scholarly journals EP26 Do early synovitis clinics triage patients with RA affectively?

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Natasha Cleaton ◽  
Tahir Khan ◽  
Sabrina R Raizada
Keyword(s):  
Inflammatory Arthritis ◽  
Quality Standards ◽  
Service Evaluation ◽  
Palindromic Rheumatism ◽  
Care Services ◽  
Soft Tissue Rheumatism ◽  
Guidance Needs ◽  
Set Up ◽  
The Uk ◽  
Early Synovitis

Abstract Background In 2013, the UK National Institute for Health and Care Excellence (NICE) published quality standards for the treatment of rheumatoid arthritis (RA); emphasising the importance of early diagnosis and treatment of RA and these were updated in 2018. NICE quality statement 1 recommends that patients with a suspected inflammatory arthritis are referred to a rheumatology service within 3 working days of presentation. Quality statement 2 recommends that these patients are assessed in a rheumatology service within 3 weeks of referral. In view of these quality standards and the benefit of treating patients with RA, early Early Synovitis Clinics (ESC) were set up at the Royal Wolverhampton Trust (RWT). GPs were invited to refer patients electronically to the ESC if they had a swollen joint, positive antibodies (RhF or anti CCP) and if they suspected RA. All referrals to the ESC and all other new patient referrals were triaged by a consultant rheumatologist to determine if they were suitable for the ESC. Methods This is a retrospective service evaluation based on new patients seen in the ESC at the RWT over a 12month period, January to December 2018. The electronic records of patients seen in the ESC were retrospectively accessed and data was collected including gender, age and diagnosis. Results 284 new patients attended the ESC in 2018; 186 (65.49%) were female, 98 (34.51%) were male. The patients age ranged 18-95years with a mean age of 58.75. 72 patients (25.4%) were classified as having RA. 135 patients (47.54%) were classified as having inflammatory arthritis, diagnoses within the inflammatory arthritis group were: psoriatic arthritis, crystal arthritis, Palindromic rheumatism, polymyalgia rheumatica, Reactive arthritis and undifferentiated inflammatory arthritis. 84 patients (29.58%) patients received a diagnosis of osteoarthritis, 12 patients (4.22%) were classified as having a connective tissue disease, 44 (15.49%) of the 284 patients were diagnosed with a condition classified in the category of soft tissue rheumatism. Conclusion This analysis found while 47.54% of patients referred to the ESC at RWT received a diagnosis categorised as inflammatory arthritis, only 25.4% of patients had RA. This compares to the recent National Early Inflammatory arthritis audit where only 35% of patients seen in rheumatology clinics with suspected inflammatory arthritis had a subsequent confirmed diagnosis of an inflammatory arthritis. This suggests more guidance needs to be provided to primary care services regarding the indications for referral to the ESC in order to provide appropriate capacity for patients with RA to be reviewed and treated quickly. Disclosures N. Cleaton: None. T. Khan: None. S.R. Raizada: None.

scholarly journals A local dental network approach to COVID-19 pandemic: innovation through collaboration

2020 ◽  
pp. 205016842098097
Author(s):  
Simon Hearnshaw ◽  
Stefan Serban ◽  
Imran Suida ◽  
Mohammed Ajmal Zubair ◽  
Deksha Jaswal ◽  
...  
Keyword(s):  
Geographical Area ◽  
Critical Evaluation ◽  
Integrated Network ◽  
Policy Makers ◽  
Care Services ◽  
Large Geographical Area ◽  
Urgent Patient ◽  
Collaborative Structures ◽  
Set Up ◽  
The Uk

The coronavirus pandemic has had significant effects on individuals, healthcare systems and governments. In the UK, whilst routine dentistry was suspended, an urgent dental care system was required to support urgent patient need. Using an adapted model of Donabedians’ framework, a critical evaluation of the services developed and implemented is provided and the various innovative approaches involved in this work are discussed. The three domains of the framework are structure, process and outcome. Structure: We present the principles for selecting and initiating hubs, the integration with secondary care services and the supply of personal protective equipment. Process: The main elements are communication, the development of referral processes to manage complex cases and data collection. Outcome: Through work with local dental stakeholders, 23 clusters and 36 hubs were set up covering a large geographical area. The integrated network of hubs and clusters has strengthened collaboration between providers and policy makers. Various leadership approaches facilitated the readiness for the transition to recovery. The new local collaborative structures could be used to support local programmes such as flexible commissioning, peer-led learning and integration with primary care networks.

scholarly journals A Multidisciplinary NHS COVID-19 Service to Manage Post-COVID-19 Syndrome in the Community

