The Scale for the Prediction of Aggression and Dangerousness in Psychotic Patients (PAD):

1994 ◽  
Vol 21 (3) ◽  
pp. 341-356 ◽  
Author(s):  
STÅL BJØRKLY
Keyword(s):  
Pilot Study ◽  
Aggressive Behavior ◽  
Physical Aggression ◽  
Rating Scale ◽  
Secure Unit

The Scale for the Prediction of Aggression and Dangerousness in Psychotic Patients (PAD) is a rating scale constructed for the assessment of psychotic patients in relation to 29 situations or interactions. The instrument is used to rate the potential of these situations/interactions for precipitating aggressive behavior in psychotic patients. These assessments result in a profile of situational vulnerability that describes a patient's potential for aggressive behavior in relation to the 29 situations or interactions. In this pilot study, 10 psychotic patients at a special secure unit were assessed by means of this scale. After the completion of the PAD ratings, systematic observations of episodes involving verbal, threatened, and physical aggression were made throughout a 2-year follow-up period. The results indicate that the PAD was able to predict the patients' potential for aggression and, to some extent, the situations that were the most potent precipitants of aggressive behavior.

scholarly journals MON-LB109 Transcutaneous Magnetic Stimulation: A Novel Treatment of Diabetic Peripheral Neuropathy

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Medha Satyarengga ◽  
Kashif M Munir
Keyword(s):  
Back Pain ◽  
Peripheral Neuropathy ◽  
Pilot Study ◽  
Diabetic Peripheral Neuropathy ◽  
Magnetic Stimulation ◽  
Rating Scale ◽  
Post Treatment ◽  
Acute Low Back Pain ◽  
Post Traumatic

Abstract Objective: Transcutaneous Magnetic Stimulation (TCMS) is reported to be an effective treatment in multiple neurologic conditions such as migraine headaches, lower back pain, and post-traumatic peripheral neuropathic pain1-3. The efficacy and safety of TCMS for diabetic peripheral neuropathy is not known. We evaluated whether TCMS is effective and safe in patients with diabetic peripheral neuropathy. Method: Eight patients with a previous diagnosis of diabetic peripheral neuropathy and baseline numerical pain-rating scale (NPRS) of 5 or greater in both feet were enrolled. NPRS scale was set from 0 to 10, 0 represents no pain and 10 representing the most severe pain. Each patient was treated with a single session of TCMS applied first on the plantar then the dorsal surface of both feet. Magnetic pulses (1.2 Tesla) were delivered every 6 seconds for 5 minutes in each foot on the plantar and dorsal surfaces, respectively. NPRS was repeated post-treatment over the course of 28-days follow-up period. Results: The mean baseline NPRS was 5.8 (± 1.0). Immediately post-treatment, mean NPRS improved to 1.3 (± 1.9), a 77.7 (± 36.5) % decrease. Mean NPRS at 7 and 28 days of follow-up was 2.9 (± 2.8) and 4.1 (± 3.3), respectively. These represent a 53.2(± 42.4) % improvement at 7 days and 30.5(±52.4) % improvement at 28 days of follow-up compared to baseline NPRS. None of the patients reported significant discomfort during the treatment, and no major side effects were observed during the study period. Conclusion: In this pilot study of patients with diabetic peripheral neuropathy, TCMS appears to be a safe and effective alternative in providing temporary pain relief. Longer and more frequent treatment sessions need to be explored to see if these can increase the effective duration. References: 1. Barker AT, Shields K. Transcranial Magnetic Stimulation: Basic Principles and Clinical Applications in Migraine. Headache. 2017 Mar;57(3):517-524. 2. Leung A, Fallah A, Shukla S. Transcutaneous Magnetic Stimulation (tMS) in Alleviating Post-Traumatic Peripheral Neuropathic Pain States: A Case Series. Pain Medicine. 2014 Jul; 15(7): 1196-1199. 3. Lim YH, Song JM, Choi EH, Lee JW. Effects of Repetitive Peripheral Magnetic Stimulation on Patients with Acute Low Back Pain: A Pilot Study. Ann Rehabil Med. 2018 Apr; 42(2): 229-238.

scholarly journals A Patient-Oriented App (ThessHF) to Improve Self-Care Quality in Heart Failure: From Evidence-Based Design to Pilot Study

