Annual Checks Research Articles

Occlusal considerations in maintaining health of implants and their restorations

Dental implants are a regular feature in daily clinical practice and there is a need to undertake routine assessment and maintenance of implants and their restorations on par with that provided for natural teeth. Occlusal checks form an important part of the maintenance regime for preserving the integrity of implants, their restorations, and health of the peri-implant tissues. Implant restorations are subjected to the full characteristics and magnitude of occlusal forces, including those associated with parafunction. Compared with the periodontal ligament around teeth, the biophysical response to occlusal forces of osseointegration is different through the more rigid link of implant to bone and reduced proprioception. Risks attributable to occlusal forces primarily affect implant restorations and they are elevated in the presence of bruxism. The occlusal guidelines recommended by the literature are aimed at reducing these risks and regular assessment and maintenance of the occlusion is essential. A four-step sequence is presented to ensure that the annual occlusal checks include the patient's input and evaluation of restoration integrity, occlusal scheme, additional protection, and spatial changes.

Wellness checks: Piloting a universal intervention for soldiers.

As part of an Army pilot program, mandatory annual wellness checks were initiated to introduce individuals to counseling and to support psychological resilience and thriving. The program was evaluated using a cross-sectional survey completed by 7,831 soldiers. Findings revealed that about half of soldiers who reported a wellness check rated the check at least moderately helpful in their professional and personal lives. Participants receiving a wellness check reported being more likely to report willingness to seek help if they were to have mental health problems and to report higher levels of resilience and thriving even after controlling for rank, age, education, months in the unit, and trait negative affect. Participants were also less likely to report stigma-related concerns compared to those who had not received a wellness check. Consistent with theory on the common factors in counseling and the contextual model of psychotherapy (Laska et al., 2014), feeling listened to and learning new skills partially mediated the association between perceived wellness check usefulness and study outcomes, although acquiring a new perspective about problems did not. While not a randomized trial, this evaluation suggests that wellness checks are associated with programmatic goals: improved attitudes toward care seeking, resilience, and thriving. Future work should consider ways to ensure counselors address therapeutic common factors and should use a randomized, longitudinal design. Study findings have implications for implementing programs like wellness checks for military personnel and others working in high-stress occupations like first responders. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Factors Associated With Diabetes Self-Care Performance in Indonesians With Type 2 Diabetes: A Cross-Sectional Study.

In Indonesia, the number of Type 2 diabetes cases is increasing rapidly, making it the third leading cause of death and among the leading noncommunicable disease healthcare expenditures in the country. Thus, there is a critical need for Indonesians with Type 2 diabetes to perform better self-care to optimize their health and prevent the onset of comorbidities. This study was designed to investigate the influence of knowledge, depression, and perceived barriers on Type 2 diabetes self-care performance in Indonesia. A cross-sectional study was conducted on 185 patients with Type 2 diabetes, with demographic, diabetes history, obesity status, diabetes knowledge, depression, perceived barriers, and self-care performance data collected. The Indonesian version of the Revised Diabetes Knowledge Test, Depression Anxiety Stress Scale, Perceived Barrier Questionnaire and Self-Care Inventory-Revised were used. Descriptive, bivariate, and multiple linear regression analyses were performed. Study participants were found to have moderate diabetes self-care performance scores. Annual eye checks, blood glucose self-monitoring, healthy diet selection, and regular exercise were the least common self-management techniques performed and were consistent with the perceived difficulties of the participants. Being illiterate or having an elementary school education (β = 4.59, p = .002), having a junior or senior high school education (β = 3.01, p = .006), having moderate depression (β = -0.92, p = .04), diabetes knowledge (β = 0.09, p = .006), and perceived barriers (β = 0.31, p < .001) were found to explain 40% of the variance in self-care performance. Educational level, depression, and perceived barriers were the strongest factors that impacted Type 2 diabetes self-care performance in this study. Nurses should not only provide diabetes education but also identify barriers to diabetes self-care early, screen for the signs and symptoms of depression, and target patients with lower levels of education.

