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Sample records for acute psychiatric wards

  1. Occupational Therapy and Multidisciplinary Working on Acute Psychiatric Wards: The Tompkins Acute Ward Study

    Simpson, A.; Bowers, L.; J. Alexander; Ridley, C.; Warren, J.

    2005-01-01

    There is limited research into occupational therapy and interprofessional working on acute psychiatric wards. This study aimed to explore relations between occupational therapists and other members of the multidisciplinary team through structured interviews with 47 staff on 14 acute psychiatric wards. The study found that occupational therapists provided assessments, group activities and individual therapeutic work, with the assessment and development of activities of daily living being c...

  2. Adverse incidents, patient flow and nursing workforce variables on acute psychiatric wards: the Tompkins Acute Ward Study

    Bowers, L.; Allan, T; Simpson, A.; Nijman, H.; Warren, J.

    2007-01-01

    Background: Adverse incidents (violence, self-harm and absconding) can cause significant harm to patients and staff, are difficult to predict, and are driving an increase in security measures and defensive practice. Aims: To explore the relationship between adverse incidents on acute psychiatric wards, admissions and nursing workforce variables. Methods: A retrospective analysis of officially collected data covering a period of 30 months on 14 acute wards at three hospitals. This data...

  3. Junior staffing changes and the temporal ecology of adverse incidents in acute psychiatric wards

    Bowers, L.; Jeffery, D; Simpson, A; C. Daly; Warren, J.; Nijman, H.

    2007-01-01

    Aim.  This paper reports an examination of the relationship between adverse incident rates, the arrival of new junior staff on wards, and days of the week on acute psychiatric wards. Background.  Incidents of violence, absconding and self-harm in acute inpatient services pose risks to patients and staff. Previous research suggests that the arrival of inexperienced new staff may trigger more adverse incidents. Findings on the relationship between incidents and the weekly routine are incons...

  4. An observational study in psychiatric acute patients admitted to General Hospital Psychiatric Wards in Italy

    Margari Francesco

    2007-01-01

    Full Text Available Abstract Objectives this Italian observational study was aimed at collecting data of psychiatric patients with acute episodes entering General Hospital Psychiatric Wards (GHPWs. Information was focused on diagnosis (DSM-IV, reasons of hospitalisation, prescribed treatment, outcome of aggressive episodes, evolution of the acute episode. Methods assessments were performed at admission and discharge. Used psychometric scales were the Brief Psychiatric Rating Scale (BPRS, the Modified Overt Aggression Scale (MOAS and the Nurses' Observation Scale for Inpatient Evaluation (NOSIE-30. Results 864 adult patients were enrolled in 15 GHPWs: 728 (320 M; mean age 43.6 yrs completed both admission and discharge visits. A severe psychotic episode with (19.1% or without (47.7% aggressive behaviour was the main reason of admission. Schizophrenia (42.8% at admission and 40.1% at discharge and depression (12.9% at admission and 14.7% at discharge were the predominant diagnoses. The mean hospital stay was 12 days. The mean (± SD total score of MOAS at admission, day 7 and discharge was, respectively, 2.53 ± 5.1, 0.38 ± 2.2, and 0.21 ± 1.5. Forty-four (6.0% patients had episodes of aggressiveness at admission and 8 (1.7% at day 7. A progressive improvement in each domain/item vs. admission was observed for MOAS and BPRS, while NOSIE-30 did not change from day 4 onwards. The number of patients with al least one psychotic drug taken at admission, in the first 7 days of hospitalisation, and prescribed at discharge, was, respectively: 472 (64.8%, 686 (94.2% and 676 (92.9%. The respective most frequently psychotic drugs were: BDZs (60.6%, 85.7%, 69.5%, typical anti-psychotics (48.3%, 57.0%, 49.6%, atypical anti-psychotics (35.6%, 41.8%, 39.8% and antidepressants (40.9%, 48.8%, 43.2%. Rates of patients with one, two or > 2 psychotic drugs taken at admission and day 7, and prescribed at discharge, were, respectively: 24.8%, 8.2% and 13.5% in mono-therapy; 22.0%, 20

  5. Duration of bed occupancy as calculated at a random chosen day in an acute care ward. Implications for the use of scarce resources in psychiatric care

    Restan Asbjørn; Berg John E

    2005-01-01

    Abstract Background Psychiatric acute wards are obliged to admit patients without delay according to the Act on Compulsive Psychiatric Care. Residential long term treatment facilities and rehabilitation facilities may use a waiting list. Patients, who may not be discharged from the acute ward or should not wait there, then occupy acute ward beds. Materials and methods Bed occupancy in one acute ward at a random day in 2002 was registered (n = 23). Successively, the length of stay of all patie...

  6. Team climate and attitudes toward information and communication technology among nurses on acute psychiatric wards.

    Koivunen, Marita; Anttila, Minna; Kuosmanen, Lauri; Katajisto, Jouko; Välimäki, Maritta

    2015-01-01

    Objectives: To describe the association of team climate with attitudes toward information and communication technology among nursing staff working on acute psychiatric wards. Background: Implementation of ICT applications in nursing practice brings new operating models to work environments, which may affect experienced team climate on hospital wards. Method: Descriptive survey was used as a study design. Team climate was measured by the Finnish modification of the Team Climate Inventory, and attitudes toward ICT by Burkes' questionnaire. The nursing staff (N = 181, n = 146) on nine acute psychiatric wards participated in the study. Results: It is not self-evident that experienced team climate associates with attitudes toward ICT, but there are some positive relationships between perceived team climate and ICT attitudes. The study showed that nurses' motivation to use ICT had statistically significant connections with experienced team climate, participative safety (p = 0.021), support for innovation (p = 0.042) and task orientation (p = 0.042). Conclusion: The results suggest that asserting team climate and supporting innovative operations may lead to more positive attitudes toward ICT. It is, in particular, possible to influence nurses' motivation to use ICT. More attention should be paid to psychosocial factors such as group education and co-operation at work when ICT applications are implemented in nursing. PMID:24393065

  7. Frequency and severity of aggressive incidents in acute psychiatric wards in Switzerland

    Fischer Joachim E

    2007-12-01

    Full Text Available Abstract Background Aggression and violence and negative consequences thereof are a major concern in acute psychiatric inpatient care globally. Variations in study designs, settings, populations, and data collection methods render comparisons of the incidence of aggressive behaviour in high risk settings difficult. Objective To describe the frequency and severity of aggressive incidents in acute psychiatric wards in the German speaking part of Switzerland. Methods We conducted a prospective multicentre study on 24 acute admission wards in 12 psychiatric hospitals in the German speaking part of Switzerland. Aggressive incidents were recorded by the revised Staff Observation Aggression Scale (SOAS-R and we checked the data collection for underreporting. Our sample comprised 2344 treatment episodes of 2017 patients and a total of 41'560 treatment days. Results A total of 760 aggressive incidents were registered. We found incidence rates per 100 treatment days between 0.60 (95% CI 0.10–1.78 for physical attacks and 1.83 (1.70–1.97 for all aggressive incidents (including purely verbal aggression. The mean severity was 8.80 ± 4.88 points on the 22-point SOAS-R-severity measure; 46% of the purely verbally aggression was classified as severe (≥ 9 pts.. 53% of the aggressive incidents were followed by a coercive measure, mostly seclusion or seclusion accompanied by medication. In 13% of the patients, one ore more incidents were registered, and 6.9% of the patients were involved in one ore more physical attack. Involuntary admission (OR 2.2; 1.6–2.9, longer length of stay (OR 2.7; 2.0–3.8, and a diagnosis of schizophrenia (ICH-10 F2 (OR 2.1; 1.5–2.9 was associated with a higher risk for aggressive incidents, but no such association was found for age and gender. 38% of the incidents were registered within the first 7 days after admission. Conclusion Aggressive incidents in acute admission wards are a frequent and serious problem. Due to the

  8. Narcissism in patients admitted to psychiatric acute wards: its relation to violence, suicidality and other psychopathology

    Wallin Juliska

    2008-02-01

    Full Text Available Abstract Background The objective was to examine various aspects of narcissism in patients admitted to acute psychiatric wards and to compare their level of narcissism to that of an age- and gender-matched sample from the general population (NORM. Methods This cross-sectional study interviewed 186 eligible acute psychiatric patients with the Brief Psychiatric Rating Scale (BPRS and the Global Assessment of Functioning (GAF. The patients filled in the Narcissistic Personality Inventory-21 item version (NPI-21, The Hospital Anxiety and Depression Scale (HADS and the Rosenberg Self-Esteem Scale. High and low narcissism was defined by the median of the total NPI-21 score. An age- and gender-matched control sample from the general population also scored the NPI-21 (NORM. Results Being male, involuntary admitted, having diagnosis of schizophrenia, higher self-esteem, and severe violence were significantly associated with high narcissism, and so were also low levels of suicidality, depression, anxiety and GAF scores. Severe violence and high self-esteem were significantly associated with high narcissism in multivariable analyses. The NPI-21 and its subscales showed test-retest correlations ≥0.83, while the BPRS and the HADS showed lower correlations, confirming the trait character of the NPI-21. Depression and suicidality were negatively associated with the NPI-21 total score and all its subscales, while positive association was observed with grandiosity. No significant differences were observed between patients and NORM on the NPI-21 total score or any of the NPI subscales. Conclusion Narcissism in the psychiatric patients was significantly associated with violence, suicidality and other symptoms relevant for management and treatment planning. Due to its trait character, use of the NPI-21 in acute psychiatric patients can give important clinical information. The similar level of narcissism found in patients and NORM is in need of further examination.

  9. A replication study of the City nurse intervention: reducing conflict and containment on three acute psychiatric wards.

    Bowers, L; Flood, C; Brennan, G; Allan, T

    2008-11-01

    Conflict and containment on acute inpatient psychiatric wards pose a threat to patient and staff safety, and it is desirable to minimize the frequency of these events. Research has indicated that certain staff attitudes and behaviours might serve to accomplish this, namely, positive appreciation, emotional regulation and effective structure. A previous test of an intervention based on these principles, on two wards, showed a good outcome. In this study, we tested the same intervention on three further wards. Two 'City nurses' were employed to work with three acute wards, assisting with the implementation of changes according to the working model of conflict and containment generation. Evaluation was via before-and-after measures, with parallel data collected from five control wards. While simple before-and-after analysis of the two experimental wards showed significant reductions in conflict and containment, when a comparison with controls was conducted, with control for patient occupancy and clustering of results by ward, no effect of the intervention was found. The results were therefore ambiguous, and neither confirm nor contradict the efficacy of the intervention. A further intervention study may need to be conducted with a larger sample size to achieve adequate statistical power. PMID:18844799

  10. Duration of bed occupancy as calculated at a random chosen day in an acute care ward. Implications for the use of scarce resources in psychiatric care

    Restan Asbjørn

    2005-05-01

    Full Text Available Abstract Background Psychiatric acute wards are obliged to admit patients without delay according to the Act on Compulsive Psychiatric Care. Residential long term treatment facilities and rehabilitation facilities may use a waiting list. Patients, who may not be discharged from the acute ward or should not wait there, then occupy acute ward beds. Materials and methods Bed occupancy in one acute ward at a random day in 2002 was registered (n = 23. Successively, the length of stay of all patients was registered, together with information on waiting time after a decision was made on further treatment needs. Eleven patients waited for further resident treatment. The running cost of stay was calculated for the acute ward and in the different resident follow-up facilities. Twenty-three patients consumed a total of 776 resident days. 425 (54.8% of these were waiting days. Patients waited up to 86 days. Results Total cost of treatment was 0.69 million Euro (0.90 mill. $, waiting costs were 54.8% of this, 0.38 million Euro (0.50 million $. The difference between acute care costs and the costs in the relevant secondary resident facility was defined as the imputed loss. Net loss by waiting was 0.20 million Euro (0.26 million $ or 28.8% of total cost. Discussion This point estimate study indicates that treating patients too sick to be released to anything less than some other intramural facility locks a sizable amount of the resources of a psychiatric acute ward. The method used minimized the chance of financially biased treatment decisions. Costs of frustration to staff and family members, and delayed effect of treatment was set to zero. Direct extrapolation to costs per year is not warranted, but it is suggested that our findings would be comparable to other acute wards as well. The study shows how participant observation and cost effectiveness analysis may be combined.

  11. Substance abuse in patients admitted voluntarily and involuntarily to acute psychiatric wards: a national cross-sectional study

    Anne Opsal

    2011-12-01

    Full Text Available Background: Substance abuse and mental disorder comorbidity is high among patients admitted to acute psychiatric wards. The aim of the study was to identify this co-occurrence as a reason for involuntary admission and if specific substance use-related diagnoses were associated with such admissions.Methods: The study was a part of a multicentre, cross-sectional national study carried out during 2005-2006 within a research network of acute mental health services. Seventy-five percent of Norwegian hospitals providing acute in-patient treatment participated. Substance use was measured using the Clinician Rating Scale and the ICD-10 diagnoses F10-19. Diagnostic assessments were performed by the clinicians during hospital stay.Results: Overall, 33.2% (n=1,187 of the total patient population (3,506 were abusing alcohol or drugs prior to admission according to the Clinician Rating Scale. No difference in the overall prevalence of substance abuserelated diagnoses between the two groups was found. Overall, 310 (26% of the admissions, 216 voluntarily and 94 involuntarily admitted patients received a double diagnosis. Frequent comorbid combinations among voluntarily admitted patients were; a combination of alcohol and either mood disorder (40% or multiple mental disorders (29%. Among involuntarily admitted patients, a combination of poly drug use and schizophrenia was most frequent (47%. Substance abusing patients diagnosed with mental and behavioral disorders due to the use of psychoactive stimulant substances had a significantly higher risk of involuntary hospitalization (OR 2.3.Conclusion: Nearly one third of substance abusing patients are involuntarily admitted to mental hospitals, in particular stimulant drug use was associated with involuntarily admissions.

  12. The impact of mindfulness meditation in promoting a culture of safety on a acute psychiatric ward

    Meijel, Berno van

    2012-01-01

    Deze pilot studie naar de effecten van een aangepast Mindfulness-Based Stress Reduction programma in cursus vorm aangeboden aan medewerkers van een acute psychiatrische unit biedt een indicatie voor positieve effecten ten aanzien van stress, aandacht, concentratie en zelfbewustzijn van de deelnemers

  13. The Practice of Seclusion and Time-out on English Acute Psychiatric Wards: The City-128 Study

    Bowers, L.; Merwe, M. van der; Nijman, H.L.I.; Hamilton, B.; Noorthoorn, E.O.; Stewart, D.; Muir-Cochrane, E.

