scholarly journals 030 Management and attitudes towards persons with epilepsy in general practice: how far have we come?

2019 ◽  
Vol 90 (e7) ◽  
pp. A11.1-A11
Author(s):  
Angelos Sharobeam ◽  
Abul Mamun ◽  
Roy G Beran
Keyword(s):  
General Practitioners ◽  
Further Education ◽  
Formal Training ◽  
List Type ◽  
Psychosocial Issues ◽  
Care Giver ◽  
Follow Up Study ◽  
Perceptual Shift ◽  
Sydney Australia

IntroductionPrevious surveys of general practitioners (GP) attitudes regarding epilepsy and people with epilepsy (PWE), conducted 20–30 years ago1 2, identified the need for further education in epilepsy care for GPs. This follow up study of GPs in Sydney, Australia, was conducted to determine the degree of changes in knowledge, attitudes and management of PWE, to evaluate if there had been significant improvement during this period.MethodsA piloted questionnaire addressing epilepsy investigations, preferred care provider and attitudes towards epilepsy was developed and completed by a representative sample of Sydney GPs.ResultsA total of 52 completed responses were received. 36 out of 47 GPs (77%) chose neurologists as the most important care giver, followed by the GP (9/47; 18.7%), 25/51 respondents (49%) mentioned they never personally initiated anti-epileptic medication (AEM) and another 27% (14/51 GPs) rarely commenced AEM therapy. 6/50 GPs did not mention EEG as a routine investigation and 21/50 did not mention MRI as routine for PWE. The five most commonly prescribed AEMs, according to frequency were sodium valproate (42), carbamazepine (37), levetiracetam (31), lamotrigine (16) and phenytoin (15). Newer AEMs, available for over a decade in Australia were not mentioned. Emotional, behavioral psychosocial issues were perceived to be more common amongst PWE.ConclusionThe study indicates little perceptual shift regarding GP’s attitudes to epilepsy, and significant deficiencies in knowledge, particularly with regards to investigations and management. The findings reinforce a need for more formal training of GPs caring for PWE.ReferencesBeran RG, Read T. A survey of doctors in Sydney, Australia: perspectives and practices regarding epilepsy and those affected by it. Epilepsia. 1983;24(1):79–104.Frith JF, Harris MF, Beran RG. Management and attitudes of epilepsy by a group of Sydney general practitioners. Epilepsia. 1994;35(6):1244–7.

scholarly journals Out-of-hospital emergency care providers’ work and clinical skills in Finland: A follow-up study

2017 ◽  
Vol 6 (1) ◽  
pp. 51
Author(s):  
Riitta Mikkola ◽  
Mari Salminen-Tuomaala ◽  
Eija Paavilainen ◽  
Päivi Leikkola
Keyword(s):  
Educational Intervention ◽  
Emergency Care ◽  
Clinical Competence ◽  
Clinical Skills ◽  
Further Education ◽  
Care Providers ◽  
Hospital Emergency ◽  
Hospital District ◽  
Follow Up Study

Objective: This follow-up study is part of a larger study on emergency medical services. Its purpose was to describe emergency care providers’ perceptions of their work, its challenges and their clinical competence. The study aimed at producing knowledge of the perceived influence of an educational intervention, to be used in developing emergency care providers’ further and updating education.Methods: Data were collected from staff working in out-of-hospital emergency care of a hospital district in Finland using a questionnaire developed for this purpose. The results were analyzed statistically using SPSS for Windows 24.Results: Over 90% of the respondents found that their work was interesting and provided sufficient challenges. The majority were also interested in continuous professional development. After the educational intervention, respondents found the work somewhat more challenging and slightly more strenuous both physically and mentally compared to the first survey. Respondents more commonly reported that new capacities were required at work and they rated their practical skills lower than in the first survey. However, work in a multiprofessional environment was found less challenging. Over 70% of the respondents planned to have further education in the near future. They rated their clinical skills as good, but slightly lower compared to the first survey.Conclusions: The results regarding work, its challenges and self-rated clinical competence remained the same or were somewhat poorer after the educational intervention. The results help improve the education to meet the needs of emergency staff.

scholarly journals Early probiotic supplementation with B. infantis in breastfed infants leads to persistent colonization at 1 year

2021 ◽  
Author(s):  
Claire E. O’Brien ◽  
Anna K. Meier ◽  
Karina Cernioglo ◽  
Ryan D. Mitchell ◽  
Giorgio Casaburi ◽  
...  
Keyword(s):  
Breast Milk ◽  
Gut Microbiome ◽  
Controlled Trial ◽  
Bifidobacterium Longum ◽  
List Type ◽  
Probiotic Supplementation ◽  
Breastfed Infants ◽  
Follow Up Study ◽  
Increased Risk

