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1.
Br J Nurs ; 30(17): 1047, 2021 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-34605250

RESUMO

The outcome of a consultation on mandatory COVID-19 vaccination for health and social care staff must result in a standard approach being taken nationwide, argues Sam Foster, Chief Nurse, Oxford University Hospitals.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Hospitais Universitários , Humanos , SARS-CoV-2 , Medicina Estatal , Reino Unido , Vacinação
2.
Br J Nurs ; 30(17): 1044-1045, 2021 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-34605253

RESUMO

John Tingle and Amanda Cattini discuss some current 'buzzwords' that raise important issues in patient safety policy development and practice.


Assuntos
Segurança do Paciente , Medicina Estatal , Humanos , Reino Unido
3.
Br J Nurs ; 30(17): 1040-1041, 2021 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-34605257

RESUMO

Emeritus Professor Alan Glasper, from the University of Southampton, discusses a recent government-commissioned review on the food system of the UK.


Assuntos
Dieta , Obesidade , Humanos , Obesidade/epidemiologia , Obesidade/prevenção & controle , Medicina Estatal , Reino Unido
4.
Mymensingh Med J ; 30(4): 991-996, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34605468

RESUMO

The prevalence of obesity continues to increase worldwide day by day causing a serious health problem and impose a significant impact on the National Health Service (NHS) budget. Obesity usually arises from the interactions of multiple genes and lifestyle factors. This study was done to evaluate changes of serum creatinine and creatinine clearance rate in obese female age ranged 30-60 years in comparison to normal healthy female of same age. This study, a cross-sectional analytical type, was carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh between the period from January 2020 to December 2020. A total number of 100 female subjects were included in this study. Among them fifty (50) normal healthy female were taken as control group (Group I) and fifty (50) obese female were taken as study group (Group II). To see the level of serum creatinine determined by Kinetic Colorimetric method and creatinine clearance rate was calculated from serum creatinine by Cockcroft-Gault equation. Data was calculated by unpaired Student's't' test and were expressed as mean (±SD). Pearson's correlation coefficient test was done to find the correlation of serum creatinine and creatinine clearance rate with BMI. In this study we found that mean serum Creatinine and Creatinine clearance rate were higher in obese female in comparison to normal healthy female. Again, serum Creatinine and Creatinine clearance rate were positively correlated with BMI. Therefore, to prevent obesity related complications and leading a healthy life we suggest estimations of these parameters routinely.


Assuntos
Obesidade , Medicina Estatal , Adulto , Creatinina , Estudos Transversais , Feminino , Taxa de Filtração Glomerular , Humanos , Pessoa de Meia-Idade , Obesidade/epidemiologia
5.
BMJ Open ; 11(10): e054410, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34598993

RESUMO

OBJECTIVES: The COVID-19 pandemic instigated multiple societal and healthcare interventions with potential to affect perinatal practice. We evaluated population-level changes in preterm and full-term admissions to neonatal units, care processes and outcomes. DESIGN: Observational cohort study using the UK National Neonatal Research Database. SETTING: England and Wales. PARTICIPANTS: Admissions to National Health Service neonatal units from 2012 to 2020. MAIN OUTCOME MEASURES: Admissions by gestational age, ethnicity and Index of Multiple Deprivation, and key care processes and outcomes. METHODS: We calculated differences in numbers and rates between April and June 2020 (spring), the first 3 months of national lockdown (COVID-19 period), and December 2019-February 2020 (winter), prior to introduction of mitigation measures, and compared them with the corresponding differences in the previous 7 years. We considered the COVID-19 period highly unusual if the spring-winter difference was smaller or larger than all previous corresponding differences, and calculated the level of confidence in this conclusion. RESULTS: Marked fluctuations occurred in all measures over the 8 years with several highly unusual changes during the COVID-19 period. Total admissions fell, having risen over all previous years (COVID-19 difference: -1492; previous 7-year difference range: +100, +1617; p<0.001); full-term black admissions rose (+66; -64, +35; p<0.001) whereas Asian (-137; -14, +101; p<0.001) and white (-319; -235, +643: p<0.001) admissions fell. Transfers to higher and lower designation neonatal units increased (+129; -4, +88; p<0.001) and decreased (-47; -25, +12; p<0.001), respectively. Total preterm admissions decreased (-350; -26, +479; p<0.001). The fall in extremely preterm admissions was most marked in the two lowest socioeconomic quintiles. CONCLUSIONS: Our findings indicate substantial changes occurred in care pathways and clinical thresholds, with disproportionate effects on black ethnic groups, during the immediate COVID-19 period, and raise the intriguing possibility that non-healthcare interventions may reduce extremely preterm births.


