London journal of primary care最新文献

{"title":"Child and Adolescent Mental Health Services in Oman.","authors":"Hassan Mirza","doi":"10.1080/17571472.2018.1482661","DOIUrl":"https://doi.org/10.1080/17571472.2018.1482661","url":null,"abstract":"<p><p>Oman is an emerging economy which has witnessed rapid development and demographic shift over the past four decades. With such changes, the country has witnessed a surge in the number of young people with various mental health problems. Despite the increasing need for mental health services for the young, there is a scarcity of such services in Oman due to severe shortage and maldistribution of facilities. Currently, only two institutes in Oman offer child and adolescent mental health services to the whole country. This paper outlines how Oman is delivering mental health services for the young despite the challenges.</p>","PeriodicalId":89823,"journal":{"name":"London journal of primary care","volume":"10 4","pages":"121-122"},"PeriodicalIF":0.0,"publicationDate":"2018-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17571472.2018.1482661","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36376077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using virtual reality to train emotional and social skills in children with autism spectrum disorder.","authors":"Sze Ngar Vanessa Yuan,&nbsp;Horace Ho Shing Ip","doi":"10.1080/17571472.2018.1483000","DOIUrl":"https://doi.org/10.1080/17571472.2018.1483000","url":null,"abstract":"<p><p>With emerging technology, computerised, internet-based and virtual reality (VR)-based treatment and training became increasingly popular. VR provides an immersive experience into a simulated environment. Autism spectrum disorder (ASD) is characterised by social communication deficits and repetitive behaviours. Children with ASD often require social skills training while VR provides a safe, controllable environment to practice skills repeatedly. The Centre for Innovative Applications of Internet and Multimedia Technologies (AIMTech Centre) at City University of Hong Kong developed a VR-enabled training program to examine its efficacy on emotional and social skills with six VR scenarios depicting the daily lives of typical children in Hong Kong. 94 children from mainstream primary schools in Hong Kong completed the study and 72 children were included in the analysis. Children from training group scored higher on emotion expression and regulation (<i>M</i> = 20.2, SD = 3.00) than before the training (<i>M</i> = 18.9, SD = 3.57, <i>t</i>(35) = -2.174, <i>p</i> = .037) and higher on social interaction and adaptation after the training (<i>M</i> = 21.8, SD = 2.99) than before training (<i>M</i> = 20.2, SD = 3.43, <i>t</i>(35) = -3.987, <i>p</i> < .0005). There was a statistically significant interaction between group and time on affective expressions, <i>F</i>(1, 70) = 5.223, <i>p</i> = .025, partial <i>η</i>² = .069, and on social reciprocity, <i>F</i>(1, 70) = 7.769, <i>p</i> = .007, partial <i>η</i>² = .100. Children were able to engage in VR training despite initial challenges with viewing goggles. Some children declined to participate due to scheduling reasons which may be minimised through the adoption of head-mounted displays as a portable, cost-effective device. VR seems to be a promising asset to traditional training and therapy while the importance trainers' or therapists' support has yet to be further investigated.</p>","PeriodicalId":89823,"journal":{"name":"London journal of primary care","volume":"10 4","pages":"110-112"},"PeriodicalIF":0.0,"publicationDate":"2018-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17571472.2018.1483000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36376074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating case studies of community-oriented integrated care.","authors":"Paul Thomas,&nbsp;Amrit Sachar,&nbsp;Andrew Papanikitas,&nbsp;Alison While,&nbsp;Chris Brophy,&nbsp;Chris Manning,&nbsp;Cliff Mills,&nbsp;Baljeet Ruprah-Shah,&nbsp;Catherine Millington-Sanders,&nbsp;David Morris,&nbsp;Deirdre Kelley Patterson,&nbsp;Diana Hill,&nbsp;Emma McKenzie-Edwards,&nbsp;Fiona Wright,&nbsp;Francesco Carelli,&nbsp;Freddy Shaw,&nbsp;Isabelle Vedel,&nbsp;John Spicer,&nbsp;Liz Wewiora,&nbsp;Malik Gul,&nbsp;Michelle Kirkbride Ba,&nbsp;Mike Sadlowski,&nbsp;Mylaine Breton,&nbsp;Ricky Banarsee,&nbsp;Sunjai Gupta,&nbsp;Tony Burch,&nbsp;Tulloch Kempe,&nbsp;Victoria Tzortziou Brown,&nbsp;John Sanfey","doi":"10.1080/17571472.2018.1477455","DOIUrl":"10.1080/17571472.2018.1477455","url":null,"abstract":"<p><p>This paper summarises a ten-year conversation within London Journal of Primary Care about the nature of community-oriented integrated care (COIC) and how to develop and evaluate it. COIC means integration of efforts for combined disease-treatment and health-enhancement at local, community level. COIC is similar to the World Health Organisation concept of a Community-Based Coordinating Hub - both require a local geographic area where different organisations align their activities for whole system integration and develop local communities for health. COIC is a necessary part of an integrated system for health and care because it enables multiple insights into 'wicked problems', and multiple services to integrate their activities for people with complex conditions, at the same time helping everyone to collaborate for the health of the local population. The conversation concludes seven aspects of COIC that warrant further attention.