Abstract Background Recent studies have reported a dysfunctional gut microbiome in breastfed infants. Probiotics have been used in an attempt to restore the gut microbiome; however, colonization has been transient, inconsistent among individuals, or has not positively impacted the host’s gut. Methods This is a 2-year follow-up study to a randomized controlled trial wherein 7-day-old infants received 1.8 × 1010 colony-forming unit Bifidobacterium longum subsp. infantis (B. infantis) EVC001 (EVC) daily for 21 days or breast milk alone (unsupplemented (UNS)). In the follow-up study, mothers (n = 48) collected infant stool at 4, 6, 8, 10, and 12 months postnatal and completed the health-diet questionnaires. Results Fecal B. infantis was 2.5–3.5 log units higher at 6–12 months in the EVC group compared with the UNS group (P < 0.01) and this relationship strengthened with the exclusion of infants who consumed infant formula and antibiotics. Infants in the EVC group had significantly higher Bifidobacteriaceae and lower Bacteroidaceae and Lachnospiraceae (P < 0.05). There were no differences in any health conditions between the two groups. Conclusions Probiotic supplementation with B. infantis within the first month postnatal, in combination with breast milk, resulted in stable colonization that persisted until at least 1 year postnatal. Impact A dysfunctional gut microbiome in breastfed infants is common in resource-rich nations and associated with an increased risk of immune diseases. Probiotics only transiently exist in the gut without persistent colonization or altering the gut microbiome. This is the first study to show that early probiotic supplementation with B. infantis with breast milk results in stable colonization of B. infantis and improvements to the gut microbiome 1 year postnatal. This study addresses a key gap in the literature whereby probiotics can restore the gut microbiome if biologically selected microorganisms are matched with their specific food in an open ecological niche.

Long-term efficacy of cognitive–behavioral therapy by general practitioners for fatigue: A 4-year follow-up study

2006 ◽  
Vol 61 (5) ◽  
pp. 601-607 ◽  
Author(s):  
Stephanie S. Leone ◽  
Marcus J.H. Huibers ◽  
IJmert Kant ◽  
Ludovic G.P.M. van Amelsvoort ◽  
Constant P. van Schayck ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
General Practitioners ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Follow Up Study ◽  
Term Efficacy

scholarly journals Support and follow-up needs of patients discharged from Intensive Care after severe COVID-19: a mixed-methods study of the views of UK general practitioners and intensive care staff during the pandemic’s first wave

2020 ◽  
Author(s):  
Ana Castro-Avila ◽  
Laura Jefferson ◽  
Veronica Dale ◽  
Karen Bloor
Keyword(s):  
Intensive Care ◽  
Mixed Methods ◽  
General Practitioners ◽  
Large Cohort ◽  
Care Staff ◽  
Support Needs ◽  
List Type ◽  
Structured Interviews ◽  
Icu Discharge

AbstractBackgroundAfter discharge from an intensive care unit(ICU), over 50% of patients face significant physical, mental and cognitive problems. The COVID-19 pandemic has resulted in a large cohort of these patients who will need follow-up services that can address their support needs.ObjectivesTo identify follow-up services planned for COVID-19 patients discharged from ICU, and to explore the views of ICU staff and General Practitioners(GPs) regarding these patients’ future needs and care coordination.DesignSequential mixed-methods UK study. We explored usual follow-up practice after ICU discharge and changes in follow-up during the pandemic through a survey of ICU staff, and GP awareness of follow-up and support needs of patients discharged from ICU through a survey of GPs. Through these surveys, we identified participants for semi-structured interviews with both groups.ResultsWe obtained 170 survey responses and conducted 23 interviews. Over 60% of GPs were unaware of the follow-up services generally provided by their local hospitals, and whether or not these were functioning during the pandemic. Eighty percent of ICUs reported some form of follow-up services, with 25% of these suspending provision during the peak of the pandemic, and over half modifying their provision (usually to provide the service remotely). Complex funding streams, poor communication between primary and secondary care, and lack of clarity about who was responsible for referrals and follow-up were the most common problems identified. Discharge documentation was described as poor and lacking key information. Both groups mentioned difficulties accessing services in the community.ConclusionsThe pandemic has highlighted long-standing issues of continuity of care and complex funding streams for post-ICU follow-up care. The large cohort of ICU patients admitted due to COVID-19 highlights the need for improved follow-up services and communication between specialists and GPs, not only for COVID-19 patients, but for all those discharged from ICU.Article SummaryStrengths and limitations of this studyThis is the first study exploring NHS staff views of post-ICU follow-up services to support patients recovering from severe COVID-19.Responses to our survey had good geographic spread but were limited in number and relied on volunteers.GP interviews were small in number, but our findings align with those of larger studies conducted before the pandemic.

Electron Microscopy of Human Gallstones

1971 ◽  
Vol 29 ◽  
pp. 296-297
Author(s):  
C. Wolpers ◽  
R. Blaschke
Keyword(s):  
Electron Microscopy ◽  
Room Temperature ◽  
Bile Pigment ◽  
X Ray Diffraction ◽  
Triclinic Crystal System ◽  
X Ray ◽  
Follow Up Study ◽  
Infra Red ◽  
Main Components

Scanning microscopy was used to study the surface of human gallstones and the surface of fractures. The specimens were obtained by operation, washed with water, dried at room temperature and shadowcasted with carbon and aluminum. Most of the specimens belong to patients from a series of X-ray follow-up study, examined during the last twenty years. So it was possible to evaluate approximately the age of these gallstones and to get information on the intensity of growing and solving.Cholesterol, a group of bile pigment substances and different salts of calcium, are the main components of human gallstones. By X-ray diffraction technique, infra-red spectroscopy and by chemical analysis it was demonstrated that all three components can be found in any gallstone. In the presence of water cholesterol crystallizes in pane-like plates of the triclinic crystal system.

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