scholarly journals Training and Integrating Public Service Interpreters in a Refugee Health Clinic: A Mixed-Method Approach to Evaluate an Innovative Program

Refuge ◽  
2021 ◽  
Vol 37 (2) ◽  
pp. 106-123
Author(s):  
Yvan Leanza ◽  
Rhéa Rocque ◽  
Camille Brisset ◽  
Suzanne Gagnon
Keyword(s):  
Time Integration ◽  
Mixed Data ◽  
Health Clinic ◽  
Quebec City ◽  
Full Time ◽  
Role Conflicts ◽  
Mutual Knowledge ◽  
Innovative Program ◽  
Method Approach

Language barriers can harm refugees’ health, and trained interpreters are a solution to overcome these barriers in all health consultations. This study trained interpreters and integrated them in a refugee clinic. Nepali-speaking migrants were recruited and underwent 50 hours of training to serve as interpreters for recently arrived Bhutanese refugees in Quebec City. To evaluate the project, mixed data were collected. At baseline and follow-up, patients’ health (as perceived by practitioners) and satisfaction were evaluated. Interpreters and practitioners were also interviewed and took part in joint discussion workshops. Patients’ health remained stable but, interestingly, patients were slightly less satisfied at follow-up. Practitioners and interpreters described both benefits and difficulties of the program. For example, integrating interpreters within the clinical team allowed for better collaboration and mutual knowledge of cultures. Challenges included work overload, conflicts between interpreters and practitioners, and role conflicts for interpreters. Overall, the full-time integration of trained interpreters in the clinic facilitated communication and case administration. This practice could be especially beneficial for refugee clients. In future interventions, interpreter roles should be better clarified to patients and practitioners, and particular attention should be paid to selection criteria for interpreters. 

A Five-Year Outcome of Discharged Chronic Psychiatric Patients

1972 ◽  
Vol 17 (6) ◽  
pp. 433-435 ◽  
Author(s):  
A.K.M. Fakhruddin ◽  
Antony Manjooran ◽  
N.P.V. Nair ◽  
Alfred Neufeldt
Keyword(s):  
Continuity Of Care ◽  
Social Life ◽  
Psychiatric Patients ◽  
Health Clinic ◽  
Full Time ◽  
The Social ◽  
The Family ◽  
Community Mental Health Clinic ◽  
Chronic Psychiatric Patients

A five-year follow-up study was done on five hundred and eight chronic psychiatric patients, discharged from Saskatchewan Hospital, Weyburn in 1963, 1964 and 1965. One hundred and twenty-seven patients died during this period — 105 were over 65 years of age, with a mean age of 78 years, two patients had accidental deaths, and the rest died of normal causes. No patient committed suicide. Fifty-five per cent of the patients continually remained in the community during the five years. Forty-five per cent had one or more admissions and of these 74 per cent spent twelve months or less in the hospital. Fifty-four per cent were readmitted within twelve months after discharge. Twenty per cent of the patients under 65 years of age were employed full-time for forty-eight months or more. Two patients affected the social life of their family and one affected the health of the family. Continuity of care was provided to 80 per cent of the patients by the community mental health clinic. Chronic psychiatric patients can thus be kept in the community, causing minimum liability to the family and the community if continuity of care close to their residences is provided for them.

Adult outcome after treatment of pediatric posterior fossa ependymoma: long-term follow-up of a single consecutive institutional series of 22 patients with more than 5 years of survival

2020 ◽  
Vol 26 (1) ◽  
pp. 22-26 ◽  
Author(s):  
Tryggve Lundar ◽  
Bernt Johan Due-Tønnessen ◽  
Radek Frič ◽  
Petter Brandal ◽  
Paulina Due-Tønnessen
Keyword(s):  
Proton Beam ◽  
Posterior Fossa ◽  
Adjuvant Treatment ◽  
Tumor Control ◽  
Full Time ◽  
Time Work ◽  
Long Term Follow Up ◽  
Long Term Survivors

