scholarly journals Disparities in Diabetes Care

EMJ Diabetes ◽  
2021 ◽  
pp. 92-101
Author(s):  
Adrian Po Zhu Li ◽  
Martin Brunel Whyte
Keyword(s):  
Adverse Effect ◽  
Social Class ◽  
Diabetes Care ◽  
Social Care ◽  
Mixed Effects ◽  
Significant Adverse Effect ◽  
Clinical Factors ◽  
Health And Social Care ◽  
Patient Groups

Disparities in the distribution of diabetes health have been reported by social class, age, gender, and ethnicity and may arise from an interplay of biological, clinical, and non-clinical factors. As well as being morally wrong, these differences in outcome will have a significant adverse effect on a nation’s health. As a result, there have been international efforts to reduce inequalities, from the strategic organisation of healthcare to providers and patients themselves, with mixed effects. This article outlines the disparities in diabetes care and outcomes in different patient groups, and how the approach of integration of health and social care may help to overcome some of the adverse aspects of societal organisation that underpins disparities.

Forearm Shortening Impact on Pronation and Supination

2019 ◽  
Vol 24 (03) ◽  
pp. 289-296
Author(s):  
Luis Schnapp ◽  
Salih Colakoglu ◽  
Jose Couceiro ◽  
Amir Oron ◽  
Guy Brock ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Statistical Analysis ◽  
Repeated Measures ◽  
Specific Model ◽  
Mixed Effects ◽  
Significant Adverse Effect ◽  
Interosseous Membrane ◽  
External Fixators ◽  
Forearm Rotation ◽  
Proximal Forearm

Background: Shortening has been described to treat severely mangled extremities, replantations and nonunions. Outcomes after this procedure in the forearm are vaguely described. This study addresses how the forearm rotation is affected by: (1) location of the shortening; (2) the amount of the shortening at different locations. Methods: Nine fresh cadaveric forearms were dissected preserving intact proximal and distal radio ulnar joints and interosseous membrane. The widest point of the interosseous space and its location over the ulna were measured, defining the peak interosseous distance (PID) and the peak interosseous distance level (PIDL). Stabilization and fixation of the specimens were performed by using a platform and external fixators. Consecutive ostectomies were performed within one centimeter intervals at the distal, middle and proximal forearm thirds. A repeated measures mixed-effects (RMME) specific model was designed for the statistical analysis. Results: Before intervention, the average full forearm rotation was 157° (101–185), supination 80° (56–90)/pronation 77° (45–95). The average PID was 15.6 mm in supination and 12.5 mm in pronation. The PIDP were 52.2% and 58.3% of the ulna length in supination and pronation, respectively. The rotation lost were: middle third 5.31°/cm in supination and 6.12°/cm in pronation, distal third 1.62°/cm in supination and 2.20°/cm in pronation, the proximal third was not affected by up to 5 cm of shortening. Conclusions: These data suggest that shortening of the middle and distal third of the forearm might have more significant adverse effect on forearm rotation compared with the proximal third.

Practices of inclusion for carers who are higher education students

2020 ◽  
Author(s):  
Jordan Taylor ◽  
Paula Gleeson ◽  
Tania Teague ◽  
Michelle DiGiacomo
Keyword(s):  
Higher Education ◽  
Social Care ◽  
Higher Education Institutions ◽  
Education Students ◽  
Institutional Settings ◽  
Policies And Procedures ◽  
Health And Social Care ◽  
Students With A Disability ◽  
Crucial Part

The role of unpaid and informal care is a crucial part of the health and social care system in Australia and internationally. As carers in Australia have received statutory recognition, concerted efforts to foster engagement in carer participation in work and education has followed. However, little is known about the strategies and policies that higher education institutions have implemented to support the inclusion of carers. This study has three components: first, it employs a review of evidence for interventions to support to support carers; second, it reviews existing higher education institutions’ policies to gauge the extent of inclusive support made available to student carers, and; third it conducts interviews with staff from five higher education institutions with concerted carer policies in Australia were held to discuss their institutions’ policies, and experiences as practitioners of carer inclusion and support. Results indicate difficulty in identifying carers to offer support services, the relatively recent measures taken to accommodate carers in higher education, extending similar measures which are in place for students with a disability, and difficulties accommodating flexibility in rigid institutional settings. A synthesis of these findings were used to produce a framework of strategies, policies and procedures of inclusion to support carers in higher education.

A case study evaluation of a community multidisciplinary team in South East England using a mixed-method approach

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711569
Author(s):  
Jessica Wyatt Muscat
Keyword(s):  
Mental Health ◽  
Mixed Method ◽  
Social Care ◽  
Free Form ◽  
Normalisation Process Theory ◽  
Multidisciplinary Teams ◽  
Mixed Method Approach ◽  
Health And Social Care ◽  
Method Approach

BackgroundCommunity multidisciplinary teams (MDTs) represent a model of integrated care comprising health, social care, and the voluntary sector where members work collaboratively to coordinate care for those patients most at risk.AimThe evaluation will answer the question, ‘What are the enablers and what are the restrictors to the embedding of the case study MDT into the routine practice of the health and social care teams involved in the project?’MethodThe MDT was evaluated using a mixed-method approach with normalisation process theory as a methodological tool. Both quantitative and qualitative data were gathered through a questionnaire consisting of the NoMAD survey followed by free-form questions.ResultsThe concepts of the MDT were generally clear, and participants could see the potential benefits of the programme, though this was found to be lower in GPs. Certain professionals, particularly mental health and nursing professionals, found it difficult to integrate the MDT into normal working patterns because of a lack of resources. Participants also felt there was a lack of training for MDT working. A lack of awareness of evidence supporting the programme was shown particularly within management, GP, and nursing roles.ConclusionSpecific recommendations have been made in order to improve the MDT under evaluation. These include adjustments to IT systems and meeting documentation, continued education as to the purpose of the MDT, and the engagement of GPs to enable better buy-in. Recommendations were made to focus the agenda with specialist attendance when necessary, and to expand the MDT remit, particularly in mental health and geriatrics.

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