The Nithsdale Schizophrenia Surveys. VIII: Do Relatives Want Family Intervention – And Does It Help?

1991 ◽  
Vol 158 (1) ◽  
pp. 110-113 ◽  
Author(s):  
R. G. McCreadie ◽  
K. Phillips ◽  
J. A. Harvey ◽  
G. Waldron ◽  
M. Stewart ◽  
...  
Keyword(s):  
British Journal ◽  
Expressed Emotion ◽  
Family Intervention ◽  
Family Meetings ◽  
Number Of Patients ◽  
Before And After ◽  
At Home

Sixty-three relatives of 52 schizophrenics living at home were offered a package of treatments by professionals working in an everyday NHS setting: educational seminars, relatives' groups, and family meetings. Thirty-two relatives refused intervention. Of the 31 relatives who agreed, 14 attended neither the educational seminars nor the relatives' groups. Seventeen relatives had a mean of ten treatment sessions, but there was little change in their level of expressed emotion after intervention. The number of patients who relapsed was the same in the 18 months before and after intervention, although the total number of relapses fell after intervention.British Journal of Psychiatry (1991), 158, 110–113

Impact of Michigan’s new opioid prescribing laws on spine surgery patients: analysis of the Michigan Spine Surgery Improvement Collaborative

2020 ◽  
pp. 1-6
Author(s):  
Paul Park ◽  
Victor Chang ◽  
Hsueh-Han Yeh ◽  
Jason M. Schwalb ◽  
David R. Nerenz ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Spinal Surgery ◽  
Readmission Rate ◽  
Rating Scale ◽  
Short Term ◽  
Readmission Rates ◽  
Opioid Prescribing ◽  
Number Of Patients ◽  
Before And After ◽  
The Impact

OBJECTIVEIn 2017, Michigan passed new legislation designed to reduce opioid abuse. This study evaluated the impact of these new restrictive laws on preoperative narcotic use, short-term outcomes, and readmission rates after spinal surgery.METHODSPatient data from 1 year before and 1 year after initiation of the new opioid laws (beginning July 1, 2018) were queried from the Michigan Spine Surgery Improvement Collaborative database. Before and after implementation of the major elements of the new laws, 12,325 and 11,988 patients, respectively, were treated.RESULTSPatients before and after passage of the opioid laws had generally similar demographic and surgical characteristics. Notably, after passage of the opioid laws, the number of patients taking daily narcotics preoperatively decreased from 3783 (48.7%) to 2698 (39.7%; p < 0.0001). Three months postoperatively, there were no differences in minimum clinically important difference (56.0% vs 58.0%, p = 0.1068), numeric rating scale (NRS) score of back pain (3.5 vs 3.4, p = 0.1156), NRS score of leg pain (2.7 vs 2.7, p = 0.3595), satisfaction (84.4% vs 84.7%, p = 0.6852), or 90-day readmission rate (5.8% vs 6.2%, p = 0.3202) between groups. Although there was no difference in readmission rates, pain as a reason for readmission was marginally more common (0.86% vs 1.22%, p = 0.0323).CONCLUSIONSThere was a meaningful decrease in preoperative narcotic use, but notably there was no apparent negative impact on postoperative recovery, patient satisfaction, or short-term outcomes after spinal surgery despite more restrictive opioid prescribing. Although the readmission rate did not significantly increase, pain as a reason for readmission was marginally more frequently observed.

Improving Genetics Clinic Efficiency and Capacity Using Design and Human Factors Methods

2021 ◽  
Vol 10 (1) ◽  
pp. 204-210
Author(s):  
Maryam Attef ◽  
Mireille Cloutier ◽  
Meredith Gillespie ◽  
Chantal Trudel ◽  
Kym Boycott
Keyword(s):  
Human Factors ◽  
Task Analysis ◽  
Healthcare Providers ◽  
Time On Task ◽  
Prenatal Genetics ◽  
Factors Influencing ◽  
Number Of Patients ◽  
Clinic Efficiency ◽  
Before And After ◽  
Improve Access

This quality improvement study focused on developing an understanding of factors influencing the ability of prenatal genetics counsellors (GCs) to efficiently see patients during the COVID-19 pandemic and strategies to improve their workflow using techniques from human factors and design. The demand for Prenatal Genetics Clinics is rising which has increased pressure on GCs to become more efficient. Genetics counsellors can improve access to their services by reducing the time spent on the tasks performed before and after a genetic counselling encounter, thereby increasing the number of patients they see. We were limited to certain methods to understand the differences in workflow before and during the COVID-19 pandemic. This study involved a literature review, archival analysis of workflow studies conducted before the pandemic, stakeholder meetings and mapping, a brainstorming session, as well as documenting time-on-task in a diary and naturalistic observation sessions. A task analysis was developed to identify factors influencing efficiency related to the design of the space, processes and the use of artefacts. Virtual and on-site workflows show that GCs spend at least half of their time on tasks before and/or after the patient’s appointment. Looking at potential inefficiencies or bottlenecks in workflow formed the development of a strategic plan for improving GC workflows at the prenatal Genetics Clinic. Improvements suggested through this analysis were constrained to support the current number of healthcare providers working within the existing space configuration.