OBJECTIVEEpendymoma is the third most common posterior fossa tumor in children; however, there is a lack of long-term follow-up data on outcomes after surgical treatment of posterior fossa ependymoma (PFE) in pediatric patients. Therefore, the authors sought to investigate the long-term outcomes of children treated for PFE at their institution.METHODSThe authors performed a retrospective analysis of outcome data from children who underwent treatment for PFE and survived for at least 5 years.RESULTSThe authors identified 22 children (median age at the time of surgery 3 years, range 0–18 years) who underwent primary tumor resection of PFE during the period from 1945 to 2014 and who had at least 5 years of observed survival. None of these 22 patients were lost to follow-up, and they represent the long-term survivors (38%) from a total of 58 pediatric PFE patients treated. Nine (26%) of the 34 children treated during the pre-MRI era (1945–1986) were long-term survivors, while the observed 5-year survival rate in the children treated during the MRI era (1987–2014) was 13 (54%) of 24 patients. The majority of patients (n = 16) received adjuvant radiotherapy, and 4 of these received proton-beam irradiation. Six children had either no adjuvant treatment (n = 3) or only chemotherapy as adjuvant treatment (n = 3). Fourteen patients were alive at the time of this report. According to MRI findings, all of these patients were tumor free except 1 patient (age 78 years) with a known residual tumor after 65 years of event-free survival.Repeat resections for residual or recurrent tumor were performed in 9 patients, mostly for local residual disease with progressive clinical symptoms; 4 patients underwent only 1 repeated resection, whereas 5 patients each had 3 or more resections within 15 years after their initial surgery. At further follow-up, 5 of the patients who underwent a second surgery were found to be dead from the disease with or without undergoing additional resections, which were performed from 6 to 13 years after the second procedure. The other 4 patients, however, were tumor free on the latest follow-up MRI, performed from 6 to 27 years after the last resection. Hence, repeated surgery appears to increase the chance of tumor control in some patients, along with modern (proton-beam) radiotherapy. Six of 8 patients with more than 20 years of survival are in a good clinical condition, 5 of them in full-time work and 1 in part-time work.CONCLUSIONSPediatric PFE occurs mostly in young children, and there is marked risk for local recurrence among 5-year survivors even after gross-total resection and postoperative radiotherapy. Repeated resections are therefore an important part of treatment and may lead to persistent tumor control. Even though the majority of children with PFE die from their tumor disease, some patients survive for more than 50 years with excellent functional outcome and working capacity.

scholarly journals Design of a prospective follow-up study on early parenthood and smoking behaviour during pregnancy in Finnish primary healthcare

2021 ◽  
pp. 140349482110224
Author(s):  
Mikael O. Ekblad ◽  
Hanna P. Wallin ◽  
Marjukka Pajulo ◽  
Päivi E. Korhonen
Keyword(s):  
Pregnant Women ◽  
Study Design ◽  
Primary Healthcare ◽  
Routine Data ◽  
Smoking Behaviour ◽  
Self Report ◽  
Health Clinic ◽  
Follow Up Study ◽  
Study Population

Aims: The primary aim of the study is to explore different factors affecting parents’ smoking behaviour, and especially how smoking may be connected with individual differences in the psychological process of becoming a parent. In the current paper, we present the study design together with basic information on the study population. Methods: The Central Satakunta Maternity and Child Health Clinic (KESALATU) Study is an ongoing prospective follow-up study in primary healthcare of the Satakunta region of southwest Finland. Families were recruited during their first maternity clinic visit between 1 September 2016 and 31 December 2019, and participation will continue until the child is 1.5 years of age. The study combines different sources and types of data: e.g. routine data obtained from primary healthcare clinic records, specific parental self-report data and data from a new exhaled carbon monoxide meter indicating maternal smoking. The data are collected using frequently repeated assessments both during pregnancy and postnatally. The methods cover the following areas of interest: family background factors (including smoking and alcohol use), self-reported parental–foetal/infant attachment and mentalization, self-reported stress, depression and quality of life. Results: 589 pregnant women and their partners were asked to participate in the study during the collection time period. The final study population consisted of 248 (42.1%) pregnant women and 160 (27.1%) partners. Conclusions: The new methods and study design have the potential to increase our understanding about the link between early parenting psychology, prenatal psychosocial risk factors and parental health behaviour.

