Torture-survivors' experiences of healthcare services for pain: a qualitative study.

Background: Increasing numbers of torture-survivors are presenting to UK healthcare services with persistent pain. However, there is a paucity of evidence surrounding the management of persistent pain among torture-survivors and their experience of healthcare services for pain is currently unknown. This qualitative study explores their experiences of services for managing pain, to inform clinical practice and service provision.

What psychological and physical changes predict patients' attainment of personally meaningful goals six months following a CBT based pain management intervention?

Purpose: To examine the influence of demographic measures, and changes in physical ability, pain, self-efficacy and emotional distress on Goal Attainment Scaling (GAS) scores, after a 15-day CBT based pain management programme.

Method: Chronic pain patients (N = 257) were referred; 225 (88%) completed the programme and were invited for follow up six months later. One hundred and sixty-two (63%), (mean age 47.

Interventions to increase or decrease the length of primary care physicians' consultation.

Background: Observational studies have shown differences in process and outcome between the consultations of primary care physicians whose average consultation lengths differ. These differences may be due to self selection. This is the first update of the original review.

One stop multidisciplinary pain clinic for survivors of torture.

Bianca Kuehler and Susan Childs speak to Jade Parker, Commissioning Editor: Dr Bianca Kuehler initially qualified in Germany as an anesthetist in 1993 and is on the specialist register in the UK. After moving to the UK she obtained a Diploma in Occupational Health to supplement the understanding and implication of chronic pain on the work environment. She is very interested in multidisciplinary approaches in treatment of chronic and acute pain patients and, therefore, working closely with Dr Childs opened a plethora of opportunities to develop new services including a fibromyalgia clinic and a specialist clinic for patients who are survivors of torture.

Provider Burnout and Patient Engagement: The Quadruple and Quintuple Aims.

The Triple Aim has become the guiding light and benchmark by which healthcare organizations plan their future efforts. It has been adopted into healthcare policies with little regard for including the skill sets of compassion and emotional intelligence. The multiple increasing demands on providers of healthcare are unsustainable and will cripple the system, resulting in outcomes that are counter to the Triple Aim goals.

Direct Pay/Concierge/Blended Care: Where Is The Sweet Spot? Part II--Seen from Your Patients' Perspective.

Physicians are actively considering the direct pay and concierge models as plausible options in providing more patient-oriented care. What are the major considerations and how do we obtain accurate data that may help in sophisticated decision-making? Part I of this article introduced the models, typical patient contract configurations, physician/provider considerations, and commercial payers. In Part II, we discuss the access, cost, and value from a patient's point of view.

Different measures, different outcomes? Survey into the effectiveness of chronic pain clinics in a London tertiary referral center.

Background: Chronic pain clinics aim to improve challenging conditions, and although numerous studies have evaluated specific aspects of therapies and outcomes in this context, data concerning service impact on outcome measures in a general pain population are sparse. In addition, current trends in commissioning increasingly warrant services to provide evidence for their effectiveness. While a plethora of outcome measures, such as pain-intensity or improvement scores, exist for this purpose, it remains surprisingly unclear which one to use.

Direct Pay/Concierge/Blended Care: Where Is the Sweet Spot? Part I: Practice and Physician Considerations.

Physicians are actively considering the direct pay and concierge models as a plausible option in providing more patient-oriented care. What are the major considerations and how do we attain accurate data that may help in sophisticated decision-making? Part I of this article provides an introduction of the models, typical patient contract configurations, and physician/provider and commercial payer considerations. Part II will discuss the access, cost, and value from a patient's point of view; patient loyalty and self-care; approaches for inviting patients and other providers; and community relations.

The clinical psychologist and the management of inpatient pain: a small case series.

Recent research has confirmed that between 25% and 33% of all hospitalized patients experience unacceptable levels of pain. Studies further indicate that this reduces patient satisfaction levels, lengthens hospital stays, and increases cost. Hospitals are aiming to discharge patients earlier, and this can interfere with adequate pain management.

Getting ready to get ready for EHRs: measure for success.

What is the easiest and most efficient way to begin readiness for electronic health records (EHRs) that most support your style of care? Just as you scrub a room before re-painting, steps presented in this article can have your entire staff prepared, trained, and ready to move! Topics covered include options that you can begin now that will "jump start" a successful transition to EHRs. This article will suggest current and future actions along the way to achieve a "win-win" situation as you adopt electronic options while maintaining a partnership of care with your patients.

Older persons' experiences of whole systems: the impact of health and social care organizational structures.

Aims: An in-depth case study of whole systems working.

Background: This paper reports on the second part of a two-part study exploring whole systems working. Part 1 of the study focused on an in-depth review of the literature pertaining to continuity of care and service integration.

The effect of interventions to alter the consultation length of family physicians: a systematic review.

Background: Observational studies have shown differences in process and outcome between the consultations of primary care physicians whose average length of consultation differs, however, these differences may be due to self selection.

Aim: To assess the effectiveness and cost effectiveness of interventions to alter primary care physicians' consultation length.

Design Of Study: Systematic review with narrative analysis.

Using mobile technologies to give health students access to learning resources in the UK community setting.

Objectives: This article describes a project which explored the potential for mobile technologies to give health students in the community access to learning resources. The purpose included the need to identify possible barriers students could face in using mobile technologies. Another focus was to assess the students perceptions of the importance of being able to access learning resources in the community.

Prevalence of Helicobacter pylori in patients with gastro-oesophageal reflux disease: systematic review.

Objectives: To ascertain the prevalence of Helicobacter pylori in patients with gastro-oesophageal reflux disease and its association with the disease.

Design: Systematic review of studies reporting the prevalence of H pylori in patients with and without gastro-oesophageal reflux disease.

Data Sources: Four electronic databases, searched to November 2001, experts, pharmaceutical companies, and journals.

The relationship between consultation length, process and outcomes in general practice: a systematic review.

The aim of the study was to examine differences in consultation process and health outcomes between primary care physicians who consult at different rates. A systematic review of observational studies was carried out, restricted to English language journal papers reporting original research or systematic reviews. Qualitative analysis with narrative overview of methodology and key results was undertaken, using MEDLINE (1966 to 1999), EMBASE (1981 to 1999), and the NHS National Research Register.