scholarly journals Multidisciplinary specialist treatment teams and abandonment of patients – who is responsible for what?

2020 ◽  
Vol 13 (2) ◽  
pp. 125
Author(s):  
D J McQuoid-Mason
Keyword(s):  
Specialist Treatment

Changes in the Complexity of Orthodontic Treatment for Patients Referred to a Teaching Hospital

1988 ◽  
Vol 15 (1) ◽  
pp. 27-32 ◽  
Author(s):  
C. D. Stephens ◽  
N. W. Harradine
Keyword(s):  
General Practitioner ◽  
Orthognathic Surgery ◽  
Orthodontic Treatment ◽  
Further Training ◽  
Fixed Appliance ◽  
Dental Hospital ◽  
Orthodontic Patients ◽  
Specialist Treatment ◽  
Fixed Appliances ◽  
Removable Appliance

The records of 200 orthodontic patients accepted for treatment by the Orthodontic Department of the Bristol Dental Hospital in 1977 were compared with 200 taken on in 1985 in order to determine whether there had been any change in the proportion of referred cases requiring more complex procedures. Within each sample, cases were categorized as follows: (a) suitable for removable appliance treatment by an undergraduate or general practitioner; (b) requiring simple one arch fixed appliance treatment such as might he attempted by a general practitioner after a period of further training; (c) needing specialist treatment such as full multibracketed fixed appliances or orthognathic surgery. It was found that there had been no change in the proportions of simple and complex cases referred during the 8-year period although the proportion of patients now receiving complex treatment had increased greatly. Possible explanations and implications are discussed.

Conservation surgery and specialist treatment

1998 ◽  
Vol 34 ◽  
pp. S46
Author(s):  
D.B. Kinqsmore ◽  
D. Hole ◽  
C.R. Gillis ◽  
W.D. George
Keyword(s):  
Conservation Surgery ◽  
Specialist Treatment

scholarly journals General practice patients starting treatment for substance use problems: observations from two data sources across levels of care

2020 ◽  
Author(s):  
Nicole Boffin ◽  
Jerome Antoine ◽  
Luk Van Baelen ◽  
Sarah Moreels ◽  
Kris Doggen
Keyword(s):  
General Practice ◽  
Substance Use ◽  
Data Sources ◽  
Treatment Episode ◽  
Specialist Care ◽  
Levels Of Care ◽  
Substance Use Problems ◽  
Stable Housing ◽  
Treatment Demand ◽  
Specialist Treatment

Abstract BackgroundIn Belgium, the incidence of treatment episodes for substance use problems is monitored by the Network of Sentinel General Practices (SGP) and by the Treatment Demand Indicator (TDI) surveillance at higher, specialist care levels. Using both data sources, we examine 1) how patients starting specialist treatment for substance use problems on referral by their GP compare to those that were referred by non-GP caregivers; 2) how patients starting GP treatment for substance use problems without receiving specialist treatment concurrently compare to those who do.MethodsThe same European protocol with common variables was used by both surveillances. Data from 2016 and 2017 were examined using 95% confidence intervals and multivariate regression.ResultsAccording to TDI-data (n=16,543), determinants of being referred by a GP (versus by a non-GP caregiver) for specialist treatment were age ≥ median (OR 1.25; 95% CI 1.13-1.38), education ≥ secondary level (OR 1.27; 95% CI 1.15-1.41), recent employment (OR 1.71; 1.56-1.88), stable housing (3.62; 95% CI 3.08-4.26), first treatment episode (OR 1.72; 95% CI 1.57-1.87), recent daily primary substance use (OR 1.46; 95% CI 1.33-1.59) and mono substance use (OR 1.23; 95% CI 1.04-1.48). Type of substance use was a significant determinant with higher odds of using pharmaceuticals (and alcohol) (OR 1.24; 95% CI 1.04-1.48), and lower odds of using cannabis only/primarily (OR 0.73; 95% CI 0.62-0.86), with reference to street drugs minus cannabis only/primarily. According to SGP data (n=314), determinants of starting GP treatment without concurrent specialist treatment were recent employment (OR 2.58; 95% CI 1.36-4.91), first treatment episode (OR 2.78; 95% CI 1.39-5.55) and living in the Brussels or Walloon region (OR 1.97; 95% CI 1.06-3.66).ConclusionsThis study adds knowledge about the general practice population treated for substance use problems and the consistency of data from the surveillances. Both studies show a relatively favourable profile of general practice patients with substance use problems.