Predictors of Identity Crime Victimization of Adolescent Youth in Foster Care

ABSTRACT Identity crimes pose serious risks and challenges for youth in foster care. As young people move through various out-of-home placements and schools, their personal data are often widely disseminated, difficult to secure, and thus vulnerable to theft and misuse. When they transition from foster care to adulthood, identity crime victims with compromised credit histories may be denied loans, employment, and/or housing during the already-precarious period of emerging adulthood. Even though federal law requires state child welfare agencies to conduct annual credit checks for adolescent youth in foster care, little is known about the factors contributing to risk of identity crime victimization among foster care-involved youth, either before or after their initial entry into care. To address this knowledge gap, we analyze linked child welfare and consumer credit records for a population cohort of 4,670 youth (age 14 to 17) in foster care in a southeastern state who received credit checks from November 2015 through December 2021. Using gradient boosted machine learning, we find that prior identity crime victimization before the youth first entered care is the strongest predictor of victimization while in foster care. Implications of these findings for policy and practice are discussed.

The clinical efficacy and safety of outside-in transobturator sling with additional paraurethral fixation – The prospective longitudinal study

Stress urinary incontinence (SUI) is a common condition that affect 30–40% of women in their lifetime. Midurethral slings (MUS) either suprapubic or transobturator can be safely used in the surgical treatment of SUI. The aim of this study was to collect clinical long-term data regarding safety and performance of transobturator sling with an additional tape fixation in women with urinary incontinence. This prospective longitudinal study was conducted on a group of 2086 female patients diagnosed with stress urinary incontinence. Follow up visits where scheduled 6 weeks, 6 and 12 months after surgery followed by annual checking when possible. Patients underwent transobturator sling procedure from 01.01.2011 to 31.12.2021. All patients had a monofilament tape inserted at the mid-urethra using outside-in technique (TOT) with 2 absorbable sutures parallel to the urethra. Success of surgery was defined as lack of any leakage during cough stress test whereas the subjective cure rate was determined by Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-SF). 87% of patients who were operated at least 10 years before assessment reported ICIQ –SF < 6. Main postoperative complications were storage symptoms – de novo urgency and voiding difficulties. TOT is safe and highly effective surgical treatment for (SUI) in a long-term observation.

The evaluation of an on-site monitoring program for activity meter quality assurance with exemption-level sources

This paper discusses the feasibility of a monitoring program for the quality assurance status of activity meters. We sent a questionnaire to clinical nuclear medicine departments of medical institutions, requesting information on their activity meters and quality assurance practices. On-site visits were conducted with exemption-level standard sources (Co-57, Cs-137 and Ba-133) for dose calibrators in nuclear medicine departments including physical inspection, accuracy and reproducibility. A method offering a quick check on the detection efficiency of the space dimension inside the activity meters was also introduced. For dose calibrator quality assurance, the daily checks had the highest implementation. However, annual checks and upon acceptance/after a repair check were reduced to 50% and 44%, respectively. The accuracy results of dose calibrators showed that all models exceeded the ±10% criteria with Co-57 and Cs-137 sources. The reproducibility results showed that some models exceeded the ±5% criteria with Co-57 and Cs-137 sources. The appropriate application of exemption-level standard sources considering the uncertainty that affects the measurement is discussed.

Diabetes in the cost‐of‐living crisis

Diabetes in the cost‐of‐living crisis

Recommendations From a Chinese-Language Survey of Knowledge and Prevention of Skin Cancer Among Chinese Populations Internationally: Cross-sectional Questionnaire Study.

There is a paucity of studies assessing awareness and prevention of skin cancer among Chinese populations. The aim of the study is to compare attitudes and practices regarding skin cancer risks and prevention between Chinese Asian and North American Chinese populations and between Fitzpatrick scores. A cross-sectional, internet-based, 74-question survey in Chinese was conducted focusing on Han Chinese participants internationally. The survey included Likert-type scales and multiple-choice questions. All participants were required to read Chinese and self-identify as being 18 years or older and Chinese by ethnicity, nationality, or descent. Participants were recruited on the internet over a 6-month period from July 2017 through January 2018 via advertisements in Chinese on popular social media platforms: WeChat, QQ, Weibo, Facebook, and Twitter. Of the 113 completed responses collected (participation rate of 65.7%), 95 (84.1%) were ethnically Han Chinese, of which 93 (96.9%) were born in China and 59 (62.1%) were female. The mean age of these 95 participants was 35.8 (SD 13.3) years; 72 (75.8%) participants were born after 1975. Few but more North American Chinese reported that Chinese Asian populations received annual skin checks (4/30, 4.2% vs 0/65, 0%; P=.009) and believed that their clinician provided adequate sun safety education (13/30, 43.3% vs 15/65, 23.1%; P=.04). Participants with higher Fitzpatrick scores less frequently received sun safety education from a clinician (4/34, 11.8% vs 22/61, 36.1%; P=.02). More participants with lower Fitzpatrick scores used sunscreen (41/61, 67.2% vs 16/34, 47.1%; P=.05), but alternative sun protection use rates are similar across groups. Cultural differences and Fitzpatrick scores can affect knowledge and practices with respect to sun protection and skin cancer among social media-using Chinese Asian and North American Chinese communities based on respondent demographics. Most participants in all groups understood that people of color have some risk of skin cancer, but >30% of all groups across regions and Fitzpatrick scores are unaware of current skin protection recommendations, receive insufficient sun safety education, and do not use sunscreen. Outreach efforts may begin broadly with concerted public and private efforts to train and fund dermatologists to perform annual total body skin exams and provide more patient education. They should spark community interest through mass media and empower Chinese people to perform self-examinations and recognize risks and risk mitigation methods.

