Evaluation of a partnership between primary and secondary care providing an accessible Level 1 sexual health service in the community

Comprehensive testing for asymptomatic sexually transmitted infections in Northern Ireland has traditionally been provided by genitourinary medicine clinics. As patient demand for services has increased while budgets have remained limited, there has been increasing difficulty in accommodating this demand. In May 2013, the newly commissioned specialist Sexual Health service in the South Eastern Trust sought to pilot a new model of care working alongside a GP partnership of 12 practices. A training programme to enable GPs and practice nurses to deliver Level 1 sexual health care to heterosexual patients aged >16 years, in accordance with the standards of BASHH, was developed. A comprehensive care pathway and dedicated community health advisor supported this new model with close liaison between primary and secondary care. Testing for Chlamydia, gonorrhoea, HIV and syphilis was offered. The aims of the pilot were achieved, namely to provide accessible, cost-effective sexual health care within a framework of robust clinical governance. Furthermore, it uncovered a high positivity rate for Chlamydia, especially in young men attending their general practice, and demonstrated a high level of patient satisfaction. Moreover the capacity of secondary care to deliver Levels 2 and 3 services was increased.

Long-term management of liquid high-level radioactive wastes stored at the Western New York Nuclear Service Center, West Valley : final Environmental Impact Statement.

"June 1982."

Strong internal controls at service delivery level will help prevent CETA-type fraud and abuse in Job Training Partnership Act programs : report to Senator Sam Nunn, ranking minority member, Permanent Subcommittee on Investigations, Senate Committee on Governmental Affairs /

"B-215774"--Preliminary p.

Federal hiring : testing for entry-level administrative positions falls short of expectations : report to the Chairman, Subcommittee on the Civil Service, Committee on Post Office and Civil Service, House of Representatives /

"B-249943"--P. 1.

A Framework for Design-Time Testing of Service-Based Applications at BPEL Level

Software applications created on top of the service-oriented architecture (SOA) are increasingly popular but testing them remains a challenge. In this paper a framework named TASSA for testing the functional and non-functional behaviour of service-based applications is presented. The paper focuses on the concept of design time testing, the corresponding testing approach and architectural integration of the consisting TASSA tools. The individual TASSA tools with sample validation scenarios were already presented with a general view of their relation. This paper’s contribution is the structured testing approach, based on the integral use of the tools and their architectural integration. The framework is based on SOA principles and is composable depending on user requirements.

Palliative Medicine:Scoping the level and extent of service provision to people with intellectual disability at end of life Poster Presentation

Background: Concerns exist about the end of life care
that people with intellectual disabilities receive. This population
are seldom referred to palliative care services and
inadequate data sets exist about their place of death.
Aim: To scope the extent of service provision to people
with intellectual disabilities at the end of life by specialist
palliative care and intellectual disability services in one
region of the United Kingdom.
Methods: As part of a larger doctoral study a regional survey
took place of a total sample (n=66) of specialist palliative
care and intellectual disability services using a postal
questionnaire containing forty items. The questionnaire
was informed by the literature and consultation with an
expert reference group. Data were analysed using SPSS to
obtain descriptive statistics.
Results: A total response rate from services of 71.2%
(n=47) was generated. Findings showed a range of experience
among services in providing end of life care to people
with intellectual disabilities in the previous five years, but
general hospitals were reported the most common place of
death. A lack of accessible information on end of life care
for people with learning disabilities was apparent. A few
services (n=14) had a policy to support this population to
make decisions about their care or had used adapted Breaking
Bad News guidelines (n=5) to meet their additional
needs. Both services recognised the value of partnership
working in assessing and meeting the holistic needs of
people with intellectual disabilities at end of life.
Conclusions: A range of experience in caring for people
with intellectual disabilities was present across services,
but more emphasis is required on adapting communication
for this population to facilitate them to participate in their
care. These findings could have international significance
given that studies in other countries have highlighted a
need to widen access to palliative care for this group of
people.