Testing for pharyngeal gonorrhoea in heterosexual men: should we revisit national guidelines?

2020 ◽  
pp. 095646242091344
Author(s):  
Melissa Dresser ◽  
Jane Hussey
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Persistent Infection ◽  
Service Evaluation ◽  
Heterosexual Men ◽  
National Guidelines ◽  
North East ◽  
The North ◽  
Current Guidelines

Pharyngeal testing for Neisseria gonorrhoeae (gonorrhoea) in heterosexual men is not currently recommended in UK guidelines; however, it was being undertaken in a service in the North East of England for those presenting with urethral infection or as contacts of gonorrhoea. This service evaluation was performed to see if this practice should continue, or cease in line with national recommendations. The results revealed that 10% of contacts were positive in the pharynx only. Had this test not been performed, it would have left these patients without any treatment, as the current guidelines now discourage epidemiological treatment of contacts. Twenty-seven per cent of all heterosexual men diagnosed with urethral infection also had oropharyngeal gonorrhoea, with implications for persistent infection, had testing not been performed followed by a test of cure.

Hangings attended by ambulance clinicians in the North East of England

2021 ◽  
Vol 6 (3) ◽  
pp. 49-57
Author(s):  
Gary Shaw ◽  
Lee Thompson ◽  
Graham McClelland
Keyword(s):  
Mental Health ◽  
Cardiac Arrest ◽  
Suicide Attempts ◽  
Service Evaluation ◽  
Health Issues ◽  
Hospital Data ◽  
North East ◽  
The North ◽  
Acute Hospitals ◽  
Future Work

Introduction: Suicide rates have risen in England over the last decade and hanging, a highly lethal method of suicide, has been the most common method. Previous work in this area identified a lack of literature discussing emergency medical services (EMS) attendance at hangings. This article aims to describe hangings attended by EMS in the North East of England in order to inform future work in this area.Methods: A retrospective service evaluation was conducted using existing data from a comprehensive pre-hospital trauma audit database to describe patients with hanging documented in their records who were attended by ambulance clinicians between 1 December 2018 and 31 November 2020.Results: Hanging was recorded in 604 incidents. Most cases (n = 579/604) involved adults (aged 18 years or older) with a median age of 35 years (IQR 27‐45 years), who were male (n = 410/579, 71%). Just over half (n = 341/579, 59%) of adult hangings resulted in cardiac arrest and of these, 10% (n = 33/341) were resuscitated and survived to hospital admission. Threatened and non-fatal hangings appear to have increased dramatically in the latter half of 2020. Previous suicide attempts and mental health issues were frequently reported across this population.Conclusion: Hangings are a method of suicide which frequently result in a cardiac arrest. In the North East of England the ambulance service attends approximately one hanging per day and one fatal hanging every two days. When fatal hangings were resuscitated, pre-hospital outcomes were similar to other causes of cardiac arrest, highlighting that despite the traumatic nature of these cases resuscitation is not futile. In order to better understand this patient group and improve care, pre-hospital data need to be linked to data from other services such as mental health services and acute hospitals.

scholarly journals Awareness of the cost of psychotropic medication among doctors: a service evaluation

2010 ◽  
Vol 34 (9) ◽  
pp. 364-366 ◽  
Author(s):  
Dhananjay Kumar Singh ◽  
Shakil Khawaja ◽  
Ishaq Pala ◽  
Jaleel Khaja ◽  
Ray Krishnanu ◽  
...  
Keyword(s):  
Cost Effective ◽  
Service Evaluation ◽  
Financial Resources ◽  
Clinical Implications ◽  
North East ◽  
The North ◽  
Old Age Psychiatry ◽  
Level Of Knowledge ◽  
The Cost ◽  
Structured Questionnaire

