Background: Applying guidelines is a universal challenge that is often not met. Intelligent software systems that facilitate real-time management during a clinical interaction may offer a solution.
Objectives-To work with specialist community teams to assess the practicality and acceptability of identified outcome measures for routine use in dementia services. Setting-Seven specialist dementia services: four multidisciplinary teams, a specialist service for carers, a community psychiatric nurse team, and a day hospital. Outcomes need to reflect the aims of the service and the needs and expectations of service users. The key objectives for dementia services were identified by questionnaires completed by general practitioners, district nurses, and specialist service professionals and by interviews with carers and excarers.4 Candidate measures from the literature review were then assessed against these objectives. The final shortlist included nine measures which met the literature criteria and service objectives.Outcome measures will only be incorporated into practice if clinicians see their value and want to use them, and they will only be used properly if they understand the basics of methodology, have been trained to use them properly, and have the time to do so.5 Evaluations of outcome measures have not always been related to clinical experience and day to day practicalities and it is these factors which are likely to effect the probability of whether measures are accepted and used by service providers. This paper describes a practical approach to overcoming this by examining the shortlisted measures from our review which have already been proved to be valid and reliable, and testing them for practicality and acceptability in routine practice. Staff views of the perceived value of the measures is also considered, as is the effect of using outcome measures with carers. We hope that the details of the
Recognition and management of nep frosis in lambs by i Angus and 'is Hodgson Ken Angus qualified in 1955 from the University of Glasgow Veterinary School and spent 12 years in large animal practice. In 1968 he joined Moredun Institute where he specialised in the pathology of gastrointestinal diseases of sheep. More recently, he has helped to coordinate research into lamb nephrosis with ultrastructural investigation of diseased kidneys. He is now engaged in private consultancy and diagnostic work. Chris Hodgson is an Agricultural Chemistry graduate of Leeds University and was awarded a PhD by Leeds University in 1977 for studies on the physiological control of rumen fermentation. Since joining the Biochemistry Department of the Moredun Research Institute in 1973, he has studied carbohydrate and protein use during lamb growth and development. More recently, his studies have shown endotoxic shock to be a major feature of watery mouth disease in lambs.
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