scholarly journals Personality disorder services in England: findings from a national survey

2017 ◽  
Vol 41 (5) ◽  
pp. 247-253 ◽  
Author(s):  
Oliver Dale ◽  
Faisil Sethi ◽  
Clive Stanton ◽  
Sacha Evans ◽  
Kirsten Barnicot ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Service Provision ◽  
Service Use ◽  
Equal Access ◽  
Clinical Implications ◽  
Levels Of Service ◽  
And Training ◽  
English National Health ◽  
English National Health Service

Aims and methodWe aimed to evaluate the availability and nature of services for people affected by personality disorder in England by conducting a survey of English National Health Service (NHS) mental health trusts and independent organisations.ResultsIn England, 84% of organisations reported having at least one dedicated personality disorder service. This represents a fivefold increase compared with a 2002 survey. However, only 55% of organisations reported that patients had equal access across localities to these dedicated services. Dedicated services commonly had good levels of service use and carer involvement, and engagement in education, research and training. However, a wider multidisciplinary team and a greater number of biopsychosocial interventions were available through generic services.Clinical implicationsThere has been a substantial increase in service provision for people affected by personality disorder, but continued variability in the availability of services is apparent and it remains unclear whether quality of care has improved.

scholarly journals Prescribing for personality disorder: qualitative study of interviews with general and forensic consultant psychiatrists

2014 ◽  
Vol 38 (3) ◽  
pp. 116-121 ◽  
Author(s):  
Lawrence Martean ◽  
Chris Evans
Keyword(s):  
Personality Disorder ◽  
Qualitative Study ◽  
Clinical Implications ◽  
Structured Interviews ◽  
Relational Processes ◽  
Technological Interventions ◽  
Patient Relationships ◽  
And Training ◽  
Pharmaceutical Interventions

Aims and methodTo explore experiences of psychiatrists considering medication for patients with personality disorder by analysis of transcribed, semi-structured interviews with consultants.ResultsThemes show important relational processes in which not prescribing is expected to be experienced as uncaring rejection, and psychiatrists felt helpless and inadequate as doctors when unable to relieve symptoms by prescribing. Discontinuity in doctor–patient relationships compounds these problems.Clinical implicationsProblems arise from: (a) the psychopathology creating powerful relational effects in consultation; (b) the lack of effective treatments, both actual and secondary to under-resourcing and neglect of non-pharmaceutical interventions; and (c) the professionally constructed role of psychiatrists prioritising healing and cure through provision of technological interventions for specific diagnoses. There is a need for more treatments and services for patients with personality disorder; more support and training for psychiatrists in the relational complexities of prescribing; and a rethink of the trend for psychiatrists to be seen primarily as prescribers.

scholarly journals Ethnic variation in personality disorder: evaluation of 6 years of hospital admissions

2018 ◽  
Vol 42 (4) ◽  
pp. 157-161 ◽  
Author(s):  
A. Hossain ◽  
M. Malkov ◽  
T. Lee ◽  
K. Bhui
Keyword(s):  
Personality Disorder ◽  
Ethnic Differences ◽  
Service Use ◽  
Hospital Admissions ◽  
Admission Rate ◽  
Clinical Implications ◽  
Ethnic Variation ◽  
Limited Evidence ◽  
Alternative Service ◽  
Minority Ethnic

Aims and methodThere is limited evidence on ethnic differences in personality disorder prevalence rates. We compared rates of people with personality disorder admitted to hospital in East London from 2007 to 2013.ResultsOf all people admitted to hospital, 9.7% had a personality disorder diagnosis. The admission rate for personality disorder has increased each year. Compared with White subjects, personality disorder was significantly less prevalent among Black and other minority ethnic (BME) groups. Personality disorder was diagnosed in 20% of forensic, 11% of general adult, 8% of adolescent and 2% of old-age in-patients.Clinical implicationsThe increasing number of personality disorder diagnoses year on year indicates the increasing impact of personality disorder on in-patient services. It is important to identify and appropriately manage patients with a personality disorder diagnosis due to the significant strain they place on resources. The reasons for fewer admissions of BME patients may reflect alternative service use, a truly lower prevalence rate or under-detection.Declaration of interestNone.

Activity based financing in England: the need for continual refinement of payment by results

2007 ◽  
Vol 2 (4) ◽  
pp. 419-427 ◽  
Author(s):  
ANDREW STREET ◽  
ALAN MAYNARD
Keyword(s):  
Primary Care ◽  
Quality Of Care ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Day Surgery ◽  
Hospital Funding ◽  
English National Health ◽  
English National Health Service

AbstractThe English National Health Service is introducing activity based tariff systems or Payment by Results (PbR) as the basis for hospital funding. The funding arrangements provide incentives for increasing activity, particularly day surgery, and, uniquely, are based on costing data from all hospitals. But prices should not be based on average costs and the potential of PbR to improve the quality of care is yet to be exploited. Without refinement, PbR threatens to undermine expenditure control, to divert resources away from primary care, and to distort needs based funding.