Aims and methodCost-effective prescribing is an increasingly important aspect of our practice. A service evaluation was carried out to assess the level of awareness and knowledge of different aspects of cost-effective prescribing among doctors working in the North East London Foundation Trust. A semi-structured questionnaire was used to benchmark knowledge against six standards.ResultsThe survey was completed by 71% of doctors working in adult or old age psychiatry. A total of 2% of doctors stated that they should always take into consideration the price of the drug when prescribing and only 5% of doctors claimed to know the price of medications they prescribe most frequently.Clinical implicationsStrategies to improve the poor level of knowledge and awareness in this area of clinical practice would be of benefit in making the best use of limited financial resources without any detriment to patient care.

scholarly journals The first 6 weeks – setting up a UK urgent dental care centre during the COVID-19 pandemic

2020 ◽  
Author(s):  
Emily Carter ◽  
Charlotte C Currie ◽  
Abisola Asuni ◽  
Rachel Goldsmith ◽  
Grace Toon ◽  
...  
Keyword(s):  
Dental Care ◽  
Care Service ◽  
Clinical Care ◽  
Service Evaluation ◽  
Urgent Care ◽  
List Type ◽  
Care Centre ◽  
North East ◽  
The North ◽  
Patient Pathways

AbstractIntroductionThe COVID-19 pandemic has posed many challenges, including provision of urgent dental care. This paper presents a prospective service evaluation during establishment of urgent dental care in the North-East of England over a six-week period.AimTo monitor patient volumes, demographics and outcomes at the North-East urgent dental care service and confirm appropriate care pathways.Main Outcome MethodsData were collected on key characteristics of patients accessing urgent care from 23rd March to 3rd May 2020. Analysis was with descriptive statistics.ResultsThere were 1746 patient triages, (1595 telephone and 151 face-to-face) resulting in 1322 clinical consultations. The most common diagnoses were: symptomatic irreversible pulpitis or apical periodontitis. 65% of clinical consultations resulted in extractions, 0.5% an aerosol generating procedure. Patients travelled 25km on average to access care, however this reduced as more urgent care centres were established. The majority of patients were asymptomatic of COVID-19 and to our knowledge no staff acquired infection due to occupational exposure.ConclusionThe urgent dental care centre effectively managed urgent and emergency dental care, with appropriate patient pathways established over the 6-week period. Dental preparedness for future pandemic crisis could be improved and informed by this data.Three In Brief PointsA summary is given of how urgent dental care was established in the North East of England during the COVID-19 pandemic which may help with future preparedness for pandemics.Aerosol generating procedures were almost always avoided in the delivery of urgent dental careA telephone triage system was effectively used to determine who needed clinical care, and to separate symptomatic, asymptomatic and shielding patients, with very few failures in triage noted.

A service evaluation of a dedicated pre-hospital cardiac arrest response unit in the North East of England

2016 ◽  
Vol 1 (2) ◽  
pp. 35-41 ◽  
Author(s):  
Graham McClelland ◽  
Paul Younger ◽  
Daniel Haworth ◽  
Amy Gospel ◽  
Paul Aitken-Fell
Keyword(s):  
Cardiac Arrest ◽  
Service Evaluation ◽  
Response Unit ◽  
North East ◽  
The North ◽  
Hospital Cardiac Arrest

Antenatal hepatitis B screening in Nigeria: A comparative analysis with syphilis and HIV

2021 ◽  
pp. 095646242110359
Author(s):  
Babayemi O Olakunde ◽  
Daniel A Adeyinka ◽  
Chinwendu D Ndukwe ◽  
Tolulope T Oladele ◽  
Hidayat B Yahaya ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Pregnant Women ◽  
Health Sector ◽  
Central Zone ◽  
Screening Rate ◽  
The South ◽  
National Guidelines ◽  
North East ◽  
The North ◽  
Hbv Screening

