The document summarizes research on the transition from child to adult mental health services in Ireland. Study 1 found that the transition process lacks structure, with minimal interaction between child and adolescent mental health services (CAMHS) and adult mental health services (AMHS). Study 2 identified differences in service cultures and resources between CAMHS and AMHS that impact collaboration and define boundaries inconsistently for 16-18 year olds. There is an urgent need to improve dialogue between services and determine responsibility for this age group's care.
The document discusses the need for reforming the UK criminal justice system to better balance punishment and rehabilitation. It argues the current system is overwhelmed and ineffective. It proposes a new model that decentralizes power, integrates services across agencies, and strengthens relationships between officials and offenders. This would address the complex roots of crime through coordinated, personalized interventions. The document recommends 14 reforms including giving local leaders more funding and control over rehabilitation programs to test innovative community sentencing approaches.
Julie Hendry: Creating a culture to ensure good patient safety, quality and e...The King's Fund
Julie Hendry, Director of Quality and Patient Experience at Mid-Staffordshire NHS Foundation Trust, gives a background to previous care failings at the trust, and explains how the culture of care has since been transformed to ensure patients are safe and well cared for.
Este documento trata sobre los adhesivos, sustancias que unen dos o más cuerpos. Explica que los adhesivos industriales se utilizan en procesos de fabricación para realizar uniones, mientras que los adhesivos domésticos o infantiles se usan en el hogar. Además, detalla que los polìmeros son componentes clave de los adhesivos y que un sinónimo común para referirse a los adhesivos es pegamento.
This document provides 10 motivational strategies and 10 guidelines for effective classroom discussion using the Classroom Discussion Model (CDM). Some key strategies include setting clear expectations for student participation, using informal talk to build rapport before discussions, arranging desks to promote interaction, using eye contact purposefully, and asking good open-ended questions. Guidelines emphasize the importance of listening, asking for clarification, challenging ideas respectfully, staying on topic, and coming to agreements through discussion. The overall goal is to create an engaging environment where all students actively participate in shared learning.
This document discusses a practice project. While few details are provided in the document, the overall goal seems to be outlining or planning for a practice project of some kind. More information would be needed to fully understand the scope and objectives of the proposed practice project.
Gavin White, Director, RBS Health ServicesInvestnet
This document discusses the UK private healthcare services sector. It shows that most revenue comes from acute care, followed by elderly care. It notes that businesses in this sector provide alternatives to public services and support innovation. The document also discusses quality assurance measures like regulatory compliance and incident management in these businesses. Finally, it depicts how care pathways can expand to include more community-based care.
Community health workers play an important role in advancing public health but often lack formal training opportunities. A new initiative aims to foster innovation in community health worker training through partnerships between health systems, academic institutions, and community organizations to improve health outcomes. The initiative's leader believes such collaboration across different sectors can help develop scalable training models and establish best practices.
The document discusses the need for reforming the UK criminal justice system to better balance punishment and rehabilitation. It argues the current system is overwhelmed and ineffective. It proposes a new model that decentralizes power, integrates services across agencies, and strengthens relationships between officials and offenders. This would address the complex roots of crime through coordinated, personalized interventions. The document recommends 14 reforms including giving local leaders more funding and control over rehabilitation programs to test innovative community sentencing approaches.
Julie Hendry: Creating a culture to ensure good patient safety, quality and e...The King's Fund
Julie Hendry, Director of Quality and Patient Experience at Mid-Staffordshire NHS Foundation Trust, gives a background to previous care failings at the trust, and explains how the culture of care has since been transformed to ensure patients are safe and well cared for.
Este documento trata sobre los adhesivos, sustancias que unen dos o más cuerpos. Explica que los adhesivos industriales se utilizan en procesos de fabricación para realizar uniones, mientras que los adhesivos domésticos o infantiles se usan en el hogar. Además, detalla que los polìmeros son componentes clave de los adhesivos y que un sinónimo común para referirse a los adhesivos es pegamento.
This document provides 10 motivational strategies and 10 guidelines for effective classroom discussion using the Classroom Discussion Model (CDM). Some key strategies include setting clear expectations for student participation, using informal talk to build rapport before discussions, arranging desks to promote interaction, using eye contact purposefully, and asking good open-ended questions. Guidelines emphasize the importance of listening, asking for clarification, challenging ideas respectfully, staying on topic, and coming to agreements through discussion. The overall goal is to create an engaging environment where all students actively participate in shared learning.
This document discusses a practice project. While few details are provided in the document, the overall goal seems to be outlining or planning for a practice project of some kind. More information would be needed to fully understand the scope and objectives of the proposed practice project.
Gavin White, Director, RBS Health ServicesInvestnet
This document discusses the UK private healthcare services sector. It shows that most revenue comes from acute care, followed by elderly care. It notes that businesses in this sector provide alternatives to public services and support innovation. The document also discusses quality assurance measures like regulatory compliance and incident management in these businesses. Finally, it depicts how care pathways can expand to include more community-based care.
Community health workers play an important role in advancing public health but often lack formal training opportunities. A new initiative aims to foster innovation in community health worker training through partnerships between health systems, academic institutions, and community organizations to improve health outcomes. The initiative's leader believes such collaboration across different sectors can help develop scalable training models and establish best practices.
