772 Quality Improvement Project – Establishment of The Breast Pain Clinic at Torbay Hospital

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
E O A Aribo ◽  
T Adeboye
Keyword(s):  
Further Education ◽  
Pain Clinic ◽  
Breast Pain ◽  
Assessment Clinic ◽  
Prospective Data ◽  
Improvement Project ◽  
Common Misconception ◽  
Triple Assessment ◽  
The Common ◽  
Positive Results

Abstract Introduction Breast pain alone should not be imaged. The common misconception that breast pain alone is a symptom of malignancy and the subsequent impact on the Triple Assessment Clinic (TAC), lead to the development of the Breast Pain Clinic (BPC), a holistic service to educate patients and reduce unnecessary imaging. Method Retrospective data was collected of TAC attendees between September-December 2018, noting patients presenting solely with breast pain (BPP); number of BPP imaged; and those with positive results. Prospective data collection of those attending the TAC and BPC were collected between September-December 2019. Results Retrospectively 17% (151/888) of TAC attendees were BPP, 23.8% (36/151) were imaged and 97.2% (35/36) had normal/benign changes. Following BPC creation 7% (67/940) of TAC attendees were BPP, 31.3% (21/67) were imaged all with no positive results. 1% (3/94) of BPC attendees were BPP, all with normal/benign imaging. 96% of questionnaire respondents felt more confident managing breast pain. Conclusions The development of a BPC was successful in educating patients and reducing anxiety. It also reduced the proportion of patients presenting to the TAC with pain and the proportion of patients imaged. With further education of community practitioners on referral adherence, this service could benefit breast services nationwide.

scholarly journals The 1969 African Refugee Convention: Innovations, Misconceptions, and Omissions

2013 ◽  
Vol 58 (1) ◽  
pp. 95-147 ◽  
Author(s):  
Marina Sharpe
Keyword(s):  
Economic Rights ◽  
Refugee Convention ◽  
Common Misconception ◽  
The Common ◽  
African Refugee ◽  
Critical Overview

This paper provides a critical overview of the 1969 African refugee convention, beginning with a survey of its legal innovations. It then addresses the most misunderstood of them—the unique refugee definition—in depth, with an emphasis on dispelling the common misconception that it is particularly expansive. Finally, it investigates the 1969 Convention’s silence regarding refugees’ civil and political, and socio-economic rights, and how it works as the “regional complement” to the 1951 global refugee convention in that regard.

scholarly journals The Positive Predictive Value of Diagnostic Ultrasound for Occult Herniae

2006 ◽  
Vol 88 (2) ◽  
pp. 165-167 ◽  
Author(s):  
M Bradley ◽  
J Morgan ◽  
B Pentlow ◽  
A Roe
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Diagnostic Tests ◽  
Diagnostic Ultrasound ◽  
Pain Clinic ◽  
Diagnostic Problem ◽  
Clinical Criteria ◽  
Negative Results ◽  
Positive Results

INTRODUCTION The aim of this study is to ascertain the accuracy of diagnostic ultrasound in the assessment of the occult abdominal and groin herniae. The authors have previously demonstrated its efficacy in diagnosing the type of clinical groin herniae but occult herniae provide a further diagnostic problem. PATIENTS AND METHODS A total of 113 consecutive patients were referred prospectively for ultrasound examinations with clinically suspected occult herniae. All positive scans were offered surgery whilst the negative results were offered further imaging or other diagnostic tests depending on the clinical criteria. The end point for negative scans was based on 18-month follow-up or resolution of symptoms. RESULTS Overall, 59 scans showed positive results for herniae and 56 of these had surgery. In the other three patients, two refused an operation, and one had no hernia detected at operation. In the remaining 57 scans, ultrasound offered alternative soft tissue diagnoses in 23 patients and surgical/endoscopic diagnoses accounted for a further 8 patients. CONCLUSIONS Ultrasound offered a diagnosis for the symptomology in 82 patients (70.6%) of which 59 were herniae. The positive predictive value for hernia is 98.3%. Twenty-six patients with no diagnosis or confirmation of herniae on follow-up showed symptom resolution in 22 cases, and four patients were treated by the pain clinic.

