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Ongoing Assessment (ongoing + assessment)
Selected AbstractsQuality of life, sexual function and decisional regret at 1 year after surgical treatment for localized prostate cancerBJU INTERNATIONAL, Issue 4 2007B. Joyce Davison OBJECTIVE To examine the effect of changes in quality of life (QoL) and levels of sexual function on decisional regret after surgical treatment of localized prostate cancer. PATIENTS AND METHODS Patients who decided to have a radical prostatectomy (RP) were assessed for health-related QoL using the general European Organization for Research and Treatment of Cancer C30 instrument and disease-specific prostate cancer module, and sexual function using the abbreviated International Index of Erectile Function-5 before and 1 year after RP. Decision control was measured before RP, and decisional regret 1 year afterward, using measures mailed to participants 1 year after treatment. RESULTS Of 130 respondents (mean age 62 years), 4% expressed regret over their decision to have surgery. Physical and social functioning, and finances, were compromised, while emotional functioning and treatment-related symptoms improved by 1 year. Higher levels of decisional regret were correlated with decreases in role and social functioning, increased pain and financial difficulty (all P < 0.01). Sexual function was decreased (P < 0.001) after treatment. Men reported feeling less masculine, having less sexual enjoyment, difficulty in getting and maintaining an erection, and discomfort when being sexually intimate after surgery. Mean scores of decisional regret were similar among patients who reported assuming either active (84%) or collaborative (11%) roles in treatment decision-making. Men who assumed a passive role reported the most variability and highest scores on decision regret. CONCLUSIONS Few men regretted having RP at 1 year after treatment, even though some QoL functions and domains were significantly affected. Ongoing assessment of the effect of surgical treatment on sexual function, sexuality and masculinity certainly deserves further exploration with this group of cancer survivors. [source] Substance misuse over the first 18 months of specialized intervention for first episode psychosisEARLY INTERVENTION IN PSYCHIATRY, Issue 3 2009Jason A. R. Carr Abstract Aim: Examine substance misuse over the first 18 months of first-episode psychosis treatment. Method: Clinicians rated alcohol and drug (mostly cannabis) misuse for 243 individuals followed prospectively. Assessments were completed at baseline and after 3, 6 and 18 months. Interventions relating to substance misuse included ongoing assessment of use, education and counselling to avoid. Results: Alcohol and drug misuse declined significantly between baseline and 3 months, especially among patients with a substance abuse or dependence diagnosis at baseline. Overall, these reductions were maintained over the 18-month follow-up period. The exception was worsening alcohol misuse over time among patients with alcohol abuse or dependence on entry. Conclusions: With good usual care, education and support, alcohol and drug misuse declined significantly during the first months of psychosis treatment. The improvements in drug misuse were generally maintained over the 18-month follow-up, and worsening alcohol misuse over time may be the greater issue. [source] First-episode psychosis: A literature reviewINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 2 2008Simone I. Reed ABSTRACT:, This paper reports on a literature review of the impacts of first-episode psychosis on both the patient and their family and carers. The discussion focuses on the effects on the patient experiencing psychotic symptoms for the first time, including disruption to their environment, social connectedness, and future plans. Patients experiencing these symptoms can experience fear, distress, and isolation. Many of these patients are also at greater risk to themselves and others. The family and carers witnessing this psychosis may experience fear, guilt, and often carry the emotional and physical burden of care. Early intervention and treatment are crucial to potentially achieving better clinical outcomes, and to alleviating the psychological impact on patients and their families. The nurse's role in the treatment of the patient experiencing first-episode psychosis is to facilitate early intervention through recognition of symptoms and ongoing assessment, work to reduce a patient's risks, manage treatments, and work with the patient to reduce the risk of relapse. [source] Relevance of Cues for Assessing Hallucinated Voice ExperiencesINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 3 2003Margaret England PhD PURPOSE. To assess psychiatric nurses' views of the importance of itemized content represented on an Inventory of Voice Experiences (IVE) for ongoing assessment of atypical auditory sense perception in people who hear voices. METHODS. Over 6 months, 317 experienced psychiatric nurses rated 58 assessment cues for