Isolde Goggin, Chairperson, The Competition AuthorityInvestnet
This document discusses universal healthcare in Ireland and how competition could operate within such a system. It outlines the vision of universal primary care and universal health insurance that is compulsory and provides a guaranteed package for all. It discusses creating a risk equalization system and white papers on financing. It explores how competition could work in primary care, hospitals, and among health insurers, noting the importance of information, incentives, and supply and demand conditions for effective competition.
Prof. Cormac Taylor, UCD Conway InstituteInvestnet
The document discusses targeting oxygen-sensitive pathways in inflammatory bowel disease (IBD) using prolyl hydroxylase domain (PHD) inhibition. PHD inhibition has shown protective effects in experimental colitis models by stabilizing hypoxia-inducible factor (HIF). However, systemic PHD inhibition could cause unwanted side effects. The development of a colon-targeted formulation of PHD inhibitor using a LEDDS nanoparticle could deliver the inhibitor locally to regions of inflammation and reduce side effects. Experimental data shows targeted PHD inhibitor delivery reduced disease activity in a colitis model more effectively than oral or injected administration alone.
Mental illnesses are more common than other serious medical conditions such as cancer, diabetes, and heart disease. Approximately one in five adults and children have a diagnosable mental disorder. The document discusses establishing a psychiatric liaison clinic that meets every two weeks and uses a paperless system to liaise with general practitioners after each clinic. Over 80 patients attended the clinic and none were admitted, reducing the number of patients attending the outpatient department.
The document lists various departments and events at a healthcare facility called W.H.P. Diagnostics including an infusion centre, art therapy exhibition, health fair, and hospice fundraiser. It was produced by the CARITAS Project and the award winning 30,000 square foot primary care centre opened in Waterford City in May 2009.
Barry O'Leary, CEO of IDA Ireland, presented on the current impact of foreign direct investment in Ireland. IDA portfolio companies currently employ over 250,000 people and contribute €115 billion to the Irish economy. Recent investments include expansions and new facilities by pharmaceutical and biopharmaceutical companies in Cork, Dublin, Sligo, and Galway, creating over 1,500 new jobs. Initiatives to support Ireland's pharmaceutical cluster include the Solid State Pharma Cluster and the National Institute for Bioprocessing Research and Training. World competitiveness rankings show Ireland is highly ranked for factors that attract foreign investment such as skilled labor, investment incentives, tax rates, and adaptability. The FDI outlook remains positive with a strong pipeline
Tuberculosis (TB) is an infectious disease that affects a growing number of people around the world. Usually, it can be treated with antibiotics but some forms of the disease have emerged that do not respond to different types of drugs, making it very difficult to treat, especially in people already infected with HIV.
What are the trends in drug-resistant tuberculosis around the world and what must be done to control it?
Guidance for commissioners of mental health services for young people in tran...JCP MH
This guide describes good quality mental health transitions services for young people making the transition from child and adolescent to adult services.
It also describes the benefits of transitions services and explains why a transitions service is important for the commissioners of specialist mental health services.
Guidance for commissioners of child and adolescent mental health servicesJCP MH
This guide describes what ‘good looks like’ for a modern child and adolescent mental health service (CAMHS). It should be of value to Clinical Commissioning Groups (CCGs) and NHS England.
By the end of this guide, readers should be more familiar with the concept of CAMHS and better equipped to understand:
what a good quality, modern, service looks like
why a good CAMHS delivers the mental health strategy and the Quality Innovation Productivity and Prevention initiative – not only in itself but also by enabling changes in other parts of the system
the benefits of CAMHS to children, young people, their families and carers, and
why CAMHS are important for commissioners.
Transforming Care: Share and Learn Webinar – 28 September 2017NHS England
The document provides information about two topics discussed in a webinar on transforming care for children and young people with learning disabilities and autism. The first topic introduces an evaluation of the Building the Right Support program, including the evaluation's purpose and methodology. The second topic shares the experience of Matthew's mother to highlight how his crisis could have been predicted and prevented with the right support systems.
This presentation was given by Maria McGill of CHAS (Children's Hospice Association Scotland) to delegates at the APM Scottish Conference 2015 which was held on 10th September at BT Murrayfield Stadium in Edinburgh.
This report published by the South West Strategic Clinical Network for Mental Health has been developed to support commissioners in leading and shaping the transformation of child and adolescent mental health service (CAMHS) in the South West.
Around 10% of children aged between five and 16 have a mental health condition. Too often though these children, young people, their families and carers, find that the services they need are not available to them at the right time or place, are fragmented, or are well meaning but poorly organised.
This guide was written by young people, clinicians, service providers and commissioners. They describe what a good service looks like, pulling together innovative service models from across the region, which have been found to improve outcomes for children, young people and their families. The aim is to maximise treatment options within community settings, which play to the geography of the region and also make economic sense by avoiding hospital care where appropriate and possible. In addition, this guide describes the services which already exist in the region across a range of agencies.
Find out more at http://mentalhealthpartnerships.com/resource/commissioning-better-camhs-in-the-south-west
The document discusses mental health issues affecting young people aged 12-25 and proposes a new service model called headspace to address these issues. Some key points:
- 14-27% of young people experience mental health problems each year, with 75% of issues emerging before age 25. Up to 50% of substance abuse is preceded by mental health issues.
