scholarly journals Physical health of patients under EIP - a service evaluation

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S342-S342
Author(s):  
Anu Priya ◽  
Keerthan Dhanasekar ◽  
James Hill-Cousins ◽  
Mudasar Aziz ◽  
Osama Suleiman ◽  
...  
Keyword(s):  
Physical Health ◽  
Reporting System ◽  
Service Evaluation ◽  
Test Results ◽  
Antipsychotic Medications ◽  
Blood Tests ◽  
The Past ◽  
Health Checks ◽  
Number Of Patients ◽  
Early Intervention In Psychosis

AimsThe aim of the project was to get a baseline of the number of patients who have had blood tests, ECG and physical health observations completed in the past 12 months.MethodThere are 30 patients under Early Intervention in Psychosis team at Bassetlaw Hospital , Nottinghamshire. The elctronic notes and blood reporting system were checked for each of the patients, to get the data on blood test results , ECG reports and Physical health (Blood pressure, heart rate and weight) .ResultIt was noted that 19/30 patients had Blood tests completed, 14/30 had ECG completed and 19/30 had physical health checks completed. All these patients except one were on antipsychotic medications.ConclusionFurther work is still required in getting 100% results for all these different variables. This may include the need to review the process of how we engage the patients for physical healthcare checks. With the inclusion of a physical healthcare worker now, we might be able to improve results. Hence this evaluation would be redone in a years' time.

scholarly journals Testing a computerised tool to improve physical health monitoring in a medium secure forensic setting

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S222-S223
Author(s):  
Mike Smith ◽  
Mustafa Abbas
Keyword(s):  
Physical Examination ◽  
Physical Health ◽  
Health Monitoring ◽  
Mental Health Problems ◽  
Relevant Information ◽  
Substantial Improvement ◽  
Due Date ◽  
Blood Tests ◽  
The Past ◽  
Health Checks

AimsThis project aimed to improve adherence to regular monitoring of the physical health of inpatients within a medium secure forensic psychiatric unit. A computerised tool to remind doctors to do checks was created, which was proposed would improve adherence.BackgroundThe physical health of people with mental health problems is of some concern, with higher rates of physical comorbidity and mortality compared to the general population.The forensic inpatient population has a high burden of both severe mental illness and physical ill health, and a high medication burden with potential adverse effects on physical health.To support the health of patients in our medium secure unit, each should routinely have three physical health checks done at least every six months. These are 1) an electrocardiogram (ECG), 2) a set of blood tests and 3) a full physical examination.MethodPatient records for 26 patients across two medium secure psychiatric wards were checked for 1) an ECG, 2) a full set of blood tests and 3) a full general physical examination within the past 6 months.A tool was created that automatically calculated the next due date for each check and colour coded which were overdue (red) or within 30 days of the due date (yellow). This tool was given to the core trainees working on these wards to help them keep track of which checks needed to be done.The records for patients on the same two wards were rechecked four months later and the adherence rates compared.ResultOn both wards, for each of the three physical health checks, a substantial improvement was seen in the proportion completed within the past 6 months.ConclusionThe tool created was a useful means of presenting, in one place, relevant information needed by doctors working in medium secure forensic wards regarding physical health checks, and drawing their attention to tasks that needed to be done. This led to an improvement in the adherence to physical health monitoring in these wards. An area for future improvement was identified regarding the unit's capacity to perform ECGs in a timely manner.

scholarly journals Annual physical health checks within a forensic inpatient service

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S72-S72
Author(s):  
Michael Cooper ◽  
Partha Gangopadhyay
Keyword(s):  
Blood Pressure ◽  
Physical Examination ◽  
Physical Health ◽  
Local System ◽  
Health Examination ◽  
Inclusion Criteria ◽  
The Past ◽  
Health Checks ◽  
Blood Monitoring ◽  
Physical Examinations