Askeri Personelde Kardiyovasküler Risk Faktörlerinin Değerlendirilmesi: Türkiye’de Yapılan Bir Araştırma

Background: Cardiovascular (CV) risk factors are associated with high morbidity and mortality rates; however, prevalence data for Turkish military members are unknown. Aim: This study determines how common cardiovascular risk factors are among military members in the Corps Command Military Unit and how they relate to socio-demographic parameters. Materials and Methods: A cross-sectional research was conducted with 25222 active-duty individuals. A questionnaire was used to assess cardiovascular risk factors. This study included patients with more than two risk factors or current cardiac complaints. ECGs, echocardiograms, and biochemical testing were performed. Results: The study employed 835 individuals with an average age of 19.43±2.12 years. 19.6% of them had hypertension, 5.6% had dyslipidemia, 39.6% were smokers, 2.4% had diabetes mellitus, and 9.8% had a positive family history. Physical activity frequency was not observed in 54% of the patients before enlisting in the military. There was a significant positive correlation between smoking and mental stress (r=1.07, p&amp;lt;0.001). Conclusion: In terms of cardiovascular risk, hypertension and smoking were found to be the most prevalent among the Corps command staff. Therefore, this study provides compelling evidence that military healthcare providers should conduct annual periodic checks on those at risk for cardiovascular diseases.

Diagnostik von Nierenerkrankungen bei Europäischen Landschildkröten (Testudo spp.)

The diagnosis of kidney diseases in tortoises is only possible to a very limited extent on the basis of the general examination due to the development of unspecific disease symptoms. Extensive additional examinations are required to confirm the diagnosis. In addition to blood and urine tests, imaging techniques such as X-ray, computed tomography and MRI are suitable for visualizing the skeletal and organ systems, while additional samples can be taken during an endoscopic examination. There are clear species-specific differences with regard to the reference values of the laboratory parameters, which are in part significantly influenced by environmental influences, the seasons or even gender. It can also be seen that kidney diseases in tortoises kept in captivity are usually very advanced at the time of diagnosis, since these animals, like reptiles in general, show a pronounced lack of symptoms. Annual checks by a veterinarian specialized in reptiles can help to detect diseases at an early stage.

Stay-at-home myopia among school children during the COVID-19 pandemic

Background: Uncorrected myopia represents a major cause of visual disability in children, especially in low-income and middle-income countries. However, there is still debate about the effect of e-learning and “stay-at-home” guidelines on the refractive status of school children, especially in the absence of long-term follow-up data. This study aimed to assess the impact of stay-at-home enforcement during the COVID-19 pandemic on myopia development or progression in students in the Suez Canal Area, Egypt.&#x0D; Methods: This longitudinal observational study included 1650 students. All students aged 8–15 years with visual complaints, who had attended routine annual vision checks since 2018, were enrolled and assessed annually for myopia development and progression until 2021. Cycloplegic and noncycloplegic refraction, axial length (AL), corneal curvature, and uncorrected and best-corrected distance visual acuity were measured. The participants were administered a questionnaire that focused mainly on collecting information on their visual habits.&#x0D; Results: Our study included 3,300 eyes of 1,650 school students with myopia during the 4-year study period from 2018 to 2021. The mean cycloplegic spherical equivalents (CSE) were - 1.02, - 1.52, - 2.00, and - 3.50 diopters (D) in 2018, 2019, 2020, and 2021, respectively. This myopic shift in CSE over time was significant (P &lt; 0.001). The average keratometric reading (Avg K) increased significantly during the follow-up period (P &lt; 0.001). The Avg K measurements were 42.32, 42.62, 43.02, and 44.19 D in 2018, 2019, 2020, and 2021, respectively. The changes in Avg K were significant (P &lt; 0.001). The mean AL measurements were 22.53, 22.59, 22.69, and 22.71 mm in 2018, 2019, 2020, and 2021, respectively. Although statistically significant (P &lt; 0.001), changes in AL were clinically insignificant throughout the study period. The mean durations spent on electronic devices at home were 2.12, 2.46, 3.10, and 6.00 hours in 2018, 2019, 2020, and 2021, respectively. The changes over time were significant (P &lt; 0.001).&#x0D; Conclusions: During the COVID-19 pandemic, studying at home accelerated the degree of refraction toward myopia in school children in Egypt. Further studies are needed to assess the academic performance of students with progressive myopia.