10.2196/24271 ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. e24271
Author(s):  
Constantinos Bakogiannis ◽  
Anastasios Tsarouchas ◽  
Dimitrios Mouselimis ◽  
Charalampos Lazaridis ◽  
Efstratios K Theofillogianakos ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Pilot Study ◽  
Rating Scale ◽  
Self Care ◽  
Care Quality ◽  
Hospitalization Rate ◽  
Evidence Based

Background Heart failure (HF) remains a major public health challenge, while HF self-care is particularly challenging. Mobile health (mHealth)–based interventions taking advantage of smartphone technology have shown particular promise in increasing the quality of self-care among these patients, and in turn improving the outcomes of their disease. Objective The objective of this study was to co-develop with physicians, patients with HF, and their caregivers a patient-oriented mHealth app, perform usability assessment, and investigate its effect on the quality of life of patients with HF and rate of hospitalizations in a pilot study. Methods The development of an mHealth app (The Hellenic Educational Self-care and Support Heart Failure app [ThessHF app]) was evidence based, including features based on previous clinically tested mHealth interventions and selected by a panel of HF expert physicians and discussed with patients with HF. At the end of alpha development, the app was rated by mHealth experts with the Mobile Application Rating Scale (MARS). The beta version was tested by patients with HF, who rated its design and content by means of the Post-Study System Usability Questionnaire (PSSUQ). Subsequently, a prospective pilot study (THESS-HF [THe Effect of a Specialized Smartphone app on Heart Failure patients’ quality of self-care, quality of life and hospitalization rate]) was performed to investigate the effect of app use on patients with HF over a 3-month follow-up period. The primary endpoint was patients’ quality of life, which was measured with the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the 5-level EQ-5D version (EQ-5D-5L). The secondary endpoints were the European Heart Failure Self-care Behavior Scale (EHFScBS) score and the hospitalization rate. Results A systematic review of mHealth-based HF interventions and expert panel suggestions yielded 18 separate app features, most of which were incorporated into the ThessHF app. A total of 14 patients and 5 mHealth experts evaluated the app. The results demonstrated a very good user experience (overall PSSUQ score 2.37 [SD 0.63], where 1 is the best, and a median MARS score of 4.55/5). Finally, 30 patients (male: n=26, 87%) participated in the THESS-HF pilot study (mean age 68.7 [SD 12.4] years). A significant increase in the quality of self-care was noted according to the EHFScBS, which increased by 4.4% (SD 7.2%) (P=.002). The mean quality of life increased nonsignificantly after 3 months according to both KCCQ (mean increase 5.8 [SD 15] points, P=.054) and EQ-5D-5L (mean increase 5.6% [SD 15.6%], P=.06) scores. The hospitalization rate for the follow-up duration was 3%. Conclusions The need for telehealth services and remote self-care management in HF is of vital importance, especially in periods such as the COVID-19 pandemic. We developed a user-friendly mHealth app to promote remote self-care support in HF. In this pilot study, the use of the ThessHF app was associated with an increase in the quality of self-care. A future multicenter study will investigate the effect of the app use on long-term outcomes in patients with HF.

scholarly journals Prescribing Patterns of Psychotropic Drugs and Risk of Violent Behavior: A Prospective, Multicenter Study in Italy

2020 ◽  
Vol 23 (5) ◽  
pp. 300-310
Author(s):  
E di Giacomo ◽  
A Stefana ◽  
V Candini ◽  
G Bianconi ◽  
L Canal ◽  
...  
Keyword(s):  
Aggressive Behavior ◽  
Psychotropic Drugs ◽  
Rating Scale ◽  
Violent Behavior ◽  
Prescribing Patterns ◽  
Overt Aggression ◽  
History Of ◽  
Axis I ◽  
Overt Aggression Scale

Abstract Background This prospective cohort study aimed at evaluating patterns of polypharmacy and aggressive and violent behavior during a 1-year follow-up in patients with severe mental disorders. Methods A total of 340 patients (125 inpatients from residential facilities and 215 outpatients) were evaluated at baseline with the Structured Clinical Interview for DSM-IV Axis I and II, Brief Psychiatric Rating Scale, Specific Levels of Functioning scale, Brown-Goodwin Lifetime History of Aggression, Buss-Durkee Hostility Inventory, Barratt Impulsiveness Scale, and State-Trait Anger Expression Inventory-2. Aggressive behavior was rated every 15 days with the Modified Overt Aggression Scale and treatment compliance with the Medication Adherence Rating Scale. Results The whole sample was prescribed mainly antipsychotics with high levels of polypharmacy. Clozapine prescription and higher compliance were associated with lower levels of aggressive and violent behavior. Patients with a history of violence who took clozapine were prescribed the highest number of drugs. The patterns of cumulative Modified Overt Aggression Scale mean scores of patients taking clozapine (n = 46), other antipsychotics (n = 257), and no antipsychotics (n = 37) were significantly different (P = .001). Patients taking clozapine showed a time trend at 1-year follow-up (24 evaluations) indicating a significantly lower level of aggressive behavior. Patient higher compliance was also associated with lower Modified Overt Aggression Scale ratings during the 1-year follow-up. Conclusion Both inpatients and outpatients showed high levels of polypharmacy. Clozapine prescription was associated with lower Modified Overt Aggression Scale ratings compared with any other antipsychotics or other psychotropic drugs. Higher compliance was associated with lower levels of aggressive and violent behavior.

