{"title":"Do not attempt cardiopulmonary resuscitation decisions (DNACPR) – Policy approaches in Wales","authors":"Mark Taubert, Ben Rose, Miriam Rigby","doi":"10.1016/j.intcar.2023.100149","DOIUrl":"https://doi.org/10.1016/j.intcar.2023.100149","url":null,"abstract":"<div><p>Cardiopulmonary resuscitation (CPR) was first described in 1960, when Kouwenhoven and colleagues described a novel technique of ‘closed chest cardiac massage’. CPR is an emergency medical intervention undertaken in an attempt to restore breathing and circulation following a respiratory or cardio-respiratory arrest. The intervention includes the administration of external chest compressions, artificial ventilation<span>, and consecutive electric shocks applied to the bare chest (known as defibrillation) and the rapid administration of medicines intravenously or intra-osseously. But there are clear differences in who will and will not respond to these ferocious interventions in cardiac arrest situations. In some instances, clinicians may be as certain as they can be that future attempts at CPR will not work. In those situations, a Do Not Attempt CPR form may be filled out, after a consultation with the patient. Here, the authors review current policies, guidelines and resources, discuss how the prospect of a natural, anticipated and accepted death in the near future can be a trigger to advance care planning, and outline resources that can help improve communication in an area rife with misconceptions and misunderstanding.</span></p></div>","PeriodicalId":100283,"journal":{"name":"Clinics in Integrated Care","volume":"19 ","pages":"Article 100149"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49732814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Non-prescribed use of gabapentinoids","authors":"David S. Baldwin, Vasilios Masdrakis","doi":"10.1016/j.intcar.2023.100164","DOIUrl":"https://doi.org/10.1016/j.intcar.2023.100164","url":null,"abstract":"<div><p>The gabapentinoid<span> drugs<span><span><span> gabapentin and </span>pregabalin are medications used clinically across a range of neurological and </span>psychiatric conditions<span>. They have analgesic<span><span><span>, anticonvulsant<span> and anxiolytic effects. Their specific licensed indications differ, and vary across countries, but include certain neurological problems such as focal seizures, peripheral </span></span>neuropathic pain<span><span>, spasticity in multiple sclerosis, and muscular symptoms in </span>motor neurone disease, and the psychological condition of </span></span>generalized anxiety disorder. However, in many countries, gabapentin and pregabalin are frequently prescribed outside the terms of their market authorisations, and non-prescribed use has become widespread and troublesome in many populations. Increasing concerns regarding non-prescribed use have led some regulatory authorities to designate gabapentin and pregabalin as controlled substances, with accompanying regulations regarding prescriptions. This review describes the pharmacological properties of gabapentin and pregabalin, highlights evidence regarding efficacy and tolerability, summarises the findings of investigations of potential hazards with these drugs, and concludes with guidance on the clinical management of non-prescribed use.</span></span></span></span></p></div>","PeriodicalId":100283,"journal":{"name":"Clinics in Integrated Care","volume":"21 ","pages":"Article 100164"},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49707440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Barriers and challenges to integrated care","authors":"Hayley Bamber, Kirsty Marshall","doi":"10.1016/j.intcar.2023.100148","DOIUrl":"https://doi.org/10.1016/j.intcar.2023.100148","url":null,"abstract":"<div><p>Integrated care is critical to the successful delivery of modern day health and social care services, however the implementation into practice poses many barriers and challenges. This article seeks to identify these barriers and present methods through which to aim to address and overcome these.</p></div>","PeriodicalId":100283,"journal":{"name":"Clinics in Integrated Care","volume":"18 ","pages":"Article 100148"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49708767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Integrated care for LGBTQ+ people","authors":"Claire Brown","doi":"10.1016/j.intcar.2023.100157","DOIUrl":"https://doi.org/10.1016/j.intcar.2023.100157","url":null,"abstract":"<div><p>While LGBTQ+ people have received increased media coverage over the past two decades, awareness has not necessarily been productive towards including all identities. Rather, some identities have been ‘othered’ or neglected within research and practice, for example, bisexual, pansexual, trans and non-binary people. Health and social care organisations have a key role in addressing discrimination to ensure minoritized gender and sexual identities are included within integrated care systems. There is an opportunity to rebuild systems, procedures and policies using contemporary knowledge of LGBTQ+ peoples' lives to contribute to a more inclusive form of integrated care. It is hoped that in doing so, the public sector can embody an integrated care approach that includes and empowers LGBTQ+ voices and perspectives to inform ethical, respectful and equitable practice. This chapter explores the ways in which health and social care sector staff and systems can work together to build a shared knowledge and understanding of LGBTQ+ people, as well as a coordinated approach to assessing and responding to their specific needs.</p></div>","PeriodicalId":100283,"journal":{"name":"Clinics in Integrated Care","volume":"18 ","pages":"Article 100157"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49708770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"People taking control of their own health information","authors":"Gillian Strudwick","doi":"10.1016/j.intcar.2023.100140","DOIUrl":"https://doi.org/10.1016/j.intcar.2023.100140","url":null,"abstract":"<div><p>The focus of this article is on the current and future state of people taking more control over their health information in a way that is facilitated by the use of technology. Nurses and midwives are already taking a significant leadership role in this space in advancing this agenda in healthcare. In the future, nurses and midwives will have an increasingly important role in not only advocating and advancing access of health information to patients, but also in identifying and providing supports to allow this to happen in both a meaningful and helpful way. The article will provide an overview of some of the current technologies that individuals use to obtain access to their health information. It will discuss some of the barriers to, and facilitators of, access and use of these technologies. Lastly, the article will conclude with a focus on the future, where trends and future outlooks related to increasing access to health information will be described.