scholarly journals Successful management of multiple pregnancies in a family with varying severity of Von Willebrand disease

2018 ◽  
Vol 11 (4) ◽  
pp. 192-194
Author(s):  
Patrick Harrington ◽  
Pippa Kyle ◽  
Jacky Cutler ◽  
Bella Madan
Keyword(s):  
Von Willebrand Factor ◽  
Von Willebrand Disease ◽  
The Other ◽  
Severe Phenotype ◽  
Mild Phenotype ◽  
History Of ◽  
Specialist Treatment ◽  
Factor Concentrate ◽  
Von Willebrand ◽  
Willebrand Factor

We present the obstetric history of a family of three sisters with Von Willebrand disease, managed in our centre over the course of nine successful pregnancies. The abnormalities result from inheritance of an exon 50 skipping mutation in the Von Willebrand factor gene, resulting from consanguinity. Two of the sisters were identified as having a severe phenotype with a Von Willebrand factor level of less than 5 IU/dl, with the other having a mild phenotype. Of the sisters with a severe phenotype, one had a number of prenatal complications and required early onset prophylaxis with Von Willebrand factor concentrate, whilst the other had a less complicated clinical course, only requiring Von Willebrand factor concentrate to cover labour. The sister with mild Von Willebrand disease had a rise in Von Willebrand factor levels during pregnancy and required no specialist treatment. The report highlights the markedly different clinical courses that can occur in patients with Von Willebrand disease and the different approaches to management.

Consultation with the Specialist: Treatment of Inflammatory Bowel Disease

1997 ◽  
Vol 18 (3) ◽  
pp. 95-98
Author(s):  
Maria R. Mascarenhas ◽  
Steven M. Altschuler
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Specialist Treatment ◽  
Inflammatory Bowel

scholarly journals Law and medical practice: A comparative vignette survey of cardiologists in Norway and Denmark

2020 ◽  
Vol 8 ◽  
pp. 205031212094621
Author(s):  
Afsaneh Bjorvatn ◽  
Anne-Mette Magnussen ◽  
Lisa Wallander
Keyword(s):  
Medical Condition ◽  
Waiting Times ◽  
Legal Regulation ◽  
General Level ◽  
Legal Regulations ◽  
Cross Sectional Survey ◽  
Severe Condition ◽  
Minor Variation ◽  
Cross Sectional ◽  
Specialist Treatment

Objective: This article explores the implications of legal regulation for medical discretion and decision-making in Norway and Denmark. Methods: The article is based on a cross-national cross-sectional survey exploring cardiologists’ assessments of patient eligibility for specialist health care. Forty-two cardiologists in Norway and 48 in Denmark were presented with two standardized case vignettes in the form of patient referrals and were asked to assess whether the patient was eligible for treatment by a specialist, and if so, what waiting time would be assigned to the patient. Results: Primarily based on descriptive statistics, our findings indicate interesting similarities and variations. While there was only minor variation across the countries in cardiologists’ professional assessments about a patient with a more severe condition, judgements of eligibility for specialist treatment varied for a patient with a less severe medical condition. Moreover, Danish cardiologists distinguished between the more severe and less severe conditions to a much lesser extent when assessing eligibility for specialist treatment. For waiting times, there was considerable variation at the general level, from 1 week to 6 months. The assigned waiting times were on average double those for Norwegian cardiologists compared with their Danish counterparts. Denmark’s legal standardization of waiting times appears to lead to shorter waiting times than those prescribed by Norway’s legal regulations. Conclusion: For a single clear overall intention with a new policy, simpler legal regulations may be more effective than very detailed and specific requirements. If policymakers’ overall intention is for medical doctors to make complex decisions involving the prioritization of patients, then more individualized regulations seem to be a better tool.

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