Treatment alliance and needs of care concerning religiousness and spirituality: A follow-up study among psychiatric inpatients

2021 ◽  
pp. 002076402110230
Author(s):  
Joke C van Nieuw Amerongen-Meeuse ◽  
Arjan W Braam ◽  
Christa Anbeek ◽  
Jos WR Twisk ◽  
Hanneke Schaap-Jonker
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Structural Equation ◽  
Treatment Compliance ◽  
Health Clinic ◽  
Care Needs ◽  
Service Engagement ◽  
Treatment Alliance ◽  
Over Time

Background: Patient satisfaction with religious/spiritual (R/S) care during mental health treatment has been associated with a better treatment alliance. Aims: To investigate the longitudinal relations between (un)met R/S care needs and treatment alliance/compliance over a 6-month period. Method: 201 patients in a Christian (CC) and a secular mental health clinic completed a questionnaire (T0) containing an R/S care needs questionnaire, the Working Alliance Inventory (WAI) and the Service Engagement Scale (SES). After 6 months 136 of them took part in a follow-up (T1). Associations were analysed using hybrid linear mixed models and structural equation modelling. Results: R/S care needs decreased over time, but a similar percentage remained unanswered (e.g. 67% of the needs on R/S conversations in a secular setting). Over a 6-month period, met R/S care needs were associated with a higher WAI score (β = .25; p < .001), and unmet R/S care needs with lower WAI score (β = −.36; p < .001), which were mainly between subjects effects. Patients reporting a high score of unmet R/S care at baseline, reported a decrease in SES over time (β = −.13; p < .05). Conclusions: Satisfaction with R/S care among mental health patients is related to a better treatment alliance. When unmet R/S care needs persist, they precede a decrease in treatment compliance. Mental health professionals are recommended to assess the presence of R/S care needs and consider possibilities of R/S care especially in the first weeks of treatment.

scholarly journals OP0252 CIRCULATING COLLAGEN TURNOVER MARKERS ARE SPECIFICALLY CHANGED IN VERY EARLY SYSTEMIC SCLEROSIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 159.1-159
Author(s):  
R. Dobrota ◽  
S. Jordan ◽  
P. Juhl ◽  
B. Maurer ◽  
M. O. Becker ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Roc Analysis ◽  
Cox Regression ◽  
Classification Criteria ◽  
Full Time ◽  
Research Support ◽  
Type Iii ◽  
Turnover Markers ◽  
Full Time Employee