- The headspace model proposes bridging gaps between services, providing early intervention, and making services accessible, youth-friendly and tailored to local needs.
- It involves co-locating and integrating services, capacity building, and meaningful youth participation to help the large portion of young people affected by mental health and substance use issues.
North Staffs Combined NHS Trust - CAMHS Presentationhealthwatchstoke
This document summarizes the services provided by the Child and Adolescent Mental Health Services (CAMHS) in Stoke-on-Trent and North Staffordshire. It outlines the specialist CAMHS teams, community and inpatient services, and research on the prevalence of mental health issues among children and young people. It also describes the priorities and plans to transform CAMHS, including establishing a central referral hub, helpline, crisis response, and improving partnerships with schools and other organizations. The goal is to provide the right support for children and families in a timely manner.
Transition for Young People to Adulthood Rachel Gair
NHS Improving Quality
Presentation from an event held in London on Wednesday 9 October with the Teenage and Young Adult (TYA) Centre Champions and our Clinical Leads to share learning, good practice examples, the successes, challenges and barriers to implementing:
Treatment summaries
End of treatment care plans
Increased self-management for TYAs after cancer treatment
The output from the meeting will be to define what support NHS IQ can provide locally to assist TYA teams in order to make progress with their implementation plans.
Young people's mental health - where we have been and where we are going - Ma...NIHR CLAHRC West Midlands
Prof Max Birchwood's presentation on early interventions in youth mental health for the CLAHRC WM Scientific Advisory Group meeting, 9th June 2015, Birmingham, UK
COVID, Mental Health Services, and Telehealth in rural MInnesota Ann Treacy
This document discusses the use of telehealth for mental health services in Minnesota before and during the COVID-19 pandemic. It finds that the percentage of mental health providers offering telehealth consultations increased dramatically during the pandemic. It also finds that most providers plan to continue offering some telehealth services after the pandemic ends. Finally, it discusses some of the benefits of telehealth, such as increased access in rural areas, as well as challenges like inadequate infrastructure and lack of private spaces for clients.
BILD Event – 21 March 2018 : Transforming care - Sharing solutions that make ...NHS England
Stream E – Clinical leadership: using dynamic risk registers to prevent admissions and Care and Treatment Reviews to facilitate discharge
Dr Roger Banks and Dr Salim Razak discuss clinical leadership and clinical culture and the dynamic process for risk stratification before describing C(E)TRs, their outcomes so far and their role in achieving successful discharge into the community.
This document discusses youth mental health service models from around the world and options for improving youth mental health services locally. It notes that 1 in 4 youth experience mental health issues and transitions from children's to adult services are often difficult. Integrated, collaborative models that are community-based, flexible and non-stigmatizing are recommended. Building on existing local services, collaborating across sectors, evaluating outcomes, and involving young people are suggested starting points to develop a modular youth mental health system that meets their needs.
This document outlines the vision and goals of Forward Thinking Birmingham, a partnership providing community mental health services for children, young people, and young adults. Their vision is to create more choice and control over services, improving life chances. Their 2020 ambitions are to provide compassionate, dignified, tailored care from skilled staff delivered safely and equitably. The partnership involves multiple organizations working together to provide a full continuum of mental health services from universal promotion to inpatient care through an integrated system centered around a single access point.
This document provides a summary of the Care Quality Commission's (CQC) inspection of services for older people provided by Bradford District Care Trust. It finds that services were safe, effective, caring, responsive and well-led. Key points include:
- Staff understood safeguarding procedures and managed risks and caseloads well
- Care was planned effectively and delivered according to individual needs
- The multidisciplinary team worked well together
- Staff provided compassionate and person-centred care
- Services were responsive to the community's needs through their provision
- Managers were accessible and the trust involved service users in development
Isolde Goggin, Chairperson, The Competition AuthorityInvestnet
This document discusses universal healthcare in Ireland and how competition could operate within such a system. It outlines the vision of universal primary care and universal health insurance that is compulsory and provides a guaranteed package for all. It discusses creating a risk equalization system and white papers on financing. It explores how competition could work in primary care, hospitals, and among health insurers, noting the importance of information, incentives, and supply and demand conditions for effective competition.
Prof. Cormac Taylor, UCD Conway InstituteInvestnet
The document discusses targeting oxygen-sensitive pathways in inflammatory bowel disease (IBD) using prolyl hydroxylase domain (PHD) inhibition. PHD inhibition has shown protective effects in experimental colitis models by stabilizing hypoxia-inducible factor (HIF). However, systemic PHD inhibition could cause unwanted side effects. The development of a colon-targeted formulation of PHD inhibitor using a LEDDS nanoparticle could deliver the inhibitor locally to regions of inflammation and reduce side effects. Experimental data shows targeted PHD inhibitor delivery reduced disease activity in a colitis model more effectively than oral or injected administration alone.
Mental illnesses are more common than other serious medical conditions such as cancer, diabetes, and heart disease. Approximately one in five adults and children have a diagnosable mental disorder. The document discusses establishing a psychiatric liaison clinic that meets every two weeks and uses a paperless system to liaise with general practitioners after each clinic. Over 80 patients attended the clinic and none were admitted, reducing the number of patients attending the outpatient department.