scholarly journals A Patient-Oriented App (ThessHF) to Improve Self-Care Quality in Heart Failure: From Evidence-Based Design to Pilot Study (Preprint)

2020 ◽  
Author(s):  
Constantinos Bakogiannis ◽  
Anastasios Tsarouchas ◽  
Dimitrios Mouselimis ◽  
Charalampos Lazaridis ◽  
Efstratios K Theofillogianakos ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Pilot Study ◽  
Rating Scale ◽  
Self Care ◽  
Care Quality ◽  
Hospitalization Rate ◽  
Evidence Based

BACKGROUND Heart failure (HF) remains a major public health challenge, while HF self-care is particularly challenging. Mobile health (mHealth)–based interventions taking advantage of smartphone technology have shown particular promise in increasing the quality of self-care among these patients, and in turn improving the outcomes of their disease. OBJECTIVE The objective of this study was to co-develop with physicians, patients with HF, and their caregivers a patient-oriented mHealth app, perform usability assessment, and investigate its effect on the quality of life of patients with HF and rate of hospitalizations in a pilot study. METHODS The development of an mHealth app (The Hellenic Educational Self-care and Support Heart Failure app [ThessHF app]) was evidence based, including features based on previous clinically tested mHealth interventions and selected by a panel of HF expert physicians and discussed with patients with HF. At the end of alpha development, the app was rated by mHealth experts with the Mobile Application Rating Scale (MARS). The beta version was tested by patients with HF, who rated its design and content by means of the Post-Study System Usability Questionnaire (PSSUQ). Subsequently, a prospective pilot study (THESS-HF [THe Effect of a Specialized Smartphone app on Heart Failure patients’ quality of self-care, quality of life and hospitalization rate]) was performed to investigate the effect of app use on patients with HF over a 3-month follow-up period. The primary endpoint was patients’ quality of life, which was measured with the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the 5-level EQ-5D version (EQ-5D-5L). The secondary endpoints were the European Heart Failure Self-care Behavior Scale (EHFScBS) score and the hospitalization rate. RESULTS A systematic review of mHealth-based HF interventions and expert panel suggestions yielded 18 separate app features, most of which were incorporated into the ThessHF app. A total of 14 patients and 5 mHealth experts evaluated the app. The results demonstrated a very good user experience (overall PSSUQ score 2.37 [SD 0.63], where 1 is the best, and a median MARS score of 4.55/5). Finally, 30 patients (male: n=26, 87%) participated in the THESS-HF pilot study (mean age 68.7 [SD 12.4] years). A significant increase in the quality of self-care was noted according to the EHFScBS, which increased by 4.4% (SD 7.2%) (<i>P</i>=.002). The mean quality of life increased nonsignificantly after 3 months according to both KCCQ (mean increase 5.8 [SD 15] points, <i>P</i>=.054) and EQ-5D-5L (mean increase 5.6% [SD 15.6%], <i>P</i>=.06) scores. The hospitalization rate for the follow-up duration was 3%. CONCLUSIONS The need for telehealth services and remote self-care management in HF is of vital importance, especially in periods such as the COVID-19 pandemic. We developed a user-friendly mHealth app to promote remote self-care support in HF. In this pilot study, the use of the ThessHF app was associated with an increase in the quality of self-care. A future multicenter study will investigate the effect of the app use on long-term outcomes in patients with HF.