</p></div>","PeriodicalId":100283,"journal":{"name":"Clinics in Integrated Care","volume":"17 ","pages":"Article 100140"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49710130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ensuring digital inclusion","authors":"Vanessa Heaslip, Debbie Holley","doi":"10.1016/j.intcar.2023.100141","DOIUrl":"https://doi.org/10.1016/j.intcar.2023.100141","url":null,"abstract":"<div><p>The last decade has seen an expansion in digital health which was rapidly advanced during the COVID-19 pandemic. Digital healthcare has the potential to both increase the quality of care provided to patients as well as enabling access to care in marginalised groups and communities promoting health for all. However, if the implementation of digital healthcare is not managed carefully then it could inadvertently widen the health gap. There are many individuals, groups and communities who find themselves digitally excluded, and this can also include nurses and midwives themselves. It is important in any service design that consideration is given to digital inclusivity, ensuing that no one is left behind.</p></div>","PeriodicalId":100283,"journal":{"name":"Clinics in Integrated Care","volume":"17 ","pages":"Article 100141"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49710140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Anatomy and physiology of feeding and swallowing: normal and abnormal","authors":"Koichiro Matsuo, Jeffrey B. Palmer","doi":"10.1016/j.intcar.2023.100139","DOIUrl":"https://doi.org/10.1016/j.intcar.2023.100139","url":null,"abstract":"<div><p>Eating and swallowing are complex behaviors involving volitional and reflexive activities of more than 30 nerves and muscles. They have two crucial biological features: food passage from the oral cavity to stomach and airway protection. The swallowing process is commonly divided into oral, pharyngeal, and esophageal stages according to the location of the bolus. The movement of the food in the oral cavity and to the oropharynx differs between eating solid food and drinking liquid. Dysphagia can result from a wide variety of functional or structural deficits of the oral cavity, pharynx, larynx or esophagus. The goal of dysphagia rehabilitation is to identify and treat abnormalities of feeding and swallowing while maintaining safe and efficient alimentation and hydration.</p></div>","PeriodicalId":100283,"journal":{"name":"Clinics in Integrated Care","volume":"16 ","pages":"Article 100139"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49709256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mindfulness-based interventions for anxiety and depression","authors":"Shalini Bhattacharya, Stefan G. Hofmann","doi":"10.1016/j.intcar.2023.100138","DOIUrl":"https://doi.org/10.1016/j.intcar.2023.100138","url":null,"abstract":"<div><p>Mindfulness-based interventions (MBIs) have a growing body of support in the literature and are increasingly popular for treating a variety of mental health disorders. The two most investigated MBIs include Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT).</p><p>We provide a comprehensive up-to-date review of MBIs for reducing anxiety and depression in a broad range of clinical populations.</p><p>MBIs outperformed passive controls for treating anxiety and depression. However, the effect sizes are mixed when compared to active controls.</p></div>","PeriodicalId":100283,"journal":{"name":"Clinics in Integrated Care","volume":"16 ","pages":"Article 100138"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49709324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Culturally competent healthcare","authors":"Shondell V. Hickson","doi":"10.1016/j.intcar.2022.100130","DOIUrl":"10.1016/j.intcar.2022.100130","url":null,"abstract":"<div><p>The healthcare system is steadily becoming more diverse at an alarming pace brought on by multiple refugee crises, employment opportunities, environmental factors, educational purposes, and reuniting with families. Therefore, healthcare providers, healthcare delivery systems, and policymakers must create and deliver culturally competent services. Providing culturally competent healthcare allows the providers and the healthcare system to effectively deliver services that meet social, cultural, and linguistic needs. Research has shown that providing culturally competent healthcare improves patient health outcomes and delivers quality care that reduces racial and ethnic health disparities. Most healthcare professionals work very hard under challenging conditions to ensure that patients receive the best possible healthcare. However, multiple studies have shown that biases, prejudice, and stereotyping on the part of healthcare providers or the system influence care delivery.</p></div>","PeriodicalId":100283,"journal":{"name":"Clinics in Integrated Care","volume":"15 ","pages":"Article 100130"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76406198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bhumi Shah, John Lee Y. Allen, Hassan Chaudhury, James O'Shaughnessy, Carina S.B. Tyrrell
{"title":"The role of digital health in the future of integrated care","authors":"Bhumi Shah, John Lee Y. Allen, Hassan Chaudhury, James O'Shaughnessy, Carina S.B. Tyrrell","doi":"10.1016/j.intcar.2022.100131","DOIUrl":"10.1016/j.intcar.2022.100131","url":null,"abstract":"<div><p><span>The incorporation of technology in healthcare is essential to driving an integrated model of care - one which is holistic, patient-centred, and shows clear communication between different specialities, providers, and levels of care. This is gaining support from doctors and patients alike and moving healthcare from reactive to preventative. Advances in technology and healthcare have led to explosive growth in virtual consultations, remote monitoring mobile health, digital therapeutics, and artificial intelligence/machine learning applied to health. Not only have their adoption led to more integrated care systems, but also more cost effective, efficient, and higher quality ones at scale. The role and importance of </span>digital health in integrated care has never been greater. The COVID-19 pandemic has allowed trials of a variety of new technologies and created a foundation for digital health to drive integrated care. This up-to-date review discusses the latest developments, challenges, opportunities, and future potential of digital health in integrated care. Understanding this field is critical as we work towards a fully integrated model of care – the validation and adoption of new medical advances, using critical insights from health information, and optimising specialists and providers for patient-centred, high-quality, cost-effective care.</p></div>","PeriodicalId":100283,"journal":{"name":"Clinics in Integrated Care","volume":"15 ","pages":"Article 100131"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73727689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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