scholarly journals Representation of Black, Asian and minority ethnic patients in secondary care mental health services: analysis of 7-year access to memory services in Leicester and Leicestershire

2020 ◽  
Vol 44 (4) ◽  
pp. 145-152
Author(s):  
Hari Subramaniam ◽  
Elizabeta B. Mukaetova-Ladinska ◽  
Andrew Wilson ◽  
John Bankart
Keyword(s):  
Odds Ratio ◽  
Asian Population ◽  
Electronic Record ◽  
Age Difference ◽  
Memory Clinic ◽  
Record System ◽  
Asian Group ◽  
Referral Rates ◽  
Asian People ◽  
Minority Ethnic

Aims and methodWe aimed to explore access by Black, Asian and minority ethnic (BAME) elders to the memory services in Leicester and Leicestershire, examining any trends over time. We then compared the odds of referral by ethnicity, using observed versus expected referrals for the city of Leicester. We gathered data on a comprehensive county-wide memory clinic used by people with suspected dementia and memory problems from the Trust electronic record system during the period 2011–2017. For Leicester city, we compared referral rates for 2011–2017 and compared observed and expected referral rates with demographics from the UK Census 2011.ResultsIn Leicester, there was a significant underrepresentation of referrals from the BAME population as compared with the White population in 2011, 2012 and 2013, when compared with population estimates of those aged ≥60 years from the 2011 UK Census Leicester city data. Data for the Black population were too small for comparisons. The odds of being referred to a memory clinic for the White group was double that of the Asian group in 2011 (odds ratio 2.15, 95% CI 1.52–3.02) and nearly 1.5 times in 2012 (odds ratio 1.40, 95% CI 1.01–1.93). This difference did not persist after 2014. However, this differential odds of referral changes when the age difference between the groups is accounted for. After adjusting for age, there were no differences between the two groups in their odds of referral to the memory clinic from 2011 to 2013, but from 2014 to 2017, members of the Asian group had higher odds of being referred.Clinical implicationsThe relationship between BAME and access to memory services is complex. The relative lower prevalence of Asian people among referrals to memory services in Leicester from 2011 to 2013 may partly be explained by the lower ages of the Asian population at referral. The higher prevalence of Asian people in 2014–2017 may be owing to use of denominators from the 2011 UK Census, which are likely to be disproportionately low for this group. Further studies are needed to explore any potential barriers to the access of services by BAME communities.

Dermatology in primary care: an audit of the proportion of patients who present to general practice with a dermatological problem that could be self-managed

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711053
Author(s):  
Luamar Dolfini ◽  
Yogesh Patel
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Acne Vulgaris ◽  
Clinical Information ◽  
Electronic Record ◽  
Self Management ◽  
Considerable Proportion ◽  
Dry Skin ◽  
Record System ◽  
Common Skin

BackgroundA considerable proportion of GPs’ workload is dermatological. It is important to investigate what common skin conditions encountered in primary care can be self-managed, in an effort to alleviate the burden on primary care.AimThe purpose of the audit was to identify the proportion of consultations that are dermatological in nature and analyse potential for self-management by patients.MethodData was collected using the patient electronic record system (EMIS) in general practice. A search was made for all consultations from the 17 April to 15 May 2019, which included all new presenting complaints that were dermatological in nature. The criteria for self-management included advising over the counter (OTC) medication or reassurance. On the other hand, a case was deemed not self-manageable if prescription only medication (POM) was prescribed or if a referral to dermatology was made.ResultsThere were a total of 2175 consultations, where 246 (11.31%) cases were dermatological. Of the 246, 80 cases (32.5%) could be self-managed. There were 46 different dermatological presenting complaints of which the 5 most common included: rash (51 cases), dermatitis (44 cases), acne vulgaris (13 cases), moles (12 cases), dry skin (11 cases). None of the acne or moles cases could be self-managed, whereas 23%, 68.2%, 72.7% of rashes, dermatitis, and dry skin cases, respectively, could be self-managed.ConclusionCertain dermatological conditions have more potential for self-management than others. Research into teledermatology as a means of addressing patient concern and providing clinical information is important in order to reduce unnecessary consultations.