Acquiring variable commands at home and abroad: Examining optatives and imperatives in L1 and L2 Spanish

2020 ◽  
Vol 13 (1) ◽  
pp. 79-113
Author(s):  
Farrah Neumann ◽  
Matthew Kanwit
Keyword(s):  
Second Language ◽  
Second Language Acquisition ◽  
Study Abroad ◽  
Language Teaching ◽  
Applied Linguistics ◽  
Future Research ◽  
Control Group ◽  
Before And After ◽  
The Individual ◽  
At Home

AbstractSince many linguistic structures are variable (i. e. conveyed by multiple forms), building a second-language grammar critically involves developing sociolinguistic competence (Canale and Swain. 1980. Theoretical bases of communicative approaches to second language teaching and testing. Applied Linguistics 1(1). 1–47), including knowledge of contexts in which to use one form over another (Bayley and Langman. 2004. Variation in the group and the individual: Evidence from second language acquisition. International Review of Applied Linguistics in Language Teaching 42(4). 303–318). Consequently, researchers interested in such competence have increasingly analyzed the study-abroad context to gauge learners’ ability to approximate local norms following a stay abroad, due to the quality and quantity of input to which learners may gain access (Lafford. 2006. The effects of study abroad vs. classroom contexts on Spanish SLA: Old assumptions, new insights and future research directions. In Carol Klee & Timothy Face (eds.), Selected proceedings of the 7th conference on the acquisition of Spanish and Portuguese as first and second languages, 1–25. Somerville, MA: Cascadilla Proceedings Project). Nevertheless, the present study is the first to examine native or learner variation between imperative (e. g. ven ‘come’) and optative Spanish commands (e. g. que vengas ‘come’). We first performed a corpus analysis to determine the linguistic factors to manipulate in a contextualized task, which elicited commands from learners before and after four weeks abroad in Alcalá de Henares, Spain. Their overall rates of selection and predictive factors were compared to local native speakers (NSs) and a control group of at-home learners.Results revealed that the abroad learners more closely approached NS rates of selection following the stay abroad. Nonetheless, for both learner groups conditioning by independent variables only partially approximated the NS system, which was more complex than previously suggested.

The effect of the COVID-19 pandemic on metabolic control in children with type 1 diabetes: a single-center experience

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Emre Sarıkaya ◽  
Dilek Çiçek ◽  
Ebru Gök ◽  
Leyla Kara ◽  
Uğur Berber ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Metabolic Control ◽  
Glycosylated Hemoglobin ◽  
Emergency Admissions ◽  
Single Center Experience ◽  
Number Of Patients ◽  
Significant Difference ◽  
Before And After ◽  
One Year

Abstract Objectives Coronavirus disease 2019 has caused a major epidemic worldwide, and lockdowns became necessary in all countries to prevent its spread. This study aimed to evaluate the effects of staying-at-home practices on the metabolic control of children and adolescents with type 1 diabetes during the pandemic period. Materials and Methods Eighty-nine patients younger than 18 years old who were diagnosed with type 1 diabetes at least one year before the declaration of the pandemic were included in the study. The last visit data of the patients before and after the declaration of the pandemic, and the frequency of presentation of diabetes-related emergencies from one year after diagnosis of type 1 diabetes to the declaration of the pandemic, and from the declaration of the pandemic to the last visit after the pandemic declaration were compared. Results The total number of patients was 89, and 48 (53.9%) were boys. The mean (± standard deviation [SD]) age at diagnosis was 8.4 ± 3.7 years (boys 7.9 ± 3.6 years; girls 8.9 ± 3.9 years). There was no statistically significant difference when the SD values of the anthropometric measurements, and the glycosylated hemoglobin (HbA1c) and lipid profile tests were compared. However, the frequency of admission to the emergency service related to diabetes was significantly different. Conclusions Although the pandemic did not significantly affect the metabolic and glycemic controls of the children with type 1 diabetes included in this study, an increase in the frequency of diabetes-related emergency admissions was noted.

