An integrated approach to neuroscience care: An innovative model to support the new integrated care system.

Integrated care systems join up health and care services, so that people have the support they need, in the right place, at the right time. The aims include improving outcomes in healthcare, tackling inequalities in access and enhancing productivity and value for money. This is needed for neuroscience care as the traditional delivery of neuroscience care is inefficient, outdated and expensive, and can involve complex referral pathways and long waiting times.

Can collaborative working improve diabetic retinal screening rates in individuals also diagnosed with a severe mental illness?

Aim: We aimed to create a collaborative data sharing project between two NHS trusts to improve attendance and access to diabetic retinopathy screening in individuals with severe mental illness (SMI).

Methods: The eligible patient lists were analysed before and after interventions to assess their effectiveness over two data runs.

Results: Screening attendance rates increased by 31% and 25% in the data runs; a significant number of patients (15%) who were screened required onward referral to hospital eye services.

Highlighting strengths and resources that increase ownership of cervical cancer screening for Indigenous communities in Northern British Columbia: Community-driven approaches.

Objective: To examine the unique and diverse strengths held by rural and remote Indigenous communities in northern British Columbia, including multi-generational support systems in health and wellness, profound connections to the land, and strong cultural foundations, and harness these strengths, allowing communities to engage in innovative and empowering health and wellness programs.

Methods: Building on these pre-existing and fundamental strengths, an alternative option to cervical cancer screening was introduced to nine Carrier Sekani health centers located in northern interior British Columbia in response to disparities in screening rates. Introduced in 2019, CervixCheck uses a self-collection approach that is private, safe, convenient, and offered at local community health centers by trained and supportive health staff.

A nurse-led model at public academic hospitals maintains high adherence to colorectal cancer surveillance guidelines.

Objective: To examine the compliance of colorectal cancer surveillance decisions for individuals at greater risk with current evidence-based guidelines and to determine whether compliance differs between surveillance models.

Design: Prospective auditing of compliance of surveillance decisions with evidence-based guidelines (NHMRC) in two decision-making models: nurse coordinator-led decision making in public academic hospitals and physician-led decision making in private non-academic hospitals.

Setting: Selected South Australian hospitals participating in the Southern Co-operative Program for the Prevention of Colorectal Cancer (SCOOP).

Interval fecal immunochemical testing in a colonoscopic surveillance program speeds detection of colorectal neoplasia.

Background & Aims: Rapidly progressing or missed lesions can reduce the effectiveness of colonoscopy-based colorectal cancer surveillance programs. We investigated whether giving fecal immunochemical tests (FITs) for hemoglobin between surveillance colonoscopies resulted in earlier detection of neoplasia.

Methods: The study included 1736 patients with a family history or past neoplasia; they received at least 2 colonoscopy examinations and were followed for a total of 8863 years.

Improving management of oesophageal varices in patients with cirrhosis.

Problem: A retrospective audit of management of oesophageal varices in patients with cirrhosis identified the need to improve adherence to guidelines.

Design: Prospective audit of the effect of disseminating guidelines in 2004; prospective audit of the effect of a nurse coordinator for oesophageal variceal screening and surveillance from 2005 to 2008.

Setting: A major public hospital in Australia 2001-2008.

Article 8 of the human rights act 1998: a review of case law related to forensic psychiatry and prisoners in the United Kingdom.

The Human Rights Act 1998 (HRA) was introduced into United Kingdom domestic law in 2000 and incorporated most of the European Convention on Human Rights. Article 8 of the HRA provides the right to respect for private and family life, home, and correspondence. It is a qualified right, underpinned by the core HRA principle of proportionality and therefore can be dynamically interpreted.

Achieving long-term compliance with colonoscopic surveillance guidelines for patients at increased risk of colorectal cancer in Australia.

We have previously demonstrated that we could improve colonoscopic surveillance practice for patients at increased risk of colorectal cancer by the adoption of guidelines, facilitated by a nurse co-ordinator. This study was to determine whether we could sustain this improvement over a longer period (4 years). All colonoscopic surveillance decisions made by the co-ordinated colorectal screening programme of our hospital between 2000 and April 2004 were reviewed.

A model for cystic endometrial hyperplasia/pyometra complex in the bitch.

The objective of this study was to develop a reliable model for the study of the cystic endometrial hyperplasia and pyometra complex (CEH/P) in the bitch. Greyhound bitches (n = 15) were ovariectomised and allocated into three groups (Group 1, n = 5; Group 2, n = 5; Group 3, n = 10, including 5 used from Group 1). Simulated proestrus, estrus and diestrus were induced by treatment with estradiol benzoate and megestrol acetate.

Interval faecal occult blood testing in a colonoscopy based screening programme detects additional pathology.

Background: Colonoscopic based surveillance is recommended for patients at increased risk of colorectal cancer. The appropriate interval between surveillance colonoscopies remains in debate, as is the "miss rate" for colorectal cancer within such screening programmes.

Aims: The main aim of this study was to determine whether a one-off interval faecal occult blood test (FOBT) facilitates the detection of significant neoplasia within a colonoscopic based surveillance programme.

Bimodal response sensitivity and bias in a test of sustained attention contrasting patients with schizophrenia and bipolar disorder to normal comparison group.