scholarly journals PARP1 rs1136410 Val762Ala contributes to an increased risk of overall cancer in the East Asian population: a meta-analysis

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052199295
Author(s):  
Yijuan Xin ◽  
Liu Yang ◽  
Mingquan Su ◽  
Xiaoli Cheng ◽  
Lin Zhu ◽  
...  
Keyword(s):  
Cancer Risk ◽  
Odds Ratio ◽  
Chinese Population ◽  
Meta Analysis ◽  
Asian Population ◽  
Cancer Type ◽  
East Asians ◽  
Asian Populations ◽  
Increased Risk ◽  
Meta Analyses

Objectives To investigate the association between poly(ADP-ribose) polymerase 1 ( PARP1) rs1136410 Val762Ala and cancer risk in Asian populations, as published findings remain controversial. Methods The PubMed and EMBASE databases were searched, and references of identified studies and reviews were screened, to find relevant studies. Meta-analyses were performed to evaluate the association between PARP1 rs1136410 Val762Ala and cancer risk, reported as odds ratio (OR) and 95% confidence interval (CI). Results A total of 24 studies with 8 926 cases and 15 295 controls were included. Overall, a significant association was found between PARP1 rs1136410 Val762Ala and cancer risk in East Asians (homozygous: OR 1.19, 95% CI 1.06, 1.35; heterozygous: OR 1.10, 95% CI 1.04, 1.17; recessive: OR 1.13, 95% CI 1.02, 1.25; dominant: OR 1.13, 95% CI 1.06, 1.19; and allele comparison: OR 1.09, 95% CI 1.03, 1.15). Stratification analyses by race and cancer type revealed similar results for gastric cancer among the Chinese population. Conclusion The findings suggest that PARP1 rs1136410 Val762Ala may be significantly associated with an increased cancer risk in Asians, particularly the Chinese population.

Abstract 14747: Dwindling Trends of Cardiology Admissions Amidst Covid-19 Pandemic in a Tertiary Care Center of Pakistan

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jamshed Ali ◽  
Osman Faheem ◽  
Pirbhat Shams ◽  
ghufran adnan ◽  
Maria Khan
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Electronic Record ◽  
Medical Attention ◽  
Care Hospital ◽  
Record System ◽  
Admission Rates ◽  
Cardiovascular Morbidity And Mortality ◽  
Number Of Patients ◽  
The Impact

Introduction: Social containment measures have been adopted globally to control COVID-19 outbreak. Reduction in hospital visits and inpatient admission rates have become cause for concern. Through this study we aimed to analyze the impact of SARS-CoV-2 virus Outbreak on cardiology inpatient admissions at a tertiary care hospital in Pakistan. Hypothesis: COVID-19 pandemic has resulted in significant decline in cardiology admissions. Methods: We conducted a retrospective study at our center. Admission log was accessed via electronic record system. Comparison was made for same months of 2019 and 2020 with regard to cardiology inpatient admissions. Results: A total of 239 patients were admitted to cardiology services in 2019 period and 106 in 2020 period with resultant reduction of 55.6%. Number of patients admitted to the coronary care unit were 179 and 78 respectively where as the numbers declined to 28 from 60 for cardiac step down. Reduction for admission numbered to 52.4% for males and 38.89% for females. 9.3% patients left against medical advice in 2019 and 3.4% in 2020. Conclusions: Our study concludes that numbers of cardiology admissions have dwindled. Possible explanation for this can be implementation of social containment and fear of acquiring infection. This has raised a question of whether a significant number of cardiovascular morbidity and mortality has occurred without seeking medical attention and has went unrecorded during the pandemic. This calls for stringent diagnostic measures in future to diagnose previously unrecorded burden.

scholarly journals Electronic Clinical Records for Physiotherapists

2006 ◽  
Author(s):  
Christine Barry ◽  
Mark Jones ◽  
Karen Grimmer
Keyword(s):  
Legal Protection ◽  
Data Retrieval ◽  
Electronic Record ◽  
Electronic System ◽  
Electronic Records ◽  
Clinical Report ◽  
Record System ◽  
Clinical Records ◽  
The Impact ◽  
Electronic Record System

