Doctors' experiences and their perception of the most stressful aspects of complaints processes in the UK: an analysis of qualitative survey data.

Objectives: To examine doctors' experiences of complaints, including which aspects are most stressful. We also investigated how doctors felt complaints processes could be improved.

Design And Methods: A qualitative study based on a cross-sectional survey of members of the British Medical Association (BMA).

Assessment of the priority target group of mental health service networks within a nation-wide reform of adult psychiatry in Belgium.

Background: Belgium is currently implementing a nation-wide reform of mental health care delivery based on service networks. These networks are supposed to strengthen the community-based supply of care, reduce the resort to hospitals, and improve the continuity of care. They are also intended to supply comprehensive care to all adult mental health users.

The use of decision aids on early detection of prostate cancer: views of men and general practitioners.

Background And Objective: While decision support tools such as decision aids can contribute to shared decision making, implementing these tools in daily practice is challenging. To identify and address issues around the use of decision support tools in routine care, this study explores the views of men and general practitioners on using a DA for early detection of prostate cancer.

Methods, Setting And Participants: Group discussions and semi-structured interviews were carried out with 43 men and 16 general practitioners familiar with a previously developed decision aid.

How do patients between the age of 65 and 75 use a web-based decision aid for treatment choice in localized prostate cancer?

Objectives: This study was designed to evaluate the use of a web-based decision aid by a 65plus patient group in their decision-making process for treatment of localized prostate cancer. Of particular interest was the use of technology features such as patients' statements, comparative tables, and a values clarification tool.

Methods: One hundred men from the University Hospital of Leuven campus, Gasthuisberg, were invited to use the web-based decision aid in their decision-making process.

Estimation of muscle fatigue using surface electromyography and near-infrared spectroscopy.

This study looks at various parameters, derived from surface electromyography (sEMG) and Near Infrared Spectroscopy (NIRS) and their relationship in muscle fatigue during a static elbow flexion until exhaustion as well as during a semidynamic exercise.We found a linear increasing trend for a corrected amplitude parameter and a linear decreasing slope for the frequency content of the sEMG signal. The tissue oxygenation index (TOI) extracted from NIRS recordings showed a four-phase response for all the subjects.

Impaired cerebral autoregulation using near-infrared spectroscopy and its relation to clinical outcomes in premature infants.

The concordance between the change in the Mean Arterial Blood Pressure (MABP) and the Cerebral Blood Flow (CBF) is studied using the Correlation, Coherence and Partial Coherence methods in order to detect Impaired Cerebral Autoregulation in Neonates. The presence of impaired autoregulation is assessed by the use of the Critical Percentage of Recording Time (CPRT). The changes in CBF are reflected by the measurement of changes in cerebral intravascular oxygenation (HbD), regional cerebral oxygen saturation (rSO(2)), and cerebral tissue oxygenation (TOI), as measured by Near-Infrared Spectroscopy (NIRS) (INVOS4100 and NIRO300).

Cerebral tissue oxygenation and regional oxygen saturation can be used to study cerebral autoregulation in prematurely born infants.

The coupling of cerebral intravascular oxygenation (dHbD) with mean arterial blood pressure (MABP) was taken as a reflection of autoregulation assuming constant arterial oxygen content. However, this method is sensitive to movement artifacts. We examined whether the cerebral tissue oxygenation index (cTOI) and regional oxygen saturation (rScO2) may replace dHbD and changes in total Hb (dHbT), respectively.

The effect of glycaemia on the cerebral oxygenation in very low birthweight infants as measured by near-infrared spectroscopy.

The cerebral tissue oxygenation index (TOI) and fractional tissue oxygen extraction (FTOE) reflect the cerebral oxygenation. We studied the effect of glycaemia on the TOI and FTOE, as measured by near-infrared-spectroscopy (NIRS). We continuously measured TOI, glycaemia, mean arterial blood pressure (MABP), saturation (SaO(2)) and transcutaneous carbon dioxide pressure (tPCO(2)) for at least 4 h during the first week of life in neonates with gestational age (GA) < 32 weeks and weight < 1500 g.

Cerebral and systemic hemodynamic effects of intravenous bolus administration of propofol in neonates.

Objectives: To assess variability of systemic hemodynamics and its covariates following bolus propofol administration in (pre)term neonates, and to analyze the effect of propofol on cerebral tissue oxygenation index (TOI) and fractional tissue oxygen extraction measured by near-infrared spectroscopy.

Methods: In (pre)term neonates, we recorded mean arterial blood pressure (MABP), saturation (SaO(2)), heart rate (HR) and TOI from 5 min before up to 60 min after intravenous bolus propofol (3 mg kg(-1)) administration during elective chest tube removal. Covariate analysis included postmenstrual age (PMA 37 weeks), postnatal age (PNA 10 days), comedication (fentanyl +/- midazolam) and congenital cardiopathy (yes/no).

New measurements for assessment of impaired cerebral autoregulation using near-infrared spectroscopy.

Some preterm infants have poor cerebral autoregulation. The concordance between cerebral intravascular oxygenation (HbD), computed as the difference between oxygenated (HbO2) and deoxygenated (Hb) haemoglobin, and mean arterial blood pressure (MABP) reflects impaired autoregulation. As HbD is not an absolute value, we developed mathematics to prove that the cerebral tissue oxygenation (TOI), an absolute signal computed as the ratio of HbO2 to total haemoglobin (Hb+HbO2), may replace HbD.

The effect of changes in tPCO2 on the fractional tissue oxygen extraction--as measured by near-infrared spectroscopy--in neonates during the first days of life.

The cerebral fractional oxygen extraction (FOE) reflects the balance between cerebral oxygen delivery (OD) and consumption (VO(2)). PCO(2) affects the cerebral blood flow (CBF): hypocapnia decreases CBF and OD and increases FOE. We recently showed that the fractional tissue oxygen extraction (FTOE) reflects FOE and hypothesized that a decrease in tPCO(2) increases FTOE.