Assuntos
COVID-19 , Pandemias , Estudos de Coortes , Controle de Doenças Transmissíveis , Inglaterra/epidemiologia , Feminino , Humanos , Recém-Nascido , Gravidez , SARS-CoV-2 , Medicina Estatal , País de Gales/epidemiologia
6.
BMC Health Serv Res ; 21(1): 1059, 2021 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-34615536

RESUMO

BACKGROUND: Understanding the influences on healthcare professionals' career choices and progression can inform interventions to improve workforce retention. Retention of health professionals is a high priority worldwide, in order to maintain expertise and meet the needs of national populations. In the UK, investment in clinical scientists' pre-registration education is high and the need to retain motivated scientists recognised. METHODS: We conducted a mixed methods study to investigate the career choices and progression of early career clinical scientists. First job sector and salary of trainees who completed the UK pre-registration Scientist Training Programme (STP) between 2014 and 2019 were analysed using descriptive statistics and Chi-Squared tests. Semi-structured interviews conducted with volunteer practising clinical scientists who completed the programme in 2015 or 2016 were analysed thematically and reviewed for alignment with theories for understanding career choice and workforce retention. RESULTS: Most scientists who completed the STP between 2014 and 2019 obtained a post in the UK National Health Service (NHS) and achieved the expected starting salary. Life scientists were more likely to work in non-NHS healthcare settings than other scientific divisions; and physiological scientists less likely to achieve the expected starting salary. Experiences during training influenced career choice and progression 0-3 years post qualification, as did level of integration of training places with workforce planning. Specialty norms, staff turnover, organisational uncertainty and geographical preferences influenced choices in both the short (0-3 years) and longer term (5 + years). Interviewees reported a strong commitment to public service; and some could foresee that these priorities would influence future decisions about applying for management positions. These factors aligned with the components of job embeddedness theory, particularly that of 'fit'. CONCLUSIONS: Training experiences, personal values, specialty norms and organisational factors all influence UK clinical scientists' early career choices and progression. Job embeddedness theory provides a useful lens through which to explore career choice and progression; and suggests types of intervention that can enhance the careers of this essential group. Interventions need to take account of variations between different scientific specialties.


Assuntos
Escolha da Profissão , Medicina Estatal , Humanos
7.
Artigo em Inglês | MEDLINE | ID: mdl-34639653

RESUMO

Within the confinements of critical infrastructures, the COVID-19 pandemic is posing a series of challenges to Health Management. In the spotlight of highly contagious and quick spreading diseases within such enclosed facilities, whether it be a detention facility or otherwise, the health and safety of those living within its internment is paramount. This paper aims to highlight the specific challenges and the possible solutions to counteract this problem, starting from the lessons learnt from the Italian prison system case study. Following the general description of the available resources within the Italian prisons, the study aimed at specifically describing the first counteracting measures deployed by the Italian prison authorities during the first phase of the COVID-19 outbreak (February-July 2020). The aim was to propose an integrated plan capable of responding to a biological threat within the prisons. In particular, the study describes the actions and technical features that, in accordance with national and international legal frameworks and the relevant organisational bodies that run the Italian Prison Service, had been adopted in managing, right from the start, the COVID-19 pandemic until Summer 2020. Available information and data showed the ability of the prison administration to comply almost completely with WHO's technical and human rights recommendations and also, in successfully handling prison emergencies both in terms of the sick and the deceased in line with the epidemiological framework of the general population. In addition, the paper proposes a draft of guidelines that should involve the National Health Service and the Prison Service that are aimed at supporting the local prison facilities with drawing up their own biological incident contingency plans. An approved, legal, standardised plan could increase the awareness of prison managers. It could even increase their self-confidence, in particular, with regard to cases of dispute and their ability to respond to them. In fact, it is valuable and forward-thinking to be able to demonstrate that every endeavour has been taken and that 'certified' best practices have been put in place in accordance with the national standards.


