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Log Roll Test

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101. Direct payments in residential care: ideas for implementation and some concerns about their value

since the financial crash of 2008, at a time of increasing demand (Lewis and West, 2014). Back in 2012, the Government initiated a pilot programme to test direct payments in residential care and participating local councils were ‘pilot sites’. When the Government extended its commitment in 2016, to introduce direct payments in residential care across England, the pilot sites became ‘trailblazers’, although national implementation has since been postponed. Methods The paper by Ettelt and colleagues (...) workers and care home residents, which as Lewis and West (2014) argue is critical to improving the quality of residential care. The barriers to implementing direct payments in residential care make it difficult to envisage how the scheme can be rolled by the new target date of 2020. Strengths and limitations The research had a clear aim – exploring barriers to implementing direct payments in residential care. A qualitative approach was appropriate because the aim was to understand and explore barriers

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2018 The Social Care Elf

102. Why You Should Ignore “The Plant Paradox” by Steven Gundry

information under the assumption that it is good science. Is it possible that Dr. Gundry is just out to make a quick buck? He admits that his patients give up to a dozen vials of blood for testing every couple of months at his clinic. Overtesting is common practice in supplement-driven clinics. This extensive testing, (which are another topic), is almost always used to demonstrate some type of nutritional pathology, which of course can only be corrected by taking the suggested supplements. And of course (...) sense not to try it wirh his patients. I even bet his customers sat at home eatting popcorn and drinking gin and call one another after every show and roll with laughter at how gullible the people are that attend the show. Personally, I feel sorry for them! Dr. Oz should be have feathers glued on his bottom and made to do the rooster dance and sing cockledoodleado until his sense of decency and compassion for other human beings returns. says: i totally agree with you: they “should be have feathers

2018 The Skeptical Cardiologist

103. Quantitative Approach Based on Wearable Inertial Sensors to Assess and Identify Motion and Errors in Techniques Used during Training of Transfers of Simulated c-Spine-Injured Patients (PubMed)

is subjective. This paper proposes a quantitative approach to measure the efficacy of the c-spine stabilization and provide objective feedback during training. Methods. 3D wearable motion sensors are positioned on a simulated patient to capture the motion of the head and trunk during a training scenario. Spatial and temporal indicators associated with the motion can then be derived from the signals. The approach was developed and tested on data obtained from 21 paramedics performing the log-roll, a transfer (...) technique commonly performed during prehospital and hospital care. Results. In this scenario, 55% of the c-spine motion could be explained by the difficulty of rescuers to maintain head and trunk alignment during the rotation part of the log-roll and their difficulty to initiate specific phases of the motion synchronously. Conclusion. The proposed quantitative approach has the potential to be used for personalized feedback during training sessions and could even be embedded into simulation mannequins

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2018 Journal of healthcare engineering

104. The Big R’s… Reform or Revolution?

Jack Chew and Connect Health took action, got the ball rolling, and are facilitating this initiative doesn’t mean they are leaders of the revolution. Also just because The Big Rs is mostly a social media initiative this doesn’t mean its only for physios who use social media. The Big Rs is for anyone who is interested in progressing and improving MSK physio in the UK. It just happens that most physios who are interested in staying up to date and in touch with progress and advances (...) . I know this first hand working as an Extended Scope Practitioner myself 2 days a week. I have been trained and given responsibility to order and review scans, blood tests, to do injections and scans myself and even consent and list patients for surgery, but technically as an ‘extended scope physio’ I am not allowed or supposed to give patients any rehab or exercise advise when I see them. This is just nuts and it is harming the physio profession and decimating physio departments across

2018 The Sports Physio blog

105. Patient Dignity (Formerly: Patient Modesty): Volume 92

women are concerned. Today, when a man with modesty concerns goes for a male specific intimate exam, test, or procedure, he is faced with the real possibility of being intimately exposed and handled by a gauntlet of women he neither knows, nor wants to be exposed in front of. To a modest man, this kind of exposure being forced upon him can have devastating results. Effects that some gentlemen never recover from. Men don't go around making fun of women for wanting a female nurse or aid

