Les besoins de la clientèle psychiatrique en préventions secondaire et tertiaire: Le point de vue d'un clinicien

1981 ◽  
Vol 26 (5) ◽  
pp. 353-356
Author(s):  
Harry Grantham
Keyword(s):  
Health Services ◽  
Critical Points ◽  
Multidisciplinary Approach ◽  
Clinical Decision ◽  
Tertiary Prevention ◽  
Clinical Perspective ◽  
Points Of View

The concept of need, discussed from many points of view, remains necessary to the planning of health services. The author tries to define psychiatric needs in a clinical perspective, limiting his approach to secondary and tertiary prevention. The critical points supporting the clinical decision permit the choice of fundamental criteria which allow one to identify and describe the psychiatric needs of a given population. Using this methodology a typology of those needs is formulated in a way which is acceptable in a multidisciplinary approach.

scholarly journals An evidence-based approach to routine outcome assessment

2012 ◽  
Vol 18 (3) ◽  
pp. 180-182 ◽  
Author(s):  
Mike Slade
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Clinical Decision Making ◽  
Academic Discipline ◽  
Community Mental Health Services ◽  
Clinical Decision ◽  
Successful Implementation ◽  
Frontline Workers ◽  
Routine Outcome Assessment

SummaryRoutine use of Health of the Nation Outcome Scales (HoNOS) has not produced the anticipated benefits for people using mental health services. Four HoNOS-specific reasons for this are: low relevance to clinical decision-making; not reflecting service user priorities; being staff-rated; and having a focus on deficits. More generally, the imposition of a centrally chosen measure on the mental health system leads to a clash of cultures, since frontline workers do not need a standardised measure to treat individuals. A better approach might be to use research from the emerging academic discipline of implementation science to inform the routine use of a standardised measure that is chosen by the people who will use it and hence is more concordant with existing clinical processes. This is illustrated using a case study of successful implementation of the Camberwell Assessment of Need (CAN) in community mental health services across Ontario, Canada.

A Case for the Computer: A History and a Projection

1972 ◽  
Vol 2 (4) ◽  
pp. 531-536
Author(s):  
E. G. Knox
Keyword(s):  
Clinical Trials ◽  
Numerical Methods ◽  
Health Services ◽  
Randomized Clinical Trials ◽  
Current Level ◽  
Computers In Medicine ◽  
Measuring Techniques ◽  
Points Of View

The growth of numerical methods in medicine is traced in this article. Many developments have been both profitable and acceptable but others have resulted in emotive confrontations with traditional points of view. The historic sequence of the latter group begins with the application of randomized clinical trials, passes through the development of error–measuring techniques, and attains the current level of turmoil arising from proposals for regular numerate studies of the effectiveness of health services organizations and systems of delivery of all kinds. Computers arrived on the scene during this period of adjustment and their own emotion–provoking properties have compounded the difficulties, first by facilitating these still controversial techniques, second by threatening to replace medical functions. In fact this is probably not a serious immediate threat and the main applications of computers in medicine, certainly in the short and intermediate terms, are to those functions which were sufficiently formalized to be delegated, and to new functions, previously not carried out at all in any explicit matter, especially in the area of simulation.

Consumer and Carer Participation in Mental Health Services

2003 ◽  
Vol 11 (2) ◽  
pp. 180-184 ◽  
Author(s):  
Chris Lloyd ◽  
Robert King
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Professional Staff ◽  
Consumer Participation ◽  
Service Development ◽  
Health Strategy ◽  
National Mental Health

Objective: To clarify the meaning of consumer and carer participation in mental health services, to identify reasons why consumer participation is important both to consumers and to services, and to discuss barriers to participation and ways of overcoming these barriers. Conclusions: Consumer and carer participation has been promoted as part of the National Mental Health Strategy and has the potential to empower consumers and their carers and to improve mental health services. Barriers to consumer participation include professional staff attitudes and resource allocation. Guidelines are provided to assist services to address these barriers and increase the level of consumer and carer participation in both clinical decision-making and service development.

scholarly journals The importance of logic planning in case of IT and innovation projects

2009 ◽  
Vol 3 (5-6) ◽  
pp. 15-20 ◽  
Author(s):  
Judit Kiss ◽  
ZsoltT. Kosztyán
Keyword(s):  
Project Management ◽  
Critical Points ◽  
Project Planning ◽  
Planning Method ◽  
Stochastic Network ◽  
Management Tools ◽  
Practical Applications ◽  
Innovation Projects ◽  
Points Of View ◽  
Feasible Solutions

