scholarly journals The development of an evidence-informed Convergent Care Theory: Working together to achieve optimal health outcomes

Author(s):  
Holly Wei
BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S99-S100
Author(s):  
Hannah Reynolds ◽  
Samaila Bello ◽  
Hanna Leech

AimsTo assess the uptake of cervical screening in patients under Birmingham and Solihull Assertive Outreach Teams; this included a re-audit of patients under the Central Birmingham Assertive Outreach Team.BackgroundPatients with severe and enduring mental illness are known to have poorer physical health outcomes. In Birmingham and Solihull there are 6 Assertive Outreach Teams. These teams manage patients with a diagnosis of psychosis who have complex needs requiring intensive multidisciplinary input and often struggle to engage with health services. The national cervical screening programme aims to prevent cervical cancer by detecting and treating cervical abnormalities. Acceptable coverage is defined as screening at least 80% of people aged 25–49 years within the last 3.5 years and 80% of people aged 50–64 years within the last 5.5 years. In 2018 71.4% of women in England and 70.9% in the West Midlands were screened adequately. An audit of 15 patients under the Central Birmingham Assertive Outreach Team in 2014 showed 46.2% had taken up screening, measured in the last 5 years for those aged 50–64 years and the last 3 years for those aged 25–49 years.MethodA list was obtained of all female patients under the Assertive Outreach Teams with patients excluded if they were under 25 years or over 64 years or if they were known to have undergone a total hysterectomy. All GP practices with eligible patients registered to them were written to requesting the date of the patient's most recent smear test. Cervical screening was classed as in date if carried out in the last 3.5 years for patients aged 25–49 years or 5.5 years for patients aged 50–64 years.ResultOut of 127 eligible patients, 110 had correct GP details on their record. Responses were received regarding 101 patients, 48 of whom had in date cervical screening (47.5%). Of 58 patients aged 25–49 years, 26 had in date cervical screening (44.8%). Of 43 patients aged 50–64 years, 22 had in date cervical screening (51.2%).Conclusion13.4% patients did not have a known GP practice, increasing the risk of multiple poor physical health outcomes. The rates of cervical screening among Assertive Outreach Team patients are similar to the original audit in 2014 and fall significantly below the national standards and averages. These findings, along with the importance of working together to address the need for physical health monitoring in this population, will be communicated with the local Assertive Outreach Teams and GP practices.


2019 ◽  
Vol 7 (4) ◽  
pp. 130-144
Author(s):  
William A. Gerber

Abstract Purpose of Review This review sought to assess the extent and causes of suboptimal healthcare outcomes for chronic variable immunodeficiency (CVID). Recent Findings Significant improvements in diagnostic technology and treatment protocols over time were found, leading to reduced morbidity and mortality for those accessing therapies. Treatments continue to be largely non-curative with financing (mainly insurance coverage) an obstacle. Symptom recognition by primary care practitioners (PCP) remains a gating factor to treatment and a widespread and persistent barrier to optimal health outcomes. Summary CVID is a subtype of primary immunodeficiency (PIDD) associated with under-diagnosis. It has emerged as a health issue more prevalent than historically known. No symptom-recognition framework for early detection of CVID has been generally accepted; those proposed for primary immunodeficiencies have shown low sensitivity, low specificity or both. Positive trends in cases diagnosed have been aided by awareness campaigns and international collaborations. However, treatments for CVID will not realize full potential without effective, accepted frameworks for timely identification in the clinic.


Proceedings ◽  
2019 ◽  
Vol 8 (1) ◽  
pp. 40
Author(s):  
Caitlin Sisson ◽  
Maria Anna Choukri

Background: Nutrition is vital to achieve optimal health outcomes for both mother and babyduring pregnancy [...]


2021 ◽  
Vol 12 ◽  
Author(s):  
Laura E. Carr ◽  
Misty D. Virmani ◽  
Fernanda Rosa ◽  
Daniel Munblit ◽  
Katelin S. Matazel ◽  
...  

Exclusive human milk feeding of the newborn is recommended during the first 6 months of life to promote optimal health outcomes during early life and beyond. Human milk contains a variety of bioactive factors such as hormones, cytokines, leukocytes, immunoglobulins, lactoferrin, lysozyme, stem cells, human milk oligosaccharides (HMOs), microbiota, and microRNAs. Recent findings highlighted the potential importance of adding HMOs into infant formula for their roles in enhancing host defense mechanisms in neonates. Therefore, understanding the roles of human milk bioactive factors on immune function is critical to build the scientific evidence base around breastfeeding recommendations, and to enhance positive health outcomes in formula fed infants through modifications to formulas. However, there are still knowledge gaps concerning the roles of different milk components, the interactions between the different components, and the mechanisms behind health outcomes are poorly understood. This review aims to show the current knowledge about HMOs, milk microbiota, immunoglobulins, lactoferrin, and milk microRNAs (miRNAs) and how these could have similar mechanisms of regulating gut and microbiota function. It will also highlight the knowledge gaps for future research.


2019 ◽  
Vol 25 (13-14) ◽  
pp. 2520-2527
Author(s):  
Amy L Ai ◽  
Henry Carretta

Anxiety is an under-investigated comorbidity in heart disease patients. Optimism/hope is a character strength that indicates confidence or favorable expectation about the future. Previous research has consistently reported optimal health outcomes among optimists. However, many studies have lacked adjustment for medical confounders and/or used small clinical samples. To bridge this gap, we tested the hypothesis that optimism/hope was inversely related to anxiety in 400+ patients with advanced heart disease during the stressful waiting period prior to open-heart surgery. The findings supported the hypothesis after controlling for general health, illness impact, behavioral risks, and cardiac medical indices used by surgeons.


2018 ◽  
Vol 101 (4) ◽  
pp. 332-359 ◽  
Author(s):  
Susan Finn ◽  
Eamonn P. Culligan ◽  
William J. Snelling ◽  
Roy D. Sleator

Nutritionally, the first 1,000 days of an infant's life – from conception to two years – has been identified as a highly influential period, during which lasting health can be achieved. Significant evidence links patterns of infant feeding to both short and long-term health outcomes, many of which can be prevented through nutritional modifications. Recommended globally, breastfeeding is recognised as the gold standard of infant nutrition; providing key nutrients to achieve optimal health, growth and development, and conferring immunologic protective effects against disease. Nevertheless, infant formulas are often the sole source of nutrition for many infants during the first stage of life. Producers of infant formula strive to supply high quality, healthy, safe alternatives to breast milk with a comparable balance of nutrients to human milk imitating its composition and functional performance measures. The concept of ‘nutritional programming’, and the theory that exposure to specific conditions, can predispose an individual's health status in later life has become an accepted dictum, and has sparked important nutritional research prospects. This review explores the impact of early life nutrition, specifically, how different feeding methods affect health outcomes.


2019 ◽  
Vol 33 (2) ◽  
pp. 61-64
Author(s):  
Ray J. Racette

The urgency for reforming our health systems to improve health outcomes and service pathways is pressing and must be championed by leaders. Coalitions of the willing must be created to lead this movement. The All Nations Health Partners in Kenora, Ontario, have formed to lead health system reform in the Kenora Health District and are doing so in the spirit of Reconciliation in Action. All nations and organizations working together to reduce health disparities and improve health outcomes for all people.


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