scholarly journals The efficiency of the medical role within a Single Point of Access (SPA) Service in reducing the number of clinic appointments required

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S312-S312
Author(s):  
Anca Bradu ◽  
Sam Nayrouz
Keyword(s):  
Social Services ◽  
Support Groups ◽  
Secondary Care ◽  
Single Point ◽  
Police Psychology ◽  
Electronic Patient Records ◽  
Clinic Appointment ◽  
Male Patients ◽  
Medical Role ◽  
And Gender

AimsThe SPA service takes referrals from general practitioners (GPs), medical professionals, the London Ambulance service, the London Police, psychology and social services, and from patients themselves and their family members or support groups. Some of these referrals require input from secondary care, but others can be solved within primary care if given specialist advice, this minimizing the time spent by patients in the healthcare system and minimizing also the NHS costs.Our aim was to evaluate the implementation of the Advice from Medics Service in a 1-year period.MethodWe examined a random sample of 200 referrals between 1st of April 2019 and 31st of March 2020 out of all referrals that were considered, after the triage, to be appropriate for an advice on treatment provided by the medics as an alternative to a clinic appointment in secondary care. We collected information from the electronic patient records regarding the dates of referrals, the senders of referrals, the type of referrals, the age and gender of patients and the reasons to be referred, and finally we analysed the outcome of the referrals and compared it with the action requested.ResultOf the 200 referrals, 113 were for female patients and 87 for male patients. The age of patients was between 18 and 91 years old, with a median of 43 years old.The person/authority making the referral was the GP in 179 cases, and others in 21 cases.The referrers asked for review in 74 cases, urgent review in 2 cases, review and advice in 31 cases, only advice in 46 cases, and did not state the type of referral in 47 cases.The primary pathology implied was affective in most of the cases (122), followed by psychotic (31) and neurotic (22), organic (8), of personality (5), hyperkinetic disorders (5), due to substance misuse (4), of psychological development (2) and learning disability (1).The outcome of the referrals was as follows: 19 patients (9.5%) were seen by the Crisis Team, 11 (5.5%) were referred to other teams, 4 (2%) did not engage with SPA, and the rest of 166 (83%) referrals were solved with advice.ConclusionThe outcome was extremely favourable as the majority of referrals requested medical review but most of them (83%) were solved with specialist advice to GPs or other professionals, highlighting that the implementation of the Advice from Medics Service has been an improvement to the SPA.

scholarly journals Recommendations for improving follow-up care for patients with mesothelioma: a qualitative study comprising documentary analysis, interviews and consultation meetings

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040679
Author(s):  
Catherine Henshall ◽  
Zoe Davey ◽  
Helen Walthall ◽  
Hannah Ball ◽  
Mitra Shahidi ◽  
...  
Keyword(s):  
Support Groups ◽  
Secondary Care ◽  
Trial Participation ◽  
Care Pathways ◽  
Pleural Mesothelioma ◽  
Tertiary Centre ◽  
Documentary Analysis ◽  
Follow Up Care ◽  
Recommendations For Practice

ObjectivesThe study aim was to explore experiences of patients with pleural mesothelioma of follow-up care in three National Health Service (NHS) Trusts to develop recommendations for practice.DesignThe study design was qualitative and comprised three interlinked phases: a documentary analysis, interviews and consultation meetings. Altheide and Johnson’s Analytic Realism theoretical framework guided the thematic data analysis process.SettingThe study was conducted in three NHS Trusts in South England. Two were secondary care settings and the third was a tertiary centre.ParticipantsThe secondary care trusts saw 15–20 patients with new mesothelioma per year and the tertiary centre 30–40. The tertiary centre had a designated mesothelioma team. Twenty-one patients met the inclusion criteria: >18 years, mesothelioma diagnosis and in follow-up care. Non-English speaking participants, those unable to provide written informed consent or those whom the clinical team felt would find participation too distressing were excluded. All participants were white, 71% were 70–79 years old and 71% were men. Three consultation meetings were conducted with key stakeholders including mesothelioma nurse specialists, patients with mesothelioma, carers and local clinical commissioning group members.Main outcome measuresSpecific outcomes were to gain a detailed understanding of mesothelioma follow-up care pathways and processes and to develop coproduced recommendations for practice.ResultsMesothelioma pathways were not always distinct from lung cancer care pathways. All trusts provided follow-up information and resources but there was varied information on how to access local support groups, research or clinical trial participation. Five themes were developed relating to people; processes; places; purpose and perception of care. Coproduced recommendations for improving mesothelioma follow-up pathways were developed following the consultation meetings.ConclusionsThis study has developed recommendations which identify the need for patients with pleural mesothelioma to access consistent, specialist, streamlined mesothelioma care, centred around specialist mesothelioma nurses and respiratory consultants, with input from the wider multidisciplinary team.