The document lists various departments and events at a healthcare facility called W.H.P. Diagnostics including an infusion centre, art therapy exhibition, health fair, and hospice fundraiser. It was produced by the CARITAS Project and the award winning 30,000 square foot primary care centre opened in Waterford City in May 2009.
Barry O'Leary, CEO of IDA Ireland, presented on the current impact of foreign direct investment in Ireland. IDA portfolio companies currently employ over 250,000 people and contribute €115 billion to the Irish economy. Recent investments include expansions and new facilities by pharmaceutical and biopharmaceutical companies in Cork, Dublin, Sligo, and Galway, creating over 1,500 new jobs. Initiatives to support Ireland's pharmaceutical cluster include the Solid State Pharma Cluster and the National Institute for Bioprocessing Research and Training. World competitiveness rankings show Ireland is highly ranked for factors that attract foreign investment such as skilled labor, investment incentives, tax rates, and adaptability. The FDI outlook remains positive with a strong pipeline
Tuberculosis (TB) is an infectious disease that affects a growing number of people around the world. Usually, it can be treated with antibiotics but some forms of the disease have emerged that do not respond to different types of drugs, making it very difficult to treat, especially in people already infected with HIV.
What are the trends in drug-resistant tuberculosis around the world and what must be done to control it?
Guidance for commissioners of mental health services for young people in tran...JCP MH
This guide describes good quality mental health transitions services for young people making the transition from child and adolescent to adult services.
It also describes the benefits of transitions services and explains why a transitions service is important for the commissioners of specialist mental health services.
Guidance for commissioners of child and adolescent mental health servicesJCP MH
This guide describes what ‘good looks like’ for a modern child and adolescent mental health service (CAMHS). It should be of value to Clinical Commissioning Groups (CCGs) and NHS England.
By the end of this guide, readers should be more familiar with the concept of CAMHS and better equipped to understand:
what a good quality, modern, service looks like
why a good CAMHS delivers the mental health strategy and the Quality Innovation Productivity and Prevention initiative – not only in itself but also by enabling changes in other parts of the system
the benefits of CAMHS to children, young people, their families and carers, and
why CAMHS are important for commissioners.
Transforming Care: Share and Learn Webinar – 28 September 2017NHS England
The document provides information about two topics discussed in a webinar on transforming care for children and young people with learning disabilities and autism. The first topic introduces an evaluation of the Building the Right Support program, including the evaluation's purpose and methodology. The second topic shares the experience of Matthew's mother to highlight how his crisis could have been predicted and prevented with the right support systems.
This presentation was given by Maria McGill of CHAS (Children's Hospice Association Scotland) to delegates at the APM Scottish Conference 2015 which was held on 10th September at BT Murrayfield Stadium in Edinburgh.
This report published by the South West Strategic Clinical Network for Mental Health has been developed to support commissioners in leading and shaping the transformation of child and adolescent mental health service (CAMHS) in the South West.
Around 10% of children aged between five and 16 have a mental health condition. Too often though these children, young people, their families and carers, find that the services they need are not available to them at the right time or place, are fragmented, or are well meaning but poorly organised.
This guide was written by young people, clinicians, service providers and commissioners. They describe what a good service looks like, pulling together innovative service models from across the region, which have been found to improve outcomes for children, young people and their families. The aim is to maximise treatment options within community settings, which play to the geography of the region and also make economic sense by avoiding hospital care where appropriate and possible. In addition, this guide describes the services which already exist in the region across a range of agencies.
Find out more at http://mentalhealthpartnerships.com/resource/commissioning-better-camhs-in-the-south-west
The document discusses mental health issues affecting young people aged 12-25 and proposes a new service model called headspace to address these issues. Some key points:
- 14-27% of young people experience mental health problems each year, with 75% of issues emerging before age 25. Up to 50% of substance abuse is preceded by mental health issues.
- The headspace model proposes bridging gaps between services, providing early intervention, and making services accessible, youth-friendly and tailored to local needs.
- It involves co-locating and integrating services, capacity building, and meaningful youth participation to help the large portion of young people affected by mental health and substance use issues.
North Staffs Combined NHS Trust - CAMHS Presentationhealthwatchstoke
This document summarizes the services provided by the Child and Adolescent Mental Health Services (CAMHS) in Stoke-on-Trent and North Staffordshire. It outlines the specialist CAMHS teams, community and inpatient services, and research on the prevalence of mental health issues among children and young people. It also describes the priorities and plans to transform CAMHS, including establishing a central referral hub, helpline, crisis response, and improving partnerships with schools and other organizations. The goal is to provide the right support for children and families in a timely manner.
Transition for Young People to Adulthood Rachel Gair
NHS Improving Quality
Presentation from an event held in London on Wednesday 9 October with the Teenage and Young Adult (TYA) Centre Champions and our Clinical Leads to share learning, good practice examples, the successes, challenges and barriers to implementing:
Treatment summaries
End of treatment care plans
Increased self-management for TYAs after cancer treatment
The output from the meeting will be to define what support NHS IQ can provide locally to assist TYA teams in order to make progress with their implementation plans.