AimsPatients prescribed antipsychotics are at risk of ill effects to their physical health. Our aims were to assess whether inpatients within a forensic service, on antipsychotic medications, were receiving annual physical health monitoring in accordance with current NICE and SIGN Guidelines. Based on these Guidelines the following objectives were identified: 1: Physical examination, BMI and blood pressure recorded within the past year2: FBC recorded within the past year3: U&Es recorded within past year4: LFTs recorded within the past year5: HbA1C / random glucose / fasting glucose recorded within the past year6: Random lipids / fasting lipids recorded within the past yearMethodInclusion Criteria: Patients admitted for longer than a year currently prescribed an antipsychotic.Data were collected cross-sectionally on 24/7/20 for all inpatients meeting the inclusion criteria. Medical notes and the blood results system were reviewed for results of any annual physical examinations and blood monitoring over the past year.Anonymized data were analysed using Excel.Result13 out of 17 inpatients fulfilled the inclusion criteria. Of these 13 inpatients, 9 (69.2%) were prescribed clozapine, 1 (7.7%) zuclopenthixol, 1 (7.7%) paliperidone and 1 (7.7%) amisulpride.All patients had BMI and blood pressures recorded within the preceding month. Only 1 patient (7.7%) had an annual physical health examination within the past year.Findings for bloods taken within the past year were as follows:12 patients (92.3%) had an FBC recorded9 patients (69.2%) had U + Es recorded9 patients (69.2%) had LFTs recorded11 patients (84.6%) had HBA1c recorded7 patients (53.8%) had lipids recordedConclusionThere is scope for improvement with both annual physical examinations and blood monitoring.All patients had regular BMIs and blood pressure recorded which is largely attributable to nursing staff protocols. Low compliance with full annual physical examination could be explained by there being no local system in place for annual physical health checks and also frequent changes in junior doctor ward cover.Blood monitoring showed variable compliance with established standards. FBC monitoring had the best compliance, likely because the vast majority of our patients are prescribed clozapine, which necessitates minimal monthly FBC monitoring.This audit was presented to the Forensic Team and thereafter it was agreed for a local system to be put in place for annual physical health checks in the summer each year. This will improve oportunities to optimise our patients health. We plan to re-audit at this time.

Atypical antipsychotic monitoring: A survey of patient knowledge and experience

2006 ◽  
Vol 23 (3) ◽  
pp. 100-102 ◽  
Author(s):  
Larkin Feeney ◽  
Mary Mooney
Keyword(s):  
Side Effects ◽  
Atypical Antipsychotic ◽  
Best Practice ◽  
Patient Knowledge ◽  
Antipsychotic Medications ◽  
Blood Tests ◽  
The Past ◽  
One Year ◽  
Atypical Antipsychotic Medications ◽  
Atypical Antipsychotic Medication

AbstractObjectives: To examine the knowledge and experiences of side-effects and their monitoring in patients prescribed atypical antipsychotic medications.Methods: A tick box survey was designed to ask questions of patients prescribed atypical antipsychotic medications about side-effects and monitoring for them. This survey was distributed anonymously to all suitable outpatient attendees over a three month period who had been prescribed atypical antipsychotic medication for at least one year.Results: Seventy-four of the 90 surveys (82%) distributed were returned complete. Fifty-six (76%) of those surveyed said they were currently experiencing side-effects. Twenty-two (39%) said they had not told their psychiatrist about the side-effects. Weight gain was most commonly complained of (49%). Forty-five (61%) said that they had had no monitoring blood tests in the past year. Fifty-one (69%) did not know that certain monitoring blood tests were recommended.Conclusions: Patients prescribed atypical antipsychotic medications are not currently being monitored as best practice dictates. It cannot be assumed that GPs will pursue this monitoring. More resources are needed for mental health services so that adequate monitoring services can be provided.

scholarly journals Physical health monitoring in antipsychotic depot clinic

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S317-S317
Author(s):  
Rebecca Davies ◽  
Anu Priya ◽  
Hardev Bhogal ◽  
Adesola Omodara ◽  
George Davies ◽  
...  
Keyword(s):  
Physical Examination ◽  
Physical Health ◽  
Service Evaluation ◽  
Health Examination ◽  
Medical Review ◽  
Anti Psychotic ◽  
Blood Tests ◽  
Evaluation Project ◽  
Key Worker