    2010-01-01

    Background - Seclusion is widely used internationally to manage disturbed behavior by psychiatric patients, although many countries are seeking to reduce or eliminate this practice. Time-out has been little described and almost completely unstudied. Aim and method - To assess the relationship of sec

  14. Psychiatric nursing as 'different' care: experience of Iranian mental health nurses in inpatient psychiatric wards.

    Zarea, K; Nikbakht-Nasrabadi, A; Abbaszadeh, A; Mohammadpour, A

    2013-03-01

    Patients with mental illness require unique and specific care. The purpose of this study was to explore the experiences of nurses, who provide such care for mentally ill people, within the context of Iranian culture. This hermeneutic phenomenological study was carried out in a university-affiliated hospital in an urban area of Iran. We interviewed 10 mental health nurses to capture in detail their experiences in psychiatric units, and the approach developed by Diekelmann et al. was employed to analyse the data. Four themes and five sub-themes were identified: 'being engaged with patients' (sub-themes: 'struggle for monitor/control', 'safety/security concerns', 'supporting physiological and emotional needs'), 'being competent', 'altruistic care' and 'facing difficulties and challenges' (sub-themes: 'socio-cultural' and 'organizational challenges'). The results provide valuable insights and greater understanding of the professional experiences of psychiatric nurses in Iran, and indicate the need for a stable and responsible organizational structure for those nurses who are expected to manage patient care in psychiatric wards. PMID:22384949

  15. Investigation of Seclusion in one of the Psychiatric Wards in Razi Teaching Hospital of Tabriz

    Maryam Vahidi; Mina Hosseinzadeh

    2014-01-01

    Seclusion is one of the methods in controlling violent behavior of inpatients in psychiatric wards. In current descriptive analytic study, data collection instrument included the seclusion list of inpatients by considering individual, social and clinical characteristics in one of the psychiatry wards In the Razi teaching hospital of Tabriz in the first six months of 2012. Among 264 admitted patients, 24 patients (9.1%) had been secluded and a total of 29 isolated incidents w...

  16. Chemical restraint in routine clinical practice: a report from a general hospital psychiatric ward in Greece

    Papamichael Georgios

    2011-02-01

    Full Text Available Abstract Background There is a dearth of studies regarding chemical restraint in routine clinical psychiatric practice. There may be wide variations between different settings and countries. Methods A retrospective study on chemical restraint was performed in the 11-bed psychiatric ward of the General Hospital of Arta, in northwestern Greece. All admissions over a 2-year-period (from March 2008 to March 2010 were examined. Results Chemical restraint was applied in 33 cases (10.5% of total admissions. From a total of 82 injections, 22 involved a benzodiazepine and/or levomepromazine, whereas 60 injections involved an antipsychotic agent, almost exclusively haloperidol (96.7% of cases, usually in combination with a benzodiazepine (61.7% of cases. In 36.4% of cases the patient was further subjected to restraint or seclusion. Conclusions In our unit, clinicians prefer the combined antipsychotic/benzodiazepine regimen for the management of patients' acute agitation and violent behaviour. Conventional antipsychotics are administrated almost exclusively and in a significant proportion of cases further coercive measures are applied. Studies on the practice of chemical restraint should be regularly performed in clinical settings.

  17. Prevalence and Risk Factors of Violence by Psychiatric Acute Inpatients: A Systematic Review and Meta-Analysis

    Iozzino, Laura; Ferrari, Clarissa; LARGE, MATTHEW; Nielssen, Olav; de Girolamo, Giovanni

    2015-01-01

    Background Violence in acute psychiatric wards affects the safety of other patients and the effectiveness of treatment. However, there is a wide variation in reported rates of violence in acute psychiatric wards. Objectives To use meta-analysis to estimate the pooled rate of violence in published studies, and examine the characteristics of the participants, and aspects of the studies themselves that might explain the variation in the reported rates of violence (moderators). Method Systematic ...

  18. Factors Associated with Readmission of Patients at a University Hospital Psychiatric Ward in Iran

    Majid Barekatain

    2013-01-01

    Full Text Available Objectives. Readmission has a major role in the reduction of the quality of life and the increase in the years of lost life. The main objectives of this study were to answer to the following research questions. (a What was the readmission rate? (b What were the social, demographic, and clinical characteristics of patients admitted to the Psychiatric Emergency Service at Nour University Hospital, affiliated to Isfahan University of Medical Sciences, Isfahan, Iran? (c What were the effective factors on readmission? Method. This cross-sectional study was conducted on a total number of 3935 patients who were admitted to Isfahan University Hospital Psychiatric Ward in Isfahan, Iran, from 2004 to 2010. Gender, age, marital status, education, self-report history of previous admission, type of psychiatric disorder, substance misuse, suicide, and the length of the current psychiatric disorder were collected from the registered medical files of patients. The data were analysed using the negative binomial regression model. Results. We found that factors such as psychiatric anxiety disorder, bipolar I, bipolar II, psychotic disorder, depression, and self report history of previous admission were statistically significant in the number of readmissions using the negative binomial model. Conclusion. Readmission to the psychiatric ward is mainly predictable by the type of diagnosis and psychosocial supports.

  19. Factors associated with readmission of patients at a university hospital psychiatric ward in iran.

    Barekatain, Majid; Maracy, Mohammad Reza; Hassannejad, Razeyeh; Hosseini, Reihane

    2013-01-01

    Objectives. Readmission has a major role in the reduction of the quality of life and the increase in the years of lost life. The main objectives of this study were to answer to the following research questions. (a) What was the readmission rate? (b) What were the social, demographic, and clinical characteristics of patients admitted to the Psychiatric Emergency Service at Nour University Hospital, affiliated to Isfahan University of Medical Sciences, Isfahan, Iran? (c) What were the effective factors on readmission? Method. This cross-sectional study was conducted on a total number of 3935 patients who were admitted to Isfahan University Hospital Psychiatric Ward in Isfahan, Iran, from 2004 to 2010. Gender, age, marital status, education, self-report history of previous admission, type of psychiatric disorder, substance misuse, suicide, and the length of the current psychiatric disorder were collected from the registered medical files of patients. The data were analysed using the negative binomial regression model. Results. We found that factors such as psychiatric anxiety disorder, bipolar I, bipolar II, psychotic disorder, depression, and self report history of previous admission were statistically significant in the number of readmissions using the negative binomial model. Conclusion. Readmission to the psychiatric ward is mainly predictable by the type of diagnosis and psychosocial supports. PMID:24236285

  20. Investigation of Seclusion in one of the Psychiatric Wards in Razi Teaching Hospital of Tabriz

    Maryam Vahidi

    2014-12-01

    Full Text Available Seclusion is one of the methods in controlling violent behavior of inpatients in psychiatric wards. In current descriptive analytic study, data collection instrument included the seclusion list of inpatients by considering individual, social and clinical characteristics in one of the psychiatry wards In the Razi teaching hospital of Tabriz in the first six months of 2012. Among 264 admitted patients, 24 patients (9.1% had been secluded and a total of 29 isolated incidents were recorded. Most of secluded incidents occurred on weekdays (75.9%, first week of inpatient (87.7%, and during the evening shifts (48.3%. The results obtained in this study demonstrate that in 55.2% cases, the duration of isolation was two hours and the most common cause of seclusion was aggressive behaviors. Most of secluded patients (66.7% were diagnosed with mood disorders.

  1. The ward atmosphere important for the psychosocial work environment of nursing staff in psychiatric in-patient care

    Wann-Hansson Christine

    2011-06-01

    Full Text Available Abstract Background The nursing staff working in psychiatric care have a demanding work situation, which may be reflected in how they view their psychosocial work environment and the ward atmosphere. The aims of the present study were to investigate in what way different aspects of the ward atmosphere were related to the psychosocial work environment, as perceived by nursing staff working in psychiatric in-patient care, and possible differences between nurses and nurse assistants. Methods 93 nursing staff working at 12 general psychiatric in-patient wards in Sweden completed two questionnaires, the Ward Atmosphere Scale and the QPSNordic 34+. Data analyses included descriptive statistics, the Mann-Whitney U-test, Spearman rank correlations and forward stepwise conditional logistic regression analyses. Results The data revealed that there were no differences between nurses and nurse assistants concerning perceptions of the psychosocial work environment and the ward atmosphere. The ward atmosphere subscales Personal Problem Orientation and Program Clarity were associated with a psychosocial work environment characterized by Empowering Leadership. Program Clarity was related to the staff's perceived Role Clarity, and Practical Orientation and Order and Organization were positively related to staff perceptions of the Organizational Climate. Conclusions The results from the present study indicate that several ward atmosphere subscales were related to the nursing staff's perceptions of the psychosocial work environment in terms of Empowering Leadership, Role Clarity and Organizational Climate. Improvements in the ward atmosphere could be another way to accomplish improvements in the working conditions of the staff, and such improvements would affect nurses and nurse assistants in similar ways.

  2. The impact of facility relocation on patients' perceptions of ward atmosphere and quality of received forensic psychiatric care.

    Alexiou, Eirini; Degl' Innocenti, Alessio; Kullgren, Anette; Wijk, Helle

    2016-08-01

    In recent years, large groups of forensic psychiatric patients have been relocated into new medium- and maximum-security forensic psychiatric facilities in Sweden, where a psychosocial care approach is embedded. From this perspective and on the assumption that physical structures affect the therapeutic environment, a prospective longitudinal study was designed to investigate the impact of the facility relocation of three forensic psychiatric hospitals on patients' perceptions of ward atmosphere and quality of received forensic psychiatric care. Participants were patients over 18 years of age sentenced to compulsory forensic psychiatric treatment. Data were obtained by validated questionnaires. Overall, 58 patients (78%) answered the questionnaires at baseline with a total of 25 patients (34%) completing follow-up 1 at six months and 11 patients (15%) completing follow-up 2, one year after relocation. Approximately two-thirds of the participants at all time-points were men and their age range varied from 18 to 69. The results of this study showed that poor physical environment features can have a severe impact on care quality and can reduce the possibilities for person-centered care. Furthermore, the study provides evidence that the patients' perceptions of person-centered care in forensic psychiatric clinics are highly susceptible to factors in the physical and psychosocial environment. Future work will explore the staff's perception of ward atmosphere and the possibilities to adapt a person-centered approach in forensic psychiatric care after facility relocation. PMID:27213839

  3. Symptoms of epilepsy and organic brain dysfunctions in patients with acute, brief depression combined with other fluctuating psychiatric symptoms: a controlled study from an acute psychiatric department

    Linaker Olav M

    2009-09-01

    Full Text Available Abstract Background In psychiatric acute departments some patients present with brief depressive periods accompanied with fluctuating arrays of other psychiatric symptoms like psychosis, panic or mania. For the purpose of the present study we call this condition Acute Unstable Depressive Syndrome (AUDS. The aims of the present study were to compare clinical signs of organic brain dysfunctions and epilepsy in patients with AUDS and Major Depressive Episode (MDE. Methods Out of 1038 consecutive patients admitted to a psychiatric acute ward, 16 patients with AUDS and 16 age- and gender-matched MDE patients were included in the study. Using standardized instruments and methods we recorded clinical data, EEG and MRI. Results A history of epileptic seizures and pathologic EEG activity was more common in the AUDS group than in the MDE group (seizures, n = 6 vs. 0, p = 0.018; pathologic EEG activity, n = 8 vs. 1, p = 0.015. Five patients in the AUDS group were diagnosed as having epilepsy, whereas none of those with MDE had epilepsy (p = 0.043. There were no differences between the groups regarding pathological findings in neurological bedside examination and cerebral MRI investigation. Conclusion Compared to patients admitted with mood symptoms fulfilling DSM 4 criteria of a major depressive disorder, short-lasting atypical depressive symptoms seem to be associated with a high frequency of epileptic and pathologic EEG activity in patients admitted to psychiatric acute departments. Trial registration NCT00201474

  4. Prevalence of body dysmorphic disorder on a psychiatric inpatient ward and the value of a screening question.

    Veale, David; Akyüz, Elvan U; Hodsoll, John

    2015-12-15

    The aim of this study was to estimate the prevalence of body dysmorphic disorder (BDD) on an inpatient ward in the UK with a larger sample than previously studied and to investigate the value of a simple screening question during an assessment interview. Four hundred and thirty two consecutive admissions were screened for BDD on an adult psychiatric ward over a period of 13 months. Those who screened positive had a structured diagnostic interview for BDD. The prevalence of BDD was estimated to be 5.8% (C.I. 3.6-8.1%). Our screening question had a slightly low specificity (76.6%) for detecting BDD. The strength of this study was a larger sample size and narrower confidence interval than previous studies. The study adds to previous observations that BDD is poorly identified in psychiatric inpatients. BDD was identified predominantly in those presenting with depression, substance misuse or an anxiety disorder. The screening question could be improved by excluding those with weight or shape concerns. Missing the diagnosis is likely to lead to inappropriate treatment. PMID:26404769

  5. The bulldozer and the ballet dancer: aspects of nurses' caring approaches in acute psychiatric intensive care.

    Björkdahl, A; Palmstierna, T; Hansebo, G

    2010-08-01

    Demanding conditions in acute psychiatric wards inhibit provision of safe, therapeutic care and leave nurses torn between humanistic ideals and the harsh reality of their daily work. The aim of this study was to describe nurses' caring approaches within this context. Data were collected from interviews with nurses working in acute psychiatric intensive care. Data were analysed using qualitative analysis, based on interpretive description. Results revealed a caring-approach continuum on which two approaches formed the main themes: the bulldozer and the ballet dancer. The bulldozer approach functioned as a shield of power that protected the ward from chaos. The ballet dancer approach functioned as a means of initiating relationships with patients. When examining the data from a theoretical perspective of caring and uncaring encounters in nursing, the ballet dancer approach was consistent with a caring approach, while the bulldozer approach was more complex and somewhat aligned with uncaring approaches. Conclusions drawn from the study are that although the bulldozer approach involves a risk for uncaring and harming actions, it also brings a potential for caring. This potential needs to be further explored and nurses should be encouraged to reflect on how they integrate paternalistic nursing styles with person-centred care. PMID:20633078

