Assessing driving fitness in dementia: a challenge for old age psychiatrists

2019 ◽  
Vol 27 (5) ◽  
pp. 501-505
Author(s):  
Duncan Neilson ◽  
Emme Chacko ◽  
Gary Cheung
Keyword(s):  
Therapeutic Alliance ◽  
Old Age ◽  
Thematic Analysis ◽  
Negative Impact ◽  
Formal Training ◽  
Fitness To Drive ◽  
Dementia Patients ◽  
Driving Fitness ◽  
Structured Approach ◽  
Previous Training

Objective: To investigate how old age psychiatrists consider the fitness of dementia patients to drive safely and the challenges they face. Method: Participants were interviewed using a semi-structured approach that explored topics including their approach to driving fitness and cessation, challenges experienced and previous training. Thematic analysis was used to generate main themes. Results: Thirteen participants were recruited. Most felt they were not experts in driving fitness. Many found these assessments challenging for both themselves and their patients, with a negative impact on therapeutic alliance. There was a lack of formal training and variability both in the approach when considering fitness to drive as well as raising the issue of driving with patients. Conclusions: These results highlight the need to increase the availability of training for driving fitness, and to develop a standardised approach to help improve consistency amongst clinicians.

Applying personalized medicine to adult severe asthma

2021 ◽  
Vol 42 (1) ◽  
pp. e8-e16 ◽  
Author(s):  
Angelica Tiotiu
Keyword(s):  
Personalized Medicine ◽  
Severe Asthma ◽  
Negative Impact ◽  
Target Therapy ◽  
Asthma Management ◽  
Future Research ◽  
Biologic Therapies ◽  
Eosinophilic Asthma ◽  
Definition Of ◽  
Structured Approach

Background: Severe asthma is a heterogeneous disease that consists of various phenotypes driven by different pathways. Associated with significant morbidity, an important negative impact on the quality of life of patients, and increased health care costs, severe asthma represents a challenge for the clinician. With the introduction of various antibodies that target type 2 inflammation (T2) pathways, severe asthma therapy is gradually moving to a personalized medicine approach. Objective: The purpose of this review was to emphasize the important role of personalized medicine in adult severe asthma management. Methods: An extensive research was conducted in medical literature data bases by applying terms such as “severe asthma” associated with “structured approach,” “comorbidities,” “biomarkers,” “phenotypes/endotypes,” and “biologic therapies.” Results: The management of severe asthma starts with a structured approach to confirm the diagnosis, assess the adherence to medications and identify confounding factors and comorbidities. The definition of phenotypes or endotypes (phenotypes defined by mechanisms and identified through biomarkers) is an important step toward the use of personalized medicine in asthma. Severe allergic and nonallergic eosinophilic asthma are two defined T2 phenotypes for which there are efficacious targeted biologic therapies currently available. Non-T2 phenotype remains to be characterized, and less efficient target therapy exists. Conclusion: Despite important progress in applying personalized medicine to severe asthma, especially in T2 inflammatory phenotypes, future research is needed to find valid biomarkers predictive for the response to available biologic therapies to develop more effective therapies in non-T2 phenotype.

What is the impact of staff wearing uniforms in psychiatric inpatient settings?

2021 ◽  
Author(s):  
Sophie Collingwood ◽  
Laura McKenzie-Smith
Keyword(s):  
Mental Health ◽  
Thematic Analysis ◽  
Negative Impact ◽  
Psychiatric Inpatient ◽  
Ideal Self ◽  
Search Terms ◽  
Mental Health Settings ◽  
Inpatient Settings ◽  
The Impact

Background: Uniform has traditionally been worn in psychiatric inpatient and other mental health settings, but there has been a move to non-uniform in recent years. Some services have made the change back to uniform, raising questionsabout the potential impact on patients and staff.Aim: To review the impact of uniform within a psychiatric inpatient or mental health setting.Method: Databases were searched for articles exploring the impact of uniform use using specified search terms. Articles were assessed for suitability with inclusion and exclusion criteria, critically appraised, then analysed for themes using thematic analysis.Results: 17 papers were included in the review. Thematic analysis identified five main themes and 29 subthemes. Main themes were Attitudes and interactions, A freer environment, Are you both nurses?, The ‘ideal self’ and There are more important things. A critical appraisal of the articles suggested issues with validityand reliability, which are discussed.Discussion: Studies identified that wearing non-uniform facilitated positive changes in both patients and staff. This raises the potential negative impact of uniform on both patients and staff, and the role of power imbalance in these settings is discussed. Further themes around identification of staff out of uniform were considered.Implications for practice: The use of uniform in mental health and psychiatric inpatient settings should be considered carefully, due to the potential negative impact, whilst also recognising the importance of staff identification and supporting professional identity.

