A Review of Virtual Week for Prospective Memory Assessment: Clinical Implications

2009 ◽  
Vol 10 (1) ◽  
pp. 14-22 ◽  
Author(s):  
Peter G. Rendell ◽  
Julie D. Henry
Keyword(s):  
Clinical Practice ◽  
Psychometric Properties ◽  
Prospective Memory ◽  
Functional Independence ◽  
Clinical Implications ◽  
Memory Assessment

AbstractIt is now recognised that prospective memory (PM) failures are commonly observed in clinical groups, and have important implications for functional independence. However, well-validated measures of PM have traditionally been lacking, making this construct difficult to assess in clinical practice. Rendell and Craik's (2000) Virtual Week measure was developed as an indicator of PM, and has been shown to have good psychometric properties and be sensitive to the effects of normal and abnormal adult ageing, as well as various forms of pathology. In this article, an overview of Virtual Week's characteristics is presented, and the literature relating to use of this measure in various populations reviewed. The potential implications of the development of a new computerised version of Virtual Week for clinical practice are discussed.

scholarly journals Cognitive therapy training for psychiatrists: impact on individual clinical practice

2004 ◽  
Vol 28 (4) ◽  
pp. 117-119 ◽  
Author(s):  
G. Swift ◽  
I. Durkin ◽  
C. Beuster
Keyword(s):  
Clinical Practice ◽  
Cognitive Therapy ◽  
Response Rate ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
Previous Survey ◽  
Therapy Training ◽  
Training And Supervision ◽  
Improved Outcomes ◽  
Therapy Sessions

Aims and MethodWe aimed to survey how psychiatrists with in-depth training in cognitive therapy use these skills. A postal questionnaire based on a previous survey was sent to all psychiatrists who are accredited members of the British Association for Behavioural and Cognitive Psychotherapies.ResultsThere was a 94% response rate. Psychiatrists in non-psychotherapy posts used formal cognitive therapy, with an average of 20% of new patients compared with 65% for those in psychotherapy posts, and were less satisfied with the extent to which they were able to use their skills (20%v. 80%). A total of 85% of respondents described themselves as being involved in teaching, training and supervision of cognitive therapy.Clinical ImplicationsUnless psychiatrists are planning on working in specialised psychotherapy posts, they are unlikely to use cognitive therapy training in formal therapy sessions. Further research is needed to determine whether cognitive therapy training for psychiatrists translates into improved outcomes for patients.

scholarly journals Variation between services in polypharmacy and combined high dose of antipsychotic drugs prescribed for in-patients

2002 ◽  
Vol 26 (11) ◽  
pp. 418-420 ◽  
Author(s):  
Maria Harrington ◽  
Paul Lelliott ◽  
Carol Paton ◽  
Maria Konsolaki ◽  
Tom Sensky ◽  
...  
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Antipsychotic Drugs ◽  
Service Level ◽  
Case Mix ◽  
Clinical Implications ◽  
High Dose ◽  
Prescribing Practice ◽  
Acute Psychiatric Wards ◽  
High Doses

Aims and MethodA 1-day census provided an opportunity to examine the variation between 44 mental health services in the frequency of prescribing high doses and polypharmacy of antipsychotic drugs to in-patients on acute psychiatric wards.ResultsThe proportion of patients prescribed a high dose ranged 0–50% and simultaneous use of more than one antipsychotic drug ranged 12–71%. A number of case-mix variables explained 26% and 40%, respectively, of the variance between services on these two indicators of prescribing practice.Clinical ImplicationsServices with high rates of prescription of high dose or polypharmacy might consider a review of clinical practice and of service-level factors that might affect prescribing.

scholarly journals Cardiac myxoma as a potential trigger of takotsubo cardiomyopathy: A brief review on mechanistic and clinical perspectives

2021 ◽  
Author(s):  
Kenan Yalta ◽  
Ugur Ozkan ◽  
Tülin Yalta ◽  
Ertan Yetkin
Keyword(s):  
Clinical Practice ◽  
Takotsubo Cardiomyopathy ◽  
Myocardial Dysfunction ◽  
Cardiac Myxoma ◽  
The Other ◽  
Clinical Implications ◽  
Transient Form ◽  
Cardiac Neoplasms ◽  
Potential Trigger ◽  
Cardiac Myxomas