Nigeria has adopted routine screening of pregnant women for hepatitis B virus (HBV) as part of the interventions to eliminate its vertical transmission. However, there is a dearth of evidence on the coverage of routine antenatal HBV screening as recommended in the national guidelines. This study examined the antenatal HBV screening rate and the positivity rate compared with syphilis and HIV. We conducted a descriptive analysis of the 2019 national HIV/AIDS health sector data. The study included approximately 2.8 million pregnant women who received antenatal care (ANC) in over 6000 health facilities providing prevention of mother-to-child transmission of HIV services in Nigeria. Of the ANC clients, 0.2 million (7.2%) were screened for HBV. At the zonal level, the South West had the highest HBV screening rate (19%), while the lowest rate was in the North East (2.5%). The percentage of pregnant women screened for HBV was lower than those screened for syphilis (16.3%) and HIV (90.3%). Among those screened for HBV, the positivity rate was 5%. The HBV positivity rate ranged from 8.5% in the North Central zone to 1.3% in the South East zone. The positivity rates for syphilis and HIV were 0.4% and 0.5%, respectively. Our results indicate a low antenatal HBV screening rate and a wide disparity compared with HIV and syphilis. This finding highlights the need to understand and address the barriers affecting routine antenatal HBV screening and to strengthen the integration of HBV services into the HIV program in Nigeria.

How well do children in the North East of England function after a crisis: a service evaluation

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Emily Staite ◽  
Lynne Howey ◽  
Clare Anderson ◽  
Paula Maddison
Keyword(s):  
Mental Health ◽  
Young People ◽  
Health Services ◽  
Service Evaluation ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
Content Type ◽  
North East ◽  
The North ◽  
The Uk

Purpose Data shows that there is an increasing number of young people in the UK needing access to mental health services, including crisis teams. This need has been exacerbated by the current global pandemic. There is mixed evidence for the effectiveness of crisis teams in improving adult functioning, and none, to the authors’ knowledge, that empirically examines the functioning of young people following intervention from child and adolescent mental health services (CAMHS) crisis teams in the UK. Therefore, the purpose of this paper is to use CAMHS Crisis Team data, from an NHS trust that supports 1.4 million people in the North East of England, to examine a young person's functioning following a crisis. Design/methodology/approach This service evaluation compared functioning, as measured by the Outcome Rating Scale (ORS), pre- and post-treatment for young people accessing the CAMHS Crisis Team between December 2018 and December 2019. Findings There were 109 participants included in the analysis. ORS scores were significantly higher at the end of treatment (t(108) = −4.2046, p < 0.001) with a small effect size (d = −0.36). Sixteen (15%) patients exhibited significant and reliable change (i.e. functioning improved). A further four (4%) patients exhibited no change (i.e. functioning did not deteriorate despite being in crisis). No patients significantly deteriorated in functioning after accessing the crisis service. Practical implications Despite a possibly overly conservative analysis, 15% of patients not only significantly improved functioning but were able to return to a “healthy” level of functioning after a mental health crisis following intervention from a CAMHS Crisis Team. Intervention(s) from a CAMHS Crisis Team are also stabilising as some young people’s functioning did not deteriorate following a mental health crisis. However, improvements also need to be made to increase the number of patients whose functioning did not significantly improve following intervention from a CAMHS Crisis Team. Originality/value This paper evaluates a young person’s functioning following a mental health crisis and intervention from a CAMHS Crisis Team in the North East of England.

scholarly journals How well do children in the North East of England function after a mental health crisis during the COVID-19 pandemic: A service evaluation

2021 ◽  
pp. 135910452110372
Author(s):  
Emily Staite ◽  
Lynne Howey ◽  
Clare Anderson
Keyword(s):  
Mental Health ◽  
Young People ◽  
Rating Scale ◽  
Service Evaluation ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
North East ◽  
The North ◽  
Before And After ◽  
The Uk

The COVID-19 pandemic has affected millions of people, and some researchers postulate that a mental health crisis will follow. The immediate effects of the COVID-19 pandemic on children’s mental health are now starting to be published, and results appear to be mixed. There is no research, to the authors’ knowledge, that empirically examines the functioning of young people following intervention from Child and Adolescent Mental Health Services (CAMHS) Crisis Teams in the UK during the COVID-19 pandemic. This service evaluation aims to do this using data from an NHS trust that supports 1.4 million people in the North East of England. We compared functioning, as measured by the Outcome Rating Scale (ORS), before and after treatment for young people discharged from the CAMHS Crisis Team between December 2019 and December 2020. ORS scores were significantly higher at the end of treatment (t(420) = −57.36, p < 0.001) with a large effect size (d = −1.56). Fifty eight percent of patients exhibited significant and reliable change (i.e. functioning improved to a ‘healthy’ level). No patients significantly deteriorated in functioning after accessing the crisis service.