Assuntos
COVID-19 , Prisões , Emergências , Humanos , Itália/epidemiologia , Pandemias , SARS-CoV-2 , Medicina Estatal
8.
Artigo em Inglês | MEDLINE | ID: mdl-34639712

RESUMO

The COVID-19 pandemic has undoubtedly affected all national healthcare systems at different levels. In countries heavily hit by the pandemic, it was reported that healthcare workers were asked to work long hours, had increased workload, were faced with difficult decisions, and that the resources were stretched. As such, the COVID-19 pandemic would create the perfect storm for burnout in healthcare workers. Within this context, we conducted a survey in a district general hospital in Southeast England. We focused on doctors in training, in different specialties. This survey included parts of the Maslach Burnout Inventory for healthcare professionals, along with other relevant questions, such as the financial impact and seeking of psychological support. The results showed moderate levels of emotional exhaustion, but high levels of personal satisfaction, a positive impact on doctors finances and very low levels of seeking support.


Assuntos
Esgotamento Profissional , COVID-19 , Esgotamento Profissional/epidemiologia , Pessoal de Saúde , Humanos , Pandemias , SARS-CoV-2 , Medicina Estatal , Confiança
9.
BMJ Open Qual ; 10(4)2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34645613

RESUMO

AIMS: Adoption of virtual clinics has been accelerated by the COVID-19 pandemic and they will continue to form an integral part of healthcare delivery. Our objective was to evaluate virtual clinics in orthopaedic practice and determine how to use them effectively and sustainably. METHODS: We surveyed 100 consecutive patients participating in orthopaedic virtual phone clinic (VPC) at an academic hospital to evaluate patient satisfaction against face-to-face (F2F) consultations and obtain suggestions for improving patient experience, and we surveyed 23 clinicians who conducted orthopaedic VPCs in 2020. Data were correlated with clinic outcomes, reason for consultation, diagnosis, patient age and clinician grade. Consultation duration, clinician-associated costs and reimbursement were analysed. Significance was tested using two-tailed Student's t-test and Fisher's exact test. RESULTS: Patient satisfaction (out of 5) for VPC was significantly lower than F2F (4.1 vs 4.5, p=0.0003), and a larger proportion of VPC scored <3 compared with F2F (11% vs 2%). Higher VPC scores were associated with appointments for delivering results and where patients felt clinical examination was not needed. Patients suggested introducing video capability, adhering to appointment time and offering the choice of VPC or F2F. Mean clinician satisfaction scores for VPC were 4.3/5 and suggested indications for VPC included: routine surveillance, communication of results, discussing/consenting for surgery and vulnerable patients. Integrating video, providing private rooms and offering patients time intervals for VPC were recommended. Current National Health Service VPC structures uses greater clinician resources and generates lower reimbursement than F2F consultations, resulting in 11.5% reduction in reimbursement. CONCLUSION: VPC plays a valuable role when clinical evaluation has been performed or considered not necessary. Offering the choice of VPC or F2F, adding video capability and providing a time interval for VPC may reduce resource use and increase satisfaction. We recommend renegotiating VPC tariffs and cost-neutral modifications of clinic structure.


Assuntos
COVID-19 , Ortopedia , Humanos , Pandemias , Satisfação do Paciente , SARS-CoV-2 , Medicina Estatal
10.
BMJ Open ; 11(9): e053014, 2021 09 30.
Artigo em Inglês | MEDLINE | ID: mdl-34593506

RESUMO

Social distancing laws during the first year of the pandemic, and its unprecedented changes to the National Health Service (NHS) forced a large majority of services, especially mental health teams to deliver patient care remotely. For many, this approach was adopted out of necessity, rather than choice, thus presenting a true 'testing ground' for remote healthcare and a robust evaluation on a national and representative level. OBJECTIVE: To extract and analyse mental health specific data from a national dataset for 1 year (March 2020-March 2021). DESIGN: A mixed-methods study using surveys and interviews. SETTING: In NHS mental health services in Wales, UK. PARTICIPANTS: With NHS patients and clinicians across child and adolescent, adult and older adult mental health services. OUTCOME MEASURES: Mixed methods data captured measures on use, value, benefits and challenges of video consulting (VC). RESULTS: A total of 3561 participants provided mental health specific data. These data and its findings demonstrate that remote mental health service delivery, via the method of VC is highly satisfactory, well-accepted and clinically suitable for many patients, and provides a range of benefits to NHS patients and clinicians. Interestingly, clinicians working from 'home' rated VC more positively compared with those at their 'clinical base'. CONCLUSIONS: Post 1-year adoption, remote mental health services in Wales UK have demonstrated that VC is possible from both a technical and behavioural standpoint. Moving forward, we suggest clinical leaders and government support to sustain this approach 'by default' as an option for NHS appointments.


