{"title":"The anatomy and physiology of pain","authors":"Carly M. Webb, Charlotte E. Steeds","doi":"10.1016/j.intcar.2022.100115","DOIUrl":"https://doi.org/10.1016/j.intcar.2022.100115","url":null,"abstract":"<div><p><span><span>Pain is an unpleasant experience that results from both physical and psychological responses to injury. A complex set of pathways transmits pain messages from the periphery to the central nervous system<span>, where control occurs from higher centres. Primary afferent pain fibres synapse with second-order neurons in the dorsal horn of the spinal cord<span>. Ascending spinothalamic and spinoreticular tracts convey pain signals to the brain, where they are processed by the thalamus and sent to the cortex. Descending tracts, via the midbrain </span></span></span>periaqueductal grey<span> and nucleus raphe magnus<span>, have a role in pain modulation. When nerves are damaged, </span></span></span>neuropathic pain results and various mechanisms have been proposed for how this takes place. These mechanisms involve both peripheral and central sensitization.</p></div>","PeriodicalId":100283,"journal":{"name":"Clinics in Integrated Care","volume":"14 ","pages":"Article 100115"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137259923","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":"History and clinical examination of an adult abdomen","authors":"Priscilla Peart","doi":"10.1016/j.intcar.2022.100113","DOIUrl":"10.1016/j.intcar.2022.100113","url":null,"abstract":"<div><p>Specific body systems have focused examinations. In this article the process of taking a clinical history from someone with abdominal pain and the assessment required is discussed. This article will guide the reader into the requirements of how to assess a patient with a presentation of abdominal pain. It will also inform how to clinically focus when presented with the multitude of possibilities and what information is required to establish a differential diagnosis. History and clinical examination is discussed in detail to allow the reader to develop their assessment skills to an advanced practice level.</p></div>","PeriodicalId":100283,"journal":{"name":"Clinics in Integrated Care","volume":"13 ","pages":"Article 100113"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74858274","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":"Understanding childhood and adolescent obesity","authors":"Sinead Murphy","doi":"10.1016/j.intcar.2022.100114","DOIUrl":"10.1016/j.intcar.2022.100114","url":null,"abstract":"<div><p>Childhood overweight and obesity is one of the most significant public health<span> concerns at a global level. A BMI<span> >85TH Percentile is a widely accepted definition of overweight and children and young people with this BMI should be screened for comorbidities. Aetiology is complex and multifactorial, involving an interaction of genetic and non-genetic factors. Treatment must therefore be wide-reaching and the importance of identification of the at risk child and prevention must not be underestimated.</span></span></p></div>","PeriodicalId":100283,"journal":{"name":"Clinics in Integrated Care","volume":"13 ","pages":"Article 100114"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73922181","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":"Cardiovascular history taking and clinical examination","authors":"Priscilla Peart","doi":"10.1016/j.intcar.2022.100105","DOIUrl":"10.1016/j.intcar.2022.100105","url":null,"abstract":"<div><p>Specific body systems have focused examinations. In this article the cardiovascular history and assessment is discussed. Building on from the previous article – Clinical History Taking, this article will guide the reader into the requirements of how to assess a patient with a cardiovascular presentation, how to clinically focus when presented with the multitude of possibilities and what information is required to establish a differential diagnosis. History taking and clinical examination is discussed in detail to allow the reader to develop their assessment skills to an advanced practice level.</p></div>","PeriodicalId":100283,"journal":{"name":"Clinics in Integrated Care","volume":"12 ","pages":"Article 100105"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82871664","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}
Jessica Shepherd, Stephanie Gurney, Harnish P. Patel
{"title":"Shared decision making and personalised care support planning: pillars of integrated care for older people","authors":"Jessica Shepherd, Stephanie Gurney, Harnish P. Patel","doi":"10.1016/j.intcar.2022.100097","DOIUrl":"10.1016/j.intcar.2022.100097","url":null,"abstract":"<div><p><span><span>Shared decision making (SDM) is a process in which individuals and clinicians work together to select tests, treatment and agree on management decisions based on the best available evidence, individual preferences, and values. SDM is based on a two-way communication on what matters most to individuals and empowers both the individual and clinician to arrive at a final management decision, which also includes medication management, self-care, and lifestyle changes. SDM is associated with better outcomes and greater patient satisfaction. Older people are a heterogeneous group of individuals whose needs often span several domains including social, psychological, cognitive as well as physical and as such require a different approach to SDM. Personalised care support planning is a future focused conversation that supports older people living with </span>multimorbidity, </span>frailty<span> and disability. Goals for long term treatment and management plans are obtained through holistic, multidisciplinary led Comprehensive Geriatric Assessment (CGA).</span></p></div>","PeriodicalId":100283,"journal":{"name":"Clinics in Integrated Care","volume":"12 ","pages":"Article 100097"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73176113","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}
