ventricular dysfunction, at a level requiring cardiac transplant. ECG showed prolonged QT interval. The patient was diagnosed with toxic dilated cardiomyopathy secondary to long term AM abuse. UK guidelines for Heart transplantation in adults deem chronic viral infection and ongoing substance misuse as relative contraindications to transplant. He was consequently commenced on medication for cardiac failure and received benzodiazepine as inpatient for managing withdrawal symptoms. On discharge, psychiatry follow-up was organised for support to help reduction of AM. At follow up, the patient reported reduced AM use by quarter, but felt he could never abstain. Discussion/conclusion AM related cardiac fatalities are caused by acute myocardial necrosis, ventricular rupture, cardiomyopathy or arrhythmia. Evidence is mostly derived from casereports. Patients using AM should be fully counselled regarding possible toxic effects.
Abstract. The resurgence of sexually transmissible infections among men who have sex with men is a concern for sexual health. Traditional strategies have relied on the promotion of condom use, regular testing, treatment, and partner management. Future sexually transmissible infection control programs must combine current prevention methods with novel approaches that target the providers, patients, and mechanisms of health care delivery.
Background/introduction Within Sexual and Reproductive Health (SRH) clinics identification of Mental Health (MH) problems is an important part of a consultation with young people (YP). Aim(s)/objectives To review the number of YP who had documentation of a conversation regarding MH. Methods Electronic patient records of 103 attendees were selected at random and reviewed. Results MH discussion was documented in 81% (26/32) of <16s, 67% (n = 20/30) aged 16, 37% (n = 15/41) of those aged 17-18 years. Of these Child and Adolescent MH Services (CAMHS) were accessed by 23% (6/26) <16s (2/6 lost FU), 15% (n = 3/20) aged 16 and 7% (n = 1/15) aged 17-18 years. Of these ten disclosed the following specific disorders ADHD (2), self-harm (3), depression (2), anorexia and past sexual abuse (1) and conduct disorder (1), suicidal thoughts (1). 3/9 aged 16 and under who had accessed CAMHS disclosed sexual abuse. Discussion/conclusion Sexual health is an important access point for YP with mental health problems, new or lost to follow up and may be associated with a disclosure of sexual abuse. Significant pressures exist in CAMHS services. Shared clinical experience and robust links between sexual health, CAMHS, general practice and youth services with appropriate referral pathways are important. We recommend training for all SRH staff should include: skills in eliciting MH problems in all consultations with YP, awareness of common MH problems in adolescence and knowledge of local service configuration including thresholds for referral to appropriate providers.
majority preferred the sexual health clinic as an acceptable venue 37% (56/150). A weekly "in-reach" service was set up with the local Drug Service to run alongside the MSM evening clinic. From August to December 2014, there were 15 clinics in total with 21 visits (max capacity 30 visits). 25% of those seen were from the local borough; the rest of the clients were from neighbouring boroughs. Discussion/conclusion The service to date has been a clinical and operational success. A patient satisfaction questionnaire completed by 13 clients noted 92% were happy to be seen at this venue, 85% felt the provision of this service was worthwhile and 85% would recommend this service to others. Further work in this area with a targeted MSM history proforma, chemsex leaflet and needle exchange schemes are also being developed. Background/introduction There is a strong tradition of collaborative research and practice in sexual health in the North East of England. Aim(s)/objectives The North East Sexual Health Research Practice Network brings together colleagues from academia, public health and clinical practice to share research findings and identify research questions based on local issues. Methods A project group with representatives from local universities, Public Health England and local authorities developed a proposal for a regional sexual health research network to promote collaboration and share evidence of what works. A steering group was established to develop an initial work plan for the network. Results The network has identified key outputs for its first year -including a website hosted by FUSE (the Centre for Translational Research in Public Health, a collaboration between the five North East universities), a mapping exercise of existing sexual health research in the region and an inaugural Research Practice event to share key findings and plan future projects. Discussion/conclusion We have identified an enthusiasm for sexual health research in the region, and hope that the network will draw together colleagues working in different fields who may not be aware of the range of work being carried out across the region. We hope that by identifying research questions that are locally meaningful, and by offering support from colleagues with expertise in the field, we will generate research that will inform sexual health practice and commissioning, reduce duplication and ultimately improve the sexual health of people in the North East and beyond. P146 ESTABLISHING A SEXUAL HEALTH RESEARCH PRACTICE NETWORK IN THE NORTH EAST