</p>","PeriodicalId":89823,"journal":{"name":"London journal of primary care","volume":"10 4","pages":"73-81"},"PeriodicalIF":0.0,"publicationDate":"2018-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17571472.2018.1477455","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36376653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socially engaged photography and wellbeing: reflections on a case study in the northwest of England.","authors":"Gary Bratchford,&nbsp;Gina Giotaki,&nbsp;Liz Wewiora","doi":"10.1080/17571472.2018.1477439","DOIUrl":"https://doi.org/10.1080/17571472.2018.1477439","url":null,"abstract":"<p><p>This paper describes a 9-month project commissioned by Halton Clinical Commissioning Group (CCG) and Liverpool photography organisation, Open Eye Gallery. Socially engaged photographers worked with local residents from the Windmill Hill estate in Runcorn to describe healthy and unhealthy aspects of the area. Six women were trained to use cameras to document everyday things that mattered to them. Through focus groups they discussed what these photographs revealed about the health and ill-health of the area. The resulting exhibition, <i>As and When,</i> told their story. Despite being a deprived area with more than average incidence of illness, they identified many positive things that enhanced their sense of wellbeing and resilience. The benefits of the project included increased social engagement and participation, an improved sense of vitality and rejuvenation, emotional benefits, a feeling of greater political agency and increased visual literacy. This paper outlines the model of practice developed with the support of CCG and in collaboration with local stakeholders. It makes a case for the value and the ways in which clusters of general practices could develop links and work with health assets in their local communities.</p>","PeriodicalId":89823,"journal":{"name":"London journal of primary care","volume":"10 4","pages":"82-88"},"PeriodicalIF":0.0,"publicationDate":"2018-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17571472.2018.1477439","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36376654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"London Journal of Primary Care - a PAUSE.","authors":"Paul Thomas","doi":"10.1080/17571472.2018.1465636","DOIUrl":"10.1080/17571472.2018.1465636","url":null,"abstract":"This is the penultimate Issue of LJPC. In August, we will PAUSE to consider a new stage. LJPC started in 2008, the year of the 60th anniversary of the UK National Health Service (NHS) and the 30th anniversary of the World Health Organisation (WHO) Alma Ata Declaration. Both the NHS and WHO advocate whole system collaboration for a healthy society. This means much more than medical care. It means integrating multiple efforts to build local health communities, including self-care, shared-care and health promotion, as well as curative medicine. How to practically do this is the question that has dominated LJPC thinking ever since. In the last 10 years, LJPC has published over 300 papers about how to achieve the WHO/NHS vision of community-oriented integrated care and health promotion. Papers have evaluated systems of care and described what health means in complex situations. John Horder, one of the most visionary general practitioners of all time, serialised his autobiography in LJPC. In particular, LJPC has co-produced papers, bringing together many different perspectives to explore wicked problems. London Journal of Primary Care has now outgrown its origins. It has expanded beyond London to become an international, peer-reviewed, PubMed-cited journal. It is a social movement more than a journal. It is concerned with whole society health as well as primary care. So we have chosen to close the journal in its present form and offer what we have learned to others who might want to lead a next stage(s). We think of it as a PAUSE. The LJPC website will remain and the papers will also be available on the RCGP website as well as on PubMed. This Issue reveals the breadth of LJPC interests. It includes: John Ashton’s Lecture at Manchester Medical Society on 31st January 2018 reminds us that the NHS was never meant to be the only thing to improve the health of the population, but ‘one part only of an attack upon five giant evils: Physical Want, Disease, Ignorance, Squalor, and Idleness’. [1]. John reminds us that the Alma Ata Declaration of 1978 agrees with NHS principles. It underpins WHO strategy for health care","PeriodicalId":89823,"journal":{"name":"London journal of primary care","volume":"10 3","pages":"39-40"},"PeriodicalIF":0.0,"publicationDate":"2018-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17571472.2018.1465636","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36340995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of exercise prescription of primary care physician on the quality of life in patients.","authors":"Hakan Yaman,&nbsp;Emrah Atay","doi":"10.1080/17571472.2018.1464731","DOIUrl":"https://doi.org/10.1080/17571472.2018.1464731","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to examine the effect of exercise prescribed by primary care physicians (PCPs) on the quality of life (QoL) of elderly people.</p><p><strong>Method: </strong>Randomisation was performed at PCPs level from 16 primary healthcare centers. Patients were divided into intervention and control groups. Both groups of physicians received theoretical training (14 h), and the intervention group received additional practical training on exercise prescription (10 h). Patients in the intervention group were prescribed endurance, flexibility, balance, and strength exercises and were given training packs. QoL was measured using Short Form-36. Measurements were taken at the beginning of the study, after the 3rd month, and at the end of the 6th month to evaluate the effectiveness of the intervention.