scholarly journals Babies born in the pre-hospital setting attended by ambulance clinicians in the north east of England

2019 ◽  
Vol 4 (3) ◽  
pp. 43-48
Author(s):  
Graham McClelland ◽  
Emma Burrow ◽  
Helen McAdam
Keyword(s):  
Rare Event ◽  
Hospital Setting ◽  
Service Evaluation ◽  
Mortality And Morbidity ◽  
North East ◽  
The North ◽  
The United Kingdom ◽  
Clinical Observations ◽  
Routinely Collected Data ◽  
One Year

Introduction: The majority of births in the United Kingdom happen in hospital or at stand-alone midwife led centres, or with the support of midwives in a planned fashion outside of hospital. The unplanned birth of a baby in the pre-hospital setting is a rare event which may result in an ambulance being called, so attendance at a birth is a rare event for ambulance clinicians. A service evaluation was conducted to report which clinical observations were recorded on babies born in the pre-hospital setting who were attended by ambulance clinicians from the North East Ambulance Service (NEAS) over a one-year period.Methods: A retrospective service evaluation was conducted using routinely collected data. All electronic patient care records covering a one-year period between 1 October 2017 and 30 September 2018 with a primary impression of ‘childbirth’ were examined.Results: This evaluation identified 168 individual pre-hospital childbirth cases attended by NEAS clinicians during the evaluation timeframe. The majority (85%) of babies were born to multiparous mothers with a median gestation of 39 weeks. Very few clinical observations were recorded on the babies (respiratory rate 23%, heart rate 21%, temperature 10%, APGAR 8%, blood sugar 1%) and no babies had all five of these observations documented. Only 5% of babies had any complications documented.Conclusion: This study showed that NEAS ambulance clinicians rarely attend babies born in the pre-hospital setting and that complications were infrequently recorded. There was a lack of observations recorded on the babies, which is an issue due to the clear link between easily measurable characteristics such as temperature and mortality and morbidity.

An antenatal alcohol service evaluation of the north-east of England and north Cumbria

2020 ◽  
Vol 42 (2) ◽  
pp. 374-387
Author(s):  
Helen Howlett
Keyword(s):  
Service Provision ◽  
Management Practices ◽  
Service Evaluation ◽  
Alcohol Screening ◽  
Screening Tools ◽  
Alcohol Prevention ◽  
Clinical Practices ◽  
North East ◽  
The North ◽  
Patient Pathways

Abstract Background NHS England’s ‘Better Births’ strategy aims to improve maternal and infant health outcomes. A strategic priority identified in the north-east local maternity system is to reduce alcohol consumption in pregnancy due to the documented diverse risks of harm to mother and baby, including foetal alcohol spectrum disorder. Aims To evaluate current alcohol prevention, screening and treatment service provision in maternity care across the region, and inform future recommendations. Methods A service evaluation survey was developed to systematically consult strategic stakeholders across all nine maternity trusts in the region over a 2-month period in 2018. Content analysis was employed to identify fundamental themes and inform recommendations for practice. Results High variation was reported throughout regional clinical practices, service provision and staff training. For example, a number of alcohol screening tools were identified, each with diverse thresholds for referral; reported data collection and documentation practices were multifarious, incomparable and unquantifiable; audit was rare and guidelines were primarily influenced by local commissioning agreements. Discussion Standardized patient pathways involving alcohol screening and management practices are required, and sharing best practices will facilitate referrals and support regardless of location. The implementation of these recommendations requires appropriate leadership, commissioning and training strategies.

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