  6. Leadership support for ward managers in acute mental health inpatient settings.

    Bonner, Gwen; McLaughlin, Sue

    2014-05-01

    This article shares findings of work undertaken with a group of mental health ward managers to consider their roles through workshops using an action learning approach. The tensions between the need to balance the burden of administrative tasks and act as clinical role models, leaders and managers are considered in the context of providing recovery-focused services. The group reviewed their leadership styles, broke down the administrative elements of their roles using activity logs, reviewed their working environments and considered how recovery focused they believed their wards to be. Findings support the notion that the ward manager role in acute inpatient settings is at times unmanageable. Administration is one aspect of the role for which ward managers feel unprepared and the high number of administrative tasks take them away from front line clinical care, leading to frustration. Absence from clinical areas reduces opportunities for role modeling good clinical practice to other staff. Despite the frustrations of administrative tasks, overall the managers thought they were supportive to their staff and that their wards were recovery focused. PMID:24779763

  7. Psychiatric Disease and Post-Acute Traumatic Brain Injury.

    Zgaljardic, Dennis J; Seale, Gary S; Schaefer, Lynn A; Temple, Richard O; Foreman, Jack; Elliott, Timothy R

    2015-12-01

    Psychiatric disorders are common following traumatic brain injury (TBI) and can include depression, anxiety, and psychosis, as well as other maladaptive behaviors and personality changes. The epidemiologic data of psychiatric disorders post-TBI vary widely, although the incidence and prevalence rates typically are higher than in the general population. Although the experience of psychiatric symptoms may be temporary and may resolve in the acute period, many patients with TBI can experience psychopathology that is persistent or that develops in the post-acute period. Long-term psychiatric disorder, along with cognitive and physical sequelae and greater risk for substance use disorders, can pose a number of life-long challenges for patients and their caregivers, as they can interfere with participation in rehabilitation as well as limit functional independence in the community. The current review of the literature considers the common psychiatric problems affecting individuals with TBI in the post-acute period, including personality changes, psychosis, executive dysfunction, depression, anxiety, and substance misuse. Although treatment considerations (pharmacological and nonpharmacological) are referred to, an extensive description of such protocols is beyond the scope of the current review. The impact of persistent psychiatric symptoms on perceived caregiver burden and distress is also discussed. PMID:25629222

  8. Acute and long-term psychiatric side effects of mefloquine

    Ringqvist, Asa; Bech, Per; Glenthøj, Birte;

    2014-01-01

    BACKGROUND: The aim of the study was to explore the profile of acute and long-term psychiatric side effects associated with mefloquine. METHODS: Subjects (n = 73) reported to a Danish national register during five consecutive years for mefloquine associated side effects were included. Acute...... psychiatric side effects were retrospectively assessed using the SCL-90-R and questions based on Present State Examination (PSE). Subjects reporting suspected psychotic states were contacted for a personal PSE interview. Electronic records of psychiatric hospitalizations and diagnoses were cross-checked. Long......-term effects were evaluated with SF-36. SCL-90-R and SF-36 data were compared to age- and gender matched controls. RESULTS: In the SCL-90-R, clinically significant scores for anxiety, phobic anxiety and depression were found in 55%, 51%, and 44% of the mefloquine group. Substantial acute phase psychotic...

  9. Patient and Staff Perceptions of Medication Administration and Locked Entrance Doors at Psychiatric Wards

    Haglund, Kristina

    2005-01-01

    The general aim was, within psychiatric inpatient care, to explore patient and staff perceptions with regard to medication administration and locked entrance doors. In Study I, medication administration was illuminated according to a mini-ethnographic approach. Nurses and voluntarily admitted patients were observed and interviewed. Two central categories of patient and nurse experiences were identified, get control and leave control. In Study II, patients and nurses were interviewed about pat...

  10. Factors Associated with Readmission of Patients at a University Hospital Psychiatric Ward in Iran

    Majid Barekatain; Mohammad Reza Maracy; Razeyeh Hassannejad; Reihane Hosseini

    2013-01-01

    Objectives. Readmission has a major role in the reduction of the quality of life and the increase in the years of lost life. The main objectives of this study were to answer to the following research questions. (a) What was the readmission rate? (b) What were the social, demographic, and clinical characteristics of patients admitted to the Psychiatric Emergency Service at Nour University Hospital, affiliated to Isfahan University of Medical Sciences, Isfahan, Iran? (c) What were the effective...

  11. Hostility and violence of acute psychiatric inpatients

    Azzoni Antonella

    2005-07-01

    Full Text Available Abstract Objective The aim of the present study was to find out the extent of hostility and violence and the factors that are associated with such hostility and violence in a psychiatric intensive care unit. Methods Retrospective analysis of data prospectively collected in a 6-year period. Results No hostility was observed in 56.1%, hostility in 40.9%, and violence in 3.0% of the admitted cases. Seclusion was never used. Six cases (2,5‰ required physical restraint. Risk factors associated with violence were younger age, suicidal risk, and diagnosis of schizophrenia. Risk factors associated with hostile and violent behavior were younger age at the onset of the disorder, being single, having no children, lower GAF scores, higher BPRS hostility, SAPS, and CGI scores, lower BPRS anxiety-depression score, higher doses of psychoactive drugs, more frequent use of neuroleptics, diagnosis of mania, personality disorder, substance and alcohol related disorders, no diagnosis of depression. Conclusion The study confirms the low rate of violence among Italian psychiatric in-patients, the major relevance of clinical rather than socio-demographic factors in respect of aggressive behavior, the possibility of a no seclusion-no physical restraint policy, not associated either with higher rates of hostility or violence or with more severe drug side effects.

  12. Compassionate containment? Balancing technical safety and therapy in the design of psychiatric wards.

    Curtis, Sarah; Gesler, Wilbert; Wood, Victoria; Spencer, Ian; Mason, James; Close, Helen; Reilly, Joseph

    2013-11-01

    This paper contributes to the international literature examining design of inpatient settings for mental health care. Theoretically, it elaborates the connections between conceptual frameworks from different strands of literature relating to therapeutic landscapes, social control and the social construction of risk. It does so through a discussion of the substantive example of research to evaluate the design of a purpose built inpatient psychiatric health care facility, opened in 2010 as part of the National Health Service (NHS) in England. Findings are reported from interviews or discussion groups with staff, patients and their family and friends. This paper demonstrates a strong, and often critical awareness among members of staff and other participants about how responsibilities for risk governance of 'persons' are exercised through 'technical safety' measures and the implications for therapeutic settings. Our participants often emphasised how responsibility for technical safety was being invested in the physical infrastructure of certain 'places' within the hospital where risks are seen to be 'located'. This illuminates how the spatial dimensions of social constructions of risk are incorporated into understandings about therapeutic landscapes. There were also more subtle implications, partly relating to 'Panopticist' theories about how the institution uses technical safety to supervise its own mechanisms, through the observation of staff behaviour as well as patients and visitors. Furthermore, staff seemed to feel that in relying on technical safety measures they were, to a degree, divesting themselves of human responsibility for risks they are required to manage. However, their critical assessment showed their concerns about how this might conflict with a more therapeutic approach and they contemplated ways that they might be able to engage more effectively with patients without the imposition of technical safety measures. These findings advance our thinking

  13. Clinical features and therapeutic management of patients admitted to Italian acute hospital psychiatric units: the PERSEO (psychiatric emergency study and epidemiology survey

    Russo Federico

    2007-11-01

    Full Text Available Abstract Background The PERSEO study (psychiatric emergency study and epidemiology is a naturalistic, observational clinical survey in Italian acute hospital psychiatric units, called SPDCs (Servizio Psichiatrico Diagnosi e Cura; in English, the psychiatric service for diagnosis and management. The aims of this paper are: (i to describe the epidemiological and clinical characteristics of patients, including sociodemographic features, risk factors, life habits and psychiatric diagnoses; and (ii to assess the clinical management, subjective wellbeing and attitudes toward medications. Methods A total of 62 SPDCs distributed throughout Italy participated in the study and 2521 patients were enrolled over the 5-month study period. Results Almost half of patients (46% showed an aggressive behaviour at admission to ward, but they engaged more commonly in verbal aggression (38%, than in aggression toward other people (20%. A total of 78% of patients had a psychiatric diagnosis at admission, most frequently schizophrenia (36%, followed by depression (16% and personality disorders (14%, and no relevant changes in the diagnoses pattern were observed during hospital stay. Benzodiazepines were the most commonly prescribed drugs, regardless of diagnosis, at all time points. Overall, up to 83% of patients were treated with neuroleptic drugs and up to 27% received more than one neuroleptic either during hospital stay or at discharge. Atypical and conventional antipsychotics were equally prescribed for schizophrenia (59 vs 65% during stay and 59 vs 60% at discharge, while atypical drugs were preferred in schizoaffective psychoses (72 vs 49% during stay and 70 vs 46% at discharge and depression (41 vs 32% during stay and 44 vs 25% at discharge. Atypical neuroleptics were slightly preferred to conventional ones at hospital discharge (52 vs 44%. Polypharmacy was in general widely used. Patient attitudes toward medications were on average positive and self

  14. Acute psychiatric admissions from an out-of-hours Casualty Clinic; how do referring doctors and admitting specialists agree?

    Hansen Vidje

    2006-03-01

    Full Text Available Abstract Background Over the last decades there has been an increasing pressure on the acute psychiatric wards in Norway. The major contributor to psychiatric acute admissions at the University Hospital of North Norway in the city of Tromsø in 2001 was the GP-based Tromsø Casualty Clinic, only open out-of-hours. We explored all acute psychiatric referrals from Tromsø Casualty Clinic in 2001. The purpose of the study was to characterize the admissions and assess the agreement between the referring doctors and the hospital specialists according to the need for hospitalization, agreement on application of the law and the diagnostic evaluation to assess whether the admissions were appropriate. Methods Retrospective, record based, descriptive study comprising 101 psychiatric acute referrals from the Tromsø Casualty Clinic to the psychiatric acute wards at the University Hospital of North Norway. Results The specialists accepted all referrals except one, they mostly agreed upon the diagnoses suggested by the referring doctors and they mostly confirmed the application of the law. Seventy-five percent of the admissions took place during weekends, public holidays or nighttimes. Diagnoses of psychoses or suicidal attempts accounted for 76 % of the total referrals. Substance abuse was noted for 43 %, and in 22 % of all admissions the patients had stopped taking their psychopharmacological medication. The police assisted the referring doctors in one third of all admissions, and was the legal representative in 52 out of 59 involuntary admissions. Thirty percent of the admissions were first- time admissions. Thirty-two percent of the hospital stays lasted for three days or less. Median length of stay was 6.5 days. Conclusion The casualty clinic physicians and the hospital specialists mostly agreed in their evaluation of patients indicating that most of the admissions were appropriate. The police was more often involved in the involuntary admissions than

  15. Acute bacterial skin and skin structure infections in internal medicine wards: old and new drugs.

    Falcone, Marco; Concia, Ercole; Giusti, Massimo; Mazzone, Antonino; Santini, Claudio; Stefani, Stefania; Violi, Francesco

    2016-08-01

    Skin and soft tissue infections (SSTIs) are a common cause of hospital admission among elderly patients, and traditionally have been divided into complicated and uncomplicated SSTIs. In 2010, the FDA provided a new classification of these infections, and a new category of disease, named acute bacterial skin and skin structure infections (ABSSSIs), has been proposed as an independent clinical entity. ABSSSIs include three entities: cellulitis and erysipelas, wound infections, and major cutaneous abscesses This paper revises the epidemiology of SSTIs and ABSSSIs with regard to etiologies, diagnostic techniques, and clinical presentation in the hospital settings. Particular attention is owed to frail patients with multiple comorbidities and underlying significant disease states, hospitalized on internal medicine wards or residing in nursing homes, who appear to be at increased risk of infection due to multi-drug resistant pathogens and treatment failures. Management of ABSSSIs and SSTIs, including evaluation of the hemodynamic state, surgical intervention and treatment with appropriate antibiotic therapy are extensively discussed. PMID:27084183

  16. Evaluation of the decision support system for antimicrobial treatment, TREAT, in an acute medical ward of a university hospital

    Arboe, Bente; Laub, Rasmus Rude; Kronborg, Gitte;

    2014-01-01

    OBJECTIVES: TREAT, a decision support system for antimicrobial therapy, was implemented in an acute medical ward. METHODS: Patients admitted on suspicion of infection were included in the study. The evaluation of TREAT was done both retrospectively and prospectively. Coverage of empirical antimic...

  17. Effects of a humor-centered activity on disruptive behavior in patients in a general hospital psychiatric ward

    Higueras, Antonio; Carretero-Dios, Hugo; Mu??oz, Jos?? P.; Idini, Esther; Ortiz, Ana; Rinc??n, Francisco; Prieto-Merino, David

    2006-01-01

    This study would not have been possible without the professional collaboration and enthusiasm of the Titiritas Clown group, who were the stars of the humor-based activities on the ward. We offer special thanks to the members of this group: Jos?? P??rez de la Blanca, Francisco Parera, and Fernando P??rez de la Blanca.

  18. Nurses' experience of collaboration with relatives of frail elderly patients in acute hospital wards: A qualitative study

    Tove, Lindhardt; Hallberg, Ingalill Rahm; Poulsen, Ingrid

    2008-01-01

    BACKGROUND: Frail elderly people admitted to hospital often receive help from relatives in managing their daily lives. These relatives are likely to continue to feel responsible after admission, and to hold valuable knowledge, which may contribute to decision-making related to care and treatment....... OBJECTIVE: To illuminate nurses' experience of collaboration with relatives of frail elderly patients in acute hospital wards, and of the barriers and promoters for collaboration. DESIGN AND SETTING: The design was descriptive. Three acute units in a large Danish university hospital participated...

  19. Nurses' experience of collaboration with relatives of frail elderly patients in acute hospital wards: a qualitative study

    Lindhardt, Tommi Bo; Hallberg, I.R.; Poulsen, Ingrid

    2008-01-01

    BACKGROUND: Frail elderly people admitted to hospital often receive help from relatives in managing their daily lives. These relatives are likely to continue to feel responsible after admission, and to hold valuable knowledge, which may contribute to decision-making related to care and treatment....... OBJECTIVE: To illuminate nurses' experience of collaboration with relatives of frail elderly patients in acute hospital wards, and of the barriers and promoters for collaboration. DESIGN AND SETTING: The design was descriptive. Three acute units in a large Danish university hospital participated...

