scholarly journals BSPD calls for equality of access to specialist care for 0-16s with highest dental needs

2021 ◽  
Vol 34 (9) ◽  
pp. 6-6
Keyword(s):  
Specialist Care ◽  
Dental Needs ◽  
Equality Of Access

Evidence-Based Treatment for the Eating Disorders

2010 ◽  
pp. 451-451
Author(s):  
Phillipa J. Hay ◽  
Angélica de M. Claudino
Keyword(s):  
Primary Care ◽  
Eating Disorders ◽  
Evidence Base ◽  
Good Evidence ◽  
Distinct Advantage ◽  
Specialist Care ◽  
Feeding And Eating Disorders ◽  
Online Therapies ◽  
Primary Care Practitioners

This chapter comprises a focused review of the best available evidence for psychological and pharmacological treatments of choice for anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified and unspecified feeding and eating disorders (OSFED and UFED), discusses the role of primary care and online therapies, and presents treatment algorithms. In AN, although there is consensus on the need for specialist care that includes nutritional rehabilitation in addition to psychological therapy, no single approach has yet been found to offer a distinct advantage. In contrast, manualized cognitive behavior therapy (CBT) for BN has attained “first-line” treatment status with a stronger evidence base than other psychotherapies. Similarly, CBT has a good evidence base in treatment of BED and for BN, and BED has been successfully adapted into less intensive and non-specialist forms. Behavioral and pharmacological weight loss management in treatment of co-morbid obesity/overweight and BED may be helpful in the short term, but long-term maintenance of effects is unclear. Primary care practitioners are in a key role, both with regard to providing care and with coordination and initiation of specialist care. There is an emerging evidence base for online therapies in BN and BED where access to care is delayed or problematic.

Evidence-Based Treatment for the Eating Disorders

2012 ◽  
Author(s):  
Phillipa J. Hay ◽  
Angélica de M. Claudino
Keyword(s):  
Primary Care ◽  
Eating Disorders ◽  
Evidence Base ◽  
Good Evidence ◽  
Distinct Advantage ◽  
Specialist Care ◽  
Feeding And Eating Disorders ◽  
Online Therapies ◽  
Primary Care Practitioners

This chapter comprises a focused review of the best available evidence for psychological and pharmacological treatments of choice for anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified and unspecified feeding and eating disorders (OSFED and UFED), discusses the role of primary care and online therapies, and presents treatment algorithms. In AN, although there is consensus on the need for specialist care that includes nutritional rehabilitation in addition to psychological therapy, no single approach has yet been found to offer a distinct advantage. In contrast, manualized cognitive behavior therapy (CBT) for BN has attained “first-line” treatment status with a stronger evidence base than other psychotherapies. Similarly, CBT has a good evidence base in treatment of BED and for BN, and BED has been successfully adapted into less intensive and non-specialist forms. Behavioral and pharmacological weight loss management in treatment of co-morbid obesity/overweight and BED may be helpful in the short term, but long-term maintenance of effects is unclear. Primary care practitioners are in a key role, both with regard to providing care and with coordination and initiation of specialist care. There is an emerging evidence base for online therapies in BN and BED where access to care is delayed or problematic.

scholarly journals Impact of Long Working Hours and Shift Work on Perceived Unmet Dental Need: A Panel Study

2021 ◽  
Vol 18 (6) ◽  
pp. 2939
Author(s):  
Hye-Eun Lee ◽  
Nam-Hee Kim ◽  
Tae-Won Jang ◽  
Ichiro Kawachi
Keyword(s):  
Shift Work ◽  
Dental Care ◽  
Fixed Effects ◽  
Panel Study ◽  
Working Hours ◽  
Care Needs ◽  
Long Working Hours ◽  
Care Services ◽  
Dental Care Needs ◽  
Dental Needs

This study investigates whether workers with long working hours as well as shift workers perceive higher unmet dental care needs, and whether there is a gender difference in the associations. We used the Korea Health Panel (2009, 2011–2014) involving 20,451 person-wave observations from 5567 individuals. Perceived unmet dental care needs was defined when the participants reported that they perceived a need for dental treatment or check-up but had failed to receive dental care services during the past year. Fixed effects logit models were applied to examine how changes in weekly working hours or shift work status were linked to changes in perceived unmet dental needs within each individual. Among participants, 15.9–24.7% reported perceived unmet dental needs and the most common reason was time scarcity. We found that long working hours (>52 h/week) was significantly associated with perceived unmet dental needs due to time scarcity in both men (OR = 1.42, 95% CI 1.13–1.78) and women (OR = 1.35, 95% CI 1.03–1.79) compared workers working 40–52 h per week. Shift work was also a significant risk factor, but only in women (OR = 1.57, 95% CI 1.06–2.32). These findings provide evidence for labor policies to reduce working hours in order to improve access to dental care services.

