The Impact of Repeated Assessments by Patients and Professionals: A 4-Year Follow-Up of a Population With Schizophrenia

The needs of people with schizophrenia are great, and having extensive knowledge of this patient group is crucial for providing the right support. The aim of this study was to investigate, over 4 years, the importance of repeated assessments by patients with schizophrenia and by professionals. Data were collected from evidence-based assessment scales, interviews, and visual self-assessment scales. The data processing used descriptive statistics, correlation and regression analyses. The results showed that the relationships between several of the patients’ self-rating assessments were stronger at the 4-year follow-up than at baseline. In parallel, the concordance rate between patient assessments and case manager assessments increased. The conclusions drawn are that through repeated assessments the patients’ ability to assess their own situation improved over time and that case managers became better at understanding their patients’ situation. This, in turn, provides a safer basis for assessments and further treatment interventions, which may lead to more patients achieving remission, which can lead to less risk for hospitalization and too early death.

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Skill Development and Problems in the Achievement of Transfer of Training Effects: Some New Zealand Rehabilitation Case Manager Data

Australian Journal of Rehabilitation Counselling ◽

10.1017/s1323892200000594 ◽

2002 ◽

Vol 8 (2) ◽

pp. 127-132

Author(s):

Ross Flett ◽

Cathie Collinson ◽

Jocelyn Handy ◽

Fiona Alpass

Keyword(s):

New Zealand ◽

Professional Training ◽

Case Manager ◽

Case Managers ◽

Post Test ◽

The Individual ◽

The Impact ◽

The Relationship ◽

Organisational Level

We examined the impact of a 27-week university-based professional training program on the self-rated skills and competencies of a group of New Zealand rehabilitation case managers. The extent to which training-related change transferred back to the workplace at both the individual and organisational level was also considered. Some pre-test/post-test increases in self-rated competencies were observed and these were maintained at 3-month follow-up. Training-related change back in the workplace was generally perceived to be in a negative direction, which highlights the fact that the relationship between the training process and subsequent skill/knowledge utilisation in the workplace is a complex and non-linear phenomenon. Some suggestions as to how research on training in rehabilitation might move forward are presented.

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Evaluation of Recovery of Activities of Daily Living in Patients with Sequelae from Cerebral Vascular Disease

Journal of Biomedical and Clinical Research ◽

10.1515/jbcr-2015-0113 ◽

2013 ◽

Vol 6 (2) ◽

pp. 125-130

Author(s):

Danelina E. Vacheva ◽

Verjinia K. Simeonova ◽

Boyko St. Stamenov

Keyword(s):

Activities Of Daily Living ◽

Cerebrovascular Disease ◽

Daily Living ◽

Personal Hygiene ◽

Rank Test ◽

Self Assessment ◽

Cerebral Vascular Disease ◽

Before And After ◽

The Right

Summary Bulgaria ranks first in the world in incidence, morbidity and death associated with cerebrovascular disease. The aim of the study was to investigate, follow-up and register recovery of activities of daily living (using the toilet and maintaining personal hygiene) in patients with sequelae from cerebrovascular disease in a subacute stage, who underwent physiotherapy and rehabilitation. Sixty-one patients were included and followed up. They were given tailored physiotherapy and rehabilitation. This included kinesitherapy, occupational therapy and electrotherapy. All the patients filled in self-assessment questionnaires before and after the rehabilitation course. Major parameters were assessed, irrespective of the limb affected -dominant or non-dominant. Results were analyzed using the Wilcoxon rank test. At the end of the rehabilitation course, the Wilcoxon curves were driven to the right, confirming improvement concerning independence, irrespective of involvement of dominant or non-dominant limb.

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Direct Reimplantation Procedure in Anomalous Aortic Origin of the Right Coronary Artery: Long-Term Single Center Outcomes

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/21501351211027478 ◽

2021 ◽

Vol 12 (6) ◽

pp. 693-699

Author(s):

Daouda Amadou ◽

Julia Mitchell ◽

Christian Bulescu ◽

Olivier Metton ◽

Roland Henaine ◽

...