Background:Timely diagnosis of patients with very early systemic sclerosis (veSSc) is essential for their personalized and optimal management. We hypothesise that changes in serum-based extracellular matrix (ECM) turnover biomarkers are already detectable in patients with veSSc, even before occurrence of specific clinical signs.Objectives:To investigate circulating ECM turnover markers as potential biomarkers for veSSc.Methods:Patients with veSSc, n=42, defined as presence of Raynaud’s syndrome and at least one of puffy fingers, positive antinuclear antibodies or pathological nailfold capillaroscopy, who did not meet any classification criteria for SSc, were compared to healthy controls (HC, n=29). Longitudinal assessment, data and sera collection were conducted by EUSTAR standards. ECM-degradation (BGM, C3M, C4M, C6M) and ECM-formation biomarkers (PRO-C3, PRO-C4, PRO-C5) were measured in serum using ELISA assays. The statistical analyses included Mann-Whitney U, Spearman correlation and ROC analysis. Using Kaplan-Meier plots and univariable Cox regression, we explored if biomarkers can predict progression towards definite SSc (fulfillment of ACR/EULAR criteria or minimum two points increase in the criteria score) during the longitudinal follow-up.Results:Compared to HC, veSSc patients showed a deregulated turnover of type III and IV collagen, with higher degradation (higher C3M, C4M, both p<0.0001 and PRO-C3, p=0.004, Figure 1a, resulting in lower turnover ratios PRO-C3/C3M and PRO-C4/C4M, both p<0.0001). The biglycan degradation biomarker BGM was also higher in veSSc (p=0.006), whereas the degradation biomarker for type VI collagen, C6M, was lower than in HC (p=0.002). In the ROC analysis, biomarkers of type III and IV collagen distinguished between veSSc and HC: C3M, AUC=0.95, p<0.0001; C4M, AUC=0.97, p<0.0001; turnover ratios PRO-C3/C3M, AUC=0.80, p<0.0001; PRO-C4/C4M, AUC=0.97; p<0.0001 (Figure 1b).Median follow up was 4.5 years (range 0.5-7.9 years), mean age was 50±2.2 years, 88% female gender, 24% with puffy fingers, 92% were ANA positive, 64% had an abnormal capillaroscopy, none had organ involvement or skin fibrosis. 14/42 veSSc patients fulfilled the ACR/EULAR classification criteria at follow-up (time to fulfilment of criteria ranged between 0.5 and 6.8 years from inclusion) and in addition, 18/42 veSSc patients gained at least two classification criteria-points. This resulted in 14, respectively 18 progressors for the longitudinal analysis. However, in univariable Cox regression, the baseline levels of the markers did not predict progression over time.Conclusion:ECM turnover is already altered in veSSc patients compared to HC. Biomarkes of type III and IV collagen distinguished between veSSc patients and HC, which may indicate them as potential biomarkers for the detection of veSSc in addition to the established immunological and capillaroscopic criteria.Disclosure of Interests:Rucsandra Dobrota: None declared, Suzana Jordan: None declared, Pernille Juhl Employee of: Nordic Bioscience, Britta Maurer Grant/research support from: AbbVie, Protagen, Novartis, congress support from Pfizer, Roche, Actelion, and MSD, Speakers bureau: Novartis, Mike O. Becker: None declared, Carina Mihai: None declared, Anne-Christine Bay-Jensen Shareholder of: Nordic Bioscience A/S, Employee of: Full time employee at Nordic Bioscience A/S., Morten Karsdal Shareholder of: Nordic Bioscience A/S., Employee of: Full time employee at Nordic Bioscience A/S., Anne Sofie Siebuhr Employee of: Nordic Bioscience, Oliver Distler Grant/research support from: Grants/Research support from Actelion, Bayer, Boehringer Ingelheim, Competitive Drug Development International Ltd. and Mitsubishi Tanabe; he also holds the issued Patent on mir-29 for the treatment of systemic sclerosis (US8247389, EP2331143)., Consultant of: Consultancy fees from Actelion, Acceleron Pharma, AnaMar, Bayer, Baecon Discovery, Blade Therapeutics, Boehringer, CSL Behring, Catenion, ChemomAb, Curzion Pharmaceuticals, Ergonex, Galapagos NV, GSK, Glenmark Pharmaceuticals, Inventiva, Italfarmaco, iQvia, medac, Medscape, Mitsubishi Tanabe Pharma, MSD, Roche, Sanofi and UCB, Speakers bureau: Speaker fees from Actelion, Bayer, Boehringer Ingelheim, Medscape, Pfizer and Roche

A Randomised Controlled Trial of Strategies to Prompt Attendance for a Pap Smear

1995 ◽  
Vol 2 (4) ◽  
pp. 211-218 ◽  
Author(s):  
Jenny Bowman ◽  
Rob Sanson-Fisher ◽  
Catherine Boyle ◽  
Stephanie Pope ◽  
Sally Redman
Keyword(s):  
At Risk ◽  
Randomised Controlled Trial ◽  
Pap Smear ◽  
Controlled Trial ◽  
Self Report ◽  
Health Clinic ◽  
Control Group ◽  
Screening Attendance ◽  
Randomised Controlled

