Au Maroc, la psychiatrie de liaison est une activité relativement récente ; elle n’est pas reconnue actuellement comme sous-spécialité psychiatrique ; cependant plusieurs équipes psychiatriques ...universitaires au Maroc ont démarré cette activité d’une manière plus au moins structurée (Fès, Casablanca, Rabat et Oujda).
L’objectif de cette étude est de décrire le déroulement et l’organisation de l’activité de psychiatrie de liaison dans le service de psychiatrie du CHU Mohamed VI d’Oujda et de l’évaluer à partir d’une étude préliminaire. À travers cette étude, nous avons évalué les motifs des demandes d’avis psychiatriques, les services demandeurs ainsi que les pathologies psychiatriques les plus fréquentes.
Il s’agit d’une étude primaire transversale descriptive et analytique pendant une période de dix mois, entre mai 2016 et février 2017, portant sur 60 patients hospitalisés dans les différents services médico-chirurgicaux du CHU Mohamed VI d’Oujda et qui nous ont été adressés pour avis psychiatrique. L’avis psychiatrique est réalisé en se basant sur un entretien psychiatrique. Les données sont recueillies à l’aide d’un « dossier de psychiatrie de liaison » rempli auprès du malade par le psychiatre.
Durant la période de l’étude, nous avons été sollicités par 17 services médico-chirurgicaux. La dermatologie (28 %), la gastro-entérologie (13 %), et la néphrologie (11 %) étaient les services les plus demandeurs d’avis psychiatriques. Les symptômes dépressifs (54 %) ainsi que l’évaluation des conduites suicidaires (19 %) étaient les motifs de demandes les plus fréquents. Le trouble dépressif (58 %) et le trouble de l’adaptation (18,7 %) étaient les diagnostics les plus fréquemment portés.
La psychiatrie de liaison est une activité en pleine évolution au Maroc, la structuration et l’organisation de cette activité s’avèrent primordiales, tenant compte de son intérêt clinique, pédagogique, de recherche et même économique.
In Morocco, liaison psychiatry is a relatively new activity and is not currently recognized as a psychiatric sub-specialty. However, several university psychiatric teams have started this activity in a more or less structured manner (Fès, Casablanca, Rabat and Oujda).
The objective of this study is to describe the development and organization of the psychiatric liaison activity in the psychiatry department of the Mohamed VI University Hospital Center in Oujda and to evaluate it from a preliminary study. Through this study, we evaluated the reasons for psychiatric consults, requesting services and the most frequent psychiatric disorders.
This is a cross-sectional descriptive and analytical primary study over a period of 10 months between May 2016 and February 2017. The study recruited 60 patients requiring psychiatric consultation from different medical and surgical departments at the University Hospital in Fès. The psychiatric assessment was based on a psychiatric interview using DSM-5 diagnostic criteria. The data were collected by a certified psychiatrist using a medical psychiatric record.
During this study, 17 medical and surgical departments of our University Hospital had requested a psychiatric assessment for their patients. Most demands were respectively emitted by the Department of Dermatology (28%), gastroenterology (13%), and nephrology (11%). Depressive symptoms (54%) and assessment of suicidal behavior (19%) were the most common motivations for psychiatric consultations. Depressive disorder (58%) and adjustment disorder (18.7%) were the most frequent psychiatric diagnoses in patients from medical and surgical departments.
Psychiatry liaison is an activity in full evolution in Morocco, the structuring and organization of this activity is paramount, given its clinical, pedagogical, research and even economic interest.
Purpose
The intensive 18-month treatment in the personality disorder (PD) therapeutic community (TC) is felt to offer improvement in many aspects of patients’ lives. This study aims to understand if ...the use of acute services was also affected via a service evaluation project.
Design/methodology/approach
The authors collected data from electronic records on the use of local services in the two years before, during and the two years after treatment in the TC. Specifically, the authors counted inpatient bed days, Emergency department (ED) presentations and days under home treatment team and liaison psychiatry; the authors used ANOVA to analyse the data.
Findings
The study included 25 adult service users, 17 female and 8 male, with an average age of 40. Whilst there were reductions in the use of inpatient beds and ED presentations, on analysis, these were not found statistically significant. The small size of the study is a limitation and may limit the generalisability of the findings. The study concludes there may be reductions in acute psychiatric service use during and after treatment in the TC. The findings were not statistically significant; the authors suggest larger multi-centre studies may be able to demonstrate statistical significance.
Originality/value
PD patients have a relatively high use of acute psychiatric services compared to other patient groups. The authors are not aware of any similar studies in the published literature.