</p><p><strong>Results: </strong>The age of participants (Intervention group <i>n</i> = 69, Control group <i>n</i> = 110) was 57.68 ± 5.08 years. At the end of the study, physical function, physical role function, social role function, mental health, vitality, general health perception, and emotional role function scores increased and body pain scores decreased in the intervention group. Significant differences (<i>p</i> < 0.05) between the intervention and control groups were observed for physical function, physical role function, body pain, mental health, vitality, and emotional role function scores but not for social role function or general health perception scores.</p><p><strong>Conclusions: </strong>Exercise prescriptions given by PCPs containing endurance, strength, flexibility, and balance exercises improve QoL in elderly people.</p>","PeriodicalId":89823,"journal":{"name":"London journal of primary care","volume":"10 4","pages":"93-98"},"PeriodicalIF":0.0,"publicationDate":"2018-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17571472.2018.1464731","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36376071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"70 years of fighting the 5 giants - lessons from the front line.","authors":"John R Ashton","doi":"10.1080/17571472.2018.1458448","DOIUrl":"https://doi.org/10.1080/17571472.2018.1458448","url":null,"abstract":"In the year that celebrates the 70th anniversary of the ‘national treasure’ that is the National Health Service, this meeting of the Manchester Medical Society is more than timely. The origins of the NHS are rooted in the fight for social justice which runs not only in Manchester, Liverpool and the NorthWest but across the industrial and commercial north of the country. Next year here in Manchester, we will be commemorating the bi-centenary of the Peterloo Massacre in which 15 people, including one John Ashton, protesting about the poor social conditions and lack of suffrage, were slaughtered in a cavalry charge. This was a defining moment in the development of our democracy, the extension of suffrage and in due course to the extension of public services for the whole population. On 5 July 1948, Aneurin Bevan, Minister of Health and midwife of the NHS inaugurated its first hospital, The Park, in Davyhulme in Trafford; and today, as we speak, former Health Minister and now elected Mayor of Greater Manchester, Andy Burnham is leading the charge for devolution and integration in partnership with the borough councils of this major conurbation. Along the M62 in Liverpool, William Henry Duncan, the country’s first full-time Medical Officer of Health pioneered a dynamic Victorian town hall based public health movement. His work has in recent years inspired a renaissance of public health going far beyond this region, a renaissance of importance when we come to looking at what the future holds in the next 70 years, not least with the long overdue move to devolution of government in arguably the most centralised country in Europe. This talk will be in two parts. In the first, I will draw on my recent Lancet article of Nicholas Timmins’ formidable review of the first 70 years of the NHS to set the scene and identify some key challenges [1]. These challenges must be addressed if our grandchildren are to be able to benefit from the NHS and the Welfare State in their later years. In the second part, I will lay out my own conclusions based on a lifetime within the NHS and my experiences of trying to ensure that a balanced approach to prevention, treatment and care underpin the pursuit of social justice within a whole systems set of arrangements and characterised by visionary local leadership. On 1 December 1942, queues stretched from his Majesty’s Stationery Office along High Holborn in London. By lunchtime all copies of Sir William Beveridge’s ground breaking report, Social Insurance and Allied Services [Cmnd 6404] had been sold. It was much the same story elsewhere. In Liverpool, my father secured the two volume report that today takes pride of place in my study. Beveridge’s report sits alongside work by others who have guided me in my career: Brian Abel Smith, Douglas Black, Ann Cartwright, Karen Dunnell, Margot Jeffries, Jerry Morris, Richard Titmuss, Peter Townsend and many others associated with the London School of Economics and the London School of Hygi","PeriodicalId":89823,"journal":{"name":"London journal of primary care","volume":"10 3","pages":"41-47"},"PeriodicalIF":0.0,"publicationDate":"2018-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17571472.2018.1458448","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36340996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What factors influence a family's decision to agree to organ donation? A critical literature review.","authors":"Cathy Miller,&nbsp;Richard Breakwell","doi":"10.1080/17571472.2018.1459226","DOIUrl":"https://doi.org/10.1080/17571472.2018.1459226","url":null,"abstract":"<p><p><b>Background:</b>There is a shortage of organs for transplantation in the UK. However, whilst 82% of the population consider donating their organs, only 35% of people have joined the NHS Organ Donor Register. Although the Human Tissue Acts (2004, 2006) and Human Transplantation (Wales) Act (2013) state that the wishes of the deceased cannot be vetoed, it is unlikely that healthcare teams will continue with the retrieval process without the family's agreement to proceed.