2021 ◽  
Vol 12 ◽  
pp. 215013272110109
Author(s):  
Amy Parkin ◽  
Jennifer Davison ◽  
Rachel Tarrant ◽  
Denise Ross ◽  
Stephen Halpin ◽  
...  
Keyword(s):  
Primary Care ◽  
Psychological Symptoms ◽  
Service Level ◽  
Community Healthcare ◽  
Skill Sets ◽  
Care Services ◽  
Primary Care Services ◽  
Level 3 ◽  
Set Up ◽  
The Uk

The National Institute for Health and Care Excellence (NICE) describe “ post COVID-19 syndrome” or “Long COVID” as a set of persistent physical, cognitive and/or psychological symptoms that continue for more than 12 weeks after illness and which are not explained by an alternative diagnosis. These symptoms are experienced not only by patients discharged from hospital but also those in the community who did not require inpatient care. To support the recovery of this group of people, a unique integrated rehabilitation pathway was developed following extensive service evaluations by Leeds Primary Care Services, Leeds Community Healthcare NHS Trust and Leeds Teaching Hospital NHS Trust. The pathway aligns itself to the NHS England “Five-point plan” to embed post-COVID-19 syndrome assessment clinics across England, supporting the comprehensive medical assessment and rehabilitation intervention for patients in the community. The pathway was first of its kind to be set up in the UK and comprises of a three-tier service model (level 1: specialist MDT service, level 2: community therapy teams and level 3: self-management). The MDT service brings together various disciplines with specialist skill sets to provide targeted individualized interventions using a specific core set of outcome measures including C19-YRS (Yorkshire Rehabilitation Scale). Community and primary care teams worldwide need such an integrated multidisciplinary comprehensive model of care to deal with the growing number of cases of post-COVID-19 syndrome effectively and in a timely manner.

scholarly journals The impact of COVID‐19 on anaesthesia and critical care services in the UK: a serial service evaluation*

Anaesthesia ◽  
2021 ◽  
Author(s):  
E. Kursumovic ◽  
T. M. Cook ◽  
C. Vindrola‐Padros ◽  
A. D. Kane ◽  
R. A. Armstrong ◽  
...  
Keyword(s):  
Critical Care ◽  
Service Evaluation ◽  
Care Services ◽  
The Uk ◽  
The Impact

Ethnic Differences in Self-Poisoning Across South London

Crisis ◽  
2014 ◽  
Vol 35 (4) ◽  
pp. 268-272
Author(s):  
Sean Cross ◽  
Dinesh Bhugra ◽  
Paul I. Dargan ◽  
David M. Wood ◽  
Shaun L. Greene ◽  
...  
Keyword(s):  
Black Women ◽  
Data Collection ◽  
White Women ◽  
Population Based ◽  
Care Services ◽  
Self Harm ◽  
Managing Risk ◽  
The Uk ◽  
Incident Cases ◽  
Minority Ethnic

Background: Self-poisoning (overdose) is the commonest form of self-harm cases presenting to acute secondary care services in the UK, where there has been limited investigation of self-harm in black and minority ethnic communities. London has the UK’s most ethnically diverse areas but presents challenges in resident-based data collection due to the large number of hospitals. Aims: To investigate the rates and characteristics of self-poisoning presentations in two central London boroughs. Method: All incident cases of self-poisoning presentations of residents of Lambeth and Southwark were identified over a 12-month period through comprehensive acute and mental health trust data collection systems at multiple hospitals. Analysis was done using STATA 12.1. Results: A rate of 121.4/100,000 was recorded across a population of more than half a million residents. Women exceeded men in all measured ethnic groups. Black women presented 1.5 times more than white women. Gender ratios within ethnicities were marked. Among those aged younger than 24 years, black women were almost 7 times more likely to present than black men were. Conclusion: Self-poisoning is the commonest form of self-harm presentation to UK hospitals but population-based rates are rare. These results have implications for formulating and managing risk in clinical services for both minority ethnic women and men.

THE PHYSICOCHEMICAL PROPERTIES OF GLUCOMANNAN FLOUR OF AMORPHOPHALLUS PAEONIIFOLIUS CULTIVALED IN THUA THIEN HUE

2014 ◽  
pp. 87-92
Author(s):  
Thi Hoai Nguyen ◽  
Thi Van Thi Tran ◽  
Trung Hieu Le ◽  
Thi Mai Huong Vo
Keyword(s):  
Physical Chemistry ◽  
Physicochemical Properties ◽  
Key Words ◽  
Quality Standards ◽  
Spectroscopic Methods ◽  
Research Results ◽  
Beneficial Effects ◽  
Laser Analysis ◽  
Set Up