  20. Study of the outcome of suicide attempts: characteristics of hospitalization in a psychiatric ward group, critical care center group, and non-hospitalized group

    Kemuyama Nobuo

    2010-01-01

    Full Text Available Abstract Background The allocation of outcome of suicide attempters is extremely important in emergency situations. Following categorization of suicidal attempters who visited the emergency room by outcome, we aimed to identify the characteristics and potential needs of each group. Methods The outcomes of 1348 individuals who attempted suicide and visited the critical care center or the psychiatry emergency department of the hospital were categorized into 3 groups, "hospitalization in the critical care center (HICCC", "hospitalization in the psychiatry ward (HIPW", or "non-hospitalization (NH", and the physical, mental, and social characteristics of these groups were compared. In addition, multiple logistic analysis was used to extract factors related to outcome. Results The male-to-female ratio was 1:2. The hospitalized groups, particularly the HICCC group, were found to have biopsychosocially serious findings with regard to disturbance of consciousness (JCS, general health performance (GAS, psychiatric symptoms (BPRS, and life events (LCU, while most subjects in the NH group were women who tended to repeat suicide-related behaviors induced by relatively light stress. The HIPW group had the highest number of cases, and their symptoms were psychologically serious but physically mild. On multiple logistic analysis, outcome was found to be closely correlated with physical severity, risk factor of suicide, assessment of emergent medical intervention, and overall care. Conclusion There are different potential needs for each group. The HICCC group needs psychiatrists on a full-time basis and also social workers and clinical psychotherapists to immediately initiate comprehensive care by a medical team composed of multiple professionals. The HIPW group needs psychological education to prevent repetition of suicide attempts, and high-quality physical treatment and management skill of the staff in the psychiatric ward. The NH group subjects need a

  1. Clinical features and therapeutic management of patients admitted to Italian acute hospital psychiatric units: the PERSEO (psychiatric emergency study and epidemiology) survey

    Russo Federico; Righi Roberto; Minervini Lina; Margari Francesco; Casacchia Massimo; Boncompagni Giancarlo; Boccalon Roberto M; Ballerini Andrea; Salteri Andrea; Frediani Sonia; Rossi Andrea; Scatigna Marco

    2007-01-01

    Abstract Background The PERSEO study (psychiatric emergency study and epidemiology) is a naturalistic, observational clinical survey in Italian acute hospital psychiatric units, called SPDCs (Servizio Psichiatrico Diagnosi e Cura; in English, the psychiatric service for diagnosis and management). The aims of this paper are: (i) to describe the epidemiological and clinical characteristics of patients, including sociodemographic features, risk factors, life habits and psychiatric diagnoses; and...

  2. Morale is high in acute inpatient psychiatry

    Bowers, L.; Allan, T; Simpson, A; Jones, J.; Whittington, R.

    2009-01-01

    Background: Morale on acute psychiatric wards has been considered to be problematic, and is reported to contribute to low quality patient care. Aim: To assess the relationship of staff morale to patient, service environment, physical environment, patient routines, conflict, containment, staff demographics, and staff group variables. Method: A multivariate cross sectional study was undertaken collecting data on morale and other variables on 136 acute admission psychiatric wards in Engl...

  3. Switch Function and Pathological Dissociation in Acute Psychiatric Inpatients

    Chiu, Chui-De; Tseng, Mei-Chih Meg; Chien, Yi-Ling; Liao, Shih-Cheng; Liu, Chih-Min; Yeh, Yei-Yu; Hwu, Hai-Gwo

    2016-01-01

    Swift switching, along with atypical ability on updating and inhibition, has been found in non-clinical dissociators. However, whether swift switching is a cognitive endophenotype that intertwines with traumatisation and pathological dissociation remains unknown. Unspecified acute psychiatric patients were recruited to verify a hypothesis that pathological dissociation is associated with swift switching and traumatisation may explain this relationship. Behavioural measures of intellectual function and three executive functions including updating, switching and inhibition were administered, together with standardised scales to evaluate pathological dissociation and traumatisation. Our results showed superior control ability on switching and updating in inpatients who displayed more symptoms of pathological dissociation. When all three executive functions were entered as predictors, in addition to intellectual quotient and demographic variables to regress upon pathological dissociation, switching rather than updating remained the significant predictor. Importantly, the relationship between pathological dissociation and switching became non-significant when the effect of childhood trauma were controlled. The results support a trauma-related switching hypothesis which postulates swift switching as a cognitive endophenotype of pathological dissociation; traumatisation in childhood may explain the importance of swift switching. PMID:27123578

  4. Switch Function and Pathological Dissociation in Acute Psychiatric Inpatients.

    Chui-De Chiu

    Full Text Available Swift switching, along with atypical ability on updating and inhibition, has been found in non-clinical dissociators. However, whether swift switching is a cognitive endophenotype that intertwines with traumatisation and pathological dissociation remains unknown. Unspecified acute psychiatric patients were recruited to verify a hypothesis that pathological dissociation is associated with swift switching and traumatisation may explain this relationship. Behavioural measures of intellectual function and three executive functions including updating, switching and inhibition were administered, together with standardised scales to evaluate pathological dissociation and traumatisation. Our results showed superior control ability on switching and updating in inpatients who displayed more symptoms of pathological dissociation. When all three executive functions were entered as predictors, in addition to intellectual quotient and demographic variables to regress upon pathological dissociation, switching rather than updating remained the significant predictor. Importantly, the relationship between pathological dissociation and switching became non-significant when the effect of childhood trauma were controlled. The results support a trauma-related switching hypothesis which postulates swift switching as a cognitive endophenotype of pathological dissociation; traumatisation in childhood may explain the importance of swift switching.

  5. Early Sleep Psychiatric Intervention for Acute Insomnia: Implications from a Case of Obsessive-Compulsive Disorder

    Abe, Yuichiro; Nishimura, Go; Endo, Takuro

    2012-01-01

    Insomnia is a common problem among patients with obsessive-compulsive disorder (OCD), and patients suffering from acute insomnia with psychiatric comorbidity are more likely to develop chronic insomnia without appropriate intervention. Here we report a case of obsessive-compulsive disorder with acute insomnia, successfully treated with early sleep psychiatric non-pharmacological intervention. The augmentation of medication runs a risk of exacerbating daytime impairment. Clinicians usually pre...

  6. Quantitative EEG findings in patients with acute, brief depression combined with other fluctuating psychiatric symptoms: a controlled study from an acute psychiatric department

    Linaker Olav M

    2008-11-01

    Full Text Available Abstract Background Patients with brief depressive episodes and concurrent rapidly fluctuating psychiatric symptoms do not fit current diagnostic criteria and they can be difficult to diagnose and treat in an acute psychiatric setting. We wanted to study whether these patients had signs of more epileptic or organic brain dysfunction than patients with depression without additional symptomatology. Methods Sixteen acutely admitted patients diagnosed with a brief depressive episode as well as another concurrent psychiatric diagnosis were included. Sixteen patients with major depression served as controls. Three electroencephalographic studies (EEG were visually interpreted and the background activity was also analysed with quantitative electroencephalography (QEEG. Results The group with brief depression and concurrent symptoms had multiple abnormal features in their standard EEG compared to patients with major depression, but they did not show significantly more epileptiform activity. They also had significantly higher temporal QEEG delta amplitude and interhemispheric temporal delta asymmetry. Conclusion Organic brain dysfunction may be involved in the pathogenesis of patients with brief depressive episodes mixed with rapidly fluctuating psychiatric symptoms. This subgroup of depressed patients should be investigated further in order to clarify the pathophysiology and to establish the optimal evaluation scheme and treatment in an acute psychiatric setting.

  7. An audit of acute psychiatric admission bed occupancy in Northern Ireland.

    Kelly, C. B.

    1998-01-01

    The Northern Ireland Section (Irish Division) of the Royal College of Psychiatrists were requested to investigate apparent increasing pressures on acute psychiatric beds. Information on bed occupancy and associated service activity was collected by clinicians on site in every psychiatric unit in Northern Ireland over the past eight years. Three separate years (1987, 1991 and 1995) were studied. Bed occupancy rose across these three years. There was an associated reduction in the number of acu...

  8. Violence prevention and management in acute psychiatric care: aspects of nursing practice

    Björkdahl, Anna

    2010-01-01

    Aim: The general aim of this thesis was to explore and evaluate different aspects of nursing practice in relation to prediction, prevention and management of patient violence in acute psychiatric care. The specific aims were: to evaluate the short-term predictive capacity of the violence risk assessment instrument Brøset Violence Checklist (BVC) when used by nurses in a psychiatric intensive care unit (study I), to compare the occurrences of coercive interventions and violence-rel...

  9. The Impact of Cannabis Use on the Dosage of Antipsychotic Drugs in Patients Admitted on the Psychiatric Ward at the University Hospital of the West Indies

    P Thomas

    2015-03-01

    Full Text Available Objective: To assess the impact of cannabis use on the efficacy of antipsychotic drugs in male subjects presenting to the University Hospital of the West Indies (UHWI with psychotic episodes. Methods: Male subjects, 18–40 years old, admitted to the psychiatric ward of the UHWI between February 2013 and May 2013, diagnosed with schizophrenia, schizophreniform disorder and who tested positive for ∆9-tetrahydrocannabinol were recruited for the study. On day one, consenting subjects were assessed using the Brief Psychiatric Rating Scale (BPRS. Patients were prescribed seven days of an oral antipsychotic medication (haloperidol, chlorpromazine, risperidone, quetiapine, olanzapine. Medicated subjects were then reassessed using the BPRS on days three and seven. Statistical analysis involved the use of Student’s t-test and repeated measure analysis of variance. Results: In total, 20 subjects were recruited (mean age = 26.00 ± 5.96 years. Subjects were grouped based on the daily chlorpromazine equivalent (CPZE dose given on day one into CPZE1 (CPZE dose of 100–300mg; n = 8 and CPZE2 (CPZE dose of 400–1250 mg; n = 12. There was no significant difference in the total BPRS score between the groups on day one (CPZE1 = 41.38 ± 16.47 versus CPZE2 = 49.42 ± 25.58; p = 0.44; similar findings were obtained for the positive (26.75 ± 9.27 versus 31.83 ± 17.30; p = 0.46 and negative (14.63 ± 7.73 versus 17.58 ± 9.74; p = 0.48 symptom component on the BPRS. For subjects in CPZE1, there was no significant decrease in total BPRS score [F(2,21 = 0.07, p = 0.93] over the study period. For CPZE2, significant reduction in total BPRS scores was achieved [F(2,33 =7.12, p = 0.01], contributed by significant decrease in the positive [F(2,33 = 5.64, p = 0.02 and negative [F(2,33 = 7.53, p = 0.01 symptom components of the BPRS. Conclusion: The findings of this study purport that male cannabis users presenting with psychotic disorders may not achieve optimal

  10. Activity sampling of nurses of a sub-acute ward of a large hospital.

    Bobdey, C S; Sandhu, M S; Urmil, A C; Dayakar, T

    1992-07-01

    A study was conducted in a 43 bedded subacute family ward of a large hospital to find out the adequacy and efficiency of its nursing service. Activity analysis in respect of nurses was carried out by Activity Sampling Technique. The study revealed that out of 334 activities, observed, 78 (23.3%) were non-productive, whereas 256 (76.7%) were productive. Out of the productive activities, 148 (44.3%) were for direct patient care mainly comprising of 46 (31.1% for carrying out technical procedures, 36 (24.32%) for determining patients' needs, 20 (13.15%) for preparing patients for various procedures and 15 (10.14%) for assisting in technical procedures. Number wise the nurses were found to be adequate. PMID:10130935

  11. Behavioural and Psychiatric Symptoms in People with Dementia Admitted to the Acute Hospital: Prospective Cohort Study

    Sampson, E L; White, N.; Leurent, B.; Scott, S; Lord, K; Round, J; Jones, L.

    2014-01-01

    BACKGROUND: Dementia is common in older people admitted to acute hospitals. There are concerns about the quality of care they receive. Behavioural and psychiatric symptoms of dementia (BPSD) seem to be particularly challenging for hospital staff. AIMS To define the prevalence of BPSD and explore their clinical associations. METHOD: Longitudinal cohort study of 230 people with dementia, aged over 70, admitted to hospital for acute medical illness, and assessed for BPSD at admission and every 4...

  12. 精神科病房护士的心理压力源分析及改善方法%An Analysis and Improving Methods on Psychological Stress Source of Nurses in Psychiatric Ward

    王伟卓; 王莉; 王新福

    2014-01-01

    Objective To investigate the psychological status of nurses in psychiatric ward, and analysis on sources of psychological stress, by that, proposed improving methods, improving work ef iciency. Methods Nurses in psychiatric ward of our hospital as the research object, Self-rating depression scale (SDS), Self-Rating Anxiety Scale (SAS) and Nurse Vocational Pressure Questionnaire (NVPQ) were used to investigate the psychological status, al data was processed by the data statistical software SPSS. Results The scores of SDS and SAS of nurses in psychiatric ward were significantly higher than that of ordinary people ( <0.01). Correlative analysis showed that there was a positive correlation between depression status and work pressure ( <0.01). 7 items of sources of work pressure were the main psychological pressure of nurses in psychiatric ward. Conclusion Take related measures, enhancing nurse psychological status, keeping them best working state, and improving nursing quality.%目的通过问卷调查了解精神科病房护士的心理状况,并对心理压力源进行分析,从而提出针对性的改善方法,提高工作效率。方法以我院精神科住院病房护士为研究对象,运用抑郁自评量表喳SDS札焦虑自评量表喳SAS札护士职业压力调查表等进行问卷调查,并对所得数据进行统计学处理。结果精神科病房护士SDS和SAS评分明显高于正常人,u值=5.28;值均<0.01差异有显著性意义抑郁状况与工作压力呈正相关,工作压力源有7项是精神科病房护士主要的心理压力源。结论采取针对性的相关措施,改善护理人员的心理状况,保持最佳的工作状态,提高护理质量。

  13. Admissions to acute adolescent psychiatric units: a prospective study of clinical severity and outcome

    Jensen Gunnar; Hatling Trond; Heyerdahl Sonja; Hanssen-Bauer Ketil; Olstad Pål; Stangeland Tormod; Tinderholt Tarje

    2011-01-01

    Abstract Background Several countries have established or are planning acute psychiatric in-patient services that accept around-the-clock emergency admission of adolescents. Our aim was to investigate the characteristics and clinical outcomes of a cohort of patients at four Norwegian units. Methods We used a prospective pre-post observational design. Four units implemented a clinician-rated outcome measure, the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA), which ...