scholarly journals Occurrence of urogenital mycoplasmas in men with the common genitourinary diseases

2021 ◽  
Author(s):  
Dominika Smolec ◽  
Alicja Ekiel ◽  
Piotr Kłuciński ◽  
Jan Kawecki
Keyword(s):  
Infectious Complications ◽  
Prostatic Hyperplasia ◽  
Control Group ◽  
Study Group ◽  
Immunocompromised Patients ◽  
Healthy Men ◽  
The Common ◽  
Estimate Prevalence ◽  
Positive Results

Abstract Many serious and fatal infections with urogenital mycoplasmas in immunocompromised patients have been reported. M. genitalium is recognized as a cause of male urethritis and other common genitourinary diseases. The aim of the study was to estimate prevalence of urogenital mycoplasmas which can cause complications in men with common genitourinary diseases. Study included 85 men with genitourinary tract carcinoma (n = 35), urolithiasis (n = 36), and BPH (benign prostatic hyperplasia) (n = 14). The control group consisted of 50 healthy men. FVU (first void urine) samples were examined by PCR for the presence of urogenital mycoplasmas DNA. Occurrence of urogenital mycoplasmas was significantly more common in study group compared with control 24/85 (28.2%) and 7/50 (14%), respectively (p = 0.05). In men with urolithiasis, positive results for mycoplasmas DNA were significantly more frequent than in control: 33.3% vs. 14% (p < 0.05). In patients with urolithiasis DNA of U. urealyticum was most often found, while in the genitourinary carcinoma and BPH groups, U. parvum was more frequent. Incidence of M. fermentans was also significantly higher in the urolithiasis group vs. control (p = 0.03). A higher percentage of positive results for urogenital mycoplasma DNA in study group has been found. Further studies are required to confirm the role of urogenital mycoplasmas in the development of infectious complications among patients with urolithiasis, genitourinary carcinoma, and BPH.

Large-scale randomized evidence: Trials and meta-analyses of trials

2020 ◽  
pp. 51-66
Author(s):  
Colin Baigent ◽  
Richard Peto ◽  
Richard Gray ◽  
Natalie Staplin ◽  
Sarah Parish ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Large Scale ◽  
Meta Analysis ◽  
False Negative ◽  
Premature Deaths ◽  
Common Causes ◽  
The Common ◽  
Meta Analyses ◽  
Positive Results

Clinical trials generally need to be able to detect or to refute realistically moderate (but still worthwhile) differences between treatments in long-term disease outcome. Large-scale randomized evidence should be able to detect such effects, but medium-sized trials or medium-sized meta-analyses can, and often do, yield false-negative or exaggeratedly positive results. Hundreds of thousands of premature deaths each year could be avoided by seeking appropriately large-scale randomized evidence about various widely practicable treatments for the common causes of death, and by disseminating this evidence appropriately. This chapter takes a look at the use of large-scale randomized evidence—produced from trials and meta-analysis of trials—and how this data should be handled in order to produce accurate result.

scholarly journals Social marketing interventions to promote physical activity among 60 years and older: a systematic review of the literature

2020 ◽  
Author(s):  
Luc Goethals ◽  
Nathalie Barth ◽  
David Hupin ◽  
Michael S. Mulvey ◽  
Frederic Roche ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Social Marketing ◽  
Program Effectiveness ◽  
Scientific Evidence ◽  
Target Population ◽  
Activity Level ◽  
Public Health Professionals ◽  
The Common ◽  
Positive Results

