Changes in trauma service workload since the introduction of the penalty points system

With the introduction of the penalty points system (PPS) has come many media reports indicating a reduction in road traffic accident (RTA) rates. We hypothesised that reduced RTAs would result in a reduction in hospital trauma workloads. To study this we examined the numbers of RTA related femoral shaft fracture presentations to the six Dublin teaching hospitals and Waterford regional hospital within the six months since the introduction of the PPS and the two previous corresponding six month periods. We also analysed all RTA related discharges from Beaumont hospital during these three time periods. Whilst a slight reduction in RTA related femoral shaft fracture numbers was observed a dramatic reduction in total RTA related discharges from Beaumont hospital was identified with 70 patients discharged in the first six months since the introduction of the PPS compared to 124 and 125 discharges in the same two preceding six month periods. This reduction was greatest for head and thoracic injuries which were halved, while total numbers of limb injuries were maintained, resulting in no reduction in orthopaedic RTA related discharges or workload.     

Changes in plasma lipids and dietary intake accompanying shifts in perceived workload and stress

Plasma lipids, dietary intake, and self-reported stress and workload were assessed in 14 employees twice before major work deadlines (high workload), and once during a comparatively quiescent period of work (low workload). Increases in self-reported stress and workload between the high and low workload periods were significantly positively associated with increases in plasma total cholesterol, although lipid levels were not increased in the group as a whole during the high workload periods. Dietary intake of calories, total fat, and percentage of calories from fat were significantly higher during high workload during a period of high workload is associated with elevated total cholesterol and that dietary intake of foods which raise cholesterol levels is also increased. Further studies of larger groups of subjects may be required to show a frank increase in cholesterol with increased workload.     

Changes in laboratory and clinical workload for Clostridium difficile infection from 2003 to 2007 in hospitals in Edinburgh

Clostridium difficile infection (CDI) is a growing concern with regard to increases in incidence and its associated financial burden. A retrospective analysis of patients admitted to Hospitals in Edinburgh from 2003 to 2007 and tested for C. difficile toxins was performed. A total of 45 412 faecal samples were tested and 6286 (13.8%) were positive. Overall CDI was identified in 1.7 cases/1000 in-patient occupied bed days (OBD). The incidence of CDI fell from 1.98 cases/1000 OBD in 2006 to 1.48 cases/1000 OBD in 2007. Renal Medicine, including Transplant Surgery, and Intensive Care had the highest incidence, with >6.2 cases/1000 OBD each, followed by Infectious Diseases and Gastrointestinal Medicine, with rates of 5.5 and 4.42 cases/1000 OBD, respectively. Medicine of the Elderly had an incidence of 1.69 cases/1000 OBD. Incidence increased with age, from 0.45 cases/1000 OBD in the 0–20-year-old age group to 2.02 cases/1000 OBD in the 61–80-year-old age group. Twelve percent of all toxin-positive patients were transferred through a minimum of two specialties when they remained positive for C. difficile toxins. Estimated costs over the study period for toxin testing were approximately £126 500 and the minimal potential hospitalization costs for patients with CDI was £20 000 000. The overall incidence of patients identified with CDI fell in 2007 compared to 2006. The incidence has increased with age; however, patients in Medicine of the Elderly had a much lower incidence than in several other specialties and therefore risk assessment of CDI should also be targeted within other specialties. Judicious application of infection control measures remains important for preventing CDI.     

Changes in the patient's perception of his therapist in the process of group and individual psychotherapy

The patient's perception of his therapist seems to be one of the major components of the therapeutic relationship. The different psychotherapeutic setting seem to influence the dynamics of the therapeutic relationship along with some other therapist and patient variables. Two groups of patients treated in the Department of Neurotic Disorders of the Institute of Psychiatry and Neurology (Warsaw) were investigated 2 times during their course of psychotherapies (individual, group). The perception of the therapist was measured by the Adjective Raging Scales constructed for the purpose of this research. These data were correlated with the results of the ACL (Gough) as a measure of personality traits and with the intensity of the clinical symptoms.     

Changes in perception of active but not passive turning following stepping on the rotating treadmill

The purpose of this work was to determine whether walking on a rotating disc would cause changes in perception of active and passive turning. Ten healthy control subjects wore a blindfold and earplugs while completing trials of active and passive turning. For active conditions, subjects were told the direction and amplitude of the desired turn and then attempted to turn in place the specified amount via actively stepping. For passive conditions, subjects were told that the disc they stood on would turn and they were to press a button when they had traveled the specified amplitude. Subjects completed active and passive trials to the left and right with amplitudes of 90, 180, 270, and 360°. Subjects then stepped in place for 15 min on a disc rotating clockwise at 90°/s, after which they repeated the trials of active and passive turning. Following rotating treadmill stimulation, subjects asked to turn in the direction opposite disc rotation (i.e., to the left) consistently and significantly overshot their targets in active trials. There were no changes in accuracy of active turning to the right or passive turning in either direction. This indicates that adaptation to the rotating treadmill is expressed even when subjects have a conscious intent to turn. The positive after-effects of the rotating treadmill add to the intended active turning in the direction of the after-effect but there is no decrement in active turning in the direction opposite the after-effect.     

