Participation of inpatients in multidisciplinary team meetings : an explorative study of mental healthcare workers' perception

Aim To explore the perception of mental healthcare workers about participation of inpatients during multidisciplinary team meetings (MTMs) and to determine which demographic and contextual factors are associated with this perception. Methods A cross-sectional multicentre study in 17 psychiatric hospitals with 701 mental healthcare workers was performed between 29 April and 19 May 2019. For measuring the perception of the mental healthcare workers, the Patient Participation during Multidisciplinary Team meetings Questionnaire was used. Results 93 % of the mental healthcare workers indicate that they are willing to allow patients to participate in a MTM. Most mental healthcare workers prefer an active role for the patient when participating in a MTM (93 %) and a collaborative role for the patient when making decisions in a MTM (75 %). Level of education, discipline, experience with patient participation in MTMs, working in a team where patient participation is applied, and recent training on patient participation, are associated with the mental healthcare worker's perception on patient participation in MTMs. Conclusion Mental healthcare workers report a great willingness to involve inpatients in MTMs. However, social workers, nurses, and pedagogues feel less competent and are less positive about the effects of patient participation in MTMs. Mental healthcare workers with recent training in patient participation and experience in patient participation in MTMs feel more competent and believe more often that the patient should fulfil a more autonomous role when participating in a MTM. These results can be used to understand and improve patient participation in MTMs in mental healthcare

Age-Related Changes in Listening Effort for Children and Teenagers With Normal Hearing and Cochlear Implants.

OBJECTIVES: A clinically viable measure of listening effort is crucial in safeguarding the educational success of hard-of-hearing students enrolled in mainstream schools. To this end, a novel behavioral paradigm of listening effort targeting school-age children has been designed and reported in Hsu et al. (2017). The current article consists of two follow-up experiments investigating the effects of noise, processing depth, and age in a similar paradigm, first in a group of participants with normal hearing (NH) followed by a sample of school-age cochlear implant (CI) users. Research objectives include the construction of normative values of listening effort and comparing outcomes between age-matched NH and CI participants. DESIGN: In Experiment 1, the listening effort dual-task paradigm was evaluated in a group of 90 NH participants with roughly even age distribution between 6 and 26 years. The primary task asked a participant to verbally repeat each of the target words presented in either quiet or noise, while the secondary task consisted of categorization true-or-false questions "animal" and "dangerous," representing two levels of semantic processing depth. Two outcome measures were obtained for each condition: a classic word recognition score (WRS) and an average response time (RT) measured during the secondary task. The RT was defined as the main listening effort metric throughout the study. Each NH participant's long-term memory retrieval speed and working memory capacity were also assessed through standardized tests. It was hypothesized that adding noise would negatively affect both WRS and RT, whereas an increase in age would see significant improvement in both measures. A subsequent Experiment 2 administered a shortened version of the paradigm to 14 school-age CI users between 5 and 14 years old at a university clinic. The patterns of results from the CI group were expected to approximate those of the NH group, except with larger between-subject variability. RESULTS: For NH participants, while WRS was significantly affected by age and noise levels, RT was significantly affected by age, noise levels, and depth of processing. RT was significantly correlated with long-term memory retrieval speed but not with working memory capacity. There was also a significant interaction effect between age and noise levels for both WRS and RT. The RT data set from the NH group served as a basis to establish age-dependent 95% prediction intervals for expected future observations. For CI participants, the effect of age on the two outcome measures was more visible when target words were presented in quiet. Depending on the condition, between 35.7% and 72.7% of the children with CI exhibited higher-than-norms listening effort as measured by categorization processing times. CONCLUSION: Listening effort appears to decrease with age from early school-age years to late teenage years. The effects of background noise and processing depth are comparable with those reported in Hsu et al. (2017). Future studies interested in expanding the paradigm's clinical viability should focus on the reduction of testing time while maintaining or increasing the sensitivity and external validity of its outcome measures.status: Published onlin

Analysis of pain management in dogs with cancer in “X“ small animal clinic in United Kingdom

