Mark Gabbay | University of Liverpool (original) (raw)

Papers by Mark Gabbay

Medicine Science and The Law, Apr 1, 2001

European Journal of General Practice, Apr 2, 2016

A fifth of patients in the study had, at least, one recurrent episode of sickness certification. ... more A fifth of patients in the study had, at least, one recurrent episode of sickness certification. Mental disorders accounted for the majority of days certified in recurrent episodes within the same diagnostic category. Design and evaluation of return-to-work interventions need to consider the sustainability of employment after return.

British Journal of General Practice, Apr 1, 2004

Background: Despite generally falling mortality and suicide rates, among young men the rates of v... more Background: Despite generally falling mortality and suicide rates, among young men the rates of violent death from accidents and suicide continue to rise. Most research has focused upon suicide, and the potential for effective interventions, particularly in primary care, remains controversial. Aims: To compare health service contacts prior to suicidal and accidental deaths among young men. Design of study: Examination of inquest data, postmortem and toxicology reports, and general practitioner (GP) and hospital records. Setting: All sudden, unexpected, violent or unnatural deaths involving young men aged between 15 and 39 years and reported to the four coroner's offices of Merseyside and Cheshire during 1995. Method: We compared data on the timing and nature of final GP contacts before death among young men with a verdict of accident or misadventure and suicide or undetermined death. Results: Out of a total of 268 violent deaths, 130 received verdicts of accident/misadventure and 97 received verdicts of suicide/undetermined death. Information on the final contact with a GP was available for 172 deaths. Although there was a significant difference between the proportion of suicide cases (56%) and that of cases of accidental death (41%) who had seen their GP during the 3 months before death, this was not significant at 1 month (38% versus 30%, respectively). Suicide cases were more likely to have seen a mental health professional at some time (27% for suicides versus 13% for accidental deaths). Conclusion: These findings confirm that relatively few young men consult their GP during the period before death from suicide or accidents. Prevention strategies must extend beyond suicide risk assessment, and consider ways to encourage young men to consult GPs when they are experiencing emotional distress or problems related to mental health or substance misuse.

Drugs-education Prevention and Policy, Jun 1, 2004

ABSTRACT

Journal of Public Health, Nov 25, 2013

Journal of Mental Health, Jul 7, 2017

Family Practice, Jun 24, 2016

Background. Little consideration has previously been given to the implications of a change in dia... more Background. Little consideration has previously been given to the implications of a change in diagnosis during a sickness certification episode. Objective. To report the extent and patterns of change in diagnosis and to identify factors associated with likelihood of change. Methods. Sixty-eight general practices in the UK recorded details of sickness certificates (fit notes) issued to patients in a 12-month data collection period. Diagnoses on fit notes were assigned to modified READ categories. Results. Over 23% (3841/16 400) of episodes consisting of more than one sickness certificate had a change in diagnosis during the course of the episode. Over 4% (438/10 398) of initial physical health episodes had a later mental health diagnosis. Lowest rate of change was found within episodes with an initial mental health diagnosis, the highest when an unspecified physical symptom was entered on the first fit note in the episode. A change in diagnosis was more likely when the total duration of the episode was longer, the episode included more fit notes and the patient was living in a socially deprived neighbourhood. Episodes where the patient had been issued fit notes by more than one GP were more likely to have a change in diagnosis. Conclusion. Change in diagnosis on fit notes is much less common when the patient has a psychological health problem.

Research Involvement and Engagement, Nov 4, 2022

Background: This paper considers remote working in patient public involvement and engagement (PPI... more Background: This paper considers remote working in patient public involvement and engagement (PPIE) in health and social care research. With the advent of the Covid-19 pandemic and associated lock-down measures in the UK (from March 2020), PPIE activities switched to using remote methods (e.g., online meetings), to undertake involvement. Our study sought to understand the barriers to and facilitators for remote working in PPIE by exploring public contributors' and PPIE professionals' (people employed by organisations to facilitate and organise PPIE), experiences of working remotely, using online and digital technologies. A particular focus of our project was to consider how the 'digital divide' might negatively impact on diversity and inclusion in PPIE in health and social care research. Methods: We used a mixed method approach: online surveys with public contributors involved in health and social care research, online surveys with public involvement professionals, and qualitative interviews with public contributors. We co-produced the study with public contributors from its inception, design, subsequent data analysis and writing outputs, to embed public involvement throughout the study. Results: We had 244 respondents to the public contributor survey and 65 for the public involvement professionals (PIPs) survey and conducted 22 qualitative interviews. Our results suggest public contributors adapted well to working remotely and they were very positive about the experience. For many, their PPIE activities increased in amount and variety, and they had learnt new skills. There were both benefits and drawbacks to working remotely. Due to ongoing Covid restrictions during the research project, we were unable to include people who did not have access to digital tools and our findings have to be interpreted in this light. Conclusion: Participants generally favoured a mixture of face-to-face and remote working. We suggest the following good practice recommendations for remote working in PPIE: the importance of a good moderator and/or chair to ensure everyone can participate fully; account for individual needs of public contributors when planning meetings; provide a small expenses payment alongside public contributor fees to cover phone/electricity or WiFi charges; and continue the individual support that was often offered to public contributors during the pandemic.