hallucinated voice experiences. Cronbach's alpha, Cohen's kappa, and Bartko's intraclass correlation coefficients were used to measure concordance of the nurses' judgments against two hypothetical standards derived for purposes of the study. FINDINGS. There was moderate support for both the internal consistency of the nurses' judgments concerning the importance of itemized content represented on the WE and overall equivalence of the content. There was modest-to-moderate concordance of the nurses' original and subsequent judgments but a lack of concordance of the nurses' judgments with equally weighted judgments of the principal investigator even though the judgments of the investigator were based on extant literature and published reports of voice hearers. CONCLUSIONS. Results may reflect the effects of repeated testing, but it also is possible that some nurses did not have enough knowledge or professional experience to quantify judgments about the importance of hallucinated voice descriptions tied to the items on the WE. The findings are being used to refine the IVE. PRACTICE IMPLICATIONS. Findings provide nurses with opportunities for discerning specific characteristics, antecedents, and consequences of voice hearing along with their implications for health and well-being. Discernment of this information will facilitate identification of more specific and meaningful options for helping voice hearers manage their voices. Search terms: Auditory hallucinations, schizophrenia [source] The effect of fire season, fire frequency, rainfall and management on fire intensity in savanna vegetation in South AfricaJOURNAL OF APPLIED ECOLOGY, Issue 4 2006NAVASHNI GOVENDER Summary 1Fire is important for the maintenance and conservation of African savanna ecosystems. Despite the importance of fire intensity as a key element of the fire regime, it is seldom measured or included in fire records. 2We estimated fire intensity in the Kruger National Park, South Africa, by documenting fuel loads, fuel moisture contents, rates of fire spread and the heat yields of fuel in 956 experimental plot burns over 21 years. 3Individual fires were conducted in five different months (February, April, August, October and December) and at five different return intervals (1, 2, 3, 4 and 6 years). Estimated fire intensities ranged from 28 to 17 905 kW m,1. Fire season had a significant effect on fire intensity. Mean fire intensities were lowest in summer fires (1225 kW m,1), increased in autumn fires (1724 kW m,1) and highest in winter fires (2314 kW m,1); they were associated with a threefold difference between the mean moisture content of grass fuels in winter (28%) and summer (88%). 4Mean fuel loads increased with post-fire age, from 2964 kg ha,1 on annually burnt plots to 3972 kg ha,1 on biennial, triennial and quadrennial burnt plots (which did not differ significantly), but decreased to 2881 kg ha,1 on sexennial burnt plots. Fuel loads also increased with increasing rainfall over the previous 2 years. 5Mean fire intensities showed no significant differences between annual burns and burns in the biennial, triennial and quadrennial categories, despite lower fuel loads in annual burns, suggesting that seasonal fuel moisture effects overrode those of fuel load. Mean fire intensity in sexennial burns was less than half that of other burns (638 vs. 1969 kW m,1). 6We used relationships between season of fire, fuel loads and fire intensity in conjunction with the park's fire records to reconstruct broad fire intensity regimes. Changes in management from regular prescribed burning to ,natural' fires over the past four decades have resulted in a decrease in moderate-intensity fires and an increase in high-intensity fires. 7The highest fire intensities measured in our study (11 000 , > 17 500 kW m,1) were significantly higher than those previously reported for African savannas, but were similar to those in South American cerrado vegetation. The mean fire intensity for late dry season (winter) fires in our study was less than half that reported for late dry season fires in savannas in northern Australia. 8Synthesis and applications. Fire intensity has important effects on savanna vegetation, especially on the dynamics of the tree layer. Fire intensity varies with season (because of differences in fuel moisture) as well as with fuel load. Managers of African savannas can manipulate fire intensity by choosing the season of fire, and further by burning in years with higher or lower fuel loads. The basic relationships described here can also be used to enhance fire records, with a view to building a long-term data set for the ongoing assessment of the effectiveness of fire management. [source] Parental participation and mismanagement: A qualitative study of child care in IranNURSING & HEALTH SCIENCES, Issue 3 2009Fereshteh Aein mscn, phd(cand) Abstract The purpose of this study was to explore parents' and nurses' experiences of parental participation in child care in hospitals in Iran. Using thematic analysis, the data were collected through interviewing 14 