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.

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.

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.

S149 – Sinonasal Mucosal Melanoma: A 12-Year Experience

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P126-P126
Author(s):  
Kailash Narasimhan ◽  
Omer Kucuk ◽  
Robert Mathog ◽  
Michael A Carron
Keyword(s):  
Patient Characteristics ◽  
Mucosal Melanoma ◽  
Recurrence Rates ◽  
Patients Âgés ◽  
The Past ◽  
Medial Maxillectomy ◽  
Melanoma Patients ◽  
Anatomic Locations ◽  
Disease Free

Objectives 1) Describe the Sinonasal Mucosal Melanoma patients (SNMM) our institution has treated. 2) Assess outcomes of surgical and adjuvant therapies for this disease. Methods Records of 18 patients diagnosed between 1995 and 2007 were reviewed, with a focus on patient characteristics, treatment outcomes, and modalities. Results Patients’ ages ranged from 31 to 85. Most common anatomic locations were maxillary sinus in 12 patients and lateral nasal walls in 6. 5 patients had cribriform plate involvement, and 3 had orbital involvement. Tumor thickness averaged 3.1 cm. 15 of the 18 patients had definitive surgical resection of their primary. Most common surgical procedure was medial maxillectomy. 6 patients were operated on despite disease in prognostically poor locations such as skull base, orbit, cribiform plate, and nasopharynx. Margins ranged from 0.5 to 4 cm. 10 patients received chemo- or immunotherapy, 11 received radiotherapy, and 6 received both. Recurrence rate was 10/18 (55%), while distant metastatic rate was 6/18 (33%), the lung being the most common metastatic location (4 patients). Average follow-up was 38.6 months, with disease-free intervals ranging from 8 to 39 months in patients with recurrences. After 2000, patients only received limited surgical resections, and were treated at stages I-II. Conclusions Despite the poor prognosis of SNMM, over the past 13 years at our institution the trend has been towards patients being diagnosed and treated at an earlier stage and having less extensive surgical resections. Advances in imaging, negative margins, radiation, and the use of immunotherapy may have influenced patient outcomes and recurrence rates.

A Comprehensive Approach To Alloplastic Cranioplasty: Novel Implant Design And Refinement of Soft Tissue Management

FACE ◽  
2021 ◽  
pp. 273250162110643
Author(s):  
Kaylee O’Connor ◽  
Cole Holan ◽  
Nikita Choudhary ◽  
Eileen Curry ◽  
Raymond Harshbarger
Keyword(s):  
Large Scale ◽  
Intraoperative Complications ◽  
Patient Characteristics ◽  
Implant Design ◽  
Brain Protection ◽  
Temporalis Muscle ◽  
The Past ◽  
Cosmetic Outcomes ◽  
A New Technique

Background: Large scale craniectomy defects are commonly reconstructed with alloplastic implants, which can restore brain protection and promote cosmesis. However, esthetic outcomes can be subpar due to skin contour abnormalities and temporal hollowing. Herein we describe a senior craniofacial surgeon’s experience using a custom composite polyetheretherketone (PEEK) and porous polyethylene (Medpor) implant for alloplastic cranioplasty. Methods: A retrospective review was conducted of all PEEK-Medpor cranioplasty cases performed over the past 2 years. Patient characteristics, intraoperative information, surgical outcomes, and cosmetic outcomes were reviewed. Results: Sixteen patients (18-70 years of age) underwent surgery. Indications for cranioplasty included craniectomy due to trauma, stroke, or tumor, and bone resorption after a prior autologous cranioplasty. Augmentation of the temporalis area using alloderm or a muscle graft was performed in 7 cases. There were no intraoperative complications. Ultimately, all implants were maintained. One implant was temporarily removed due to infection, but successfully replaced. Three minor complications occurred. At an average follow-up of 9 months, 93.8% of surgical sites showed no significant temporal hollow. Conclusion: We describe a series of 16 implants using a composite PEEK Medpor implant for alloplastic cranioplasty, which resulted in a low infection rate and improved postoperative regional contour. Use of this implant with suspension of the temporalis muscle is a new technique that may allow for better adherence of the temporalis muscle to its anatomic position, while still providing good brain protection.

