Service evaluation of the South Wales police control room mental health triage model: outcomes achieved, lessons learned and next steps

Purpose – South Wales Police Mental Health (MH) Triage service was initiated to meet the WelshGovernment MH priority of early intervention to prevent MH crisis. Community Psychiatric Nurses, based in the control-room, provide advice to police and control room staff on themanagement ofMH-related incidents. The purpose of this paper is to evaluate the first 12months of operation (January-December 2019).Design/methodology/approach – Service evaluation of the first 12 months of operation(January–December 2019). Data were analysed in relation to: MH incidents; repeat callers; Section (S) 136 use/assessment outcomes. Police, health staff and triage service users were interviewed andsurveyed to capture their opinions of the service.Findings – Policing areas with high engagement in triage saw reductions in S136 use and estimatedopportunity costs saving. Triage was considered a valuable service that promoted cross agencycollaborations. De-escalation in cases of mental distress was considered a strength. Access to follow-on services was identified as a challenge.Practical implications – Triage enables a multi-agency response in the management of MH-relatedincidents. Improving trust between services, with skilled health professionals supporting police decision making in real time.Originality/value – There is a gap in the research on the impact of police-related MH triage modelsbeyond the use of S136. This project evaluated the quality of the service, its design and the relationship between health, police and partner agencies during the triage process. Multi-agency assessment of follow-up is needed tomeasure the long-termimpact on services and users

An Evaluation of Initial Vancomycin Dosing in Infants, Children, and Adolescents

Background. The pharmacokinetics of many medications change as we age, thus most would assume dosing strategies would adjust for these changes. The objective of this study is to evaluate the initial vancomycin dosing in three pediatric age groups based on measured serum trough concentrations. Methodology. This retrospective database review included patients aged from 1 month to 18 years old admitted to the Moses H. Cone Memorial Hospital. Patients had to have received vancomycin dosed at 15 mg/kg every 8 hours with an appropriately measured trough concentration. The primary outcome was to determine the percentage of patients in 3 pediatric age groups achieving therapeutic trough concentrations with the initial vancomycin dosing regimen. Results. Twenty-five patients were included in the study. None of the patients had therapeutic trough concentrations after receiving vancomycin 15 mg/kg every 8 hours. Only one patient had a supratherapeutic level, while all of the other patients had levels less than 10 mcg/mL. Conclusions. Vancomycin 15 mg/kg every 8 hours did not provide therapeutic serum trough concentrations for any pediatric age groups. Higher doses and/or more frequent dosing regimens need to be evaluated for each age group to determine the most appropriate strategies for producing therapeutic trough concentrations

Clinical Study An Evaluation of Initial Vancomycin Dosing in Infants, Children, and Adolescents

Background. The pharmacokinetics of many medications change as we age, thus most would assume dosing strategies would adjust for these changes. The objective of this study is to evaluate the initial vancomycin dosing in three pediatric age groups based on measured serum trough concentrations. Methodology. This retrospective database review included patients aged from 1 month to 18 years old admitted to the Moses H. Cone Memorial Hospital. Patients had to have received vancomycin dosed at 15 mg/kg every 8 hours with an appropriately measured trough concentration. The primary outcome was to determine the percentage of patients in 3 pediatric age groups achieving therapeutic trough concentrations with the initial vancomycin dosing regimen. Results. Twenty-five patients were included in the study. None of the patients had therapeutic trough concentrations after receiving vancomycin 15 mg/kg every 8 hours. Only one patient had a supratherapeutic level, while all of the other patients had levels less than 10 mcg/mL. Conclusions. Vancomycin 15 mg/kg every 8 hours did not provide therapeutic serum trough concentrations for any pediatric age groups. Higher doses and/or more frequent dosing regimens need to be evaluated for each age group to determine the most appropriate strategies for producing therapeutic trough concentrations

Effect of osteoarthritis on the repeatability of patella tendon angle measurement in dogs