Objective – To assess the comparative efficacy, by randomised controlled trial, of three interventions designed to encourage “at risk” women to have a Pap smear: an educational pamphlet; letters inviting attendance at a women's health clinic; and letters from physicians. Methods – Subjects at risk for cervical cancer who had not been adequately screened were identified by a random community survey and randomly allocated to one of the intervention groups or a control group. Six months after intervention implementation, a follow up survey assessed subsequent screening attendance. Self report was validated by comparison with a national screening data base. Results – A significantly greater proportion of women (36.9%) within the group receiving a physician letter reported screening at follow up than in any other group (P =0.012). The variables most strongly predicting screening attendance were: age, perceived frequency of screening required, use of oral contraceptives, and allocation to receive the physician letter intervention. Conclusions – The relative efficacy of the GP letter in prompting screening attendance shows that this strategy is worthy of further investigation. There remains a need to examine the barriers to screening for older women, and to develop tailored strategies for this population.

Rare Diseases, Common Problems: Recognition and Management

PEDIATRICS ◽  
1978 ◽  
Vol 62 (6) ◽  
pp. 1056-1060
Author(s):  
Neil A. Holtzman
Keyword(s):  
Johns Hopkins Hospital ◽  
Full Time ◽  
Test Results ◽  
Irreversible Damage ◽  
Negative Results ◽  
Initial Symptoms ◽  
Metabolic Conditions ◽  
Common Problems

Although a growing number of inherited metaboic diseases can be treated effectively, diagnosis often comes too late to benefit the patient. There are at least two ways, however, in which diagnosis can be made before irreversible damage occurs. First, physicians whose services are sought when a patient becomes ill could be attuned to the possibility of metabolic conditions. This is difficult when the initial symptoms, for example, vomiting or poor feeding, resemble those of common, self-limited illnesses, or when they suggest, as with respiratory distress, other categories of serious illness. Second, all infants could be screened for indicators of some of these conditions. Then the primary physician has a responsibility to determine the significance of both positive and negative results and to decide whether follow-up is needed. This study had three objectives: (1) to determine whether physicians are aware of the common problems with which inherited metabolic conditions often present; (2) to determine whether their management of common problems facilitates the early diagnosis of such conditions; and (3) to assess their evaluation of screening test results. METHODS Physicians who were participating in three continuing education programs were asked to answer, anonymously, several questions dealing with recognition and in management of geneticmetaboic diseases before they were given any instruction on the subject. The same questionnaire was distributed to the pediatric house staff at The Johns Hopkins Hospital. The tabulated results were discussed with the respondents collectively during hour-long conferences. RESULTS AND COMMENTS Classification of Respondents One hundred fifty-six physicians returned the questionnaire: 67 pediatricians (in practice, 56; full-time faculty, 6: unknown, 5), 30 general or family practitioners, and 59 pediatric house officers.

Counseling Parents of a Child with Meningomyelocele

1983 ◽  
Vol 4 (10) ◽  
pp. 317-321
Author(s):  
Claire O. Leonard
Keyword(s):  
Spina Bifida ◽  
Care Physician ◽  
Treatment Center ◽  
Full Time ◽  
Coordination Of Care ◽  
Prognostic Information ◽  
The Family ◽  
Social Treatment ◽  
Ongoing Support

The primary care physician has an important role in counseling families of children with meningomyelocele and providing ongoing support and coordination of care. A spina bifida treatment center will provide subspecialists in neurology, neurosurgery, orthopedics, urology, physical therapy, occupational therapy, nutrition, social work, and genetics. When the family does not live near a center, the pediatrician may fill many of these roles as well as that of team coordinator himself with the psychosocial and educational issues, as these are often forgotten by the multiple subspecialists seen by these children. The outlook for children with spina bifida is changing rapidly. The evolving medical, educational, and social treatment of individuals with meningronyelocele makes reliable prognostic information unavailable. Intelligence is usually normal and death due to renal insufficiency is extremely rare. A follow-up of surviving patients treated from 1928 to 1951 revealed that more than half were self-sufficient, full-time college students or housewives.7 With the improved outlook today, the majority of affected children can expect to become independent adults.

scholarly journals Digital Images in Teaching and Learning at York University: Are the Libraries Meeting the Needs of Faculty Members in Fine Arts?