  14. Detection and documentation of dementia and delirium in acute geriatric wards.

    Laurila, Jouko V; Pitkala, Kaisu H; Strandberg, Timo E; Tilvis, Reijo S

    2004-01-01

    Detection of cognitive impairment among hospitalized older individuals has shown to be insufficient. A point prevalence study in two geriatric hospitals in Helsinki, Finland, was performed among 219 acutely ill individuals over 70 years to assess the detection of dementia and delirium. Documentation of dementia and delirium in medical records, and recordings of confusional symptoms in nurses' notes were compared with the researchers' diagnosis made after a detailed assessment of cognitive status. The cognitive decline was mentioned in medical records in 70/88 (79.5%) of the cases. Cognitive testing was performed on 42/88 (47.7%) of the dementia patients, and the diagnosis of dementia was recorded in 47/88 (53.4%) of them. A specific etiological diagnosis was recorded in only 4/88 (4.5%) cases. Cognitive impairment in at least one of these four means was recorded in 80/88 (90.9%) of cases (sensitivity 0.93). Eight patients had a false-positive diagnosis of dementia (specificity 0.94). Delirium was diagnosed in 77 (35.2%) patients by the researchers, but it was recorded in only 31/77 (40.3%) in medical records. In 64/77 (83.1%) cases signs of confusion were recorded in nurses' notes. Poor detection and documentation may lead to undertreatment of both disorders. PMID:14757300

  15. 医护联合查房在精神科临床实践中的应用%Application on nursing ward rounds with doctor in psychiatric clinical practice

    樊建民

    2011-01-01

    目的 探讨医护联合查房在精神科的临床应用效果.方法 自2005年以来在我院开展了医护联合查房,并对患者满意度、意外事件、患者或家属投诉3个方面进行了开展前后的对比.结果 开展医护联合查房后患者满意度提高(χ2=85.369,P=0.000),各类意外事件发生率、投诉率下降.结论 医护联合查房促进了"交流一协作-互补"型医护关系的建立,提高了患者满意度,减少了意外事件发生,提升了护士自身价值感.%Objective To discuss the impact on nursing ward rounds with doctor in psychiatric clinical practice.Methods Since 2005,our hospital has carried out the nursing ward rounds with doctor,it has compared with the three aspects of patient satisfaction,accidents,complaints of patients or their families foreand-aft.Results Patient satisfaction was improved(χ2=85.369,P=0.000),and varioustypes accidents and complaints dropped after the nursing ward rounds with doctor.Conclusions Nursing ward rounds with doctor promoted establishing"communication-collaboration-complement"relationship between nurses and doctors,improved patient satisfactions,reduced accidents,improved self-sense of worth of nurses.

  16. Experiences of patients with acute abdominal pain in the ED or acute surgical ward --a qualitative comparative study

    Schultz, Helen; Qvist, Niels; Backer Mogensen, Christian;

    2013-01-01

    observation unit. A phenomenological-hermeneutic comparative field study with participant observation and interviews was performed. The analysis showed five themes: Waiting, being placed on the edge, taking or not taking initiative, being the object of attention and being taken seriously. The conclusion was...... that the ED included a multidisciplinary team with nurses, who mainly had interactions with the patients before surgical assessment. In all, it resulted in fragmentation of care and a patient experience of repetition. In ASW, focus was on assessment by a senior physician, only, and the nurses......' interaction with the patients took place after surgical assessment. In all, patients experienced long waiting times. The study shows a need to define the roles of the professionals in units receiving patients with acute abdominal pain in order to fulfil the medical as well as the experienced needs of the...

  17. A systematic review of music therapy practice and outcomes with acute adult psychiatric in-patients.

    Catherine Carr

    Full Text Available There is an emerging evidence base for the use of music therapy in the treatment of severe mental illness. Whilst different models of music therapy have been developed in mental health care, none have specifically accounted for the features and context of acute in-patient settings. This review aimed to identify how music therapy is provided for acute adult psychiatric in-patients and what outcomes have been reported.A systematic review using medical, psychological and music therapy databases. Papers describing music therapy with acute adult psychiatric in-patients were included. Analysis utilised narrative synthesis.98 papers were identified, of which 35 reported research findings. Open group work and active music making for nonverbal expression alongside verbal reflection was emphasised. Aims were engagement, communication and interpersonal relationships focusing upon immediate areas of need rather than longer term insight. The short stay, patient diversity and institutional structure influenced delivery and resulted in a focus on single sessions, high session frequency, more therapist direction, flexible use of musical activities, predictable musical structures, and clear realistic goals. Outcome studies suggested effectiveness in addressing a range of symptoms, but were limited by methodological shortcomings and small sample sizes. Studies with significant positive effects all used active musical participation with a degree of structure and were delivered in four or more sessions.No single clearly defined model exists for music therapy with adults in acute psychiatric in-patient settings, and described models are not conclusive. Greater frequency of therapy, active structured music making with verbal discussion, consistency of contact and boundaries, an emphasis on building a therapeutic relationship and building patient resources may be of particular importance. Further research is required to develop specific music therapy models for this

  18. Acute atropine intoxication with psychiatric symptoms by herbal infusion of Pulmonaria officinalis (Lungwort

    Enrique Baca-García

    2007-06-01

    Full Text Available Background and objectives: Lungwort infusion is a preparation extracted from Pulmonaria officinalis which is occasionally used as a folk remedy for the common cold. The current report aims to describe acute atropine intoxications with delirium caused by Lungwort infusion in several members of the same family. Methods: Description of three case reports. Search of literature through Medline. Results: Three generations of a same family presented acute and moderately severe atropine intoxications after drinking an infusion prepared with Pulmonaria officinalis. Conclusions: Despite the lack of scientific evidence for its clinical use, medicinal plants continue being widely used. In spite of severe adverse effects reported, the general thought is that herbal remedies are harmless. To our knowledge, this is the first report of acute atropine intoxications with psychiatric symptoms secondary to Pulmonaria officinalis in several members of a family. We suspect that the lungwort infusion may have been contaminated with some other substance with atropinic properties.

  19. Treatment needs, diagnoses and use of services for acutely admitted psychiatric patients in northwest Russia and northern Norway

    Sørgaard Knut W

    2013-01-01

    Full Text Available Abstract Background We compared demography, diagnoses and clinical needs in acutely admitted psychiatric hospital patients in northwest Russia and northern Norway. Method All acutely admitted psychiatric patients in 1 psychiatric hospital in north-west Russia and 2 in northern Norway were in a three months period assessed with HoNOS and a Norwegian form developed to study acute psychiatric services (MAP. Data from a total of 841 patients were analysed (377 Norwegian, 464 Russian with univariate and multivariate statistics. Results Russian patients were more often males who had paid work. 2/3 were diagnosed with alcohol and organic disorders, and 70% reported problems related to sleep. Depression was widespread, as were problems associated with occupation. Many more Norwegian patients were on various forms of social security and lived in community supported homes. They had a clinical profile of affective disorders, use of drugs, suicidality and problems with activities involved of daily life. Slightly more Norwegian patients were involuntary admitted. Conclusion Acutely admitted psychiatric patients in North West Russia and Northern Norwegian showed different clinical profiles: alcohol, depression and organic disorders characterised Russian patients, affective disorders, suicidality and use of drugs characterised the Norwegians. Whereas Norwegian patients are mainly referred from GPs the Russians come via 1.line psychiatric services (“dispensaries”. Average length of stay for Russian patients was 2.5 times longer than that of the Norwegian.

  20. Emergency room referral to internal medicine wards or to coronary care units of patients with first acute myocardial infarction. Israel Study Group on First Acute Myocardial Infarction.

    Drory, Y; Shapira, I; Goldbourt, U; Fisman, E Z; Villa, Y; Tenenbaum, A; Pines, A

    2000-01-01

    The objective of the study was to assess factors associated with ward assignment in the emergency room for patients assignment (coronary care unit versus internal ward). Eight major centrally located Israeli hospitals provided data during one year. The study population included 1252 patients, of whom 83% were men, 37% were hypertensives, 22% were diabetics, and 14% had previous anginal syndrome. Most patients (83%) were admitted to the coronary care unit. Internal medicine ward assignment was significantly associated with advanced age, history of hypertension or diabetes, a longer time from appearance of symptoms to arrival at the hospital, and myocardial infarction type (non-Q-wave or non-anterior). The likelihood of medical ward referral increased stepwise with the increasing number of a patient's predictive factors: those with > or = 4 factors had a > 30% chance of being assigned to a medical ward compared to a decision making in the emergency room are needed to resolve this paradoxical situation. PMID:10998758

  1. Short-Term Diagnostic Stability of Acute Psychosis: Data from a Tertiary Care Psychiatric Center in South India

    Narayanaswamy, Janardhanan C.; Virupaksha Harave Shanmugam; Dhanya Raveendranathan; Biju Viswanath; Kesavan Muralidharan

    2012-01-01

    Context: Studies on acute psychosis in patients from India report good outcome. A small proportion of these patients may suffer relapses or other develop major psychiatric disorders later. Aim: The aim of this study was to examine the diagnostic stability of acute psychosis in patients from India. Materials and Methods: The records of patients who presented with the first episode of acute and transient psychotic disorder (n=57) over 1 year (2004) were analyzed, and the follow-up data at the e...

  2. Implementing the care programme for the last days of life in an acute geriatric hospital ward: a phase 2 mixed method study

    Verhofstede, Rebecca; Smets, Tinne; Cohen, Joachim; Costantini, Massimo; Van Den Noortgate, Nele; Deliens, Luc

    2016-01-01

    Background: To improve the quality of end-of-life care in geriatric hospital wards we developed the Care Programme for the Last Days of Life. It consists of 1) the Care Guide for the Last Days of Life, 2) supportive documentation and 3) an implementation guide. The aim of this study is (1) to determine the feasibility of implementing the Care Programme for the Last Days of Life in the acute geriatric hospital setting and (2) to explore the health care professionals' perceptions of the effects...

  3. Longitudinal assessment of quality of life in acute psychiatric inpatients: reliability and validity.

    Russo, J; Roy-Byrne, P; Reeder, D; Alexander, M; Dwyer-O'Connor, E; Dagadakis, C; Ries, R; Patrick, D

    1997-03-01

    This study examined the reliability, validity, and responsiveness of Lehman's Quality of Life Interview (QOLI) as an outcome measure on 981 acutely ill psychiatric inpatients assessed longitudinally at admission and discharge. Patients were stratified into five diagnostic (DX) (depressed bipolar, depressed unipolar, schizophrenia, mania, and other diagnoses) and two substance use disorder (SA) strata (with and without concurrent substance abuse/dependence) based on DSM-III-R criteria. There was good replication of the factor structure, excellent internal consistency, overall and within DX and SA groups. Intercorrelations showed that the functional and satisfaction indices measure unique aspects of the quality of life. The construct consistency of the QOLI was dependent upon psychiatric diagnosis and life domain. Intercorrelations of functional and satisfaction indices for patients with depression were greater than for manic patients. We demonstrated strong consistency of construct validity for family and social relation domains, but not safety or leisure activities. Construct validity was shown to hold longitudinally. Analyses of DX and SA group differences on satisfaction and functional indices of the 8 life domains supported discriminative validity: Depressed patients reported the most dissatisfaction, followed by schizophrenic patients, and manic patients reported the greatest satisfaction in most life domains. Patients with concurrent substance abuse generally reported less satisfaction and lower quality of life than patients without a dual diagnosis. Examination of longitudinal changes in satisfaction indicated the QOLI is responsive to changes in global life, leisure activities, living situation, and social relations from hospital admission to discharge (an average of 2 weeks). This study supports the use of the QOLI as an outcome measure to assess quality of life in acutely ill hospitalized psychiatric patients. PMID:9091598

  4. "We Have to Be Satisfied with the Scraps": South African Nurses' Experiences of Care on Adult Psychiatric Intellectual Disability Inpatient Wards

    Capri, Charlotte; Buckle, Chanellé

    2015-01-01

    Background: Migrating nursing labour inadvertently reinforces South Africa's care drain, contributes to a global care crisis and forces us to reconsider migration motivation. This paper highlights issues that complicate psychiatric intellectual disability nursing care and identifies loci for change in an attempt to redress this care challenge.…

  5. Psychiatric Wards Nursing Management Responsibility in Grouping Application Significance to Explore the Nursing Mode%精神科病房护理管理中责任分组护理模式的应用意义探究

    张凤坤

    2015-01-01

    Objective To analysis the psychiatric ward nursing management responsibility group nursing mode application significance. Methods In February 2012 -March 2015 treated in our hospital during the period of psychiatric patients, 102 cases as the research object, by using the method to computer group 51 cases were divided into observation group and con-trol group in 51 cases. The observation group patients' responsibility group nursing mode, control group patients give the traditional model of nursing. Comparative analysis of two groups of patients nursing satisfaction. Results After different nursing mode, the observation group of patients nursing satisfaction was 96.1% (49/51); The control group patients nursing satisfaction was 70.6% (36/51);The observation group was better than control group (P<0.05), the more significant differ-ence between the two groups. Conclusion Grouping responsibility nursing model was applied to the psychiatric ward nurs-ing management can improve the patient's nursing satisfaction, while increasing patients compliance, has high practical val-ue, can promote in clinical use.%目的 分析精神科病房护理管理中责任分组护理模式的应用意义. 方法 选取该院精神科2012年2月-2015年3月收治的102例患者为研究对象,采用电脑分组将其随机分为观察组和对照组,各51例患者. 观察组给予责任分组护理,对照组给予传统护理.对比分析两组患者的护理满意度.结果经过不同模式的护理,观察组和对照组患者的护理满意度分别为96.1%(49/51)和70.6%(36/51);观察组明显优于对照组(P<0.05),两组间比较差异有统计学意义.结论 将责任分组护理模式应用于精神科病房护理管理中能够使患者的护理满意度提升,同时使患者的依从性增加,具有良好的实用价值,临床中可推广使用.