scholarly journals “When we talk about intimate partner violence we talk in an adult way” – Social workers’ descriptions of intimate partner violence between teenagers

2021 ◽  
pp. 147332502110028
Author(s):  
Emmy Högström Tagesson ◽  
Carina Gallo
Keyword(s):  
Intimate Partner Violence ◽  
Social Workers ◽  
Social Services ◽  
Partner Violence ◽  
Qualitative Interviews ◽  
Intimate Partner ◽  
Treatment Quality ◽  
Age And Gender ◽  
The Social ◽  
And Gender

This article examines how seven social workers within the Swedish social services describe intimate partner violence between teenagers (IPV-BT). The article adds to the literature by examining IPV-BT outside a U.S. context, where most studies have been conducted. Based on semistructured qualitative interviews, the authors analyze descriptions of IPV-BT in relation to Charles Tilly’s notion of category making through transfer, encounter, negotiation, and imposition. They also analyze how the social workers’ descriptions of IPV-BT relate to the intersection between age and gender. The results show that the social workers mostly described IPV-BT by referring to encounters with teenagers and by transferring knowledge and theoretical definitions from their specialized working areas, primarily intimate partner violence between adults (IPV-BA) and troubled youth. More rarely, the social workers based their definitions of IPV-BT upon negotiating dialogues with teenagers. Also, those who worked in teams specialized on IPV had the mandate to impose their definitions of IPV-BT to other professionals and teenagers. When taking age and gender hierarchies in consideration, the results show IPV-BT risks being subordinate IPV-BA on a theoretical level, a practical level and in terms of treatment quality. The study suggests that social work with IPV-BT needs to be sensitive to the double subordinations of the teenage girl and of the teenagers who do not follow gender expectations.

Women and Athletic Fund Raising: Exploring the Connection between Gender and Giving

1996 ◽  
Vol 10 (4) ◽  
pp. 401-416 ◽  
Author(s):  
Ellen J. Staurowsky
Keyword(s):  
Support Groups ◽  
Support Group ◽  
Fund Raising ◽  
Demographic Characteristics ◽  
Division I ◽  
Division Iii ◽  
Donor Motivation ◽  
Chi Square ◽  
Motivation Factors ◽  
And Gender

In this study, demographic characteristics and donor motivation profiles of donors to a Division I and a Division III men's athletic support group and a Division I and a Division III women's athletic support group (N = 20l )were compared. Demographic characteristics and donor motivation factors were measured by the Athletic Contributions Questionnaire Revised Edition-II (AC-QUIRE-II). Chi-square tests for two independent samples were used along with SPSS-X Crosstabs procedures to test the differences in demographic variables between the donors to men's and women's athletic support groups and female and male donors. Multivariate analyses of variance with follow up univariate F-tests were used to examine differences in donor motivation on the basis of gender of the donor and gender of the recipient. Based on the findings from this study, a preliminary profile suggests that female athletic donors are younger than their male counterparts, contribute at lower donation levels, are more inclined to give to women's programs, and are motivated by success and philanthropic factors.

scholarly journals What is the prevalence of dyslipidemia in patients with idiopathic tinnitus?

