Does standardized needs assessment improve the outcome of psychiatric day hospital care for older people? A randomized controlled trial.

There is little evidence to indicate how far psychiatric day hospitals for older people can identify and address the needs of older people who attend. The current practice of Care Programme Approach (CPA) in which multidisciplinary team members, patients and their families meet, may provide a suitable forum for needs to be discussed and interventions planned and implemented. One hundred and twelve new day hospital patients over a period of one year were randomly allocated to an experimental group in which the Camberwell Assessment of Need for the Elderly (CANE). Assessment reports were fed back to day hospital staff but not to the control group in which routine practice was maintained. Similar follow-up assessments were performed after three months in the day hospital or at the time of discharge. At follow-up, both the experimental and control groups had over 60% of their initial unmet needs being adequately met. In both groups, the Health of the Nation Outcome Scales 65+ scores and number of unmet needs were reduced indicating an improvement for both groups. However, there were no significant differences in outcome at follow-up between the experimental and control groups. Day hospitals for older people with mental health problems appear effective in identifying and meeting needs. The feedback from CANE made no difference in terms of outcome.

The temporalis muscle plus glabellar flap: handy local flaps for orbital repair after exenteration.

Primary tissue coverage of the orbit is desirable after orbital exenteration. This apart from reducing morbidity, is cost effective. Two patients who had immediate local flap reconstruction with temporalis muscle and glabellar skin, after major orbital resection are presented. The advantages of flap reconstruction over skin grafting are discussed.

Assessing the contribution of soybean utilisation on the nutritional status of children from low-income families: Lagos State, Nigeria as a case study.

Questionnaires were administered to mothers from 120 randomly selected households. Anthropometric measurement of 258 children from these households were taken, to assess the contribution of soybean in the diet of the infants from low-income families in Lagos State (Imota, Idimu and Badagry), Nigeria. The result showed that majority of the mothers either have no formal education or were primary-school leavers. Most mothers were categorised into low-income earners because they earn about N500 (US$6) per month. The frequency of soybean consumption in Idimu and Imota is significantly higher (P < 0.05) than that of Badagry. Although the frequency of animal protein consumption in Badagry households is significantly higher (P < 0.05), it is found to be inadequate to meet their daily requirements. The protein intakes were between 92-110, 97-100 and 75-103% of FAO requirements for the children in Idimu, Imota and Badagry respectively. The weight and height of children from Idimu and Imota are higher than the children from Badagry. About 26, 32 and 71% of the children studied in Idimu, Imota and Badagry respectively fell below the WHO 5th centile bracket of weight for age. These differences are attributed to the introduction and contribution of soybean (a cheaper source of protein) to Imota and Idimu.