Purpose: This pilot study compared traditional (paper-based) and electronic (computerized) clinical physiotherapy records. The content of the records and the software’s user acceptability were considered. Methods: A neuro-musculoskeletal patient scenario involving two encounters (initial and follow-up) was scripted and role-played to each of three experienced physiotherapists (A, B and C). Participants assessed the patient and made traditional clinical records. After basic training in an electronic record system, they repeated the assessments and made electronic records via a laptop computer. Three experienced physiotherapists (A, D and E) each used their usual method to write a clinical report and an electronic record to write a report with the aid of the software’s report tool. The two participants who wrote reports but did not assess the patient (D and E) received a brief software demonstration just prior to writing the electronic record report. The electronic and traditional clinical records and reports were compared regarding their content and completion time. Participants recorded their expectations and experience of learning and using the electronic record system via questionnaires. Results: Participants expressed initial apprehension regarding an unfamiliar documentation system, but generally found the electronic system easy to learn and use. Some would have preferred additional customization options. All traditional records contained pages that lacked patient identification details. The electronic records contained more details related to symptoms, social circumstances and physical examination findings. The participants used more time for assessment and recording the initial examination when using the electronic system. Participants reported easier data retrieval from the computerized records than from the traditional records. Conclusions:The electronic clinical record system may prompt more complete recording and facilitate better patient record identification. These effects have implications for patient care, communication between providers and clinicians’ medico-legal protection. Further research is needed to determine the system’s efficiency and to clarify the impact of other characteristics of electronic record systems for physiotherapists.

scholarly journals Redesigning the psychiatry induction

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S162-S162
Author(s):  
Sharadha Wisidagama ◽  
Martin Schmidt
Keyword(s):  
Junior Doctor ◽  
General Medical Council ◽  
Electronic Record ◽  
Junior Doctors ◽  
Medical Council ◽  
Education Department ◽  
Record System ◽  
Training Requirements ◽  
Regulatory Bodies ◽  
Service Gap

AimsTo analyse the current psychiatry induction programme with regards to national guidance, local requirements, trainee and trainer feedback and implement recommendations to streamline where possible.BackgroundJunior doctors in training rotate every 4 or 6 months depending on the grade/programme group. GP and FY trainees are often new to psychiatry therefore require a comprehensive induction.Our Trust has had a three day induction for new junior doctors comprised of 1 day Corporate Induction, 1 day Electronic Records Training and 1 day Local induction.During the 3 day induction programme there is often a service gap with covering out of hours and acute services. Trainees and trainers have expressed concern regarding the service gap.We therefore embarked on a review of the induction programme to investigate whether it could be improved in content and length of time to deliver.MethodReview the regulatory bodies requirements for junior doctor induction.Gain an understanding of the trainees and trainers perspective of the induction programme.Review the items in the induction programme according to the requirements of the regulatory bodies.Tailor the induction programme for junior doctors’ needs whilst complying with the regulatory bodies requirements.ResultThe General Medical Council (GMC), British Medical Association (BMA), Gold Guide, Health Education England (HEE) and National Health Service (NHS) employment have no specific statutory and mandatory training requirements for induction.The regulatory bodies have generic standards for junior doctor induction.Induction is the responsibility of the Trust.Trainee perspective: Electronic record system, Mental Health Act (MHA) and pharmacy training were agreed as needing review in terms of its content and length.Trainees also requested extra items to be included in the induction programme to support successful transition in to their work placements.The education department met with the Digital Team, MHA Team and Pharmacy Team to develop new and more relevant course content and add in the requested items.The new induction programme was launched in December 2019 and was reduced in length from 3 to 2 and a half days. Trainee satisfaction improved as evidence by trainee feedback.ConclusionThe review was helpful in establishing the requirements for a good induction and highlighting areas for improvement.The new induction was more focussed, shorter in duration and had improved trainee feedback.The Medical Education Department will assess the changes following the December 2019 induction and continue to review its induction programme.