In case of using methodology of project planning, in the first step we had to create a “good” logic network. We had to determine the successors and predecessors of the tasks. However, usually successors and predecessors proceed from the technology, sometimes (especially in case of IT and innovation projects) these relations between tasks are not explicit. In case of projects, especially IT and innovation projects, one of the most critical points of view is the phase of logic planning. However, it is a very important phase, only slightly supported by any kind of Project Management tools. Our goal was to support the logic planning phase. In our paper a new planning method, namely SNPM (Stochastic Network Planning Method) is introduced through some practical applications. SNPM can determine all feasible solutions with the help of stochastic variables and can also take into consideration all possible precedents. The parameters of logic relations can be changed if the impacts on the project change. With this method the most probable project scenario can be determined taking into account costs and resource demands.

scholarly journals Decentralized Digital Health Services Caught Between the Pressure for Innovation and the Burden of Regulations

2021 ◽  
Author(s):  
Lea Meier ◽  
Kevin Tippenhauer ◽  
Murat Sariyar
Keyword(s):  
Decision Support ◽  
Health Services ◽  
Digital Health ◽  
Clinical Decision Support Systems ◽  
Clinical Decision ◽  
Support Service ◽  
Third Party ◽  
Trade Offs ◽  
External Software ◽  
Multiple Challenges

Multiple challenges await third-party digital health services when trying to enter the health market. Prominent examples of such services are clinical decision support systems provided as external software. Uncertainty about their challenges, technical as well as legal, pose serious hurdles for many innovations to be adopted early on. There are many options and trade-offs to provide digital healthcare solutions as a third-party service. This paper discusses them by referring to a pharmacogenetic decision support service. By providing best-practices, scenario descriptions and templates designed for third-party services with respect to legal and technical issues, obstacles and uncertainties can be reduced, which will have an impact on better diagnoses and treatments in the healthcare system.

scholarly journals Cultural Landscape Assessment: The Rural Architectural Heritage (13th–17th Centuries) in Mediterranean Valleys of Marina Alta, Spain

Buildings ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. 140
Author(s):  
Alba Soler-Estrela
Keyword(s):  
Physical Environment ◽  
Cultural Landscape ◽  
Multidisciplinary Approach ◽  
Architectural Heritage ◽  
13Th Century ◽  
Different Types ◽  
Archival Documents ◽  
Exceptional Value ◽  
Points Of View ◽  
Specific Contribution

Europe’s cultural heritage is a rich and diverse legacy that shows evolution through many centuries of history. The Mediterranean landscape is the result of a long process of human activity in the physical environment, which makes the cultural landscape concept remarkable. Despite its growing interest, most cases are still exposed to different types of threats that can compromise their permanence. Given cultural variety, its consideration requires a multidisciplinary approach to provide scientific knowledge and to assess its values from different points of view (e.g., territorial, historical, technical, artistic, etc.). The valleys of Marina Alta are a most interesting example of different periods of history, from prehistory to recent rural life. Mountain conditions have favoured the survival of rural heritage, which is not that affected by the threat of better communicated areas and can be consider a place of exceptional value. In this context, our paper focuses on houses and hamlets of a Muslim origin that date back to at least the 13th century according to archival documents. Scattered in valleys, they are essential to understand historic transformations. They are directly related to the natural environment, are located in and have adapted to mountains to obtain small farming areas with small irrigated areas. Given their present state of ruin, an architectural assessment is needed to recognise the values and threats, and to make proposals for their conservation as a specific contribution to be considered part of an interdisciplinary vision.

scholarly journals A qualitative study of experiences of NHS mental healthcare workers during the Covid-19 pandemic

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elisa Liberati ◽  
Natalie Richards ◽  
Janet Willars ◽  
David Scott ◽  
Nicola Boydell ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Healthcare Workers ◽  
Clinical Decision Making ◽  
Health Workers ◽  
Comparative Method ◽  
Mental Healthcare ◽  
Community Mental Health Services ◽  
Clinical Decision