Changes in sensory perception of sports drinks when consumed pre, during and post exercise

The aim of this study was to examine sensory perceptions towards different formulations of sports drinks when consumed before, at various points during, and following exercise. Following familiarisation 14 recreational runners underwent four trials in a single blind counterbalanced design. Each trial utilised one of four different solutions: 7.5% carbohydrate, 421 mg L^− 1 electrolyte (HiC-HiE); 7.5% carbohydrate, 140 mg L^− 1 electrolyte (HiC-LoE); 1.3% carbohydrate, 421 mg L^− 1 electrolyte (LoC-HiE) and water. Subjects were provided with 50-ml samples to ingest and then rate (using a 100-mm line scale) the intensity of sweetness, saltiness, thirst-quenching ability and overall liking before (− 30 min), during (0, 30 and 60 min) and following (90 and 120 min) treadmill running exercise. Ratings of sweetness for all energy-containing drinks were higher during exercise relative to pre- and post-exercise conditions (P < 0.05); ratings also increased with duration of exercise (P < 0.001). Sweetness ratings for LoC-HiE increased during exercise (P < 0.05) but remained the same for other beverages. Ratings of saltiness decreased for all energy-containing drinks during exercise relative to pre-exercise (P < 0.05); ratings decreased with duration of exercise in these drinks (P < 0.05). Ratings of thirst-quenching ability (P = 0.039) and overall liking (P = 0.013) increased with duration of exercise with all beverages. Significant changes in sensory perception occur when consuming sports drinks during exercise relative to non-exercise conditions. Temporal changes also occur during exercise itself which leads to enhanced liking of all beverages.     

Changes in Australian women''s perception of the menopause and menopausal symptoms before and after the climacteric

The symptoms and perceptions of menopause of 60 Australian women were studied, by questionnaire, when they were premenopausal and 10 years later when they were postmenopausal. Menopausal symptoms expected and experienced by the women were compared, fewer women experiencing hot flushes, headache, depression and nervousness and more experiencing insomnia, increase in appetite, abdominal fullness, numbness and muscular problems. The symptoms women thought were due to hormonal changes at menopause were compared. In 1993 more women cited osteoporosis, insomnia, loss of libido, obesity and loss of muscle tone as due to hormone change while fewer cited depression. The premenstrual symptoms and their severity experienced by a woman when she was premenopausal significantly predicts the type and severity of the menopausal symptoms experienced by the woman. The expected menopausal symptoms and their severity cited by a woman also significantly predicts the type of severity of the menopausal symptoms experienced. More premenstrual symptoms predict the menopausal symptoms than those menopausal symptoms the women expected. The expectation menopause will be ‘a relief’ or ‘a nuisance’ significantly predicted the overall menopause experience described by the women. Their negative attitudes about doctors' understanding and information available about menopause remained unchanged but they forget menstrual cycle problems over the 10 years. The results suggest a possible physiological basis for premenstrual and menopausal symptoms. Assistance for women with their premenstrual and menstrual cycle symptoms may improve their quality of life at menopause.     

The hidden increase in histopathologists' workload.

The informational content of histopathological reports generated between 1985 and 1995 was assessed. This showed an exponential rise over the past five years. It is postulated that this has arisen from developments in medical science and demands from clinical colleagues. This increase in workload is not addressed by present methods of measurement and has major resource implications.     

Changes in future time perception of day hospital psychiatric patients in response to small group treatment approaches

Attempted to assess the effects of small group approaches on future time perception of psychiatric patients in a da hospital. The research employed two patient groups within the day hospital A control group, (N = 12) which received routine day hospital treatment, and an experimental group,(N = 12) which received, in addition, the small group treatment. Measures of future time perception were administered to both groups before and after a 12-week treatment. Results indicated significant positive changes in response to group treatment on Future Events and the dimension of Importance. However, no positive significant differences were found on Time Extension, Directionality, and Quality of Affect. While it is not within the scope of this research to evaluate whether the, secured change can be maintained, it was clear that in immediate posttesting important changes had resulted from the treatment strategy.     

Changes in neural complexity during the perception of 3D images using random dot stereograms.

One developing theme in consciousness research is that consciousness is not the product of any specific component of the brain, rather it is an emergent property of the changing patterns of connectivity between different specialised functional components. For example, the dynamic core hypothesis proposes that conscious experience requires high levels of neural complexity, where complexity is defined in terms of functional connectivity. To test this hypothesis, electroencephalography was recorded while participants were shown random dot-stereograms. Consistent with the dynamic core hypothesis, neural complexity increased as the participants changed from simply viewing the stereogram to consciously perceiving the hidden 3D image.