Publications by authors named "Paul Hoff"

Objective: To explore perspectives about consumer sleep technology (CST) and barriers to its regular use and whether these vary by sociodemographic characteristics.

Methods: A multidisciplinary team developed a survey instrument which was disseminated to a national sample via an online platform. A mixed methods analysis using descriptive statistics, logistic regression, and thematic content analysis was employed.

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Unlabelled: Consumer sleep technology (CST) has an emerging role in monitoring sleep, including screening or surveillance of sleep disorders; however, few data are available on CST in patients with obstructive sleep apnea. We analyzed attitudes toward CST and patterns of CST use among individuals with obstructive sleep apnea. Among 251 respondents (mean age 57.

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The work methods of eminent psychiatrist Emil Kraepelin (1856-1926) and of literary and cultural critic Walter Benjamin (1892-1940) are described based on the literature describing their ways of working. Kraepelin's approach of cross-sectional observation of symptoms and the longitudinal study of illness course in distinguishing 'disease entities' as well as his research strategy of investigating causes and correlates using methods of experimental psychology, pathology and neurobiology are described. Critical statements (on Kraepelin's work) highlighting preconceived concepts, ideological positions and a lack of critical reflection are reported.

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Since its beginnings psychiatry controversely debated about the appropriate concept of illness, about nosology and the diagnostic terms and procedures based upon it. This paper discusses the approaches introduced by Emil Kraepelin (1856-1926), Karl Jaspers (1883-1969) and Arthur Kronfeld (1886-1941). Whereas Kraepelin postulated the existence of «natural entities» with regard to mental illness, Jaspers acknowledged the heuristic value of the term «disease entity», but declared it a «regulative idea» in a Kantian sense, i.

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Article Synopsis
  • The study aimed to explore public attitudes and usage of consumer sleep technology (CST) for detecting obstructive sleep apnea (OSA) among U.S. adults.
  • A survey was created with input from sleep experts and was completed by 897 respondents, revealing that demographics like income, insurance type, and education level influenced CST usage.
  • Most participants saw value in CST for OSA screening, but disparities in usage highlight the need for further research on barriers and equitable access to sleep disorder care.
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Article Synopsis
  • A study evaluated a new streamlined approach for hypoglossal nerve stimulator (HGNS) implantation, comparing it to a traditional method.
  • The streamlined pathway reduced hospital costs by an average of $9,258 and decreased time to surgery by about 3.82 months without compromising clinical outcomes.
  • The findings suggest that this new approach could be beneficial for certain patients, but more research is needed to refine patient selection and assess long-term effects.
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Purpose: Upper airway (UA) surgery is commonly employed in the treatment of patients with obstructive sleep apnea (OSA). The intricate pathophysiology of OSA, variability in sites and patterns of UA collapse, and the interaction between anatomical and non-anatomical factors in individual patients may contribute to possible surgical failures. This clinical consensus statement aims to identify areas of agreement among a development group comprising international experts in OSA surgery, regarding the appropriate definition, predictive factors in patients, and management of surgical failure in OSA treatment.

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Background And Hypothesis: This survey explores Swiss mental health professionals', users', and relatives' opinions on re-naming schizophrenia exploiting Switzerland's specific multilingualism to examine possible effects of linguistic and microcultural differences on the issue.

Study Design: Opinions on 'schizophrenia' were collected using a self-rated online questionnaire incl. Freetext answers available in the three main Swiss languages, German, French and Italian.

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Any acute state of dyspnoea will lead to feelings of insecurity and anxiety. In this context the paper elucidates the conceptual horizon of anxiety, stretching from its status as «normal», essential element of conditio humana, to representing a symptom of another (somatic or mental) illness and to constituting a psychiatric disorder of its own. In any case of acute dyspnoea it is important to «normalize» the patient's anxiety, i.

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Background: Evaluation and interpretation of the literature on obstructive sleep apnea (OSA) allows for consolidation and determination of the key factors important for clinical management of the adult OSA patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA).

Methods: Using previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidence-based review with recommendations (EBR-R) formats.

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Hypoglossal nerve stimulation (HGNS) has emerged as a successful surgical treatment strategy for moderate to severe obstructive sleep apnea in patients failing first-line positive airway pressure therapy. HGNS explantation due to adverse events such as pain and infection is rare and has yet to be well described. Here, our correspondence describes the first case series of patients who have undergone explantation of the Inspire HGNS system.

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Background: Communicating about delusions is generally considered a challenging task.

Material And Methods: Assuming that there are nevertheless a variety of communicative resources competently employed to meet this challenge, the authors present a conversation analytic study of two narrative interviews in which people talk about their experience of delusions.

