Word Count: 2960 words. Abstract 274 words. ABSTRACT ObjectiveMedication arrangements for patients with severe mental illness (SMI), including schizophrenia and bipolar disorder, can be complex. Some have shared care between primary and secondary services whilst others have little specialist input. This study investigated the contribution a specialist mental health clinical pharmacy team could make to medicines optimisation for patients on the SMI register in primary care. Research shows that specialist mental health pharmacists improve care in inpatient settings. However little is known about their potential impact in primary care. MethodFive General Practice (GP) Surgeries were allocated half a day per week of a specialist pharmacist and technician for 12 months. The technician reviewed primary and secondary care records for discrepancies. Records were audited for high dose or multiple antipsychotics, physical health monitoring and adherence. Issues were referred to the pharmacist for review. Surgery staff were encouraged to refer psychotropic medication queries to the team. Interventions were recorded and graded.Results 316/472 patients on the SMI register were prescribed antipsychotics or mood stabilisers. 23 (7%) records were updated with missing clozapine and depot information. Interventions by the pharmacist included clarifying discharge information (12/104), reviewing high dose and multiple antipsychotic prescribing (18/104), correcting errors (10/104), and investigating adherence issues (16/104), following up missing health checks (22/104) and answering queries from surgery staff (23/104). Five out of six interventions possibly preventing hospital admission were for referral of non-adherent patients. ConclusionThe pharmacy team found a variety of issues including incomplete medicines reconciliation, adherence issues, poor communication, drug errors and the need for specialist advice. The expertise of the team enabled timely resolution of issues and bridges were built between primary and secondary care.
While death is universal, reactions to death and ways of dealing with the dead body are hugely diverse, and archaeological research reveals numerous ways of dealing with the dead through time and across the world. In this paper, findings are presented which not only demonstrate the power of archaeology to promote and aid discussion around this difficult and challenging topic, but also how our approach resulted in personal growth and professional development impacts for participants. In this interdisciplinary pilot study, archaeological case studies were used in 31 structured workshops with 187 participants from health and social care backgrounds in the UK, to explore their reactions to a diverse range of materials which documented wide and varied approaches to death and the dead. Our study supports the hypothesis that the past is a powerful instigator of conversation around challenging aspects of death, and after death care and practices: 93% of participants agreed with this. That exposure to archaeological case studies and artefacts stimulates multifaceted discourse, some of it difficult, is a theme that also emerges in our data from pre, post and follow-up questionnaires, and semi-structured interviews. The material prompted participants to reflect on their biases, expectations and norms around both treatment of the dead, and of bereavement, impacting on their values, attitudes and beliefs. Moreover, 87% of participants believed the workshop would have a personal effect through thinking differently about death and bereavement, and 57% thought it would impact on how they approached death and bereavement in their professional practice. This has huge implications today, where talk of death remains troublesome, and for some, has a near-taboo status–‘taboo’ being a theme evident in some participants’ own words. The findings have an important role to play in facilitating and normalising discussions around dying and bereavement and in equipping professionals in their work with people with advanced illness.
YesThe Dean of the School of Health Studies at the University of Bradford, requested a review of the experiences and outcomes amongst undergraduate health professional higher education students with protected characteristics (as defined by the Equality and Human Rights Commission, 2010). The rational for this work was the University of Bradford’s recognition that all students are entitled to a valuable and rewarding university experience regardless of age, ability, gender or ethnicity. Across the higher education sector nationally, it has been suggested that whilst many students benefit from positive outcomes and experiences, some do not. This literature review was undertaken, as a precursor to a wider project, in order to report on current published research illustrating examples of negative and positive student experiences and outcomes in health higher education. \ud \ud Objectives\ud - To review available literature in order to examine the relationship between undergraduate health professional students with protected characteristics and their experiences and outcomes in health higher education.\ud - To identify and report examples of good practice relating to the review aims\ud \ud Method\ud The literature review was undertaken systematically, using a protocol-based approach between 31.01.14 and 31.07.14. Only primary or secondary research data were included in the review. Databases and search terms were pre-specified and literature published between 2010 and 2014 was retrieved. Data bases searched included CINAHL, Medline, ERIC, BHI ASSIA and the Higher Education Academy. Papers were screened at title and abstract against exclusion criteria and eligible papers were included in the review.\ud \ud Results \ud Thirty seven papers were included in this review. Data were broadly organized and displayed through the Equality and Human Rights Commission (2010) protected characteristics categories. These included the presentation of three categories: disability, gender and ethnicity. No papers relating to age were included. Data describing both negative and positive student experiences and outcomes was presented in the context of medical, nursing and allied health professions.\ud \ud Discussion\ud Findings were presented in a narrative format. Included literature predominantly centred on pre-registration nursing students and ethnicity. There were more examples of negative student experiences and outcomes with fewer positive examples to report. Further empirical and secondary research focusing on age, disability, gender and ethnicity is required. The review also highlights the need to examine each protected characteristic student group independently to enable closer examination of specific issues
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