scholarly journals CAMHS Emergency Assessment Service (EAS): development & implementation during the COVID-19 crisis

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S55-S55
Author(s):  
Tania Saour ◽  
Jovanka Tolmac ◽  
Braulio Girelas ◽  
William Turton ◽  
Lauren Branney
Keyword(s):  
Young People ◽  
Alcohol Intoxication ◽  
Medical Intervention ◽  
Care Team ◽  
Urgent Care ◽  
Medical Attention ◽  
Psychotic Episode ◽  
List Type ◽  
Service Users ◽  
Set Up

Aims•To provide emergency psychiatric assessment throughout the COVID-19 pandemic.•To maintain patient and staff safety by minimising exposure to infection risk by reducing A&E contact.•To alleviate pressures on the A&E department by enabling CAMHS patients be seen in an alternative setting.•To provide a more appropriate environment for the assessment of young people in acute distress.Method•Service live 8th April 2020 to 8th June 2020.•Exclusion criteria: 1) confirmed/suspected overdose; 2) self-harm with injuries requiring medical attention; 3) acute psychotic episode; 4) drug/alcohol intoxication; 5) high risk of absconding (ASD/LD/LAC), 6) severe agitation/aggression; 7) eating disorders requiring medical intervention; 8) section 136 of the MHA; 9) break down of a social care placement; 10)medically unexplained symptoms.Data reviewed of all young people who were referred to A&E during March–April 2020. Each case was assessed as to whether they were then seen within the EAS Service.These cases were reviewed demographically looking at ethnicity, gender, while also reviewing the reason for referral.Result•A total of 90 cases referred to Urgent Care Team•Nineteen (21%) met criteria for assessment at EAS•80% of presentations between 12am and 9am.•Commonest reasons for referral : low mood with suicidal ideation (42%), anxiety (26%) →50% service users not previously known to CAMHS•Majority of service users were female•Mean age 15 years•All but one of the young people assessed at the EAS, were discharged home with community follow-upConclusion•Average total no. monthly referrals to CAMHS Urgent Care Team (UCT) fell from approx. 90 to 45.•Only a small proportion of referrals (21%) could be safely seen by the EAS, suggesting that the majority of young people required a joint assessment by A&E and CAMHS Urgent Care Team.•When need arises, very rapid reconfiguration and implementation of CAMHS emergency services is achievable.•EAS diverted a small number of young people from exposure to COVID-19 in A & E.•The service was set up speedily without evaluation of parent/carer/young people views or evaluation of cost-effectiveness.•If similar services are to be set up permanently, the balance between safety and the risk of division between mental & physical health services and potential to increase stigmatisation of mental illness should be considered.•Adaptation to future outbreaks should be informed by this initiative.

Prediction of root damaging during mechanical shaking of fruit trees

2014 ◽  
Vol 10 (1) ◽  
pp. 1-15
Author(s):  
Z. Láng
Keyword(s):  
Field Experiments ◽  
Calculated Data ◽  
Fruit Trees ◽  
List Type ◽  
Structure Model ◽  
Root Damage ◽  
Set Up ◽  
Simple Tree ◽  
The Given ◽  
Cherry Trees

The possible effect of shaker harvest on root damage of 10-year-old cherry trees was studied on a simple tree structure model. The model was composed of elastic trunk and rigid main roots, the ends of which were connected to the surrounding soil via springs and dumping elements. Equations were set up to be able to calculate the relation between shaking height on the trunk and strain in the roots. To get the data for root break and their elongation at different shaking heights on the trunk, laboratory and field experiments were carried out on cherry trees and on their roots. Having evaluated the measured and calculated data it could be concluded that root damage is to be expected even at 3.6% strain and the risk of it increases with increased trunk amplitudes, i.e.with the decrease of shaking heightat smaller stem diameters (i.e. in younger plantation), andif the unbalanced mass of the shaker machine is too large for the given tree size.

scholarly journals Cocaine Rituals in Club Culture: Intensifying and Controlling Alcohol Intoxication

2021 ◽  
pp. 002204262098651
Author(s):  
Marit Edland-Gryt
Keyword(s):  
Young Adult ◽  
Young People ◽  
Alcohol Intoxication ◽  
Qualitative Interviews ◽  
Cocaine Use ◽  
Interaction Rituals ◽  
Collective Effervescence ◽  
Drinking Culture ◽  
Cocaine Users ◽  
And Control

Clubbing is an important part of the nighttime economy, and cocaine use is, for some young people, an essential part of this clubbing culture. However, the interaction rituals around the use of powder cocaine in this context remain understudied. This study is based on qualitative interviews with young adult recreational cocaine users ( n = 28) and explores how they use cocaine in club settings, in relation to rituals and drinking culture. The analysis identified three main explanations for using cocaine: (a) unity with friends because of shared transgression, (b) the high as a “collective effervescence,” and (c) the possibility to control, extend, and intensify drinking to intoxication. These three explanations illustrate how cocaine rituals were deeply integrated in drinking-to-intoxication rituals, and how the illegality of cocaine use reinforced feelings of unity with friends. In the nighttime economy, cocaine use and its related rituals are used to intensify and control alcohol-fuelled partying.

scholarly journals Collateral impact of COVID-19: why should children continue to suffer?