Assuntos
Serviços de Saúde Mental , Medicina Estatal , Adolescente , Idoso , Criança , Humanos , Encaminhamento e Consulta , Reino Unido , País de Gales
11.
BMJ Open ; 11(9): e054377, 2021 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-34489298

RESUMO

OBJECTIVES: To develop an understanding of health professionals' experiences of working at the point of care during the COVID-19 pandemic, the impact on their health and well-being and their support needs. DESIGN: A qualitative study using semistructured interviews. Data were analysed using framework analysis. SETTING: One large National Health Service integrated care trust. PARTICIPANTS: A purposive sample of 19 qualified health professionals (doctors, nurses or allied health professionals), working with patients with COVID-19 admitted to the hospitals between March and May 2020 were eligible to take part. RESULTS: Eight major categories were identified: (1) Working in a 'war zone', (2) 'Going into a war zone without a weapon', (3) 'Patients come first', (4) Impact of COVID-19, (5) Leadership and management, (6) Support systems, (7) Health professionals' support needs, and (8) Camaraderie and pride. Health professionals reported increased levels of stress, anxiety and a lack of sleep. They prioritised their patients' needs over their own and felt a professional obligation to be at work. A key finding was the reported camaraderie among the health professionals where they felt that they were 'fighting this war together'. CONCLUSIONS: This study provides a valuable insight into the experiences of some of the frontline health professionals working in a large London-based hospital trust during the first COVID-19 peak. Findings from this study could be used to inform how managers, leaders and organisations can better support their health professional staff during the current pandemic and beyond.


Assuntos
COVID-19 , Pandemias , Humanos , Sistemas Automatizados de Assistência Junto ao Leito , Pesquisa Qualitativa , SARS-CoV-2 , Medicina Estatal , Reino Unido
12.
Rev Med Chil ; 149(4): 602-616, 2021 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-34479349

RESUMO

Among the several programs that allow access to medical specialization in Chile, the National Health Services System Entrance Contest (CONISS) is held annually for newly graduated physicians, which has a high number of applicants. The academic qualifications expressed as National Medical Qualification (CMN) are the main item of the scoring system. We reviewed the total scores and the CMN of the different medical specialization programs that exist in the country, which constitutes novel and relevant information for future medical graduates interested in applying to the program. In addition, the quotas of the different programs are reported, expressed as total, free, and used quotas.


Assuntos
Internato e Residência , Medicina , Médicos , Chile , Humanos , Especialização , Medicina Estatal
13.
Acta Ortop Mex ; 35(1): 3-10, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-34480432

RESUMO

INTRODUCTION: Healthcare pressure has changed the acquisition of knowledge during residency training. The aim of this study was to analyze the clinical and research training, and level of satisfaction, during orthopedic and traumatology residency in different hospitals of the Spanish National Health Service. MATERIAL AND METHODS: An online survey was distributed between 06/25/2020 and 07/31/2020. Demographic, institution, clinical and research variables were analyzed. Satisfaction was graded in a scale from 0 to 5. RESULTS: 120 residents answered the survey, having a mean age of 27 years and being 58% male. Distribution of residents by year was 26 R5 (21.7%), 24 R4 (20.0%), 45 R3 (37.5%), 25 R2 (20.9%). Only 37.5% answered that they did not have any clinical activity the next day after medical guard, and 45% answered that they performed clinical activity outside of working hours. A total of 56.7% answered that their orthopedic training program did not include research training. No resident had specific time assigned to research activities. Mean satisfaction value was 2.4 points. CONCLUSIONS: Clinical activity shows aspects incompatible with current legislation. Orthopedic programs need improvements with regard to research training. A significant percentage of residents are unsatisfied with their training.


