Promoting early dementia diagnosis: a video designed by patients, for patients

2016 ◽  
Vol 29 (5) ◽  
pp. 863-867 ◽  
Author(s):  
Nina Baruch ◽  
Charlotte L. Allan ◽  
Maureen Cundell ◽  
Samuel Clark ◽  
Brian Murray
Keyword(s):  
Early Diagnosis ◽  
Small Sample Size ◽  
Small Sample ◽  
Memory Clinic ◽  
Patient Feedback ◽  
Before And After ◽  
Diagnosis Of Dementia ◽  
Memory Clinics ◽  
Advance Decisions ◽  
Level Of Understanding

ABSTRACTEarly diagnosis of dementia allows people to access effective treatment and make advance decisions while they still have capacity. We aimed to encourage people to attend memory clinic, in order to boost rates of diagnosis. We created a patient information video about Oxford Health NHS Foundation Trust Memory Clinics, to inform and empower those awaiting assessment and to promote early diagnosis.Fourteen people (patients, carers, and staff) were approached prior to developing the video to ascertain their views on the themes the video should cover. The video consisted of unscripted interviews with patients, carers, and staff. We surveyed participants and new patients attending memory clinic to get feedback on the video and to assess patients’ level of understanding and confidence about a memory assessment before and after watching the video. The video content was refined based on this feedback and a final version was produced.Patient feedback demonstrated that confidence and understanding increased after watching the video.Although this study is limited by its small sample size and lack of access to those with undiagnosed dementia, feedback suggested that the video empowered and reassured those awaiting assessment and could be used as a tool to reduce barriers to early diagnosis. Patients and carers involved in making the video found it a therapeutic activity in itself.

Participant Reactions to Suicide-Focused Research

Crisis ◽  
2020 ◽  
Vol 41 (5) ◽  
pp. 367-374
Author(s):  
Sarah P. Carter ◽  
Brooke A. Ammerman ◽  
Heather M. Gebhardt ◽  
Jonathan Buchholz ◽  
Mark A. Reger
Keyword(s):  
Medical Records ◽  
Research Study ◽  
Small Sample Size ◽  
Psychiatric Inpatient ◽  
Small Sample ◽  
Inpatient Unit ◽  
Online Laboratory ◽  
Psychiatric Inpatient Unit ◽  
Before And After ◽  
Participant Reactions

Abstract. Background: Concerns exist regarding the perceived risks of conducting suicide-focused research among an acutely distressed population. Aims: The current study assessed changes in participant distress before and after participation in a suicide-focused research study conducted on a psychiatric inpatient unit. Method: Participants included 37 veterans who were receiving treatment on a psychiatric inpatient unit and completed a survey-based research study focused on suicide-related behaviors and experiences. Results: Participants reported no significant changes in self-reported distress. The majority of participants reported unchanged or decreased distress. Reviews of electronic medical records revealed no behavioral dysregulation and minimal use of as-needed medications or changes in mood following participation. Limitations: The study's small sample size and veteran population may limit generalizability. Conclusion: Findings add to research conducted across a variety of settings (i.e., outpatient, online, laboratory), indicating that participating in suicide-focused research is not significantly associated with increased distress or suicide risk.

scholarly journals O-225 Effects of SARS-Corona virus 2 on IVF treatment parameters: A cohort study of post COVID-19 patients

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Y Kabalkin ◽  
M Gil ◽  
E Lifshitz ◽  
A Moav ◽  
M Kabessa ◽  
...  
Keyword(s):  
Cohort Study ◽  
Virus Disease ◽  
Small Sample Size ◽  
Sperm Concentration ◽  
Small Sample ◽  
Cycle Performance ◽  
Ang Ii ◽  
P Values ◽  
Corona Virus ◽  
Before And After