Keyword(s):

Physical Activity ◽

Coronary Artery ◽

Right Coronary Artery ◽

Early Death ◽

Time Lapse ◽

Single Center ◽

Complete Restoration ◽

Single Center Study ◽

The Right

Background: Anomalous aortic origin of the right coronary artery is known to be a cause of sudden cardiac death in athletes. There are no specific guidelines concerning treatment strategy in the literature. The aim of this study is to describe and report our experience of direct reimplantation technique in the treatment of this anomaly. Methods: This was a retrospective single center study of 30 patients who underwent surgery in the congenital heart disease unit of Louis Pradel Heart and Lung Hospital between January 2003 and December 2016. The mean follow-up was seven years (3 months-17 years). Results: Thirty patients underwent surgery. The median age was 17 years (0.2-52 years). There were 24 males. The median weight was 58 kg (3.6-118 kg). Fourteen patients were actively engaged in sports. Twenty-six patients had exertional chest pain or syncope. The median time lapse between diagnosis and intervention was 4.5 months (0.5-179 months). Twenty-seven (90%) patients underwent reimplantation of the anomalous coronary artery without transverse aortotomy, while in 3 (10%) patients transverse aortotomy was used to facilitate reimplantation to avoid tension at the anastomosis. There was no early death; one late death occurred in the third postoperative month. At the last follow-up, all patients had returned to normal physical activity without evidence of ischemia. Conclusions: Direct reimplantation allows for a complete restoration of the coronary anatomy and enables patients to return to normal physical activity. Our study shows encouraging results using a direct reimplantation technique without aortotomy.

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Surgical Interventions Are Effective for Treating Unruptured Sinus of Valsalva Aneurysms

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.707147 ◽

2021 ◽

Vol 8 ◽

Author(s):

Juntao Qiu ◽

Enzehua Xie ◽

Yuetang Wang ◽

Wei Wang ◽

Cuntao Yu ◽

...

Keyword(s):

Quality Of Life ◽

Coronary Sinus ◽

Surgical Repair ◽

Heart Function ◽

Early Death ◽

Sinus Of Valsalva ◽

Surgical Interventions ◽

The Right

Background: This study investigates the optimal management for unruptured sinus of Valsalva aneurysms (USVAs) combined with other cardiovascular lesions.Methods: This retrospective study examined 33 USVA patients who underwent surgical repair from February 1, 2007 to January 31, 2012. We analyzed the surgical procedures and the patients' quality of life after surgery. Additionally, echocardiography follow-up was performed before and after the operation.Results: Most USVAs (87.8%) originated in the right coronary sinus. Aside from one patient who was preoperatively misdiagnosed as having a ruptured sinus of Valsalva aneurysm (SVA). USVAs of the right coronary sinus were addressed by reinforcing this sinus with a Dacron patch through the right ventricle. USVAs were corrected by aortotomy using an autogenous pericardium patch when they originated in the non-coronary or left coronary sinus. Thirty patients (90.9%) were followed up for 22–119 months. No early death, residual fistula or SVA recurrence were found during the follow-up period. They all had a good quality of life and good heart function (New York Heart Association class I–II).Conclusions: Active surgical repair of an USVA can be achieved with satisfactory results in patients combined with other cardiovascular lesions.

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P1096Cardioneuroablation changes the type of vaso-vagal response in patients with asystolic reflex syncope

EP Europace ◽

10.1093/europace/euaa162.303 ◽

2020 ◽

Vol 22 (Supplement_1) ◽

Author(s):

R Piotrowski ◽

A Zuk ◽

J Baran ◽

A Sikorska ◽

T Krynski ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Postgraduate Medical Education ◽

