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1 – 10 of 11Ewa Emich-Widera, Beata Kazek, Barbara Szwed-Białożyt, Ilona Kopyta and Anna Kostorz
Somatoform disorders are often the main cause for seeking professional advice and performing a number of specialist checks. The aim of the study was to determine the frequency of…
Abstract
Somatoform disorders are often the main cause for seeking professional advice and performing a number of specialist checks. The aim of the study was to determine the frequency of somatoform disorders in the form of headaches in children and adolescents neurologically diagnosed and the risk factors thereof. Analysis of the biological and situational risk factors were established. Somatoform disorders were diagnosed in 27 out of 276 children with headaches. We concluded that in the differential diagnosis of headaches, somato-form headaches should not be omitted as every 10th patient in the developmental age diag nosed on the neurological ward because of headache shows signs of somatoform heada -ches. In diagnostically difficult cases it is recommended that analysis of biological and situational risk factors be performed with special attention paid to chronic disease of the patient and/or in his immediate family, the patient's psychological disorders and dysfunctional or low social status families. The creation of separate criteria for somatoform disorders of the developmental age should be considered.
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Lucia Parisi, Teresa Di Filippo, Sabina La Grutta, Rosa Lo Baido, Maria Stella Epifanio, Maria Esposito, Marco Carotenuto and Michele Roccella
Sturge-Weber-Krabe syndrome (SWS), also known as encephalotrigeminalangiomatosis and named the forthfacomatosis, recall the names of the authors who first describedit in its basic…
Abstract
Sturge-Weber-Krabe syndrome (SWS), also known as encephalotrigeminalangiomatosis and named the forthfacomatosis, recall the names of the authors who first describedit in its basic clinical, radiological andanatomopathological aspects. We report here 14 cases of Sturge-Weber disease. In 6 of these, despite what had been previously described in literature, an extension of the angioma has been noted in other parts of the body. The study of these subjects stresses not only the need for a pharmacological/neuropsychomotor intervention, but alsothe need of a psychotherapeutic approach, for the emotional and affective implications thatcould derive from this syndrome. The reported cases are similar to those presented in literature for their main features. In particular, two elements are interesting: i) the exceptional diffusion of the red nevousto the whole hemicorpo; and ii) the evaluation of the way the patients live the disease, which has not beenpreviously considered in literature. We can conclude that SWS is a multisystem disorder that requires the neurologist to be aware of the possible endocrine, psychiatric, ophthalmological, and other medical issues that can arise and impact on the neurological status of the patients.
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Imma Latessa, Antonella Fiorillo, Ilaria Picone, Giovanni Balato, Teresa Angela Trunfio, Arianna Scala and Maria Triassi
One of the biggest challenges in the health sector is that of costs compared to economic resources and the quality of services. Hospitals register a progressive increase in…
Abstract
Purpose
One of the biggest challenges in the health sector is that of costs compared to economic resources and the quality of services. Hospitals register a progressive increase in expenditure due to the aging of the population. In fact, hip and knee arthroplasty surgery are mainly due to primary osteoarthritis that affects the elderly population. This study was carried out with the aim of analysing the introduction of the fast track surgery protocol, through the lean Six Sigma, on patients undergoing knee and hip prosthetic replacement surgery. The goal was to improve the arthroplasty surgery process by reducing the average length of stay (LOA) and hospital costs
Design/methodology/approach
Lean Six Sigma was applied to evaluate the arthroplasty surgery process through the DMAIC cycle (define, measure, analyse, improve and control) and the lean tools (value stream map), adopted to analyse the new protocol and improve process performance. The dataset consisted of two samples of patients: 54 patients before the introduction of the protocol and 111 patients after the improvement. Clinical and demographic variables were collected for each patient (gender, age, allergies, diabetes, cardiovascular diseases and American Society of Anaesthesiologists (ASA) score).
Findings
The results showed a 12.70% statistically significant decrease in LOS from an overall average of 8.72 to 7.61 days. Women patients without allergies, with a low ASA score not suffering from diabetes and cardiovascular disease showed a significant a reduction in hospital days with the implementation of the FTS protocol. Only the age variable was not statistically significant.
