Uveal Melanoma: Refusal of Treatment

2021 ◽  
pp. 1-7
Author(s):  
Randy Christopher Bowen ◽  
Soto Hansell ◽  
Vishal Raval ◽  
Jacquelyn M. Davanzo ◽  
Arun D. Singh
Keyword(s):  
Mental Health ◽  
Uveal Melanoma ◽  
Vision Loss ◽  
Small Sample Size ◽  
Neovascular Glaucoma ◽  
Small Sample ◽  
Average Delay ◽  
Patient Reported ◽  
Sociodemographic Profile ◽  
The Impact

<b><i>Purpose:</i></b> This study aimed to explore factors for refusing treatment in patients diagnosed with uveal melanoma and their subsequent clinical course. <b><i>Methods:</i></b> This study included patients with uveal melanoma who refused standard of care treatment. Patient-reported reasons and pre-existing mental health diagnoses were assessed. The sociodemographic profile was compared with the controls. Ocular survival, metastasis-free survival (MFS), and overall survival (OS) were calculated. <b><i>Results:</i></b> Nine patients with uveal melanoma declined ocular treatment (plaque brachytherapy, <i>n</i> = 7 [78%]; enucleation, <i>n</i> = 2 [22%]). The choroidal melanomas were small (<i>n</i> = 1 [11%]), medium (<i>n</i> = 5 [56%]), and large (<i>n</i> = 3 [33%]) in size (COMS criteria). The sociodemographic profile of the study patients was not different from those that accepted treatment. One patient (11%) had pre-existing mental health diagnosis. Five patients (56%) eventually accepted treatment following an average delay of 19 months (range: 4–55 months) due to neovascular glaucoma or severe vision loss. MFS could not be ascertained, and OS was 67% (6/9) at 4.2 years of follow-up (mean). <b><i>Conclusions:</i></b> Refusal of initial recommended treatment is associated with poor ocular survival. The small sample size did not allow for an evaluation of the impact on survival.

scholarly journals Why make the effort? Exploring recovery college engagement

2018 ◽  
Vol 22 (1) ◽  
pp. 27-33 ◽  
Author(s):  
Leanne Harper ◽  
Mick McKeown
Keyword(s):  
Mental Health ◽  
Social Factors ◽  
Design Methodology ◽  
Small Sample Size ◽  
Structured Interview ◽  
Small Sample ◽  
Mental Health Recovery ◽  
Valuable Contribution ◽  
Content Type ◽  
The Impact

Purpose Whilst there is growing evidence to suggest that the recovery college (RC) environment supports students towards their mental health recovery (Meddings et al., 2015b), students’ initial motivations for engagement, alongside factors that may hinder or support attendance, have yet to be exclusively explored. The paper aims to discuss these issues. Design/methodology/approach All new RC students were invited to take part in a semi-structured interview three months following their enrolment. Four participants completed an interview which were later analysed using thematic analysis. Findings Four themes emerged within analysis: making the effort; being “too unwell”; friendly environment; and glad I came. These are discussed alongside the literature, and it is proposed that whilst there is a substantial struggle involved in engagement with a RC, likely related to mental health and social factors, the RC environment, peer support and support of the tutors helps students to overcome the impact of this. Research limitations/implications Due to the small sample size and exploratory stance of this study, additional research into the complexities around engagement with RCs is strongly recommended. Only students who had attended at least one RC course chose to participate in this study, therefore an under-researched population of non-attendees may provide a valuable contribution to further understanding. Originality/value This is one of the first studies to qualitatively explore factors which may support, or hinder, initial and ongoing engagement with a RC. It is proposed that a greater understanding of these important issues could be used to increase RC accessibility and inclusion.

Design for Simulator Performance Evaluations of Driving with Vision Impairments and Visual Aids

2005 ◽  
Vol 1937 (1) ◽  
pp. 128-135 ◽  
Author(s):  
E. Peli ◽  
A. R. Bowers ◽  
A. J. Mandel ◽  
K. Higgins ◽  
R. B. Goldstein ◽  
...  
Keyword(s):  
Visual Field ◽  
Vision Loss ◽  
Driving Simulator ◽  
Small Sample Size ◽  
Visual Field Loss ◽  
Small Sample ◽  
Visual Aids ◽  
Pilot Studies ◽  
Strong Basis ◽  
The Impact

Driving simulator technology provides a safe method for evaluating the impact of vision loss on different components of the driving task and the potential efficacy of visual aids intended to compensate for a particular type of vision loss. Most previous investigations have used general driving scenarios. It is proposed here that scenarios with different task requirements be designed specifically to address the condition under investigation. As an example, the design of driving scenarios and tasks that are specific for the evaluation of one type of visual field loss, homonymous hemianopia, is described. Results of pilot studies show that even with a small sample size, the design is sufficiently sensitive to differentiate individuals with hemianopic visual field loss from control drivers. These results suggest that careful design of test situations, measurements, and analyses provides a strong basis for investigations of driving performance of individuals with specific types of vision impairment and could be used to evaluate the efficacy of low-vision driving aids.

