scholarly journals Beyond year zero: getting the best out of revalidation

2014 ◽  
Vol 20 (4) ◽  
pp. 237-246
Author(s):  
Mary Jane Tacchi

SummaryMedical revalidation was introduced in the UK in 2012 (‘year zero’) after years of discussion and debate. This article describes what it aims to achieve. The General Medical Council's Good Medical Practice is used as a framework on which to build to provide evidence of competencies. Practical aspects of appraisal and revalidation are discussed, with suggestions of how to get the most out of the process both for patients and doctors.LEARNING OBJECTIVES•Understand the purpose of revalidation.•Understand the role of the responsible officer.•Describe the types of supporting information necessary for revalidation.

2014 ◽  
Vol 20 (5) ◽  
pp. 359-365 ◽  
Author(s):  
Vivek Khosla ◽  
Phil Davison ◽  
Harvey Gordon ◽  
Verghese Joseph

SummaryWith the subspecialisation of psychiatry in the UK, clinicians encounter problems at the interfaces between specialties. These can lead to tension between clinicians, which can be unhelpful to the clinical care of the patient. This article focuses on the interface between general and forensic psychiatry in England and Wales. The pattern of mental health services in England and Wales differs to an extent from those in Scotland, Northern Ireland and in the Republic of Ireland. Consequently, the interface between general and forensic psychiatry is subject to varying influences. Important interface issues include: the definition of a ‘forensic patient’; the remit and organisation of services; resources; clinical responsibility; and care pathways. This article also discusses a general overview of how to improve collaboration between forensic and general adult psychiatric services.Learning Objectives•Develop an understanding of important issues at the forensic/general adult psychiatry interface.•Be aware of areas of conflict that may arise at the forensic/general adult psychiatry interface.•Be aware of options for optimum cooperation at the interface.


2014 ◽  
Vol 20 (4) ◽  
pp. 250-257
Author(s):  
Philip Graham ◽  
Julian C. Hughes

SummaryShould the law be changed to allow health professionals to assist mentally competent, terminally ill people to end their own lives? In this article Philip Graham (P.G.) puts the arguments in favour of such a change in the law and Julian Hughes (J.H.) opposes these arguments. J.H. then sets out why he believes such a law should not be passed and P.G., in turn, sets out counterarguments. Before concluding comments, both P.G. and J.H. independently make brief closing statements supporting their own positions.LEARNING OBJECTIVESUnderstand the differences between various types of ‘assisted dying’.Appreciate some of the ethical arguments in favour of and against changes in the law on assisted dying in the UK.Understand some of the empirical data involved in arguments about assisted dying.


Author(s):  
A Nikolic ◽  
K Ellestad ◽  
M Johnston ◽  
PB Dirks ◽  
FJ Zemp ◽  
...  

Glioblastoma is the most common primary malignant brain tumour in adults, and remains uniformly lethal. These tumours contain a subpopulation of glioblastoma stem cells (GSCs) that drive tumour recurrence and drug resistance. We find that MacroH2A2 is a histone variant that can stratify glioblastoma patients, with higher levels of this histone variant associated with better patient prognosis. Knockdown of macroH2A2 in GSCs is associated with increased self-renewal and an increased expression of stemness genes by RNA-seq. Our preliminary results suggest that macroH2A2 is a novel biomarker for glioblastoma and that macroH2A2 loss is a marker of GSC stemness and a poor prognostic marker in glioblastoma. This work identifies loss of macroH2A2 as a feature of GSCs and provides a framework for therapeutic modulation of this histone variant.LEARNING OBJECTIVESThis presentation will enable the learner to:1.Explain the role of epigenetics in glioblastoma pathophysiology


2018 ◽  
Vol 24 (2) ◽  
pp. 93-100 ◽  
Author(s):  
Julian C. Hughes ◽  
David Crepaz-Keay ◽  
Charlotte Emmett ◽  
K. W. M. Fulford

SUMMARYThis article starts with a brief review of the UK Supreme Court's decision in the Montgomery case. Although much of the focus in discussing the case has been on the disclosure of risk, an important aspect of the model of consent contained in the judgment is that of dialogue. The model of informed consent set out in Montgomery suggests shared decision-making as the norm. Central to shared decision-making, however, is an awareness of values and of how values can vary between people. We introduce values-based practice as an approach that is entirely in keeping with the precepts of the Montgomery judgment. We go on to review how values-based practice and shared decision-making are relevant to psychiatric practice, using as examples recovery practice and compulsory detention under the Mental Health Act 1983.LEARNING OBJECTIVES•Appreciate that a new test of consent has been established as of a result of the UK Supreme Court's Montgomery ruling•Learn about the role of values-based practice as a partner to evidence-based practice in implementing Montgomery•Understand how values-based practice and Montgomery together support shared decision-making in psychiatryDECLARATION OF INTERESTNone.


2014 ◽  
Vol 20 (5) ◽  
pp. 350-358 ◽  
Author(s):  
Harvey Gordon ◽  
Vivek Khosla

SummaryMental disorder and criminality are separate entities but some people with a mental disorder commit criminal offences and some criminals have a mental disorder. Before 1800 there was no separate category of mentally disordered offenders (referred to as criminal lunatics until 1948) in UK legislation. The provision of facilities for mentally disordered offenders in Britain and Ireland overlapped with, but was also separate from, provision for the mentally ill generally. The interface between general and forensic psychiatry is an area of tension and of collaboration. To understand how contemporary general and forensic psychiatry interact, it is useful to have an understanding of how factors have evolved overtime.Learning Objectives•Have an understanding of the evolution of general and forensic psychiatry in the UK over the past 200 years.•Comprehend the similarities and differences between general and forensic psychiatry.•Be aware of some of the roots of conflict between general and forensic psychiatry.