Abstract Study question Does recovery from SARS–Corona virus 2 (SARS–CoV-2) infection negatively effect IVF cycle parameters? Summary answer Female IVF treatment parameters were comparable to the pre-Covid-19 infection cycle performance. Sperm concentration and motility demonstrated lower mean counts following Covid-19 infection. What is known already Corona-virus disease-19 (Covid-19) is a global pandemic caused by SARS–Corona virus 2 (SARS–CoV-2). The virus primarily affects the respiratory system, but other systemic and immune mediated effects have been reported. The spikes of SARS-CoV-2 have strong affinity for the Angiotensin converting enzyme (ACE) 2 receptor, leading to an increased Angiotensin II (Ang II) mediated pro-inflammatory response. ACE2 receptors exist in the human reproductive tract (more in males) and pose a regulatory role together with Ang II. So far, reports have been inconsistent regarding testicular effects. Other implications involving fertility and fertility treatment post infection are scarce. Study design, size, duration In this retrospective cohort study, IVF cycle performance was compared before and after Corona-virus disease-19. Patients were included only in cases where an IVF cycle was initiated within 3 months of Covid-19 recovery, between March 2020-December 2020. Participants/materials, setting, methods The study was conducted in a University affiliated IVF unit. Post Covid- 19 cycle parameters were compared to previous cycles of the same individual prior to infection. If previous cycles were not available, parameters were compared to non-exposed patients of same age, same treatment and identical indication. Sperm concentration and motility were compared before and after infection. Non exposure was defined by a lack of past Covid-19 diagnosis and a negative PCR throughout the treatment. Main results and the role of chance All together, including the matched cycles, we compared 40 cycles which started within 3 months of recovery: 26 fresh stimulation cycles and 14 frozen thawed transfer cycles. In 28 of these cycles the patient could serve as its own control. Mean age for the female partner was 33.2 years ±6.5 years. Eight male partners presented post infection and provided fresh samples for a cycle involving fertilization. We compared stimulation parameters including maximal Estradiol level, stimulation length, FSH dosage, number of oocytes retrieved, fertilization rates, number of embryos created, high quality embryo number and endometrial thickness. All of these were comparable to non-exposed cycles (generalized estimating equations, p values >0.1). No complications were recorded, specifically no thromboembolic events or respiratory complications. A total of 8 patients conceived: 1 was a chemical pregnancy, 1 extra-uterine pregnancy, 3 miscarriages and 3 ongoing, of those 1 was complicated by early bleeding. Male sperm analyses showed a trend towards lower post disease parameters, not reaching a statistical significance: 23mil/ml compared to 13.6 and 20.7% progressive motility compared to 12.3% (p values 0.09 and 0.17, respectively). Limitations, reasons for caution Current results are based on a small sample size, still insufficient for deducing definite conclusions or guidelines. Pregnancy outcome following IVF treatment in Covid-19 recoverees should further be studied. By the time of the conference, the number of cases is expected to be significantly higher. Wider implications of the findings This study provides preliminary data regarding the effects of SARS-COV-2 infection on IVF treatment outcomes. Despite the small sample size, treatment parameters seem unaffected, however, sperm performance seems to be compromised. Health policy and patients’ decisions regarding whether or not to postpone IVF procedures necessitates additional data. Trial registration number Not applicable - retrospective

scholarly journals A Pilot Placebo Controlled Randomized Trial of Dexamethasone for Chronic Subdural Hematoma

2016 ◽  
Vol 43 (2) ◽  
pp. 284-290 ◽  
Author(s):  
Michel Prud’homme ◽  
François Mathieu ◽  
Nicolas Marcotte ◽  
Sylvine Cottin
Keyword(s):  
Conservative Treatment ◽  
Adverse Events ◽  
Small Sample Size ◽  
Chronic Subdural Hematoma ◽  
Symptomatic Patient ◽  
Placebo Treatment ◽  
Small Sample ◽  
Chi Square ◽  
Serious Adverse Events ◽  
Before And After

AbstractBackground: Current opinions regarding the use of dexamethasone in the treatment of chronic subdural hematomas (CSDH) are only based on observational studies. Moreover, the use of corticosteroids in asymptomatic or minimally symptomatic patient with this condition remains controversial. Here, we present data from a prospective randomized pilot study of CSDH patients treated with dexamethasone or placebo. Methods: Twenty patients with imaging-confirmed CSDH were recruited from a single center and randomized to receive dexamethasone (12 mg/day for 3 weeks followed by tapering) or placebo as a conservative treatment. Patients were followed for 6 months and the rate of success of conservative treatment with dexamethasone versus placebo was measured. Parameters such as hematoma thickness and clinical changes were also compared before and after treatment with chi-square tests. Adverse events and complications were documented. Results: During the 6-month follow-up, one of ten patients treated with corticosteroids had to undergo surgical drainage and three of ten patients were treated surgically after placebo treatment. At the end of the study, all remaining patients had complete radiological resolution. No significant differences were observed in terms of hematoma thickness profile and impression of change; however, patients experienced more severe side effects when treated with steroids as compared with placebo. Dexamethasone contributed to many serious adverse events. Conclusions: Given the small sample size, these preliminary results have not shown a clear beneficial effect of dexamethasone against placebo in our patients. However, the number of secondary effects reported was much greater for corticosteroids, and dexamethasone treatment was responsible for significant complications.

