Interdisciplinary Program in Sweden Related to Transgender Voice

2015 ◽  
Vol 25 (2) ◽  
pp. 87-97 ◽  
Author(s):  
Maria Södersten ◽  
Ulrika Nygren ◽  
Stellan Hertegård ◽  
Cecilia Dhejne
Keyword(s):  
Gender Dysphoria ◽  
Life Quality ◽  
Standards Of Care ◽  
National Guidelines ◽  
Voice Assessment ◽  
Quality Registry ◽  
Bodily Appearance ◽  
National Quality ◽  
Unique Source ◽  
Voice Range

Gender incongruence occurs when there is a discrepancy between gender identity and a person's sex assigned at birth and their bodily appearance. Sweden was the first country in the world to pass a law regulating a person's legal right to change gender. There are six psychiatric gender teams in Sweden responsible for diagnostic assessments and coordination of gender confirming medical interventions. Extended gender teams include endocrinologists, speech-language pathologists, phoniatricians, gynecologists, dermatologists, and surgeons. All male-to-female (MtF) and female-to-male (FtM) transgender individuals are referred for voice assessment when a gender dysphoria diagnosis has been confirmed. Voice assessment includes questionnaires and voice recordings in habitual and loud voice and voice range profiles. Voice and communication therapy is provided for both MtF and FtM individuals. Pitch-raising surgery can be considered and pre- and post-operative voice therapy is required for optimal results. The Swedish Association for Transsexual Health was launched 2004. The national guidelines were recently updated to make those more congruent with WPATH's Standards of Care version 7. A national quality registry for Gender Dysphoria has been accepted for financial support. The registry will in the future be a unique source to provide data concerning patient satisfaction, safety, and life quality.

Considering Form and Function: A Commentary on the Review of the Early Years Learning Framework for Australia

2021 ◽  
pp. 183693912110185
Author(s):  
Caroline Cohrssen
Keyword(s):  
Early Childhood ◽  
Learning Outcomes ◽  
Quality Standard ◽  
Early Years ◽  
National Guidelines ◽  
Form And Function ◽  
Learning Framework ◽  
National Quality ◽  
Planning Cycle ◽  
Standard Quality

An important milestone in early childhood education and care is reached in 2021 as Belonging, Being and Becoming: The Early Years Learning Framework for Australia is reviewed. The Early Years Learning Framework (EYLF) was groundbreaking. It has been influential in providing national guidelines around pedagogical principles, practice and learning outcomes for children. This commentary is intended to contribute to the wider conversation that is taking place this year. It proposes that a refined EYLF retains the focus on child-centredness and playful learning, and advocates for the structure of the revised document to include continua of learning and development. The provision of learning trajectories would assist early childhood educators to enact the planning cycle, meet National Quality Standard Quality Area 1, and thus potentially increase the learning outcomes for all children.

scholarly journals Lessons learnt during the implementation of a web-based triage tool for Dutch intensive care follow-up clinics

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e021249 ◽  
Author(s):  
Ilse van Beusekom ◽  
Ferishta Bakhshi-Raiez ◽  
Nicolette F de Keizer ◽  
Dave A Dongelmans ◽  
Marike van der Schaaf
Keyword(s):  
Intensive Care ◽  
Health Professionals ◽  
Web Based ◽  
Quality Registry ◽  
Email Address ◽  
National Quality ◽  
The Web ◽  
Screening Software ◽  
National Quality Registry

ObjectivesScreening for symptoms of postintensive care syndrome is based on a long list of questionnaires, filled out by the intensive care unit (ICU) survivor and manually reviewed by the health professional. This is an inefficient and time-consuming process. The aim of this study was to evaluate the feasibility of a web-based triage tool and to compare the outcomes from web-based questionnaires to those from paper-based questionnaires.DesignA mixed-methods study.SettingNine Dutch ICU follow-up clinics.Participants221 ICU survivors and 14 health professionals.InterventionsA web-based triage tool was implemented by nine ICU follow-up clinics. End users, that is, health professionals were interviewed in order to evaluate the feasibility of the triage tool. ICU survivors were invited to fill out web-based questionnaires 3 months after hospital discharge.Primary outcomesOutcomes of the questionnaires were merged with clinical data from a national quality registry to assess the differences in outcomes between paper-based and web-based questionnaires.Results221 ICU survivors received an invitation to fill out questionnaires, 93 (42.1%) survivors did not respond to the invitation. Respondents to the web-based questionnaires (n=54) were significantly younger and had a significantly longer ICU stay than those who preferred the paper-based questionnaires (n=74). The prevalence of mental, physical and nutritional problems was high, although comparable between the groups. Health professionals’ interviews revealed that the software was complex to use (n=8) and although emailing survivors is very convenient, not all survivors have an email address (n=7).ConclusionsWeb-based screening software has major benefits compared with paper-based screening. However, implementation has shown to be rather difficult and there are important barriers to consider. Although different in age, the health status is comparable between the users of the web-based questionnaire and paper-based questionnaire.

