scholarly journals Evaluation of physical health assessments for new admissions to the Oleaster during the first wave of COVID-19

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S88-S88
Author(s):  
Erin Lawson-Smith ◽  
Danielle Sutherland ◽  
Eleanor Brookes ◽  
Alex Zhang ◽  
Joji George
Keyword(s):  
Physical Health ◽  
Smoking Status ◽  
Health Assessment ◽  
Data Set ◽  
Positive Effects ◽  
Retrospective Audit ◽  
Health Assessments ◽  
Medical Records System ◽  
Mental Health Foundation ◽  
Psychiatry Trainee

AimsPhysical health of psychiatric inpatients is worse than the general population. Physical health monitoring of these patients can have positive effects on outcomes. Birmingham and Solihull Mental Health Foundation Trust (BSMHFT) states that a physical health assessment (PHA) should be completed within 72 hours of admission. This comprises a physical health form (PHF) and minimum data set (MDS): BP, BMI, TB and BBV status, alcohol and drug screen, smoking status, Hba1c and lipids. In a 2017 audit, compliance was shown to need improvement, with 28.3% of admissions not having a PHF documented.ObjectivesTo assess whether PHAs for new admissions to the Oleaster, Birmingham during the first wave of COVID-19 were completed in line with trust policyTo compare findings with a previous auditTo make recommendations to improve inpatient physical health and compliance with trust policyMethodA retrospective audit was conducted, with PHA details accessed via the electronic medical records system RiO. Admissions from 16/03/2020-30/06/2020 were accessed and 158 admissions (155 patients) were included. 21 admissions were excluded as they were internal transfers; only data from the initial admission were included. Data were collected by 2 medical students and a psychiatry trainee using a data collection tool. Data were recorded and analysed on Excel.ResultOf 158 admissions, 81 had PHFs (51.3%). 59 were completed within 72 hours of admission (34.3%); 39 were completed fully (24.7%). Of incomplete PHFs, 2 explicitly stated incompletion due to COVID-19. 22 PHFs were created but not completed within 72 hours. 15 gave a deferral reason e.g., refusal to consent or agitation. For 77 admissions (47.3%), no assessment was documented, with no reason given.2 admissions (1.3%) recorded the full MDS within 72 hours of admission.2 admissions (1.3%) had fully complete PHAs (PHF and MDS) within 72 hours of admission, fulfilling trust policy.Conclusion51.3% of admissions had a PHF, with 34.3% documented within 72 hours of admission. However, only 1.3% of admissions fulfilled trust policy of both a completed PHF and MDS within 72 hours of admission. There were more admissions without a PHF than in the previous 2017 audit; 47.33% compared to 28.3% previously. Given trust targets that a PHA should be fully completed for 100% of admissions, it was found that the Oleaster did not meet these guidelines during this period and improvements must be made to maintain integrity of patient care.

scholarly journals Microfinance and Vulnerability to Seasonal Famine in a Rural Economy: Evidence from Monga in Bangladesh

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Claudia Berg ◽  
M. Shahe Emran
Keyword(s):  
Food Security ◽  
Rural Economy ◽  
Screening Process ◽  
Data Set ◽  
Estimation Strategy ◽  
Positive Effects ◽  
Unique Data ◽  
Primary Mechanism ◽  
Poor Households ◽  
Microfinance Institution

AbstractThis paper uses a unique data set on 143,000 poor households from Northern Bangladesh to analyze the effects of microfinance membership on a household’s ability to cope with seasonal famine known as Monga. We develop an identification and estimation strategy that exploits a jump and a kink at the 10-decimal land ownership-threshold driven by the Microfinance Institution screening process to ensure repayment by excluding the ultra-poor. Evidence shows that microfinance membership improves food security during Monga, especially for the poorest households who survive at the margin of one and two meals a day. The positive effects on food security are, however, not driven by higher income, as microcredit does not improve the ability to migrate for work, nor does it reduce dependence on distress sale of labor. The evidence is consistent with consumption smoothing being the primary mechanism behind the gains in food security of MFI households during the season of starvation.

