ABSTRACT
Aim
To evaluate the incidence, severity and characteristics of aggressive behaviour in patients hospitalized in acute psychiatric wards, as well as the association between patient ...characteristics and the incidence of recurrent aggressive behaviour.
Methods
A multicentre prospective study included all twelve acute wards in Slovenian psychiatric hospitals with a total capacity of 232 beds. Over five consecutive months, data on the number of treatment episodes involving aggressive behaviour and the number of aggressive incidents, their severity and characteristics were obtained using the Staff Observation Aggression Scale-Revised (SOAS-R). Patient- and event-based incident rates of verbal and physical aggression were calculated. The association between patient characteristics and recurrent aggressive behaviour was analysed. Patient characteristics data were extracted from hospital databases.
Results
3,190 treatment episodes were included during a 5-month period. Aggressive behaviour was observed in 13.4% of treatment episodes, and 922 aggressive incidents were recorded, which resulted in 3.98 incidents per 100 occupied bed days and 9.48 incidents per bed per year. 74.1% of incidents were severe, and more than half of incidents included physical aggression. 75.5% of incidents were directed against medical staff. 5.9% of treatment episodes were involved in multiple aggressive incidents. Compared to patients with single incidents, patients with recurrent aggression had a less frequent main diagnosis of substance use disorders and a longer duration of hospitalization.
Conclusion
Monitoring the frequency and characteristics of aggressive behaviour allows comparisons with other studies and, more importantly, it is necessary for planning and assessing the effectiveness of preventative aggression management strategies.
When we talk about personality disorders, people usually have a very emotional reaction, with pain and unpleasant emotions being the most common. Those who have a relationship with a person who has a ...personality disorder, usually do not know what they are facing, but they do experience feelings of unease, despair, sadness, anger and depression, while doubting their own experience and perception of the world. Family and friends often feel like they are “caught in a relationship web”, which keeps getting more and more tangled, instead of untangling. Personality disorders cause everyone a lot of suffering, anger and disappointment, manifesting in every dimension of the human experience, but the behavior of a person with a personality disorder and the responses from the environment are actually a lot more predictable than you might imagine. In order to present this demanding and little-known topic to the widest range of readers, the handbook uses stories of everyday people to illustrate how their experiences of personality disorders intertwine with stress, mood disorders and problems with addiction. It also presents the process of identifying individual personality disorders and various options of self-help and recovery. The handbook is intended for anyone who is interested in the field of personality disorders, is personally facing mental health problems, or has a relative who is dealing with these issues.
Dementias present a global health challenge and give rise to significant economic costs. This study aims to evaluate the economic impact of one-year outpatient healthcare, nursing home, and formal ...and informal home help costs for all patients referred to the Centre for Cognitive Impairments at the Department of Neurology, Ljubljana University Medical Centre, Slovenia.
Data was acquired retrospectively from physicians' records and the costs for 2015 were calculated. Total costs were estimated by means of a bottom-up calculation of outpatient visits, diagnostic examinations and anti-dementia medication. In a subgroup of 120 patients with dementia, the Resource Utilization in Dementia questionnaire was used to estimate formal and informal care costs.
A total of 720 patients visited the memory clinic in 2015. Diagnosis at first visit was subjective cognitive or mild cognitive impairment (SCI/ MCI) for 322 patients, dementia for 258 patients, and psychiatric or other disorders for 140 patients. The average annual cost per patient was EUR 578. It was highest for patients with dementia (EUR 751), EUR 550 for patients with SCI/MCI, and lowest for patients with psychiatric and other disorders (EUR 324). Monthly informal and social care costs were between EUR 1,037 and EUR 3,369, depending on the methodology used.
The cost of diagnosing a cognitive disorder depends on how extensive the diagnosis is. With an estimated prevalence of 34,137 persons with dementia in Slovenia, basic diagnostic investigations incur costs of approximately EUR 7 million. Direct medical costs represent a smaller portion of total dementia costs; this is because annual costs for formal and informal home help are estimated at EUR 265 million and nursing home placements at EUR 105 million.