Sinus Node ◽

Pacemaker Implantation ◽

Heart Rate Variability Parameter ◽

History Of ◽

The Right ◽

The Impact

Abstract Funding Acknowledgements Centre of Postgraduate Medical Education No. 501-1-10-14-19 Background. Cardioneuroablation (CNA) - ablation of ganglionated plexi (GP) to eliminate or reduce parasympathetic overactivity, has been recently proposed as a new therapeutic method in patients with vaso-vagal syncope (VVS) due to cardioinhibitory or mixed mechanism. Purpose. To assess the impact of CNA on the type of VV response during tilt testing (TT). Methods. The study group consisted of the first 20 patients (7 males, mean age 38 ± 9 – year – old) enrolled in the ongoing prospective Roman study (NCT 03903744). All patients had a history of ECG documented syncope due to asystole and confirmed asystolic form of VVS at baseline TT. CNA was performed using electroanatomical system Carto 3 and radiofrequency applications delivered in the right and left atrium at the right anterior GP and right inferior GP sites. The second TT was performed three months later. Resting heart rate (HR) and heart rate variability parameter (SDDN) were also assessed. Results. At baseline TT, nineteen patients had cardioinhibitory syncope (asystole ranging from 3 to 60 s) (sinus node arrest – 17 patients, A-V block – 2 patients) and 1 had mixed form of VVS (asystole lasting 3 s preceded by hypotension). During three-month follow-up no syncopal episodes were noted. At the 3-month TT, 6 (30 %) patients had no syncope whereas the remaining 13 (65 %) had syncope – twelve (60 %) due to vasodepressor mechanism and only one (5 %) due to asystole - as before CNA. One patient did not have TT because of pregnancy. Mean resting HR after CNA was significantly faster and SDNN significantly lower than before the procedure (82 ± 9 vs 69 ± 11 beats/min, p = 0.0004 and 74 ± 22 vs 143 ± 40 ms, p = 0.00003, respectively) and these changes were was similar in those who fainted during second TT and those who did not (82 ± 11 vs 81 ± 4 beats/min, p = NS and (75 ± 2 vs 77 ± 18 ms, p = NS, respectively). Conclusions. CNA profoundly affects the type of VV reaction causing normalization of the response to tilting or changing cardiodepression to vasodepression. These effects are also depicted by changes in HR and heart rate variability. Elimination of TT-induced reflex asystole may prevent clinical recurrences of syncope during short-term follow-up. These findings encourage to conduct further studies involving CNA since this method appears to be effective and obviates the need for pacemaker implantation in young people with reflex asystolic syncope.

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PENERAPAN MODEL EVALUASI KIRKPATRICK EMPAT LEVEL DALAM MENGEVALUASI PROGRAM DIKLAT DI BALAI BESAR PELATIHAN PERTANIAN (BBPP) LEMBANG

Jurnal Pendidikan Nonformal ◽

10.17977/um041v14i1p12-21 ◽

2019 ◽

Vol 14 (1) ◽

pp. 12

Author(s):

Ramayana Ritonga ◽

Asep Saepudin ◽

Uyu Wahyudin

Keyword(s):

Human Resource Development ◽

Evaluation Model ◽

Evaluation Process ◽

Training Institution ◽

Skilled Workers ◽

Ongoing Training ◽

Level 3 ◽

The Right ◽

The Impact

Abstract: In Improving Human Resource Development (PSDM), the Lembang Center for Agricultural Training (BBPP) is the right place to carry out technical training and functional training in agriculture. It has been proven that BBPP Lembang has printed a lot of skilled workers in the field of agriculture, this can be used as an indicator of the success of this training institution, not only that, the welfare of the farmers has also increased. BBPP Lembang is one of the places that can be used as a job that helps reduce the number of people who do not get jobs. To improve the ongoing training and on target BBPP Lembang always conducts evaluation activities that aim to see the success of the programs that have been held and follow up on the weaknesses that were obtained when the evaluation process took place both at the beginning of the program and at the end of the program. The application of the Kirkpatrick Four Level Evaluation Model is used as a frame of reference for evaluating programs, where evaluations at levels 1 and 2 will produce information for the organization about conducting training both in the middle and the end. Whereas levels 3 and 4 produce information that focuses on the impact of training for organizations and trainees. Abstrak: Dalam Meningkatkan Pengembangan Sumber Daya Manusia (PSDM), Balai Besar Pelatihan Pertanian (BBPP) Lembang menjadi tempat yang tepat sasaran untuk melaksanakan pelatihan teknis dan pelatihan fungsional di bidang pertanian. Sudah terbukti BBPP Lembang banyak sekali mencetak tenaga yang handal dibidang pertanian, hal ini bisa dijadikan sebagai indicator keberhasilan dari lembaga diklat ini, bukan hanya itu, kesejahteraan para petani pun sudah meningkat. BBPP Lembang menjadi salah satu wadah yang bisa dijadikan sebagai lapangan kerja yang membantu mengurangi jumlah warga yang tidak mendapatkan pekerjaan. Untuk meningkatkan pelatihan berkelanjutan dan tepat sasaran BBPP Lembang senantiasa melakukan kegiatan evaluasi yang bertujuan melihat keberhasilan program yang telah diselenggarakan dan menindaklajuti kelemahan-kelemahan yang didapat ketika proses evaluasi berlangsung baik di awal program dan maupun diakhir program. Penerapan Model Evaluasi Kirkpatrick Empat Level dugunakan sebagai kerangka acuan untuk mengevaluasi program, dimana evaluasi pada level 1 dan 2 akan mengasilkan informasi untuk organisasi tentang penyelenggaraan pelatihan baik diwal-tengan dan akhir. Sedangkan pada level 3 dan 4 menghasilkan informasi yang berfokus pada dampak pelatihan bagi organisasi dan peserta pelatihan

