Health Care Issues Research Articles

Comprehensive Risk Assessment of Infection Induced by SARS-CoV-2.

The pandemic COVID-19 (coronavirus disease 2019) is caused by the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), which devastated the global economy and healthcare system. The infection caused an unforeseen rise in COVID-19 patients and increased the mortality rate globally. This study gives an overall idea about host-pathogen interaction, immune responses to COVID-19, recovery status of infection, targeted organs and complications associated, and comparison of post-infection immunity in convalescent subjects and non-infected individuals. The emergence of the variants and episodes of COVID-19 infections made the situation worsen. The timely introduction of vaccines and precautionary measures helped control the infection's severity. Later, the population that recovered from COVID-19 grew significantly. However, understanding the impact of healthcare issues resulting after infection is paramount for improving an individual's health status. It is now recognised that COVID-19 infection affects multiple organs and exhibits a broad range of clinical manifestations. So, post COVID-19 infection creates a high risk in individuals with already prevailing health complications. The identification of post-COVID-19-related health issues and their appropriate management is of greater importance to improving patient's quality of life. The persistence, sequelae and other medical complications that normally last from weeks to months after the recovery of the initial infection are involved with COVID-19. A multi-disciplinary approach is necessary for the development of preventive measures, techniques for rehabilitation and strategies for clinical management when it comes to long-term care.

Development of a «people-centred approach» to realising healthcare by facilitating, patient participation in health attainment in South Africa and Ukraine

Object of this research is South Africa's healthcare system. South Africa's healthcare system faces numerous challenges that contribute to inadequate access to quality healthcare for its citizens. These challenges include a scarcity of healthcare workers, insufficient funding and resource allocation, a high burden of communicable and non-communicable diseases, as well as disparities in healthcare access and outcomes driven by socioeconomic status and geographic location. Consequently, many South Africans endure unfavourable health outcomes, limited availability of essential health services, and a prevailing sense of mistrust towards the healthcare system. Concurrently, Ukraine has encountered its own set of healthcare obstacles, including similar shortages of healthcare professionals, funding deficiencies, and disparities in healthcare access exacerbated by armed conflict. This study provides insights into the patient experience, utilizing Kolb's experiential learning theory. It employs qualitative and quantitative methods, including a questionnaire administered to conveniently sampled participants at Chris Hani Baragwanath hospital's HIV/AIDS unit. Data analysis using Excel and SPSS reveals a communication gap between healthcare workers and patients, highlighting the need for Department of Health training on communication and diversity. Finally, the implementation of consistent patient feedback mechanisms is essential for healthcare institutions to comprehend evolving patient needs, fostering the adoption of a «people-centred» approach to delivering high-quality healthcare services. By incorporating insights from Ukraine's challenges, this study not only addresses the specific healthcare obstacles faced by South Africa but also provides a broader perspective on healthcare issues across diverse contexts. These insights enable policymakers and healthcare professionals to identify potential solutions and work towards improving healthcare access and outcomes for all citizens, ensuring the overall health and well-being of the population of South Africa and other countries with similar challenges.

The Prevalence of Cognitive Impairment and Dementia in Incarcerated Older Adults.

In view of the growing number of older incarcerated persons in the United States, cognitive impairment represents one of the most challenging and costly health care issues facing the U.S. correctional system. This study examined the prevalence and correlates of this growing public health issue in the nation's largest prison system. In this study of a random sample of 143 older (≥55 years) adults incarcerated in the Texas prison system, we assessed-using the Montreal Cognitive Assessment (MoCA)-the percentage of inmates who met the MoCA thresholds for mild cognitive impairment (MCI; <23) and dementia (<18). Due to sample size limitations, our multivariable analysis assessed the binary outcome, MoCA <23. Overall, 35.0% of our random sample of incarcerated older adults in Texas met the threshold for MCI and 9.1% met the threshold for dementia. After adjusting for covariates, study participants who were Black (odds ratio [OR] = 4.12, 95% confidence interval [CI] = 1.57-10.82), Hispanic (OR = 4.34, 95% CI = 1.46-12.93), and those with a diagnosis of major depressive disorder (8.56, 95% CI = 1.21-60.72) all had higher prevalence of a positive screen for MCI or dementia. Dementia was underdiagnosed in our study sample of incarcerated adults, with 15.4% of MoCA-diagnosed dementia patients having a dementia diagnosis documented in their medical records. Future studies of cognitive impairment in prisons and jails can inform health care planning and resource allocation, such as expansion of access to palliative care, advance care planning, and targeted cognitive screening in older age groups.