Young people's mental health - where we have been and where we are going - Ma...NIHR CLAHRC West Midlands
Prof Max Birchwood's presentation on early interventions in youth mental health for the CLAHRC WM Scientific Advisory Group meeting, 9th June 2015, Birmingham, UK
COVID, Mental Health Services, and Telehealth in rural MInnesota Ann Treacy
This document discusses the use of telehealth for mental health services in Minnesota before and during the COVID-19 pandemic. It finds that the percentage of mental health providers offering telehealth consultations increased dramatically during the pandemic. It also finds that most providers plan to continue offering some telehealth services after the pandemic ends. Finally, it discusses some of the benefits of telehealth, such as increased access in rural areas, as well as challenges like inadequate infrastructure and lack of private spaces for clients.
BILD Event – 21 March 2018 : Transforming care - Sharing solutions that make ...NHS England
Stream E – Clinical leadership: using dynamic risk registers to prevent admissions and Care and Treatment Reviews to facilitate discharge
Dr Roger Banks and Dr Salim Razak discuss clinical leadership and clinical culture and the dynamic process for risk stratification before describing C(E)TRs, their outcomes so far and their role in achieving successful discharge into the community.
This document discusses youth mental health service models from around the world and options for improving youth mental health services locally. It notes that 1 in 4 youth experience mental health issues and transitions from children's to adult services are often difficult. Integrated, collaborative models that are community-based, flexible and non-stigmatizing are recommended. Building on existing local services, collaborating across sectors, evaluating outcomes, and involving young people are suggested starting points to develop a modular youth mental health system that meets their needs.
This document outlines the vision and goals of Forward Thinking Birmingham, a partnership providing community mental health services for children, young people, and young adults. Their vision is to create more choice and control over services, improving life chances. Their 2020 ambitions are to provide compassionate, dignified, tailored care from skilled staff delivered safely and equitably. The partnership involves multiple organizations working together to provide a full continuum of mental health services from universal promotion to inpatient care through an integrated system centered around a single access point.
This document provides a summary of the Care Quality Commission's (CQC) inspection of services for older people provided by Bradford District Care Trust. It finds that services were safe, effective, caring, responsive and well-led. Key points include:
- Staff understood safeguarding procedures and managed risks and caseloads well
- Care was planned effectively and delivered according to individual needs
- The multidisciplinary team worked well together
- Staff provided compassionate and person-centred care
- Services were responsive to the community's needs through their provision
- Managers were accessible and the trust involved service users in development
Early Intervention: Improving Access to Mental Health by 2020 [Presentations]Sarah Amani
This document summarizes a presentation on extending early intervention services to additional mental health conditions beyond psychosis. It discusses how early intervention aims to improve outcomes by promptly starting effective treatments and providing intensive support. The network's priorities are outlined, which include identifying conditions early in adolescence/early adulthood where early intervention may be effective. Obsessive compulsive disorder is provided as an example condition that meets the priorities, as evidence demonstrates it often has onset in young people, can become severe and enduring without treatment, and responses well to early interventions. The case is also made for early intervention in anorexia nervosa based on evidence that outcomes are better when treatment is provided within the first three years.
The document discusses the Future in Mind report on transforming children and young people's mental health services in the UK. It notes that half of ill health under age 65 is mental illness, and less than 50% received appropriate treatment previously. The Future in Mind report launched in 2015 aimed to increase funding and early intervention services to prevent adult mental illness. Key challenges to implementing the recommendations include workforce shortages, variable leadership and commissioning, and limited school involvement. Ongoing efforts focus on maintaining momentum for change through local action.
Grainne Flynn was diagnosed with diabetes in 1993 and began her journey of diabetes education and peer support that empowered her as a patient. She became involved in diabetes advocacy as a blogger, event organizer, and support group facilitator. Through education, family and peer support online and in support groups, she felt empowered in managing her diabetes.
This document outlines a modified diabetes care model called the Portsmouth Model or "Super Six." It describes the different patient populations and types of care provided at the hospital, primary care, and diabetes support team levels. The hospital team focuses on acute, pregnancy/pre-pregnancy, active foot disease, advancing CKD/RRT, type 1 diabetes including insulin pumps, and complex type 2 diabetes patients. Primary care manages those at risk of diabetes, with controlled type 2 diabetes, and uncontrolled type 2 diabetes with guidelines. The diabetes support team cares for uncontrolled type 2 diabetes patients and type 1 patients who do not attend appointments are invited to an online community. Patient numbers are provided for each group.
Gerald Tomkin , Director of the Diabetes Institute Beacon HospitalInvestnet
This document summarizes a presentation on diabetes, atherosclerosis, and cholesterol. It discusses how diabetes increases the risk of cardiovascular disease and mortality. It notes that achieving lipid targets substantially reduces cardiovascular risk, but that target achievement is still uncommon. New therapies that inhibit microsomal triglyceride transfer protein, apolipoprotein C3, proprotein convertase subtilisin/kexin type 9, and other targets may help lower lipids and reduce risk, but require further study of long-term safety and efficacy. The need to more intensively reduce risk factors to further lower cardiovascular event rates is emphasized.
Dr. Ronan Canavan , Clinical lead of the National Clinical Programme for Diab...Investnet
Ronan Canavan, a consultant endocrinologist, gave a presentation at the Future Health Summit on designing better diabetes care. The presentation discussed standards, an integrated care model, retinopathy screening and treatment, podiatry, education, and paediatrics. It reviewed a 1999 model of diabetes care and discussed progress made in the last 5 years, including establishing a clinical diabetes program, retinal screening, developing a model of care for diabetic foot care, and integrated diabetes nurse specialists. The presentation concluded by discussing how Ireland can be the best in areas like prevention, technology, and education.