Patient preferences for specialist outpatient video consultations: A discrete choice experiment

2021 ◽  
pp. 1357633X2110228
Author(s):  
Centaine L Snoswell ◽  
Anthony C Smith ◽  
Matthew Page ◽  
Liam J Caffery
Keyword(s):  
General Practitioner ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Patient Preferences ◽  
Choice Experiment ◽  
Healthcare Delivery ◽  
General Practitioner Practice ◽  
Specialist Care ◽  
Time Away ◽  
Out Of Pocket Costs

Introduction Telehealth has been shown to improve access to care, reduce personal expenses and reduce the need for travel. Despite these benefits, patients may be less inclined to seek a telehealth service, if they consider it inferior to an in-person encounter. The aims of this study were to identify patient preferences for attributes of a healthcare service and to quantify the value of these attributes. Methods We surveyed patients who had taken an outpatient telehealth consult in the previous year using a survey that included a discrete choice experiment. We investigated patient preferences for attributes of healthcare delivery and their willingness to pay for out-of-pocket costs. Results Patients ( n = 62) preferred to have a consultation, regardless of type, than no consultation at all. Patients preferred healthcare services with lower out-of-pocket costs, higher levels of perceived benefit and less time away from usual activities ( p < 0.008). Most patients preferred specialist care over in-person general practitioner care. Their order of preference to obtain specialist care was a videoconsultation into the patient’s local general practitioner practice or hospital ( p < 0.003), a videoconsultation into the home, and finally travelling for in-person appointment. Patients were willing to pay out-of-pocket costs for attributes they valued: to be seen by a specialist over videoconference ($129) and to reduce time away from usual activities ($160). Conclusion Patients value specialist care, lower out-of-pocket costs and less time away from usual activities. Telehealth is more likely than in-person care to cater to these preferences in many instances.

scholarly journals Task shifting in the care for patients with hand osteoarthritis. Protocol for a randomized controlled non-inferiority trial

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ingvild Kjeken ◽  
Kjetil Bergsmark ◽  
Ida K. Haugen ◽  
Toril Hennig ◽  
Merete Hermann-Eriksen ◽  
...  
Keyword(s):  
Health Care ◽  
Disease Activity ◽  
Primary Outcome ◽  
Hand Osteoarthritis ◽  
List Type ◽  
Specialist Care ◽  
Randomized Controlled ◽  
Number Of Patients ◽  
Specialist Health Care ◽  
And Function

Abstract Background Current health policy states that patients with osteoarthritis (OA) should mainly be managed in primary health care. Still, research shows that patients with hand OA have poor access to recommended treatment in primary care, and in Norway, they are increasingly referred to rheumatologist consultations in specialist care. In this randomized controlled non-inferiority trial, we will test if a new model, where patients referred to consultation in specialist health care receive their first consultation by an occupational therapy (OT) specialist, is as safe and effective as the traditional model, where they receive their first consultation by a rheumatologist. More specifically, we will answer the following questions: What are the characteristics of patients with hand OA referred to specialist health care with regards to joint affection, disease activity, symptoms and function? Is OT-led hand OA care as effective and safe as rheumatologist-led care with respect to treatment response, disease activity, symptoms, function and patient satisfaction? Is OT-led hand OA care equal to, or more cost effective than rheumatologist-led care? Which factors, regardless of hand OA care, predict improvement 6 and 12 months after baseline? Methods Participants will be patients with hand OA diagnosed by a general practitioner and referred for consultation at one of two Norwegian departments of rheumatology. Those who agree will attend a clinical assessment and report their symptoms and function in validated outcome measures, before they are randomly selected to receive their first consultation by an OT specialist (n = 200) or by a rheumatologist (n = 200). OTs may refer patients to a rheumatologist consultation and vice versa. The primary outcome will be the number of patients classified as OMERACT/OARSI-responders after six months. Secondary outcomes are pain, function and satisfaction with care over the twelve-month trial period. The analysis of the primary outcome will be done by logistic regression. A two-sided 95% confidence interval for the difference in response probability will be formed, and non-inferiority of OT-led care will be claimed if the upper endpoint of this interval does not exceed 15%. Discussion The findings will improve access to evidence-based management of people with hand OA. Trial registration ClinicalTrials.gov, NCT03102788. Registered April 6th, 2017, https://clinicaltrials.gov/ct2/show/NCT03102788?term=Kjeken&draw=2&rank=1 Date and version identifier: December 17th, 2020. First version.

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