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.

PERCUTANEOUS EPIDURAL NEUROPLASTY (PEN) USING COMBINATION OF HYALURONIDASE AND HYPERTONIC SALINE (NaCl 3%) IN TREATING FAILED BACK SURGERY SYNDROME

2018 ◽  
Vol 1 (1) ◽  
pp. 1
Author(s):  
Wawan Mulyawan ◽  
Yudi Yuwono Wiwoho ◽  
Syaiful Ichwan
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Hypertonic Saline ◽  
Failed Back Surgery Syndrome ◽  
Favourable Outcome ◽  
Lumbar Spine Surgery ◽  
Low Back ◽  
Failed Back Surgery ◽  
Scale Scores

Background: Following surgical treatments for low back pain, lower extremity pain or neurologic symptoms would last or recur, this is defined as failed sack surgery syndrome (FBSS). FBSS usually occurs in 5-40% of these surgical patients. The most common cause is an epidural scar adhesion. Percutaneous epidural neuroplasty is the non-mechanical treatment for this condition. Previously, the use of hyaluronidase and hypertonic saline separately is commonly used for epidurolysis but the combination of hyaluronidase and hypertonic saline 3% has not been explored.Objective: To investigate the two-year outcomes of percutaneous epidural neuroplasty using a combination of hyaluronidase and hypertonic saline 3% in patients with FBSS.Methods: Twelve patients who experience low back pain, with or without radiculopathy, who have underwent lumbar spine surgery previously were assigned to the study. Parameters, such as the visual analogue scale scores for the back (VAS-B) and legs (VAS-L), and the Oswestry disability index (ODI), were recorded and compared between pretreatment, 1 week, 1 month, 3 months, 1 year and 2 years follow-up.Results: For all 12 patients, the postoperative VAS-B, VAS-L, and ODI were significantly different from the preoperative values in all follow-up periods: 1 month, 3 months, 1 year, and 2 years.Conclusion: Based off this study group, percutaneous epidural neuroplasty using a combination of hyaluronidase and hypertonic saline 3% has a favourable outcome in the 2 years follow-up

Awareness of Pregnant Women for COVID-19 Infection

2020 ◽  
Author(s):  
Erhan Okuyan ◽  
Emre Gunakan ◽  
Sertaç Esin
Keyword(s):  
Pregnant Women ◽  
Respiratory Diseases ◽  
Prospective Observational Study ◽  
Information Source ◽  
Home Birth ◽  
Patient Characteristics ◽  
Emotional Status ◽  
Prevention Method ◽  
And Behavior

Covid outbreak has been getting worse and spread affected all over the world. Pregnant patients are also vulnerable to respiratory diseases. We aimed to evaluate the awareness, emotional status, and behavior of pregnant during the COVID outbreak. This study's main benefit is to analyze the knowledge and understanding of pregnant women about the pandemic and draw attention to the prevention issues that need improvement. This research is a prospective observational study that 199 patients subjected to a questionnaire including 29 questions about patient characteristics, pregnancy information, knowledge about COVID19-infection, behavioral and emotional changes. 130 (65.3) of the patients stated an above-average knowledge level. Television was the most frequent information source (75.4%, n:150) and was the only information source for 90 (45.1%) of the patients. Sixty-nine patients used more than one information source. More than one prevention method uses by 149 (75%) of the patients. Washing hands (n:183, 92.0%) and cleaning the house (n:122, 61.3%) were the most preferred methods. Only 55 (27.6%) of the patients used a mask for prevention. 88(44.2%) of the patients stated that they preferred a shorter hospital stay, and 75 (37.7%) of the patients indicated that they postponed or avoided the pregnancy follow-up visits due to the COVID-19 issue. Pregnant women seem to be aware and stressed of COVID-19, but knowledge of what to do seems insufficient. Patients informed of risks of COVID infection, unplanned hospital admission, and chances of avoiding necessary visits and home birth demands.

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