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Simulation-based training in critical resuscitation procedures improves residents' competence

CJEM ◽

10.1017/s1481803500011805 ◽

2009 ◽

Vol 11 (06) ◽

pp. 535-539 ◽

Cited By ~ 44

Author(s):

Trevor S. Langhan ◽

Ian J. Rigby ◽

Ian W. Walker ◽

Daniel Howes ◽

Tyrone Donnon ◽

...

Keyword(s):

Skill Acquisition ◽

Clinical Skills ◽

Skills Training ◽

The Self ◽

Self Assessment ◽

Procedural Skills ◽

Training Course ◽

Simulation Based ◽

The Impact

ABSTRACT Objective: Residents must become proficient in a variety of procedures. The practice of learning procedural skills on patients has come under ethical scrutiny, giving rise to the concept of simulation-based medical education. Resident training in a simulated environment allows skill acquisition without compromising patient safety. We assessed the impact of a simulation-based procedural skills training course on residents' competence in the performance of critical resuscitation procedures. Methods: We solicited self-assessments of the knowledge and clinical skills required to perform resuscitation procedures from a cross-sectional multidisciplinary sample of 28 resident study participants. Participants were then exposed to an intensive 8-hour simulation-based training program, and asked to repeat the self-assessment questionnaires on completion of the course, and again 3 months later. We assessed the validity of the self-assessment questionnaire by evaluating participants' skills acquisition through an Objective Structured Clinical Examination station. Results: We found statistically significant improvements in participants' ratings of both knowledge and clinical skills during the 3 self-assessment periods (p < 0.001). The participants' year of postgraduate training influenced their self-assessment of knowledge (F 2,25 = 4.91, p < 0.01) and clinical skills (F 2,25 = 10.89, p < 0.001). At the 3-month follow-up, junior-level residents showed consistent improvement from their baseline scores, but had regressed from their posttraining measures. Senior-level residents continued to show further increases in their assessments of both clinical skills and knowledge beyond the simulation-based training course. Conclusion: Significant improvement in self-assessed theoretical knowledge and procedural skill competence for residents can be achieved through participation in a simulation-based resuscitation course. Gains in perceived competence appear to be stable over time, with senior learners gaining further confidence at the 3-month follow-up. Our findings support the benefits of simulation-based training for residents.

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Arteriovenous malformation of the conus supplied by the artery of Desproges-Gotteron

Journal of Neurosurgery Spine ◽

10.3171/2010.11.spine10726 ◽

2011 ◽

Vol 14 (4) ◽

pp. 529-531 ◽

Cited By ~ 10

Author(s):

R. Shane Tubbs ◽

Martin M. Mortazavi ◽

Andrew J. Denardo ◽

Aaron A. Cohen-Gadol

Keyword(s):

Arteriovenous Malformation ◽

Transarterial Embolization ◽

Conus Medullaris ◽

Treatment Interventions ◽

First Case ◽

Plantar Aspect ◽

Repeat Angiography ◽

The Right ◽

Spinal Avm

The artery of Desproges-Gotteron is rarely mentioned in the literature and is unfamiliar to most neurosurgeons. The authors report a unique case of an arteriovenous malformation (AVM) of the conus in an adult woman, which received blood supply from an artery of Desproges-Gotteron. The patient presented with intermittent pain radiating down the right posterior thigh and foot and transient bladder incontinence. On examination, there was weakness of the right lower limb with hypalgesia of the plantar aspect of the right foot. Magnetic resonance imaging revealed a mass near the anterior aspect of the conus medullaris and angiography confirmed a spinal AVM at the L-1 level and a shunt located at the inferior L-3 level. The patient underwent transarterial embolization, and at 2-year follow-up, repeat angiography demonstrated no evidence of residual or recurrent spinal AVM, intermittent and tolerable pain without treatment interventions, and a normal neurological examination. The artery of Desproges-Gotteron appears to be a rare arterial variation. Moreover, the authors believe this to be the first case of a conal AVM supplied by such an artery. The anatomy and implications of such an arterial variant are discussed.