Abstract Background: Falls are a significant source of morbidity in people aged 65 and over, affecting one in three people in this age group. The scientific evidence indicates that physical activity is the most effective method for preventing falls among seniors. Although public health professionals often use social marketing to design and plan successful interventions, its use to promote physical activity and prevent falls among older people remains low. This article aims to provide a new systematic literature review of social marketing interventions promoting physical activity and targeting people aged 60 and over.Methods: Following CRD’s guidance and PRISMA guidelines, we searched between January 2008 and July 2019 for relevant articles in five primary databases using predefined search and inclusion criteria. Two independent reviewers analysed the selected articles to identify evidence of the seven social marketing benchmark criteria, defined by experts in the field as the common elements that contribute to social marketing success.Results: The final review included nine studies. Of the studies selected, three specifically targeted over 60-year-olds, whereas the others segmented the population into several age-based subcategories, including over 60-year-olds. Eight studies highlighted positive results for the participants with an increase in participation or an increase in physical activity level. None of the nine studies selected for this systematic review implemented the entire social marketing approach.Conclusion: Few published interventions use the seven social marketing criteria. Further research is required to encourage uptake and inclusion in successful social marketing interventions to increase program effectiveness in this target population.

scholarly journals "All is not lost" - Rethinking the nature of memory and the self in dementia

2019 ◽  
Author(s):  
Cherie Strikwerda-Brown ◽  
Matthew D. Grilli ◽  
Jessica R. Andrews-Hanna ◽  
Muireann Irish
Keyword(s):  
Neurodegenerative Disorders ◽  
Sense Of Self ◽  
The Self ◽  
Dynamic Nature ◽  
Everyday Functioning ◽  
Common Assumption ◽  
Loss Of Self ◽  
Common Misconception ◽  
The Common ◽  
New Framework

Memory and the self have long been considered intertwined, leading to the common assumption that without memory, there can be no self. This line of reasoning has led to the common misconception that a loss of memory in dementia necessarily results in a diminished sense of self. Here, we challenge this assumption by considering discrete facets of the self, and their relative profiles of loss and sparing, across three neurodegenerative disorders: Alzheimer’s disease, semantic dementia, and frontotemporal dementia. By exploring canonical expressions of the self across past, present, and future contexts in dementia, relative to healthy ageing, we reconcile previous accounts of loss of self in dementia, and propose a new framework for understanding and managing everyday functioning and behaviour. Notably, our approach highlights the multifaceted and dynamic nature in which the self is likely to change in healthy and pathological ageing, with important ramifications for development of person-centred care. Collectively, we aim to promote a cohesive sense of self in dementia across past, present, and future contexts, by demonstrating how, ultimately, ‘All is not lost’.

scholarly journals EP.FRI.849 Quality Improvement Project for Management of Unstable Ankle Fracture in Scunthorpe General Hospital

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Jian Zi Poh
Keyword(s):  
Ankle Fracture ◽  
Ankle Fractures ◽  
Prospective Data ◽  
Improvement Project ◽  
Good Communication ◽  
Clinical Notes ◽  
Root Cause ◽  
Fracture Management ◽  
Skin Integrity ◽  
Change In Practice

Abstract Introduction In SGH, little emphasis is placed on ankle fracture as compared to hip fracture. Hence, an audit was done to compare management of unstable ankle fracture in adherence to BOAST guidelines. It was found out that few aspects of management in A&E were inadequate. Analyzing the root cause of non-adherence to guideline can lead to better care for these patients. Aim Primary aim is to ensure that ankle fractures are treated effectively in line with BOAST guidelines. Secondary aim is to ensure that ankle fractures are treated in a timely manner. Change in practice Discussion was held between Orthopaedic consultant and A&E consultant. Firstly, poster displaying algorithm for ankle fracture management displayed in A&E. Secondly, Orthopaedics doctor would come to A&E to reduce fracture after first failed attempt. Methods Prospective data is collected. Patients with unstable ankle fracture who are admitted in SGH are assessed in regards to BOAST guidelines via WebV, PACS and clinical notes. Results Major improvement is seen in different aspects. The documentation of neurovascular assessment and skin integrity in A&E department is improved by 57%. Additional radiographs of the whole leg when clinical examination suggests a more proximal fracture of the fibula (Maisonneuve injury) was performed in 60% more patients as compared to previously. Adequacy of reduction done in A&E is improved by 25%. Conclusion Small changes can make a big difference. Good communication and teamwork between different departments is the best way to provide better care for patients.