Association Between Nonsyndromic Cleft Lip and Palate and 2 Polymorphic Loci: A Meta-Analysis

2020 ◽  
pp. 105566562096268
Author(s):  
Yusi Wang ◽  
Xueyuan Jia ◽  
Yuandong Qiao ◽  
Lidan Xu ◽  
Xuelong Zhang ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Cleft Lip ◽  
Methylenetetrahydrofolate Reductase ◽  
Cleft Lip And Palate ◽  
Meta Analysis ◽  
Craniofacial Development ◽  
Asian Group ◽  
Potential Association ◽  
Increased Risk ◽  
The Relationship

Objectives: The relationship between Noggin ( NOG) and methylenetetrahydrofolate reductase and nonsyndromic cleft lip and palate (NSCLP) has been reported participate in craniofacial development but need further evidence. To indicate the susceptibility between the 2 genes and NSCLP, rs227731 and rs1801131 polymorphisms were included in the present research. This research may provide some genetic clues for disease detection and surveillance. Design: Seventeen studies including 4023 cases and 5691 controls were provided for meta-analysis, and odds ratio (OR) with 95% CI were obtained to estimate NSCLP risk. Results: Our analysis suggested potential association of rs227731C on increasing the risk of NSCLP in the Caucasian group and total group but not Asian group under all models: allele (OR = 1.45, 95% CI = 1.21-1.75, P < .0001), homozygote (OR = 2.03, 95% CI = 1.42-2.90, P < .0001), heterozygote (OR = 1.44, 95% CI = 1.19-1.73, P = .0001), dominant (OR = 1.61, 95% CI = 1.27-2.04, P < .0001), and recessive models (OR = 1.63, 95% CI = 1.25-2.12, P = .0003). Besides, increased risk is related to rs1801131 in Asian group under 3 models: allele (OR = 1.24, 95% CI = 1.06-1.44, P = .006), heterozygote (OR = 1.24, 95% CI = 1.02-1.52, P = .03), and dominant models (OR = 1.29, 95% CI = 1.06-1.56, P = .009). Conclusions: Our analysis indicates polymorphisms rs227731 and rs1801131 are associated with NSCLP, with predominance of different ethnic group and deepen understanding of NSCLP.

scholarly journals Impact of COVID-19 pandemic on surgical care of patients with acute aortic conditions

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
X Yuan ◽  
U Rosendahl ◽  
G Asimakopoulos ◽  
C Quarto ◽  
B Rosser ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Surgical Care ◽  
Electronic Record ◽  
Case Volume ◽  
Record System ◽  
Emergent Operation ◽  
Acute Aortic Syndromes ◽  
Care Systems ◽  
Urgent Operation ◽  
The Impact

Abstract Background The outbreak of COVID-19 pandemic catastrophically interrupted medical care systems causing substantial decrease in the admission of patients and consecutively a sharp decline in the number of surgeries and interventions. In several European countries, the nationwide lockdown severely restricted movement which may have contributed to this phenomenon on top of anxiety of patients to contract COVID-19 when admitted to hospital. Purpose The aim of this analysis was to evaluate the impact of the COVID-19 pandemic onto acute and elective thoracic aortic surgeries and interventions and to compare the data with the same period in 2019 in a single aortic centre. Methods Information on admission and surgery/intervention was extracted from hospital electronic record system. Patients who were admitted for treatment of aortic conditions between January 1st to June 30th both in 2019 and 2020 were identified and selected for this analysis. The time from referral to admission and surgery/intervention was noted for service delay analysis. Aortopathies were classified as type A aortic dissection, type B aortic dissection, aortic aneurysm and others. In a daily central hub meeting, urgency was defined as emergent (operation required before the next working day), urgent (operation needed within 48 hours), and elective. Patients' condition and comorbidities were represented by ACEF II score. Results Total case volume of 81 in 2019 reference period was reduced to 70 in 2020 (−14%). Elective cases significantly declined from 59 (72.8%) in 2019 to 30 (42.8%) in 2020 (−49%). Urgent and emergent cases were performed more frequently in 2020 with 40 cases versus 22 in 2019 (+45%). The ACEF II score showed no difference for patients in both periods (2.1±1.9 vs. 2.5±2.1, p=0.221), however, a trend to higher ACEF II score in 2020 consistent with a higher proportion of urgent and emergent cases. The overall in-hospital delay (from admission to surgery) was not significant affected with 1 (IQR 1–2) versus 1 (IQR 0–2); p=0.991. However, with the official declaration of a pandemic and introduction of restrictions, no in-hospital delay was documented. In-hospital mortality was observed lower in 2019 as compared in 2020 (6.1% vs 11.4%, P=0.251). Conclusion The first wave of COVID-19 pandemic disrupted the aortic service, however, acute care for urgent thoracic aortic conditions and subsequent procedures even increased compared to 2019 as a result of both centralised allocation system and decline of elective cases. Acute aortic syndromes were managed despite COVID-19 according to current guidelines. FUNDunding Acknowledgement Type of funding sources: None. Impact of COVID on aortic case load

scholarly journals EP.WE.1026Pathways to the Upper GI MDT; an evaluation of the factors influencing patient routes to diagnosis of oesphago-gastric cancer