Originality/value
The introduction of the FTS in the orthopaedic field, analysed through the LSS, demonstrated to reduce LOS and, consequently, costs. For each individual patient, there was an economic saving of € 445.85. Since our study takes into consideration a dataset of 111 patients post-FTS, the overall economic saving brought by this study amounts to €49,489.35.
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Usanun Intamas, Tassanee Rawiworrakul, Kwanjai Amnatsatsue, Sutham Nanthamongkolchai and Mary H. Palmer
This study aims to describe survivors of stroke circumstances, issues with providing care for survivors of stroke and services expected by caregivers and survivors of stroke.
Abstract
Purpose
This study aims to describe survivors of stroke circumstances, issues with providing care for survivors of stroke and services expected by caregivers and survivors of stroke.
Design/methodology/approach
A qualitative research design was conducted in Singburi Province. Data collection methods included in-depth interviews, focus groups and participatory observations. Semi-structured in-depth interview guides, quality-of-life scale and depression scale were used to collect data from survivors of stroke, their caregivers, health personnel, local governors and village health volunteers. Naturalistic research tradition was used for qualitative data analysis and descriptive statistics for quantitative data analysis.
Findings
The majority of survivors of stroke had hemiplegic limb and severe deficits in their activities of daily living. Caregivers were family members, and they often developed depression. Issues with providing care to stroke survivors included lack of knowledge about stroke and home care, inadequacy and discontinuity of care and the shortage of stroke care personnel in the community. A stakeholder's expected stroke services included the provision of effective continuing care, community participation in care and enhancing the village health volunteer's capacity.
Originality/value
This study illustrated the stroke service systems in rural Thai communities. The study's findings could be applied when planning future research using community participation to test a model of care for stroke survivors to promote better outcomes and be responsive to the needs of stroke survivors, especially those who are disabled.
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Naomi Algeo and Leanne M. Aitken
A recent paradigm-shift in patient care advocates for long-term recovery and quality of life in survivors of critical illness. Evidence suggests that occupational therapists in…
Abstract
Purpose
A recent paradigm-shift in patient care advocates for long-term recovery and quality of life in survivors of critical illness. Evidence suggests that occupational therapists in critical care can contribute to recovery in areas such as functional outcomes, length of stay and delirium, although poor role understanding can limit service-utilisation. The purpose of this study is to investigate current and future roles and practices of critical care occupational therapists in the UK.
Design/methodology/approach
Occupational therapists with clinical experience in adult critical care were invited to participate in a mixed-methods design using a locally developed online questionnaire and semi-structured interviews, concurrently. Descriptive statistics were generated through SPSS. Qualitative data were analysed using the framework approach.
Findings
Twelve occupational therapists participated in the survey element, with five continuing to interview. Occupational therapists described a multifaceted role in critical care where the majority reported practice in upper limb function, seating/positioning, cognition, psychosocial sequelae and discharge planning. Role and internal characteristics impacted on service delivery. It is envisaged that earlier intervention in a greater percentage of patients, a greater evidence-base, raising awareness and adequate staffing will be features for future development.
Originality/value
This study provides new insight into the current role and practices of adult critical care occupational therapists in England and generates insights into their role in addressing physical and non-physical morbidity for this patient cohort. Findings are preliminary in nature; however, future research is warranted to evaluate the effectiveness of interventions.
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Cognitive computing is part of AI and cognitive applications consists of cognitive services, which are building blocks of the cognitive systems. These applications mimic the human…
Abstract
Cognitive computing is part of AI and cognitive applications consists of cognitive services, which are building blocks of the cognitive systems. These applications mimic the human brain functions, for example, recognize the speaker, sense the tone of the text. On this paper, we present the similarities of these with human cognitive functions. We establish a framework which gathers cognitive functions into nine intentional processes from the substructures of the human brain. The framework, underpins human cognitive functions, and categorizes cognitive computing functions into the functional hierarchy, through which we present the functional similarities between cognitive service and human cognitive functions to illustrate what kind of functions are cognitive in the computing. The results from the comparison of the functional hierarchy of cognitive functions are consistent with cognitive computing literature. Thus, the functional hierarchy allows us to find the type of cognition and reach the comparability between the applications.