Recent advances in biosensors for real time monitoring of pH, temperature, and oxygen in chronic wounds.

Chronic wounds are among the major healthcare issues affecting millions of people worldwide with high rates of morbidity, losses of limbs and mortality. Microbial infection in wounds is a severe problem that can impede healing of chronic wounds. Accurate, timely and early detection of infections, and real time monitoring of various wound healing biomarkers related to infection can be significantly helpful in the treatment and care of chronic wounds. However, clinical methodologies of periodic assessment and care of wounds require physical visit to wound care clinics or hospitals and time-consuming frequent replacement of wound dressing patches, which also often adversely affect the healing process. Besides, frequent replacements of wound dressings are highly expensive, causing a huge amount of burden on the national health care systems. Smart bandages have emerged to provide in situ physiochemical surveillance in real time at the wound site. These bandages integrate smart sensors to detect the condition of wound infection based on various parameters, such as pH, temperature and oxygen level in the wound which reduces the frequency of changing the wound dressings and its associated complications. These devices can continually monitor the healing process, paving the way for tailored therapy and improved quality of patient's life. In this review, we present an overview of recent advances in biosensors for real time monitoring of pH, temperature, and oxygen in chronic wounds in order to assess infection status. We have elaborated the recent progress in quantitative monitoring of several biomarkers important for assessing wounds infection status and its detection using smart biosensors. The review shows that real-time monitoring of wound status by quantifying specific biomarkers, such as pH, temperature and tissue oxygenation to significantly aid the treatment and care of chronic infected wounds.

Complement Anaphylatoxins C3a And C5a in Diabetic and Non-Diabetic Iraqi COVID-19 patients

CoV-2 infection has become a global issue in healthcare since December 2019. According to our findings, diabetes raises the likelihood and severity of COVID-19 disease in 2019. High blood sugar was found to reduce immunity and worsen COVID-19 while it is linked to several other risk factors. With COVID-19, the study will assess the levels of C3a and C5a in diabetes and non-diabetic patients. This study included 120 covid-19 patients (60 diabetic and 60 non-diabetic). Serum levels were measured in patients and the results showed that the mean levels of C3a and C5a were higher in non-diabetic Covid-19 patients (451.82±108.94 and 215.70±48.37pg/ml respectively) compared with those with diabetes (357.88±41.22 and 188.86±33.98pg/ml respectively) with a significant difference between the two groups (p &lt; 0.001).

Strategic decisions in healthcare: Impact on goals and enhancing service quality for organizational success

This study underscores the crucial imperatives of governments aiming to establish effective social protection systems: prioritizing human capital development, reinforcing social protection mechanisms, and improving the populace's standard of living. The primary objective is to conduct a comprehensive analysis of central healthcare issues and propose strategic solutions for the advancement of healthcare services. The methodology involves a detailed examination and segmentation of the healthcare sector, tailoring enhancements to specific segments. The article critically examines strategic management nuances within the healthcare sector, offering detailed segmentations and proposals for potential improvements. It extends its focus to advanced healthcare systems worldwide, providing valuable insights for assimilating foreign experiences. The study systematically explores the intricacies of strategic action planning and management in both public and corporate healthcare sectors, including transnational corporations. Findings underscore the imperative of continual development and improvement in healthcare service quality, emphasizing the necessity for judicious strategic decisions to sustain the healthcare market's functionality and vitality. This study is relevant for administrative institutions, organizations, governmental bodies, and corporate entities aiming to enhance decision-making processes and operational aspects while prioritizing healthcare quality.

Driving a key generation strategy with training-based optimization to provide safe and effective authentication using data sharing approach in IoT healthcare

Blockchain technology offers a solution to the interoperability issues that currently plague health information systems (BT). Additionally, blockchain technology provides the cutting-edge standard that ensures the safe exchange of computerized health data among healthcare providers, institutions, people, and medical specialists. Recently, both businesses and academics recognized the Internet of Things (IoT) as one of the top study fields. Nevertheless, a significant issue in IoT healthcare across several product domains is the secrecy of patient health data transmission. For secure and effective authentication with data sharing strategy in IoT healthcare, a method called Driving Training Based Optimization (DTBO) Key generation is presented to address these issues. The entities involved in the proposed DTBO_Key generation technique are the user, owner, authenticating minor, blockchain, and IoT server. The suggested technique consists of seven stages: initialization, registration phase, key creation, login phase, data protection, authentication process, and verification phase. A minimum memory consumption of 2.983 MB, a computation cost of 28.008%, and an accuracy of 0.9 were attained using the proposed method.