Results: It is shown that through pauses, breaks, reformulations, negotiations of the so-called common ground and the use of metaphoric speech, they succeed in conveying many aspects of the experience of delusions that cannot simply be described in terms of content.

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The aim of this article is to propose that reading Samuel Beckett's novels can improve compassionate acceptance of mental phenomena and human behavior deemed incomprehensible. In a narrative inquiry into all of Beckett's novels, we could discern nihilism and existential insecurity as themes both central to Beckett's prose and relevant in working with people with severe mental disorders. By deconstructing narrative structures and struggling to say the unsayable, Beckett can provide a perspective that goes beyond rational understanding.

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Unlabelled: Hypoglossal nerve stimulation (HGNS) has evolved as a novel and effective therapy for patients with moderate-to-severe obstructive sleep apnea. Despite positive published outcomes of HGNS, there exist uncertainties regarding proper patient selection, surgical technique, and the reporting of outcomes and individual factors that impact therapy effectiveness. According to current guidelines, this therapy is indicated for select patients, and recommendations are based on the Stimulation Therapy for Apnea Reduction or STAR trial.

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Objective: To discuss the virtual management options and strategies learned during the COVID-19 pandemic for treatment of patients with sleep complaints and sleep disordered breathing presenting to the otolaryngologist.

Methods/results: The addition of a virtual evaluation can be beneficial in assessing the patient presenting to the otolaryngologist with sleep complaints. With the implementation of telemedicine, validated subjective assessment tools, and a limited physical exam, patients can be triaged for the need for treatment implementation, further evaluation or testing, and counseled regarding various management options.

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Candidacy evaluation for hypoglossal nerve stimulation (HGNS) is resource intensive. This proof-of-concept study investigates use of in-office volitional snore during flexible laryngoscopy as an efficient, cost-effective screening tool for HGNS evaluation. Adults with moderate to severe obstructive sleep apnea that failed continuous positive airway pressure treatment (n = 41) underwent evaluation for HGNS from 2018 to 2019.

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Some psychiatric patients develop severe and persistent mental illness (SPMI), which, for a variety of reasons, can be therapy-refractory. Sometimes, treatment is not considered helpful by the patients themselves and does not improve their subjective quality of life. Furthermore, many SPMI patients experience compulsory interventions such as seclusion, restraint, or treatment against their will, which can cause harm.

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Purpose: No study to date has described the overall landscape of sleep disorders management and training in otolaryngology departments of different countries. The aim of our study was to investigate and compare settings, diagnostic and therapeutic approaches and training programmes.

Methods: An international online survey was developed with the collaboration of the YO-IFOS (Young Otolaryngologists-International Federation of Otorhinolaryngological Societies) to assess the current practice of otolaryngologists in the management of sleep disorders.

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Introduced in 2010, transoral robotic surgery (TORS) is recognized as an effective treatment of moderate to severe obstructive sleep apnea (OSA) in the setting of lymphoid and muscular tongue base hypertrophy. Upper airway stimulation (UAS) or hypoglossal nerve stimulation has emerged as a promising treatment of patients with moderate to severe OSA who have failed continuous positive airway pressure. UAS has shown favorable success rates and low morbidity compared with traditional soft tissue and skeletal framework surgery.

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Background: In 2018, Switzerland introduced a nationwide case-based prospective remuneration system (TARPSY), with decreasing daily rates for reimbursement of inpatient care in mental health facilities. Initially, there were concerns that declining daily rates could result in early discharges and increased readmission rates.

Methods: We compared length of stay (LOS) and readmission rates for patients in adult and geriatric psychiatry treatment at four psychiatric hospitals between 2017 (the last year with the traditional remuneration system) and 2018 (the first year with TARPSY).

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Ever since psychiatry emerged as a clinical discipline and field of scientific inquiry in the late 18th century, debates about diagnosis have been at its very heart. Considered by many a requirement for clinical communication as well as for systematic study, others have critiqued psychiatric diagnosis for being modeled on a medical conception of disease that is ill-suited to the specific nature of mental disorders. Based on a review of seminal positions in the conceptual history of psychiatry and an examination of their epistemological underpinnings, we propose to consider diagnosis as dialogue.

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'Beauty' - a Topic for Psychiatry? Reflections on the Relation Between Psychopathology and the Body Establishing a relation with one's own physicality is an essential element of our anthropological framework (conditio humana). This relation can be disturbed by critical life events as well as by mental disorders, which is here illustrated by clinical examples. Furthermore we discuss the prerequisites for a stable therapeutical relationship with this particular group of patients.

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The therapeutic relationship and its importance for psychotherapy outcome have been the subject of extensive research over the last decades. An acute psychiatric inpatient setting is a unique environment where severely ill patients receive intensive treatment over a limited, relatively short, period of time. This renders establishing a good therapeutic relationship difficult for various reasons.

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