Abstract 13215: Gender-affirming Hormones Are Associated With Increased Risk of QT Prolongation in Transgender Females

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Daniel Antwi Amoabeng ◽  
Ahmed Hanfy ◽  
Munadel Awad ◽  
Bryce D Beutler ◽  
Amneet Rai ◽  
...  
Keyword(s):  
Qt Interval ◽  
Small Sample Size ◽  
Qt Prolongation ◽  
Small Sample ◽  
Rank Test ◽  
Qt Interval Prolongation ◽  
Northern Nevada ◽  
Increased Risk ◽  
Before And After ◽  
Signed Rank Test

Introduction: Women have a longer QT interval than men. This sex-specific difference is attributed to hormones associated with the biological female sex. Male-to-female transgender individuals often take antiandrogens such as spironolactone or goserelin in addition to estrogens to suppress testosterone effects while increasing feminine features. Effects of gender-affirming hormone therapy (GHT) on the QT interval in these individuals remains to be elucidated. Hypothesis: We assessed the hypothesis that the use of GHT is associated with an increased risk for QT interval prolongation in transgender females. Methods: We identified 46 transgender females through a search of the electronic medical records of a Veterans Administration hospital in Northern Nevada. Patients with a diagnosis of congenital long QT syndrome were excluded. Of these, 13 patients had ECGs before and after initiation of GHT and were included. We adapted the Tisdale score using the auto-calculated corrected QT interval (QTc) to estimate the risk of QT prolongation. Age, QTc, and Tisdale scores before and after GHT initiation were compared using the Wilcoxon signed-rank test. All tests were performed as two-tailed at a 5% level of significance. Results: All 13 study patients were taking estrogens. Of these, 3 (23.1%) were taking goserelin and 9 (69.2%) were taking spironolactone. Mean ± SEM age at ECG acquisition was 45.0 ± 4.4 and 47.7 ± 4.7 years before and after the initiation of GHT respectively. Mean ± SEM QTc after initiation of GHT was significantly higher compared to the baseline (467.5 ± 12.8 ms vs. 428.2 ± 7.1 ms) (Figure 1A). The average baseline Tisdale score was significantly smaller on follow-up (1-point vs. 3 points) (Figure 1B). Conclusions: GHT appears to be associated with increased QTc in transgender women. This needs to be interpreted with caution owing to the very small sample size in this study. Further studies to investigate the strength of this association, if it exists, are warranted.

scholarly journals The use of the Addenbrooke's Cognitive Examination in a community memory clinic

2014 ◽  
Vol 27 (1) ◽  
pp. 167-168
Author(s):  
Victor Michael Aziz ◽  
Padmavathy Srinivasalu Gopinath ◽  
Georgia Baily
Keyword(s):  
Early Diagnosis ◽  
Neurological Examination ◽  
Clinical Assessment ◽  
Cognitive Assessment ◽  
Cognitive Tests ◽  
Accurate Assessment ◽  
Memory Clinic ◽  
Next Of Kin ◽  
Diagnosis Of Dementia ◽  
Addenbrooke’S Cognitive Examination

Early diagnosis of dementia enables early intervention and gives people the opportunity to make choices and plan for their future. Such an early diagnosis requires accurate assessment. A clinical assessment in people with suspected dementia in a memory clinic setting should include a clinical interview of the patient and their next of kin, a physical and neurological examination, cognitive assessment with appropriate cognitive tests, blood investigations, ECG (electrocardiography), and brain imaging.

scholarly journals ‘How do they want to know?’ Doctors’ perspectives on making and communicating a diagnosis of dementia