The purpose was to determine the incidence of voice disorders in a group of professional actors and singers, to compare the two groups, and to investigate the potential causes of their voice ...problems.
65 actors and 63 singers from professional theatres and choirs were included. The data concerning voice problems, their possible causes, and factors adversely affecting voice quality were obtained through a questionnaire. The results were compared between the groups of professional singers and actors, and between the subgroups of singers and actors both with and without frequent voice problems.
The incidence of frequent voice problems over the entire career in singers and actors was lower than reported in the literature. Professional actors displayed more inappropriate life and vocal habits than the singers. Significant risk factors for voice disorders in singers turned out to be loud speech (p=0.029) and the presence of allergies or asthma (p=0.048). No such significant risk factors were found in actors.
The study confirmed the importance of preventive examination of the vocal tract function before enrolling in studies for an elite voice user. Professional singers and especially actors demonstrated insufficient knowledge of proper voice care. The results suggest that elite voice users require additional information on voice hygiene and occasional professional help from college to the end of career. Speech and language therapists can play a crucial role in such voice care in order to effectively prevent voice problems in elite voice users.
Abstract Introduction Among physiotherapists, work-related musculoskeletal disorders (WMSDs) are the most common health problem. This study aimed to provide evidence for planning evidence-based ...health promotion programmes for ensuring and maintaining adequate physical fitness (PF) to decrease WMSDs among physiotherapists which would have started already during the study. Methods A cross-sectional study involved the participation of a total of 100 physiotherapy students and 62 physiotherapists. Observed variables were prevalence of WMSDs in the last 12 months, lasting >3 days during physiotherapeutic activities and five PF components: body composition, cardiorespiratory and muscle endurance, muscle strength, and flexibility. A chi-square test and binary logistic regression were used as the main analytical methods. Results Prevalence of WMSDs in physiotherapists was 63.9% (the most common locations: lower back, shoulders, neck), while in physiotherapy students it was 46.5% (the most common locations: lower back, neck, upper back) (p=0.031). Among the PF components, the results showed statistically significantly worse flexibility among students compared to physiotherapists (about two thirds of students had poor or very poor results of flexibility testing) (p=0.002) in comparison to physiotherapists. A statistically significant positive association between WMSDs and PF was observed only between knee pain and poor cardiorespiratory endurance (OR=4.03 with 95% CI 1.12-14.58; p=0.033). Conclusion The study showed poor flexibility among students indicating that it is necessary to direct them to perform activities that will increase the extensibility of muscles. The awareness of this problem should be increased. A specific role should be played by staff involved in clinical practice.
Heart rhythm disorders (HRD) are often present in patients visiting their family physician (FP). Dealing with their problems is not always simple, efficient and cost effective. The aim of this paper ...is to review the existing literature about the use and experience of telecardiology in patients experiencing HRD.
We conducted a review of literature in PubMed biographical databases (MeSH thesaurus), Web of Science and Cochrane, between 1995 and 2019. We included original articles in English that describe the use of telecardiology at primary and secondary healthcare levels. Exclusion criteria are those publications that discuss heart failure or observation of the activity of pacemakers or defibrillators and the age of patients under 18 years. A total of 19 papers met the inclusion criteria, thirteen of them were original scientific articles and we included them in the analysis.
Use of telemedicine can shorten the time from diagnosis to the necessary treatment (2/13), telemedicine can reduce mortality in patients with acute myocardial infarction (4/13), it can shorten the time to diagnose atrial fibrillations (4/13), it can help determine the diagnosis for patients complaining about heart rhythm disorders which were not detected on the standard ECG recording (2/13) and can also help identify cardiac causes for syncope or collapse (2/13). All studies have confirmed that the use of telecardiology significantly reduces the number of unnecessary referrals to a cardiologist or hospitalization, and shortens the time needed to treat patients with life-threatening conditions.
The use of telecardiological techniques increases the quality and safety of work in managing patients with cardiovascular disease in FP practice. Usage of telecardiologic devices can also save money and bridge the gap between the primary and secondary healthcare levels.
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