scholarly journals P01.151 Gender differences in glioma - findings from the Swedish National Quality Registry for Primary Brain Tumors

2018 ◽  
Vol 20 (suppl_3) ◽  
pp. iii267-iii267
Author(s):  
A Malmström ◽  
L Åkesson ◽  
T Asklund ◽  
S Kinhult ◽  
K Werlenius ◽  
...  
Keyword(s):  
Gender Differences ◽  
Brain Tumors ◽  
Primary Brain Tumors ◽  
Quality Registry ◽  
National Quality ◽  
National Quality Registry

Improving care for patients with stage III/IV NSCLC: Learnings for multidisciplinary teams from the ACCC national quality survey.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19195-e19195
Author(s):  
Ravi Salgia ◽  
Leigh Boehmer ◽  
Catherine Celestin ◽  
Judy Yu ◽  
David R. Spigel
Keyword(s):  
Significant Negative Correlation ◽  
Steering Committee ◽  
Stage Iii ◽  
Tumor Board ◽  
Standards Of Care ◽  
Multidisciplinary Teams ◽  
Optimal Care ◽  
Double Blind ◽  
National Quality

e19195 Background: Refinement of the multidisciplinary team (MDT) approach continues to offer significant potential for improving the quality of non-small cell lung cancer (NSCLC) care and adherence to guideline-recommended protocols. This opportunity arises, in part, from insufficient characterization of MDT practice patterns and barriers to optimal care provision within U.S. cancer programs. The Association of Community Cancer Centers (ACCC), therefore, conducted a national survey to improve understanding on how patients with stage III/IV NSCLC were diagnosed and managed across different practice settings, with the aim of informing the design and execution of process-improvement plans to address identified barriers. Methods: ACCC convened an expert steering committee of multidisciplinary specialists, including oncologists, thoracic surgeons, pathologists, pulmonologists, and representation from patient advocacy, for a comprehensive, double-blind, web-based survey (January–April 2019), to obtain insights on cancer patient care in a diverse set of U.S. community cancer programs. Results: Of 1211 questionnaires, 639 responses affiliated to 160 unique cancer programs across 44 U.S. states were suitable for analysis. In total, 41% (n = 261) of respondents indicated that their cancer program did not have a thoracic multidisciplinary clinic. The average time to first therapeutic intervention in newly diagnosed patients was 4 weeks (range = 1–10 weeks; n = 298). A significant negative correlation between frequency of tumor board meetings and time to complete disease staging (r = −0.13, P = 0.03) was observed. Nurse navigators ( P = 0.03) and radiation oncologists (P = 0.04) were significantly more likely to engage in shared decision-making practices than other disciplines. The most challenging barriers to delivering high-quality NSCLC care are listed (Table). Conclusions: Multiple opportunities exist to improve the delivery and quality of care for patients with stage III/IV NSCLC, including lowering barriers to effective screening, diagnosis, and care coordination and adhering to evolving standards of care. [Table: see text]

An audit on the management of pelvic inflammatory disease in the West Midlands, UK

2007 ◽  
Vol 18 (10) ◽  
pp. 717-719 ◽  
Author(s):  
M Walzman ◽  
A Tariq ◽  
S Bhaduri ◽  
J D C Ross
Keyword(s):  
Data Collection ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
National Standards ◽  
National Standard ◽  
Standards Of Care ◽  
National Guidelines ◽  
The West ◽  
West Midlands

The potential complications of pelvic inflammatory disease (PID) make optimizing its management a high priority. A clinical audit of PID against current national management guidelines was conducted in 14 departments of genitourinary medicine in the West Midlands for women presenting with PID between January and December 2005. There were a total of 810 diagnoses of PID made from a total of 49,390 female attendees for that year, giving an incidence of 164 cases per 10,000 attendees. Of these 810 cases, data collection and analysis for this audit were performed on 139. An ofloxacin 400 mg twice daily (b.i.d.) based regimen was prescribed in 91 (65%, 95% confidence interval [CI] 57–73%) cases. Doxycycline 100 mg b. i. d. for 14 days plus metronidazole 400 mg b. i. d. for 5–14 days was prescribed in 44 (32%, 95% CI 25–40%) cases, but a third-generation cephalosporin was only given with this regimen in three cases. Partner notification was performed in 101 (73%, 95% CI 65–79%) cases. A total of 130 male contacts were recorded on the data collection forms, and of these 58 (45%) were traced and 51 (39%), treated. A follow-up appointment was given to 133 (96%, 95% CI 91–98%) women, although in most cases this was for seven days or more, and 104 (78%, 95% CI 67–81%) women attended for follow-up. Adherence to the national guidelines in this cohort of patients did not reach the national standard for choice of treatment regimen nor did it attain the target for proportion of male partners traced. Barriers preventing adherence to the national guidelines need to be explored and appropriate assistance given to physicians to help meet national standards of care.

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