Improving VTE risk assessment and prophylaxis prescribing rate in medical patients: integrating risk assessment tool into the workflow.

Medical inpatients often have important risk factors for venous thromboembolism (VTE). In our institution, VTE prophylaxis in this group was underused. The main barriers identified were inattention to VTE prophylaxis, competing priorities and lack of confidence in the decision-making.

Trans-disciplinary advanced allied health practitioners for acute hospital inpatients: a feasibility study.

Objective: To explore cost-efficiency, safety and acceptability of trans-disciplinary advanced allied health (AH) practitioners for acute adult general medicine inpatients.

Design: Quasi-experimental feasibility study.

Setting: Three acute general medical units in an Australian urban hospital.

Improving accuracy in DOSY and diffusion measurements using triaxial field gradients.

NMR measurements of diffusion in solution, whether primarily quantitative, or, (as in DOSY, Diffusion-Ordered Spectroscopy) qualitative, can be particularly demanding. Here we show how the use of appropriate transverse (x, y) pulsed field gradients, orthogonal to the more usual z axis pulsed field gradient applied along the long axis of the sample, can greatly reduce two important sources of systematic error in diffusion experiments. These are the extra signal attenuation caused by sample convection, and gradient-dependent signal phase shifts caused by the magnetic field and field-frequency lock disturbances generated by field gradient pulses.

The Glasgow Benefit Inventory: a systematic review of the use and value of an otorhinolaryngological generic patient-recorded outcome measure.

Background: The Glasgow Benefit Inventory (GBI) is a validated, generic patient-recorded outcome measure widely used in otolaryngology to report change in quality of life post-intervention.

Objectives Of Review: To date, no systematic review has made (i) a quality assessment of reporting of Glasgow Benefit Inventory outcomes; (ii) a comparison between Glasgow Benefit Inventory outcomes for different interventions and objectives; (iii) an evaluation of subscales in describing the area of benefit; (iv) commented on its value in clinical practice and research.

Type Of Review: Systematic review.

Sample convection in liquid-state NMR: why it is always with us, and what we can do about it.

Many NMR experiments on liquids suffer if the sample convects. This is particularly true for applications, such as the measurement of diffusion, that rely on spatial labelling of spins. It is widely assumed that, in most well-conducted experiments with stable temperature regulation, samples do not convect.

Induction of ischemic stroke in awake freely moving mice reveals that isoflurane anesthesia can mask the benefits of a neuroprotection therapy.

Anesthetics such as isoflurane are commonly used to sedate experimental animals during the induction of stroke. Since these agents are known to modulate synaptic excitability, inflammation and blood flow, they could hinder the development and discovery of new neuroprotection therapies. To address this issue, we developed a protocol for inducing photothrombotic occlusion of cerebral vessels in fully conscious mice and tested two potential neuroprotectant drugs (a GluN2B or α4β2 nicotinic receptor antagonist).

Surgical interventions for the early management of Bell's palsy.

Background: Bell's palsy is an acute paralysis of one side of the face of unknown aetiology. Bell's palsy should only be used as a diagnosis in the absence of all other pathology. As the proposed pathophysiology is swelling and entrapment of the nerve, some surgeons suggest surgical decompression of the nerve as a possible management option.

The effect of experience on the sensitivity and specificity of the whispered voice test: a diagnostic accuracy study.

Objectives: To determine the sensitivity and specificity of the whispered voice test (WVT) in detecting hearing loss when administered by practitioners with different levels of experience.

Design: Diagnostic accuracy study of WVT, through acoustic analysis of whispers of experienced and inexperienced practitioners (experiment 1) and behavioural validation of these recordings (experiment 2).

Setting: Research institute with a pool of patients sourced from local clinics in the Greater Glasgow area.

Health-related quality of life before and after management in adults referred to otolaryngology: a prospective national study.

Objective: An assessment of the effect of otolaryngological management on the health-related quality of life of patients.

Design: Application of the Health Utilities Index mark 3 (HUI-3) before and after treatment; application of the Glasgow Benefit Inventory (GBI) after treatment.

Setting: Six otolaryngological departments around Scotland.

Surgical interventions for the early management of Bell's palsy.

Background: Bell's palsy is an acute paralysis of one side of the face of unknown aetiology. Bell's palsy should only be used as a diagnosis in the absence of all other pathology. As the proposed pathophysiology is swelling and entrapment of the nerve, some surgeons suggest surgical decompression of the nerve as a possible management option.

A randomised controlled trial of the use of aciclovir and/or prednisolone for the early treatment of Bell's palsy: the BELLS study.