Abstract Background The Covid-19 pandemic has imposed extraordinary strains on healthcare workers. But, in contrast with acute settings, relatively little attention has been given to those who work in mental health settings. We aimed to characterise the experiences of those working in English NHS secondary mental health services during the first wave of the pandemic. Methods The design was a qualitative interview-based study. We conducted semi-structured, remote (telephone or online) interviews with 35 members of staff from NHS secondary (inpatient and community) mental health services in England. Analysis was based on the constant comparative method. Results Participants reported wide-ranging changes in the organisation of secondary mental health care and the nature of work in response to the pandemic, including pausing of all services deemed to be “non-essential”, deployment of staff across services to new and unfamiliar roles, and moves to remote working. The quality of participants’ working life was impaired by increasing levels of daily challenge associated with trying to provide care in trying and constrained circumstances, the problems of forging new ways of working remotely, and constraints on ability to access informal support. Participants were confronted with difficult dilemmas relating to clinical decision-making, prioritisation of care, and compromises in ability to perform the therapeutic function of their roles. Other dilemmas centred on trying to balance the risks of controlling infection with the need for human contact. Many reported features of moral injury linked to their perceived failures in providing the quality or level of care that they felt service users needed. They sometimes sought to compensate for deficits in care through increased advocacy, taking on additional tasks, or making exceptions, but this led to further personal strain. Many experienced feelings of grief, helplessness, isolation, distress, and burnout. These problems were compounded by sometimes poor communication about service changes and by staff feeling that they could not take time off because of the potential impact on others. Some reported feeling poorly supported by organisations. Conclusions Mental health workers faced multiple adversities during the pandemic that were highly consequential for their wellbeing. These findings can help in identifying targets for support.

scholarly journals COVID-19-associated takotsubo cardiomyopathy

2020 ◽  
Vol 13 (12) ◽  
pp. e236811
Author(s):  
Joanne Michelle Dumlao Gomez ◽  
Gatha Nair ◽  
Prema Nanavaty ◽  
Anupama Rao ◽  
Karolina Marinescu ◽  
...  
Keyword(s):  
Takotsubo Cardiomyopathy ◽  
Multidisciplinary Approach ◽  
Clinical Decision Making ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Apical Ballooning ◽  
Clinical Decision ◽  
Left Ventricular ◽  
Apical Ballooning Syndrome ◽  
The Novel

The novel COVID-19 has had an unprecedented and devastating spread internationally. COVID-19 infection can lead to a number of cardiovascular sequelae, including heart failure, which may portend worse clinical outcomes. Here, we report a rare case of a 57-year-old woman who developed acute left ventricular systolic dysfunction with apical ballooning consistent with takotsubo cardiomyopathy (TCM), and mixed cardiogenic and septic shock in the setting of COVID-19 disease. We briefly review the pathophysiology and diagnosis of TCM (also described as apical ballooning syndrome and stress-induced cardiomyopathy). Additionally, this case highlights the importance of a multidisciplinary approach to clinical decision-making and resource allocation in diagnosis and management of critical illness in the setting of the ongoing international COVID-19 pandemic.

scholarly journals Local, Early, and Precise: Designing a Clinical Decision Support System for Child and Adolescent Mental Health Services

2020 ◽  
Vol 11 ◽  
Author(s):  
Thomas Brox Røst ◽  
Carolyn Clausen ◽  
Øystein Nytrø ◽  
Roman Koposov ◽  
Bennett Leventhal ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Clinical Decision ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Mental Health Disorders ◽  
Evidence Based ◽  
Health Disorders

Mental health disorders often develop during childhood and adolescence, causing long term and debilitating impacts at individual and societal levels. Local, early, and precise assessment and evidence-based treatment are key to achieve positive mental health outcomes and to avoid long-term care. Technological advancements, such as computerized Clinical Decision Support Systems (CDSSs), can support practitioners in providing evidence-based care. While previous studies have found CDSS implementation helps to improve aspects of medical care, evidence is limited on its use for child and adolescent mental health care. This paper presents challenges and opportunities for adapting CDSS design and implementation to child and adolescent mental health services (CAMHS). To highlight the complexity of incorporating CDSSs within local CAMHS, we have structured the paper around four components to consider before designing and implementing the CDSS: supporting collaboration among multiple stakeholders involved in care; optimally using health data; accounting for comorbidities; and addressing the temporality of patient care. The proposed perspective is presented within the context of the child and adolescent mental health services in Norway and an ongoing Norwegian innovative research project, the Individualized Digital DEcision Assist System (IDDEAS), for child and adolescent mental health disorders. Attention deficit hyperactivity disorder (ADHD) among children and adolescents serves as the case example. The integration of IDDEAS in Norway intends to yield significantly improved outcomes for children and adolescents with enduring mental health disorders, and ultimately serve as an educational opportunity for future international approaches to such CDSS design and implementation.

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