scholarly journals Microfinance and Vulnerability to Seasonal Famine in a Rural Economy: Evidence from Monga in Bangladesh

2020 ◽  
Vol 20 (3) ◽  
Author(s):  
Claudia Berg ◽  
M. Shahe Emran
Keyword(s):  
Food Security ◽  
Rural Economy ◽  
Screening Process ◽  
Data Set ◽  
Estimation Strategy ◽  
Positive Effects ◽  
Unique Data ◽  
Primary Mechanism ◽  
Poor Households ◽  
Microfinance Institution

AbstractThis paper uses a unique data set on 143,000 poor households from Northern Bangladesh to analyze the effects of microfinance membership on a household's ability to cope with seasonal famine known as Monga. We develop an identification and estimation strategy that exploits a jump and a kink at the 10 decimal land ownership-threshold driven by the Microfinance Institution (MFI) screening process to ensure repayment by excluding the ultra-poor. Evidence shows that microfinance membership improves food security during Monga, especially for the poorest households who survive at the margin of one and two meals a day. The positive effects on food security are, however, not driven by higher income, as microcredit does not improve the ability to migrate for work, nor does it reduce dependence on distress sale of labor. The evidence is consistent with consumption smoothing being the primary mechanism behind the gains in food security of MFI households during the season of starvation.

Health assessments for Indigenous Australians at Orange Aboriginal Medical Service: health problems identified and subsequent follow up

2016 ◽  
Vol 22 (3) ◽  
pp. 233 ◽  
Author(s):  
Tegan Dutton ◽  
Wendy Stevens ◽  
Jamie Newman
Keyword(s):  
Medical Service ◽  
Pap Smear ◽  
Aboriginal Health ◽  
Indigenous Australians ◽  
Adult Women ◽  
Health Issues ◽  
Retrospective Audit ◽  
Health Assessments ◽  
Clinical Records

This study aimed to document the types, management and follow up of health issues identified by all Aboriginal Health Assessments (AHA) performed at Orange Aboriginal Medical Service from 1 January 2011 to 31 December 2012. This was done with a retrospective audit of clinical records. In total, 1169 AHAs were performed: 41% child, 53% adult and 6% older person AHAs. Newly identified health issues were documented in 85% (984). Being overweight (41%; 476) and smoking (26%; 301) were the common risk factors identified. As a result of the AHA, most children who were not up-to-date with their vaccinations received catch-up immunisations; 11% (36) of adult women (n=314) received a Pap smear, although Pap smear status was unknown or not up-to-date for 61% (192); 27% (311) of cases were prescribed new medication; and 1239 referrals were made but only 40% were attended. At 6 months following the AHA, 26% (240) of cases with newly identified health issues were completely managed and followed up, whereas 25% (226) received no follow up. The AHAs are useful for identifying new health issues; however, follow up of the identified health issues should be improved. If AHAs are to improve health outcomes, appropriate management and follow up of the identified health issues are essential.

scholarly journals Completed Audit of Physical Health Status of Patients with Severe Mental Illness in a Medium Secure Forensic Psychiatric Rehab Ward

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
M. George ◽  
P. Thakkar ◽  
K. Vasudev ◽  
N. Mitcheson
Keyword(s):  
Health Status ◽  
Physical Health ◽  
Health Monitoring ◽  
Smoking Status ◽  
Physical Health Status ◽  
Medication Regimen ◽  
National Guidelines ◽  
Blood Lipid Profile ◽  
Cholesterol Ratio ◽  
Image Position

Aim:An audit was conducted in September 2006 to determine whether the Physical health monitoring of patients on anti-psychotic medication was concurrent with the national guidelines.This audit done in Dec 07 aimed to ascertain to what extent the recommendations were implemented and followed, thereby completing the audit cycle.Methods:The Audit was conducted in a 15 bedded medium secure forensic rehab ward.As there was a lack of recording of the physical health status a monitoring sheet was introduced in the notes after the first audit. Age, Weight, Height, Smoking status, Blood Pressure, Diabetic Status, Blood Lipid Profile, ECG and the Medication regimen were noted for each of the patient.Results:Conclusion:100% physical health monitoring was achieved and improvements in weight, CV risk, Total/HDL cholesterol ratio was noted 4 cases of significant QT prolongation and another 3 cases of prolactin elevation were detected because of the introduction of monitoring.