Assuntos
Procedimentos Ortopédicos , Traumatologia , Adulto , Feminino , Hospitais , Humanos , Masculino , Satisfação Pessoal , Pesquisa , Espanha , Medicina Estatal
16.
Bone Joint J ; 103-B(9): 1541-1549, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34465152

RESUMO

AIMS: While a centralized system for the care of patients with a sarcoma has been advocated for decades, regional variations in survival remain unclear. The aim of this study was to investigate regional variations in survival and the impact of national policies in patients with a soft-tissue sarcoma (STS) in the UK. METHODS: The study included 1,775 patients with a STS who were referred to a tertiary sarcoma centre. The geographical variations in survival were evaluated according to the periods before and after the issue of guidance by the National Institute for Health and Care Excellence (NICE) in 2006 and the relevant evolution of regional management. RESULTS: There had been a significant difference in survival between patients referred from the North East, North West, East Midlands, West Midlands, South West, and Wales in the pre-NICE era (five-year disease-specific survival (DSS); South West, 74% vs North East, 47% (p = 0.045) or West Midlands, 54% (p = 0.049)), which was most evident for patients with a high-grade STS. However, this variation disappeared in the post-NICE era, in which the overall DSS for high-grade STS improved from 47% to 68% at five years (p < 0.001). Variation in the size of the tumour closely correlated with the variation in DSS, and the overall size of the tumour and incidence of metastasis at the time of diagnosis also decreased after the national policies were issued. CONCLUSION: The survival of patients with a STS improved and regional variation corrected after the introduction of national policies, as a result of a decreasing size of tumour and incidence of metastasis at the time of diagnosis, particularly in patients with a high-grade STS. This highlights the positive impact of national guidelines on regional variation in the presentation, management, and outcome in patients with a STS. Cite this article: Bone Joint J 2021;103-B(9):1541-1549.


Assuntos
Extremidades , Política de Saúde , Sarcoma/mortalidade , Neoplasias de Tecidos Moles/mortalidade , Neoplasias Torácicas/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Metástase Neoplásica , Características de Residência , Estudos Retrospectivos , Medicina Estatal , Taxa de Sobrevida , Reino Unido/epidemiologia
17.
Artigo em Inglês | MEDLINE | ID: mdl-34501970

RESUMO

Background: COVID-19 vaccination programmes offer hope for a potential end to the acute phase of the COVID-19 pandemic. We present perceptions following from a cohort of healthcare staff at the UK NHS hospital, which first initiated the BNT162b2 mRNA COVID-19 ("Pfizer") vaccination program. Methods: A paper-based survey regarding perceptions on the BNT162b2 mRNA COVID-19 vaccine was distributed to all healthcare workers at the University Hospitals Coventry & Warwickshire NHS Trust following receipt of the first vaccine dose. Results: 535 healthcare workers completed the survey, with a 40.9% response rate. Staff felt privileged to receive a COVID-19 vaccine. Staff reported that they had minimised contact with patients with confirmed or suspected COVID-19. Reported changes to activity following vaccination both at work and outside work were guarded. Statistically significant differences were noted between information sources used by staff groups and between groups of different ethnic backgrounds to inform decisions to receive vaccination. Conclusions: NHS staff felt privileged to receive the COVID-19 vaccine, and felt that their actions would promote uptake in the wider population. Concerns regarding risks and side effects existed, but were minimal. This research can be used to help inform strategies driving wider vaccine uptake amongst healthcare staff and the public.


Assuntos
COVID-19 , Vacinas , Vacinas contra COVID-19 , Atenção à Saúde , Hospitais Universitários , Humanos , Pandemias , Percepção , RNA Mensageiro , SARS-CoV-2 , Medicina Estatal , Vacinação
18.
BMC Health Serv Res ; 21(1): 951, 2021 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-34507575

