Patients’ and Psychologists’ Preferences for Feedback Reports on Expected Mental Health Treatment Outcomes: A Discrete-Choice Experiment

In recent years, there has been an increasing focus on routine outcome monitoring (ROM) to provide feedback on patient progress during mental health treatment, with some systems also predicting the expected treatment outcome. The aim of this study was to elicit patients’ and psychologists’ preferences regarding how ROM system-generated feedback reports should display predicted treatment outcomes. In a discrete-choice experiment, participants were asked 12–13 times to choose between two ways of displaying an expected treatment outcome. The choices varied in four different attributes: representation, outcome, predictors, and advice. A conditional logistic regression was used to estimate participants’ preferences. A total of 104 participants (68 patients and 36 psychologists) completed the questionnaire. Participants preferred feedback reports on expected treatment outcome that included: (a) both text and images, (b) a continuous outcome or an outcome that is expressed in terms of a probability, (c) specific predictors, and (d) specific advice. For both patients and psychologists, specific predictors appeared to be most important, specific advice was second most important, a continuous outcome or a probability was third most important, and feedback that includes both text and images was fourth in importance. The ranking in importance of both the attributes and the attribute levels was identical for patients and psychologists. This suggests that, as long as the report is understandable to the patient, psychologists and patients can use the same ROM feedback report, eliminating the need for ROM administrators to develop different versions.

     

Results of 131 consecutive operated patients with a displaced proximal humerus fracture: an analysis with more than two years follow-up

Objective  

The purpose of this study is to determine the efficacy of the open reduction and fixation of a dislocated proximal humerus fracture with a locking plate, also evaluating the incidence of complications and functional recovery of the shoulder. A retrospective study focusing on patients who had suffered a fracture of the proximal humerus and were treated by means of an open reduction and internal fixation with a locking plate, using either the Philos or the LPHP plate. We have also included a comparison of these two plates.     

Effects of salmeterol on host resistance to Trichinella spiralis in rats.

Salmeterol is a long-acting beta2-adrenoreceptor agonist. The compound has previously been screened for immunotoxic potential in a repeated dose toxicity study in rats for 28 days. The total serum IgG levels were increased at dose levels of 2 and 10 mg/kg/day. Presently, salmeterol was studied in an immune function assay addressing the host resistance to Trichinella spiralis parasites. Rats were daily treated with salmeterol for 28 days at dose levels of 0, 2, 6 and 10 mg/kg/day. On day 29, the animals were infected with T. spiralis parasites. After six weeks, host resistance was examined. The numbers of T. spiralis muscle larvae in the tongue nor the inflammatory reactions around the encapsulated larvae were affected by salmeterol treatment. The yield of muscle larvae in the whole carcass was not changed either. The IgM, IgA and IgE antibody responses to T. spiralis were unaffected. Only at the highest dose level tested, the anti-T. spiralis IgG antibody response was decreased significantly. However, salmeterol's interference with the generation of anti-T. spiralis antibodies of the IgG subclass apparently did not adversely affect the resistance to infection.     

Progress in magnetic resonance imaging of brain tumours

PURPOSE OF REVIEW: Advances in magnetic resonance based techniques have yielded improvements in both high-resolution anatomical imaging and methods to evaluate physiology and function. This review focuses on recent developments in these techniques as applied to pretreatment staging and post-treatment evaluation of brain tumours. RECENT FINDINGS: High-resolution spectroscopic imaging may contribute to pre-therapeutic grading and characterization of gliomas, as can diffusion techniques. The latter also hold promise in predicting survival in malignant supratentorial astrocytoma and could help to define areas for biopsy. Both methods can differentiate recurrent tumour from radiation injury. Perfusion-weighted magnetic resonance techniques offer potential markers of tumour angiogenesis and capillary permeability, and correlate well with vascular endothelial growth factor expression in grade II and grade III tumours. Functional magnetic resonance imaging can assess whether surgical treatment is feasible and select patients for intraoperative cortical stimulation. Combining multiple parameters in a magnetic resonance based diagnostic strategy could improve overall performance. SUMMARY: Magnetic resonance imaging provides insights into the physiology of human tumours in a way that is both noninvasive and radiation free. We may expect from these new imaging methods greater specificity in diagnosis and useful tools with which to predict and assess response to therapy.     

Tape versus cast for non-operative treatment of primary patellar dislocation: a randomized controlled trial

Purpose

We hypothesized that taping results in better short-term functional outcome and comparable redislocation rates.

Methods

In a prospective randomised clinical trial, 18 patients with a primary patellar dislocation ≥18?years old without accompanying fractures or previous surgery to the knee were included. After 1?week of dorsal splinting, they were randomized into two groups: taping and cylinder cast immobilization. Physical examination and knee function according to the Lysholm Knee Scoring Scale were taken at 1-, 6- and 12-week and at 1- and 5-year follow-up. We also compared the redislocation rates.

Results

Taping resulted in a significantly better Lysholm score at 6 and 12?weeks post-dislocation (P?P?Conclusion Tape bandage immobilization seems superior to a cylinder cast even after 5?years.     

Radioembolization of the Spleen: A Revisited Approach for the Treatment of Malignant Lymphomatous Splenomegaly

Intraarterial administration of ⁹⁰Y microspheres to the spleen in patients with malignant lymphoma was mentioned once in the literature in 1973. This case study illustrates the potential indication of selective internal radiotherapy in a heavily pretreated patient with highly refractory disease with a marginal zone lymphoma in leukemic phase and symptomatic splenomegaly. We describe the clinical course of disease; the biological and clinical response to the treatment after radioembolization; and simulation and dosimetry by multimodal imaging via single-photon emission computed tomography and computed tomography. The advantages of radioembolization for the management of lymphomatous splenomegaly are discussed.     

Computerized electronystagmography: normative data revisited

This study provides normative data from computerized electronystagmography (ENG) testing of 40 healthy subjects with an average age of 45 years. The clinical test protocol comprises an extensive vestibular examination with oculomotor, positional, rotary chair and caloric tests. The results show that with a computerized ENG set-up considerable variabilities of 22% for rotary chair asymmetry and 19% for caloric labyrinth asymmetry remain.     

Ultrasonic determination of the residual bladder volume

In a clinical study the ultrasonic determination of the residual bladder volume is evaluated by applying several echographic methods described in the literature. 163 patients (age 3-89 years, 114 males and 49 females) and 13 students were examined. Only in the latter group the bladder volume was also determined by a planimetric method. The most practical method showed a good agreement (with a maximum deviation of 25%) between the ultrasonically measured volumes and the volumes measured by catheterization in 66% of the cases. This method makes use of the formula Vus = 0.5(Vt + Vl), where Vus = residual volume estimated by ultrasonography; Vt = volume measured by the computer using the largest transversal ultrasonic bladder section, and Vl = volume measured for the largest longitudinal section). Factors that influence image quality and accuracy because of changes in the form of the bladder were analyzed. The magnitude of the residual volume determined the image quality and the accuracy above all: lower volumes give worse images and are less accurate. Other factors seem to be relatively unimportant. To avoid discomfort, caused by urine tract infection and urethral strictures, ultrasonic determination of the residual urine is recommended for clinical application.