It is estimated that 450 million individuals worldwide are affected by mental, neurological or behavioral problems at any time, and that 873,000 die annually by suicide. Key international authorities and a literature review suggest that women are disproportionately affected by depression, anxiety and eating disorders, which usually go unrecognized and untreated, and that the mental health of women can be understood only if their biological, social, cultural, economic and personal context is considered. International efforts should increase to prevent, recognize and treat mental disorders in girls and women. An International Women's Mental Health Consensus Statement is herein provided, for endorsement by interested organizations wishing to begin this task.
Summary Photodermatoses, or photosensitivity conditions, are a group of skin disorders caused by exposure to sunlight, overall affecting a large number of people. They cause a range of distressing symptoms including pain and burn, and can make the skin blister, flake and scar. The conditions themselves and the need for patients to avoid and protect themselves from sunlight may affect quality of life and psychological health. This study, from the U.K., aimed to find out what methods of assessment (tools) have been used to evaluate quality of life and psychological health in photodermatoses, and report what the impact is for patients. The authors reviewed relevant published English‐language studies and summarised their findings. 20 studies were included: 19 assessing quality of life and three assessing psychological function. Six different tools had been used to assess quality of life, and four different tools to assess psychological health. It was shown that 31‐39% of patients with photodermatoses experienced a very large impact on their quality of life. There was a particular impact on issues related to employment, social/leisure activities and clothing choices. Patients had around double the rates of anxiety and depression found in the general population, although few studies focussed on psychological health. The authors also noted that most available tools were not designed to address the unique impact of intermittent sunlight‐induced skin conditions and suggested that development of more specific tools could be beneficial. In conclusion, this study confirmed that patients with photodermatoses experience substantial impact on their quality of life and that more research is needed. This is a summary of the study: Quality of life and psychological impact in the photodermatoses: a systematic review.
Introduction: The skeletal survey (SS) is used to evaluate and diagnose bone abnormalities, including fractures caused by child abuse. The American Academy of Pediatrics recommends initial SS for all children younger than 24 months old who are suspected victims of abuse and a follow-up skeletal survey (FUSS) 2 weeks later. The latter can further characterize abnormal or equivocal findings, detect ongoing trauma, or fractures too acute for visualization upon initial assessment. Methods: Preintervention review at our hospital for FUSS completion of children younger than 36 months old yielded a low 40% average monthly completion rate. We reviewed charts of children who underwent SS during the study period for FUSS completion. There were several barriers to FUSS completion, including lack of provider knowledge regarding FUSS importance, lack of an order for FUSS before hospital discharge, absent chart documentation regarding FUSS decision, loss to follow-up, and parental refusal. Interventions targeting the barriers included provider education, protocolizing FUSS scheduling, standardizing documentation, and community pediatrician outreach. The goal was to increase the average monthly FUSS completion rate from 40% to 90% over 1 year. Results: After interventions implementation, the average monthly FUSS completion rate rapidly increased from 40% to 80%. There was sustained improvement over the subsequent 12 months. Conclusions: Interventions were implemented sequentially, targeting barriers at various levels of workflow. Provider education was key and helped increase the reliability of intervention implementation. The most effective intervention was protocol change. This approach led to significant improvement in FUSS completion and sustained improvement.
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