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This paper aims to present the distinctive roles and perspectives of the members of a multidisciplinary team supporting a man with multiple diagnoses who was under Section by the Mental Health Act.

The management of risk for this man with intellectual disability, mental illness and a degenerative neurological condition was particularly complex due to his self‐harming and impulsivity. Each specialist clinician (nurse, speech and language therapist, psychiatrist) reflects on their role as a member of a team approach. The perspective of the man himself is represented, although he was unable to give a consistent descriptive self report.

For people with mental illness and intellectual disability the capacity to understand and retain information about their condition may be limited and variable. The paper discusses the multiple ethical issues in attempting to preserve a modified autonomy and in decision making around best interests.

Supporting someone with dysphagia presents specific challenges to staff teams due to the everyday and familiar nature of mealtimes. When the person is unable to understand and refuses to comply with guidelines outlining restrictions to mealtime choices, the staff's role in safeguarding is particularly complex. The paper considers how to mitigate against risks to mental and physical health.

In cases of self harm the care team is challenged to respect autonomy and maintain quality of life whilst ensuring safety of the individual. The paper discusses maintaining professional integrity when considering compromise.

The purpose of this paper is to carry out the business process re‐engineering (BPR) of a surgical ward in a hospital in order to improve the efficiency of the ward.

This work was developed using a case study on a surgical ward. In this type of ward, in which scheduled and unscheduled operations often have to coexist and be managed, ways to minimise patient inconvenience need to be studied. A framework based on event‐driven process chains (EPCs) methodology, the entity‐relationship model and discrete event simulation is presented to define and analyse the current state of a surgical ward and design a future system. The modelling of the processes, activities and sub‐activities, which took up a great amount of ward resources, allowed a what‐if analysis to be developed which simulates various scenarios and assesses their performance.

Using Delphi methodology, it was possible to identify a number of areas for improvement: number of operating sessions, preparation of the operating rooms for each operation, availability of specific surgical instruments. Moreover, the discrete event simulation approach led to an understanding of the most efficient management choices.

The decision to use Delphi methodology for the information collection stage before starting the BPR process is not found in other studies in the literature. Moreover, the use of models based on EPCs methodology allowed the panel of experts to develop models to examine and understand the resource requirements of medical assessment units and to provide a framework or develop standards that hospital developers and clinical managers can consult.

To determine how the correlational structure of emotion differs for individuals age 60 and above, compared to those under age 60, and to discuss the profound implications these differences may have for the experience and management of emotion.

Structural equation modeling and shortest path analysis of emotion items from the General Social Survey (GSS)’s (1996) emotions module.

Some positive and negative emotion pairs are more distant for individuals over age 60, while others are in fact closer. This variability leads to differences in available shortest paths between emotions, especially when emotional transitions require segueing through intermediary feelings. The segueing emotions most readily available to those over 60 are limited to the poles of affective meaning, whereas those used by ones under age 60 are more variable. The majority of negative emotions are more tightly correlated, whereas the majority of positive emotions are less so, among those over age 60.

Although the measures are limited to 18 of the 19 emotions recorded by the GSS, and are based on self-report data regarding feelings felt over a period of seven days, these results suggest that attempts at intrapersonal and interpersonal emotion management may differ depending up the age of the actor/object.

Addresses the need for more nuanced analyses of emotional experience that goes moves beyond simple frequencies. Also suggests potential bridges between sociological and psychological approaches to the study of emotion.

This paper empirically explores the role of skill losses during unemployment behind firms' behaviour in interviewing long-term unemployed

The analysis makes use of the Work Employment Relations Survey in the UK, while it applies a panel probit modelling approach to estimate the empirical findings.

The findings document that skill losses during long-term unemployment reduce the likelihood of an interview, while they emphasize the need for certain policies that could compensate for this deterioration of skills. For robustness check, the estimation strategy survives the examination of the same predictors under different types of the working environment.

The original values of the work 1 combines for the first time both duration and technology as predictors of interview probability. Until now, the independent variables were used to test whether an individual has managed to exit unemployment, thus skipping the step of the interview process.

The purpose of this paper is to review the application of a syndromic approach to seizure disorders in intellectual disabilities, in the light of recent advances in research and the International League Against Epilepsy (ILAE) Report on classification in 2010.

The ILAE Report is reviewed with an emphasis on neurodevelopmental seizure disorders, which may present to clinicians working in the field of adult intellectual disability. The advantages of applying a syndromic approach and the difficulties often encountered are also discussed.

Adopting a syndromic approach to seizure disorders in adults with intellectual disability should lead to rational prescribing, appropriate packages of care, and an improvement in the quality of research in this field.

This paper highlights the importance of identifying epilepsy syndromes in adults with intellectual disability, in the light of recent international reports on classification. It is of value to clinicians (particularly psychiatrists and learning disability nurses) practising in the field of epilepsy and intellectual disability.

A major component of hospital stroke care involves prompt identification of stroke in admitted patients. Delays in recognizing stroke symptoms and initiating treatment for in-hospital stroke can adversely impact patient outcomes. This quality improvement intervention used simulation together with a traditional lecture to instruct nurses at a university hospital about a new stroke protocol being implemented to increase rapid recognition of stroke and meet Joint Commission National Hospital Inpatient Quality Measures. The paper aims to discuss these issues.

In total, 86 registered nurses from the neurology and cardiology units attended a lecture and participated in a simulation scenario with a standardized patient exhibiting stroke symptoms. Participants completed a ten-item pre-test to measure their knowledge of stroke care prior to the lecture; they repeated the test pre-simulation and once again post-simulation to evaluate changes in knowledge.

Overall mean stroke knowledge scores increased significantly from pre-lecture to pre-simulation, and from pre-simulation to post-simulation. Simulation plus lecture was more effective than lecture alone in increasing knowledge about hospital stroke protocol despite assigned unit (cardiology or neurology), years of experience, or previous exposure to simulation.

All eligible nurses who agreed to participate received training, making it impossible to compare improvements in knowledge to those who did not receive the training.

A diverse array of nursing professionals and their patients may benefit from simulation training. This quality improvement intervention provides a feasible model for establishing new care protocols in a hospital setting.

An overview of the impact of dementia that focuses on underdeveloped countries across the globe, and migrant and minority ethnic communities within the developed world. Increased longevity increases the risk of dementia and brings new challenges in terms of cultural perspectives and cultural obligations in the care of elders. The chapter examines these challenges in detail and their consequences in planning for support and care.

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.

Neurological disease and neurodisability cause significant disruption to families, who come under substantial pressure to adapt to changes in the condition over time. Family members are often disadvantaged in their coping because of infrequent access to professional consultations, and by default carers tend to neglect their own needs. One threat to relationships can be a pull towards acting as the main carer, even carrying out personal care tasks, especially if the family unit resists extending its boundaries to include paid carers. We discuss the distinct challenges that families are faced with at different stages of disease progression (emerging, diagnostic, longterm adaptation, crisis, chronic, and terminal) for one particular condition (multiple sclerosis or MS). A number of recommendations are made for supporting family members in the form of a ‘family care pathway’ for neurology and neurodisability.