In clinical practice, cardiac myxomas constitute the majority of benign cardiac neoplasms, and might potentially present with a variety of embolic, obstructive as well as constitutional symptoms. On the other hand, these neoplasms might be potentially associated with the evolution of takotsubo cardiomyopathy (TTC) that is universally considered as a transient form of acute myocardial dysfunction. Accordingly, the present paper primarily aims to focus on potential mechanisms and associated clinical implications of TTC evolution in the setting of cardiac myxomas.

scholarly journals Reconciling the information needs of clinicians, managers and commissioners – a pilot project

2001 ◽  
Vol 25 (11) ◽  
pp. 423-425 ◽  
Author(s):  
Matthew Broadbent
Keyword(s):  
Clinical Practice ◽  
Information Needs ◽  
Pilot Project ◽  
Information Model ◽  
Clinical Implications ◽  
Clinical Settings ◽  
Accurate Data ◽  
Clinical Model

Aims and MethodClinicians are often required, by managers, to provide information that does not appear relevant to clinical practice. Rooted in compromise, an outcome-based information model that supports practice and also provides information for managers was developed. A 9–month pilot project at three sites in South-East London took place to test the feasibility of this model in real clinical settings.ResultsAccurate data were reliably collected. Clinicians at participating sites agreed the model produced potentially useful information and, on condition that support is provided, continue to collect data voluntarily.Clinical ImplicationsThis is not an exclusively clinical model. However, because it also fulfils management needs there is a better chance that clinicians will get the support they need.

P-740 Socio-cultural and clinical implications of ‘routine’ AMH testing in India: Insights from an interview study with the healthcare professionals (HCPs)

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
P Satalkar ◽  
V Provoost
Keyword(s):  
Clinical Practice ◽  
Fertility Preservation ◽  
Healthcare Professionals ◽  
Screening Tool ◽  
Clinical Implications ◽  
Age Difference ◽  
Indian Women ◽  
Fertility Treatments ◽  
Indian Context ◽  
Cultural Implications

Abstract Study question How do Indian healthcare professionals describe their clinical experience with and perspectives on AMH testing in Indian women seeking fertility treatments including fertility preservation? Summary answer The HCPs cautioned against AMH testing as a screening tool in presumed fertile Indian women due to its anticipated impact on women’s arranged-marriage prospects. What is known already AMH test is being increasingly used to assess women’s ovarian reserve (OR) while planning fertility treatments or to guide decisions about fertility preservation (FP). There is weak evidence suggesting that serum AMH level and fertility treatment outcomes vary in different population groups. Surveys with women in reproductive age (e.g. the US, Ireland, the Netherlands) indicate that a majority wants to know their OR to aid reproductive decision making. As yet, both globally and in an Indian context, there are only few qualitative studies exploring the views of HCPs on the OR assessment in clinical practice and its socio-cultural implications. Study design, size, duration This paper reports the findings of an exploratory qualitative research aimed at understanding whether and how elective fertility preservation could influence reproductive autonomy of Indian women. Between June 2018 and April 2019, IVF specialists and obstetricians practicing in ten cities across five Indian states were interviewed in English (language commonly spoken) using a semi-structured interview guide. The discussion about OR assessment with AMH-testing was initiated by the participants indicating its significance in their clinical practice. Participants/materials, setting, methods The study sample included 17 male and 15 female HCPs, the majority (18/32) was practicing in Mumbai. Twenty-six of them were in private practice while six worked as OBGYNs in publicly funded teaching hospitals. Twenty-six participants were interviewed in their clinics and the remaining six using Skype or telephone. After several rounds of immersive reading, the interview sections on OR and AMH-test were analyzed inductively using Braun and Clarke’s thematic analysis. Main results and the role of chance Several participants reported that many of their patients present with decreased OR (DOR) at a younger age and need higher dosages of hormones for ovulation induction compared to the dosages mentioned in international guidelines. They corroborated this experience with a few peer-reviewed articles indicating a six-years age difference in OR of Indian women undergoing IVF compared to Spanish women. A majority of participants advocated for the rational use of OR assessment in IVF patients but warned against its indiscriminate use or interpretation out of context due to concerns about overdiagnosis of ovarian factor infertility and overtreatment with IVF with donor eggs. Although the physicians who had performed elective FP perceived AMH test as a simple, affordable and empowering tool to guide FP decisions, most participants were critical of using AMH-test as a screening tool in young, presumed fertile women completing university education. They were concerned that a diagnosis of DOR as a result of such screening in this population in the Indian context will adversely impact women’s chances of marriage and might further increase pressure on women to get married and complete their childbearing early even if they are not ready for it. Limitations, reasons for caution This is the first qualitative study assessing views of Indian HCPs on AMH testing. These results are indicative rather than a representation of views of Indian HCPs. Almost half of the contacted HCPs did not respond to interview requests; we do not know whether they had different views. Wider implications of the findings The insights on clinical implications of AMH testing in India are relevant to other societies beyond the Euro-American and Australian context where AMH testing will increase in the future. The socio-cultural implications of ‘routine’ AMH testing in India urges us to be aware of similar implications in other cultural contexts. Trial registration number Not applicable

