Peer specialist services: New frontiers and new roles.

Aims and methodStreet triage services are increasingly common and part of standard responses to mental health crises in the community, but little is understood about them. We conducted a national survey of mental health trusts to gather detailed information regarding street triage services alongside a survey of Thames Valley police officers to ascertain their views and experiences.ResultsTriage services are available in most areas of the country and are growing in scope. There is wide variation in levels of funding and modes of operation, including hours covered. Police officers from our survey overwhelmingly support such services and would like to see them expanded.Clinical implicationsMental health crises now form a core part of policing and there are compelling reasons for the support of specialist services. Recent changes to the law have heightened this need, with a requirement for specialist input before a Section 136 is enacted. Those who have experienced triage services report it as less stigmatising and traumatic than a traditional approach, but there remains little evidence on which to base decisions.Declaration of interestNone.

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144 Centralising the renal cancer multi-disciplinary team for equitable access to specialist services

10.1136/leader-2020-fmlm.144 ◽

2020 ◽

Author(s):

E Day ◽

B Venugopal ◽

G Lamb ◽

G Oades ◽

Keyword(s):

Renal Cancer ◽

Equitable Access ◽

Specialist Services ◽

Multi Disciplinary Team

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Dementia epidemiology in Hungary based on data from neurological and psychiatric specialty services

Scientific Reports ◽

10.1038/s41598-021-89179-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Nóra Balázs ◽

András Ajtay ◽

Ferenc Oberfrank ◽

Dániel Bereczki ◽

Tibor Kovács

Keyword(s):

Psychiatric Services ◽

Psychiatric Diagnoses ◽

Prevalence Rates ◽

Health Insurance System ◽

Crude Incidence ◽

Specialist Services ◽

Single Payer ◽

Icd 10 ◽

Medical Reports ◽

The Mean

AbstractHungary has a single-payer health insurance system covering 10 million inhabitants. All medical reports of the in- and outpatient specialist services were collected in the NEUROHUN database. We used ICD-10 codes of Alzheimer’s disease (AD), vascular dementia (VaD), miscellaneous dementia group and mild cognitive impairment (MCI) for the inclusion of the patients. Incidence, prevalence and survival of different dementias and MCI were calculated and analyzed depending on the diagnoses given by neurological or psychiatric services or both. Between 2011 and 2016, the mean crude incidence of all dementias was 242/100,000/year, whereas the age standardized incidence was 287/100,000/year. Crude and age standardized mean prevalence rates were 570/100,000 and 649/100,000, respectively. There were significantly more VaD diagnoses than AD, the VaD:AD ratio was 2.54:1, being the highest in patients with psychiatric diagnoses only (4.85:1) and the lowest in patients with only neurological diagnoses (1.32:1). The median survival after the first diagnosis was 3.01 years regarding all dementia cases. Compared to international estimates, the prevalence of dementia and MCI is considerably lower in Hungary and the VaD:AD ratio is reversed.

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Prevention and early help for eating disorders in young people with type 1 diabetes

Clinical Child Psychology and Psychiatry ◽

10.1177/1359104521994172 ◽

2021 ◽

pp. 135910452199417

Author(s):

Rosie Oldham-Cooper ◽

Claire Semple

Keyword(s):

Eating Disorders ◽

Type 1 Diabetes ◽

Early Intervention ◽

Young People ◽

Current Evidence ◽

Future Directions ◽

Team Collaboration ◽

Children And Young People ◽

Specialist Services

There is building evidence that early intervention is key to improving outcomes in eating disorders, whereas a ‘watch and wait’ approach that has been commonplace among GPs and other healthcare professionals is now strongly discouraged. Eating disorders occur at approximately twice the rate in individuals with type 1 diabetes compared to the general population. In this group, standard eating disorder treatments have poorer outcomes, and eating disorders result in a particularly high burden of morbidity. Therefore, our first priority must be prevention, with early intervention where disordered eating has already developed. Clinicians working in both eating disorders and diabetes specialist services have highlighted the need for multidisciplinary team collaboration and specific training, as well as improved treatments. We review the current evidence and future directions for prevention, identification and early intervention for eating disorders in children and young people with type 1 diabetes.

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The multifactorial aetiology of gingival overgrowth: a case report illustrating diagnosis and management

Dental Update ◽

10.12968/denu.2019.46.7.662 ◽

2019 ◽

Vol 46 (7) ◽

pp. 662-671

Author(s):

Rachael Y Jablonski ◽

Bethany Rushworth ◽

Kathryn A Durey

Keyword(s):

Case Report ◽

Renal Transplantation ◽

Vitamin C ◽

Oral Hygiene ◽

Patient Engagement ◽

Surgical Intervention ◽

Gingival Overgrowth ◽

Vitamin C Deficiency ◽

Specialist Services ◽

Detailed Assessment

Gingival overgrowth is the enlargement of gingival tissues and has various underlying aetiological factors. This case report highlights the multifactorial aetiology of gingival overgrowth for a patient who was prescribed an immunosuppressive strategy following renal transplantation, had poor levels of oral hygiene and a diet deficient in fruit and vegetables. The report highlights the importance of a detailed assessment to identify all underlying factors and demonstrates how a referral to the specialist services for gingival overgrowth led to a diagnosis of vitamin C deficiency. It also illustrates how both patient engagement and a conservative cause-related therapy can achieve a satisfactory resolution without any surgical intervention. CPD/Clinical Relevance: This case report highlights the importance of a detailed assessment to diagnose all relevant underlying aetiological factors involved in the development of gingival overgrowth. It also illustrates how both patient engagement and a conservative cause-related therapy can achieve a satisfactory resolution of gingival overgrowth without any surgical intervention.

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