2012 ◽  
Vol 7 (2) ◽  
pp. 20 ◽  
Author(s):  
Mary Kandiuk ◽  
Aaron Lupton
Keyword(s):  
North America ◽  
Teaching And Learning ◽  
Electronic Mail ◽  
Digital Images ◽  
Fine Arts ◽  
Image Databases ◽  
Faculty Members ◽  
Full Time ◽  
Training And Support

Objective – This study assessed the needs for digital image delivery to faculty members in Fine Arts at York University in order to ensure that future decisions regarding the provision of digital images offered through commercial vendors and licensed by the Libraries meet the needs of teaching faculty. Methods – The study was comprised of four parts. A Web survey was distributed to 62 full-time faculty members in the Faculty of Fine Arts in February of 2011. A total of 25 responses were received. Follow-up interviews were conducted with nine faculty members. Usage statistics were examined for licensed library image databases. A request was posted on the electronic mail lists of the Art Libraries Society of North America (ARLIS-L) and the Art Libraries Society of North America Canada Chapter (CARLIS-L) in April 2011 requesting feedback regarding the use of licensed image databases. There were 25 responses received. Results – Licensed image databases receive low use and pose pedagogical and technological challenges for the majority of the faculty members in Fine Arts that we surveyed. Relevant content is the overriding priority, followed by expediency and convenience, which take precedence over copyright and cleared permissions, resulting in a heavy reliance on Google Images Search. Conclusions – The needs of faculty members in Fine Arts who use digital images in their teaching at York University are not being met. The greatest shortcomings of licensed image databases provided by the Libraries are the content and technical challenges, which impede the ability of faculty to fully exploit them. Issues that need to be resolved include the lack of contemporary and Canadian content, training and support, and organizational responsibility for the provision of digital images and support for the use of digital images.

scholarly journals Nyutdannede jordmødres vurdering av utdanning, klinisk kompetanse og arbeidsforhold

2015 ◽  
Vol 10 (2) ◽  
pp. 139 ◽  
Author(s):  
Mari Landsverk Hagtvedt ◽  
Tine Schauer Eri
Keyword(s):  
Working Conditions ◽  
Clinical Competence ◽  
Professional Competence ◽  
Perinatal Period ◽  
Evaluation Study ◽  
Full Time ◽  
Self Assessment ◽  
Part Time ◽  
Time Position

<p>Newly qualified midwives’ self-assessment of education, clinical competence and working conditions</p><p>In Norway, post-graduate nursing programmes are being transformed into master programmes. This occurs without previous evaluation of the study programmes. The level of competence and the requirements of newly qualified are being discussed, and a mentoring programme has been suggested to ensure follow-up and development of clinical competence. In central parts of the country, newly qualified midwives have difficulties getting a permanent full time position, which affects their possibilities to develop clinical competence. An evaluation study of the midwifery program at Vestfold University College has been performed to assess its relevance for professional work, as well as mapping the respondents’ working conditions and their self-assessment of clinical competence. The method used was a survey. The respondents rate the program as good. They lack competence to manage complicated conditions related to the perinatal period, and are inadequate when it comes to issues related to women’s sexual heath. These midwives work part-time, and it may take years to get a permanent position. They rate the follow-up as newly qualified as satisfying, yet they do not feel sufficiently confident during clinical practice. Comprehensive national midwifery competence will require more full time positions and better follow-up of newly qualified. To lay the basis for the content in master programmes, there is a need for a national evaluation of the midwifery programmes and a review of the professional competence of newly qualified.</p>

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