  6. Admissions to acute adolescent psychiatric units: a prospective study of clinical severity and outcome

    Jensen Gunnar

    2011-01-01

    Full Text Available Abstract Background Several countries have established or are planning acute psychiatric in-patient services that accept around-the-clock emergency admission of adolescents. Our aim was to investigate the characteristics and clinical outcomes of a cohort of patients at four Norwegian units. Methods We used a prospective pre-post observational design. Four units implemented a clinician-rated outcome measure, the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA, which measures mental health problems and their severity. We collected also data about the diagnoses, suicidal problems, family situations, and the involvement of the Child Protection Service. Predictions of outcome (change in HoNOSCA total score were analysed with a regression model. Results The sample comprised 192 adolescents admitted during one year (response rate 87%. Mean age was 15.7 years (range 10-18 and 70% were girls. Fifty-eight per cent had suicidal problems at intake and the mean intake HoNOSCA total score was 18.5 (SD 6.4. The largest groups of main diagnostic conditions were affective (28% and externalizing (26% disorders. Diagnoses and other patient characteristics at intake did not differ between units. Clinical psychiatric disorders and developmental disorders were associated with severity (on HoNOSCA at intake but not with outcome. Of adolescents ≥ 16 years, 33% were compulsorily admitted. Median length of stay was 8.5 days and 75% of patients stayed less than a month. Compulsory admissions and length of stay varied between units. Mean change (improvement in the HoNOSCA total score was 5.1 (SD 6.2, with considerable variation between units. Mean discharge score was close to the often-reported outpatient level, and self-injury and emotional symptoms were the most reduced symptoms during the stay. In a regression model, unit, high HoNOSCA total score at intake, or involvement of the Child Protection Service predicted improvement during admission

  7. The application of nursing model with grouping responsibility system in the psychiatric wards%小组责任制护理模式在精神科病房中的应用

    周勤玲; 林素英; 高镇松; 郑素燕; 陈友兰; 黄琼娇

    2012-01-01

    目的 探讨小组责任制护理模式在精神科示范病房中的应用效果.方法 对优质护理服务示范工程男女两个试点病区实行小组责任制护理,在实施前及实施一年后各抽取120例患者(男女各半)对护理工作满意度进行评价比较,并于实施后调查医生、护士对小组责任制护理的满意度.结果 实施一年后,2个试点病区患者对护理工作满意度显著高于实施前(P< 0.05或P< 0.01),护士总满意率为93.2%,医生总满意率为95.8%.结论 对精神病患者实施小组责任制护理能密切护患关系,增强患者对护理的依从性,促进患者精神康复,有效提高了护士的整体水平和综合素质、树立医院形象.%Objective To explore the implementation effect of nursing model with grouping responsibility system in the psychiatric wards.Methods Patients in male and female pilot wards of quality nursing care demonstration project were practised nursing model with grouping responsibility system.Before and after one year's practice,120 patients (by halves as sex) were randomly sampled to compare nursing satisfaction.After practice,doctors and nurses were investigated to measure satisfaction about implementation of grouping responsibility system.Results After one year' s practice,the nursing care satisfaction rates of two pilot wards patients showed significantly higher than that before practice( P< 0.05 ).The total satisfaction rate was 93.2% in nurse,and 95.8% in doctor.Conclusions Grouping responsibility system nursing care services for patients with mental illness can close nurse-patient relationship,enhance patient nursing compliance,promote patients mental recovery,raise nurse nursing level,multiple qualifications,and set up a better image of the hospital.

  8. The application of humane care concept in the management of psychiatric ward%人文关怀理念在精神科病房管理中的应用

    姜杨

    2014-01-01

    介绍日本及我国香港和台湾地区医院精神科病房如何通过提高员工的人文素养、改进病房环境设计、保护患者权益等措施来体现人文关怀,彰显了只有确保患者与员工的安全才是完整的医疗行为。安全、舒适、便捷的工作环境与职业情感、团队协作精神的有机结合,是精神科人文关怀的最好体现。启示我们须加强对人文关怀的理解,注重人文关怀能力的教育。%To introduce Japan, as well as some Chinese regions such as Hong Kong and Taiwan relfected the requirements of humane care,by improving the quality of psychiatric staff,ward environment design, facilities transitions, and rights protection of the patients for tangible and intangible services .The idea highlightens the importance of medical activities in a safe, comfortable and convenientenviroment The combination of safe, comfortable and convenient working environment with occupational emotion, and collaborative teamwork is the best embodiment of humanistic care in psychiatry.

  9. Acute pain treatment on postoperative and medical non-surgical wards [Akutschmerztherapie auf operativen und konservativen Stationen

    Korczak, Dieter

    2013-05-01

    Full Text Available [english] The effectiveness of acute pain treatment in hospitals is examined. An efficient therapy of acute pain is efficient and cost-effective. Although every patient is entitled for the relief of pain, many hospitals do not treat acute pain in an optimal manner.[german] Es wird die Effektivität der Akutschmerztherapie in Krankenhäusern untersucht. Eine effiziente Behandlung akuter Schmerzen ist wirksam und spart Kosten. Obwohl jeder Patient Anspruch auf Linderung seiner Schmerzen hat, behandeln viele Krankenhäuser akute Schmerzen noch nicht optimal.

  10. Acute effects of electroconvulsive therapy on regional cerebral blood flow (rCBF) in psychiatric disorders

    Electroconvulsive therapy (ECT) is frequently used in the treatment of major depression and other psychiatric disorders; its mechanism of action is not established, but previous evidence suggests that it is associated with postictal metabolic suppression. The authors have used measurements of rCBF as an index of cortical metabolic activity to study the acute effects of ECT. Measurements of rCBF were made in 32 cortical regions in 10 patients (pts) following one minute breathing of Xe-133 (5mCi/L); the measurements were performed 30min before and 50min after ECT. Bilateral ECT was administered to six pts (five diagnosed as major depressives and one schizophrenic) and unilateral ECT to four (all diagnosed as unipolar or bipolar affective disorder). The total rCBF material consists of 52 measurements in these pts, made before and after 16 bilateral and 10 unilateral treatments. ECT was found to cause significant reduction of rCBF. Mean hemispheric flows (using the Initial Slope Index to measure grey-matter flow) were reduced by about 5% in both hemispheres following bilateral treatment. Unilateral treatment caused a 9% reduction of flow in the treated hemisphere, but only 2% contralaterally. Regional patterns of flow decreases also differed between the two treatment modes: bilateral frontal reductions were found after bilateral treatment, whereas unilateral ECT caused a widespread flow reduction in the treated hemisphere, and almost no effect contralaterally. These results suggest that rCBF studies are useful for assessing ECT, and indicate that the acute cerebral effects of ECT vary with the mode of treatment

  11. Clinical, Paraclinical, and Antimicrobial Resistance Features of Community-Acquired Acute Bacterial Meningitis at a Large Infectious Diseases Ward in Tehran, Iran.

    Heydari, Behrooz; Khalili, Hossein; Karimzadeh, Iman; Emadi-Kochak, Hamid

    2016-01-01

    In this study demographic, clinical, paraclinical, microbiological, and therapeutic features of patients with community-acquired acute bacterial meningitis admitted to a referral center for infectious diseases in Iran, have been evaluated. Medical records of adult (> 18 years) individuals with confirmed diagnosis of community-acquired bacterial meningitis during a 4-year period were retrospectively reviewed. All required data were obtained from patients' medical charts. Available findings about antimicrobial susceptibility of isolated bacteria from CSF and/or blood were also collected. Kirby-Bauer disc diffusion method was used to determine their antimicrobial susceptibility profile. Details of medical management including antibiotic regimen, duration, patients' outcome, and possible sequelae of meningitis were recorded. The most commonly isolated microorganism from CSF or blood of patients was Streptococcus pneumonia (33.33%) followed by Neisseria meningitidis (27.78%) and Haemophilus influenza (16.67%). The most common antimicrobial regimen was ceftriaxone plus vancomycin (69.44%) followed by ceftriaxone plus vancomycin plus ampicillin (11.11%). Neurological sequelae of meningitis including cranial nerve palsy, deafness, and hemiparesis were identified in 4 (11.11%), 2 (5.56%), and 1 (2.78%) subjects, respectively. Regarding mortality, only 3 (8.33%) patients died from bacterial meningitis and the remaining 33 individuals discharged from the hospital. In conclusion, findings of the current study demonstrated that the mean incidence of acute bacterial meningitis in a referral infectious diseases ward in Iran was 9 episodes per year. The majority cases of community-acquired acute bacterial meningitis admitted to our center had negative CSF culture and classic triad of meningitis was absent in them. PMID:27610176

  12. Can patients with moderate to severe acute respiratory failure from COPD be treated safely with noninvasive mechanical ventilation on the ward?

    Yalcinsoy M

    2016-05-01

    Full Text Available Murat Yalcinsoy,1 Cuneyt Salturk,2 Selahattin Oztas,2 Sinem Gungor,2 Ipek Ozmen,2 Feyyaz Kabadayi,2 Aysem Askim Oztim,2 Emine Aksoy,2 Nalan Adıguzel,2 Ozlem Oruc,2 Zuhal Karakurt2 1Department of Pulmonary Medicine, Inonu University Medical Faculty, Turgut Ozal Medical Center, Malatya, 2Department of Pulmonary Medicine, Sureyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey Purpose: Noninvasive mechanical ventilation (NIMV usage outside of intensive care unit is not recommended in patients with COPD for severe acute respiratory failure (ARF. We assessed the factors associated with failure of NIMV in patients with ARF and severe acidosis admitted to the emergency department and followed on respiratory ward.Patients and methods: This is a retrospective observational cohort study conducted in a tertiary teaching hospital specialized in chest diseases and thoracic surgery between June 1, 2013 and May 31, 2014. COPD patients who were admitted to our emergency department due to ARF were included. Patients were grouped according to the severity of acidosis into two groups: group 1 (pH=7.20–7.25 and group 2 (pH=7.26–7.30.Results: Group 1 included 59 patients (mean age: 70±10 years, 30.5% female and group 2 included 171 patients (mean age: 67±11 years, 28.7% female. On multivariable analysis, partial arterial oxygen pressure to the inspired fractionated oxygen (PaO2/FiO2 ratio <200, delta pH value <0.30, and pH value <7.31 on control arterial blood gas after NIMV in the emergency room and peak C-reactive protein were found to be the risk factors for NIMV failure in COPD patients with ARF in the ward.Conclusion: NIMV is effective not only in mild respiratory failure but also with severe forms of COPD patients presenting with severe exacerbation. The determination of the failure criteria of NIMV and the expertise of the team is critical for treatment success. Keywords: noninvasive mechanical ventilation

  13. Stepping Back and Listening: Staff Experiences of Using a Coaching Approach in an Acute Rehabilitation Ward for Older Adults.

    Gray, Debra; Ross, Kirsty; Prat-Sala, Merce; Kibble, Sharon; Harden, Beverley

    2016-08-01

    Previous research has highlighted that acute care provision can lead to a loss of confidence, control, and independent functioning in older adult patients. In addition, it is recognized that interactions between patients and health care staff are central to the prevention of functional decline in patients. In this study, we aimed to affect the staff-patient relationship by implementing a coaching intervention in an older adult acute care setting. Here, we report on staff experiences of this coaching approach. Data were collected from 16 members of staff via semi-structured interviews, which were analyzed using thematic analysis. Four themes were identified: Putting a Label on It, Stepping Back and Listening, Identifying the Opportunities, and Working as Team. Our findings show that a coaching approach can be successful in getting staff to reconsider their interactions with patients and to focus on strategies that foster the independence and autonomy of older adult patients. PMID:26481943

  14. Examination of acute treatment strategies in 314 patients with putaminal hemorrhage from the view point of functional prognosis in kaifukuki rehabilitation wards

    We examined the influence of acute treatment strategies for putaminal hemorrhage from the view point of the functional prognosis in Kaifukuki rehabilitation wards. Subjects were 314 patients with putaminal hemorrhage for inpatient rehabilitation in our hospital. For all patients, Functional Independence Measure (FIM), Barthel Index (BI), Independence of Gait (IOG) was measured on admission and discharge, respectively. We examined the functional prognosis, according to method of treatment, age, volume of hematoma, CT classification, side of damage, sex, and hospitalization waiting period. A significant difference was admitted with FIM, BI, and IOG in the age, the volume of hematoma, the hospitalization waiting period, and the CT classification (p<0.05). The functional prognosis was excellent in the conservative treatment than in the surgical treatment. The hospitalization waiting period was significantly a long term in the surgical treatment (p<0.05). In the analysis where the age is arranged the volume of hematoma, the surgical treatment was more excellent than the conservative treatment, in the patients less than 70 years old and the volume of hematoma with 60 ml or more. The functional prognosis of putaminal hemorrhage was excellent in the conservative treatment, but the stereotactic hematoma evacuation is recommended to the limited case as a surgical treatment. Early rehabilitation is a pressing need for the improvement of the functional prognosis. Especially, it is indispensable to shorten the hospitalization waiting period in the surgical treatment. (author)

  15. Investigation the effects of professionalized nursing health education on psychiatric patients in ward%专职化护理健康教育对住院精神病患者的影响

    郑慧芳; 姜海涛

    2011-01-01

    目的 探讨专职化护理健康教育对住院精神病患者的影响及效果.方法 将在我院的住院精神病患者212例,随机分为研究组105例和对照组107例.研究组实施专职化护理健康教育,对照组实施常规健康教育,比较两组患者在干预前及干预10周后患者对治疗的依从性,护理满意度、健康教育内容的掌握程度以及希望获得健康教育的途径.结果 研究组对治疗的依从性,护理满意度、健康教育内容的掌握程度均高于对照组,差异有统计学意义.两组患者均希望以更多的传播形式来获得健康教育知识.结论 实施专职化护理健康教育能提高住院精神病患者对治疗的依从性、密切护患关系,提高满意度.%Objective To investigate the effects of professionalized nursing health education on psychiatric patients in ward.Methods 212 patents,recruited from April,2009 to December,2010,were randomized to study group(105)and control group(107).Patients in study group received professionalized health education,and the 0nes in control group got regular health education.After 10-week intervention,treatment compliance,nursing satisfaction,health knowledge,and understanding of health information pathway were systemically compared between study group and control group.Results The rating scores of treatment compliance,nursing satisfaction,and health knowledge from study group were significantly higher than those scores from control group.Furthermore,patients in beth groups demonstrated the importance of health education in various ways.Conclusions Professionalized health nursing education is able to improve treatment compliance,relationship of patients and nurses, nursing satisfaction, and health-related knowledge.The pathways of health education need to be developed in diverse directions so as to maximize the effects of nursing health education.