Background: There are many beneficial effects such as reducing the risk of obesity, diabetes, hyperlipidemia and hypercholesterolemia from Amorphophallus sp. This reports are research results of physicochemical properties of glucomannan flour from tubers of Amorphophallus paeoniifolius cultivated in Thua Thien Hue. Materials: Glucomannan flour from tubers of Amorphophallus paeoniifolius (Dennst) Nicolson – Araceae cultivated in Thua Thien Hue. Method: Identify the quantity and physicochemical properties by many methods such as using enzymes, chemistry, physical chemistry, spectroscopic methods, laser analysis. Results: Identified starch and glucomannan quantity, physicochemical properties and indicators of microbiological of glucomannan flour. Conclusion: From the achieved results set up quality standards of glucomannan flour from tubers of Amorphophallus paeoniifolius cultivated in Thua Thien Hue. Key words: Glucomannan, starch, β-amylase.

What Advantages Can Be Expected from the Acceptance of Variable Quality Standards for Sewage Treatment Effluents?

1988 ◽  
Vol 20 (4-5) ◽  
pp. 249-251
Author(s):  
Jacques Bernard
Keyword(s):  
Water Quality ◽  
Sewage Treatment ◽  
Quality Standards ◽  
Quality Level ◽  
Environment Protection ◽  
Economical Benefit ◽  
Quality Objective ◽  
Set Up ◽  
Variable Quality

The flow and the water quality of the rivers vary throughout the year. Very frequently the environment protection authorities set up a quality objective for the river water and this mini mum quality level is constant. So, it wou1d seem possible to accept variable quality standards for plant effluents. A first approach of the problem,by a small French task group,based on three actual cases leads to the provisory conclusion that such a regulation is suitable and presents economical benefit only in some very limit ed cases.

Volunteering in hospice and palliative care in the United Kingdom

2018 ◽  
Author(s):  
Ros Scott
Keyword(s):  
Palliative Care ◽  
United Kingdom ◽  
Care Services ◽  
The United Kingdom ◽  
Strategic Direction ◽  
Palliative Care Services ◽  
History Of ◽  
The Uk ◽  
Hospice And Palliative Care ◽  
Changing Role

This chapter explores the history of volunteers in the founding and development of United Kingdom (UK) hospice services. It considers the changing role and influences of volunteering on services at different stages of development. Evidence suggests that voluntary sector hospice and palliative care services are dependent on volunteers for the range and quality of services delivered. Within such services, volunteer trustees carry significant responsibility for the strategic direction of the organiszation. Others are engaged in diverse roles ranging from the direct support of patient and families to public education and fundraising. The scope of these different roles is explored before considering the range of management models and approaches to training. This chapter also considers the direct and indirect impact on volunteering of changing palliative care, societal, political, and legislative contexts. It concludes by exploring how and why the sector is changing in the UK and considering the growing autonomy of volunteers within the sector.

scholarly journals Collateral impact of COVID-19: why should children continue to suffer?

2021 ◽  
Author(s):  
Prasad Nagakumar ◽  
Ceri-Louise Chadwick ◽  
Andrew Bush ◽  
Atul Gupta
Keyword(s):  
Young People ◽  
Large Scale ◽  
Hospital Admissions ◽  
Severe Disease ◽  
Children And Young People ◽  
Collateral Effects ◽  
Rsv Infection ◽  
Syncytial Virus ◽  
Set Up ◽  
The Uk

AbstractThe COVID-19 pandemic caused by SARS-COV-2 virus fortunately resulted in few children suffering from severe disease. However, the collateral effects on the COVID-19 pandemic appear to have had significant detrimental effects on children affected and young people. There are also some positive impacts in the form of reduced prevalence of viral bronchiolitis. The new strain of SARS-COV-2 identified recently in the UK appears to have increased transmissibility to children. However, there are no large vaccine trials set up in children to evaluate safety and efficacy. In this short communication, we review the collateral effects of COVID-19 pandemic in children and young people. We highlight the need for urgent strategies to mitigate the risks to children due to the COVID-19 pandemic. What is Known:• Children and young people account for <2% of all COVID-19 hospital admissions• The collateral impact of COVID-19 pandemic on children and young people is devastating• Significant reduction in influenza and respiratory syncytial virus (RSV) infection in the southern hemisphere What is New:• The public health measures to reduce COVID-19 infection may have also resulted in near elimination of influenza and RSV infections across the globe• A COVID-19 vaccine has been licensed for adults. However, large scale vaccine studies are yet to be initiated although there is emerging evidence of the new SARS-COV-2 strain spreading more rapidly though young people.• Children and young people continue to bear the collateral effects of COVID-19 pandemic

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