AimsA service evaluation project to look at if annual bloods, ECG, physical examination, and medical review was completed within the last year for patients attending anti-psychotic depot clinic at Bassetlaw mental health services in Nottinghamshire HealthCare NHS Foundation Trust.MethodElectronic notes were examined in October 2020 for 25 patients who attend anti-psychotic depot clinic to ascertain if medical review and physical examination had been completed along with annual bloods and ECG.ResultOut of 25 patients attending depot clinic in 2020 at Bassetlaw Hospital, 21 had all their blood tests done, 1 patient had refused bloods and 2 patients did not have blood tests done. ECG was completed for 3 patients at Bassetlaw hospital and 8 patients had it requested from primary care with 2 patients refusing to have ECG done. For 12 patients there was no evidence of ECG being requested or completed. 8 patients had physical examination completed and rest 17 patients did not have the physical examination completed including due to refusal. Out of 25, only 14 patients had a medical review conducted.ConclusionPatients who attend depot clinic may have an allocated community psychiatric nurse (CPN) or get reviewed by medics in outpatient clinics and would usually have their blood tests, physical health examination and ECGs requested and monitored by them. Patients who do not have any allocated CPN or medic tend to miss out on blood tests and ECG. General Practitioners are expected to complete physical health checks for patients who do not have CPN or regular outpatient review. The results of these investigations may not always be received in depot clinic, hence there is no documentation on electronic RIO system. When these patients disengage from the depot clinic, it is often very difficult to track them. As a follow-up from this service evaluation, all depot clinic patients will be allocated a key worker/CPN. This will ensure that they have a responsible person to facilitate annual checks. This will be reviewed in a years' time to evaluate the effectiveness of this intervention.

Perbedaan sensitivitas tetes telinga antibiotik terhadap Pseudomonas aeruginosa pada otitis media supuratif kronik

2012 ◽  
Vol 42 (2) ◽  
Author(s):  
Anton Budhi Darmawan ◽  
Dwi Utami Anjarwati
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Otitis Media ◽  
Chronic Suppurative Otitis Media ◽  
Test Results ◽  
Sectional Study ◽  
Suppurative Otitis Media ◽  
Number Of Patients ◽  
Significant Difference ◽  
Cochran Test ◽  
Post Hoc