ПЕРСПЕКТИВЫ УЛУЧШЕНИЯ СПЕЦИАЛИЗИРОВАННОЙ ПОМОЩИ ПАЦИЕНТАМ С НЕСПЕЦИФИЧЕСКИМИ ГНОЙНЫМИ ЗАБОЛЕВАНИЯМИ ПОЗВОНОЧНИКА

Innova ◽  
2020 ◽  
Vol 20 (3) ◽  
pp. 18-24
Author(s):  
Максим Юрьевич Гончаров ◽  
◽  
Яна Алексеевна Горева ◽  
Keyword(s):  
Systemic Inflammatory Response Syndrome ◽  
Early Diagnosis ◽  
Inflammatory Response ◽  
Treatment Outcomes ◽  
Improve Treatment ◽  
Organizational Issues ◽  
Number Of Patients ◽  
Before And After ◽  
Specialized Care ◽  
The Russian Federation

The problem of early diagnosis of non-specific purulent diseases of the spine remains relevant. The main organizational problems in providing medical care to these patients are considered to be late diagnosis, late administration of antibacterial therapy and neurosurgical care. The goal of our work was to improve treatment outcomes by reducing the time of diagnosis and the duration of the stage before providing specialized care. Based on the identified variable factors that influenced the treatment outcomes, we proposed an algorithm for the diagnosis and treatment of non-specific purulent diseases of the spine, implemented in the activities of hospitals in the Sverdlovsk region. To evaluate the effectiveness of our proposed algorithm, we retrospectively compared the main indicators and results of the treatment of patients conducted before and after the implementation of the developed algorithm. Educational and methodological work with doctors was also important for reducing the time of diagnosis of the disease. After the implementation of the developed algorithm of diagnostics and tactics in nonspecific suppurative diseases of the spine and the necessary organizational issues, there was a reduction of the duration from the first signs of the disease to provide specialized assistance, as well as the number of patients who had gross neurological deficit and/or systemic inflammatory response syndrome upon admission to a hospital. The results obtained allow us to recommend the developed algorithm of diagnostics and tactics for non-specific purulent diseases of the spine for implementation in other regions of the Russian Federation.

Measuring Change in Nurses’ Perceptions About Family Nursing Competency Following a 6-Day Educational Intervention

2018 ◽  
Vol 24 (4) ◽  
pp. 508-537 ◽  
Author(s):  
Susanne Broekema ◽  
Marie Louise A. Luttik ◽  
Gabriëlle E. Steggerda ◽  
Wolter Paans ◽  
Petrie F. Roodbol
Keyword(s):  
Educational Intervention ◽  
Nursing Care ◽  
Family Intervention ◽  
Assessment Model ◽  
Paired Samples ◽  
Family Nursing ◽  
Positive Attitudes ◽  
Before And After ◽  
Nurses Perceptions ◽  
Depth Interviews

This study describes nurses’ perspectives about their experience of being involved in a 6-day educational intervention which focused on the development of competency in family nursing practice with a particular emphasis on family nursing conversations. The foundational knowledge of the educational intervention was based on the Calgary Family Assessment Model (CFAM) and the Calgary Family Intervention Model (CFIM). A research design incorporating quantitative and qualitative measurement was used. Before and after the family nursing educational intervention, nurse participants ( n = 18) completed the Families’ Importance in Nursing Care–Nurses’ Attitudes (FINC-NA) instrument. The outcomes were analyzed using paired-samples t tests. FINC-NA scores increased by 6.94 points ( SD = 5.66, p < .001). To complement the quantitative findings, in-depth interviews were conducted with all of the participants. Participants reported increased awareness of the importance of families in nursing care. In addition to an increase in positive attitudes about families, participants perceived that their knowledge and skills regarding family nursing conversations were more comprehensive. A 6-day educational intervention with a focus on reflection appears useful in helping nurses to “think family” and encouraging perceptions of increased competence in family nursing conversations.

Impact of a Vancomycin Restriction Policy on Use and Cost of Vancomycin and Incidence of Vancomycin-Resistant Enterococcus

1997 ◽  
Vol 31 (9) ◽  
pp. 970-973 ◽  
Author(s):  
Amy S Morgan ◽  
Patrick J Brennan ◽  
Neil O Fishman
Keyword(s):  
Policy Implementation ◽  
University Teaching ◽  
Vancomycin Resistant Enterococcus ◽  
Vancomycin Therapy ◽  
Billing Data ◽  
Restriction Policy ◽  
Number Of Patients ◽  
Before And After ◽  
Vancomycin Resistant ◽  
Prophylactic Use