2021 ◽  
Author(s):  
Prasad Nagakumar ◽  
Ceri-Louise Chadwick ◽  
Andrew Bush ◽  
Atul Gupta
Keyword(s):  
Young People ◽  
Large Scale ◽  
Hospital Admissions ◽  
Severe Disease ◽  
Children And Young People ◽  
Collateral Effects ◽  
Rsv Infection ◽  
Syncytial Virus ◽  
Set Up ◽  
The Uk

AbstractThe COVID-19 pandemic caused by SARS-COV-2 virus fortunately resulted in few children suffering from severe disease. However, the collateral effects on the COVID-19 pandemic appear to have had significant detrimental effects on children affected and young people. There are also some positive impacts in the form of reduced prevalence of viral bronchiolitis. The new strain of SARS-COV-2 identified recently in the UK appears to have increased transmissibility to children. However, there are no large vaccine trials set up in children to evaluate safety and efficacy. In this short communication, we review the collateral effects of COVID-19 pandemic in children and young people. We highlight the need for urgent strategies to mitigate the risks to children due to the COVID-19 pandemic. What is Known:• Children and young people account for <2% of all COVID-19 hospital admissions• The collateral impact of COVID-19 pandemic on children and young people is devastating• Significant reduction in influenza and respiratory syncytial virus (RSV) infection in the southern hemisphere What is New:• The public health measures to reduce COVID-19 infection may have also resulted in near elimination of influenza and RSV infections across the globe• A COVID-19 vaccine has been licensed for adults. However, large scale vaccine studies are yet to be initiated although there is emerging evidence of the new SARS-COV-2 strain spreading more rapidly though young people.• Children and young people continue to bear the collateral effects of COVID-19 pandemic

scholarly journals Collaborative digital platform France – Cuba: oncorehabilitation in reproductive and sexual health

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Thierry Almont ◽  
Louis Bujan ◽  
Clarisse Joachim ◽  
Guillaume Joguet ◽  
Mylène Vestris ◽  
...  
Keyword(s):  
Sexual Health ◽  
Cancer Registries ◽  
Cancer Surveillance ◽  
Practical Training ◽  
List Type ◽  
Digital Platform ◽  
Reproductive And Sexual Health ◽  
The Caribbean ◽  
Collaborative Platform ◽  
Set Up

Abstract Background In the French West-Indies, few studies have been performed on fertility and sexual problems in cancer survivors, which are frequent and recurring issues reported by surveys on unmet needs. Additionally, mutualizing human and material resources and promoting cooperation through a collaborative platform are the most appropriate response to complex health pathways in the Caribbean territories. Implementation of such a collaborative platform will help to launch a strategic Caribbean partnership to transfer theoretical and technical skills and care standards in oncofertility and oncosexuality. Methods We propose to set up a collaborative digital platform to strengthen, from the French expertise, Cuban health professionals’ knowledge, know-how, and skills in oncofertility and oncosexuality. The project will be coordinated by a coordinating, scientific, and supervisory committee, and the main activities will include: Theoretical training in e-learning adapted to low-speed Internet. Practical training in fertility preservation and sexual rehabilitation. Digital multidisciplinary consultation meetings for medical decisions to be taken for complex clinical cases. The platform will benefit from a recurrent evaluation, by the two cancer registries of Martinique and Cuba, with the following performance indicators: number of Cuban professionals trained, number of professionals sensitized, hourly volumes (or number of training courses provided), satisfaction of trained professionals, number of e-RCPs carried out online and number of missionaries supported. These indicators will be set up and analyzed by the registers. This project meets the Cuban and French health policies (cancer plans and national sexual health strategies) and will be implemented in liaison with the Health Agencies of both countries and the Embassy of France in Cuba. Discussion This project aims to provide support through bilateral exchanges to improve reproductive and sexual health in Cuba’s cancer patients. This collaboration will be based on a long-lasting French expertise and a solid Cuban health system. Consequently, this collaborative digital platform will contribute to data collection for cancer surveillance, and the two participating countries will ultimately be identified in the Caribbean as having centers of competence and excellence in oncofertility and oncosexuality with care standards.