scholarly journals A realistic evaluation of evidence-based therapeutic processes in mental health services– Context-Mechanisms-Outcomes

2020 ◽  
Author(s):  
Eric Badu ◽  
Anthony Paul O’Brien ◽  
Rebecca Mitchell ◽  
Akwasi Osei
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Health Professional ◽  
Therapeutic Alliance ◽  
Thematic Analysis ◽  
Mental Health Professional ◽  
Evidence Based ◽  
Realistic Evaluation ◽  
Alliance Building

Abstract Background Evidence-based clinical practice is an inherent component of developed countries mental health professional practice, however, little is known about Ghana mental health professional perspectives on evidence-based practice. This paper outlines the processes involved in the delivery of best practice in Ghana. The paper describes a realistic evaluation of mental health nurses and allied health opinions regarding the evidenced-based therapeutic process in Ghana mental health facilities. Methods A purposive sample of 30 Mental Health Professionals (MHPs) was recruited to participate in semi-structured in-depth interviews. Thematic analysis was used to analyse the data. A programme theory of Context + Mechanism = Outcome (CMO) configuration was developed from the analysis. Results The thematic analysis identified two CMO configurations: 1) technical competency stimulates evidence-based mental health services; and, 2) therapeutic alliance-building ensures effective interaction. The study demonstrated that contextual factors (technical competencies and therapeutic alliance building) together with mechanisms (intentional and unintentional) help to promote the quality of mental health services. However, contextual factor such as the lack of sign language interpreters yielded an unintended outcome such as consumer-provider communication barrier for consumers with hearing impaired and those from linguistically minority background. Conclusion We conclude that government stakeholders and policymakers should prioritize policy documents, periodic monitoring and adequate financial incentives to support the on-going mechanisms that promote mental health professional technical competence and therapeutic alliance building.

scholarly journals An audit: fitness to drive assessment in inpatients of general adult and old age psychiatry

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S200-S201
Author(s):  
Ismail Khan ◽  
Nneamaka Asiodu ◽  
Dr Divyanish ◽  
Anum Yaqoob ◽  
Hasanain Qureshi
Keyword(s):  
Old Age ◽  
Social Withdrawal ◽  
Data Collection Tool ◽  
Fitness To Drive ◽  
Good Medical Practice ◽  
Adult Psychiatry ◽  
Old Age Psychiatry ◽  
Duty To Inform ◽  
The Impact ◽  
Physical Health Screening

AimsTo determine if fitness to drive is assessed on admission and discharge, if applicable, and for this to be documented during clerking and on discharge notifications.To determine if patients are being educated about the impact of their condition on the ability to safely drive.To ascertain if patients are aware of the duty to inform the DVLA if they for any reason are not fit to drive.BackgroundRisk factors include social, behavior and iatrogenic factors such as social withdrawal, increased likelihood of substance abuse and side effects of anti-psychotic medication.MethodThis trust wide audit involved the random sampling of a total of 71 case notes, 4 case notes per Consultant team in general adult psychiatry and old age psychiatry across Dudley and Walsall sites (total of 3 sites). A data collection tool was developed and included relevant questions regarding fitness to drive. Data were collected between October and December 2019.Result18/49 patients had physical health screening prior to medication initiation.ConclusionAn important aspect of good medical practice is to educate patients about their condition, this includes their fitness to drive as this can be affected both by their diagnosis and medication. It is clear that clinicians also need to be educated about this responsibility to ensure assessment is performed especially on inpatient discharge.

