scholarly journals Barriers and Challenges in Hyperemesis Gravidarum Research

2015 ◽  
Vol 8s1 ◽  
pp. NMI.S29523 ◽  
Author(s):  
Iris J. Grooten ◽  
Tessa J. Roseboom ◽  
Rebecca C. Painter
Keyword(s):  
Hyperemesis Gravidarum ◽  
Meta Analysis ◽  
Treatment Options ◽  
Improve Patient Care ◽  
Well Being ◽  
Electrolyte Imbalance ◽  
Nutritional Interventions ◽  
Barriers And Challenges ◽  
Care Costs ◽  
Improve Patient

Nausea and occasional vomiting in early pregnancy (NVP) are common. When vomiting is severe or protracted, it is referred to as hyperemesis gravidarum (HG). HG affects up to 3% of pregnancies and is characterized by weight loss, dehydration, electrolyte imbalance, and the need for hospital admission. HG has significant consequences for maternal well-being, is associated with adverse birth outcomes, and leads to major health care costs. Treatment options are symptomatic, hampered by the lack of evidence-based options including studies on nutritional interventions. One of the reasons for this lack of evidence is the use of a broad range of definitions and outcome measures. An internationally accepted definition and the formulation of core outcomes would facilitate meta-analysis of trial results and implementation of evidence in guidelines to ultimately improve patient care.

scholarly journals Termination of wanted pregnancy and suicidal ideation in hyperemesis gravidarum: A mixed methods study

2021 ◽  
pp. 1753495X2110409
Author(s):  
Melanie Nana ◽  
Florence Tydeman ◽  
Georgie Bevan ◽  
Harriet Boulding ◽  
Kimberley Kavanagh ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Hyperemesis Gravidarum ◽  
Healthcare Providers ◽  
Improve Patient Care ◽  
Termination Of Pregnancy ◽  
Free Text ◽  
Optimal Care ◽  
Specialist Services ◽  
Timely Access ◽  
Improve Patient

Background Difficulty accessing medication and poor patient experience have been implicated as risk factors for termination of pregnancy and suicidal ideation in women with hyperemesis gravidarum. We aimed to gain further insight into these factors in order to further inform and improve patient care. Methods We performed a sub-analysis on quantitative data generated through a UK-wide survey of 5071 participants. A qualitative analysis of free text comments was performed using an inductive thematic approach. Results 41.2% % of women taking prescribed medications had to actively request them. ‘Extremely poor’ or ‘poor’ experiences were described in 39.4% and 30.0% of participants in primary and secondary care respectively. Protective factors for termination of pregnancy and suicidal ideation include holistic support from family, friends and healthcare providers. Conclusion Optimal care in hyperemesis gravidarum should incorporate timely access to pharmacotherapy, assessment of mental health, consideration of referral to specialist services and care being delivered in a compassionate manner.

scholarly journals Embedding neuroscience in psychiatry training

2020 ◽  
Vol 26 (6) ◽  
pp. 379-380
Author(s):  
Christopher O'Loughlin
Keyword(s):  
Patient Care ◽  
Royal College ◽  
Treatment Options ◽  
Improve Patient Care ◽  
Medical Specialty ◽  
Psychiatry Training ◽  
Clinical Assessments ◽  
The Uk ◽  
Improve Patient ◽  
Scientific Fields

SUMMARYTraining in neuroscience is vital to the future of psychiatry as a medical specialty. Trainees and trainers alike demonstrate a desire to keep up to date with developments in the associated scientific fields. Neuroscience increasingly underpins clinical assessments, treatment options and patients’ expectations. Psychiatry training in the UK can embrace neuroscience at many levels, from discussing patient presentations with supervisors, to teaching programmes supported by the Royal College of Psychiatrists’ activities. Although challenges remain, neuroscience literacy enhances the specialty and will improve patient care.

scholarly journals Non-lesional treatment options for tremor in idiopathic Parkinson syndrome: a protocol for a systematic literature review

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e048367
Author(s):  
Anna Julia Pedrosa Carrasco ◽  
Felicitas Mügge ◽  
David José Pedrosa
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Meta Analysis ◽  
Treatment Options ◽  
Inclusion Criteria ◽  
Parkinson Syndrome ◽  
Registration Number ◽  
Future Publication ◽  
Rich Data ◽  
Improve Patient