Abstract TMP2: Reduction of Time to Endovascular Treatment and Improved Outcomes After Ischemic Stroke in Routine Clinical Practice: Comparison of the MR CLEAN Registry First and Second Cohorts

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Kars C Compagne ◽  
Manon Kappelhof ◽  
Robert-Jan B Goldhoorn ◽  
Charles B Majoie ◽  
Yvo B Roos ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Ischemic Stroke ◽  
Clinical Practice ◽  
Endovascular Treatment ◽  
Acute Ischemic Stroke ◽  
Functional Independence ◽  
Routine Clinical Practice ◽  
Anterior Circulation ◽  
Time To Treatment ◽  
Mr Clean

Introduction: Outcomes after endovascular treatment (EVT) for acute ischemic stroke are highly time dependent, but whether active reduction of time to treatment leads to better outcome has not been demonstrated. We compared data of the two subsequent MR CLEAN Registry cohorts, comprising all patients in the Netherlands who had EVT for acute ischemic stroke from 2014-2017, for a trend in time to treatment and its association with outcome. Methods: We compared workflow, successful reperfusion (eTICI 2B-3), NIHSS at 24h, functional outcome (mRS) at 90 days, occurrence of symptomatic intracranial hemorrhage (sICH) and mortality in patients with ischemic stroke and a proximal intracranial occlusion in the anterior circulation included in the second cohort of the Registry (June 2016-November 2017; n = 1779) to those in patients included in the first cohort (March 2014-June 2016; n = 1526) using logistic regression. Results: Baseline NIHSS was 16 in both cohorts. Times from onset-to-groin and onset-to-reperfusion were shorter in the second cohort than in the first (185 versus 210 minutes; p<0.01 and 238 versus 270 minutes; p<0.01, respectively) (Figure 1). Successful reperfusion was achieved more often in the second than in the first cohort (72% versus 58%; p<0.01). Rates of sICH and mortality did not differ (5.9% versus 5.7%; p=0.94 and 29% versus 29%; p=0.60). However, follow-up NIHSS was lower (median 10 versus 11; p<0.001) and more patients achieved functional independence at 90 days (42.6% versus 38.9%; p = 0.012) in the second cohort (Figure 1). In a logistic regression model, the difference in good outcome between the two cohorts (aOR 1.27; 95%CI 1.08-1.50) was reduced after additional adjustment for time to reperfusion (aOR 1.15; 95%CI 0.96-1.36) as well as successful reperfusion (aOR 1.16; 95%CI 0.95-1.41). Discussion: Our data show that outcomes after EVT in routine clinical practice are improving, likely attributable to improved workflow and experience.