scholarly journals Working in the woodlands: a mixed methods evaluation of Green Care in first episode psychosis

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S51-S51
Author(s):  
Harriet Sharp ◽  
Sharon Cuthbert ◽  
Clio Berry
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Thematic Analysis ◽  
Small Sample Size ◽  
Small Sample ◽  
First Episode ◽  
Psychotic Experience ◽  
Care Programme ◽  
Patient Reported ◽  
Early Intervention In Psychosis

AimsRecognition of the essential role of nature-based activities for general wellbeing is expanding. Previous evaluation of nature-based activities has shown that those with greater mental health needs may benefit proportionally more compared to the general population. Currently, there is limited evidence of the benefits of green care for those with severe and enduring mental illness, including psychosis.We aim to establish benefits and difficulties encountered during a 10-session green care programme for 18-30 year olds who have experienced first episode of psychosis (FEP) using a mixed methods approach.MethodThis was a service evaluation of the Woodland Group, run by Circle of Life Rediscovery (CLR) and commissioned by Sussex Partnership NHS Foundation Trust in Autumn 2019 for 10 half-day sessions. All participants were aged 18–30 years, referred from Early Intervention in Psychosis service and had experienced FEP. Patients were supported by EIS staff with a ratio of at least 3:1. Sessions consisted of a welcome and agenda setting, ice-breaking activity, core nature-based activity (such as roasting chestnuts, maintaining the woodland area) and a ‘sense meditation’.Quantitative data for this evaluation were collected through routinely collected 15-item Questionnaire on the Process of Recovery (QPR), and a semi-structured intervention experience questionnaire. Qualitative data were collected via a focus group within the final session of the Woodlands Group. Thematic analysis was performed by the three co-authors.ResultSession attendance ranged between 3-15. 4/8 patients showed reliable improvement on QPR outcome measures, 1 showed deterioration and 3 showed no change. Mean QPR scores showed modest increase from average 3.4 (week 1) to 3.8 (week 10). 100% of respondents would recommend this group to others. Thematic analysis identified themes of connection with nature and others, development of a sense of wellbeing and ‘peacefulness’ and new perspectives on psychotic experience.ConclusionThis small, retrospective evaluation is the first to investigate green care interventions for young people experiencing FEP. Our results reflect the positive informal feedback from participants and supporting staff following attendance at the Woodlands Group. Limitations include small sample size, incomplete data, and reliance on patient-reported outcomes. These findings show promise for green care activities within EIS and represents a sustainable intervention in mental health care.

scholarly journals A gardening and woodwork group in mental health: a step towards recovery

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Róisín Sinnott ◽  
Maria Rowlís
Keyword(s):  
Mental Health ◽  
Group Intervention ◽  
Goal Attainment ◽  
Small Sample Size ◽  
Therapy Group ◽  
Small Sample ◽  
Content Type ◽  
Mental Health Settings ◽  
Goal Attainment Scale ◽  
The Impact

Purpose This paper aims to evaluate the impact of an eight-week gardening and woodwork group programme on individuals’ recovery goals in an adult community mental health setting. Design/methodology/approach Seven individuals participated in the research. The programme was designed and facilitated by two occupational therapists (the authors) and one horticulture and trade skills facilitator. The goal attainment scale was used as a quantitative outcome measure as it allowed individuals to collaboratively set occupation-focused recovery-oriented goals. Due to the small sample size, descriptive statistics were used to analyse this data. Qualitative feedback was gathered through participant feedback forms when the programme ended. Findings Quantitative findings indicate positive results for individuals’ progression towards their recovery goals, with six out of seven participants either achieving or exceeding their goals. One person who attended only one out of eight groups had “worse than expected” goal achievement. Originality/value While there is evidence for the use of gardening and woodwork group therapy in mental health settings, most studies have relied on symptom-focused questionnaires or qualitative results rather than quantifiable recovery-oriented measures (Cipriani et al., 2017; Kamioka et al., 2014; Parkinson et al., 2011). It is hoped that this paper begins to bridge that gap and also outlines how recovery principles, gardening and woodwork can be incorporated into occupational therapy group programmes. This is of particular merit during the COVID-19 pandemic, which has led to a greater need for group intervention in outdoor settings, where social distancing can be comfortably facilitated.

Locked down and drinking? Are more people self-identifying as having mental health difficulties alongside their drinking via an online platform?