Topical application of a TRPA1 antagonist reduced nociception and inflammation in a model of traumatic muscle injury in rats.

Musculoskeletal pain is a widely experienced public healthcare issue, especially after traumatic muscle injury. Besides, it is a common cause of disability, but this pain remains poorly managed. However, the pathophysiology of traumatic muscle injury-associated pain and inflammation has not been fully elucidated. In this regard, the transient receptor potential ankyrin 1 (TRPA1) has been studied in inflammatory and painful conditions. Thus, this study aimed to evaluate the antinociceptive and anti-inflammatory effect of the topical application of a TRPA1 antagonist in a model of traumatic muscle injury in rats. The mechanical trauma model was developed by a single blunt trauma impact on the right gastrocnemius muscle of Wistar male rats (250-350g). The animals were divided into four groups (Sham/Vehicle; Sham/HC-030031 0.05%; Injury/Vehicle, and Injury/HC-030031 0.05%) and topically treated with a Lanette® N cream base containing a TRPA1 antagonist (HC-030031, 0.05%; 200mg/muscle) or vehicle (Lanette® N cream base; 200mg/muscle), which was applied at 2, 6, 12, 24, and 46h after muscle injury. Furthermore, we evaluated the contribution of the TRPA1 channel on nociceptive, inflammatory, and oxidative parameters. The topical application of TRPA1 antagonist reduced biomarkers of muscle injury (lactate/glucose ratio), spontaneous nociception (rat grimace scale), inflammatory (inflammatory cell infiltration, cytokine levels, myeloperoxidase, and N-acetyl-β-D-glucosaminidase activities) and oxidative (nitrite levels and dichlorofluorescein fluorescence) parameters, and mRNA Trpa1 levels in the muscle tissue. Thus, these results demonstrate that TRPA1 may be a promising anti-inflammatory and antinociceptive target in treating muscle pain after traumatic muscle injury.

A sensitive non-enzymatic dual-conductive biosensor for continuous glucose monitoring

BackgroundDiabetes and diabetic wound management have always been urgent issues for global healthcare. In the demand for blood glucose monitoring and wound management, phenylboronic acid (PBA)-based glucose biosensors are effective assistance due to their excellent glucose specificity, high sensitivity, and response stability. Nevertheless, PBA-based glucose biosensors still have challenges in terms of wide linearity and large deformation requirements. Therefore, it is necessary to develop PBA-based glucose biosensors with satisfactory mechanical properties, high response sensitivity, excellent stability, and wide linearity. ResultsIn this work, a glucose-responsive PBA-based biosensor was successfully synthesized for the first time. The sensor materials exhibited excellent mechanical properties with an elongation at break reached up to 1000%, and the healing efficiency was over 90% within 30 min at 45 °C. Furthermore, the biosensor exhibited exceptional electromechanical responsiveness, stability, high sensitivity, and wide linearity due to the specificity of phenylboronic acid to glucose and the construction of a special HCNT/PEDOT:PSS dual conductive structure. In addition, the assembled biosensor displayed remarkable glucose, pH and temperature responses, exhibiting a linear response to glucose concentration range from 0.20 mM to 2.0 mM, with a sensitivity coefficient of 47.11 mA mM−1 and regression coefficient of 0.942. Moreover, the sensor materials showed satisfactory cytocompatibility, hemocompatibility, and antibacterial properties against Escherichia coli and Staphylococcus aureus. SignificanceFor the first time, a dual conductive structural glucose biosensor based on PBA-based copolymer was synthesized. In addition to excellent glucose sensitivity and response stability, the biosensor has a wide linearity range, excellent self-healing property, and satisfactory mechanical performance. As a promising substitute for non-enzymatic glucose biosensors, this new material with special structure and characteristics would also be beneficial to wound management in diabetic patients.