parents and 11 nurses from two pediatric hospitals. The results showed that four major themes emerged, including the necessity of a parent's presence, the unplanned and informal delegation of care to the parents (which itself had five subthemes: the parents as nurses, the delegation of care without sufficient and planned parental training, informal parent-to-parent support, the continuum of parents' willingness to participate, and the neglect of parents' needs), the inconsistency of care, and the parents as informal evaluators of care. Based on the study's findings, effective communication by nurses with parents is required. Nurses need to make an ongoing assessment of parents' wishes for involvement and negotiate care accordingly, with enough support and supervision to warrant quality of care. [source] Suicide risk during anticonvulsant treatment,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 5 2010Maurizio Pompili MD Abstract Recent research findings suggest possible increases in risk of suicidal behaviors among patients treated with anticonvulsants. The available evidence appears to support such a risk more clearly for patients diagnosed with epilepsy rather than with primary psychiatric disorders. However, the studies involved are limited by providing associational findings that may be confounded by several uncontrolled variables. Such limitations should be considered in future research on adverse effects of anticonvulsants and other centrally acting drugs. For now, however, clinical prudence calls for routine, ongoing assessment of mood and suicidal thoughts among neurological or psychiatric patients, whether or not treated with particular drugs. Copyright © 2010 John Wiley & Sons, Ltd. [source] Practitioner Review: Beyond shaken baby syndrome: what influences the outcomes for infants following traumatic brain injury?THE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 9 2010Rebecca Ashton Background:, Traumatic brain injury (TBI) in infancy is relatively common, and is likely to lead to poorer outcomes than injuries sustained later in childhood. While the headlines have been grabbed by infant TBI caused by abuse, often known as shaken baby syndrome, the evidence base for how to support children following TBI in infancy is thin. These children are likely to benefit from ongoing assessment and intervention, because brain injuries sustained in the first year of life can influence development in different ways over many years. Methods:, A literature search was conducted and drawn together into a review aimed at informing practitioners working with children who had a brain injury in infancy. As there are so few evidence-based studies specifically looking at children who have sustained a TBI in infancy, ideas are drawn from a range of studies, including different age ranges and difficulties other than traumatic brain injury. Results:, This paper outlines the issues around measuring outcomes for children following TBI in the first year of life. An explanation of outcomes which are more likely for children following TBI in infancy is provided, in the areas of mortality; convulsions; endocrine problems; sensory and motor skills; cognitive processing; language; academic attainments; executive functions; and psychosocial difficulties. The key factors influencing these outcomes are then set out, including severity of injury; pre-morbid situation; genetics; family factors and interventions. Conclusions:, Practitioners need to take a long-term, developmental view when assessing, understanding and supporting children who have sustained a TBI in their first year of life. The literature suggests some interventions which may be useful in prevention, acute care and longer-term rehabilitation, and further research is needed to assess their effectiveness. [source] Rational Analyses of Information Foraging on the WebCOGNITIVE SCIENCE - A MULTIDISCIPLINARY JOURNAL, Issue 3 2005Peter Pirolli Abstract This article describes rational analyses and cognitive models of Web users developed within information foraging theory. This is done by following the rational analysis methodology of (a) characterizing the problems posed by the environment, (b) developing rational analyses of behavioral solutions to those problems, and (c) developing cognitive models that approach the realization of those solutions. Navigation choice is modeled as a random utility model that uses spreading activation mechanisms that link proximal cues (information scent) that occur in Web browsers to internal user goals. Web-site leaving is modeled as an ongoing assessment by the Web user of the expected benefits of continuing at a Web site as opposed to going elsewhere. These cost,benefit assessments are also based on spreading activation models of information scent. Evaluations include a computational model of Web user behavior called Scent-Based Navigation and Information Foraging in the ACT Architecture, and the Law of Surfing, which characterizes the empirical distribution of the length of paths of visitors at a Web site. [source] | |||||||||||||