Using an Implementation Framework to Survey Outcome Measurement and Treatment Practices in Aphasia

2021 ◽  
pp. 1-30
Author(s):  
Carla Tierney-Hendricks ◽  
Megan E. Schliep ◽  
Sofia Vallila-Rohter
Keyword(s):  
Quality Of Life ◽  
Service Provision ◽  
Outcome Measurement ◽  
The United States ◽  
Clinical Practices ◽  
Multifaceted Approach ◽  
Treatment Practices ◽  
Whole Person ◽  
Levels Of Service

Purpose: Best practices in the field of aphasia rehabilitation increasingly acknowledge a whole-person approach that values interventions aimed at reducing impairments, while also recognizing the impact of aphasia on participation and quality of life. Guided by the Consolidated Framework for Implementation Research (CFIR), this study aimed to examine whether current clinical practices along levels of service provision reflect this whole-person, multifaceted approach. Method: Speech-language pathologists (SLPs) in the United States who provide intervention to people with aphasia across the continuum of care completed this cross-sectional online survey. Current outcome measurement and treatment practices were evaluated within the Living With Aphasia: Framework for Outcome Measurement via multiple-choice and open-text response questions. Data were analyzed descriptively and using ordinal logistic regression models to compare clinical practices along levels of service provision. Results: Data from 90 SLPs revealed that language and cognitive skills are assessed with equal consistency across clinical settings; however, functional communication, participation, and quality of life domains are prioritized in settings providing care to clients within the community. Psychological well-being is rarely assessed within clinical practice along most of the rehabilitation process and prioritized within the university clinic setting when clients are in the chronic stage of recovery. Conclusions: Clinical practices related to a multifaceted approach to aphasia intervention are variable across levels of service provision. Further exploration of barriers and facilitators to multifaceted aphasia care along the domains of the CFIR is needed to provide an informed approach to implementing change.

Effect of Computerized Auditory Training on Speech Perception of Adults With Hearing Impairment

2013 ◽  
Vol 20 (3) ◽  
pp. 91-106 ◽  
Author(s):  
Rachel Pizarek ◽  
Valeriy Shafiro ◽  
Patricia McCarthy
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Literature Review ◽  
Low Cost ◽  
Experimental Designs ◽  
Auditory Training ◽  
Hearing Impairments ◽  
Communicative Disorders ◽  
And Training

Computerized auditory training (CAT) is a convenient, low-cost approach to improving communication of individuals with hearing loss or other communicative disorders. A number of CAT programs are being marketed to patients and audiologists. The present literature review is an examination of evidence for the effectiveness of CAT in improving speech perception in adults with hearing impairments. Six current CAT programs, used in 9 published studies, were reviewed. In all 9 studies, some benefit of CAT for speech perception was demonstrated. Although these results are encouraging, the overall quality of available evidence remains low, and many programs currently on the market have not yet been evaluated. Thus, caution is needed when selecting CAT programs for specific patients. It is hoped that future researchers will (a) examine a greater number of CAT programs using more rigorous experimental designs, (b) determine which program features and training regimens are most effective, and (c) indicate which patients may benefit from CAT the most.

Strategi Penyelenggaraan Diklat Dan Ujian Sertifikasi Keahlian Pengadaan Barang/ Jasa Pemerintah Di Lingkungan Pemerintah Kabupaten Magelang

2017 ◽  
Vol 24 (1) ◽  
pp. 87-106
Author(s):  
Wiharyanto Wiharyanto
Keyword(s):  
Education And Training ◽  
Test System ◽  
Civil Servants ◽  
Quality Of Education ◽  
Alternative Formulation ◽  
Computer Assisted ◽  
Certification Exams ◽  
The Government ◽  
And Training