IMPACT OF SHORTAGE OF STAFF NURSES ON QUALITY CARE OF PATIENTS AT SPECIALISED HOSPITALS IN LAHORE

The nursing shortage has been recognized as a global healthcare issue that can negatively impact the quality of patient care. Adequate staffing of nurses is an essential factor that can ensure the provision of high-quality healthcare services to patients. A shortage of nurses may lead to poor patient outcomes, including medication errors, patient falls, and hospital-acquired infections. Therefore, addressing the nursing shortage is critical to improve patient care and health outcomes. This study investigates the impact of nursing shortage on patient care in healthcare settings. This study used a quantitative cross-sectional descriptive study design to assess the impact of nursing shortage on patient care. The study was conducted in multiple healthcare settings across different regions. A convenience sampling technique was used to select participants for the study. The patients in settings with nursing shortages used and filled out a questionnaire according to international guidelines. The results of the study showed that the majority of the participants reported a negative impact of nursing shortage on patient care. The shortage of nurses was associated with decreased patient satisfaction with nursing staff care. Furthermore, the study found that nursing shortages often led to nurses being overworked and exhausted, leading to medical errors and declining patient quality of care. The study concluded that the nursing shortage significantly negatively impacts patient care in healthcare settings. The shortage of nurses leads to decreased quality of care, increased length of hospital stay, patient mortality rates, and decreased patient satisfaction with care. Therefore, addressing the nursing shortage is crucial for improving patient outcomes and ensuring the provision of high-quality healthcare services.

Evaluation of a pre-professional pathway program: perspectives of former students in the rural pre-medicine program at Selkirk College.

Having a rural background is one of the most predictive factors in eventually having a rural practice, but people from rural areas face several barriers to post-secondary education. Pre-professional rural pathway initiatives are a potential solution. The Rural Pre-Medicine Program (RPM) at Selkirk College, British Columbia was developed to provide students with the credits necessary to apply to medicine and other health professional programs, an introduction to rural healthcare issues, and a unique and comprehensive support program to enable success. We administered a cross-sectional survey to former students who left the program from its inception in September 2014 to May 2020 to explore the extent to which program aims are being met. The response rate was 49.4% (40/81). Respondents agreed the program increased their skills, their understanding of rural healthcare issues, and enhanced their competitiveness for applying to health professional programs. Most agreed the program increased their future rural work intentions. Respondents suggested that academic programming be more flexible to allow for more varied post-program pathways. This survey provides preliminary evidence the RPM Program is on track to increase the number of people with a rural affinity who prepare to become health professionals.

Past Adversity Influencing Now (PAIN): perspectives on the impact of temporal language on the persistence of pain.

Persistent pain is a significant healthcare issue, often unresponsive to traditional treatments. We argue for incorporating non-biomedical perspectives in understanding pain, promoting more comprehensive solutions. This article explores how language, specifically time-related terms, may affect the persistence (stickiness) of pain. We delve into how language influences one's experience of the world, especially in understanding pain through spatial metaphors. Notably, time perceptions differ across languages and cultures and there is no absolute construct of temporal pain experience. In English, time is viewed linearly as past, present, and future. We introduce a framework called Past Adversity Influencing Now (PAIN) which includes various temporal phases of pain; Past Perfect, Past Imperfect, Present, Future Imperfect, and Future Perfect. We suggest that past negative memories (emotional memory images) can "trap" individuals in a "sticky" pain state. We speculate that the process of diagnosing pain as "chronic" may solidify this "stickiness", drawing from the ancient Greek idea of "logos", where pain communicates a message across time and space needing recognition. Our PAIN framework encourages examining pain through a temporal lens, guiding individuals towards a more positive future.

Burnout in Healthcare Staff due to COVID Pandemic in a Tertiary Care Dedicated COVID Hospital

Objectives To evaluate the socio-demographic profile and burnout among frontline doctors, paramedical, and other supporting staff in dedicated tertiary COVID hospitals. Materials and Methods The samples taken were divided into three groups as follows: Doctors, paramedical staff, and other supporting staff working in a tertiary hospital dedicated to handling the COVID-19 pandemic at SKIMS-MCH Bemina Hospital. Results In this study, a total of 185 participants took part out of which 388 individuals were employed across the medical departments of this hospital. This was an overall response rate of 47.6%. Most participants were in the age group of 31–50 years (48.6%). Males comprised 53.5%, married 66.4%, living with family 82.7%, and as per job description, most responses were from paramedical staff (53.51%). On analysis of the mean ± SD score of burnout across individual socio-demographic variables predominant burnout was seen in paramedical staff (45 ± 5.2) followed by those living with family (42 ± 3.7), married (43 ± 1.2), and those older than 50 years (40 ± 3.9). Conclusion Our study showed that the high prevalence of burnout was among healthcare professionals in the tertiary hospital who were exposed to working and catering large population with serious healthcare and emergency issues caring for patients during the new pandemic. Factors such as female gender, living with family, and older age of healthcare professionals were associated with significant burnout. These findings can help to improve the preparedness for the future.