Resuscitation Quality Improvement (RQI®).

Cardiopulmonary resuscitation (CPR) is a fundamental skill for all health care providers. Annual skills reviews and certification checks are the time-honored tradition for tracking and evaluating such skills. The assumption that CPR retraining in its traditional form is a sufficient measure of basic competence has been challenged by recent studies, and technical evaluations of the efficacy of CPR competence of certified nurses have surfaced significant gaps. Nursing schools and employers can bridge those gaps with Resuscitation Quality Improvement (RQI®). [J Contin Educ Nurs. 2022;53(9):393-394.].

362 Recommendations from cross-sectional, Chinese-language survey of knowledge and prevention of skin cancer among chinese populations internationally

Although there is evidence that skin cancer rates are increasing among Chinese populations, sociobehavioral understanding of perceptions and behaviors among the demographic globally relating to skin cancer risks and protection are poorly understood. We report the current knowledge and beliefs of Chinese populations in North America and Asia regarding skin cancer and propose recommendations for closing the gap. Participants recruited via social media answered a 74-question, internet-based survey in Chinese. Comparisons with chi-squared and Fisher’s exact tests were made between responses by Chinese participants in Asia versus in North America and by those with modified Fitzpatrick scores ≤ 14 versus ≥ 15. Of the 113 completed responses (participation rate of 65.7%), 84.1% were Han Chinese, 96.9% were born in China, and 71.4% resided in China. Few but more North American Chinese than Chinese Asians received annual skin checks (4.2% vs 0%, p=0.0086) and believe that their clinician provided adequate sun safety education (43.3% vs 23.1%, p=0.0441). Participants with higher Fitzpatrick scores less frequently received sun safety education from a clinician (11.8% vs 36.1%, p=0.0154). More participants with lower Fitzpatrick scores use sunscreen (67.2% vs 47.1%, p=0.0546), but alternative sun protection usage rates are similar across groups. In conclusion, cultural differences and Fitzpatrick scores can affect knowledge and practices with respect to sun protection and skin cancer among Asian and North American Chinese communities. Through a collective and adaptive effort across all levels of healthcare, knowledge and practices with respect to sun protection and skin cancer can be improved to reduce morbidity and mortality among Chinese populations globally.

Annual Credit Checks for Adolescent Youth in Foster Care: Factors Associated with Identity Fraud Victimization.

Child identity fraud, or the criminal exploitation of a child's personal data, poses serious risks and challenges for youth in foster care. Despite the 10-year history of a federal mandate requiring state child welfare agencies to conduct annual credit checks for adolescent foster youth (42 U.S.C. § 675), identity fraud has received scant attention in child welfare research. Analyzing a state-level administrative dataset with linked child welfare and consumer credit records, we employed hierarchical binary logistic regression modeling to analyze demographic and foster care placement factors associated with identity fraud victimization among a statewide population cohort of 1176 youth (age 14-17) in foster care in a mid-Atlantic state. In the model of best fit, covariates significantly associated with differing odds of identity fraud victimization included African American race (OR = 2.67, p < .001); two or more races (OR = 2.95, p = .003); and older age at credit check (OR = 3.49, p < .001). Youth with history of prior home removals (OR = 1.59, p = .059) were marginally more likely than youth with no prior home removals to experience identity fraud, controlling for all other variables.