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Roberta Bullingham ◽  
Thomas McKane ◽  
Frances Hughes
Keyword(s):  
First Language ◽  
Electronic Record ◽  
Demographic Trends ◽  
Record System ◽  
Upper Gi ◽  
Acute Presentation ◽  
Data Points ◽  
One Year ◽  
The Uk ◽  
Electronic Record System

Abstract Aims To review the characteristics of the patient group referred to Barts Health with Oesphago-gastric (OG) Cancer in one year (2018-19). To evaluate demographic trends in patients presenting as emergency referrals and the effect of language on patients’ pathway to diagnosis. Methods We collated a list of patients referred to the Upper GI MDT with OG cancer in one year (2018-2019). We collected relevant pre-determined data points from the trust electronic record system. Patients with missing or insufficient data were excluded. Results Our population of 125 patients (median age 69) included 51% White British, 11% Bangladeshi, 10% Afro-Caribbean and 4% Pakistani; proportions which are significantly different to that of the UK average (p &lt; 0.002). 46% of patients presented by GP 2WW referrals and 32% emergency referrals. The 29% of the population that did not have English as a first language were not shown to be more likely to present acutely (p = 0.49). 18.7% of patients had more than 62 days between referral and MDT discussion; themes of delay were inappropriate referral type, histology delay and atypical presentation. Conclusions Our OG cancer population has a significantly different ethnic makeup compared to UK average. Our data shows higher acute presentations and lower GP 2WW referrals. We did not demonstrate that language as a single parameter was linked to acute presentation. A number of modifiable delays to diagnosis were identified particularly the need for repeat biopsies. Further analysis is required using more sophisticated socio-economic parameters to assess how ethnicity can influence presentation of OG cancer.

scholarly journals Association of Helicobacter pylori infection with diabetes mellitus: A Meta-analysis of Case Control Studies

2019 ◽  
Author(s):  
Kamyar Mansori ◽  
Yousef Moradi ◽  
Sara Naderpour ◽  
Roya Rashti ◽  
Ali Baradaran Moghaddam ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Asian Population ◽  
Case Control ◽  
Case Control Studies ◽  
Analysis Study ◽  
Geographical Regions ◽  
H Pylori

Abstract Background Results of previous studies were showed that the association between H. pylori infection and the risk of diabetes is still controversies. Therefore, this systematic review and meta-analysis study was designed and implemented aimed to determine the association between H. pylori infection and the risk of diabetes.Methods All case control articles were searched in international databases, including Medline (PubMed), Web of sciences, Scopus, EMBASE, and CINHAL. Search was done from January 1990 to March 2019 without language limitations. Also, logarithm and standard error logarithm odds ratio (OR) were used for meta-analysis.Results A total of 41 studies were included in this meta-analysis. The range of association with odds ratio in case control studies which published between 1990 to 2019 was 0.21 to 6.08. The pooled estimate of the association between H. pylori infection with diabetes was 1.27 (95% CI 1.11 to 1.45, P = 0.0001, I 2 = 86.6%). The effect of H. pylori infection on diabetes mellitus, type 1 and type 2 diabetes was 1.17 (95% CI 0.94 to 1.45), 1.19 (95% CI 0.98 to 1.45), and 1.43 (95% CI 1.11 to 1.85) respectively. Subgroup analysis by the geographical regions showed in Asian population risk of the effect of H. pylori infection on diabetes was higher than other population, but in the American, this was a protective relationship.Conclusion In conclusion, this systematic review & meta-analysis study suggested that H. pylori infection was associated with the risk of diabetes as compared to non- diabetes individual.

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