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Deirdre Manning, Mairead Campbell and Frances Horgan
This paper aims to understand the clinical practice of physiotherapists and occupational therapists in the Republic of Ireland in the assessment and treatment of spasticity in…
Abstract
Purpose
This paper aims to understand the clinical practice of physiotherapists and occupational therapists in the Republic of Ireland in the assessment and treatment of spasticity in adults, to inform and improve spasticity management practice. This study also aims to describe therapists’ knowledge, confidence and perceived barriers in the management of spasticity.
Design/methodology/approach
A cross sectional survey design study was completed, and respondents were recruited through an online survey.
Findings
In total, 92 respondents from a wide range of clinical settings revealed there is considerable variation in services available nationally for adults presenting with spasticity. There were significant inconsistencies across all areas of practice. The majority of respondents (94%) did provide intervention to patients with spasticity, yet three quarters did not have access to a specialist spasticity clinic, and the majority (82%) did not feel they were providing sufficient treatment intensity for spasticity.
Originality/value
These findings provide a unique insight into the assessment and treatment practices of Irish physiotherapists and occupational therapists. These results demonstrate the need for further upskilling and specialist high-quality spasticity services nationally.
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Noninvasive brain stimulation (NIBS) such a transcranial magnetic stimulation, intermittent theta burst stimulation, transcranial direct current stimulation and electroconvulsive…
Abstract
Purpose
Noninvasive brain stimulation (NIBS) such a transcranial magnetic stimulation, intermittent theta burst stimulation, transcranial direct current stimulation and electroconvulsive therapy have emerged as an efficacious and well-tolerated therapy for treatment-resistant psychiatric disorders. While novel NIBS techniques are an exciting addition to the current repertoire of neuropsychiatric therapies, their success is somewhat limited by the wide range of treatment responses seen among treated patients.
Design/methodology/approach
In this study, the authors will review the studies on relevant genetic polymorphisms and discuss the role of RNA genotyping in personalizing NIBS.
Findings
Genome studies have revealed several genetic polymorphisms that may contribute for the heterogeneity of treatment response to NIBS where the presence of certain single nucleotide polymorphisms (SNPs) are associated with responders versus nonresponders.
Originality/value
Historically, mental illnesses have been arguably some of the most challenging disorders to study and to treat because of the degree of biological variability across affected individuals, the role of genetic and epigenetic modifications, the diversity of clinical symptomatology and presentations and the interplay with environmental factors. In lieu of these challenges, there has been a push for personalized medicine in psychiatry that aims to optimize treatment response based on one’s unique characteristics.
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Despite the potential for research institutes to advance interdisciplinary research on university campuses, There have been few studies on how interdisciplinary research centres…
Abstract
Purpose
Despite the potential for research institutes to advance interdisciplinary research on university campuses, There have been few studies on how interdisciplinary research centres integrate multiple disciplines in practice, how they influence the collaborative behaviours of scientists and how they establish collaborative communities. This study aims to provide a deeper understanding of how interdisciplinary research is being enabled at research institutes and offers signposts for how research institutes can further embed interdisciplinarity within their units.
Design/methodology/approach
Within this study, 30 interviews were conducted with leadership and faculty within 4 sustainability research institutes in the USA exploring how research institutes support interdisciplinary research within their units. A thematic analysis on the interview data revealed themes on how research institutes are enabling interdisciplinary research within their organisations and universities.
Findings
The study highlights eight themes on how research institutes are, and can further, enable interdisciplinary research within their organisations and universities. Some of the themes are fully implemented within the research institutes, whilst others are more aspirational and highlight where institutes can create additional capability and capacity for interdisciplinary research within their units and universities.
Research limitations/implications
Whilst the study is limited to four major sustainability research institutes the findings will be applicable to all research centres and institutes attempting to create interdisciplinary research environments.
Practical implications
The study will be of particular interest to research institutes and university leadership who wish to cultivate a deeper culture of interdisciplinary research within their organisations.
Social implications
The advancement of inter- and transdisciplinary research within universities are seen by many academic institutions, expert groups and funding bodies as essential for solving wicked problems and grand challenges facing society. The findings of this paper will help universities increase their capacity for interdisciplinary research.
Originality/value
There are few comparable publications in terms of methodology, approach and focus on research institutes.
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