Edward Jones, Sarah Mould, Lucy Ward, Larissa Ryan, Harnish P. Patel
{"title":"Integrated care for people living with dementia","authors":"Edward Jones, Sarah Mould, Lucy Ward, Larissa Ryan, Harnish P. Patel","doi":"10.1016/j.intcar.2022.100095","DOIUrl":"10.1016/j.intcar.2022.100095","url":null,"abstract":"<div><p><span>People with dementia, and their families are likely to have multiple needs across the biological, psychological, and social domains. These complex needs are best met by multidisciplinary teams who can work across different healthcare settings and apply models of integrated care. In this review, we describe several examples of integrated care for people living with dementia such as specialist dementia wards, psychiatric liaison teams, community mental health teams and Admiral Nurses. Gaps in services for people with dementia are likely to include crisis or out-of-hours support, and specialist end-of-life or </span>palliative care services.</p></div>","PeriodicalId":100283,"journal":{"name":"Clinics in Integrated Care","volume":"11 ","pages":"Article 100095"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81655687","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":"Healing wound management","authors":"Glo Neilsen, Kerrie Coleman","doi":"10.1016/j.intcar.2022.100096","DOIUrl":"10.1016/j.intcar.2022.100096","url":null,"abstract":"<div><p>There are many variables when it comes to delivering wound care from the person to the wound, the type of wound, the available resources, and the knowledge and skill of the clinician delivering this care.</p><p>Approximately three quarters of wound care occurs in the home setting where practitioners are often working without the immediate support of another clinician to help them with that decision making.</p><p>Research informing practice remains sparse and currently few institutions devote core classes dedicated to teaching wound care in medicine, nursing, and other health professionals.</p><p>Although there is fragmented knowledge of the outcomes associated with wound care nurses’ practice, their knowledge and practice are a key element for improving health outcomes. Therefore, further research is needed, dissemination of that research needs to reach the frontline clinicians, acknowledging the clinical context in which they practice.</p></div>","PeriodicalId":100283,"journal":{"name":"Clinics in Integrated Care","volume":"11 ","pages":"Article 100096"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74900497","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":"Clinical history taking","authors":"Priscilla Peart","doi":"10.1016/j.intcar.2021.100088","DOIUrl":"https://doi.org/10.1016/j.intcar.2021.100088","url":null,"abstract":"","PeriodicalId":100283,"journal":{"name":"Clinics in Integrated Care","volume":"121 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86855822","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":"Clinical history taking","authors":"Priscilla Peart","doi":"10.1016/j.intcar.2021.100088","DOIUrl":"https://doi.org/10.1016/j.intcar.2021.100088","url":null,"abstract":"<div><p><span>Non-medical staff are often required from their role to take a medical history from patients. The skills to do this to the level of a doctor are not taught in other fields and can lead to a limited ability to collect the knowledge required. The systematic sequence of </span>history taking can increase any clinician's ability to make critical judgements and clinical decisions to safely treat the patient. The sequence of taking a clinical history has been established for generations of doctors but not often communicated to the wider health network. By understanding the basics and the structure will enable a non-medical clinician to take a concise history from a patient to aid in further diagnostic assessments.</p></div>","PeriodicalId":100283,"journal":{"name":"Clinics in Integrated Care","volume":"10 ","pages":"Article 100088"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91719437","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":"Leadership in healthcare","authors":"Robin DC. Kumar","doi":"10.1016/j.intcar.2021.100080","DOIUrl":"https://doi.org/10.1016/j.intcar.2021.100080","url":null,"abstract":"<div><p>Effective leadership by healthcare professionals is vital in modern healthcare settings. The major factor underpinning this is the drive to improve the quality of healthcare provision. There are many reasons why quality improvement programmes fail, however the lack of engagement of clinicians and their resistance to change are amongst the most important factors. Clinicians who assume leadership roles need to overcome these barriers and adopt a style of leadership that is inclusive and meets the needs of healthcare professionals.</p></div>","PeriodicalId":100283,"journal":{"name":"Clinics in Integrated Care","volume":"10 ","pages":"Article 100080"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137221369","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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