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Liverpool, United Kingdom

Grant L.,The Walton Center Foundation Trust
Nursing times | Year: 2011

A vast amount of information relating to standards of patient care is collated from hospital wards, yet there is not always evidence that this information is discussed or acted upon by ward staff. Involving ward staff in setting up systems to monitor performance and then deciding how to address shortcomings uses their insights into care provision and gives them ownership over standards of care. The balanced scorecard is an effective tool for monitoring quality that can be applied to healthcare. This article discusses how to use it to develop and implement systems of measuring the quality of care.

Ooi M.H.,University of Liverpool | Ooi M.H.,University Malaysia Sarawak | Wong S.C.,Sibu Hospital | Lewthwaite P.,University of Liverpool | And 3 more authors.
The Lancet Neurology | Year: 2010

Although poliomyelitis has been mostly eradicated worldwide, large outbreaks of the related enterovirus 71 have been seen in Asia-Pacific countries in the past 10 years. This virus mostly affects children, manifesting as hand, foot, and mouth disease, aseptic meningitis, poliomyelitis-like acute flaccid paralysis, brainstem encephalitis, and other severe systemic disorders, including especially pulmonary oedema and cardiorespiratory collapse. Clinical predictors of severe disease include high temperature and lethargy, and lumbar puncture might reveal pleocytosis. Many diagnostic tests are available, but PCR of throat swabs and vesicle fluid, if available, is among the most efficient. Features of inflammation, particularly in the anterior horns of the spinal cord, the dorsal pons, and the medulla can be clearly seen on MRI. No established antiviral treatment is available. Intravenous immunoglobulin seems to be beneficial in severe disease, perhaps through non-specific anti-inflammatory mechanisms, but has not been tested in any formal trials. Milrinone might be helpful in patients with cardiac dysfunction. © 2010 Elsevier Ltd.

Iniesta I.,The Walton Center Foundation Trust
Practical Neurology | Year: 2011

The term Jacksonian epilepsy was coined by Jean Martin Charcot following John Hughlings Jackson's 1870 paper 'A study of convulsions', where he had defined a convulsion as "a symptom resulting from an occasional, an excessive and a disorderly discharge of nerve tissue on muscles". His earlier writings had included cases of syphilis related epilepsy, and the introduction of the fi rst successful antiepileptic drugs-the bromides. Based on careful clinical observation or, as Hughlings Jackson himself put it, on the "experiments performed by disease", 'A study of convulsions' was a synthesis of those previous reports which has contributed to our practical understanding of epilepsy, a contribution which continues to inform our thinking to the present day.

Nicolson A.,The Walton Center Foundation Trust | Marson A.G.,University of Liverpool
Practical Neurology | Year: 2010

Juvenile myoclonic epilepsy is one of the most common types of epilepsy seen in an adult epilepsy clinic. Most patients have a good prognosis, particularly when treated with valproate, but a significant minority are more difficult to treat. In this article, we will focus on a management strategy when the initial antiepileptic drug is unsuccessful and outline an approach that translates directly to the clinic.

Sathasivam S.,The Walton Center Foundation Trust
Progress in Neurology and Psychiatry | Year: 2014

Myasthenia gravis is the most common primary disorder of neuromuscular transmission and one of the most treatable neurological disorders. In this review, Dr Sathasivam examines the epidemiology, presentation, aetiology, diagnosis and treatment of myasthenia gravis. © 2014 John Wiley & Sons, Ltd.

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