Abstract
Introduction
national reports highlight deficiencies in the care of older patients undergoing surgery. A 2013 survey showed less than a third of NHS trusts had geriatrician-led perioperative ...medicine services for older surgical patients. Barriers to establishing services included funding, workforce and limited interspecialty collaboration. Since then, national initiatives have supported the expansion of geriatrician-led services for older surgical patients.
This repeat survey describes geriatrician-led perioperative medicine services in comparison with 2013, exploring remaining barriers to developing perioperative medicine services for older patients.
Methods
an electronic survey was sent to clinical leads for geriatric medicine at 152 acute NHS healthcare trusts in the UK. Reminders were sent on four occasions over an 8-week period. The survey examined the nature of the services provided, extent of collaborative working and barriers to service development. Responses were analysed descriptively.
Results
eighty-one (53.3%) respondents provide geriatric medicine services for older surgical patients, compared to 38 (29.2%) in 2013. Services exist across surgical specialties, especially in orthopaedics and general surgery. Fourteen geriatrician-led preoperative clinics now exist. Perceived barriers to service development remain workforce issues and funding. Interspecialty collaboration has increased, evidenced by joint audit meetings (33% from 20.8%) and collaborative guideline development (31% from 17%).
Conclusion
since 2013, an increase in whole-pathway geriatric medicine involvement is observed across surgical specialties. However, considerable variation persists across the UK with scope for wider adoption of services facilitated through a national network.
This piece is written in liaison with the “writing differently” movement aimed to counter common academic writing through a non‐, biographic, embodied account of 10 years as a female, able‐bodied ...disability, and gender researcher. The tone of the article is intentionally kept simple, while its form resembles a memoir. One day, I started to think and type about the times my body felt out of place and many months later this resulted in a timeline of “my body estranged.” I warn the reader in advance: there is nothing particularly shocking about these experiences: they are mostly ordinary and privileged. Anyone interested in the ordinariness of semi‐dominant bodies might find the memories relatable. Looking back, one constant bodily ambivalence stands out: loud mind, lips sealed – an abundance of silence and an absence of speaking up. With this writing, I break the silence, in my own voice, a voice free of jargon and vocabulary (Grey & Sinclair, 2006). A voice readable to a broad community and illustrated through ambivalent art work (Figure 1).1
1
FIGURE
Personal, political but not universal (Ambivalently Yours)
In the spring of 2020, our hospital faced a surge of critically ill coronavirus disease 2019 patients, with intensive care unit (ICU) occupancy peaking at 204% of the baseline maximum capacity. In ...anticipation of this surge, we developed a remote communication liaison program to help the ICU and palliative care teams support families of critically ill patients. In just nine days from inception until implementation, we recruited and prepared ambulatory specialty providers to serve in this role effectively, despite minimal prior critical care experience. We report here the primary elements needed to reproduce and scale this program in other hospitals facing similar ICU surges, including a checklist for replication (Appendix I). Keys to success include strong logistical support, clinical reference material designed for rapid evolution, and a liaison team structure with peer coaching.
This article examines a relatively recent yet under-researched role in the governance of elite European football – namely, the Supporter Liaison Officer. The Supporter Liaison Officer, as appointed ...by football clubs, is commonly envisioned as a mediator between fans and the clubs, authorities and security actors situated in the European football field. However, following its formal inception in the 2012/2013, little is known about how stakeholders understand the evolving and heterogeneously implemented Supporter Liaison Officer role. Drawing upon documentary and interview data, this article unpacks two key themes to develop two primary arguments. First, it argues that Supporter Liaison Officers may be understood as ‘social brokers’ that bridge together stakeholders who often possess diverging viewpoints and whose relationships are impacted by social barriers. Second, Supporter Liaison Officers are perceived as possessors of what is conceptualised here as a ‘supporter gaze’. Whilst contributing to the literature on supporter engagement and dialogue, these arguments also matter because if we understand the Supporter Liaison Officer implementation as influenced by supporter activism in Europe, then this article speaks to how outcomes of supporter pressure mature over time and their implications on football's supporter and security cultures.
A large number of people admitted to medical wards have co-morbid mental health problems, and these predominantly include depression, dementia and delirium. An additional one third of medically ill ...patients remain in hospitals with undetected and, therefore, undiagnosed mental health problems. The comorbidity of mental and physical illnesses leads to poor health outcomes, prolonged inpatient stays and use of inpatient resources, involvement of various affiliated health services, introduction of medications and discharge to long-term facilities, including residential and nursing 24-h care, increased both readmission rates and mortality. The establishment of Liaison psychiatry services to meet the needs for people with mental health problems admitted to medical wards is a priority for many acute health Trusts. This has an economical background in terms of cost-savings, especially in relation to the older adults, with decreasing readmission rates and quicker hospital discharges. In the current review, we address the latest policies regarding Liaison psychiatry services; especially those for older people with dementia and delirium, and discuss their future shaping.