scholarly journals A pilot study of possible anti-inflammatory effects of the specific carbohydrate diet in children with juvenile idiopathic arthritis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Lillemor Berntson
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Health Assessment ◽  
Short Chain Fatty Acids ◽  
Carbohydrate Diet ◽  
Positive Effects ◽  
Link Type ◽  
Parents And Children ◽  
Inflammatory Proteins ◽  
Anti Inflammatory ◽  
Specific Carbohydrate Diet

Abstract Background To explore possible anti-inflammatory effects of the specific carbohydrate diet in children with juvenile idiopathic arthritis. This diet has shown anti-inflammatory effect in children with inflammatory bowel disease. Methods Twenty-two patients with juvenile idiopathic arthritis (age 6.3–17.3 years), with ≤2 inflamed joints and an erythrocyte sedimentation rate < 30 mm/h, were included in this explorative study. Fifteen children completing four weeks on the diet were evaluated. A dietician introduced parents and children to the diet, and two follow-ups were performed during the intervention. Conventional laboratory tests and multiplex analyses of 92 inflammatory proteins were used. Short-chain fatty acids in faecal samples were examined. Results The diet significantly decreased morning stiffness (p = 0.003) and pain (p = 0.048). Physical function, assessed through the child health assessment questionnaire, improved (p = 0.022). Arthritis improved in five of the seven children with arthritis; in those seven, multiplex analyses showed a significant decrease in nine inflammatory proteins, including TNF-alpha (p = 0.028), after four weeks. Faecal butyrate, analysed in all 15 participants, increased significantly (p = 0.020). Conclusion The specific carbohydrate diet may have significant positive effects on arthritis in children with juvenile idiopathic arthritis, but further studies are needed. Clinical trials identifier NCT04205500, 2019/12/17, retrospectively registered. URL: https://register.clinicaltrials.gov

P–184 Assisted hatching does not improve live birth rates, a prospective double-blinded randomized study

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
V Montalvo ◽  
J Masso ◽  
A Garcia-Faura ◽  
B Marques ◽  
M Lopez-Teijon
Keyword(s):  
Live Birth ◽  
Human Embryos ◽  
Assisted Hatching ◽  
Small Data ◽  
Success Rates ◽  
Birth Rates ◽  
Data Set ◽  
Positive Effects ◽  
Live Birth Rates ◽  
Frozen Embryo Transfers

Abstract Study question Does Assisted hatching (AH) improve success rates when applied to frozen embryo transfers? Summary answer AH does not improve implantation, ongoing pregnancy or live birth rates when applied to thawed embryos. What is known already Vitrification has been proven to be the most efficient technique to preserve human embryos. However, vitrification has some consequences for the embryos, zona pellucida (ZP) hardening being one of them. Multiple studies suggest the need to apply laser Assisted hatching or ZP thinning to thawed embryos in order to improve success rates. Still, there is not enough evidence to ensure the utility of AH, and considering the great variation in design between studies more evidence is needed. Study design, size, duration Study performed from October 2019 and January 2020. Disregarding embryos with natural Hatching and PGT-A. Embryos that, immediately after thawing, were completely expanded (trophectoderm in contact with ZP) were also excluded from the study. We applied a randomization to choose in which embryos we had to perform AH. Neither the gynecologist nor the embryologist performing the embryo transfer knew whether the embryo had AH performed or not. Participants/materials, setting, methods 353 frozen embryo transfers of one blastocist were considered for the study, 71 excluded for expansion after thawing, 65 excluded because of PGT-A, 103 in which we performed AH (AH+) and 114 without AH (AH-). In the AH+ group we performed laser-AH of 1/3 of the ZP, avoiding to damage the trophectoderm and performing the laser shots as far away to the ICM as possible. We used Chi-square testing to assess the effects of AH. Main results and the role of chance We assessed all relevant clinical data parameters. No statistical differences were found in egg age, maternal age, embryo quality, nor endometrial thickness between groups. Implantation and miscarriage rates were equivalent between AH+ group (40.9%; 20.5%) and AH- group (47.4%; 18.5%). The main outcome of this study was live birth rates. No statistical differences were found between groups (AH-= 38.6%; AH + = 30.1%; p = 03221) proving that making it easier to get out of the ZP does not affect success rates. Analyzing the data from the excluded embryos we found no improvement on live birth rates when embryos were expanded just after thawing (38.0%; p = 0.457). As expected, PGT-A embryos yielded higher live birth rates (52.3%; p &lt; 0,05) Limitations, reasons for caution Preliminary study with a small data set. Wider implications of the findings: This study suggest that thawed embryos have the capacity to get out of the ZP regardless if AH was performed or not. Having no positive effects, AH seems to be unnecessary in this scenario. Trial registration number Not applicable