scholarly journals Wykorzystanie swobód wspólnego rynku Unii Europejskiej przez młodych Polaków

2010 ◽  
Vol 6 ◽  
pp. 524-531
Author(s):  
Krystian Sowislok
Keyword(s):  
Young People ◽  
Secondary School ◽  
Secondary School Students ◽  
Internal Market ◽  
Further Education ◽  
Living Standards ◽  
School Students ◽  
The Common ◽  
Work Abroad ◽  
The Eu

The internal market of the EU comprises an area with no internal borders, in which a free flow of persons, goods, services and capital has been introduced. Among the main aims of creating the common market were: lowering of prices and their turnover, an increase in availability and competitiveness of services and making unrestricted movement within the union possible. This was aimed to enhance living standards among citizens of member states.Polish citizens are now enjoying these freedoms. As a teacher of entrepreneurship, I am interested mainly in entrepreneurship among young people, and in this particular case, in the way they are taking advantage of the opportunities created by Poland’s accession to the EU. In order to become better acquainted with the opinions of young Poles’ on the above mentioned topics, a survey was conducted among my secondary school students. As a result, I learned about the plans of secondary school final year students concerning further education or the search for employment, including the possibility of finding work abroad. Similar research was conducted in 2006 and 2007, presenting the opportunity to compare the results. The most im­portant conclusions resulting from the comparison are the following: the students are closely following the economic situation of Poland and the EU, and are adapting their plans according to the changes currently taking place.

scholarly journals Special Features of the Spiritual Leadership of St. Theofan the Recluse

2021 ◽  
pp. 61-76
Author(s):  
Михаил Степанович Иванов
Keyword(s):  
Spiritual Leadership ◽  
Fundamental Principle ◽  
Common Misconception ◽  
The World ◽  
Spiritual Tradition ◽  
The Common ◽  
Historical Basis ◽  
The Universe ◽  
The Church ◽  
True Relationship

Статья посвящена специфике аскетической практики известного русского подвижника благочестия епископа Феофана (Говорова). В начале статьи даётся историческое обоснование диалектическому противостоянию между миром и монастырём, которое разрешается в одну из благодатных форм христианской жизни. Далее проводится различение между понятиями «мир Божий», как сотворённая Богом Вселенная, и «мир греха», как господство зла, вторгшегося в окружающий мир по вине человека. Это различение помогает снять распространённое заблуждение относительно монашеского отречения от мира и выявить подлинные отношения, которые рождает человек, ставший на монашеский путь духовного возрождения. Развивая эти отношения, монах входит в целостное, органическое, духовное и благодатное единство с миром Божиим, что позволяет ему установить основанное на любви ко всему божественному творению подлинное отношение ко всем обитателям тварного мира. На этом основополагающем принципе монашеской жизни, как пишет епископ Феофан, Затворник Вышенский, как раз и нужно строить архипастырское руководство всеми членами Церкви - не только монашеским братством, но и мирскими людьми, тем самым продолжая духовную традицию русского старчества. The article is devoted to the specifics of the ascetic practice of the famous Russian devotee of piety, Bishop Theofan (Govorov). At the beginning of the article, a historical basis is given for the dialectical confrontation between the world and the monastery, which is resolved into one of the blessed forms of Christian life. Further, a distinction is made between the concepts of «the world of God», as the universe created by God, and the «world of sin», as the rule of evil that invaded the surrounding world through the fault of man. This distinction helps to remove the common misconception about monastic renunciation of the world and to reveal the true relationship that a person gives birth to when he embarks on the monastic path of spiritual rebirth. Developing these relationships, the monk enters into an integral, organic, spiritual and grace-filled unity with the world of God, which allows him to establish a genuine relationship based on love for the entire divine creation with all the inhabitants of the created world. On this fundamental principle of monastic life, as Bishop Theofan, the Recluse of Vyshensky writes, it is precisely necessary to build the archpastoral leadership of all members of the Church - not only the monastic brotherhood, but also the secular people, thereby continuing the spiritual tradition of the Russian eldership.

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