What services are useful for patients with an intellectual disability?

It is well-known that people with an intellectual disability often face a host of health inequalities and co-morbidities. These include childhood obesity, mental health problems, and challenging behaviour. People with an intellectual disability also have reduced life expectancy. GPs are uniquely placed to advocate for and signpost these patients, ensuring they have access to appropriate support. However, it is often unclear what resources are, in reality, both available and beneficial. Here we aim to summarise some of the common inequalities and complexities when working with patients with an intellectual disability and provide an overview of some potentially helpful services.NIHR School for Primary Care Research [RG94577] and Wellcome Trust [Grant WT103343MA]

Interprofessional Healthcare Education, Research and Practice

Background • What we ‘know’ – Literature identifies demonstrated change in attitudes as a result of learning with, about and from each other (Barr, et.al., 2000) – Similar experiences at UK • Less understood: – What if students are required to participate if the primary motivation of the experience is not IPE? – What does the process of interprofessional development look like? • Relevant vectors for IPE – Clinical is idea – Consider global health as an appropriate contex

Learnings From a National Cyberattack Digital Disaster During the SARS-CoV-2 Pandemic in a Pediatric Emergency Medicine Department

Objective: The primary objective was to analyze the impact of the national cyberattack in May 2021 on patient flow and data quality in the Paediatric Emergency Department (ED), amid the SARS-CoV-2 (COVID-19) pandemic. Methods: A single site retrospective time series analysis was conducted of three 6-week periods: before, during, and after the cyberattack outage. Initial emergent workflows are described. Analysis includes diagnoses, demographic context, key performance indicators, and the gradual return of information technology capability on ED performance. Data quality was compared using 10 data quality dimensions. Results: Patient visits totaled 13 390. During the system outage, patient experience times decreased significantly, from a median of 188 minutes (pre-cyberattack) down to 166 minutes, most notable for the period from registration to triage, and from clinician review to discharge (excluding admitted patients). Following system restoration, most timings increased. Data quality was significantly impacted, with data imperfections noted in 19.7% of data recorded during the system outage compared to 4.7% before and 5.1% after. Conclusions: There was a reduction in patient experience time, but data quality suffered greatly. A hospital’s major emergency plan should include provisions for digital disasters that address essential data requirements and quality as well as maintaining patient flow

An Experimental Education Project for Consultations of Older Adults during the Pandemic and Healthcare Lockdown

Objective: To develop a mentor-supervised, interprofessional, geriatric telemedicine experiential education project in response to the COVID-19 pandemic. Method: Medical and pharmacy students collaborated via remote consultations to address the coexistence of multimorbidity and polypharmacy in geriatric patients. In-depth interviews of students and patients as well as Likert scale-based telephonic survey were performed for a comprehensive evaluation of the project’s significance. Results: To date, 49 consultations have been conducted. Remote consultations performed by medical and pharmacy students working collaboratively were beneficial for both students, participants. Conclusions and Practice Implications: This experimental education project provided students with authentic challenges while simultaneously delivering care to the older adults who are susceptible to disruption of care associated with the pandemic. Further development and expanded implementation of such approaches may be a post-pandemic practice to provide more accessible care for senior patients while incorporating interprofessional education

Physician Empathy in Public and Private Internal Medicine Residency Training Programs in Pasig City

Research Question: What are the levels of patient-perceived and self-assessed physician empathy among internal medicine (IM) residents in two tertiary hospitals in Pasig City? Is there a significant difference in patient-perceived and self-assessed physician empathy levels between public and private tertiary hospitals? Background: Empathy is important because it has been speculated to have a positive effect on patient outcomes; it is a skill that can be learned and developed. Objectives: This study obtained quantitative measurements of patient-perceived and self-assessed physician empathy. Empathy levels between public and private tertiary hospitals were compared. General Study Design: This study utilized a quantitative cross-sectional design, with surveys as the strategy for data collection. Participants: 162 out-patient department patients aged 19-75, and 69 IM residents were sampled from one private and one public tertiary hospital. Outcome Measures: The Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE) and the Jefferson Scale of Physician Empathy (JSE) were used to measure the empathy levels. Analysis: Sample size calculation was done using OpenEpi. An alpha level of .05 was used for computing the independent samples t-test. Results: Internal medicine patients from the private hospital rated the physicians with higher empathy scores (mean=31.23) compared to their public hospital counterparts (mean=29.01), which is significant (p=.0134). Residents from the private hospital also scored a higher self-assessed empathy score (mean=110.46) compared to physicians from the public hospital (mean=102.13), which is significant (p=.0147). Conclusion: This study provided preliminary information on the empathy levels of physicians in the Philippine setting between private and public hospitals, showing that physician empathy levels are consistently higher in the private hospital facility. The results can help hospitals incorporate or improve training in empathy in internal medicine residency programs, as empathy is known to affect patient health outcome