<b>Aim:</b>To understand what influences the decision of families to donate in order to guide clinical practice, education, training and increase donation rates to 80% in line with the NHS Blood and Transplant - Taking Organ Donation to 2020 strategy. <b>Method:</b> A literature review of published research. <b>Results:</b> Seven papers met the inclusion criteria. Several significant factors were identified that influence family decisions, including prior knowledge of the deceased's wishes (e.g. carrying a donor card), presence at the time of the donor's injury, understanding of brain stem death testing, 'personal realisation' of death and hospital related factors (e.g. information, communication and care). These were organised to form the acronym DONATE that serves as a useful mnemonic to guide the requester prior to discussing organ donation. <b>Conclusions:</b> Rates of donation of organ donation may increase through understanding family decision-making.</p>","PeriodicalId":89823,"journal":{"name":"London journal of primary care","volume":"10 4","pages":"103-107"},"PeriodicalIF":0.0,"publicationDate":"2018-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17571472.2018.1459226","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36376073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"General practitioners' perceptions on their role in light of the NHS five year forward view: a qualitative study.","authors":"Tara Humphrey,&nbsp;Karen Cleaver","doi":"10.1080/17571472.2018.1455270","DOIUrl":"https://doi.org/10.1080/17571472.2018.1455270","url":null,"abstract":"<p><strong>Background: </strong>The NHS is undergoing unprecedented change, central to which is policy aimed at integrating health and social care services, resulting in the implementation of new care models. GPs are at the forefront of this change. However, there is lack of academic literature on General Practitioners' perceptions on their role in light of the new models of care proposed by the NHS Five Year Forward View which this small-scale study begins to address.</p><p><strong>Objectives: </strong>This study aims to produce a description of how GP's construct their current and future general practice, professional status and identify within the context of the current NHS transformation agenda.</p><p><strong>Methods: </strong>Qualitative study using semi-structured interviews and one focus group to gather the perspective of GPs (<i>n</i> = 10) working across three clinical commissioning groups in South East England.</p><p><strong>Results: </strong>While the GPs embraced the principles underpinning the new care models, they were both willing and reluctant to adopt their new roles, struggled with inter-organisational and cultural barriers and their changing professional identity.</p><p><strong>Conclusion: </strong>Multi-professional education in primary and community care could be an effective model to offer support and resources to the development of the clinical and leadership skills GPs will require to respond effectively to the transformation agenda. The emergence of community education provider networks, innovative network organisations designed to support workforce transformation through education and training, can provide the vehicle through which clinical and leadership skills training are sourced and coordinated.</p>","PeriodicalId":89823,"journal":{"name":"London journal of primary care","volume":"10 3","pages":"54-58"},"PeriodicalIF":0.0,"publicationDate":"2018-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17571472.2018.1455270","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36340998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Homeless mortality data from East London.","authors":"Khalil Hassanally,&nbsp;Miqdad Asaria","doi":"10.1080/17571472.2018.1458443","DOIUrl":"https://doi.org/10.1080/17571472.2018.1458443","url":null,"abstract":"<p><strong>Background: </strong>The rate of homeless mortality is known to be significantly below the national average, with mortality rates varying geographically. This study aims to look at the rates and causes of homeless mortality within East London.</p><p><strong>Question: </strong>To characterise homeless mortality of patients registered in two specialist homeless practices, between 2001 and 2016 in the London boroughs of Tower Hamlets and Hackney, by age at death and cause of death.</p><p><strong>Study design: </strong>A retrospective study of general practice electronic patient records.</p><p><strong>Methods: </strong>Electronic patient records across two general practice surgeries specialising in care for the homeless in East London were examined and their mortality data extracted.</p><p><strong>Results: </strong>Two hundred and three deaths recorded in the two general practice surgeries were examined. The average age at death was 47 years, with the highest numbers of deaths being attributed to substance misuse, liver disease and cardiac-related deaths. Those dying of cardiac-related causes died at an average of 51, those dying of liver-related causes died at an average age of 49 years and those dying from substance misuse died at an average age of 38.</p><p><strong>Conclusions: </strong>Those dying of substance misuse-related causes died much younger than the average homeless patient did.</p>","PeriodicalId":89823,"journal":{"name":"London journal of primary care","volume":"10 4","pages":"99-102"},"PeriodicalIF":0.0,"publicationDate":"2018-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17571472.2018.1458443","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36376072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}