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Angela Calcan ◽  
Mark Holmes
Keyword(s):  
Mental Health ◽  
Mental Health Treatment ◽  
Small Sample Size ◽  
Small Sample ◽  
Self Report ◽  
Control Group ◽  
Treatment Needs ◽  
Content Type ◽  
Digital Service ◽  
The Impact

Purpose The purpose of this paper is to offer a viewpoint on the impact that the COVID-19 pandemic has had on people’s engagement with an online alcohol service in the UK. This paper examines whether self-reported mental health concerns increased during the pandemic compared to pre-pandemic times. Design/methodology/approach A comparison was made between service data captured in one contract area – West Sussex, England – pre-pandemic (April 2019 to March 2020) and during pandemic (April 2020 to March 2021). Findings Self-reported mental health treatment needs increased during the pandemic period (71.2% of presentations compared to 50% pre-pandemic) via the online coaching service. Male referrals increased by 74% during the pandemic period compared to the previous year. Female referrals decreased by 4% in the same time period. Feelings of shame and guilt as well as loss of a confidential space to engage in online interventions were common concerns reported by service users. Research limitations/implications Research limitations include the relatively small sample size, the sample comprised of self-referred treatment seeking clients, and there was no control group. All data collected is self-report therefore subjective and not necessarily meeting diagnostic criteria. Practical implications Of note was the impact of the pandemic on women and their reduced access to the online service during the pandemic. Commissioners and services must adapt their service design and delivery alongside the new “normal” way of living and working. Routine screening of mental health and alcohol use are recommended. Originality/value This paper offers insight from an established online/digital service and the impact of the pandemic on people’s engagement with the service.

An influence of social isolation on the level of physical activity as well as on well-being and mental state of people during the coronavirus COVID-19 pandemic

2019 ◽  
Vol 129 (4) ◽  
pp. 127-131
Author(s):  
Agnieszka Parfin ◽  
Krystian Wdowiak ◽  
Marzena Furtak-Niczyporuk ◽  
Jolanta Herda
Keyword(s):  
Physical Activity ◽  
Social Isolation ◽  
Small Sample Size ◽  
Statistical Tests ◽  
Population Group ◽  
Well Being ◽  
Small Sample ◽  
Subjective Well Being ◽  
Tract Infections ◽  
The Impact

AbstractIntroduction. The COVID-19 is the name of an infectious disease caused by a new strain of coronavirus SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2). It was first diagnosed in December 2019 in patients in Wuhan City, Hubei Province, China. The symptoms are dominated by features of respiratory tract infections, in some patients with a very severe course leading to respiratory failure and, in extreme cases to death. Due to the spread of the infection worldwide, the WHO declared a pandemic in March 2020.Aim. An investigation of the impact of social isolation introduced due to the coronavirus pandemic on selected aspects of life. The researchers focused on observing changes in habits related to physical activity and their connections with people’s subjective well-being and emotional state.Material and methods. The study was carried out within the international project of the group „IRG on COVID and exercise”. The research tool was a standardized questionnaire.Results. Based on the data collected and the analysis of the percentage results, it can be observed that the overwhelming majority of people taking up physical activity reported a better mood during the pandemic. However, statistical tests do not confirm these relationships due to the small sample size.Conclusions. Isolation favours physical activity. Future, in-depth studies, by enlarging the population group, are necessary to confirm the above observations.

scholarly journals The Role of Dopamine Receptor D2 in Bridging the Intention-Behavior Gap in Sport Participation

2021 ◽  
Vol 18 (5) ◽  
pp. 2379
Author(s):  
Seiyeong Park ◽  
Junhye Kwon ◽  
Chiyoung Ahn ◽  
Hae-Sung Cho ◽  
Hyo Youl Moon ◽  
...  
Keyword(s):  
University Students ◽  
Dopamine Receptor ◽  
Sport Participation ◽  
Small Sample Size ◽  
Behavioral Model ◽  
Small Sample ◽  
Male Students ◽  
Future Research ◽  
Dopamine Receptor D2 ◽  
The Impact

Previous studies have identified that a behavior can occur through the strongest predictor intention, but there is a gap between intention and behavior. Dopamine receptor D2 (DRD2) is known to account for a variance in sporting behaviors in human and animal subjects. However, the relationship between DRD2 and sport participation has been poorly studied, and the limited available reports are inconsistent. The present study was performed to examine the impact of DRD2 on sport participation among Korean university students based on the integrated behavioral model (IBM). Data were collected from enrolled university students in Seoul (N = 45). Participants answered survey questions first, and then they gave investigators their hair to provide DNA information (i.e., the A1 allele of DRD2). DRD2 had a significant effect on sport participation, but only in male students. Male students who carried the A1 allele of DRD2 significantly participated in 105.10 min more sporting activities than male students who did not. Moreover, the effect of intention on sport participation was significantly decreased when considering DRD2. Despite the small sample size, the results of this study could be a preliminary case for a larger study and indicate the direction of future research. Our results suggest that DRD2 may have played an important role as the “actual skill” shown in the IBM.