Examining Experienced S&C Coaches’ Reflections on the Effectiveness of Psychosocial Behaviors in Coaching

2020 ◽  
pp. 1-9
Author(s):  
Christoph Szedlak ◽  
Jo Batey ◽  
Matthew J. Smith ◽  
Matthew Church
Keyword(s):  
Reflective Practice ◽  
Learning Strategies ◽  
Thematic Analysis ◽  
Constructivist Learning ◽  
Formal Training ◽  
Semistructured Interview ◽  
Development Programs ◽  
Strength And Conditioning ◽  
Holistic Development ◽  
Coach Development

This study aimed to examine elite, experienced strength and conditioning (S&C) coaches’ reflections on the effectiveness of psychosocial behaviors in S&C coaching. In particular, this study aimed to explore which psychosocial behaviors are essential, the process of how these might influence coaching practice, and how the development of psychosocial behaviors should be encouraged. Eight elite, experienced S&C coaches were recruited and partook in a semistructured interview. Using a reflexive thematic analysis, six themes were identified: understanding athlete’s needs, communicating effectively, caring and connecting with the athlete, practicing what you preach, the importance of reflective practice, and the contribution of formal training. The findings of this study enhance the literature by highlighting that elite, experienced S&C coaches perceive psychosocial behaviors to be essential in effective S&C coaching practice. In particular, the findings describe the processes of how identified psychosocial behaviors might positively influence athlete development by enhancing motivation, buy-in, and autonomy. In addition, the authors’ results suggest that current S&C coach development programs are limited in facilitating the learning of psychosocial behaviors. Thus, their findings strengthen the call for S&C coach educators to utilize constructivist learning strategies including facilitated reflection to encourage the development of essential psychosocial behaviors that contribute to the holistic development of the athlete.

scholarly journals Clinical evaluation of fitness to drive in patients with brain metastases

2019 ◽  
Vol 6 (6) ◽  
pp. 484-489
Author(s):  
Cristina Valencia-Sanchez ◽  
Vanessa C Gorelkin ◽  
Maciej M Mrugala ◽  
Akanksha Sharma ◽  
Sujay A Vora ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Motor Skills ◽  
Cognitive Assessment ◽  
Neurologic Examination ◽  
Fitness To Drive ◽  
Trail Making ◽  
Group Members ◽  
The Mean ◽  
Driving Fitness ◽  
Ability To Drive

Abstract Background Guidelines to provide recommendations about driving restrictions for patients with brain metastases are lacking. We aim to determine whether clinical neurologic examination is sufficient to predict suitability to drive in these patients by comparison with an occupational therapy driving assessment (OTDA). Methods We prospectively evaluated the concordance between neurology assessment of suitability to drive (pass/fail) and OTDA in 41 individuals with brain metastases. Neuro-oncology evaluation included an interview and neurological examination. Participants subsequently underwent OTDA during which a battery of objective measures of visual, cognitive, and motor skills related to driving was administered. Results The mean age of patients who failed OTDA was age 68.9 years vs 59.3 years in the group members who passed (P = .0046). The sensitivity of the neurology assessment to predict driving fitness compared with OTDA was 16.1% and the specificity 90%. The 31 patients who failed OTDA were more likely to fail Vision Coach, Montreal Cognitive Assessment, and Trail Making B tests. Conclusions There was poor association between the assessment of suitability to drive by neurologists and the outcome of the OTDA in patients with brain metastases. Subtle deficits that may impair the ability to drive safely may not be evident on neurologic examination. The positive predictive value was high to predict OTDA failure. Age could be a factor affecting OTDA performance. The results raise questions about the choice of assessments in making recommendations about driving fitness in people with brain metastases. OTDA should be strongly considered in patients with brain metastases who wish to continue driving.

TV food advertising aimed at children: qualitative study of Pakistani fathers’ views

2014 ◽  
Vol 26 (4) ◽  
pp. 647-658 ◽  
Author(s):  
Muhammad Kashif ◽  
Mubashir Ayyaz ◽  
Sara Basharat
Keyword(s):  
Thematic Analysis ◽  
Negative Impact ◽  
Food Advertising ◽  
Structured Interviews ◽  
Consumer Socialization ◽  
Content Type ◽  
Tv Advertising ◽  
Managerial Implications ◽  
Advertising To Children ◽  
The Impact