Objective To review the appropriateness of vancomycin therapy, changes in vancomycin use, and the incidence of vancomycin-resistant Enterococcus (VRE) after implementation of a limited restriction policy requiring approval from the Infectious Diseases Approval service to continue vancomycin therapy beyond 72 hours. Design A prospective chart review was conducted in April 1995. Pharmacy billing data and infection control data were compared before and after policy implementation. Setting A 725-bed university teaching institution. Patients All patients receiving vancomycin during April 1995. Main outcome Measures Appropriateness of use was based on the Centers for Disease Control and Prevention (CDC) recommendations for prudent vancomycin use. Results A total of 333 courses of vancomycin therapy were reviewed. Vancomycin use was appropriate in 219 (66%) courses. Of the 114 courses that did not meet the CDC guidelines, 76 (67%) were for empiric use, 35 (31%) were for prophylactic use, and 3 (3%) were for therapeutic use. Overall, the total number of grams used decreased 9%, grams per 1000 patient-days decreased by 10, and the total number of patients exposed to vancomycin decreased 0.5%. Several services had large decreases in vancomycin use. Vancomycin expenditures decreased by $15 788 for the 7-month time period. The incidence of VRE remained unchanged, at 30% of all enterococcal isolates 2 years after policy implementation. Conclusions The limited restriction policy was effective in decreasing the total grams of vancomycin used. However, one-third of vancomycin therapy was inappropriate and the incidence of VRE was unchanged. A more stringent restriction policy could potentially increase appropriate use, further decrease the amount of vancomycin used, and decrease the incidence of VRE.

scholarly journals PENGARUH TERAPI BEKAM TERHADAP PENURUNAN KADAR KOLESTEROL PADA PASIEN HYPERCHOLESTEROLEMIA DI RUMAH SEHAT AL-HIJAMAAH TAHUN 2014/2015

2019 ◽  
Vol 1 (1) ◽  
pp. 41-47
Author(s):  
Sitti Aulia Hidayat ◽  
Salsa Anggeraini ◽  
TaufiQul Hidayat
Keyword(s):  
Sampling Method ◽  
Sampling Technique ◽  
Cupping Therapy ◽  
T Test ◽  
Primary Data ◽  
Probability Sampling ◽  
Cholesterol Levels ◽  
Before And After ◽  
Paired T Test ◽  
At Home

To know the effect of cupping therapy to decrease cholesterol levels in patients at Home Healthy hiperkolestrolemia Al-hijamaah in the year 2014/2015. Research observational analytic-numerical categorical pairs. Samples were hypercholesterolemic patients at Home Healthy Al-hijamaah in 2014/2015. Taken by using non-probability sampling technique with purposive sampling method. The primary data obtained directly from respondents, and analyzed by paired T test. The number of samples involved in this study were 45 respondents. Most of the samples were aged 20-45 years were 28 respondents (62.2%), female 27 respondents (60%), and average cholesterol levels before cupping therapy of 262.84 mg / dl and the average after cupping therapy 239.53 mg / dl. In this study, the results of Test Independent t test t test = 2.64 with p = 0,010 (p 0.05) which means that there are significant differences in cholesterol levels before and after cupping therapy

scholarly journals SP9.1.1 The Impact of Anaesthetic Use on Healing in Sub-cutaneous Abscess Management: A Retrospective Before and After Cohort Study

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Hannah Elkadi ◽  
Eleanor Dodd ◽  
Theodore Poulton ◽  
William Bolton ◽  
Joshua Burke ◽  
...  
Keyword(s):  
Wound Healing ◽  
Local Anaesthetic ◽  
Surrogate Endpoints ◽  
Incision And Drainage ◽  
Number Of Patients ◽  
Significant Difference ◽  
Patient Reported ◽  
Before And After ◽  
The Impact

Abstract Aims Despite being the most common surgical procedure, there is wide variation that exists in the management of simple subcutaneous abscesses with no national guideline describing best practice. During the COVID-19 Pandemic national guidelines promoted the use of regional or local anaesthetic (LA) instead of general anaesthesia (GA) to avoid aerosol generating intubation associated with GA. This study aimed to assess the impact of anaesthetic choice in outcomes following incision and drainage of subcutaneous abscesses. Methods Two cohorts of patients undergoing abscess incision and drainage at St. James’ University Hospital Leeds were retrospectively identified over a 14-week period before and after the introduction of the new COVID-19 anaesthetic guidelines. Wound healing surrogate endpoints were used: i) total number of follow up appointments and ii) attendance to healthcare services after 30 days from I&D. Result 133 patients were included. Significantly more procedures were performed under LA after the intervention (84.1% vs 5.7%; p &lt; 0.0001) with a significant reduction in wound packing (68.3% vs 87.1%. p=0.00473). Follow up data found no significant difference in the average number of follow-up appointments (7.46 vs 5.11; p = 0.0731) and the number of patients who required ongoing treatment after 30 days (n = 14 vs n = 14, p = 0.921). Conclusion Drainage of simple subcutaneous abscess under 5 cm is safe under local anaesthetic with no significant difference in surrogate endpoints of wound healing observed in this patient cohort. Recurrent packing may not be required. Future work should explore patient reported measures such as pain management and the health economics of this intervention.