  16. Psychiatric side effects of acute high-dose corticosteroid therapy in neurological conditions.

    Lotan, Itay; Fireman, Liora; Benninger, Felix; Weizman, Abraham; Steiner, Israel

    2016-07-01

    It has been implied that high-dose corticosteroids (CSs) commonly cause psychiatric side effects. Here, we examined the rate and risk factors of psychiatric side effects during high-dose CS treatment in patients with neurological disorders. Patients treated with high-dose intravenous CSs for neurological disorders were evaluated for depression, mania, and psychosis using the Beck Depression Inventory, the Geriatric Depression Scale, the Young Mania Rating Scale, and the Brief Psychiatric Rating Scale before CS treatment, immediately after, and 1 month following treatment. Forty-nine consecutive patients were monitored. There was a reduction in the Beck Depression Inventory and Geriatric Depression Scale scores as well as in the Brief Psychiatric Rating Scale scores throughout the study period and a transitory increase in the Young Mania Rating Scale score immediately after CS administration. Thus, a tendency to develop transient mild euphoria during high-dose CS treatment exists, but is reversible at 1 month, whereas a reduction in depressive symptoms tended to persist. Overall, our data indicate that high-dose CS treatment for neurological diseases is relatively safe with respect to psychiatric complications. PMID:26938038

  17. Locked doors in acute inpatient psychiatry: a literature review.

    van der Merwe, M; Bowers, L; Jones, J; Simpson, A; Haglund, K

    2009-04-01

    Many acute inpatient psychiatric wards in the UK are permanently locked, although this is contrary to the current Mental Health Act Code of Practice. To conduct a literature review of empirical articles concerning locked doors in acute psychiatric inpatient wards, an extensive literature search was performed in SAGE Journals Online, EBM Reviews, British Nursing Index, CINAHL, EMBASE Psychiatry, International Bibliography of the Social Sciences, Ovid MEDLINE, PsycINFO and Google, using the search terms 'open$', 'close$', '$lock$', 'door', 'ward', 'hospital', 'psychiatr', 'mental health', 'inpatient' and 'asylum'. A total of 11 empirical papers were included in the review. Both staff and patients reported advantages (e.g. preventing illegal substances from entering the ward and preventing patients from absconding and harming themselves or others) and disadvantages (e.g. making patients feel depressed, confined and creating extra work for staff) regarding locked doors. Locked wards were associated with increased patient aggression, poorer satisfaction with treatment and more severe symptoms. The limited literature available showed the urgent need for research to determine the real effects of locked doors in inpatient psychiatry. PMID:19291159

  18. Challenges in Obtaining HIV Testing in an Acute Involuntary Inpatient Psychiatric Setting.

    Weller, Jennifer; Levitt, Gwen; Myers, Robert; Riley, Aaron; Gesmundo, Celsius-Kit

    2016-01-01

    Even in health care professions, a stigma remains for patients with co-occurring HIV and serious mental illness. Researchers at a large, urban medical center encountered this stigma when they attempted to initiate a study of cognition in psychiatric inpatients with and without HIV who were seen as vulnerable in the context of research. Education efforts and advocacy on the part of the research team was instrumental and resulted in system-wide changes in the hospital, including the addition of HIV testing to the psychiatric admission laboratory panel. Within the first year that routine laboratory orders included an HIV test, the rate of testing ordered by inpatient-attending psychiatrists reached 60% of admissions. As of 2014, 13 HIV tests were found to be HIV seropositive in inpatients, with four of those cases classified as new-onset, as opposed to two positive tests in the year prior to our study. PMID:27426407

  19. An Evaluative Study of the WOW Program on Patients' Satisfaction in Acute Psychiatric Units

    Xie Huiting; Li Ziqiang

    2013-01-01

    Background: Patient satisfaction is one of the key evidence of the quality of health-care delivery in nursing. Nursing is a patient-centered activity; although nurse-patient interaction is one of the key tenets of mental health nursing, a structured program to enhance this interaction is lacking. To address the gap, the WOW program was developed in a psychiatric hospital but its effectivenesss had not been evaluated.Objective: This study aims to compare satisfaction levels between patients wh...

  20. An Evaluative Study of the WOW Program on Patients' Satisfaction in Acute Psychiatric Units

    Xie Huiting

    2013-01-01

    Full Text Available Background: Patient satisfaction is one of the key evidence of the quality of health-care delivery in nursing. Nursing is a patient-centered activity; although nurse-patient interaction is one of the key tenets of mental health nursing, a structured program to enhance this interaction is lacking. To address the gap, the WOW program was developed in a psychiatric hospital but its effectivenesss had not been evaluated.Objective: This study aims to compare satisfaction levels between patients who have undertaken the WOW program and those who have not.Methodology: A comparative survey design was employed for this study. A purposive sample of 91 adults was obtained from two inpatient psychiatric units: one where the WOW program had beenimplemented and the other, a matched control unit. After patients had been admitted to one of the two inpatient psychiatric units for a week, a questionnaire, modified from the Newcastle Satisfaction with Nursing Scale (NSNS, was administered to participants to assess their level of satisfaction with nursing care.Results and Conclusion: When the satisfaction scores of participants in the WOW group and the control group were compared, it was revealed that the WOW group was more satisfied with nursing care than the control group. Though the difference was not statistically significant, the potential of a structured nurse-patient interaction program to enhance patients’ satisfaction is encouraging. Theresults of this study offer valuable information that may direct the future enhancement and development of programs to improve patient satisfaction.

  1. Effects of psychiatric disorders on Type A acute aortic dissection pathogenesis and analysis of follow-up results

    Paolo Nardi

    2015-12-01

    Full Text Available Aims: A connection between psychiatric disorders (PDs and Type A acute aortic dissection (AAD has not been shown. The aim of this study was to define the psychological profile of patients treated for AAD, and to analyze the prevalence of PDs in their medical histories, in the immediate postoperative period, and at a mid-term follow-up. Patients and Methods: From March 2005 to October 2014, 240 consecutive patients underwent surgery for AAD. 60 patients (mean age 60+/-13 years; 43 males underwent psychiatric consultation postoperatively, and they represent the subjects of our retrospective study. Ascending aorta +/- arch replacement was performed in 43 patients, whereas the Bentall procedure +/- arch replacement was performed in 17. Data were retrospectively analyzed. Follow-ups were completed in 59 patients (mean duration 35+/-23 months. Results: PDs were present in the medical histories of 34 patients. Postoperatively, in 28 cases, a definitive diagnosis of PD (group PD was made in agreement with the diagnostic and statistical manual of mental disorders-IV criteria, including: Major depression (n=13, anxious-depressive syndrome (n=6, bipolar disorder Type 2 (n=4, panic attacks (n=2, paranoid schizophrenia (n=1, and anxiety (n=2. 32 patients without a definitive psychiatric diagnosis were classified as Group non-PD. In the postoperative period, clinical manifestations of PDs, including delirium, persistent spatio-temporal disorientation, and psychomotor agitation were evident in 22 patients (78% in group PD versus 8 patients (25% in group non-PD (P<0.0001. During follow-up, only one death for non-cardiac reasons occurred in group PD. There were no suicides; only 10 patients of group PD required PD treatment (P<0.0001 vs. early postoperative findings; 4 patients in group non-PD required PD treatment. Conclusion: Our findings suggest a strong relationship between PD and AAD. Because the psychiatric conditions appeared to be largely stable after

  2. The Relationship between Adjustment and Perceived Locus of Control for Female Psychiatric Inpatients.

    Youkilis, Hildreth D.; Bootzin, Richard R.

    1979-01-01

    Examines the longitudinal relationship between internal-external locus of control and adjustment using independent measures within two dissimilar treatment environments: a traditional ward and a token economy ward. Subjects were 65 female psychiatric inpatients. (CM)

  3. Comparing the Obvious: Interactional characteristics of staff in acute mental health nursing and forensic psychiatric nursing

    Hounsgaard, Lise; Alkier Gildberg, Frederik; Bradley, S. K.

    2013-01-01

    interviews. Findings show that both acute and forensic mental health nursing practice is characterized by two overriding themes; ‘trust and relationship-enabling care’ and ‘behavior and perception-corrective care.’ The comparison of the two studies shows no major differences in the characteristics of staff...

  4. Lattice supersymmetric ward identities

    SUSY Ward identities for the N=1 SU(2) SUSY Yang-Mills theory are studied on the lattice in a non-perturbative numerical approach. As a result a determination of the subtracted gluino mass is obtained

  5. Violence in psychiatric inpatient care

    Omérov, Majda

    2004-01-01

    This thesis investigates incidents of violence in two psychosis wards, analyses types of violence and the staff s emotional reaction to violence, assesses a new pharmacological treatment strategy of acutely disturbed psychotic patients. One of aims was to investigate the efficiency of violence prevention programme in a new ward for 12 acute psychotic patients. Furthermore, the staff members' and psychotic patients' experiences of one and the same violent incident was compare...

  6. Ward rounds, participants, roles and perceptions: literature review.

    Walton, Victoria; Hogden, Anne; Johnson, Julie; Greenfield, David

    2016-05-01

    Purpose - The purpose of this paper is to classify and describe the purpose of ward rounds, who attends each round and their role, and participants' perception of each other's role during the respective ward rounds. Design/methodology/approach - A literature review of face-to-face ward rounds in medical wards was conducted. Peer reviewed journals and government publications published between 2000 and 2014 were searched. Articles were classified according to the type of round described in the study. Purposes were identified using keywords in the description of why the round was carried out. Descriptions of tasks and interactions with team members defined participant roles. Findings - Eight round classifications were identified. The most common were the generalised ward; multidisciplinary; and consultant rounds. Multidisciplinary rounds were the most collaborative round. Medical officers were the most likely discipline to attend any round. There was limited reference to allied health clinicians and patient involvement on rounds. Perceptions attendees held of each other reiterated the need to continue to investigate teamwork. Practical implications - A collaborative approach to care planning can occur by ensuring clinicians and patients are aware of different ward round processes and their role in them. Originality/value - Analysis fulfils a gap in the literature by identifying and analysing the different ward rounds being undertaken in acute medical wards. It identifies the complexities in the long established routine hospital processes of the ward round. PMID:27142947

  7. Characteristics and dying trajectories of adult hospital patients from acute care wards who die following review by the rapid response team.

    Coombs, M A; Nelson, K; Psirides, A J; Suter, N; Pedersen, A

    2016-03-01

    A third of patients reviewed by rapid response teams (RRT) require end-of-life care. However, little is known about the characteristics and management of these patients following RRT review. This paper presents results of a retrospective, descriptive audit that explored the dying trajectory of adult ward inpatients who died outside of intensive care following RRT review. The study setting was a 430-bed tertiary New Zealand hospital during 2013. RRT, inpatient databases and hospital notes were used to identify 100 consecutive adult inpatients who died subsequent to RRT review. Outcome measures included time from RRT review to death, place of death, pre-existing co-morbidities and frequency of medical review. Results demonstrated that patients were old (median 77 years, IQR 63-85years), emergency admissions (n=100) and admitted under a medical specialty (n=71). All but one of the cohort had pre-existing co-morbidities (mean 3.2, SD 1.7), almost a third (n=31) had cancer and 51% had 1-4 previous inpatient admissions within the previous 12 months. The mean length of stay prior to RRT review was 4.9 days (SD 5.5) during which patients were frequently reviewed by senior medical staff (mean 6.8 times, SD 6.9, range 0-44). Twenty per cent of patients died after their first RRT review with a further 40% receiving treatment limitation/palliation. Fifty-two per cent of patients had a pre-existing DNAR. Eighty per cent of patients died in hospital. Whilst the RRT fulfils an unmet need in decision-making at end of life, there is a need to understand what RRT, instead of ward-based or palliative care teams, offers dying patients. PMID:27029659

  8. Transmission of endemic ST22-MRSA-IV on four acute hospital wards investigated using a combination of spa, dru and pulsed-field gel electrophoresis typing.

    Creamer, E

    2012-11-01

    The transmission of meticillin-resistant Staphylococcus aureus (MRSA) between individual patients is difficult to track in institutions where MRSA is endemic. We investigated the transmission of MRSA where ST22-MRSA-IV is endemic on four wards using demographic data, patient and environmental screening, and molecular typing of isolates. A total of 939 patients were screened, 636 within 72 h of admission (on admission) and 303 >72 h after admission, and 1,252 environmental samples were obtained. Isolates were typed by spa, dru and pulsed-field gel electrophoresis (PFGE) typing. A composite dendrogram generated from the three sets of typing data was used to divide isolates into \\'dendrogram groups\\' (DGs). Ten percent of patients (92\\/939) were MRSA-positive; 7 % (44\\/636) on admission and 16 % (48\\/303) >72 h after admission (p = 0.0007). MRSA was recovered from 5 % of environmental specimens (65\\/1,252). Most isolates from patients (97 %, 85\\/88) and the environment (97 %, 63\\/65) exhibited the ST22-MRSA-IV genotype. Four DGs (DG1, DG4, DG16 and DG17) accounted for 58 % of ST22-MRSA-IV isolates from patients. Epidemiological evidence suggested cross-transmission among 44\\/92 patients (48 %) but molecular typing confirmed probable cross-transmission in only 11 instances (13 %, 11\\/88), with the majority of cross-transmission (64 %; 7\\/11) occurring on one ward. In the setting of highly clonal endemic MRSA, the combination of local epidemiology, PFGE, spa and dru typing provided valuable insights into MRSA transmission.

  9. Effects of music therapy on self- and experienced stigma in patients on an acute care psychiatric unit: a randomized three group effectiveness study.