Purpose – There is plethora of advertising research that has highlighted the mothers’ perspective to TV food advertising. However, the fathers’ perspective on children food advertising in societies that score high on masculinity is important but absent from literature. The purpose of this paper is to present opinions of respondents as fathers, concerning the impact of TV food advertisements on children buying and consumption habits. Design/methodology/approach – The qualitative data through semi-structured interviews has been collected from 32 males having at least one child between the ages of seven and 14 years. The respondents were purposefully selected from a private sector university located in the province of Punjab, Pakistan. The collected data have been analysed through thematic analysis. Findings – Thematic analysis revealed six themes; quantity of ads, negative impact of TV food ads, changing buying patterns, positive/productive impact on children, father's perceptions of TV advertising, and advertising changes to be incorporated. The findings have some social, cultural, and managerial implications for core advertising stakeholders. Practical implications – This study is useful for marketing managers whose job is to persuade children and their families into buying their products. They can benefit from the findings of this study to customize the brand communication strategies as per the expectations of respondents as fathers. Furthermore, the study proposes useful insights that will help in devising consumer-led advertising policies in Pakistan. Originality/value – The gender role of males while influencing family decision making with regards to food products marketing has been a new area of research. The study is pioneer in the field of consumer socialization in that it focuses upon the fathers’ perspective on TV advertising to children.

scholarly journals People with aphasia’s perception of the therapeutic alliance in aphasia rehabilitation post stroke: a thematic analysis

Aphasiology ◽  
2018 ◽  
Vol 32 (12) ◽  
pp. 1397-1417 ◽  
Author(s):  
Michelle Lawton ◽  
Gillian Haddock ◽  
Paul Conroy ◽  
Laura Serrant ◽  
Karen Sage
Keyword(s):  
Therapeutic Alliance ◽  
Thematic Analysis ◽  
Post Stroke

scholarly journals Recruitment into old age psychiatry

2019 ◽  
Vol 43 (3) ◽  
pp. 131-135 ◽  
Author(s):  
Lynsey McAlpine ◽  
Alex Bailey ◽  
Kate Milward ◽  
Charlotte Blewett
Keyword(s):  
Physical Health ◽  
Old Age ◽  
Thematic Analysis ◽  
Social Care ◽  
Health Needs ◽  
Recruitment Strategy ◽  
Factors Affecting ◽  
Qualitative Survey ◽  
Old Age Psychiatry ◽  
The Uk

This research aimed to explore the trainee perspective on factors affecting recruitment into old age psychiatry higher training in the UK. A qualitative survey was created by the Faculty of Old Age Psychiatry and distributed to current higher trainees in all psychiatric subspecialties. A total of 324 higher trainees responded to the survey, representing a broad demographic range. Thematic analysis was carried out, with sufficient responses to achieve saturation. Key themes included concerns about the future of the specialty, issues with social care, lack of support with patients’ physical health needs, issues with training posts, and workload. The need to improve core trainees’ experience of the specialty was highlighted. Many positive themes arose from the data; however, a number of barriers to recruitment were also identified. The findings have implications for recruitment to the specialty and should be used to inform recruitment strategy moving forward.Declaration of interestNone.

scholarly journals Socioeconomic status trajectories and health in China

2019 ◽  
Author(s):  
Ning Wei ◽  
Lülin Zhou ◽  
Wenhao Huang
Keyword(s):  
Mental Health ◽  
Socioeconomic Status ◽  
Health Status ◽  
Old Age ◽  
Family Income ◽  
Negative Impact ◽  
Historical Period ◽  
Physical And Mental Health ◽  
Term Adverse Effect

Abstract Background: After 40 years of reform and opening-up, China's social and economic conditions have undergone tremendous changes. For individuals who have experienced this historical period, the socioeconomic transition has brought different effects on their health status. This research examines the issue and provides evidence that government policies need to be improved. Methods: This study adopted data from the 2015 China Health and Retirement Longitudinal Study (CHARLS). We set the education level, occupation, and family income during old age as the socioeconomic status for the early, middle, and late stages of life. Based on specific criteria, we classified the population as disadvantaged and advantaged, considering eight changing trajectories of socioeconomic status. We used multiple regression analysis to examine how the eight trajectories affect individuals' physical and mental health. Results: After controlling for social demography and health behavior variables, we found that compared with those in the advantaged group long term, people who were in the disadvantaged group suffered from a significantly negative impact of their socioeconomic status on physical and mental health. The health status of those who moved upward in socioeconomic status was substantially better than those who remained in the same status. Conclusion: This study confirms that early disadvantaged socioeconomic status has a long-term adverse effect on health. However, the negative impact can be mitigated by improving one’s occupation during middle age or family income during old age throughout China's socioeconomic transitions. Therefore, increasing upward social mobility at any stage helps eliminate health inequalities.

Sign in / Sign up

Export Citation Format

Share Document