IntroductionIdiopathic Parkinson syndrome (iPS) is one of the most common neurodegenerative disorders characterised by the triad of bradykinesia, rigidity and tremor. Tremor at rest predominantly at one side is often perceived by patients as severely disabling and yet ranges among the most difficult symptoms to treat. In medically refractory cases, lesional approaches have proven to be effective alternatives. However, to date, there is no comprehensive analysis of non-surgical therapies to manage iPS-patients’ tremor. We therefore present a detailed study protocol for a systematic literature review assessing efficacy/effectiveness and safety of non-lesional treatments for tremor in iPS.Methods and analysisWe will search three electronic databases (MEDLINE, EMBASE and PsycINFO) using a combination of title/abstract keywords. Additionally, hand-searched reference and citation lists of key reviews identified through the search strategy will be screened. Eligible studies should investigate the efficacy/effectiveness and safety of therapeutic options for tremor in iPS excluding lesional interventions. Publications will be independently assessed for inclusion criteria by two investigators and study information summarised using a standardised template including quality assessment according to the QualSyst tool. We will provide a narrative synthesis of results and conduct a meta-analysis whenever possible.Ethics and disseminationWe commit to present contemporary evidence on the efficacy/effectiveness and safety of non-lesional interventions for tremor in iPS in a future publication. We aim to compile rich data of published studies to inform healthcare professionals in order to ultimately improve patient outcomes.PROSPERO registration numberCRD42020202911).

scholarly journals Mindfulness-based interventions for mental well-being among people with multiple sclerosis: a systematic review and meta-analysis of randomised controlled trials

2019 ◽  
Vol 90 (9) ◽  
pp. 1051-1058 ◽  
Author(s):  
Robert Simpson ◽  
Sharon Simpson ◽  
Nitish Ramparsad ◽  
Margaret Lawrence ◽  
Jo Booth ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Treatment Options ◽  
Well Being ◽  
Controlled Trials ◽  
Medical Subject Headings ◽  
Randomised Controlled ◽  
Mental Well Being

ObjectiveImpairment of mental well-being (anxiety, depression, stress) is common among people with multiple sclerosis (PwMS). Treatment options are limited, particularly for anxiety. The aim of this study was to update our previous systematic review (2014) and evaluate via meta-analysis the efficacy of mindfulness-based interventions (MBIs) for improving mental well-being in PwMS.MethodsSystematic searches for eligible randomised controlled trials (RCTs) were carried out in seven major databases (November 2017, July 2018), using medical subject headings and key words. Studies were screened, data extracted, quality appraised and analysed by two independent reviewers, using predefined criteria. Study quality was assessed using the Cochrane Collaboration risk of bias tool. Mental well-being was the primary outcome. Random effects model meta-analysis was performed, with effect size reported as standardised mean difference (SMD).ResultsTwelve RCTs including 744 PwMS were eligible for inclusion in the systematic review, eight had data extractable for meta-analysis; n=635. Ethnicity, socioeconomic status, comorbidity and disability were inconsistently reported. MBIs varied from manualised to tailored versions, lasting 6–9 weeks, delivered individually and via groups, both in person and online. Overall SMD for mental well-being (eight studies) was 0.40 (0.28–0.53), p<0.01, I2=28%; against active comparators only (three studies) SMD was 0.17 (0.01–0.32), p<0.05, I2 =0%. Only three adverse events were reported.ConclusionsMBIs are effective at improving mental well-being in PwMS. More research is needed regarding optimal delivery method, cost-effectiveness and comparative-effectiveness.PROSPERO registration numberCRD42018093171.

scholarly journals Patient and caregiver perspectives on a tool to identify undiagnosed dementia: A qualitative study

2021 ◽  
Author(s):  
Lorella Palazzo ◽  
Clarissa Hsu ◽  
Deborah Barnes ◽  
Marlaine Figueroa-Gray ◽  
Mikael Anne Greenwood-Hickman ◽  
...  
Keyword(s):  
At Risk ◽  
Treatment Options ◽  
Improve Patient Care ◽  
Dementia Diagnosis ◽  
Kaiser Permanente ◽  
Team Members ◽  
Dementia Risk ◽  
Patients At Risk ◽  
Improve Patient

Abstract BACKGROUND Early detection of dementia may improve patient care and quality of life, yet as many as half of patients are undiagnosed. Electronic health record (EHR) data could potentially be used to help to identify patients at risk of having undiagnosed dementia who could be targeted for outreach and assessment, but acceptability to patients and caregivers is unknown. METHOD We conducted five focus groups at Kaiser Permanente Washington, an integrated healthcare system in Washington State, to explore feelings about timing of dementia diagnosis, use of EHR-33 based tools to predict risk of undiagnosed dementia, and communication about risk. Two team members analyzed transcripts using inductive thematic coding. RESULTS Participant groups included: patients with dementia or mild cognitive impairment, patients with neither diagnosis, and caregivers. People who were non-white or Hispanic were oversampled. Forty patients and caregivers (63% women; 59% non-white/Hispanic) participated in focus 39 groups. Participants supported early diagnosis, describing benefits such as time to adjust to the disease, plan, involve caregivers, and identify resources. They also acknowledged the possible psychosocial toll of receiving the diagnosis. Participants also supported use of an EHR-based tool, but some worried about accuracy and privacy. Participants emphasized that information about dementia risk should be communicated thoughtfully by a trusted provider and should include advice about prognosis, treatment options and other resources. CONCLUSION Overall, patients and caregivers supported using EHR-based tools to help identify patients at risk of having undiagnosed dementia. Such tools must be implemented carefully to address concerns and ensure patients and caregivers are adequately supported.

scholarly journals Overheating and Hospitals - What do we know?