2018 Bioethics Discussion Blog

106. Isolation of the Operative Field Influences the Survival Rate of Composite Restorations

-effectiveness of the restorations and the discomfort reported by the patient (measured using the Wong-Baker scale). The Kaplan-Meier survival analysis and log-rank test will be applied to the survival of the restoration. All variables will be modeled and compared with a Cox regression model of shared fragility. The discomfort reported by the patient will be analyzed by Ordinal Logistic Regression (α = 5%). Condition or disease Intervention/treatment Phase Dental Caries in Children Procedure: Rubber dam (...) (in Brazilian reais), as well as the cost-effectiveness of the restorations and the discomfort reported by the patient (measured using the Wong-Baker scale). The Kaplan-Meier survival analysis and log-rank test will be applied to the survival of the restoration. All variables will be modeled and compared with a Cox regression model of shared fragility. The discomfort reported by the patient will be analyzed by Ordinal Logistic Regression (α = 5%). Study Design Go to Layout table for study information Study

2018 Clinical Trials

107. Psychological, social and biological determinants of ill health (pSoBid)

and to the participants themselves. This study was funded by the Glasgow Centre for Population Health which is a partnership between NHS Greater Glasgow and Clyde, Glasgow City Council and the University of Glasgow, supported by the Scottish Government. Jennifer McLean July 2013 3Abbreviations and glossary AVLT Auditory Verbal Learning Test: assesses short-term auditory-verbal memory BMI Body mass index BP Blood pressure CHD Coronary heart disease cIMT Carotid intima-media thickness: a surrogate marker (...) from the most and least deprived communities of Glasgow. This study also illustrates the willingness of subjects to volunteer for a variety of investigations involving psychological, behavioural, sociological and medical questions and tests. The depth and range of the data collected and the analyses undertaken in this study yield important information concerning the relationships between health and socioeconomic status, inflammation, atherosclerosis, mental outlook, cognitive performance

2013 Glasgow Centre for Population Health

108. The outcomes of a school-based intervention for depressive symptoms in adolescents do not echo the promising findings of earlier studies

, please see our . Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here The outcomes of a school-based intervention for depressive symptoms in adolescents do not echo the promising findings (...) setting, using a model of delivery that could be scaled up for national dissemination. Care was taken to address some of the weaknesses of previous studies with rigorous trial design conducted in a real-world setting, testing a model that could be implemented in practice and, most particularly, the use of an attention control group. Disappointingly, the positive results from the earlier trials , were not replicated. Few previous studies used an attention control group and many preventive interventions

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2014 Evidence-Based Mental Health

109. Do we need a Truth and Reconciliation process in psychiatry?

comes in the wake of austerity politics, a recovery agenda that now individualises and makes patients reponsible for their own mental health care, and the promotion of a rolling back of State and communal responsibility for those of us who experience mental distress (Harper and Speed, 2015). The article considers T and R processes in the context of increasing interest in (TIAs), which Sarah explored in a previous blog summarising emerging evidence that many people who access mental health services (...) to inform a healing process in the wake of institutional abuse and neglect in psychiatric services in the UK. They also acknowledge the ideas and work of the service user and survivor movement, most notably that of pioneering UK survivor activist Jan Wallcraft (2010). In order to test their position, they respond to four objections to T and R in mental health systems : What if psychiatry would not accept any wrongdoing and apologise? Surely psychiatric harm is not equivalent to other human rights abuses

2017 The Mental Elf

110. A crisis map: charting the topography of home treatment

A crisis map: charting the topography of home treatment A crisis map: charting the topography of home treatment - National Elf Service Search National Elf Service Search National Elf Service » » » » A crisis map: charting the topography of home treatment Feb 16 2017 Posted by >, The NHS Plan of 2000 (Dept of Health, 2000) mandated the national roll-out of Crisis Resolution Teams (CRTs) , with guidance on their design and implementation. The major principles were to help avoid hospital admission (...) to standards , and CRTs are providing a less comprehensive service than was initially envisioned, with no clear pattern of change since a smaller survey that was reported in 2008. The authors argue that resources need to be developed and tested to support CRTs in their care interventions, not least in determining what might be the optimal model of a CRT. The US Evidence Based Practice Programme (Mueser et al, 2003) is put forth as a template for the evaluation of complex mental health service models