This study examined response discrimination (d') and bias (likelihood ratio) differentials in a computer-generated test of auditory and visual attention functioning. Patients with bipolar disorder (n=42) and schizophrenia (n=47) were contrasted to a normal comparison group (n=89) in two conditions: (a) simple modal responsivity (auditory and visual stimuli) and (b) ipsimodal (auditory/auditory and visual/visual) and crossmodal (auditory/visual and visual/auditory) responding. The results of this study indicated that in the simple modal condition both subject groups showed differential modal preferences but in opposite directions.

Written and verbal information versus verbal information only for patients being discharged from acute hospital settings to home: systematic review.

This article presents the results of a Cochrane review which was conducted to determine the effectiveness of providing written and verbal health information compared with verbal information only to patients being discharged from acute hospital settings to home. Only two trials met the review inclusion criteria. In both trials the participants were parents of children being discharged from hospital to home.

Accessing health information in a hospital setting: a consumer views study.

Meeting consumers' needs for health information is an important role for all health professionals. A Consumer Views Study was conducted at Flinders Medical Centre (FMC) to ensure strategies for improving access to health information for staff and consumers were congruent with consumers' views. Semi-structured questionnaires were completed by 100 consumers of FMC services.

Written and verbal information versus verbal information only for patients being discharged from acute hospital settings to home.

Background: It is becoming commonplace for patients to be discharged earlier from acute hospital settings to their own homes and be required to manage various aspects of their own care. This has increased the need for detailed information to be given to patients and/or significant others to enable them to effectively manage care at home. It has been suggested that providing written health information can assist in this self management.

GABAAbenzodiazepine receptor (GBzR) sensitivity: test-retest reliability in normal volunteers.

Rationale: Alcohol, benzodiazepines and barbiturates act through the GABA(A) benzodiazepine receptor (GBzR). Patients with some forms of anxiety disorder have reduced GBzR sensivity, although it is not clear whether this is a state or a trait phenomenon. We have developed a paradigm for assessing GBzR sensitivity using slowing of saccadic eye movements in response to intravenous midazolam.

Applying evidence-based guidelines improves use of colonoscopy resources in patients with a moderate risk of colorectal neoplasia.

Objectives: To determine whether applying National Health and Medical Research Council (NHMRC) guidelines for colorectal cancer prevention would reduce the number of follow-up colonoscopies.

Design: A prospective audit of colonoscopic surveillance decisions before and after the intervention.

Setting: The endoscopy suite at a metropolitan tertiary hospital three months before and after January 2000.

Modal attention asymmetry in patients with schizophrenia and bipolar disorder.

This cross-sectional study examined modal attention asymmetries in patients with schizophrenia (n = 47) and bipolar disorder (n = 42), as contrasted to a matched-sample comparison group of normal participants (n = 89). A test of continuous auditory and visual attention was the primary measure. The data were analyzed from 2 experimental conditions: simple modal responses (auditory and visual) and modal switching responses (ipsimodal and cross-modal switching).

Crossover trial of pagoclone and placebo in patients with DSM-IV panic disorder.

Pagoclone is a cyclopyrrolone that is believed to act as a partial agonist at the gamma-aminobutyric acid (GABA)-A/benzodiazepine (BDZ) receptor. In theory, such partial agonists should be anxiolytic but lack the adverse side-effects of sedation, tolerance and withdrawal associated with full GABA-A/BDZ agonists. The objective of the randomized double-blind crossover study was to assess whether pagoclone was an effective anti-panic agent and also to assess its side-effect profile.

The psychobiology of anxiolytic drug. Part 2: Pharmacological treatments of anxiety.

Benzodiazepines have been the mainstay of pharmacological treatment of anxiety over the last 4 decades. The problems associated with their use prompted the research for alternative agents that would be useful in anxiety conditions. Old classes of antidepressants, such as tricyclic antidepressants and monoamine oxidase inhibitors, showed effectiveness in some anxiety syndromes, even in areas where benzodiazepines were not very effective.

The psychobiology of anxiolytic drugs. Part 1: Basic neurobiology.

The authors provide an overview of the current state of knowledge with regards to the neurobiological mechanisms involved in normal and pathological anxiety. A brief review of the classification and cognitive psychology of anxiety is followed by a more in-depth look at the neuroanatomical and neurochemical processes and their relevance to our understanding of the modes of action of anxiolytic drugs. The serotonergic, noradrenergic, and gamma-aminobutyric acidergic systems are reviewed.

A CAT-derived one to three session intervention for repeated deliberate self-harm: a description of the model and initial experience of trainee psychiatrists in using it.

We describe a new Cognitive Analytic Therapy (CAT)-based intervention for those who repeatedly self-harm. It is specifically designed to be deliverable by staff with no training in psychotherapy. The intervention is simply manualized into sequential tasks that are mediated by new CAT-style standardized tools.

Mechanisms of action of selective serotonin reuptake inhibitors in the treatment of psychiatric disorders.

Selective serotonin reuptake inhibitors (SSRIs) have demonstrated efficacy in depression and anxiety disorders. This raises the question of how the single action of serotonin reuptake inhibition can improve several psychiatric conditions. In order to understand this apparent paradox it is necessary to consider where SSRIs act in the pathogenic process underlying depression or anxiety disorders.