a multi-component, delirium prevention intervention directed at delirium risk factors and implemented by local clinical staff can reduce incident delirium on specialist elderly care wards.

A greater proportion of those presenting and diagnosed with DLB had a documentation of a suspected delirium than those diagnosed with AD. Delirium may lead to a higher risk of DLB as opposed to other forms of dementia, or delirium may, at least in some cases, represent the early stages of DLB. These data suggest that a diagnosis of DLB should be specifically considered in those presenting with a delirium.

a complex intervention for delirium prevention in care homes is feasible and has the potential to improve staff practice and outcomes for residents. This work provides the basis for the next phase of the evaluation to establish its effectiveness and cost-effectiveness.

No abstract

Single-use negative pressure wound therapy (PICO™) has been used on high-risk surgically incised wounds with encouraging results, but there is no evidence for its use in oncoplastic breast surgery. This article reports a case series with closed incisions in oncoplastic breast procedures following the introduction of PICO™.

No abstract

Findings show clinically and statistically significant weight loss among participants with improvements in physical and mental health.

Objective: The study investigated adult outpatient Health Psychology appointment attendance, cancellation, and missed appointments (A/C/M). The first objective was to determine which demographic and process factors predicted the probability of A/C/M. The second objective was to determine whether there remained residual significant differences in A/C/M between therapists (i.e. a "therapist effect"), after controlling for explanatory variables. Methods: A practice-based retrospective 2-year cohort study. 3-level multilevel models were constructed and tested to analyse the probability of A/C/M at a) assessment appointments (N = 1,175), and b) follow-up appointments (N = 5,441). Results: After controlling for predictor variables, significant therapist effects were found for attendance (10.0-13.0%) and cancellation (4.4%) at follow-up appointments (but not assessments), indicating significantly different attendance rates at follow-up between therapists. Predictors of attendance at follow-up included patient age, pre-therapy symptom severity scores (including Risk and Symptom scores), and completion of intake questionnaires. Early morning follow-up appointments were least likely to be cancelled, followed by late afternoon and finally midday appointments. Treatment intensity predicted attendance, but among qualified therapists, qualification type and pay level were non-significant. No significant predictors of attendance at assessment were detected. Conclusions: Attendance at Health Psychology outpatient appointments varies significantly according to patient, therapist, and appointment factors. Key routinely collected variables are predictive of attendance at followup. Clinical implications include the potential to identify patients at risk of non-attendance, and target engagement interventions to these patients. Research directions include closer examination of variability in follow-up attendance between therapists.