Background: Chronic suppurative otitis media (CSOM) is one infectious disease of the middle ear, most commonly caused by Pseudomonas aeruginosa. A high number of patients come to the ENT outpatient clinic with active benign type of CSOM. The bacteria Pseudomonas aeruginosa is capable of producing biofilm which protects itself from penetration of antibiotics, and therefore creates resistance towards antibiotics and difficult to eradicate. Objective: The aim of this study was to compare the sensitivity levels of chloramphenicol, polymyxin-neomycin, cyprofloxacin and ofloxacine against Pseudomonas aeruginosa in patients with active benign type CSOM in ENT clinic. Method: The method used was across sectional study on 25 patients, from August 2010 until December 2010. Samples were taken withear swab and then put on sensitivity test to chloramphenicol, polymyxin-neomycin, cyprofloxacin andofloxacine using the diffusion disc method. The analysis used in this study was Cochran test. Results: Results showed a significant difference in sensitivity among chloramphenicol (38,70%), polymyxinneomycin(83,87%),cyprofloxacin(90,32%)andofloxacin(58,06%)withp=0,000(p<0,05).PostHocanalysisusing the Mc Nemar indicated that there were significant differences in sensitivity betweenpolymyxin-neomycin to chloramphenicol with p=0,000 (p<0,05), ciprofloxacin to chloramphenicol andciprofloxacin to ofloxacine with p= 0,002, but there were no significant differences between cyprofloxacinto polymyxin-neomycin with p=0,687, polymyxin-neomycin to ofloxacin p=0.057 and ofloxacin tochloramphenicol p=0,109.   There were significant differences in antibiotic ear dropssensitivity to Pseudomonas aeruginosa in patients with active benign type of CSOM. Cyprofloxacin andpolymyxin-neomycin were more sensitive than ofloxacin and chloramphenicol. Keywords: Pseudomonas aeruginosa, active benign type of chronic suppurative otitis media, antibioticear drops.  Abstrak :  Latar belakang: Otitis media supuratif kronik (OMSK) merupakan penyakit infeksi kronik telinga tengah yang sering dijumpai di klinik THT. Penyebab tersering OMSK adalah bakteri Pseudomonasaeruginosa. Pseudomonas aeruginosa mempunyai kemampuan untuk membentuk biofilm yangmelindunginya dari penetrasi antibiotik sehingga menimbulkan resistensi terhadap antibiotik dan sulituntuk eradikasinya. Tujuan: Untuk mengetahui perbandingan tingkat sensitivitas kloramfenikol,polimiksin-neomisin, ciprofloksasin dan ofloksasin terhadap isolat Pseudomonas aeruginosa padapasien OMSK benigna aktif di klinik THT RSMS. Metode: Metode yang digunakan adalah crosssectional terhadap 29 pasien OMSK di klinik THT RSMS periode bulan Agustus 2010 - Desember2010. Pengambilan sampel dilakukan dengan swab telinga. Uji sensitivitas terhadap kloramfenikol,polimiksin-neomisin, ciprofloksasin dan ofloksasin dilakukan dengan metode cakram secara difusi.Analisis yang digunakan dalam penelitian ini adalah Cochran dan analisis post hoc. Hasil: Didapatkansensitivitas kloramfenikol sebesar 38,70%, polimiksin-neomisin sebesar 83,87%, ciprofloksasin sebesar90,32% dan ofloksasin sebesar 58,06% dengan p=0,01 (P<0,05), yang menunjukkan adanya perbedaansensitivitas yang bermakna antara kloramfenikol, polimiksin-neomisin, ciprofloksasin dan ofloksasinterhadap Pseudomonas aeruginosa. Analisis post hoc menggunakan Mc Nemar menunjukkan bahwaterdapat perbedaan sensitivitas yang bermakna antara tetes telinga polimiksin-neomisin terhadapkloramfenikol, dan ciprofloksasin terhadap kloramfenikol p=0,000 (p<0,05), serta terdapat perbedaanyang bermakna antara tetes telinga ciprofloksasin terhadap ofloksasin, p=0,002, tetapi tidak terdapatperbedaan yang bermakna antara ciprofloksasin terhadap polimiksin-neomisin, p=0,687, polimiksinneomisinterhadap ofloksasin p=0,057, dan kloramfenikol terhadap ofloksasin p=0,109. Kesimpulan:Terdapat perbedaan sensitivitas yang bermakna tetes telinga antibiotik terhadap Pseudomonas aeruginosa pada pasien OMSK benigna aktif. Ciprofloksasin dan polimiksin-neomisin tetes telinga mempunyai sensitivitas yang lebih baik dibanding ofloksasin dan kloramfenikol. Kata kunci: Pseudomonas aeruginosa, otitis media supuratif kronik, tetes telinga antibiotik 

Modeling the Tensile Behaviour of a SiC/SiC Composite by Master Curves

2000 ◽  
Author(s):  
J. Shi
Keyword(s):  
Master Curve ◽  
Ceramic Matrix Composites ◽  
Test Material ◽  
Tensile Behaviour ◽  
Matrix Composites ◽  
Test Results ◽  
Master Curves ◽  
The Past ◽  
Test Parameters ◽  
Tensile Data