Psychotic disorders in young adults with perinatally acquired HIV: a UK case series

2020 ◽  
pp. 1-7
Author(s):  
I. Mallik ◽  
T. Pasvol ◽  
G. Frize ◽  
S. Ayres ◽  
A. Barrera ◽  
...  
Keyword(s):  
Mental Health ◽  
Young Adults ◽  
Young People ◽  
Case Series ◽  
Psychotic Episode ◽  
Published Data ◽  
Growing Up ◽  
Term Care ◽  
Perinatally Acquired

Abstract Background Increasing numbers of children with perinatally acquired HIV (PaHIV) are transitioning into adult care. People living with behaviourally acquired HIV are known to be at more risk of psychosis than uninfected peers. Young adults living with PaHIV face numerous risk factors; biological: lifelong exposure to a neurotrophic virus, antiretroviral medication and immune dysfunction during brain development, and environmental; social deprivation, ethnicity-related discrimination, and migration-related issues. To date, there is little published data on the prevalence of psychotic illness in young people growing up with PaHIV. Methods We conducted a retrospective case note review of all individuals with PaHIV aged over 18 years registered for follow up at a dedicated clinic in the UK (n = 184). Results In total, 12/184 (6.5%), median age 23 years (interquartile range 21–26), had experienced at least one psychotic episode. The presentation and course of the psychotic episodes experienced by our cohort varied from short-lived symptoms to long term illness and nine (75%) appear to have developed a severe and enduring mental illness requiring long term care. Conclusion The prevalence of psychosis in our cohort was clearly above the lifetime prevalence of psychosis in UK individuals aged 16–34 years, which has been reported to be 0.5–1.0%. This highlights the importance of clinical vigilance regarding the mental health of young people growing up with PaHIV and the need to integrate direct access to mental health services within the HIV centres providing medical care.

scholarly journals Can evolutionary thinking shed light on gender diversity?

2019 ◽  
Vol 25 (6) ◽  
pp. 351-362 ◽  
Author(s):  
Bernadette Wren ◽  
John Launer ◽  
Michael J. Reiss ◽  
Annie Swanepoel ◽  
Graham Music
Keyword(s):  
Gender Identity ◽  
Gender Diversity ◽  
Medical Intervention ◽  
List Type ◽  
Sex And Gender ◽  
Medical Interventions ◽  
The Core ◽  
Causal Pathways ◽  
And Gender ◽  
Shed Light

SUMMARYIssues of sexual reproduction lie at the core of evolutionary thinking, which often places an emphasis on how individuals attempt to maximise the number of successful offspring that they can produce. At first sight, it may therefore appear that individuals who opt for gender-affirming medical interventions are acting in ways that are evolutionarily disadvantageous. However, there are persuasive hypotheses that might make sense of such choices in evolutionary terms and we explore these here. It is premature to claim knowledge of the extent to which evolutionary arguments can usefully be applied to issues of gender identity, although worth reflecting on the extent to which nature tends towards diversity in matters of sex and gender. The importance of acknowledging and respecting different views in this domain, as well as recognising both the uncertainty and likely multiplicity of causal pathways, has implications for clinicians. We make some suggestions about how clinicians might best respond when faced with requests from patients in this area.LEARNING OBJECTIVESAfter reading this article you will be able to:•understand evolutionary arguments about diversity in human gender identity•identify strengths and weaknesses in evolutionary arguments applied to transgender issues•appreciate the range and diversity of gender experience and gender expression among people who present to specialist gender services, as well as the likely complexities of their reasons for requesting medical intervention.

scholarly journals Why did the children stop coming? Reasons for paediatric emergency department attendance decrease during the first wave of the COVID-19 pandemic in the United Kingdom: A qualitative study

2021 ◽  
Author(s):  
Matthew Breckons ◽  
Sophie Thorne ◽  
Rebecca Walsh ◽  
Sunil Bhopal ◽  
Stephen Owens ◽  
...  
Keyword(s):  
Public Health ◽  
Emergency Department ◽  
United Kingdom ◽  
Substantial Reduction ◽  
Healthcare Services ◽  
Urgent Care ◽  
List Type ◽  
Paediatric Emergency Department ◽  
Paediatric Emergency ◽  
Health Messaging