Mittendrin oder nur dabei? Fühles-Ubach, Simone
Bibliothek Forschung und Praxis,
12/2018, Letnik:
42, Številka:
3
Journal Article
Recenzirano
Zusammenfassung
Kundenorientierung ist in den vergangenen Jahren in der Literatur zum Bibliotheksmanagement immer wichtiger geworden, wohingegen der Beitrag von Bibliotheken zur übergeordneten ...Gesamtstrategie ihrer Trägereinrichtungen eine eher untergeordnete Rolle einnimmt. Ein sichtbarer und nachweisbarer Beitrag der Bibliothek prägt jedoch die Wahrnehmung durch das Management der Institution. In diesem Kontext werden die verschiedenen Kommunikationsebenen betrachtet, die ein modernes Bibliotheksmanagement abdecken muss. In einer empirischen Untersuchung werden Strategiepapiere europäischer Bibliotheken auf ihre Verbindung zur Trägerorganisation hin untersucht. Die Untersuchung basiert auf der Grundannahme, dass bei einer engen Verzahnung im Sinne eines klaren Beitrags zur Gesamtstrategie der Trägerorganisation, die Wahrnehmung und Integration der Bibliothek im organisationalen Kontext klarer und fester verankert sein dürfte. Anschließend werden drei Modelle zur Strategie-Entwicklung vorgestellt, die in Öffentlichen Bibliotheken zum Einsatz kommen. Diese werden auf ihre Verbindung zum Träger hin untersucht. Gebraucht werden nicht nur „embedded“ oder „liaison librarians“, sondern eine insgesamt im Zentrum der Organisation verankerte „embedded library“ mit entsprechender Bedeutung für die zukünftige Entwicklung der Gesamtinstitution, d. h. der Kommune, der Hochschule oder der Forschungseinrichtung.
Summary
The cost-effectiveness of Fracture Liaison Services (FLSs) for prevention of secondary fracture in osteoporosis patients in the United Kingdom (UK), and the cost associated with their ...widespread adoption, were evaluated. An estimated 18 fractures were prevented and £21,000 saved per 1,000 patients. Setup across the UK would cost an estimated £9.7 million.
Introduction
Only 11% to 28% of patients with a fragility fracture receive osteoporosis treatment in the UK. FLSs provide an efficient means to identify patients and are endorsed by the Department of Health but have not been widely adopted. The objective of this study was to evaluate the cost-effectiveness of FLSs in the UK and the cost associated with their widespread adoption.
Methods
A cost-effectiveness and budget-impact model was developed, utilising detailed audit data collected by the West Glasgow FLS.
Results
For a hypothetical cohort of 1,000 fragility-fracture patients (740 requiring treatment), 686 received treatment in the FLS compared with 193 in usual care. Assessments and osteoporosis treatments cost an additional £83,598 and £206,544, respectively, in the FLS; 18 fractures (including 11 hip fractures) were prevented, giving an overall saving of £21,000. Setup costs for widespread adoption of FLSs across the UK were estimated at £9.7 million.
Conclusions
FLSs are cost-effective for the prevention of further fractures in fragility-fracture patients. The cost of widespread adoption of FLS across the UK is small in comparison with other service provision and would be expected to result in important benefits in fractures avoided and reduced hospital bed occupancy.
Foreign institutional actors (INAs) can act as a liaison between firms and authorities and other power players to navigate bureaucratic structures, both as resource and legitimacy providers in the ...host market. Building on institutional theory, this study draws from broader organizational sociological literature, to explore the structural position of INAs in a host country context, and engages with fundamental questions of legitimacy, status, and power. It responds to repeated calls that more studies in international business research are needed on the impact of institutional differences, how to obtain legitimacy, and enhance the home country support networks. To understand INAs' position, specifically within the social structure of a bureaucratic host environment, our study uses in-depth interviews with elite actors from the support networks. Japan is chosen for this study as a host market, because it is the European Union's second largest trading partner in Asia, has a strong central bureaucracy, and historically and currently remains a challenging market for Westerners due to complex market entry barriers. The findings provide a new theoretically derived empirical model demonstrating the positional leverage of these INAs, to “open-doors” into a complex environment and offer a nuanced understanding of their formal and informal structural positions of power. The findings also demonstrate a significant overlap between organizational legitimacy and the exemplary status of these INAs in the bureaucratic environment, which enhances and empowers their leverage to reach authorities, press, and other important actors in the market.
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