Managing Transition of Care in Adolescent Females with Epilepsy

2020 ◽  
Vol 09 (04) ◽  
pp. 150-155
Author(s):  
Roohi Katyal ◽  
Divya Singhal
Keyword(s):  
Social Services ◽  
Primary Care Physicians ◽  
Mental Health Problems ◽  
Adolescent Females ◽  
Pediatric Epilepsy ◽  
Transition Of Care ◽  
Adult Health ◽  
Limited Availability ◽  
Pregnancy And Lactation ◽  
Set Up

AbstractTransition of care from pediatric epilepsy clinics to adult health care is often a challenging process, especially due to limited availability of relevant guidelines. It carries even more significant implications in specific population subsets such as adolescent females, given a myriad of physiological as well as psychosocial changes seen in this age group. Women with epilepsy face distinct challenges because of hormonal variations on seizures (catamenial epilepsy). Furthermore, seizures and antiepileptic drugs impact menstruation, pregnancy, and lactation. These patients are at a higher risk for developing mental health problems, and a close follow-up with appropriate screening for psychiatric disorders is prudent.Several factors contributing to poor transition of care include limited availability of a multidisciplinary set-up and social-support services, delayed referral to specialist(s), and tendency for treatment nonadherence. In this review, we discuss the current scenario of transition of care in adolescent females with epilepsy and explore avenues for improvement based on our subspecialty clinic experiences. We illustrate the value of interdisciplinary care proactively involving neurologists/epileptologists, primary care physicians, obstetricians–gynecologists, and relevant social services and emphasize shared decision-making, effective contraceptive methods, preconceptual counseling, maintenance of bone-health, and enhanced quality of life.

Pharmacological Considerations When Transitioning the Care of Epilepsy Patients from Pediatric to Adult Epilepsy Centers

2020 ◽  
Vol 09 (04) ◽  
pp. 177-185
Author(s):  
Natalie Guido-Estrada ◽  
Shifteh Sattar
Keyword(s):  
Medication Compliance ◽  
Lifestyle Changes ◽  
Transition To Adult Care ◽  
Pediatric Epilepsy ◽  
Transition Of Care ◽  
Adult Health ◽  
Adult Care ◽  
Adult Model ◽  
Antiepileptic Medications ◽  
The Many

AbstractThere is scarce evidence in review of the available literature to support a clear and superior model for the transition of care for epilepsy patients from pediatric to adult centers. Anecdotally, there is a common perception that families are reluctant to make this change and that the successful transition of care for epilepsy can be a challenge for patients, families, and physicians. As part of the effort to prepare the patient and family for the adult model of care, several treatment issues should be addressed. In this article, we discuss the specific challenges for physicians in transition of care for epilepsy patients from a pharmacological standpoint, which include differences in metabolism and pharmacodynamics that can impact tolerability or efficacy of antiepileptic medications, lifestyle changes affecting medication compliance and seizure control, acquired adult health conditions necessitating new medications that may result in adverse drug interactions, and adult neurologists' potential lack of familiarity with certain medications typically used in the pediatric epilepsy population. We offer this as a guide to avoid one of the many possible pitfalls when epilepsy patients transition to adult care.

scholarly journals FACTORES DE RIESGO ASOCIADOS A LOS MALOS TRATOS A PERSONAS MAYORES SEGÚN EL GÉNERO DE LAS VÍCTIMAS

2016 ◽  
Vol 1 (2) ◽  
pp. 289
Author(s):  
Carmen Touza Garma ◽  
Carmen Prado Nóvoa
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Social Services ◽  
Mental Health Problems ◽  
Elder Abuse ◽  
Domestic Abuse ◽  
Assessment Protocol ◽  
Factores De Riesgo ◽  
Salud Mental ◽  
Las Mujeres