Objective: To determine whether oral prednisolone or aciclovir, used separately or in combination, early in the course of Bell's palsy, improves the chances of recovery at 3 and 9 months.

Design: A 2 x 2 factorial randomised double-blind trial. Patients were randomly assigned to treatment by an automated telephone service using a permuted block randomisation technique with block sizes of four or eight, and no stratification.

Economic evaluation of early administration of prednisolone and/or aciclovir for the treatment of Bell's palsy.

Objectives: Bell's palsy (BP), which causes facial paralysis, affects 11-40 people per 100 000 per annum in the UK. Its cause is unknown but as many as 30% of patients have continuing facial disfigurement, psychological difficulties and occasionally facial pain. We present an randomised controlled trial (RCT)-based economic evaluation of the early administration of steroids (prednisolone) and/or antivirals (acyclovir) compared to placebo, for treatment of BP.

Family caregivers of older relatives: ways of coping and change in distress.

The aim of this secondary analysis was to examine the relationships between the ways in which caregivers coped with caregiving stressors and their experience of distress over time. Three coping subscales were derived from the Carers' Assessment of Management Index (CAMI) coping scale: "maintaining balance", "focusing on caregiving" and "avoidance". A proportional (relative) scoring technique was applied.

Early treatment with prednisolone or acyclovir in Bell's palsy.

Background: Corticosteroids and antiviral agents are widely used to treat the early stages of idiopathic facial paralysis (i.e., Bell's palsy), but their effectiveness is uncertain.

Evidence review and ENT-UK consensus report for the use of aminoglycoside-containing ear drops in the presence of an open middle ear.

Unlabelled: BACKGROUND AND OBJECTIVES OF REVIEW: The use of aminoglycoside drops in the presence of a perforation/grommet is still a common practice amongst the UK ENT community, in spite of theoretical risk of ototoxicity. Mindful of the need to produce clinical guidelines based on the best available evidence, it was the intention of the Clinical Audit and Practice Advisory Group of the British Association of Otolaryngologists - Head and Neck Surgeons (ENT-UK) to produce evidence-based guidelines. In the absence of good evidence, intentions were shifted towards producing consensus guidelines using validated methodology.

Outcomes of septal surgery.

Objective: To assess the change in health-related quality of life following septal surgery.

Study Design: Post-intervention, health-related quality of life questionnaire.

Participants: Adult patients undergoing septal surgery, recruited from two sources (the Scottish ENT outcomes study and the North Glasgow National Health Service Trust) over an 18-month period.

Does patient-perceived handicap correspond to the modified clinical test for the sensory interaction on balance?

Objective: To determine whether patient self-reported handicap correlates with scores obtained from the modified Clinical Test for the Sensory Interaction on Balance as assessed by the Neurocom VSR Balance Master platform.

Study Design: Prospective observational.

Setting: Balance clinic in tertiary referral center.

An international otology database.

There are many reports in the literature on the outcome of ear surgery. However, it is difficult to make comparisons from these reports because of a lack of uniformity in the way in which outcomes are reported. At the same time, the general public expects doctors to provide them with information regarding the benefits and risks of surgery.

Interobserver reliability in evaluating postural stability between clinicians and posturography.

Objectives: To assess the interobserver reliability in assessing postural stability and to compare with results obtained by computerized posturography.

Design: Cross-sectional study.

Setting: Balance clinic, teaching hospital.

Measuring quality of life in preschool children with sore throats and otitis media using the TAPQOL questionnaire.

Objectives: TNO-AZL Preschool Quality of Life Questionnaire (TAPQOL) is one of the few instruments designed to assess health-related quality of life in preschool children but its applicability to otolaryngology is unknown.

Study Design And Setting: We studied a consecutive series of children aged 1 to 5 years referred to hospital with recurrent sore throats, recurrent acute otitis media, or otitis media with effusion.

Results: TAPQOL domain scores were not influenced by age, sex, or socio-economic class, but correlated with markers of disease severity (frequency of sore throat or pyrexia, time off school), ear-related handicap (assessed with the OM6 questionnaire), and other measures of health-related quality of life (visual analogue scale, 5-point rating scale and the Health Utilities Index mark III).

The Glasgow Children's Benefit Inventory: a new instrument for assessing health-related benefit after an intervention.

Most health-related quality-of-life measures make an assessment at a single point in time. Comparing results before and after an intervention is often difficult, because the difference measured is usually small compared with the variation between individuals. A retrospectively applied measure specifically worded to assess benefit would be very useful for clinical research.