Prospectus, October 7, 1991

https://spark.parkland.edu/prospectus_1991/1014/thumbnail.jp

Prospectus, November 4, 1991

https://spark.parkland.edu/prospectus_1991/1016/thumbnail.jp

Climate Change Adaptation in Great Lakes Cities

For decision-makers in the cities of Toledo, Dayton, Elyria, and Avon Lake, Ohio, climate change is quickly becoming a planning and policy concern. The latest climate science focusing on the Great Lakes region largely supports these concerns. Climate models predict warmer temperatures, shifting rain and snow patterns, and an increased likelihood of extreme events by the end of the 21st century. Scientists also predict that lake levels will likely be lower, with additional impacts on aquatic species, as well as impacts upon the industries of tourism and trade. The anticipated impacts of climate change will likely not be distributed equally across each city included in this study. However, societies have the capacity to adapt in the face of climatic change and have done so in the past. Researchers have identified a variety of resources, assets, and governance structures that increase the ability and likelihood of successful adaptation—even in the face of significant uncertainty. In order to anticipate and successfully respond to these impacts, cities in the Great Lakes region need to better understand the opportunities and constraints within their current governance structures to build their adaptive capacity. To evaluate this capacity, we conducted an Integrated Assessment (IA) of the four cities mentioned above in the state of Ohio. Our study takes a broad view of the political, social, and ecological causes, consequences, and potential solutions to climate vulnerability and impact reduction. The results of our study describe the capacities and constraints each city possesses, as well as identifies best practices cities can implement to take advantage of these capacities and overcome constraints. While each city had specific capacities and constraints based on our analysis, several overarching themes emerged. First, decision-makers in each city expressed interest in adapting to climate change. Leaders within city governments are working to connect issues of sustainability and adaptation to the core mission of their departments, as well as forming policy networks across the city, to accomplish broader adaptation and sustainability goals. Employees throughout each city also demonstrated dedication to improving the vibrancy of the cities within which they work. They displayed a depth of knowledge and creativity in accomplishing department tasks in the face of severe financial constraints. Overall, leadership and the quality of current city employees emerged as key capacities throughout our study. However, there are significant constraints to adaptation as well. Two broad trends identified are scarce financial resources and limited access to scientific knowledge. Interviewees reported financial resources significantly constrained adaptation and sustainability action. Identifying methods to utilize co-benefits of standard operating procedures and practices to enhance climate adaptation needs, as well as increasing flexibility in funding structures, are strategies that can aid in minimizing this constraint. Moreover, consideration of the potential distribution of impacts from climate change when implementing adaptation and sustainability policies can ensure the most effective, economic and equitable actions are taken. The availability of usable climate knowledge, along with other kinds of knowledge needed to inform decision-making about adaptation, is limited across the four cities. Knowledge in this case includes not only an understanding of anticipated climate change impacts, but also how it interplays with other kinds of knowledge (e.g. socioeconomic, health and ecosystem management related data) that inform cities’ decision-making.Master of ScienceNatural Resources and EnvironmentUniversity of Michiganhttp://deepblue.lib.umich.edu/bitstream/2027.42/97435/1/CCAGL_2013.pd

Percussion Convocation

List of performers and performances

Concert recording 2015-04-26

[Track 01]. Catching shadows / Ivan Trevino -- [Track 02]. Variation in F-sharp minor, op. 24. Theme : Andante cantabile ; Variation I : Allegretto scherzando ; Variations III : Andante molto sostenuto ; Variation V : Vivo scherzando / Léon Stekke -- [Track 03]. Concerto in E minor. Allegro apassionoto / Felix Mendelssohn -- [Track 04]. Cantabile et presto / George Enesco -- [Track 05]. Poem / Charles Griffes -- [Track 06]. Legende / George Enesco -- [Track 07]. Violin concerto in A minor, op. 53. Allegro ma non troppo / Antonin Dvorâk -- [Track 08]. Fantasie concertante / Jacques Casérède