Dementia ◽  
2018 ◽  
Vol 18 (7-8) ◽  
pp. 3004-3022 ◽  
Author(s):  
Cate Bailey ◽  
Jemima Dooley ◽  
Rose McCabe
Keyword(s):  
Cognitive Impairment ◽  
Public Awareness ◽  
Memory Clinic ◽  
Training And Supervision ◽  
Diagnosis Of Dementia ◽  
Memory Clinics ◽  
The Individual ◽  
Limiting Condition ◽  
The Uk ◽  
First Time

Recent drives to facilitate earlier identification of dementia have led to increased memory clinic referrals and diagnoses. This study explored the perspectives of memory clinic doctors on making and delivering diagnoses. Four focus groups were conducted with 13 psychiatrists and two geriatricians in the UK. Transcripts were coded line by line using NVIVO. Thematic analysis identified 39 categories, 18 sub-themes and eight overarching themes. Inter-rater reliability on 31% of the data was 0.89. Increased public awareness of dementia was viewed positively in facilitating access to diagnosis and treatment. Doctors viewed diagnosis as a process and expressed concerns about limited pre-diagnostic counselling and post-diagnostic support. In diagnostic delivery doctors sought to develop a narrative drawing on the patient’s report of symptoms and adjust explanations to patient preferences and awareness. However, tailoring the delivery to the individual patient was challenging when meeting for the first time. These consultations often involved three participants (doctor, patient and relative), who were felt to have differing needs and expectations. Doctors emphasized that delicacy was required in deciding in what could be discussed in front of both parties, however also stressed the importance of explicitly naming ‘dementia’. Efforts were made to balance honesty and hope when discussing prognosis and medication. The work was sometimes emotionally distressing, with limited supervision. Existing communication training was felt to be inadequate for consultations involving triads or people with cognitive impairment. Delivering a dementia diagnosis is a nuanced and challenging task. Negotiating honest descriptions of a life-limiting condition whilst instilling hope is further complicated when cognitive impairment affects comprehension. Misunderstandings at the time of feedback may limit patient opportunities for informed future planning afforded by early diagnosis. Doctors in memory clinics would benefit from evidence based training and supervision to prepare them for these emotionally challenging and complex consultations.

Evaluation of Patient Feedback following Laparoscopic Cholecystectomy based on Information Described in the Informed Consent form Developed by the Association of Polish Surgeons

2015 ◽  
Vol 87 (11) ◽  
Author(s):  
Piotr Misiak ◽  
Sławomir Jabłoński ◽  
Jerry Lazarek ◽  
Katarzyna Malinowska ◽  
Edyta Santorek-Strumiłło ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Informed Consent ◽  
Surgical Intervention ◽  
Small Sample Size ◽  
Laparoscopic Approach ◽  
Invasive Procedure ◽  
Small Sample ◽  
Consent Form ◽  
Patient Feedback ◽  
Informed Consent Form

AbstractThe cholecystectomy procedure is the most routinely performed intervention in general surgery. The current international gold standard is via the laparoscopic approach. It is a safe, minimally-invasive procedure; however, it is associated with complications in 1% of cases.was to analyze patient feedback, by means of a survey, to determine how much knowledge patients possessed about their disease state and proposed surgical intervention, based primarily on information contained within the informed consent form developed by the Association of Polish Surgeons.This study involved the participation of 51 patients who underwent laparoscopic cholecystectomy, indicated by a diagnosis of gallstones, in the years 2014 and 2015.Despite having signed the informed consent form, there was considerable variation among the responses given to the survey by the 51 patients in this study. Some patients’ responses were tangential to the questions asked; many patients did not respond to any of the sub points.Given that this study is based on a small sample size of patients, it must be presumed that the process by which the patient declares his or her informed consent requires further consideration with respect to the means by which it is obtained. The authors of this study thus recommend that multimedia resources be harnessed as part of the process of obtaining the informed consent of patients prior to surgical intervention.