2012 ◽  
Vol 2 (1) ◽  
pp. 1 ◽  
Author(s):  
Catriona Carmichael ◽  
Graham Bickler ◽  
Sari Kovats ◽  
David Pencheon ◽  
Virginia Murray ◽  
...  
Keyword(s):  
Health Care ◽  
Occupational Health ◽  
Improve Patient Care ◽  
Evidence Based ◽  
Carbon Reduction ◽  
Health And Wellbeing ◽  
It Systems ◽  
Hot Weather ◽  
Care Costs ◽  
Improve Patient

Heatwaves have well described impacts on human health and wellbeing. Heatwaves also have impacts on hospitals. Patients, visitors, equipment, medication and IT systems have all been affected or compromised during episodes of extreme heat. High indoor temperatures are also of concern for the comfort, efficiency, and occupational health of staff. The Heatwave Plan for England describes actions to prepare for and be taken in the event of a heatwave. Advice for a hospital is so far limited and not evidence based.  In this paper, we review what is currently known about the impacts of heatwaves on hospitals and identify several important information gaps. Improved responses to hot weather could improve patient care and staff comfort. If seen as part of a wider approach to sustainability, proper planning will also enable hospitals to reduce health care costs, increase efficiency and meet carbon reduction targets.

scholarly journals Developing Lifetime Relationships with Patients: Strategies to Improve Patient Care and Build Your Practice

2008 ◽  
Vol 9 (1) ◽  
pp. 105-112 ◽  
Author(s):  
Roger P. Levin
Keyword(s):  
Oral Health ◽  
Home Care ◽  
Patient Care ◽  
Customer Service ◽  
Improve Patient Care ◽  
Well Being ◽  
Dental Practice ◽  
Patient Centered ◽  
Comprehensive Service ◽  
Improve Patient

Abstract Aim The purpose of this article is to describe three strategies to build a thriving, patient-centered practice and promote oral health throughout a patient's lifetime. Background Compared to previous decades, more dental patients are “shopping around” for dental care and changing dental practices. This trend is due to factors such as acceptance of dental insurance, more comprehensive service offerings by other dentists, and effective marketing campaigns by other dental offices. Findings Delivering customer service exceeding patient expectations (“WOW” service), advocating patient education, and developing customized home care regimens will help lead to long-term patient retention and promote optimal patient care. Discussion A dental team making relationship-building a priority conveys respect for their patients’ time and well-being. Once trust has been established patients are more likely to be receptive to oral health education and become more compliant with home care regimens. Since a patient's oral health status will likely change over time, it's important to make education and customized treatment planning an integral part of each visit. Conclusions By demonstrating a strong commitment to customer service, education, and home care, patients recognize the care providers in a dental practice are interested in their well-being rather than simply treating problems. Clinical Significance If patients recognize a dental practice is focused on prevention and at-home oral health care, they are more likely to partner with that practice for a lifetime of excellent oral health care. Keywords Patient-centered practice, comprehensive service, patient education Citation Levin RP. Developing Lifetime Relationships with Patients: Strategies to Improve Patient Care and Build Your Practice. J Contemp Dent Pract 2008 January; (9)1:105-112.

scholarly journals Should interventional radiology gain speciality status within the royal college of radiologists?

2020 ◽  
pp. 20201118
Author(s):  
Yakup Kilic ◽  
Shahzad Illyas
Keyword(s):  
Interventional Radiology ◽  
Treatment Options ◽  
Improve Patient Care ◽  
Minimal Invasive ◽  
Left Behind ◽  
The Past ◽  
Leadership Management ◽  
Integral Role ◽  
Turf Wars ◽  
Improve Patient

Interventional Radiology (IR) medicine’s best kept secret will revolutionise healthcare like never before. The legacy Charles Dotter left behind not only showcases IR’s pursuit of innovative and complex techniques in order to provide better treatment options for patients, it also sparked an opportunity for radiologists to use their imagination and creativity to develop IR into a speciality catering for the 21st century. By utilising imaging as well as clinical and minimal invasive surgical knowledge IRs are able to play an integral role in caring for patients in nearly all specialities. Over the past few decades, the absence of radiology in the leadership management arena has allowed other specialities to perpetuate turf wars and utilise techniques developed by IR. A concerted effort is required by the wider radiology community to address the problems faced by IR and to recognise its true potential as a speciality to further improve patient care.

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