Mental health programming for law enforcement: a first look at trends and perceptions of effectiveness

ABSTRACT Traumatic events, irregular shifts, and other job-related stressors impact the mental health of law enforcement officers. However, little information exists regarding the availability and perceptions of the effectiveness of mental wellness programming and resources in police departments and sheriff’s offices across the United States. Using a paper and pencil survey with a stratified random sample, we explored the types of mental wellness programming available throughout agencies in the United States and the perceived effectiveness of such programs. Most respondents provided information on mental wellness resources, employee assistance programs, and external event response. Resiliency building/training and annual mental wellness checks were the least common program/resource currently provided. Peer counseling/support was slightly more common in police departments, while external event response, chaplain support, and mentoring programs were more common in sheriff’s offices. Respondents generally perceived chaplain support, psychological services, external event response, and resiliency building/training to be effective forms of mental wellness programming, while annual mental wellness checks, mental wellness resources, and mentoring programs were deemed less effective. Limitations and directions for future research are provided.

Cousin Marvin's Secret

Cousin Marvin's Secret

Progressive lateralization and constant hip geometry in children with DDH, NDH, and LCPD following hip reconstructive surgery: a cohort study of 73 patients with a mean follow-up of 4.9 years

BackgroundPelvic and femoral osteotomies have been effective methods to treat developmental dysplasia of the hip (DDH), neurogenic dislocation of the hip (NDH), and Legg–Calvé–Perthes disease (LCPD). The aim of this study was to evaluate the mid-term results after hip reconstruction in children with DDH, NDH, and LCPD.MethodsIn a retrospective study, X-rays of 73 children (2–19 years) with DDH, NDH, and LCPD were measured before, 3 months, and at final follow-up (FU) after hip reconstructive surgery (open reduction, and femoral and/or pelvic osteotomy ± soft-tissue procedures between 2008 and 2018). Measurement of hip geometry included acetabular index (AI), center-edge angle (CE), and Reimers migration index (RMI). Mean follow-up time at final FU was 4.9 years. P value was set P < 0.05.ResultsAfter surgery (femoral osteotomy: 84 hips, Salter innominate osteotomy: 21 hips, Pemberton osteotomy: 30 hips, open reduction: 28 hips, Chiari osteotomy: 4 hips, and soft-tissue release: 24 hips), hip geometry parameters improved significantly. Nevertheless, at final FU, there was deterioration in hip geometry with femoral head lateralization (RMI) compared to the data at 3 months after surgery (RMI: preop/3 months/final FU: 40.6 ± 16.1%/6.1 ± 9.0/15.4 ± 16.0%; CE: 11.3° ± 20.0°/30.2° ± 9.5°/27.9 ± 15.4°; AI: 28.8° ± 9.6°/19.1° ± 7.6°/18.3 ± 7.6°). Sub-group analysis did not show differences concerning the progression of RMI in DDH, NDH, and LCPD at final FU. Regardless of basic disease, the lateralization was observed in all three groups (DDH, NDH, and LCPD) and statistically significant comparing X-rays 3 months postoperatively to maximum follow-up (DDH; NDH; LCPD: 2.7 ± 6.8%/7.6 ± 10.1%; 13.7 ± 15.3%/22.8 ± 19.8%; 1.7 ± 4.1%/14.9 ± 11.3%). Additional soft-tissue release techniques in patients with DDH or NDH did not show postoperative differences with statistical significance. Concerning surgical techniques, a connection between the lower RMI and the procedure of osteotomy of the ilium was found. In 25 patients, (34%) complications were observed: superficial skin lesions in 8, deep skin lesions in 3, contraction of adductors in 3, subluxation in 2, dislocations of the cast in 2, osteonecrosis of the femoral head in 2 cases, reluxation in 1, infection of the implanted plate in 1, compliance problem in 1, delayed bone healing in 1, and contraction of knee flexors in 1 case.DiscussionThe basic results of this study show a significant improvement of hip geometry at a follow-up of 4.9 years and prove findings of previously published literature. Moreover, the study was able to show a progression of RMI in all patient groups, which have undergone reconstructive surgery, despite basic hip geometry data (AI, CE angle) did not change. Those findings were independent from underlying pathology. Complications were counted in 34% of the patients and involved all known adverse events after hip reconstructive surgery. This makes clear why annual follow-up checks are needed not to miss the right indication for revision surgery.Clinical relevanceEvidence level: Level IV, case series.Trial registration: This manuscript is part of a prospective randomized clinical trial, registered in the German Clinical Trials Register DRKS-ID: DRKS00016861.