T3 Are Burns a Chronic Condition: Examining Physical and Mental Functioning up to 20 Years After Injury

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S2-S3
Author(s):  
Callie Abouzeid ◽  
Audrey E Wolfe ◽  
Gretchen J Carrougher ◽  
Nicole S Gibran ◽  
Radha K Holavanahalli ◽  
...  
Keyword(s):  
Mental Health ◽  
Hospital Stay ◽  
National Database ◽  
Time Points ◽  
Patient Reported ◽  
Burn Survivors ◽  
Population Demographic ◽  
The Impact ◽  
Over Time

Abstract Introduction Burn survivors often face many long-term physical and psychological symptoms associated with their injury. To date, however, few studies have examined the impact of burn injuries on quality of life beyond 2 years post-injury. The purpose of this study is to examine the physical and mental well-being of burn survivors up to 20 years after injury. Methods Data from the Burn Model System National Database (1997–2020) were analyzed. Patient-reported outcome measures were collected at discharge with a recall of preinjury status, and then at 5, 10, 15, and 20 years after injury. Outcomes examined were the Physical Component Summary (PCS) and Mental Component Summary (MCS) of the Short Form-12. Trajectories were developed using linear mixed methods model with repeated measures of PCS and MCS scores over time and controlling for demographic and clinical variables. The model fitted score trajectory was generated with 95% confidence intervals to demonstrate score changes over time and associations with covariates. Results The study population included 420 adult burn survivors with a mean age of 42.4 years. The population was mainly male (66%) and white (76.4%) with a mean burn size of 21.5% and length of hospital stay of 31.3 days. Higher PCS scores were associated with follow-up time points closer to injury, shorter hospital stay, and younger age. Similarly, higher MCS scores were associated with earlier follow-up time points, shorter hospital stay, female gender, and non-perineal burns. MCS trajectories are demonstrated in the Figure. Conclusions Burn survivors’ physical and mental health worsened over time. Such a trend is different from previous reported results for mental health in the general population. Demographic and clinical predictors of recovery over time are identified.

Nipple Confusion

PEDIATRICS ◽  
1993 ◽  
Vol 92 (2) ◽  
pp. 300-301
Author(s):  
DOREN FREDRICKSON
Keyword(s):  
Breast Feeding ◽  
Statistical Power ◽  
White Women ◽  
Small Sample Size ◽  
False Negative ◽  
Small Sample ◽  
Bottle Feeding ◽  
Feeding Duration ◽  
Breast Feed ◽  
The Impact

To the Editor.— I wish to comment on the study reported by Cronenwett et al,1 which was a fascinating prospective study among married white women who planned to breast-feed. Women were randomly selected to perform either exdusive breast-feeding or partial breast-feeding with bottled human milk supplements to determine the impact of infant temperament and limited bottle-feeding on breast-feeding duration. The authors admit that small sample size and lack of statistical power make a false-negative possible.

The impact of vestibular symptoms and electronystagmography results on recovery from sudden sensorineural hearing loss

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Gaelle Vofo ◽  
Marrigje Aagje de Jong ◽  
Michal Kaufman ◽  
Julia Meyler ◽  
Ron Eliashar ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Small Sample Size ◽  
Small Sample ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Caloric Test ◽  
Routine Identification ◽  
The Impact ◽  
Caloric Tests

Abstract Objectives Idiopathic sudden sensorineural hearing loss (SSNHL) represents a frequently encountered otological entity, of various types and severity, with an array of associated symptoms including vertigo. This is a devastating life-changing condition with a blurry prognosis. The objective of this study was to determine the clinical association of vestibular impairment by electronystagmography (ENG) and caloric tests, and their ability to predict prognosis. Methods An observational, crossectional study was carried out amongst patients admitted with SSNHL. Each consenting patient had an audiometry test performed on admission as well as ENG and caloric tests. Treatment included oral steroids and carbogen with intratympanic steroids used only as salvage treatment. Follow-up was completed after 6 months when hearing gains were evaluated. Finally, an association was sought between the rate of recovery and ENG and caloric test results. Results Of 35 patients included, marked recovery was seen in patients without vertigo when compared to those with vertigo (p=0.003). A statistically significant association was found between the presence of vertigo and hearing deterioration (p=0.008). More so, normal electronystagmography results were associated with marked recovery (p=0.04). Conclusions The vestibular end organs are both subjectively and objectively affected in SSNHL as demonstrated by the abnormal ENG and caloric tests in our study despite the small sample size. Concomitant vestibular involvement carries poorer prognosis and routine identification may help foresee the recovery of patients with SSNHL and as such, aid in patient counseling. ENG and caloric tests are easily available and may be recommended for all patients with SSNHL.

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