Abstract.RISK FACTORS ASSOCIATED WITH ELDER ABUSE BY GENDER OF THE VICTIMSElder abuse is an increasingly recognized social problem because it is a violation of Human Rights and because of its serious consequences for the wellbeing and quality of life of older people. In addition, the prevalence of the problem could increase due to the aging population. Within this context, women appear in some studies as more frequent victims of abuse than men, although there are few studies that analyze why the risk of suffering domestic abuse may be higher in women than in men. The objective of this research was to assess whether there are different risk factors depending on the gender of the victims. The study involved 46 professional of social services teams who analyzed the situation of 202 elderly people (134 women and 68 men) through an assessment protocol that collected information on major risk factors for domestic abuse raised in the investigations. The results showed that although both genders shared a large number of risk factors, some turned out to be only significant for women: three factors related to the care-receiver (lack of income, problems of mental health and signs of cognitive decline) and four factors related to the caregiver (problems of mental health, problems with alcohol or other drugs, having experienced abuse at other times in his or her life and being financially dependent). These results could indicate some factors that increase the vulnerability of women and have important implications for the prevention and detection of risk situations of abuse.Key words: elder abuse, risk factors, human sex differences, gender.Resumen.Los malos tratos a la personas mayores son un problema social cada vez más reconocido porque suponen una violación de los Derechos Humanos y porque pueden producir graves consecuencias en su bienestar y calidad de vida. Además, la prevalencia del problema podría aumentar debido al envejecimiento de la población. Dentro de este contexto, la mujeres aparecen en algunos estudios como víctimas más frecuentes de los malos tratos que los varones, aunque son escasos los estudios que analicen por qué el riesgo de sufrir malos tratos domésticos puede ser mayor en las mujeres que en los hombres. El objetivo de esta investigación fue valorar si existen distintos factores de riesgo en función del género de las víctimas. En el estudio participaron 46 profesionales de equipos de servicios sociales que analizaron la situación de 202 personas mayores (134 mujeres y 68 hombres) a través de un protocolo de valoración que recogía información sobre los principales factores de riesgo de los malos tratos domésticos planteados en las investigaciones. Los resultados encontrados mostraron que aunque ambos géneros compartían un elevado número de factores de riesgo, algunos resultaron ser únicamente significativos para las mujeres: tres factores relacionados con la persona mayor (la falta de ingresos económicos, los  problemas de salud mental y la presencia de signos de deterioro cognitivo) y cuatro factores relacionados con el cuidador (los problemas de salud mental, los problemas con el alcohol u otras drogas, haber sufrido malos tratos y ser económicamente dependiente). Estos resultados podrían indicar algunos factores que aumentarían la vulnerabilidad de las mujeres y tienen importantes implicaciones para la prevención y detección de situaciones de riesgo de malos tratos.Palabras clave: malos tratos a las personas mayores, factores de riesgo, diferencias de género.

scholarly journals LEVERAGING CRITICAL RURAL GERONTOLOGY TO IMPROVE RURAL GERONTOLOGICAL HEALTH

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S399-S399
Author(s):  
Laura Poulin ◽  
Neil Hanlon
Keyword(s):  
Older Adults ◽  
Social Services ◽  
Older Adult ◽  
Adult Health ◽  
Critical Approach ◽  
Complex Interplay ◽  
Policy And Practice ◽  
Rural Settings ◽  
Health Experiences ◽  
Dynamic Communities

Abstract A critical approach in rural gerontology has led to a better understanding of the complex interplay between older adults unique aging experiences and the multidimensional and dynamic communities in which they live. The evolution of critical rural gerontology will be explored, outlining why a similar approach is needed in rural gerontological health. In particular, rural gerontological health literature must expand beyond a deficit focus that homogenizes older adult health experiences and recognize the complexities of negotiating older adult health within multidimensional rural spaces. Inherent in this approach is recognizing the intersectionality of older adult health as well as the need to study rural gerontological health as an experience enhanced and inhibited by interactions within and across formal health services, informal social services and informal care. This approach will contribute to innovations in policy and practice addressing the burgeoning interest of how to effectively care for older adults in rural settings.

scholarly journals Academic performance in mathematics and reading and self-reported mental health problems in children across Europe

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Husky
Keyword(s):  
Mental Health ◽  
The Netherlands ◽  
Video Game ◽  
Mental Health Problems ◽  
Externalizing Disorders ◽  
Mental Health Measure ◽  
Funded Project ◽  
The Difference ◽  
Set Up ◽  
Two Stages