Workplace Satisfaction Before and After Move to an Open Plan Office - Including Interactions with Gender and Introversion

2017 ◽  
Vol 61 (1) ◽  
pp. 455-459 ◽  
Author(s):  
Nathan Bos ◽  
Kylie Molinaro ◽  
Alexander Perrone ◽  
Kelly Sharer ◽  
Ariel Greenberg
Keyword(s):  
Ad Hoc ◽  
Additional Data ◽  
Small Sample Size ◽  
Small Sample ◽  
Workplace Satisfaction ◽  
Flexible Support ◽  
Before And After ◽  
Open Plan ◽  
Data Source ◽  
Insight Into

Open plan offices are both popular and controversial. We studied the response of a group moving from shared, but closed offices to an open plan office. The main data source reported here is a workplace satisfaction survey given pre-move, post-move, and to a lab baseline comparison group at the same organization, with some additional data from observations and interviews. Workers moving to the open plan office appreciated the flexible support for collaboration and the space’s appearance. There was lower satisfaction related to space for private concentrated work, temperature control, and ability to have private conversations. There were also some statistical interactions suggesting more positive responses by males and less positive responses by introverts; analysis was limited by small sample size. Observations and interviews gave further insight into open plan “neighborhoods” and the design of ad hoc spaces.

scholarly journals Human milk for neonatal pain relief during ophthalmoscopy

2013 ◽  
Vol 47 (5) ◽  
pp. 1039-1045 ◽  
Author(s):  
Laiane Medeiros Ribeiro ◽  
Thaila Correa Castral ◽  
Liciane Langona Montanholi ◽  
Mariana Firmino Dare ◽  
Aline Carolina de Araujo Silva ◽  
...  
Keyword(s):  
Pain Relief ◽  
Early Diagnosis ◽  
Human Milk ◽  
Premature Infants ◽  
Neonatal Intensive Care ◽  
Small Sample Size ◽  
Small Sample ◽  
University Hospital ◽  
Experimental Investigations ◽  
Significant Difference

Ophthalmoscopy performed for the early diagnosis of retinopathy of prematurity (ROP) is painful for preterm infants, thus necessitating interventions for minimizing pain. The present study aimed to establish the effectiveness of human milk, compared with sucrose, for pain relief in premature infants subjected to ophthalmoscopy for the early diagnosis of ROP. This investigation was a pilot, quasi-experimental study conducted with 14 premature infants admitted to the neonatal intensive care unit (NICU) of a university hospital. Comparison between the groups did not yield a statistically significant difference relative to the crying time, salivary cortisol, or heart rate (HR). Human milk appears to be as effective as sucrose in relieving acute pain associated with ophthalmoscopy. The study’s limitations included its small sample size and lack of randomization. Experimental investigations with greater sample power should be performed to reinforce the evidence found in the present study.

Is increased screen time associated with the development of anxiety or depression in young people?

2017 ◽  
Vol 41 (S1) ◽  
pp. S530-S531 ◽  
Author(s):  
J. Khouja ◽  
M. Munafò ◽  
K. Tilling ◽  
N. Wiles ◽  
C. Joinson ◽  
...  
Keyword(s):  
Young People ◽  
Screen Time ◽  
Maternal Education ◽  
Small Sample Size ◽  
Small Sample ◽  
Anxiety And Depression ◽  
Parents And Children ◽  
Increased Risk ◽  
Before And After ◽  
Competing Interest

IntroductionEmerging evidence suggests that sedentary behaviour, specifically time spent taking part in screen-based activities, such as watching television, may be associated with mental health outcomes in young people [1]. However, recent reviews have found limited and conflicting evidence for both anxiety and depression [2].ObjectivesThe purpose of the study was to explore associations between screen time at age 16 years and anxiety and depression at 18.MethodsSubjects (n = 1958) were from the Avon Longitudinal Study of Parents and Children (ALSPAC), a UK-based prospective cohort study. We assessed associations between screen time (measured via questionnaire at 16 years) and anxiety and depression (measured in a clinic at 18 years using the Revised Clinical Interview Schedule) using ordinal logistic regression, before and after adjustment for covariates (including sex, maternal education, family social class, parental conflict, bullying and maternal depression).ResultsAfter adjusting for potential confounders, we found no evidence for an association between screen time and anxiety (OR = 1.02; 95% CI 0.95–1.09). There was weak evidence that greater screen time was associated with a small increased risk of depression (OR = 1.05, 95% CI 0.98–1.13).ConclusionsOur results suggest that young people who spend more time on screen-based activities may have a small increased risk of developing depression but not anxiety. Reducing youth screen time may lower the prevalence of depression. The study was limited by screen time being self-reported, a small sample size due to attrition and non-response, and the possibility of residual confounding. Reverse causation cannot be ruled out.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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