctive features, including a range of mature female characters who are sufficiently well drawn and socially diverse as to offer a profoundly pleasurable experience for the female viewer seeking representations of aging femininity that go beyond the sexualised body of the ‘successful ager’. Equally importantly, these two programmes present compelling examples of the ‘conjunctural text’, which appears at a moment of intense political polarisation, marking struggles over consent to a contemporary political position by re-presenting the past. Because both programmes foreground older women as crucial figures in their respective communities, but offer very different versions of the social role and ideological positioning that this entails, the underlying politics of such nostalgia becomes apparent. A critical analysis of these two versions of Britain's past thus highlights the ideological investments involved in period drama and the extent to which this ‘cosy’ genre may legitimate or challenge contemporary political claims.

EFFICACY OF TREATMENT OF H.PYLORI EARDICATION WITH STANDARD TRIPLE THERAPY IN PEPTIC ULCER PATIENTS

2011 ◽  
pp. 122-129
Author(s):  
Quang Di Bui ◽  
Phuoc Lam Nguyen
Keyword(s):  
Peptic Ulcer ◽  
Adverse Effects ◽  
Triple Therapy ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Duodenal Ulcers ◽  
Ulcer Disease ◽  
Intention To Treat ◽  
Standard Triple Therapy

Objectives: The aim of study is to evaluate the efficacy, tolerability and adverse effects of a standard triple therapy including Rabeprazole, Clarithromycin and Amoxicilline at Sai gon Hoan My hospital in order to consider treatment H.pylori for patients who have not yet eradicated before or need to be undertaked by alternative regimens. Methods: By descriptive cross-sectional study, the authors have examined 116 patients sufferring from peptic ulcer received 10-day therapy including Rabe (20mg b.d) plus Clari(500mg b.d) plus Amoxi(1g b.d). Eradication is confirmed with endoscopy after 4 weeks from completing of treatment. Results and Discussion: 100% of patients were initially included and noboby was dropped out of the follow-up satges. The mean age was 49 in which 62% was male, 73(62,9%) presented duodenal ulcer, 28(24,1%) gastric ulcer and 15(13%) simultaneous gastric and duodenal ulcers. All patients took medications correctly. Per-protocol and intention to treat eradication rates were both 75%(95% CI=73,4-78,3). Additionally, 62(53,4%) patients had at least one risky factor for peptic ulcer disease, smoking being the most common one 44(37,9%).The adverse effects were reported overall in 67% of the patients, mainly including changed taste, very bitter, tired 49%, trouble sleeping 12% and diarrhea 5%. Conclusion: this ten-day standard triple therapy used in this study is ineffective with high adverse effects.The first line eradication with new regimens should be alternative.

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