Developmental disorders of the brain

2019 ◽  
pp. 971-982
Author(s):  
Colin Ferrie ◽  
Daniel Warren ◽  
Atul Tyagi
Keyword(s):  
Clinical Practice ◽  
Corpus Callosum ◽  
Developmental Disorders ◽  
Clinical Implications ◽  
Brain Malformations ◽  
Genetic Abnormalities ◽  
Genetic Mechanisms ◽  
Posterior Fossa Malformations ◽  
And Migration ◽  
The Brain

Prenatal and postnatal development of the brain is controlled by a multiplicity of genetic mechanisms. Genetic abnormalities and environmental insults are responsible for a bewildering array of developmental disorders associated with brain malformations. Classic embryology remains key to understanding these, and an appreciation of the processes of gastrulation, dorsal and ventral induction, neuronal differentiation, proliferation, histogenesis, and migration and myelination will help the neurosurgeon understand the conditions likely to be encountered in clinical practice. In this chapter the more common and many less common brain malformations are reviewed. These include anencephaly, holoprosencephaly, septo-optic dysplasia, schizencephaly, grey matter heterotopias, lissencephaly/pachygyria, polymicrogyria, porencephaly, developmental anomalies of the corpus callosum, microcephaly, hemimegalencephaly, and posterior fossa malformations. The emphasis is on promoting an understanding of concepts and on clinical implications, rather than on imparting detail.

scholarly journals Occipitalization of atlas - a case report

2016 ◽  
Vol 05 (02) ◽  
pp. 107-109
Author(s):  
Saranya Deb Barma ◽  
Gunamani Rabba ◽  
Kunjalal Talukdar
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Clinical Practice ◽  
Undergraduate Students ◽  
Neurological Complications ◽  
Occipital Bone ◽  
Clinical Implications ◽  
Short Neck ◽  
Neck Movement ◽  
Orthopaedic Surgeons

AbstractThe atlas vertebra articulates with the occipital bone of the skull by a pair of sunovial joints. Occipitalization is a congenital fusion of the atlas to the base of the occiput which reduces the foramen mangnum dimension leading to neurological complications due to compression of spinal cord. Individuals with occipitalization of the atlas may have low hairline, torticollis, restricted neck movement and abnormal short neck. During routine osteology demonstration class for undergraduate students, a total atlanto-occipital fusion was seen. The clinical implications of altanto-occipitalization may be beneficial for neurosurgeons, neurologists, orthopaedic surgeons and radiologists in day-to-day clinical practice.

Multi-disciplinary assessment of attention-deficit hyperactivity disorder: a tertiary assessment package

1999 ◽  
Vol 23 (7) ◽  
pp. 421-424 ◽  
Author(s):  
H. Kat ◽  
Clay Frake ◽  
Rebecca Sawtell
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Clinical Practice ◽  
Attention Deficit ◽  
Pilot Project ◽  
Clinical Implications ◽  
Assessment Protocol ◽  
Hyperactivity Disorder ◽  
Set Up

Aims and methodA tertiary assessment package was set up for the more equivocal cases of attention-deficit hyperactivity disorder (ADHD) who present with problems of inattention, impulsivity and overactivity. The structure of the three-day package was discussed, with an analysis of our experience in assessing 12 children using the pilot project. The package and Its use in clinical practice are presented.ResultsThe pilot project described can be modified into a two-day package.Clinical implicationsAssessment of ADHD conducted in multiple settings inherently has many advantages over single clinic assessment. We suggest that such an assessment protocol can be conducted cost effectively.

scholarly journals Histopathology of vasculitis

Reumatismo ◽  
2018 ◽  
pp. 155-164 ◽  
Author(s):  
G. Bajocchi ◽  
A. Cavazza
Keyword(s):  
Clinical Practice ◽  
Clinical Assessment ◽  
Gold Standard ◽  
Sampling Error ◽  
Systemic Vasculitis ◽  
Clinical Implications ◽  
Disease Evolution ◽  
Changes Over Time ◽  
Broad Complex ◽  
Over Time

The range of pathologies that are related to primitive vasculitis is broad, complex and not as typical as we would expect. Clinicians should be aware that several forms of primitive and systemic vasculitis, regardless of the size of the affected vessel, may exhibit identical histological alterations. This observation has important clinical implications as it means that cases of vasculitis do not correspond clinically and histologically. Thus, while histology remains the diagnostic gold standard, it can be used only as part of the most complete clinical assessment possible. Another point worth of the clinician’s attention is that vasculitis histology changes over time, as do disease evolution and activity, even without considering the masking effects of treatment and the possibility of sampling error due to the patchy occurrence of vasculitis. The purpose of this review is to identify the most common forms of vasculitis in clinical practice, and to provide guidance to the clinician on the pathology of the vessels.

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