Objective: To evaluate the influence of osteoarthritis on the measurement of patella tendon angle (PTA) and determine intraobserver and interobserver variability. Study design: Retrospective clinical study. Sample population: Eighty‐seven mediolateral radiographs that were obtained prior to tibial tuberosity advancement. Methods: Radiographic osteoarthritis was scored by 2 observers using guidelines derived from the International Elbow Working Group Protocol. Patella tendon angle was measured by 3 observers on 3 occasions, with at least 7 days between measurements. The data were statistically analyzed via weighted κ and Kruskal‐Wallis testing. Results: A fair strength of agreement was found among observers scoring osteoarthritis, with the same grades in 48% of radiographs. The intraobserver average bias between PTA measurements 1 and 3 ranged from −0.38° to −0.94°. Interobserver bias in angle measurement ranged from −0.92° to −2.00°. Observer 1 had the narrowest range of PTA differences (12.1°), and observer 3 had the highest range of PTA differences (23.5°). Observer 2 had the lowest mean bias (−0.38°). The mean bias was lowest between observers 1 and 2 (−0.92°) and highest between observers 1 and 3 (−2.0°). The mean intraobserver standard deviation of the PTA measurement differences was 2.90°, and interobserver standard deviation of the PTA measurement differences was 2.26°. The degree of osteoarthritis did not influence PTA measurements or their variability. Conclusion: The current study did not find evidence of an influence of osteoarthritis on PTA or on the repeatability of measurements. Clinical significance: Our findings suggest that osteoarthritis should not affect the radiographic planning for tibial tuberosity advancement surgery. The high variances in PTA measurement in less experienced observers may influence the clinical outcome of surgery

Friends of Henderson Library Newsletter

In This Issue: Volunteer Opportunities , Art and the Henderson Library , Henderson Library\u27s Automated Retrieval Collection (ARC) , Farm to Table , Recent Friends Events , A Fine Romance , $aving the Green , James Dunwoody Bulloch & Modern US Naval Strategy , \u27Throw My Troubles Out the Door:\u27Bob Dylan & the Southern Musical Landscape , Memorial Books in Henderson Library , Henderson Heroes: Spotlight on Employees , Save the Dat

Capture Hi-C identifies the chromatin interactome of colorectal cancer risk loci.

Multiple regulatory elements distant from their targets on the linear genome can influence the expression of a single gene through chromatin looping. Chromosome conformation capture implemented in Hi-C allows for genome-wide agnostic characterization of chromatin contacts. However, detection of functional enhancer-promoter interactions is precluded by its effective resolution that is determined by both restriction fragmentation and sensitivity of the experiment. Here we develop a capture Hi-C (cHi-C) approach to allow an agnostic characterization of these physical interactions on a genome-wide scale. Single-nucleotide polymorphisms associated with complex diseases often reside within regulatory elements and exert effects through long-range regulation of gene expression. Applying this cHi-C approach to 14 colorectal cancer risk loci allows us to identify key long-range chromatin interactions in cis and trans involving these loci

Fractal dimension (df) as a new structural biomarker of clot microstructure in different stages of lung cancer

Venous thromboembolism (VTE) is common in cancer patients, and is the second commonest cause of death associated with the disease. Patients with chronic inflammation, such as cancer, have been shown to have pathological clot structures with modulated mechanical properties. Fractal dimension (df) is a new technique which has been shown to act as a marker of the microstructure and mechanical properties of blood clots, and can be performed more readily than current methods such as scanning electron microscopy (SEM). We measured df in 87 consecutive patients with newly diagnosed lung cancer prior to treatment and 47 matched-controls. Mean group values were compared for all patients with lung cancer vs controls and for limited disease vs extensive disease. Results were compared with conventional markers of coagulation, fibrinolysis and SEM images. Significantly higher values of df were observed in lung cancer patients compared with controls and patients with extensive disease had higher values than those with limited disease (p< 0.05), whilst conventional markers failed to distinguish between these groups. The relationship between df of the incipient clot and mature clot microstructure was confirmed by SEM and computational modelling: higher df was associated with highly dense clots formed of smaller fibrin fibres in lung cancer patients compared to controls. This study demonstrates that df is a sensitive technique which quantifies the structure and mechanical properties of blood clots in patients with lung cancer. Our data suggests that df has the potential to identify patients with an abnormal clot micro-structure and greatest VTE risk