Primary Health Care Research & Development, Mar 10, 2016

Aim: To report the types and duration of sickness certification for different common mental disor... more Aim: To report the types and duration of sickness certification for different common mental disorders (CMDs) and the prevalence of GP advice aimed at returning the patient to work. Background: In the United Kingdom, common mental health problems, such and depression and stress, have become the main reasons for patients requesting a sickness certificate to abstain from usual employment. Increasing attention is being paid to mental health and its impact on employability and work capacity in all parts of the welfare system. However, relatively little is known about the extent to which different mental health diagnoses impact upon sickness certification outcomes, and how the GP has used the new fit note (introduced in 2010) to support a return to work for patients with mental health diagnoses. Methods: Sickness certification data was collected from 68 UK-based general practices for a period of 12 months. Findings: The study found a large part of all sickness absence certified by GPs was due to CMDs (29% of all sickness absence episodes). Females, younger patients and those living in deprived areas were more likely to receive a fit note for a CMD (compared with one for a physical health problem). The highest proportion of CMD fit notes were issued for 'stress'. However, sickness certification for depression contributed nearly half of all weeks certified for mental health problems. Only 7% of CMD fit notes included any 'may be fit' advice from the GP, with type of advice varying by mental health diagnostic category. Patients living in the most socially deprived neighbourhoods were less likely to receive 'may be fit' advice on their CMD fit notes.

Addiction Science & Clinical Practice, Sep 1, 2013

SSM Annual Scientific Meeting, Aug 1, 2022

Journal of Public Health, Dec 23, 2014

Family Medicine and Community Health, Nov 1, 2022

Objective Artificial intelligence (AI) will have a significant impact on healthcare over the comi... more Objective Artificial intelligence (AI) will have a significant impact on healthcare over the coming decade. At the same time, health inequity remains one of the biggest challenges. Primary care is both a driver and a mitigator of health inequities and with AI gaining traction in primary care, there is a need for a holistic understanding of how AI affect health inequities, through the act of providing care and through potential system effects. This paper presents a systematic scoping review of the ways AI implementation in primary care may impact health inequity. Design Following a systematic scoping review approach, we searched for literature related to AI, health inequity, and implementation challenges of AI in primary care. In addition, articles from primary exploratory searches were added, and through reference screening. The results were thematically summarised and used to produce both a narrative and conceptual model for the mechanisms by which social determinants of health and AI in primary care could interact to either improve or worsen health inequities. Two public advisors were involved in the review process. Eligibility criteria Peer-reviewed publications and grey literature in English and Scandinavian languages. Information sources PubMed, SCOPUS and JSTOR. Results A total of 1529 publications were identified, of which 86 met the inclusion criteria. The findings were summarised under six different domains, covering both positive and negative effects: (1) access, (2) trust, (3) dehumanisation, (4) agency for self-care, (5) algorithmic bias and (6) external effects. The five first domains cover aspects of the interface between the patient and the primary care system, while the last domain covers care systemwide and societal effects of AI in primary care. A graphical model has been produced to illustrate this. Community involvement throughout the whole process of designing and implementing of AI in primary care was a common suggestion to mitigate the potential negative effects of AI. Conclusion AI has the potential to affect health inequities through a multitude of ways, both directly in the patient consultation and through transformative system effects. This review summarises these effects from a system tive and provides a base for future research into responsible implementation. ⇒ This review summarises these effects from a system-wide perspective and provides a base for future research into responsible implementation.

Health Expectations

IntroductionCovid‐19 expanded the use of remote working to engage with public contributors in hea... more IntroductionCovid‐19 expanded the use of remote working to engage with public contributors in health and social care research. These changes have the potential to limit the ability to participate in patient and public involvement and engagement (PPIE) for some public contributors. It is therefore important to understand public contributors' preferences, so that remote working can be organized in an optimal way to encourage rather than discourage participation.MethodsWe use an economic preference elicitation tool, a discrete choice experiment (DCE), via an online survey, to estimate public contributors’ preferences for and trade‐offs between different features of remote meetings. The features were informed by previous research to include aspects of remote meetings that were relevant to public contributors and amenable to change by PPIE organizers.ResultsWe found that public contributors are more likely to participate in a PPIE project involving remote meetings if they are given f...

The SAGE Encyclopedia of Abnormal and Clinical Psychology

Child abuse prevention programs are under increasing pressure to demonstrate results and implemen... more Child abuse prevention programs are under increasing pressure to demonstrate results and implement system and practice changes to improve program outcomes. However, putting a new approach or program into practice, changing the way an agency or organization operates, or how services are delivered, is easier said than done. Whether you want to expand family resource centers, begin a home visiting program, improve collaboration across systems, or take a more proactive approach to strengthening families, you are likely to encounter challenges along the way. Unfortunately, only a few innovations are sustained over time, regardless of the initial success they achieved. However, there is a science to putting good ideas and new approaches into action.