Tidlig avklaring – et møte mellom mennesker. Ny tilnærming for vurdering og planlegging av behandling i poliklinisk psykisk helsevern.

Background: Mental health care services are facing challenges due to the increasing number of referrals of patients with multifaceted problems. This study aims to describe the Early Assessment Team, a novel method of organizing intake assessments for the outpatient mental health service in a community mental health center. Method: During the first two years of EAT, 1,034 cases were included in a descriptive quality assurance study. Patient population, method of work, re-referrals and patient satisfaction were evaluated. Results: After contact with EAT, two-thirds of patients were assessed as not in need of further treatment in the outpatient clinic. The assessment was performed during one to three sessions in 90% of cases. Fewer than 20% of cases that were screened out by EAT were re-referred to the CMHC within six months. Patients expressed satisfaction with the service. Implications: The results indicate that intake assessment by an early assessment team may be an alternative in clinical practice, though further controlled studies are needed. Keywords: community mental health center (CMHC), health service development, intake assessment, general mental health

Ny tilnærming for vurdering og planlegging av behandling i poliklinisk psykisk helsevern

Background: Mental health care services are facing challenges due to the increasing number of referrals of patients with multifaceted problems. This study aims to describe the Early Assessment Team (EAT), a novel method of organizing intake assessments for the outpatient mental health service in a community mental health center (CMHC). Method: During the first two years of EAT, 1,034 cases were included in a descriptive quality assurance study. Patient population, method of work, re-referrals and patient satisfaction were evaluated. Results: After contact with EAT, two-thirds of patients were assessed as not in need of further treatment in the outpatient clinic. The assessment was performed during one to three sessions in 90% of cases. Fewer than 20% of cases that were screened out by EAT were re-referred to the CMHC within six months. Patients expressed satisfaction with the service. Implications: The results indicate that intake assessment by an early assessment team may be an alternative in clinical practice, though further controlled studies are needed.

Global overview of dietary outcomes and dietary intake assessment methods in maritime settings: a systematic review

Background Seafaring is a risky occupation with high prevalence of risk factors for non-communicable diseases. Food intake and eating habits are important cornerstones regarding health and health promotion. The aim of this study was to provide an overview of dietary intake and dietary intake assessment methods of seafarers and suggestions for applicable assessment tools. Methods We systematically searched PubMed and NLM Gateway (for MEDLINE), Web of Science, and SCOPUS up to February 2020 using standard keywords including nutrition OR diet OR meal AND maritime settings. Two independent reviewers extracted the data. The quality of included studies was assessed using the Joanna Briggs Institute Critical Appraisal checklist. Results From 4449 studies initially identified, 26 articles were included in the final review. Qualitative data (e.g. on unhealthy eating) had been gathered using in-depth individual or group interviews, participant observations, and phone-based chats. Composition of menu analysis, 24 h dietary recall, food diaries/ diet records, dietary habits questionnaire, food stores and food waste of the ship were used to assess the quantitative outcomes (e.g. dietary intakes). Access to meat, processed meat and egg, frozen and canned food items, sugary drinks, alcohol, greasy and salty food was high. In contrast, consumption of fruit, vegetables, dairy products, and cereals was lower than recommended. Conclusions Eating habits and dietary intakes in maritime settings are unhealthy. Subjective dietary assessment methods combining menu analysis with new technologies (e.g. mobile-based) might be an applicable method in this hard to reach setting which is the vessels.

Comparing Three Approaches to Salt Intake Assessment Among Lactating Women in Rural Cambodia

Objectives Monitoring population salt intake is a critical component of implementing salt fortification programs. In Cambodia, salt is being considered as a vehicle for thiamine fortification to prevent infantile beriberi among breastfed infants. However, salt intake among lactating mothers is not known. The gold standard for assessing sodium intake is repeat 24-hr urinary sodium concentrations. This method has logistical barriers, especially in low-resource settings, and other methods have not been trialed in this population. Here we compare three methods of assessing salt intake in lactating Cambodian women: repeat 24-hr urinary sodium concentrations (USC), repeat 12-hr observed weighed intake records (OWIR), and household salt disappearance (HSD). Methods Data from trial: NCT03616288. Salt intake was assessed using the three methods in a subsample of lactating women (n = 104) between 8 and 22 weeks postpartum. Women were asked to collect two 24-hour urine samples within 7 days. Repeat 12-hr OWIR were collected from women. Household salt disappearance was recorded fortnightly, and was divided by the number of household members to estimate individual intakes. Descriptive household salt use was also recorded. Differences in estimated salt intake from each method were compared using a Kruskal-Wallis test. Results Mean (95%CI) estimated salt intakes from repeat 24-hr USC, repeat 12-hr OWIR, and HSD were: 9.0 (8.3, 9.8) g/day, 9.1 (7.9, 10.3) g/day, and 10.9 (9.8, 11.9) g/day, respectively. Estimated intakes from HSD were significantly higher than both 24-hr USC (p = 0.009) and 12-hr OWIR (p = 0.002). Estimated intakes from 24-hr USC and 12-hr OWIR were not statistically different (p = 0.6). Salt was being used for purposes other than consumption, such as cleaning fish and vegetables, in 26% of fortnightly visits. Conclusions Repeat 24-hr USC and 12-hr OWIR are both acceptable and logistically feasible methods of salt intake assessment among lactating women in rural Cambodia. While HSD is a less resource-intensive approach, this method over-estimated salt intake. Salt being used for purposes other than consumption may contribute to over-estimation using this method. Funding Sources Bill & Melinda Gates Foundation, New York Academy of Sciences, Canadian Institutes of Health Research, Research Nova Scotia.