RESUMO

BACKGROUND: There is evidence of geographical variation in the use of mental health services in the UK and in international settings. It is important to understand whether this variation reflects differences in the prevalence of mental disorders, or if there is evidence of variation related to other factors, such as population socioeconomic status and access to primary care services. METHODS: This is a cross-sectional ecological study using Public Health England data. The unit of analysis was the population served by clinical commissioning groups (CCGs), National Health Service (NHS) catchment areas. The analysis explored associations between area characteristics and the number of people in contact with mental health services using regression modelling. Explanatory variables included age, gender, prevalence of severe mental illness (SMI), prevalence of common mental disorder (CMD), index of multiple deprivation (IMD), unemployment, proportion of the population who are Black and Minority Ethnic (BAME), population density, access to and recovery in primary care psychological therapies. Unadjusted results are reported, as well as estimates adjusted for age, prevalence of CMD and prevalence of SMI. RESULTS: The populations of 194 CCGs were included, clustered within 62 trusts (NHS providers of mental health services). The number of people in contact with mental health services showed wide variation by area (range from 1131 to 5205 per 100,000 population). Unemployment (adjusted IRR 1.11; 95% CI 1.05 to 1.17; p < 0.001) and deprivation (adjusted IRR 1.02 95% CI 1.01 to 1.04; p < 0.001) were associated with more people being in contact with mental health services. Areas with a higher proportion of the population who are BAME (IRR 0.95 95% CI 0.92 to 0.99 p = 0.007) had lower service use per 100,000 population. There was no evidence for association with access to primary care psychological therapies. CONCLUSIONS: There is substantial variation in the use of mental health services by area of England. Social factors including deprivation, unemployment and population ethnicity continued to be associated with the outcome after controlling for the prevalence of mental illness. This suggests that there are factors that influence the local population use of mental health services in addition to the prevalence of mental disorder.


Assuntos
Transtornos Mentais , Serviços de Saúde Mental , Estudos Transversais , Inglaterra/epidemiologia , Humanos , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Medicina Estatal
19.
BMC Psychiatry ; 21(1): 446, 2021 09 09.
Artigo em Inglês | MEDLINE | ID: mdl-34496806

RESUMO

BACKGROUND: Screening for depression and anxiety disorders has been proposed in prison populations but little is known about caseness thresholds on commonly used self-report measures in relation to core symptoms, risk factors and symptom patterns. METHOD: A cross-sectional prevalence survey measured depression and anxiety caseness (threshold scores > 10 and > 15 on PHQ-9 and GAD-7 and diagnostic algorithm on PHQ-9) in 1205 male prisoners aged 35-74 years eligible for an NHS Healthcheck from six English prisons. Caseness scores were compared with the presence or absence of daily core symptoms of depression and generalised anxiety disorder (GAD), demographic, prison and cardiovascular risk factors. Cluster analysis was applied to PHQ-9 and GAD-7 items in prisoners scoring > 10 on PHQ-9. RESULTS: 453(37.6%) and 249(20.7%) prisoners scored > 10 and > 15 respectively on PHQ-9; 216 (17.9%) had a depressive episode on the PHQ-9 algorithm; 378(31.4%) and 217(18.0%) scored > 10 and > 15 on GAD-7 respectively. Daily core items for depression were scored in 232(56.2%) and 139(74.3%) prisoners reaching > 10 and > 15 respectively on PHQ-9; daily core anxiety items in 282(74.9%) and 179(96.3%) reaching > 10 and > 15 on GAD-7. Young age, prison and previous high alcohol intake were associated with > 15 on the PHQ-9. Cluster analysis showed a cluster with core symptoms of depression, slowness, restlessness, suicidality, poor concentration, irritability or fear. Altered appetite, poor sleep, lack of energy, guilt or worthlessness belonged to other clusters and may not be indicative of depression. CONCLUSIONS: In male prisoners > 35 years, a score of > 10 on the PHQ-9 over diagnoses depressive episodes but a score of > 10 on the GAD-7 may detect cases of GAD more efficiently. Further research utilising standardised psychiatric interviews is required to determine whether the diagnostic algorithm, a higher cut-off on the PHQ-9 or the profile of symptoms on the PHQ-9 and GAD-7 used singly or in combination may be used to screen depressive episodes efficiently in prisoners.


Assuntos
Questionário de Saúde do Paciente , Prisioneiros , Ansiedade/diagnóstico , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Estudos Transversais , Depressão/diagnóstico , Depressão/epidemiologia , Humanos , Masculino , Medicina Estatal
20.
Br J Nurs ; 30(16): 986-987, 2021 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-34514819

RESUMO

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses several reports looking at how our clinical negligence compensation system operates, and possible reform of this.


Assuntos
Imperícia , Medicina Estatal , Humanos
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