IntroductionThe Five Year Forward Review calls for an upgrade in prevention and public health and Making Every Contact Count suggests utilisation of provider encounters to enable positive behavioural change. The London Sexual Health Transformation Programme will be implemented in April 2017 and it is proposed that asymptomatic patients will access services online rather than attending a clinic.MethodsIn the financial year 2015 – 16 there were 1975 attendances of 998 individuals <18 at a sexual & reproductive health service. A risk assessment proforma was used in 98.82% (n=505/511) of those 16 or under and 72.9% (n=355/487) of those aged 17. These were analysed using an electronic report.ResultsCurrent mental health problems, smoking, drug and alcohol use was recorded in 837 (97%), 694 (81%) and 818 (95%) records respectively.Abstract P193 Table 1Under 18s attending SRHUnder 16 n=205Age 16 n=300Age 17 n=355Mental health difficulties47 (23%)63 (21%)93 (26%)Smoking70 (34%)85 (28%)122 (34%)Alcohol use alone67 (32.7%)124 (41.3%)128 (36%)Drug use alone5 (2.4%)12 (4%)10 (2.8%)Drug + alcohol use14 (6.8%)18 (6%)31 (8.7%)DiscussionMental health difficulties, smoking, drug and alcohol use are common across all ages. Assessment enables health promotion through brief interventions and is important to identify young people at risk; commissioners should ensure that opportunities are not lost with online access. We suggest commissioning of a one stop shop model for under 18s or robust online screening protocols to ensure opportunities for intervention are not lost.
Background/introduction Within Sexual and Reproductive Health (SRH) clinics identification of Mental Health (MH) problems is an important part of a consultation with young people (YP). Aim(s)/objectives To review the number of YP who had documentation of a conversation regarding MH. Methods Electronic patient records of 103 attendees were selected at random and reviewed. Results MH discussion was documented in 81% (26/32) of <16s, 67% (n = 20/30) aged 16, 37% (n = 15/41) of those aged 17-18 years. Of these Child and Adolescent MH Services (CAMHS) were accessed by 23% (6/26) <16s (2/6 lost FU), 15% (n = 3/20) aged 16 and 7% (n = 1/15) aged 17-18 years. Of these ten disclosed the following specific disorders ADHD (2), self-harm (3), depression (2), anorexia and past sexual abuse (1) and conduct disorder (1), suicidal thoughts (1). 3/9 aged 16 and under who had accessed CAMHS disclosed sexual abuse. Discussion/conclusion Sexual health is an important access point for YP with mental health problems, new or lost to follow up and may be associated with a disclosure of sexual abuse. Significant pressures exist in CAMHS services. Shared clinical experience and robust links between sexual health, CAMHS, general practice and youth services with appropriate referral pathways are important. We recommend training for all SRH staff should include: skills in eliciting MH problems in all consultations with YP, awareness of common MH problems in adolescence and knowledge of local service configuration including thresholds for referral to appropriate providers.
IntroductionLegally, 16 and 17 year olds can consent to sex but may still be vulnerable to sexual exploitation; opportunities to identify vulnerability may be lost when transitioning into adult services.MethodsIn the financial year 2015–16 there were 1975 attendances of 998 individuals <18 at a sexual & reproductive health service. A risk assessment proforma was used in 98.8% (n=505/511) of those 16 or under and 72.9% (n=355/487) of those aged 17. These were analysed using an electronic report.Results DiscussionUsing arisk assessment proforma with16 and 17 year olds enabledstaff to recognise vulnerabilities related to child sexual exploitation, 53% of all concerns were among this age group. When transitioning to online and adult services care modelsshould include assessment to identifyvulnerabilities such as pre-existing involvement with social care, older partners & mental health difficulties. Staff should be competent in managingdisclosures and have aworking knowledge of social care, referral thresholds and pathways within local networks for those at risk of CSE.Abstract P106 Table 1The inbetweenersUnder 16 n=205Age 16 n=300Age 17 n=355New safeguarding concern14 (7%)8 (4.3%)8 (3.8%)Known to social care52 (34%)61 (20%)70 (20%)> 10 sexual partners2 (1%)9 (3.2%)14 (4.2%)Age of current or last partner 18–24 years9 (4.3%)66 (23.8%)195 (58.9%)Age of current or last partner 25 years or >04 (1.4%)5 (1.5%)Mental health difficulties47 (23%)63 (21%)93 (26%)
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