Data for the study was collected in the period of July-October in 2018, in small animal clinic „X“ in United Kingdom. In total 26 dogs were diagnosed with an oncological disease. Materials and methods: 26 dogs were diagnosed with oncological diseases and pain score was assessed during clinical examination. Patients which presented with signs of pain and received a surgical treatment, were evaluated by Glasgow University composite measure pain score – short form before and after treatment. The form evaluates various dog behavioural traits such as: vocalization, attention to wound, movements, response to touch, general condition and pose. Pain management and surgical procedure assessment was also carried out. All statistical analysis of the data was carried out using GraphPad Software Prism 8 by using descriptive statistics methods. Results: 61 patients were suspected with oncological disease, but only 30 of them were approved by other diagnostic procedures. 26 cases were confirmed with actual disease (42 %). It has been determined that 14 dogs (53.8 %) were females (5 of them were neutered) and 12 (46,2 %) dogs were males (4 were neutered). Age median was 7.29 years, for females 7.5 and for males 7 years. Oncological disease can be identified in various dog breeds. Mix breed, Staffordshire bull terrier, retriever and English cocker spaniel were diagnosed more frequently. 23.1% of all diagnosed patients were present with pain symptom (n=6). By using the CMPS-SF scale the highest pain score was for osteosarcoma patient (17 points) and adenocarcinoma (10 points). The median for pain score was 9. Two patients were euthanized due to receiving a bad prognosis. The most frequent drug for analgesia was non-steroid-anti- inflammatory-drug meloxicam

QualiBuddy: an online tool to improve research skills in qualitative data analysis

Purpose: Novice researchers experience difficulties in analysing qualitative data. To develop the skills necessary for qualitative data analysis, theoretical manuals are often insufficient. Supervisors supporting students in analysing qualitative data stress the need for practical guidance, including exercises and feedback. The purpose of this paper is to present and discuss QualiBuddy, an interactive online support tool in answer to this need. Design / methodology / approach: An online support tool was developed in answer to existing problems regarding analysing qualitative data. The tool provides a learning trajectory of eleven stages of analysis, which all contain examples, exercises, feedback, verification questions and questions for reflection. This tool is developed from a multidisciplinary perspective and is constructed around various steps. During the development process, internal feedback from the members of the project team, as well as external feedback from an international steering group with experts in qualitative research were taken into account. Findings: The tool QualiBuddy is based on an empirically and theoretically grounded approach to qualitative data analyses. Pilot tests with experienced qualitative researchers suggest that the tool potentially allows novice researchers from various domains to develop and improve their skills in conceptualising interview data, specifically within a Grounded Theory approach. Originality / value: QualiBuddy is a newly developed interactive online education tool based on and complementary to existing guides for qualitative data analysis.status: publishe

Longitudinal linguistic outcomes of toddlers with congenital single sided deafness – six with and twelve without cochlear implant and nineteen normal hearing peers

This longitudinal study is the first to assess linguistic and cognitive outcomes of children with cSSD implanted at a very young age. Despite the young age, these developing skills could be assessed by means of standardized test material and comparison to control groups. The toddlers of the SSD_CI group wear their device and perform largely in line with the NH control group. Linguistic and cognitive results of the SSD_noCI control group appear more diverse. Longitudinal observation is of key importance to draw conclusions regarding CI benefit. This article is protected by copyright. All rights reserved.status: publishe

T Cell and Antibody Response Following Double Dose of BNT162b2 mRNA Vaccine in SARS-CoV-2 Naïve Heart Transplant Recipients

Introduction: Preliminary studies have suggested a low post-vaccination antibody response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in heart transplant(HTx)recipients. Although many studies have focused on the role of antibodies in vaccine-induced protection against SARS-CoV-2, the role of T cell immunity is less well characterized. To date, data regarding seroconversion and T cell response after mRNA SARS-CoV-2 vaccination in patients undergoing HTx are scarce. Therefore, the present study aimed to assess the specific memory humoral and cellular responses after two doses of the BNT162b2 vaccine in HTx recipients. Methods: Blood was drawn from heart transplant (HTx) recipients at two pre-specified time points after the first and second vaccine doses to measure both the anti-SARS-CoV-2 antibody response against the spike protein and the SARS-CoV-2-reactive T cell response. Results: Our study included 34 SARS-CoV-2 naïve HTx recipients (mean age, 61 ± 11 years). The mean time from transplantation to the first vaccine dose is 10 ± 10 years. Subgroup analysis (n = 21) demonstrated that after the first vaccine dose, only 14% had antibodies and 19% had a SARS-CoV-2-reactive T-cell response, which increased to 41% and 53%, respectively, after the second dose. Interestingly, 20% of patients with no antibodies after the second dose still had a positive SARS-CoV-2-reactive T cell response. The percentage of patients with positive S-IgG antibody titers was significantly higher 5 years after transplantation (18% 0–5 years post-TX vs. 65% 5 years post-TX, p = 0.013). Similarly, 5 years after heart transplantation, the percentage of patients with a T cell response was significantly higher (35% 0–5 years post-TX vs. 71% 5 years post-TX, p = 0.030). Conclusions: In SARS-CoV-2 naïve HTx recipients, post-vaccination antibody titers but also SARS-CoV-2 specific T cell response are low. Therefore, the protection from SARS-CoV-2 that is generally attributed to vaccination should be regarded with caution in HTx recipients