AbstractObjectiveTo explore parent’s experiences and views relating to their use of children’s emergency healthcare services during the Covid-19 pandemic.DesignQualitative telephone interview study using in-depth interviews, based on the principles of grounded theory. Recorded, transcribed verbatim, managed in NVivo version 12, analysed by thematic analysis.SettingNorth East England, United Kingdom.ParticipantsParents of children aged 0-8 years.FindingsThree major themes emerged from the interview data: Risk to children and families, Sources of Information, and Making Healthcare-seeking Decisions. These themes encompassed a range of intellectual and emotional responses in the way that parents interpreted information related to Covid-19, and their sense of responsibility towards family and wider society.ConclusionsTogether these themes aid understanding of the changes in paediatric emergency department attendances reported in the early months of the Covid-19 pandemic in the UK. The analysis suggests that public health messaging directed at those seeking urgent care for children may be inadequate and lead to adverse consequences, the impacts of which require further study and refinement.What is known about the subjectFollowing lockdown, there was a substantial reduction in the number of children taken to unscheduled medical care across the countryDelays in presentation can impact on children’s healthIt is not known what parents’ views are on accessing emergency health services in a pandemic situationWhat this study addsParents had to weigh up a number of information sources before deciding on whether to take their child to hospitalPublic health messaging directed at those seeking urgent care for children may lead to a reduction in use of emergency healthcare servicesFuture lockdowns should implement focussed strategies, optimising use of emergency healthcare services, whilst avoiding harm.

scholarly journals Transition of young people from CAMHS to AMH 2017-19

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S168-S168
Author(s):  
Vesna Acovski ◽  
Rahat Ghafoor ◽  
Rachel Shead
Keyword(s):  
Young People ◽  
Clinical Audit ◽  
Transition Process ◽  
Poor Mental Health ◽  
Referral Letter ◽  
Service Users ◽  
Emergency Admissions ◽  
Face To Face ◽  
Transition Service ◽  
Transition Plan

AimsTransition from CAMHS to AMH is recognised as a potential struggle for young people who suffer with poor mental health. In response to the 2017-19 NHS CQUIN project, LPT organised a monthly working group to establish the best transition process & deliver the CQUIN project.BackgroundIt is estimated that more than 25,000 young people transition each year. It is reported that this process is often handled poorly, which can result in repeat assessments and emergency admissions for this large cohort of service users at a critical stage in life. The result is that young may go on to develop more severe problems in the absence of an appropriate transition service.MethodCohort of service users eligible for transition (17yrs 6months) was identified. They were referred from CAMHS to AMH with a transition plan and referral letter. A face-to-face transition meeting was arranged which included the patient, carer & clinicians from sending & receiving services. A clinical audit was completed to ensure that care was transferred to AMH post-18th birthday of the patient. The process was followed up by pre- and post-transitions surveys.ResultFrom 110 identified service users 46% had joint-agency transition meeting and 79% had transition plan in place. 72% felt prepared to transition to AMH and 89% felt their transition goals were met. Positive comments have been received from service users.ConclusionLink workers were identified to facilitate the transition process. Flow chart was established and disseminated across LPT. Services that need an improvement will be targeted and monitored. LPT will host an event for patients and carers to involve them in enhancing the transition process.

scholarly journals Development of a co-produced tool for monitoring and supporting the mental health of young people

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S267-S267
Author(s):  
Joy MacKeith ◽  
Anna Good ◽  
Sara Burns
Keyword(s):  
Mental Health ◽  
Young People ◽  
Psychometric Properties ◽  
Internal Consistency ◽  
Healthy Lifestyle ◽  
Care Plan ◽  
Medium Effect ◽  
Service Users ◽  
Extensive Experience ◽  
Active Involvement

AimsThe aims were to develop and validate a tool for monitoring and supporting the mental health of young people. Based on extensive experience of developing similar tools, the hypothesis was that a user-friendly tool could be produced with sound psychometric properties.BackgroundThe Outcomes Star is a suite of collaboratively completed, strengths-based tools with the dual roles of both supporting and monitoring change. Service users are empowered through their active involvement in identifying their strengths and creating their care plan. Triangle, the creators of the Outcomes Star was approached by a number of organisations to develop a version of the Star for young people with mental health issues in early intervention services and also to support young people in managing a diagnosed mental illness.MethodUsing a series of focus groups and an iterative process of refinement we gathered data from practitioners and service users on the domains in which they wish to create change, and the steps of the change process. A draft version of the new tool was piloted in two organisations by 67 workers and 177 young people over six months. The pilot data were analysed to assess the psychometric properties of My Mind Star (acceptability, skew, factor structure, internal consistency, item redundancy and responsiveness).ResultThe resulting tool, My Mind Star consisted of seven domains: Feelings and emotions, Healthy lifestyle, Where you live, Friends and relationships, School, training and work, How you use your time and Self-esteem. Almost all young people and practitioners (94%) agreed that their completed Star was ‘a good summary of my life right now’ and that it gave a better idea of service users’ support needs. Psychometric analyses indicated a unidimensional structure with good internal consistency (α = .76) and no item redundancy. My Mind Star was responsive to change between the first and second readings, with medium and small-medium effect sizes.ConclusionInitial findings suggest that My Mind Star has good psychometric properties and is perceived as acceptable and useful by young people and practitioners, Further research is planned to conduct a full validation of the psychometric properties of this Star including inter-rater reliability and predictive validity.Financial sponsorship of the study: Action for Children

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