Influence of exercise and fasting on blood parameters in juvenile green turtles (Chelonia mydas): implications for health assessments

2020 ◽  
pp. 1-8
Author(s):  
D. March ◽  
E. Ariel ◽  
D. Blyde ◽  
L. Christidis ◽  
B.P. Kelaher
Keyword(s):  
Biochemical Parameters ◽  
Health Assessment ◽  
Chelonia Mydas ◽  
Blood Parameters ◽  
Fasting State ◽  
Intense Exercise ◽  
Post Exercise ◽  
Green Turtles ◽  
Health Assessments ◽  
Lactate Levels

This study investigated the influence of exercise and fasting state on haematologic and biochemical parameters in juvenile green turtles (Chelonia mydas). Animals were divided into two groups; one group was fasted for 72 h and one group was fed 1 h prior to exercise. Exercise was induced by repeated righting reflexes and blood values were measured prior to and post-exercise. Prior to exercise, fasted animals showed significantly decreased levels of urea, pH, PVCO2 and HCO3- and significant increases in Cl- and PVO2, compared to fed animals and fasted animals had significantly poorer exercise performance. Following exercise both fasted and fed animals had significant increases in Na+, K+, Cl-, PVCO2, PVO2, urea and lactate and significant decreases in pH and HCO3-. The magnitude of increase in lactate levels was significantly less in fasted animals. Prior to exercise, a significant correlation was calculated in fasted animals between pH and HCO3-. Following exercise, significant correlations were calculated in fed animals between pH and HCO3-, PVCO2 and lactate, and between pH and HCO3- in fasted animals. These results show that analytical method, fasting state and the physiologic changes induced during the intense exercise can affect haematologic and biochemical analytes and these factors should be considered when interpreting results from health assessment of wild animals.

Advantaged/Disadvantaged School Neighborhoods, Parental Networks, and Parental Involvement at Elementary School

2017 ◽  
Vol 90 (4) ◽  
pp. 355-377 ◽  
Author(s):  
Angran Li ◽  
Mary J. Fischer
Keyword(s):  
Elementary School ◽  
First Grade ◽  
School Level ◽  
School Involvement ◽  
School Students ◽  
Data Set ◽  
Positive Effects ◽  
Parental School Involvement ◽  
Formal Organizations ◽  
Nationally Representative

This article examines the relationship between parental networks and parental school involvement during the elementary school years. Using a large, nationally representative data set of elementary school students—the Early Childhood Longitudinal Study–Kindergarten Cohort—and contextual data from the 2000 U.S. Census, our multilevel analysis shows that higher levels of parental networks in first grade are associated with higher levels of parental school involvement in third grade after controlling for individual- and school-level characteristics. Parental networks are positively related to school involvement activities in formal organizations that consist of parents, teachers, and school staff, including participating in parent–teacher organizations and volunteering at school. Furthermore, the positive effects of parental networks on parental school involvement is stronger for families whose children attend schools in disadvantaged neighborhoods. This suggests that well-connected parental networks can serve as a buffer against school neighborhood disadvantages in encouraging parents to be actively involved in schools.

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