This document presents information on CliniBridge, a behavioral analysis software platform for clinicians that is integrated with a mobile platform for patients and caregivers. The platforms were pilot tested with Sussex Community NHS Trust and aimed to 1) avoid patient relapses and readmissions to meet funding targets, 2) allow patients to self-manage for improved outcomes, 3) increase the effectiveness of therapy, and 4) use silent data and intervention systems. The platforms were presented by Dervilla O'Brien, Managing Director and Co-Founder of CliniBridge.
The document describes an app developed by Dr. Malcolm R. Kell and colleagues to help breast cancer survivors focus on physical activity, diet, and reducing their body mass index (BMI) after treatment. The free app allows users to select an exercise intensity, see how much exercise is needed over 10 weeks to lower BMI by 10%, update their BMI, and access simple recipes to support a healthy diet for weight loss. The goal is to provide breast cancer survivors a simple tool to promote healthy living and improved survivorship after breast cancer.
Serious problems require serious solutions. Alcohol misuse costs €57 billion annually and only 1 in 9 people who misuse alcohol receive treatment. A smartphone and web-based platform is proposed as an innovative, user-friendly, evidence-based, and cheaper way to provide personalized treatment at scale. The platform utilizes computerized cognitive behavioral therapy and text messaging, which studies have shown can be effective in treating alcohol misuse. It seeks to revolutionize the UK addiction treatment market and plans clinical trials in Ireland and the UK in 2016 before rolling out more broadly in Europe and the US.
Dr. Robert Kelly discusses pressures facing the Irish health system including resources, costs, quality, and efficiency. Barriers include doctors' limited time and resources, and patients' issues with access, time, mobility and costs. Telemedicine can help overcome these barriers by giving patients more convenient lower-cost access supported by information to high-quality care. VideoDoc is an Irish telemedicine platform provider that operates a virtual clinic model and enables doctors to integrate the platform into their practices to develop telemedicine solutions for patients. The platform aims to improve healthcare experiences and outcomes at affordable costs through more engaged patients.
Cathal Brennan , Medical Device Assessor- Human Products Authorisation and Re...Investnet
This document discusses the regulation of standalone software as a medical device. It begins by defining standalone software and noting the EU directive that amended the definition of a medical device to include software intended for medical purposes. It then covers how to qualify standalone software as a medical device and classify it. The document reviews essential requirements, harmonized standards, conformity assessment procedures including CE marking, and registration requirements. It provides advice for manufacturers on ensuring compliance and for users on reporting issues. The role of the Irish regulator HPRA in providing guidance and conducting oversight is also discussed.
This document summarizes the effects of digital distraction on human behavior and brain function. It notes that people now spend 2-3 times as much time online as a decade ago and most check social media daily and switch between devices over 20 times an hour. This constant connectivity is changing how our brain functions, shortening attention spans and affecting memory. The ability to stay focused without distraction has become a rare "superpower." However, the document also sees opportunities to make sense of data and provide tips to use technology in a supportive rather than substitutive way.
1) The document discusses using neuroimaging and machine learning to detect dementia earlier by predicting which patients with mild cognitive impairment (MCI) will progress to dementia within a year.
2) The researchers have developed a model that can predict MCI to dementia progression with 75% accuracy by analyzing brain MRIs.
3) They are working to improve their model's accuracy and to predict the biological brain age and time to dementia for patients.
Keregen Therapeutics is a UK-based early stage drug discovery and development company focused on developing precision medicines for Parkinson's Disease. They were founded in 2015 and are operating out of University College London and Stevenage Bioscience Catalyst. Keregen is developing first-in-class small molecule activators of the Nrf2 pathway as a disease-modifying treatment for Parkinson's with the goal of a safer oral therapy that can be taken once daily. The company has participated in accelerator programs, secured initial funding, hired new employees, and aligned with academia to access resources and personnel as they progress their lead candidate towards clinical trials.
Darren Cunningham, Inflection Bio SciencesInvestnet
Darren Cunningham, CEO of Inflection Bio, presented an overview of the company's mission to develop new cancer treatments by targeting the PIM kinase pathway. Inflection Bio has a pipeline of targeted therapeutics for cancers like multiple myeloma, NSCLC, and hematological malignancies. Its lead candidates inhibit both PIM and PI3K/mTOR to address resistance to existing therapies. The company utilizes a network of research collaborators and has raised €2.2 million to advance its preclinical programs, with the goal of securing partners after Phase I trials.
This document discusses developing more effective drug delivery systems for treating blindness linked to diabetes or aging. It describes Phision Therapeutics' work on developing novel small molecule drugs and biodegradable microcapsule formulations for sustained drug release over 4-6 months via microneedles, as an alternative to frequent eye injections. The founders aim to commercialize this technology to reduce the burden of treatment for patients and clinicians.
This document describes the development of the BraineyApp, a mobile application created by Niamh Malone to help with self-recovery and rehabilitation following acquired brain injuries like stroke or traumatic brain injury. The app provides a personalized recovery journey broken into weekly and monthly goals. It underwent user testing and focus groups. Funding is being sought to further develop prototypes with input from medical experts and technology companies to expand the app's reach and features to support recovery from various neurological conditions and surgeries.