Scatter in test results is common for relatively brittle materials such as ceramic matrix composites. The scatter may come from differences in material processing conditions, specimen machining/handling and from variations in test parameters for nominally the same test material. Large scatter in test results makes material modeling difficult. In the past, master curve concepts have been proposed to reduce scatter in tensile data and to interpret fatigue/creep results. In this paper, one such concept is examined in detail by applying it to the recent tensile test results of a SiC/SiC composite. It was found that the way to construct master curves did not apply to the CMC studied and thus a new master curve was developed to better represent the tensile data. In addition, the test data were analysed statistically based on the new master curve.

scholarly journals Assessment of Lacrimal Duct Patency in Patients Undergoing Endoscopic Medial Maxillectomy

2021 ◽  
Vol 10 (2) ◽  
pp. 245
Author(s):  
Andrzej Sieśkiewicz ◽  
Tomasz Łysoń ◽  
Marek Rogowski ◽  
Marek Bielecki ◽  
Ewa Gindzienska-Sieskiewicz ◽  
...  
Keyword(s):  
Assessment Method ◽  
Test Results ◽  
Functional Disorders ◽  
Lacrimal Duct ◽  
Assessment Tests ◽  
Number Of Patients ◽  
Study Results ◽  
Assessment Techniques ◽  
Medial Maxillectomy ◽  
Comparison Of The Results

Purpose: The risk of epiphora after medial maxillectomy with lacrimal duct transection is difficult to assess. The data available in the literature are inconclusive due to various operating techniques used by the authors of medical publications, different additional procedures aimed at improving tear drainage after maxillectomy, and a variety of lacrimal duct patency assessment techniques. The aim of our work was to assess the anatomical and functional patency of lacrimal ducts after medial maxillectomy without performing additional procedures to improve tear drainage as well as comparison of the results obtained with different assessment tests. Materials and methods: 21 patients who underwent medial maxillectomy in the years 2016–2019 were assessed for discomfort and epiphora based on patients’ own reports and basic clinical examination, lacrimal duct rinse test, the Munk score, and a modified endoscopic Jones I test. Results: Gradually increasing the sensitivity of the assessment method resulted in an increase in the number of patients with potential tear drainage disorders, starting from 0% in the rinsing test, 4.8% self-reported tearing complaints, 14.3% Munk score, and 19% modified endoscopic Jones I test. Conclusions: The study results revealed that a small fraction of patients tend to report epiphora as a consequence of medial maxillectomy themselves. Subtle functional disorders, which are not particularly bothersome to patients, are more common. More sensitive lacrimal duct patency tests reveal more cases of tear drainage disorders. The results of studies assessing the incidence of epiphora after medial maxillectomy appear to depend on the type of test used.

scholarly journals The use of routine blood tests to assist the diagnosis of COVID-19 in symptomatic hospitalized patients

2021 ◽  
pp. 000456322199907
Author(s):  
IT Parsons ◽  
AT Parsons ◽  
E Balme ◽  
G Hazell ◽  
R Gifford ◽  
...  
Keyword(s):  
Cell Count ◽  
Retrospective Review ◽  
Blood Test ◽  
Patient Flow ◽  
White Cell Count ◽  
Area Under The Curve ◽  
White Cell ◽  
Test Results ◽  
Rt Pcr ◽  
Blood Tests

Introduction Specific patterns of blood test results are associated with COVID-19 infection. The aim of this study was to identify which blood tests could be used to assist in diagnosing COVID-19. Method A retrospective review was performed on consecutive patients referred to hospital with a clinical suspicion of COVID-19 over a period of four weeks. The patient’s clinical presentation and severe acute respiratory syndrome coronavirus 2 reverse-transcription polymerase chain reaction (SARS-CoV-2 RT-PCR) were recorded. The patients were divided by diagnosis into COVID (COVID-19 infection) or CONTROL (an alternate diagnosis). A retrospective review of consecutive patients over a further two-week period was used for the purposes of validation. Results Overall, 399 patients (53% COVID, 47% CONTROL) were analysed. White cell count, neutrophils and lymphocytes were significantly lower, while lactate dehydrogenase and ferritin were significantly higher, in the COVID group in comparison to CONTROL. Combining the white cell count, lymphocytes and ferritin results into a COVID Combined Blood Test (CCBT) had an area under the curve of 0.79. Using a threshold CCBT of –0.8 resulted in a sensitivity of 0.85 and a specificity of 0.63. Analysing this against a further retrospective review of 181 suspected COVID-19 patients, using the same CCBT threshold, resulted in a sensitivity of 0.73 and a specificity of 0.75. The sensitivity was comparable to the SARS-CoV-2 RT PCR. Discussion Mathematically combining the blood tests has the potential to assist clinical acumen allowing for rapid streaming and more accurate patient flow pending definitive diagnosis. This may be of particular use in low-resource settings.