Perspectives on artificial intelligence in healthcare from a Patient and Public Involvement Panel in Japan: an exploratory study.

Patients and members of the public are the end users of healthcare, but little is known about their views on the use of artificial intelligence (AI) in healthcare, particularly in the Japanese context. This paper reports on an exploratory two-part workshop conducted with members of a Patient and Public Involvement Panel in Japan, which was designed to identify their expectations and concerns about the use of AI in healthcare broadly. 55 expectations and 52 concerns were elicited from workshop participants, who were then asked to cluster and title these expectations and concerns. Thematic content analysis was used to identify 12 major themes from this data. Participants had notable expectations around improved hospital administration, improved quality of care and patient experience, and positive changes in roles and relationships, and reductions in costs and disparities. These were counterbalanced by concerns about problematic changes to healthcare and a potential loss of autonomy, as well as risks around accountability and data management, and the possible emergence of new disparities. The findings reflect participants' expectations for AI as a possible solution for long-standing issues in healthcare, though their overall balanced view of AI mirrors findings reported in other contexts. Thus, this paper offers initial, novel insights into perspectives on AI in healthcare from the Japanese context. Moreover, the findings are used to argue for the importance of involving patient and public stakeholders in deliberation on AI in healthcare.

Plight of migrant construction-site workers during the COVID-19 lockdown in 2020: A qualitative exploration in Bhavnagar, Western India.

During the unexpected lockdown implemented in early 2020 in reaction to the coronavirus 2019 (COVID-19) pandemic, a considerable section of India's population of migrant construction-site workers were stuck. Our objective was to explore the lived experiences and consequent perceptions of migrant workers related to the COVID-19 lockdown and the consequences on their lives. We conducted structured in-depth interviews (IDIs) with twelve migrant construction-site workers in Bhavnagar, Western India, from November to December 2020, using qualitative research methods. All IDIs were conducted with participant's consent, audio-recorded, transcribed in English, inductively coded, and thematically analyzed. The primary financial challenges mentioned by the migrant workers in the interviews were unemployment, monetary issues, and a difficult sustenance. The social concerns were described as anxious migrant exodus, discrimination, mistreatment, lack of social assistance, inability to fulfil their family's expectations, lack of safe transportation arrangements by the authorities during the exodus, inadequacies in the public distribution system, law and order, and apathy of their employers. The psychological repercussions were described using terms like "fear," "worry," "loneliness," "boredom," "helplessness," and "trapped." Monetary compensation, job opportunities at the native place, and a well-managed migrant exodus were reportedly their key expectations from the government. Healthcare issues mentioned during the lockdown included a lack of facilities to treat common ailments, substandard care, and repeated COVID-19 testing prior to departure. The study highlights the need to have rehabilitation mechanisms such as targeted cash transfers, ration kits, and safe transportation services for migrant workers through inter-sectoral coordination for mitigating hardship.

When Positive is Negative: Health Literacy Barriers to Patient Access to Clinical Laboratory Test Results.

Health literacy is a multidimensional set of skills (e.g., narrative, numeracy, digital, medication) that patients need to access and understand health information timely and accurately to make evidence-based informed decisions. Multiple barriers prevent patients from effectively interacting with health information. The most salient barriers are poor overall health literacy skills and linguistic proficiency in English. As patients prefer direct access to laboratory test results, especially those of routine tests, contextualization and provider-directed interpretation of results are required to foster shared decision-making to address their healthcare issues and improve health outcomes. The use of systematic approaches that account for poor health literacy skills and include culturally and linguistically appropriate planning and availability of resources is warranted at individual and population health levels (e.g., human-centered design of patient portals).