Toby Basey-Fisher , CEO, Co Founder, Eva DiagnosticsInvestnet
Evadiagnostics provides a smart health solution that offers immediate blood testing and actionable patient information to help with triaging. Their clinically validated platform technology connects devices, software, and data to improve patient care through better planning and quality of care driven by new data insights. They were recently recognized as European winners for their award-winning team and significant health economic impact through health solutions that improve patient outcomes.
Ena Prosser, Fountain Healthcare PartnersInvestnet
This document summarizes information about a life sciences venture capital partnership. They have €170 million under management across two funds and invest in companies seeking €8-10 million or more that have large market potential and an acceptable level of risk. Their team includes experts across clinical, commercial, IP, manufacturing and legal areas. They take an active role in their investments and want to connect early with companies that have strong teams critical to success.
Raglan Capital is an investment firm based in Dublin that develops investment opportunities by identifying and sourcing proprietary projects. In recent years it has raised over $500 million for ventures in sectors like oil and gas, financial technology, online gaming, medtech, and life sciences. One of Raglan's recent successes was instrumental in the formation of Amryt Pharma, a rare disease drug company that listed on the London AIM exchange in April 2016 with a market capitalization of $50 million and $20 million in cash.
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1. Transition from Child to Adult Mental
Health Services in Ireland
Niamh McNamara BA, PhD
School of Medicine & Medical Science
University College Dublin
The National Mental Healthcare Conference
Thursday 27th September 2012
3. The ITRACK Project
• Research team: University College Dublin, Trinity
College Dublin, Lucena Clinic, Cluain Mhuire
Services.
• Collaborators: University of Warwick, University
of Exeter, University of Limerick, University of
Melbourne, NSUE, Bodywhys, HADD, SHINE.
• Funded by the Health Research Board
• Aims: To identify the barriers & enablers to
effective transition for adolescents from CAMHS
to adult services
4. Why focus on transition?
• Transition will become increasingly important as
Child & Adolescent Mental Health Services
(CAMHS) begin to take on new presentations of
16 and 17 year olds
• Reports place emphasis on developing &
improving mental health services for young
people
– No focus on crucial link between CAMHS and adult
services
• Lack of information on transition process in
Ireland
– Likely issues found abroad will be mirrored here
5. ITRACK Studies
• Study 1: Survey of transition policies &
procedures in CAMHS and AMHS nationwide
– Compare best practice for smooth transition with
current clinical practice
• Study 2: Semi-structured interviews with
consultant psychiatrists, GPs, and staff from
national youth organisations
– Identify organisational facilitators and barriers to
transition
– Explore professionals’ experiences of service
provision for older adolescents including transition
6. Best practice guidelines for transition
• International transition policies & best
practice recommendations:
– Young people should receive the most
suitable and effective care for their needs
– Transitions should be seamless and user-
centred
– Should involve period of joint working
between services
7. Study 1: An investigation of operational
policies for 16-18 year olds
• Structured interviews with 57 consultant
psychiatrists (32 CAMHS, 25 AMHS)
– Based on mapping tool used in TRACK study (Singh
et al., 2009)
• Questions addressed key areas:
– Transition boundaries & annual transition rates
– Co-ordination of the transition process
– Degree of collaboration between services
– Involvement of young person in the transition
process
8. Age Boundary
• 84% CAMHS teams reported upper age limit of
18
– Typically refers to existing cases
– Practice varies regarding re-referrals & new cases
aged 16-18
– 34% accept new referrals aged 16-18
• 52% AMHS teams reported lower age limit of 18
– 84% reported accepting cases between 16 -18
9. CAMHS Transition Numbers
Mean SD Range N
Cases suitable for transfer to AMHS 7.73 9.86 1 – 50 25
per year
Cases transferred to AMHS per year 4.50 3.33 1 – 10 20
Cases remaining in CAMHS past 5.46 6.37 0 – 21 26
transition boundary per year
AMHS Transition Numbers
Mean SD Range N
Cases referred for transfer to AMHS 4.63 3.52 0 – 10 19
per year
Cases transferred to AMHS per year 4.82 3.54 0 – 10 17
* numbers represent clinician recall
10. Lost in Transition?
• Most teams lack a structured process
– 67% report lack of agreed, accessible & known
transition care arrangements
– 48% believe professionals unaware of their role in
transition process and services each offers
• Good information exchange
– 93% report a comprehensive summary of notes is
made available (with permission) to AMHS
• Minimal interaction between services
– 7% always hold professionals transfer meeting
– 12% always hand-over care through meetings
involving both services & the young person
11. Reminder: Best Practice Guidelines for
Transition
• Young people should receive the most suitable
and effective care for their needs
– Issue of access to services for 16-18 year olds
• Transitions should be seamless and user-centred
– Seems to be an administrative event rather than a
process
• Should involve a period of joint working between
services
– Limited interaction between services
12. Study 2: Qualitative study of professionals’
transition experiences
• Face-to-face semi-structured interviews
– Consultant Child & Adolescent Psychiatrists (n=8)
– Consultant Adult Psychaitrists (n=8)
– GPs (n=8)
– Staff from national youth organisations (n=9)
• Interview length ranged from 35 to 70 minutes
• Questions addressed experiences providing mental
health services to older adolescents and factors
impacting on transition
• Interview recordings transcribed verbatim & data
analysed using thematic analysis
13. Questions for Today
• Are young people receiving the most suitable and
effective care for their needs?