scholarly journals THink: Inferring Cognitive Status from Subtle Behaviors

AI Magazine ◽  
2015 ◽  
Vol 36 (3) ◽  
pp. 49-60 ◽  
Author(s):  
Randall Davis ◽  
David Libon ◽  
Roda Au ◽  
David Pitman ◽  
Dana Penney
Keyword(s):  
Neuropsychological Testing ◽  
Cognitive Status ◽  
Major Advance ◽  
Test Results ◽  
Clock Drawing Test ◽  
The Past ◽  
Drawing Test ◽  
Testing Technology ◽  
Opening Up

The digital clock drawing test is a fielded application that provides a major advance over existing neuropsychological testing technology. It captures and analyzes high precision information about both outcome and process, opening up the possibility of detecting subtle cognitive impairment even when test results appear superficially normal. We describe the design and development of the test, document the role of AI in its capabilities, and report on its use over the past seven years. We outline its potential implications for earlier detection and treatment of neurological disorders. We set the work in the larger context of the THink project, which is exploring multiple approaches to determining cognitive status through the detection and analysis of subtle behaviors.

Predicting abnormal laboratory blood test results in the intensive care unit using novel features based on information theory and historical conditional probability (Preprint)

2021 ◽  
Author(s):  
Camilo E. Valderrama ◽  
Daniel J. Niven ◽  
Henry T. Stelfox ◽  
Joon Lee
Keyword(s):  
Machine Learning ◽  
Intensive Care ◽  
Conditional Probability ◽  
Blood Test ◽  
Laboratory Tests ◽  
Conditional Entropy ◽  
Admission Diagnosis ◽  
Test Results ◽  
Abnormal Laboratory ◽  
Blood Tests

BACKGROUND Redundancy in laboratory blood tests is common in intensive care units (ICU), affecting patients' health and increasing healthcare expenses. Medical communities have made recommendations to order laboratory tests more judiciously. Wise selection can rely on modern data-driven approaches that have been shown to help identify redundant laboratory blood tests in ICUs. However, most of these works have been developed for highly selected clinical conditions such as gastrointestinal bleeding. Moreover, features based on conditional entropy and conditional probability distribution have not been used to inform the need for performing a new test. OBJECTIVE We aimed to address the limitations of previous works by adapting conditional entropy and conditional probability to extract features to predict abnormal laboratory blood test results. METHODS We used an ICU dataset collected across Alberta, Canada which included 55,689 ICU admissions from 48,672 patients with different diagnoses. We investigated conditional entropy and conditional probability-based features by comparing the performances of two machine learning approaches to predict normal and abnormal results for 18 blood laboratory tests. Approach 1 used patients' vitals, age, sex, admission diagnosis, and other laboratory blood test results as features. Approach 2 used the same features plus the new conditional entropy and conditional probability-based features. RESULTS Across the 18 blood laboratory tests, both Approach 1 and Approach 2 achieved a median F1-score, AUC, precision-recall AUC, and Gmean above 80%. We found that the inclusion of the new features statistically significantly improved the capacity to predict abnormal laboratory blood test results in between ten and fifteen laboratory blood tests depending on the machine learning model. CONCLUSIONS Our novel approach with promising prediction results can help reduce over-testing in ICUs, as well as risks for patients and healthcare systems. CLINICALTRIAL N/A

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