Determinants of Diabetes Disease Management, 2011–2019

This study estimated the effects of Medicaid Expansion, demographics, socioeconomic status (SES), and health status on disease management of diabetes over time. The hypothesis was that the introduction of the ACA and particularly Medicaid Expansion would increase the following dependent variables (all proportions): (1) provider checks of HbA1c, (2) provider checks of feet, (3) provider checks of eyes, (4) patient education, (5) annual physician checks for diabetes, (6) patient self-checks of blood sugar. Data were available from the Behavioral Risk Factor Surveillance System for 2011 to 2019. We filtered the data to include only patients with diagnosed non-gestational diabetes of age 45 or older (n = 510,991 cases prior to weighting). Linear splines modeled Medicaid Expansion based on state of residence as well as implementation status. Descriptive time series plots showed no major changes in proportions of the dependent variables over time. Quasibinomial analysis showed that implementation of Medicaid Expansion had a statistically negative effect on patient self-checks of blood sugar (odds ratio = 0.971, p < 0.001), a statistically positive effect on physician checks of HbA1c (odds ratio = 1.048, p < 0.001), a statistically positive effect on feet checks (odds ratio = 1.021, p < 0.001), and no other significant effects. Evidence of demographic, SES, and health status disparities existed for most of the dependent variables. This finding was especially significant for HbA1c checks by providers. Barriers to achieving better diabetic care remain and require innovative policy interventions.

Changes of base-year and Indian GDP growth: an agnostic look

Purpose World over, change of base year in the gross domestic product (GDP) is a standard practice of GDP estimation. However, unless a consistent series of GDP is released with respect to the new base for the earlier period, the existence of multiple growth rates creates problems for applied researchers, policymakers and the general public alike. Faced with such a menu of GDP series researchers often try to interpolate a consistent series of GDP. The main purpose of this paper is to analyses the nature of the data generating process of such multiple interpolated series of quarterly growth rates and tries to discern the consistency of such processes. Design/methodology/approach The present paper tries to look into the statistical implications and complications of such interpolated quarterly GDP/growth series in India in terms of three series of GDP, namely, with 1999–2000, 2004–2005 and 2011–2012 as its bases. Findings The analysis reveals that as a result of a change of base year, the nature of the data generating process of the old and new GDP series could undergo changes and experience different breakpoints. While all these conclusions seem to be valid for GDP growth at quarterly intervals, taking the data at annual frequency is less problematic. Practical implications The observation suggests that in most applied work, researchers may not have the luxury of only working with annual data and certain consistency checks will be necessary to check the veracity of the results based on quarterly data with those based on annual data. Second, moving forward it may be useful for the Authorities to make a transition to a chain-based linking method rather than fixed time-period-based bases as is currently done. Originality/value The analysis of Indian GDP in this paper is, perhaps, indicative of the fact that usage of quarterly GDP data is to be handled with caution and it is preferable that any serious empirical analysis uses annual GDP data whenever it is available/feasible. The comparison of GDP growth rates at different frequencies and examining the true nature of the process are quite unique in their contribution towards empirical macroeconomic research.

Physical health monitoring in antipsychotic depot clinic

AimsA service evaluation project to look at if annual bloods, ECG, physical examination, and medical review was completed within the last year for patients attending anti-psychotic depot clinic at Bassetlaw mental health services in Nottinghamshire HealthCare NHS Foundation Trust.MethodElectronic notes were examined in October 2020 for 25 patients who attend anti-psychotic depot clinic to ascertain if medical review and physical examination had been completed along with annual bloods and ECG.ResultOut of 25 patients attending depot clinic in 2020 at Bassetlaw Hospital, 21 had all their blood tests done, 1 patient had refused bloods and 2 patients did not have blood tests done. ECG was completed for 3 patients at Bassetlaw hospital and 8 patients had it requested from primary care with 2 patients refusing to have ECG done. For 12 patients there was no evidence of ECG being requested or completed. 8 patients had physical examination completed and rest 17 patients did not have the physical examination completed including due to refusal. Out of 25, only 14 patients had a medical review conducted.ConclusionPatients who attend depot clinic may have an allocated community psychiatric nurse (CPN) or get reviewed by medics in outpatient clinics and would usually have their blood tests, physical health examination and ECGs requested and monitored by them. Patients who do not have any allocated CPN or medic tend to miss out on blood tests and ECG. General Practitioners are expected to complete physical health checks for patients who do not have CPN or regular outpatient review. The results of these investigations may not always be received in depot clinic, hence there is no documentation on electronic RIO system. When these patients disengage from the depot clinic, it is often very difficult to track them. As a follow-up from this service evaluation, all depot clinic patients will be allocated a key worker/CPN. This will ensure that they have a responsible person to facilitate annual checks. This will be reviewed in a years' time to evaluate the effectiveness of this intervention.