2020 ◽  
Vol 8 (8) ◽  
pp. 2983
Author(s):  
Suleyman Erdogdu
Keyword(s):  
Blood Lipid ◽  
Control Group ◽  
Test Results ◽  
Cochlear Blood Flow ◽  
Number Of Patients ◽  
Significant Difference ◽  
Low Hdl ◽  
Training And Research ◽  
Male Patients ◽  
And Gender

Background: Dyslipidemia is a metabolic disorder that results from imbalanced and overfeeding as well as sedentary life. Elevated blood lipid levels can affect cochlear blood flow and fluidity, leading to decreased hearing and tinnitus. We aimed to determine whether there is a relationship between tinnitus and dyslipidemia by investigating the blood lipoprotein values of patients with tinnitus.Methods: The lipid profiles of the patients with idiopathic tinnitus who were selected among the patients who applied to Istanbul Haydarpaşa Numune Training and Research Hospital with the complaint of tinnitus between January 2019 and May 2020 were examined. The test results and age and gender distributions were compared with control groups without tinnitus complaints and statistical evaluation was performed.Results: Hypercholesterolemia in 42% of 6472 patients with idiopathic tinnitus, 18% low HDL, 50% high LDL, Hyperlipidemia was detected in 21%. 1942 (30%) of these patients were male; 4530 (70%) are women. The number of patients in the control group without tinnitus was 6470. Hypercholesterolemia in 49% of this group; 21% low HDL, 42% high LDL, 16% hyperlipidemia was detected. In this control group, 1950 (30%) of the patients were male and 4520 (70%) were female. Cholesterol of male and female patients with tinnutus. When the cholesterol, LDL and triglyceride values of HDL and LDL values and female and male patients in the control group were examined, a statistically significant difference was found (p <0.005). No statistically significant difference was found between HDL values of female and male patients with tinnutus and HDL values of female and male patients in the control group (P> 0.05).Conclusions: There is a statistically relationship between tinnitus and dyslipidemia. The presence of dyslipidemia is vital due to atherosclerosis caused by dyslipidemia, especially coronary artery involvement. Therefore, dyslipidemia should be treated as it causes many diseases.

scholarly journals The nasopalatine canal and its relationship with the maxillary central incisors: a cone-beam computed tomography study

2021 ◽  
Vol 10 (15) ◽  
pp. e351101522978
Author(s):  
Ana Carolina Neves Melgaço de Lima ◽  
Dominique A. Peniche ◽  
Thais M. C. Coutinho ◽  
Fábio R. Guedes ◽  
Maria Augusta Visconti ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Average Diameter ◽  
Cone Beam ◽  
Nasopalatine Canal ◽  
Gender And Age ◽  
Post Test ◽  
Male Patients ◽  
And Gender ◽  
Student’S T

Objective: To evaluate the dimensions of the nasopalatine canal (NPC) and its relationship with the maxillary central incisors (MCI) using cone-beam computed tomography (CBCT) and to determine variations in the NPC in relation to age and gender. Methods: CBCT scans from 333 patients (67% female; 35.9 ± 14.6 years) were included. The CBCT scan was analyzed to determine the length and diameter of the NPC, the distance between the NPC and the MCI, and to evaluate the morphology of the NPC. The data were analyzed using the independent Student's t-test, the Mann–Whitney and Kruskal–Wallis tests, and Dunn's post-test (p < 0.05). Results: The average diameter and length of the NPC were 2.92 ± 0.91 mm and 12.67 ± 3.32 mm, respectively. The minimum and maximum distance between the MCI and the NPC were 0.78 ± 0.42 mm and 2.56 ± 1.38 mm, respectively. The NPC of male patients was greater in length compared with the female patients (p < 0.05). The majority presented a funnel-like morphology (34.1%), followed by a cylindrical morphology (27.5%). Conclusions: There was variability in the dimensions of the NPC and its relationship with the MCI, which was influenced by gender and age.

The multidisciplinary team

2021 ◽  
pp. 561-592
Author(s):  
Terry Robinson ◽  
Jane Scullion
Keyword(s):  
Lung Function ◽  
Respiratory Disease ◽  
Social Services ◽  
Health Professionals ◽  
Multidisciplinary Team ◽  
Secondary Care ◽  
Patient Population ◽  
Community Pharmacists ◽  
Occupational Therapists