Pilot testing in the wild: Feasibility, acceptability, usage patterns and efficacy of an integrated web/smartphone platform for bipolar II disorder (Preprint)

2021 ◽  
Author(s):  
Kathryn Fletcher ◽  
Katrina Lindblom ◽  
Elizabeth Seabrook ◽  
Fiona Foley ◽  
Greg Murray
Keyword(s):  
Pilot Study ◽  
Rating Scale ◽  
Clinical Care ◽  
Management Program ◽  
Self Management ◽  
Post Intervention ◽  
Mindfulness Skills ◽  
Bipolar Ii ◽  
Usage Patterns

BACKGROUND Bipolar II (BD-II) disorder is associated with significant burden, disability and mortality, yet there continues to be a dearth of evidence-based psychological interventions for this condition. Technology-mediated interventions incorporating self-management have untapped potential to help meet this need as an adjunct to usual clinical care. OBJECTIVE The objectives of this pilot study were to assess the feasibility, acceptability and clinical utility of a novel intervention for BD-II (Tailored Recovery-oriented Intervention for Bipolar II Experiences; TRIBE), in which mindfulness-based psychological content is delivered via an integrated web/smartphone platform. A focus of the study was evaluation of the dynamic usage patterns emerging from ecological momentary assessment and intervention to assist real-world application of mindfulness skills learnt from web-delivered modules. METHODS An open trial design using pre-test and post-test assessments with nested qualitative evaluation was used. Individuals (aged 18 to 65) with a diagnosis of BD-II were recruited worldwide and invited to use a prototype of the TRIBE intervention over a 3-week period. Data were collected via online questionnaires and phone interviews at baseline and 3-week follow-up. RESULTS A total of 18 participants completed baseline and follow-up assessments. Adherence rates (daily app use) were 65.6% across the 3-week study, with up to 88.9% of participants using the app synergistically alongside the web-based program. Despite technical challenges with the prototype intervention (from user, hardware and software standpoints), acceptability was adequate: The majority of participants rated the intervention positively in terms of the concept (companion app with website), content and credibility, and utility in supporting their management of BD. Evaluation using behavioural archetypes identified important use pathways and a provisional model to inform platform refinement. As hypothesised, depression scores significantly decreased post-intervention (Montgomery Asberg Depression Rating Scale baseline mean = 8.60 vs. follow-up mean = 6.16, t = 2.63, p = .01, d = .53, 95% CI = 0.52, 4.36). CONCLUSIONS Our findings suggest that TRIBE is feasible and represents an appropriate and acceptable self-management program for BD-II. Preliminary efficacy results are promising and support full development of TRIBE informed by the present behavioural archetype analysis. Modifications suggested by the pilot study include increasing the duration of the intervention and increasing technical support.

A Pilot Study of Mobile Telephone Message Interventions with Suicide Attempters in China

Crisis ◽  
2010 ◽  
Vol 31 (2) ◽  
pp. 109-112 ◽  
Author(s):  
Hui Chen ◽  
Brian L. Mishara ◽  
Xiao Xian Liu
Keyword(s):  
Pilot Study ◽  
Effective Means ◽  
Text Message ◽  
Text Messages ◽  
Mobile Telephone ◽  
Future Research ◽  
Quick Method ◽  
Suicide Attempters ◽  
To Receive

Background: In China, where follow-up with hospitalized attempters is generally lacking, there is a great need for inexpensive and effective means of maintaining contact and decreasing recidivism. Aims: Our objective was to test whether mobile telephone message contacts after discharge would be feasible and acceptable to suicide attempters in China. Methods: Fifteen participants were recruited from suicide attempters seen in the Emergency Department in Wuhan, China, to participate in a pilot study to receive mobile telephone messages after discharge. All participants have access to a mobile telephone, and there is no charge for the user to receive text messages. Results: Most participants (12) considered the text message contacts an acceptable and useful form of help and would like to continue to receive them for a longer period of time. Conclusions: This suggests that, as a low-cost and quick method of intervention in areas where more intensive follow-up is not practical or available, telephone messages contacts are accessible, feasible, and acceptable to suicide attempters. We hope that this will inspire future research on regular and long-term message interventions to prevent recidivism in suicide attempters.