2017 The Mental Elf

111. Self-guided iCBT for depression: effective but still not sticky enough

) and treatment response (β = 0.53; odds ratio, 1.95; 95% CI, 1.52 to 2.50; number needed to treat, 8 ). The authors indicate that heterogeneity across studies was moderate to high , and significant. A secondary result is that treatment response was not moderated by a broad range of socio-demographic or clinical characteristics tracked by the researchers across their chosen studies. All statistical tests use p=0.001 as a significant level. The authors did identify adherence to treatment as a moderating factor (...) . Implications for practice Health professionals who introduce their clients to iCBT, or who are interested in developing an iCBT service, might consider how best to help their clients sustain their engagement with any technology that they offer. Making self-guided online interventions more sticky is essential before they can be rolled out to routine care. Conflicts of interest Stefan Rennick-Egglestone has previously engaged in funded research work with members of the SilverCloud design team. Links Primary

2017 The Mental Elf

112. In search of the sweet spot: the links between dysglycaemia and first episode psychosis

. Except this idea is but a small, solid sugar cube. For many years, this lonely cube sits patiently at the top of the great hill, the world turning around it, waiting for just the right propelling gust of wind. Eventually, that long-awaited gust of wind arrives, tipping the cube from its resting point at the top, and into motion. Our cube begins to roll, at first haphazardly, down the powdery white hill. As it whirls, the sweet sticky powder sticks to the cube, growing not just in size but also (...) birthweight, preterm birth, gestational diabetes and maternal malnutrition (Onwuameze, O. et al, 2016). The research in this area has been expanding much like our sugary snowball rolling down the hill, culminating in two recent meta-analyses. The first was published in The Lancet Psychiatry in November 2016 and of which I am an author (Perry, B. et al, 2016) and the second, the subject of this blog, published in JAMA in January 2017 (Pillinger, T. et al, 2017). The prevalence of type 2 diabetes

2017 The Mental Elf

113. Street triage: all it’s cooked up to be?

background rate of 136 use. Statistical hypothesis testing suggested large differences in 136 rate in the before versus the after period. Given that 136 did not fall in areas where street triage was not happening, an effect of street triage on 136 seems plausible, under the assumption that nothing else important changed in those particular areas over the study period, that might have affected the occurrence of 136 detentions. However, this assumption doesn’t seem to be covered in much detail in the paper (...) and the experiences of patients . This must take the form of better descriptions of who is detained using this Section and for what reasons, in order to identify what reasonable clinical outcomes we should be measuring. In clinical practice, we see many patients who, without the use of 136 powers, would not have seen a clinician until much further into an episode of illness. In a resource-poor NHS, how realistic it is to comprehensively roll out mental health staff to accompany police officers remains to be seen

2017 The Mental Elf

114. Feeling the burn: do interventions to prevent burnout in doctors work?

Feeling the burn: do interventions to prevent burnout in doctors work? Feeling the burn: do interventions to prevent burnout in doctors work? Search National Elf Service Search National Elf Service » » » » Feeling the burn: do interventions to prevent burnout in doctors work? Jan 4 2017 Posted by As the festive season rolls around we think of time with family and friends, holidays and giving. But for anyone working in health care we also think of the increased burden of care the winter brings (...) as an In-patient General Adult Psychiatrist at the Susan Carnegie Centre in Angus, Scotland for NHS Tayside. His interests include medical education, history and philosophy of psychiatry and the future of medicine, particularly the increasing use of internet technology to improve medical practice Follow me here – Logging In... Profile or Comment Name Email Not published Website Last reply was January 5, 2017 Vijayk View Hi Thanks for the summary. I’d read this article when it came out in the journal, and so I

2017 The Mental Elf

115. A crisis map: charting the topography of home treatment

A crisis map: charting the topography of home treatment A crisis map: charting the topography of home treatment - National Elf Service Search National Elf Service Search National Elf Service » » » » A crisis map: charting the topography of home treatment Feb 16 2017 Posted by >, The NHS Plan of 2000 (Dept of Health, 2000) mandated the national roll-out of Crisis Resolution Teams (CRTs) , with guidance on their design and implementation. The major principles were to help avoid hospital admission (...) to standards , and CRTs are providing a less comprehensive service than was initially envisioned, with no clear pattern of change since a smaller survey that was reported in 2008. The authors argue that resources need to be developed and tested to support CRTs in their care interventions, not least in determining what might be the optimal model of a CRT. The US Evidence Based Practice Programme (Mueser et al, 2003) is put forth as a template for the evaluation of complex mental health service models