Respiratory services should be delivered in an integrated way, taking into account the overlap in patient population and in the personnel providing care. The majority of patients with respiratory disease are cared for by a team of health professionals from both primary and secondary care. Respiratory nurses work as part of the multidisciplinary team. This team includes doctors, ward-based, and outpatient nurses, physiotherapists, occupational therapists, lung-function technicians, community pharmacists, social services and, of course, the patient, and their family and carers. This chapter outlines the responsibilities and contributions of each member of the multidisciplinary team in providing respiratory services.

scholarly journals Increased DJ-1 in Urine Exosome of Korean Males with Parkinson’s Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Dong Hwan Ho ◽  
Sanghak Yi ◽  
Hyemyung Seo ◽  
Ilhong Son ◽  
Wongi Seol
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dependent Manner ◽  
Protein Levels ◽  
Significant Difference ◽  
Daily Dose ◽  
Male Patients ◽  
And Gender ◽  
Urine Exosomes ◽  
Potential Use

Parkinson’s disease (PD) is a difficult disease to diagnose although it is the second most common neurodegenerative disease. Recent studies show that exosome isolated from urine contains LRRK2 or DJ-1, proteins whose mutations cause PD. To investigate a potential use for urine exosomes as a tool for PD diagnosis, we compared levels of LRRK2,α-synuclein, and DJ-1 in urine exosomes isolated from Korean PD patients and non-PD controls. LRRK2 and DJ-1, but notα-synuclein, were detected in the urine exosome samples, as reported previously. We initially could not detect any significant difference in these protein levels between the patient and the control groups. However, when age, disease duration, L-dopa daily dose, and gender were considered as analytical parameters, LRRK2 and DJ-1 protein levels showed clear gender-dependent differences. In addition, DJ-1 level was significantly higher (1.7-fold) in male patients with PD than that in male non-PD controls and increased in an age-dependent manner in male patients with PD. Our observation might provide a clue to lead to a novel biomarker for PD diagnosis, at least in males.

scholarly journals Neuroactive Steroids in First-Episode Psychosis: A Role for Progesterone?

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Martino Belvederi Murri ◽  
Flaminia Fanelli ◽  
Uberto Pagotto ◽  
Elena Bonora ◽  
Federico Triolo ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Serum Levels ◽  
First Episode Psychosis ◽  
Neuroactive Steroids ◽  
First Episode ◽  
Positive Symptoms ◽  
Symptom Dimensions ◽  
Episode Psychosis ◽  
Male Patients ◽  
And Gender

Neuroactive steroids may play a role in the pathophysiology of psychotic disorders, but few studies examined this issue. We compared serum levels of cortisol, testosterone, dehydroepiandrosterone, and progesterone between a representative sample of first-episode psychosis (FEP) patients and age- and gender-matched healthy subjects. Furthermore, we analyzed the associations between neuroactive steroids levels and the severity of psychotic symptom dimensions. Male patients had lower levels of progesterone than controls (p=0.03). Progesterone levels were inversely associated with the severity of positive symptoms (p=0.007). Consistent with preclinical findings, results suggest that progesterone might have a role in the pathophysiology of psychotic disorders.

The Effects of Prenatal Care on Birth Outcomes: Reconciling a Messy Literature

2019 ◽  
Author(s):  
Hope Corman ◽  
Dhaval Dave ◽  
Nancy E. Reichman
Keyword(s):  
Prenatal Care ◽  
Social Services ◽  
Support Groups ◽  
Birth Outcomes ◽  
Low Birthweight ◽  
Population Level ◽  
Spillover Effects ◽  
The United States ◽  
Long Term Effects

Prenatal care, one of the most frequently used forms of healthcare in the United States, involves a series of encounters during the gestational period, educates women about pregnancy, monitors existing medical conditions, tests for gestational health conditions, and refers expectant mothers to services such as support groups and social services. However, an increasingly methodologically rigorous literature suggests that the effects of prenatal care timing and quantity on birth outcomes, particularly low birthweight, are modest at the population level. A review and synthesis of the literature suggests that the questions typically being asked may be too narrow and that more attention should be paid to the characterization of infant health, characterization of the content and quality of prenatal care, potential heterogeneous effects, potential indirect effects on health behaviors that may benefit offspring, potential long-term effects, potential spillover effects (i.e., on mothers and their subsequent children), effects of preconceptional and lifetime care, and intergenerational effects.

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