Prognostic significance of C1–C2 facet malalignment after surgical decompression in adult Chiari malformation type I: a pilot study based on the Chicago Chiari Outcome Scale

2020 ◽  
pp. 1-7
Author(s):  
Michael Lumintang Loe ◽  
Tito Vivas-Buitrago ◽  
Ricardo A. Domingo ◽  
Johan Heemskerk ◽  
Shashwat Tripathi ◽  
...  
Keyword(s):  
Pilot Study ◽  
Chiari Malformation ◽  
Prognostic Significance ◽  
Foramen Magnum ◽  
Bivariate Analysis ◽  
Type I ◽  
Foramen Magnum Decompression ◽  
Swallowing Function ◽  
Chiari Malformation Type I

OBJECTIVEThe authors assessed the prognostic significance of various clinical and radiographic characteristics, including C1–C2 facet malalignment, in terms of surgical outcomes after foramen magnum decompression of adult Chiari malformation type I.METHODSThe electronic medical records of 273 symptomatic patients with Chiari malformation type I who were treated with foramen magnum decompression, C1 laminectomy, and duraplasty at Mayo Clinic were retrospectively reviewed. Preoperative and postoperative Neurological Scoring System scores were compared using the Friedman test. Bivariate analysis was conducted to identify the preoperative variables that correlated with the patient Chicago Chiari Outcome Scale (CCOS) scores. Multiple linear regression analysis was subsequently performed using the variables with p < 0.05 on the bivariate analysis to check for independent associations with the outcome measures. Statistical software SPSS version 25.0 was used for the data analysis. Significance was defined as p < 0.05 for all analyses.RESULTSFifty-two adult patients with preoperative clinical and radiological data and a minimum follow-up of 12 months were included. Motor deficits, syrinx, and C1–C2 facet malalignment were found to have significant negative associations with the CCOS score at the 1- to 3-month follow-up (p < 0.05), while at the 9- to 12-month follow-up only swallowing function and C1–C2 facet malalignment were significantly associated with the CCOS score (p < 0.05). Multivariate analysis showed that syrinx presence and C1–C2 facet malalignment were independently associated with the CCOS score at the 1- to 3-month follow-up. Swallowing function and C1–C2 facet malalignment were found to be independently associated with the CCOS score at the 9- to 12-month follow-up.CONCLUSIONSThe observed results in this pilot study suggest a significant negative correlation between C1–C2 facet malalignment and clinical outcomes evaluated by the CCOS score at 1–3 months and 9–12 months postoperatively. Prospective studies are needed to further validate the prognostic value of C1–C2 facet malalignment and the potential role of atlantoaxial fixation as part of the treatment.

Short-Term Ultramicronized Palmitoylethanolamide Therapy in Patients with Myasthenia Gravis: a Pilot Study to Possible Future Implications of Treatment

2019 ◽  
Vol 18 (3) ◽  
pp. 232-238 ◽  
Author(s):  
Emanuela Onesti ◽  
Vittorio Frasca ◽  
Marco Ceccanti ◽  
Giorgio Tartaglia ◽  
Maria Cristina Gori ◽  
...  
Keyword(s):  
Pilot Study ◽  
Myasthenia Gravis ◽  
Repetitive Nerve Stimulation ◽  
Beneficial Effects ◽  
Antibody Titers ◽  
The Stability ◽  
Ultramicronized Palmitoylethanolamide ◽  
Open Pilot

Background: The cannabinoid system may be involved in the humoral mechanisms at the neuromuscular junction. Ultramicronized-palmitoylethanolamide (μm-PEA) has recently been shown to reduce the desensitization of Acetylcholine (ACh)-evoked currents in denervated patients modifying the stability of ACh receptor (AChR) function. <p> Objective: To analyze the possible beneficial effects of μm-PEA in patients with myasthenia gravis (MG) on muscular fatigue and neurophysiological changes. <p> Method: The duration of this open pilot study, which included an intra-individual control, was three weeks. Each patient was assigned to a 1-week treatment period with μm-PEA 600 mg twice a day. A neurophysiological examination based on repetitive nerve stimulation (RNS) of the masseteric and the axillary nerves was performed, and the quantitative MG (QMG) score was calculated in 22 MG patients every week in a three-week follow-up period. AChR antibody titer was investigated to analyze a possible immunomodulatory effect of PEA in MG patients. <p> Results: PEA had a significant effect on the QMG score (p=0.03418) and on RNS of the masseteric nerve (p=0.01763), thus indicating that PEA reduces the level of disability and decremental muscle response. Antibody titers did not change significantly after treatment. <p> Conclusion: According to our observations, μm-PEA as an add-on therapy could improve muscular response to fatigue in MG. The possible modulation of AChR currents as a means of eliciting a direct effect from PEA on the conformation of ACh receptors should be investigated. The co-role of cytokines also warrants an analysis. Given the rapidity and reversibility of the response, we suppose that PEA acts directly on AChR, though further studies are needed to confirm this hypothesis.

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