The study aims to analyze about the low graduation and certification exam training participants of the procurement of goods / services of the government and its contributing factors, and formulate a strategy of education and training and skills certification exams procurement of goods / services of the government. Collecting data using the method of study documentation, interviews, and questionnaires. Is the official source of information on the structural and functional Regional Employment Board, as well as the participants of the training and skills certification exams procurement of goods / services of the government in Magelang regency government environment. Analysis using 4 quadrant SWOT analysis, to determine the issue or strategic factors in improving the quality of education and training and skills certification exams procurement of government goods / services within the Government of Magelang regency. The results show organizer position is in quadrant I, which is supporting the growth strategy, with 3 alternative formulation strategies that improve the quality of education and training and skills certification exams procurement of government goods / services, and conducts certification examination of the procurement of government goods / services with computer assisted test system (CAT). Based on the research recommendations formulated advice to the organizing committee, namely: of prospective participants of the training and skills certification exams procurement of goods / services the government should consider the motivation of civil servants, is examinees who have attended training in the same period of the year, the need for simulation procurement of goods / services significantly, an additional allocation of training time, giving sanction to civil servants who have not passed the exam, the provision of adequate classroom space with the number of participants of each class are proportional, as well as explore the evaluation of education and training and skills certification exams procurement of goods / services for Government of participants.

Feasibility and Clinical Implications of Remotely Guided Ultrasound Examinations

2020 ◽  
Vol 91 (7) ◽  
pp. 592-596
Author(s):  
Quinn Dufurrena ◽  
Kazi Imran Ullah ◽  
Erin Taub ◽  
Connor Leszczuk ◽  
Sahar Ahmad
Keyword(s):  
Clinical Utility ◽  
Regional Wall Motion ◽  
Subjective Assessment ◽  
Clinical Implications ◽  
Pilot Studies ◽  
Objective Quality ◽  
The Us ◽  
Regional Wall Motion Abnormalities ◽  
Wall Motion Abnormalities

BACKGROUND: Remotely guided ultrasound (US) examinations carried out by nonmedical personnel (novices) have been shown to produce clinically useful examinations, at least in small pilot studies. Comparison of the quality of such exams to those carried out by trained medical professionals is lacking in the literature. This study compared the objective quality and clinical utility of cardiac and pulmonary US examinations carried out by novices and trained physicians.METHODS: Cardiac and pulmonary US examinations were carried out by novices under remote guidance by an US expert and independently by US trained physicians. Exams were blindly evaluated by US experts for both a task-based objective score as well as a subjective assessment of clinical utility.RESULTS: Participating in the study were 16 novices and 9 physicians. Novices took longer to complete the US exams (median 641.5 s vs. 256 s). For the objective component, novices scored higher in exams evaluating for pneumothorax (100% vs. 87.5%). For the subjective component, novices more often obtained clinically useful exams in the assessment of cardiac regional wall motion abnormalities (56.3% vs. 11.1%). No other comparisons yielded statistically significant differences between the two groups. Both groups had generally higher scores for pulmonary examinations compared to cardiac. There was variability in the quality of exams carried out by novices depending on their expert guide.CONCLUSION: Remotely guided novices are able to carry out cardiac and pulmonary US examinations with similar, if not better, technical proficiency and clinical utility as US trained physicians, though they take longer to do so.Dufurrena Q, Ullah KI, Taub E, Leszczuk C, Ahmad S. Feasibility and clinical implications of remotely guided ultrasound examinations. Aerosp Med Hum Perform. 2020; 91(7):592–596.

Vocation Education Quality from Demand Side’s Perspective: The Case of Transport Technology Universities in the North of Vietnam

2019 ◽  
Vol 10 (11) ◽  
pp. 1089-1097
Author(s):  
Nguyen Quynh Hoa ◽  
◽  
Phung Chu Hoang ◽  
Keyword(s):  
Vocational Training ◽  
Vocational Education And Training ◽  
Quality Outcomes ◽  
The North ◽  
Job Opportunities ◽  
Management Capacity ◽  
Negative Effect ◽  
Training Quality ◽  
And Training

Quality outcomes from vocational education and training (VET) are fundamental to ensuring a skilled workforce and supporting a productive economy. The quality of vocational training from the demand’s perspective is defined as meeting the customer specification, needs or requirements. Using the method of Exploratory Factor Analysis (EFA) and Multiple Regression Analysis to get the analytical results of 275 respondents as graduates of University of Transport and Communication, University of Transport Technology (the two universities training on transportation in the North of Vietnam), the results show that factors are measured by the observed variables in the study that ensure reliability and relevance. The descriptive statistics result of vocational training quality is 3.28, while all independent variables are at average level (between 3.1 to 3.48) with the highest value related to the quality of the teacher and the lowest are facilities and training programs and management capacity of university. However, the regression results show that the qualification of the teacher, material facilities and training program, management capacity and job opportunities at the training school do not affect the quality of the training while “Learners-NH” have a great positive effect and the labor market information has a negative effect on the training quality of the school significantly. Base on those data, some policy recommendations have been given out in order to improve the training quality of transport technology universities in the north of Vietnam in particular and the vocational training quality of Vietnam in general.

Sign in / Sign up

Export Citation Format

Share Document