Application of systems modeling language (SysML) and discrete event simulation to address patient waiting time issues in healthcare

A robust health care system is crucial to reducing patient stress and contributing to economic growth. The future of the health care industry depends upon a reliable and efficient system to deal with the increasing number of patients. However, in today's healthcare system, patients face negative experiences as a result of long wait times. Now the pressing question is how to develop an effective healthcare system? To address this issue, this study uses systems engineering modeling language (SysML) coupled with a simulation approach to assess the performance of the healthcare system, identify the problem, and offer recommended alternatives. To elaborate, a formal modeling language, SysML will be used to visualize the complicated system architecture and interactions between its different components through a set of diagrams. A blood laboratory within an outpatient clinic located at southern US State is considered a testing bed. The detailed architecture of the system of interest is studied, and required data are collected for modeling and simulation. This article will provide a reference point for practitioners who would like to apply the SysML approach to address health sector-related issues.

An AI-Enabled Hybrid Lightweight Authentication Scheme for Intelligent IoMT Based Cyber-Physical Systems

In the era of smart healthcare, Internet of Medical Things (IoMT) based Cyber-Physical Systems (CPS) plays an important role, while accessing, monitoring, assessing, and prescribing patients ubiquitously. Efficient authentication and secure data transmission are the influential impediments of these networks to be addressed to maintain credence amidst clients, healthcare specialists, pharmacologists, and other associated entities. To address the authentication and data privacy issues in smart healthcare, in this paper, we proposed a hybrid lightweight authentication scheme leveraging supervised machine learning (SML) technique followed by Cryptographic Parameter Based Encryption and Decryption (CPBE&D) scheme to ensure the validation of legal patient wearable devices with secure transmission over the wireless communication channel. To achieve better results, we enabled the decentralized authentication of legitimate patient wearable devices to minimize computation cost, authentication time, and communication overhead with the help of SML technique to predicate and forward authentication attributes of patient wearable devices to the next concerned trusted authority, when it is shifted from region to another region. Simulation upshots of the SML and CPBE&D scheme exhibit extraordinary security features with cost-effective validation of legal patient wearable devices accompanied by worthwhile communication functionalities compared with the predecessor work.

Врачи уходят…куда? Зачем? И почему?

The shortage of healthcare personnel is a contemporary issue of national healthcare. At the same time, admission to medical colleges and universities is always highly competitive. However, having become a doctor, many specialists either seek private medical practice or retire from medicine. It is widely thought that low earnings of healthcare professionals are the reason for that. But this is not entirely true. The article summarizes the results of a sociological trial used to conclude about the hierarchy of reasons for the reduction in the number of physicians in state medicine of modern Russia. The trial was conducted in a typical region of the Russian Federation — the Volgograd region. An expert survey of the heads of state medical organizations was used. It turned out that ethical and legal insecurity of doctors promoted retiring from medicine and seeking private medical practice. It is the profession that healthcare professionals worry about the most; they have to shun medicine due to the decline of the value of the profession in the society and inattentiveness to healthcare professionals, which is most acutely felt by young physicians. Thus, care for medical personnel, especially young specialists, is the most pressing issue. That’s why mentors of medical beginners play a specific role as they do not only educate but also raise devotion to the profession. At the same time, mentors need state support as well. The article suggests which forms of support can be provided.

'Auspicious liaisons'-evaluating the impact of a liaison geriatrician initiative on older adults psychiatric wards.

Although liaison services in acute hospitals are now the norm, the reverse is not usually available for patients in mental health trusts. Following the introduction of support from geriatricians to older people's mental health inpatient wards, we wanted to see if this intervention was effective and acceptable to clinicians. We performed a retrospective cohort service evaluation on the impact of a liaison geriatrician, using routinely collected data, and assessed acceptability among medical staff by semi-structured interview. Our service introduced regular sessions from consultant community geriatricians across older adults psychiatric wards including a mixture of video conference and face-to-face input. There was no significant decrease in emergency transfers but there was a significant reduction in length of stay with an associated cost benefit for the service after the introduction of a liaison geriatrician. There was a significant increase in geriatrician consultations and a decrease in specialty consultations to other specialists. There was no change in discharge prescriptions or destination. There was a significant reduction in falls in the intervention arm but not in falls leading to emergency hospital admissions geriatricians gave confidence to psychiatrists of all grades to treat physical health care issues. A liaison geriatrician service may be a component in reducing length of stay (although there are many others) and improving continuity of care, although it confers no impact on emergency transfers. The intervention was highly acceptable to clinicians.