scholarly journals Expressed Emotion Towards Individuals with Mental and Physical Health Conditions: A Structured Literature Review

2018 ◽  
Vol 5 (2) ◽  
pp. 108-117
Author(s):  
Лариса Засєкіна
Keyword(s):  
Mental Illness ◽  
British Journal ◽  
Literature Review ◽  
Physical Health ◽  
Clinical Psychology ◽  
Expressed Emotion ◽  
Autism Spectrum ◽  
Health Conditions ◽  
Family Psychology ◽  
Mental And Physical Health

Expressed Emotion (EE) is a well-validated measure of the family environment of individuals with mental and physical conditions that examines relatives’ critical, hostile and emotionally overinvolved attitudes towards a family member with a condition. This review focuses on studies of EE on containing data of the impact of Expressed Emotion on the course of chronic illnesses and clinical outcomes in mental and physical health conditions. The structural literature review is based on the search of articles in peer-reviewed journals from 1991 to November, 2018 in the databases Psyc-Info and PubMed. Taken together, these results suggest that there is an association between EE towards patients with both physical and mental conditions and  a poor clinical and personal recovery. Interestingly, the lower levels of EE towards individuals with a condition were observed  in partners comparatively with parents, adult children and relatives. However, the results have been obtained only from two populations with dementia and Type I diabetes and have been considered as important issue for future research.   References Ayilara, O., Ogunwale, A., & Babalola, E. (2017). Perceived expressed emotion in relatives of patients with severe mental illness: A comparative study. Psychiatry research, 257, 137-143. Bogojevic, G., Ziravac, L., & Zigmund, D. (2015). Impact of expressed emotion on the course of schizophrenia. European Psychiatry, 30, 390. Brown, G. W., Birley, J. L. T., & Wing, J. K. (1972). Influence of family life on the course of schizophrenic disorders: A replication. British Journal of Psychiatry, 121, 241–258. Chan, K. K., & Mak, W. W. (2017). The content and process of self-stigma in people with mental illness. American Journal of Orthopsychiatry, 87(1), 34-43. Cherry, M. G., Taylor, P. J., Brown, S. L., & Sellwood, W. (2018). Attachment, mentalisation and expressed emotion in carers of people with long-term mental health difficulties. BMC Psychiatry, 18(1), 257. Coomber, K., & King, R. M. (2013). Perceptions of carer burden: differences between individuals with an eating disorder and their carer. Eating Disorders, 21(1), 26-36 Engel, G. L. (1977). The need for a new medical model: a challenge for biomedicine. Science, 196(4286), 129-136. Flanagan, D. A., & Wagner, H. L. (1991). Expressed emotion and panic fear in the prediction of diet treatment compliance. British Journal of Clinical Psychology, 30, 231–240. Hooley, J. M., & Parker, H. A. (2006). Measuring expressed emotion: An evaluation of the shortcuts. Journal of Family Psychology, 20(3), 386. Rienecke, R. D., Lebow, J., Lock, J., & Le Grange, D. (2015). Family profiles of expressed emotion in adolescent patients with anorexia nervosa and their parents. Journal of Clinical Child & Adolescent Psychology, 46(3), 428-436. Safavi, R., Berry, K., & Wearden, A. (2018). Expressed emotion, burden, and distress in significant others of people with dementia. Journal of Family Psychology, 32(6), 835. Romero-Gonzalez, M., Chandler, S., & Simonoff, E. (2018). The relationship of parental expressed emotion to co-occurring psychopathology in individuals with autism spectrum disorder: A systematic review. Research in developmental disabilities, 72, 152-165. Wearden, A. J., Tarrier, N., Barrowclough, C., Zastowny, T. R., & Rahill, A. A. (2000). A review of expressed emotion research in health care. Clinical Psychology Review, 20(5), 633-666. Wearden, A. J., Tarrier, N., & Davies, R. (2000). Partners' expressed emotion and the control and management of Type 1 diabetes in adults. Journal of Psychosomatic Research, 49(2), 125-130.

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