• What are the potential barriers to close dialogue
and collaboration between child and adult mental
health services?
14. Service Cultures
• Respondents identified key differences between
CAMHS and AMHS
– Focus of service
– Treatment model used
– Working practices
– Type of resources available
• Service culture impacts on:
– How service boundaries are defined
– Level of inter-agency communication and collaboration
15. Defining Service Boundaries:
Age
• As seen in Study 1, considerable variation in age boundaries
• Issue of who is responsible for 16-18 year old age group
impacts on quality of relationships between services
• Resources used as justification for setting age boundaries in
both services
“As a service we’re a bit rigid about the 18 year old
mark and that comes from, the management
team are very strict about it, it’s partly a resource
issue because we’re on an extremely tight budget
and we don’t , you know, we need to be careful about
that but we get clear instruction you cannot take
somebody under 18”
AMHS05 consultant
16. CAMHS02 Each sector has found its own unsatisfactory way of dealing
with it so for us if you’re unlucky enough to have been
vulnerable enough before you were sixteen you’ll still get a
service from us but if you were lucky enough to be resilient
enough until after you were sixteen you won’t get a service
from us you’ll go straight to adult so it’s not right but that’s
where it is
[…..]
Int And is the lower age for adult 16 years or is it 18?
CAMHS02 Em well we work off the em the kind of the agreement that if
they’re as I said earlier if they’re it they’ve been here before
they were 16 we’ll take them if they’re coming in cold at 16 we
don’t take them they go to adult
Int And are adult happy to [take them]?
CAMHS02 No
Int But will they take them?
CAMHS02 yeah, yeah
17. Defining service boundaries:
Clinical Presentation
“I mean you’re set up to meet needs I suppose, you know, and the needs we
address are, you know, from adult up to the age of 65, is major mental illness
em that’s that’s what that’s the need that needs to be met and that’s what
we’re good at”
AMHS04 Consultant
“….I suppose my logic on it was that if it was a child who was say psychotic
and was going to be requiring probably inpatient treatment at some point
[and] definitely going to be graduating to adult psych services I thought that
was less clearly ours whereas obviously a young person with difficulties within
a family setting, I thought that maybe we could do an intervention more
quickly and maybe discharge”
CAMHS05 Consultant
“…I think general adult psychiatrists are totally at sea with ADHD, with
Asperger’s syndrome, Autism, I think the, you know, our level of knowledge is
atrocious and I feel really sorry for people who are leaving child and adolescent
services and they have to face into that gulf of knowledge and services
available….”
AMHS01 consultant
18. Some flexibility around age depending
on clinical need
“There is a limited flexibility around it….traditionally this
area has had [a CAMH] service that did provide input up
to the age of 18 and that persists occasionally there are
people who kind of exceed the capacity of a child and
adolescent service….for example we have somebody
who’s under 18 attending who’s prescribed clozapine and
[the CAMHS] isn’t able to provide a clozapine service
because the infrequency with which it’s prescribed so
there is a kind of shared care arrangement there in place
so in circumstances where you know a case is made for
somebody under 18 that they have a particular need
which we can best meet we would try to come to some
kind of shared care arrangement”
AMHS05 consultant
19. Collaboration and communication
“….The reality is that there’s very little communication or
liaison between child psychiatry and adult services, they
are quite different, you know we don’t have in my view
we don’t have enough joint working, we don’t do things
together, and there’s very much a….I mean there’s very
much a bit of a fight really you know, it’s always maybe
the only time when there’s any discussion is about this
controversial 16 to 18 year and there’s a lot of
resentment on both sides I would say about that, so I
think that’s a real difficulty, you know once people go
into training, you know we might have trainees they go
into child psychiatry and that’s it, and child psychiatry as
I say we rarely meet if ever, I don’t know if we ever
meet”
AMHS03 Consultant
20. Study 2: Conclusion
• Variation in level of contact and quality of
relationships between child & adult mental health
services
– Underpinned by differing service cultures and
working practices
– Limited resources place constraints on what can be
achieved
• Urgent need to resolve issue of responsibility of
care for 16-18 year old group
21. Summary
• Study 1: Transition process is under-developed in
Ireland
• Study 2: Difficult to separate transition from
wider issue of mental health service provision for
16-18 year olds
• Need to encourage close dialogue and
collaboration between child and adult mental
health services
• Currently collecting data on transition experiences
of young people and parents/carers
22. Questions?
• Research team:
– Prof Fiona McNicholas (Principal Investigator)
– Dr Niamh McNamara (UCD), Dr Blanaid Gavin (Lucena
Clinic), Dr Siobhan Barry (Cluain Mhuire Services), Dr
Barbara Dooley (UCD), Prof Imelda Coyne (TCD), Prof
Swaran Singh (University of Warwick), Dr Moli Paul
(University of Warwick), Dr Tamsin Ford (Peninsula
College of Medicine), Prof Walter Cullen (UL)
– Dr Karen O’Connor, Dr Nicolas Ramperti
– Ms Cliana Doyle, Ms Erin Brennan (Lucena Clinic)
• Contact details: Dr Niamh McNamara
– niamh.mcnamara@ucd.ie