2017 The Mental Elf

116. Self-guided iCBT for depression: effective but still not sticky enough

) and treatment response (β = 0.53; odds ratio, 1.95; 95% CI, 1.52 to 2.50; number needed to treat, 8 ). The authors indicate that heterogeneity across studies was moderate to high , and significant. A secondary result is that treatment response was not moderated by a broad range of socio-demographic or clinical characteristics tracked by the researchers across their chosen studies. All statistical tests use p=0.001 as a significant level. The authors did identify adherence to treatment as a moderating factor (...) . Implications for practice Health professionals who introduce their clients to iCBT, or who are interested in developing an iCBT service, might consider how best to help their clients sustain their engagement with any technology that they offer. Making self-guided online interventions more sticky is essential before they can be rolled out to routine care. Conflicts of interest Stefan Rennick-Egglestone has previously engaged in funded research work with members of the SilverCloud design team. Links Primary

2017 The Mental Elf

117. Preventive Human Papilomavirus (HPV) Vaccine Trial in Kidney Transplant Recipients

] Will provide an estimate of the rate and two approximate and one exact 95% confidence intervals (CIs). For approximate CI will use a) approximate normality of p-hat, and b) approximate normality of log(p-hat); and for exact CI will use the Clopper-Pearson exact confidence interval. Secondary Outcome Measures : HPV vaccine-type-specific seroconversion rates [ Time Frame: 12 months post-transplant ] Will provide descriptive statistics such as means, rates, and exact or approximate 95% CI. Will compare (...) stratified rates to each other, using an exact test for number doses. Will provide mean, median, and range for time elapsed for time elapsed between last vaccine dose and transplant procedure. Lists of dosing types by medication variety will be provided and summaries applied when possible and appropriate for variations in dosing and types of post-transplant immunosuppressant medications. Descriptive statistics and graphics will be used for visual comparison and assessment for differences in human

2017 Clinical Trials

118. The 3-Shot Hepatitis B Vaccine – Do I Need to Restart the Series if I Am Off the Recommended Schedule?

with the first shot of the 3 shot series. I’m HbsAg positive (Reading says >250 IU/ml). And my HBV-DNA test says 91 IU/ml (1.96 Log value). My wife is HbsAg Negative and she got 2 out 3 HepB vaccine(Engerix) shots (0, 1 month). 1. How safe is to have sex(Unprotected) after 2 doses? If it is not safe now, when exactly she would be completely protected? 2. What treatment is recommended (Oral Medicine or Interferon)? We consulted couple of doctors and we got different opinions. 3. Any other precautions I/my (...) + miu, could i possibly aquire hepa b? Hello: Your hepatitis B surface antibody level is above 10 mIU/mL, so you should be protected against infection. For more information, please read: Good luck. hello im positive for hepa b, can i get vaccine for hepa b? Hello: If you are already infected with hepatitis B and test positive for the hepatitis B surface antigen (HBsAg), then the vaccine will not help you. The vaccine contains only HBsAg, which is the viral protein that covers the surface

2017 hepbblog

119. Six-monthly appointment spacing for clinical visits as a model for retention in HIV Care in Conakry-Guinea: a cohort study. (PubMed)

in circumstances where access to healthcare is restricted.A retrospective cohort study in 2014 of the outcome of a group of stable patients (viral load ≤1000 copies/μl) enrolled voluntarily in R6M compared with a group of stable patients continuing standard one to three monthly visits in Conakry. Log-rank test and Cox proportional hazards model were used to compare rates of attrition (deaths and defaulters) from care between the two groups. A linear regression analysis was used to describe the trend or pattern (...) system in Guinea. R6M could be rolled out as the model of care for stable patients where and when feasible as a strategy likely to improve retention in HIV care.

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2017 BMC Infectious Diseases

120. Patient Modesty: Volume 81

and so what got said is limited but hopefully the message can be reinforced with some comments. You have to be logged in to comment, and as yet I have not found where I can register so as to comment. If someone figures that out, I'd appreciate hearing it. I would add that the search feature they have does not seem very robust either. Even if articles can't say everything that you would like to say or can't say it forcefully enough, the more articles that get out there the more awareness (...) is enough give us a choice. They’ve been brow beaten for so long by the system, they’re brainwashed on the idea they will be completely exposed and humiliated and that’s the way it is. The other group of guys are the ones that haven’t had to use the system yet. They naively believe the healthcare system is going to protect their privacy and respect their dignity. Then they go in for an exam or test & come out of the encounter shell shocked when they see what we were saying is how it is. The other road

2017 Bioethics Discussion Blog

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