2014 ◽  
Vol 20 (2) ◽  
pp. 101-112 ◽  
Author(s):  
Cyrus S. H. Ho ◽  
Melvyn W. B. Zhang ◽  
Anselm Mak ◽  
Roger C. M. Ho

SummaryMetabolic syndrome comprises a number of cardiovascular risk factors that increase morbidity and mortality. The increase in incidence of the syndrome among psychiatric patients has been unanimously demonstrated in recent studies and it has become one of the greatest challenges in psychiatric practice. Besides the use of psychotropic drugs, factors such as genetic polymorphisms, inflammation, endocrinopathies and unhealthy lifestyle contribute to the association between metabolic syndrome and a number of psychiatric disorders. In this article, we review the current diagnostic criteria for metabolic syndrome and propose clinically useful guidelines for psychiatrists to identify and monitor patients who may have the syndrome. We also outline the relationship between metabolic syndrome and individual psychiatric disorders, and discuss advances in pharmacological treatment for the syndrome, such as metformin.LEARNING OBJECTIVES•Be familiar with the definition of metabolic syndrome and its parameters of measurement.•Appreciate how individual psychiatric disorders contribute to metabolic syndrome and vice versa.•Develop a framework for the prevention, screening and management of metabolic syndrome in psychiatric patients.


2004 ◽  
Vol 30 ◽  
pp. 263-280
Author(s):  
R.W. Small

AbstractThe landscape of the UK has been largely determined by past agricultural practices that have given rise to a range of anthropogenic habitats much valued by conservationists. Many of these have been created by, or for, grazing livestock. The suggestion that grazing and browsing animals were instrumental in ‘cyclical succession’ in the preagricultural period is also gaining ground. For these reasons the use of grazing animals in the management of conservation sites has become more common. Since its foundation in 1997 the Grazing Animals Project (GAP) has promoted and facilitated the use of grazing livestock in management of habitats for conservation.In 2001 GAP produced, in consultation with animal welfare organizations, A Guide to Animal Welfare in Nature Conservation Grazing. The practical advice in, and approach of, this document is potentially invaluable not only to conservation managers and graziers but also to all keepers of livestock. Another GAP publication, the Breeds Profiles Handbook, gives brief descriptions of 55 breeds of livestock known, or anticipated, to be of value in conservation grazing. Many of these are rare or traditional breeds, as these have the characteristics that enable the stock to thrive on the nutritionally relatively poor forage afforded by many conservation sites. These characteristics are often identified as ‘hardiness’ and ‘thriftiness’, but are poorly defined except through the practical experience of conservation managers.Conservation grazing is a relatively new niche, and one that cannot be filled by modern breeds or strains adapted to high-input, high-output systems. It is, therefore, a great opportunity for rare and traditional breeds, many of which developed in parallel with habitats now appreciated for their conservation value. This applies not only in the UK but also in other European countries. Moreover, recent developments, such as English Nature's Traditional Breeds Incentive for Sites of Special Scientific Interest, several grazing projects funded by the Heritage Lottery Fund and the Limestone Country Life Project, suggest that this niche is no longer confined to nature reserves.Conservation grazing can contribute to genetic conservation by:•Enabling an increase in numbers and wider distribution of rare and traditional breeds.•Allowing breeders to identify, and select, those individuals that fare best under relatively austere conditions.•Providing an outlet, or providing additional grazing, for stock that could not otherwise be kept.•Providing a market for good animals without reference to the showring.•Providing a refuge for rare breeds from threats such as that posed by the National Scrapie Plan.


2018 ◽  
Vol 28 (2) ◽  
pp. 234-234
Author(s):  
Susan Colmar

I am pleased to introduce two practitioner papers for this issue of the Journal of Psychologists and Counsellors in Schools. 1.School camp refusal and reluctance: The role of the school psychologist. Mary Woods and John Burns.2.Understanding trauma in the refugee context. Kimberley De Deckker.


2019 ◽  
Vol 25 (3) ◽  
pp. 157-165 ◽  
Author(s):  
Richard Taylor ◽  
Jessica Yakeley

SUMMARYMulti-agency public protection arrangements (MAPPA) have been in operation for around 18 years in England and Wales. The primary purpose is for the sharing of information between agencies regarding the risk management of offenders returning to the community from custodial and hospital settings. The legal framework regarding information by psychiatrists is not dealt with in one single policy or guidance document. Psychiatrists must use their clinical and professional judgement when engaging with the MAPPA process, mindful of guidance available from professional bodies such as the Royal College of Psychiatrists, General Medical Council and British Medical Association.LEARNING OBJECTIVESAfter reading this article you will be able to: •Learn the legal and political background that led to the formation of MAPPA•Understand the structure and function of MAPPA•Understand the role of psychiatrists in the MAPPA processDECLARATION OF INTERESTR.T. is a member of the London Strategic Management Board for MAPPA.


2014 ◽  
Vol 20 (6) ◽  
pp. 380-389 ◽  
Author(s):  
Henry O'Connell ◽  
Sean P. Kennelly ◽  
Walter Cullen ◽  
David J. Meagher

SummaryProviding optimal healthcare for increasingly elderly hospital populations who have high rates of cognitive disorder is a great challenge. Using delirium as an example, we describe how improved management of acute cognitive problems through a multifaceted hospital-wide programme can promote cognitive-friendly hospital environments. A specific plan of action is described that spans interventions in day-to-day clinical care of individual patients all the way to wider organisational practices.Learning Objectives•Understand the concept of cognitive friendliness and how addressing the problem of delirium can contribute to this in our healthcare system.•Become more aware of specific aspects of a cognitive-friendly programme and how these can be implemented in practice.•Explore the key outstanding issues for research that can further enhance our awareness of cognitive-friendly practices.


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