Abstract Background The School Children Mental Health Europe was a EU funded project designed to set up a kit of instruments enabling cross EU comparisons. Methods A literature review allows to select the SDQ (Strengths and Difficulties questionnaire) to be administered to the parents and teachers after a validation process in each country and the Dominic Interactive (DI), a sort of video game designed to evaluate DSM more commune diagnoses on children 6 to 11 years old. Results Data were collected on 7682 children randomly selected in a two stages selection: schools by country and children within the schools for whom 1) either parent- or teacher SDQ were completed: Overall, 12.8 % of children have any probable disorder with significant inter-country differences, 8.4 % probable conduct disorder, and 2.0 % probable hyperactivity/inattention. Adjusting for socio-demographic variables and parental psychological distress, country of residence did not predict the odds of having any disorder. 2) Overall, 22.0% of children were identified per their own evaluation as having at least one mental disorder, ranging from 16.4% in the Netherlands to 27.9% in Bulgaria. The prevalence of internalizing disorders was 18.4% across countries and ranged from 11.8% in the Netherlands to 24.3% in Turkey. The prevalence of externalizing disorders was lower with an average of 7.8%, ranging from 3.5% in Turkey to 10.5% in Bulgaria. Combining samples across European countries, 1 in 5 children reported internalizing problems and 1 in 12 children externalizing problems. Conclusions This lecture aims to present and discuss child mental health measure instruments from different informants perspectives, comparisons across countries and the challenges for interpreting the difference.

scholarly journals Rediscovering Recovery: Reconceptualizing Underlying Assumptions of Citizenship and Interrelated Notions of Care and Support

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Caroline Vandekinderen ◽  
Griet Roets ◽  
Rudi Roose ◽  
Geert Van Hove
Keyword(s):  
Mental Health ◽  
Social Services ◽  
Mental Health Problems ◽  
Research Policy ◽  
Health Problems ◽  
Policy And Practice ◽  
Social Service Delivery ◽  
Care And Support ◽  
Conceptual Distinction ◽  
The Individual

Over the last few decades, research, policy, and practice in the field of mental health care and a complementary variety of social work and social service delivery have internationally concentrated onrecoveryas a promising concept. In this paper, a conceptual distinction is made between anindividualapproach and asocialapproach to recovery, and underlying assumptions of citizenship and interrelated notions and features of care and support are identified. It is argued that the conditionality of the individual approach to recovery refers to a conceptualization of citizenship asnormative, based on the existence of a norm that operates in every domain of our society. We argue that these assumptions place a burden ofself-governanceon citizens with mental health problems and risk producing people with mental health problems as nonrecyclable citizens. The social approach to recovery embraces a different conceptualization of citizenship asrelational and inclusiveand embodies the myriad ways in which the belonging of people with mental health problems can be constructed in practice. As such, we hope to enable social services and professionals in the field to balance their role in the provision of care and support to service users with mental health problems.

scholarly journals Clinical decisions and stigmatizing attitudes towards mental health problems in primary care physicians from Latin American countries

PLoS ONE ◽  
2018 ◽  
Vol 13 (11) ◽  
pp. e0206440 ◽  
Author(s):  
Angel O. Rojas Vistorte ◽  
Wagner Ribeiro ◽  
Carolina Ziebold ◽  
Elson Asevedo ◽  
Sara Evans-Lacko ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Latin American ◽  
Primary Care Physicians ◽  
Mental Health Problems ◽  
Health Problems ◽  
Clinical Decisions ◽  
Stigmatizing Attitudes ◽  
Latin American Countries

scholarly journals Beds, budgets and burdens: Learning disability expenditure v. workload across English health authorities

2002 ◽  
Vol 181 (3) ◽  
pp. 200-207 ◽  
Author(s):  
Bunny Forsyth ◽  
Paul Winterbottom
Keyword(s):  
Learning Disabilities ◽  
Learning Disability ◽  
Social Services ◽  
Rural Areas ◽  
Population Distribution ◽  
National Database ◽  
Health Authorities ◽  
Audit Commission ◽  
Using Data ◽  
Set Up

BackgroundFollowing the closure of asylums and widespread changes in the population distribution of people with learning disabilities, there has been little investigation of changing expenditure requirements of health authorities in England.AimsTo compare expenditure on learning disability health services across England with the burden of services regionally, as estimated by numbers of people with learning disabilities.MethodA national database was set up using data from the National Audit Commission and the Department of Health. The spend/burden ratio was calculated and correlation tests for likely causes of inequality were applied.ResultsThere is widespread discrepancy from the median spend/burden ratio of £10 260 per person with learning disability. There is a positive correlation between ratios and levels of net exports of people funded by their local authority social services to reside ‘out of area’. Comparative underspending occurs in rural areas.ConclusionsThere are inequalities in levels of spending on learning disability services. Comparison of regions suggests resources may not be allocated fairly. Health authorities should ensure that population increases are mirrored by appropriate adjustments in expenditure.

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