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MR-guided stereotactic body radiation therapy for primary cardiac sarcomas

Radiation Oncology ◽

10.1186/s13014-021-01791-9 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Stefanie Corradini ◽

Rieke von Bestenbostel ◽

Angela Romano ◽

Adrian Curta ◽

Dorit Di Gioia ◽

...

Keyword(s):

Radiation Therapy ◽

Rare Disease ◽

Treatment Options ◽

Cardiac Tumors ◽

Initial Surgery ◽

Cardiac Lesions ◽

High Doses ◽

The Right ◽

The Impact

Abstract Background Primary cardiac tumors are an extremely rare disease with limited prognosis. The treatment of choice is surgery. Other treatment options include chemotherapy and radiation therapy, which historically represented a palliative approach in patients who were not eligible for surgery. The development of hybrid MR-guided radiation therapy makes it possible to better visualize cardiac lesions and to apply high doses per fraction in sensible organs such as the heart. Case presentation Patients affected by inoperable primary cardiac sarcomas and treated at two different institutions were considered for this analysis and retrospectively analyzed. All patients were treated using a 0.35 T hybrid MR Linac system (MRIdian, ViewRay Inc., Mountain View, CA). In the present study we investigated the feasibility, early outcome and toxicity of MR-guided RT in primary cardiac sarcomas. Four consecutive non-metastasized patients who were treated between 05–09/2020 were analyzed. The cardiac sarcomas were mostly located in the right atrium (50%) and one patient presented with 3 epicardial lesions. All patients received MRgRT as a salvage treatment for recurrent cardiac sarcoma after initial surgery, after a mean interval of 12 months (range 1–29 months). Regarding the treatment characteristics, the mean GTV size was 22.9 cc (range 2.5–56.9 cc) and patients were treated with a mean GTV dose of 38.9 Gy (range 30.1–41.1 Gy) in 5 fractions. Regarding feasibility, all treatments were completed as planned and all patients tolerated the treatment very well and showed only mild grade 1 or 2 symptoms like fatigue, dyspnea or mild chest pain at early follow-up. Conclusion To the best of our knowledge, in this retrospective analysis we present the first and largest series of patients presenting with primary cardiac sarcomas treated with online adaptive MRgRT. However, further studies are needed to evaluate the impact of this new methodology on the outcome of this very rare disease.

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Impact on core values of family medicine from a 2-year Master’s programme in Gezira, Sudan: observational study

BMC Family Practice ◽

10.1186/s12875-019-1037-1 ◽

2019 ◽

Vol 20 (1) ◽

Author(s):

Khalid Gaffer Mohamed ◽

Steinar Hunskaar ◽

Samira Hamid Abdelrahman ◽

Elfatih Mohamed Malik

Keyword(s):

Family Medicine ◽

Core Values ◽

National Guidelines ◽

Patient Centeredness ◽

Patient Centered ◽

Self Assessment ◽

Orientation Scale ◽

A Prospective Study ◽

The Impact

Abstract Background Training of family physicians should include not only clinical and procedural skills, but also core values as comprehensive care, continuity of care, leadership and patient-centeredness. The Gezira Family Medicine Project (GFMP) is a 2 years Master’s programme in family medicine in Sudan. We assessed the impact of GFMP on the candidates’ adherence to some core values of family medicine. Methods This is a prospective study with before-after design based on repeated surveys. We used Patient-Practitioner Orientation Scale (PPOS) to assess physicians’ attitude towards patient-centeredness. Practice based data from individual patients’ consultations and self-assessment methods were used to assess physicians’ adherence to core values. Results At the end of the programme the candidates (N = 110) were significantly more active in community health promotion (p < 0.001), more confident as a team leader (p = 0.008), and showed increased adherence to national guidelines for managing diabetes (p = 0.017) and hypertension (p = 0.003). The responding candidates had more knowledge about patients’ medical history (p < 0.001), family history (p < 0.001) and family situation (p < 0.001). There were more planned follow up consultations (p < 0.001) and more referrals (p = 0.040). In contrast, results from PPOS showed slightly less orientation towards patient-centeredness (p = 0.007). Conclusions The GFMP Master’s programme induced a positive change in adherence to several core values of family medicine. The candidates became less patient-centered.

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