    Silverman, Michael J

    2013-10-01

    Stigma is a major social barrier that can restrict access to and willingness to seek psychiatric care. Psychiatric consumers may use secrecy and withdrawal in an attempt to cope with stigma. The purpose of this study was to determine the effects of music therapy on self- and experienced stigma in acute care psychiatric inpatients using a randomized design with wait-list control. Participants (N=83) were randomly assigned by cluster to one of three single-session group-based conditions: music therapy, education, or wait-list control. Participants in the music therapy and education conditions completed only posttests while participants in the wait-list control condition completed only pretests. The music therapy condition was a group songwriting intervention wherein participants composed lyrics for "the stigma blues." Results indicated significant differences in measures of discrimination (experienced stigma), disclosure (self-stigma), and total stigma between participants in the music therapy condition and participants in the wait-list control condition. From the results of this randomized controlled investigation, music therapy may be an engaging and effective psychosocial technique to treat stigma. Limitations, suggestions for future research, and implications for clinical practice and psychiatric music therapy research are provided. PMID:24070990

  10. A memorable ward round

    Douglas Seaton

    2009-01-01

    @@ Some 25 years ago, I was a young consultant physician about to start an early morning ward round with my usual team of registrar,senior house officer, and preregistration house physician. All started according to plan except that the SHO was absent. I knew her to be diligent, so I assumed she had probably been distracted by some other pressing call of duty. By the time we had progressed to our third patient, however, I was starting to feel uneasy about her continued absence. Suddenly it came to me: a colleague had mentioned that she was using a novel device to infuse insulin continuously-she was diabetic. We broke off the round and conferred in the ward sister'a office. We knew that our SHO lived with her husband out of town and that he was also a junior doctor, but at another large hospital about 50 miles away.

  11. Douglas House. Seven years' experience of a community hostel ward.

    Creighton, F J; Hyde, C E; Farragher, B

    1991-10-01

    Of 24 residents of a ten-bed, community-based hostel ward suffering chronic psychiatric illness, nine have been resettled in the community, with four more expected to follow them. Five residents have made Douglas House their home but another six have manifested behavioural disturbance necessitating return to hospital wards. We found community discharge to be associated with illnesses having good prognostic features, while organic illness militated against such placement. Indicators of a prior history of behavioural disturbance seem to predict difficulties in managing a patient in this environment. PMID:1751859

  12. Computerized Psychiatric Diagnostic Interview

    Zetin, Mark; Warren, Stacey; Lanssens, Ed; Tominaga, Doris

    1987-01-01

    A computerized psychiatric diagnostic interview was developed and administered to 121 adult acute psychiatric inpatients. Data on the 100 completers was evaluated for sensitivity and specificity of the computer diagnostic evaluation relative to the hospital discharge diagnosis and revealed sensitivity greater than 70% for major depression, alcohol/substance abuse, adjustment disorder, bipolar/mania, dependent personaltiy disorder, and histrionic personality disorder. Specificity was greater t...

  13. Clinical Risk Factors of Death From Pneumonia in Children with Severe Acute Malnutrition in an Urban Critical Care Ward of Bangladesh

    Mohammod Jobayer Chisti; Mohammed Abdus Salam; Hasan Ashraf; Faruque, Abu S. G.; Pradip Kumar Bardhan; Md Iqbal Hossain; Shahid, Abu S. M. S. B.; Shahunja, K. M.; Sumon Kumar Das; Gazi Imran; Tahmeed Ahmed

    2013-01-01

    BACKGROUND: Risks of death are high when children with pneumonia also have severe acute malnutrition (SAM) as a co-morbidity. However, there is limited published information on risk factors of death from pneumonia in SAM children. We evaluated clinically identifiable factors associated with death in under-five children who were hospitalized for the management of pneumonia and SAM. METHODS: For this unmatched case-control design, SAM children of either sex, aged 0-59 months, admitted to the Dh...

  14. The Amsterdam Studies of Acute Psychiatry - II (ASAP-II: a comparative study of psychiatric intensive care units in the Netherlands

    van Venrooij Janine

    2009-09-01

    Full Text Available Abstract Background The number of patients in whom mental illness progresses to stages in which acute, and often forced treatment is warranted, is on the increase across Europe. As a consequence, more patients are involuntarily admitted to Psychiatric Intensive Care Units (PICU. From several studies and reports it has become evident that important dissimilarities exist between PICU's. The current study seeks to describe organisational as well as clinical and patient related factors across ten PICU's in and outside the Amsterdam region, adjusted for or stratified by level of urbanization. Method/Design This paper describes the design of the Amsterdam Studies of Acute Psychiatry II (ASAP-II. This study is a prospective observational cohort study comparing PICU's in and outside the Amsterdam region on various patient characteristics, treatment aspects and recovery related variables. Dissimilarities were measured by means of collecting standardized forms which were filled out in the framework of care as usual, by means of questionnaires filled out by mental health care professionals and by means of extracting data from patient files for every consecutive patient admitted at participating PICU's during a specific time period. Urbanization levels for every PICU were calculated conform procedures as proposed by the Dutch Central Bureau for Statistics (CBS. Discussion The current study may provide a deeper understanding of the differences between psychiatric intensive care units that can be used to promote best practice and benchmarking procedures, and thus improve the standard of care.

  15. Splitting Ward identity

    Safari, Mahmoud [Institute for Research in Fundamental Sciences (IPM), School of Particles and Accelerators, P.O. Box 19395-5531, Tehran (Iran, Islamic Republic of)

    2016-04-15

    Within the background-field framework we present a path integral derivation of the splitting Ward identity for the one-particle irreducible effective action in the presence of an infrared regulator, and make connection with earlier works on the subject. The approach is general in the sense that it does not rely on how the splitting is performed. This identity is then used to address the problem of background dependence of the effective action at an arbitrary energy scale. We next introduce the modified master equation and emphasize its role in constraining the effective action. Finally, application to general gauge theories within the geometric approach is discussed. (orig.)

  16. A study into ward traffic

    P. Hardcatle

    1982-09-01

    Full Text Available The study was undertaken in 1980 and was prompted by a need to highlight some of the problems associated with the ward milieu, both for patient care and for nurse teaching. Being associated at that time with the clinical teaching department the author was very interested in looking into the amount of traffic entering the ward area. It seemed that the ward sister had a very difficult task in providing a therapeutic environment for her patients, and that patient care was always being criticised with little thought to what was actually occurring in the ward.

  17. Drug dispensing errors in a ward stock system

    Andersen, Stig Ejdrup

    2010-01-01

    . Multivariable analysis showed that surgical and psychiatric settings were more susceptible to involvement in dispensing errors and that polypharmacy was a risk factor. In this ward stock system, dispensing errors are relatively common, they depend on speciality and are associated with polypharmacy. These...... results indicate that strategies to reduce dispensing errors should address polypharmacy and focus on high-risk units. This should, however, be substantiated by a future trial....

  18. Being in a process of transition to psychosis, as narrated by adults with psychotic illnesses acutely admitted to hospital

    Sebergsen, K; Norberg, A; Talseth, A-G

    2014-01-01

    Accessible summary Early intervention to prevent and reduce new episodes of psychosis involves patients, relatives and mental health personnel recognizing the early signs of psychosis. Twelve participants with psychotic illnesses narrated how they experienced becoming psychotic before they were admitted to acute psychiatric wards. The results of this study demonstrate that participants and their close others who sensed, understood and articulated experienced changes as signs of psychosis esta...

  19. Caregivers' perceptions of coercion in psychiatric hospital admission.

    Ranieri, Veronica; Madigan, Kevin; Roche, Eric; Bainbridge, Emma; McGuinness, David; Tierney, Kevin; Feeney, Larkin; Hallahan, Brian; McDonald, Colm; O'Donoghue, Brian

    2015-08-30

    While knowledge on service users' perspective on their admissions to psychiatric wards has improved substantially in the last decade, there is a paucity of knowledge of the perspectives of caregivers. This study aimed to determine caregiver's perception of the levels of perceived coercion, perceived pressures and procedural justice experienced by service users during their admission to acute psychiatric in-patient units. The perspective of caregivers were then compared to the perspectives of their related service users, who had been admitted to five psychiatric units in Ireland. Caregivers were interviewed using an adapted version of the MacArthur admission experience interview. Sixty-six caregivers participated in this study and the majority were parents. Seventy one percent of service users were admitted involuntarily and nearly half had a diagnosis of schizophrenia or schizoaffective disorder. Caregivers of involuntarily admitted individuals perceived the service users' admission as less coercive than reported by the service users. Caregivers also perceived a higher level of procedural justice in comparison to the level reported by service users. Reducing the disparity of perceptions between caregivers and service users could result in caregivers having a greater understanding of the admission process and why some service users may be reluctant to be admitted. PMID:26163727

  20. Acute and chronic effects of cannabinoids on human brain: gene-environment interactions related to psychiatric disorders

    Batalla Cases, Albert

    2014-01-01

    Tesi realitzada a l'Institut Clínic de Neurociències / Hospital Clínic 1) Introduction Cannabis use has been associated to mental health problems and worsened outcome of established psychiatric disorders. Disturbances of the endocannabinoid system may be responsible for long-lasting effects, such as neuropsychological deficits and morphological brain alterations. As not all the exposed individuals are equally affected, proneness to cannabis induced impairment may rely on key factors su...

  1. Psychiatric mental health nursing in a biopsychosocial era.

    Abbondanza, D M; Puskar, K R; Wilkinson, B; Welch, C; Rudert, S; Gallippi, B

    1994-01-01

    Clients in long-term facilities carry a wide array of psychiatric diagnoses, often with equally diverse medical problems. This "back ward" population requires a specialized area of psychiatric mental health nursing practice. The need for comprehensive assessment and adequate interventions, and the various frustrations of nursing staff, are discussed using a case example. PMID:7862514

  2. Clinical risk factors of death from pneumonia in children with severe acute malnutrition in an urban critical care ward of Bangladesh.

    Mohammod Jobayer Chisti

    Full Text Available BACKGROUND: Risks of death are high when children with pneumonia also have severe acute malnutrition (SAM as a co-morbidity. However, there is limited published information on risk factors of death from pneumonia in SAM children. We evaluated clinically identifiable factors associated with death in under-five children who were hospitalized for the management of pneumonia and SAM. METHODS: For this unmatched case-control design, SAM children of either sex, aged 0-59 months, admitted to the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b during April 2011 to July 2012 with radiological pneumonia were studied. The SAM children with pneumonia who had fatal outcome constituted the cases (n = 35, and randomly selected SAM children with pneumonia who survived constituted controls (n = 105. RESULTS: The median (inter-quartile range age (months was comparable among the cases and the controls [8.0 (4.9, 11.0 vs. 9.7 (5.0, 18.0; p = 0.210]. In logistic regression analysis, after adjusting for potential confounders, such as vomiting, abnormal mental status, and systolic hypotension (<70 mm of Hg in absence of dehydration, fatal cases of severely malnourished under-five children with pneumonia were more often hypoxemic (OR = 23.15, 95% CI = 4.38-122.42, had clinical dehydration (some/severe (OR = 9.48, 95% CI = 2.42-37.19, abdominal distension at admission (OR = 4.41, 95% CI = 1.12-16.52, and received blood transfusion (OR = 5.50, 95% CI = 1.21-24.99 for the management of crystalloid resistant systolic hypotension. CONCLUSION AND SIGNIFICANCE: We identified hypoxemia, clinical dehydration, and abdominal distension as the independent predictors of death in SAM children with pneumonia. SAM children with pneumonia who required blood transfusion for the management of crystalloid resistant systolic hypotension were also at risk for death. Thus, early identification and prompt management of these simple clinically

  3. Critical Cases Faced by Mental Health Nurses and Assistant Nurses in Psychiatric Hospitals in Greece

    Evmorfia Koukia

    2013-01-01

    Full Text Available Background: Psychiatric Nurses and nurses’ assistants working in an inpatient unit experience a significant number of critical cases. A small number of studies have explored which patients’ problems nurses perceive as ‘critical case or incident’ and particularly which interventions they choose. Aim: The aim of the research was 1. To identify the clinical problems that mental health nurses and assistant nurses characterize as critical 2. To report the main nursing interventions 3. To investigate the main person involved in the critical incident. Material-Method: Critical incident technique was used as a method of data collection. Content analysis was carried out in order nurses’ information to be categorized into subcategories. The sample consisted of 35 mental health nurses and nurses’ assistants who work in psychiatric acute inpatient wards.Results: Nurses identified ten types of critical incidents. They noted violence (verbal, physical by patients and psychotic symptoms to be the most critical situations. Nurses were the main person involved in these incidents. The study also described eight nursing interventions used by nurses when faced with critical events. Conclusions: The findings indicated that mental health nurses and assistant nurses working in acute inpatient wards are called to confront a variety of critical incidents in their every day practice. Further research is necessary to identify in-depth nursing interventions and decision-making used in these situations.

  4. Day care for alcoholism in psychiatric hospital »Sveti Ivan« 2004–2012

    Orešković, Anto; Mihanović, Mate; Mimica, Nino; Bodor, Davor; Petrov, Božo

    2013-01-01

    Alcohol addiction treatment represents complex and lingering therapeutic procedure which can be provided stationary, within specialized psychiatric wards, and through partial hospitalization or day care hospitals for alcoholism. A psychiatric hospital day care, or partial hospitalization, represents facility for patients requiring intensive psychiatric treatment within relatively structured environment. While it offers the same variety of treatment procedures as the mental h...

  5. Experiences of nursing staff on psychiatric care of depressed patients

    Suutarinen, Kreetta-Maija

    2012-01-01

    The thesis researched the views and experiences of nursing staff of psychiatric special care ward on psychiatric care of depressed patients. Because caring is patient/client oriented profession, it is essential to include patients and nursing staff in the development work. This assumption was basis for the thesis. The thesis aimed to add knowledge on the views of the nursing staff and to show how this knowledge can be used in development of psychiatric care. The thesis also pursue...

  6. A 5-year retrospective study of demographic, anamnestic, and clinical factors related to psychiatric hospitalizations of adolescent patients

    Di Lorenzo R

    2016-01-01

    Full Text Available Rosaria Di Lorenzo,1 Nina Cimino,2 Elena Di Pietro,3 Gabriella Pollutri,4 Vittoria Neviani,5 Paola Ferri2 1Service of Psychiatric Diagnosis and Treatment, Department of Mental Health, AUSL Modena, Modena, 2School of Nursing, University of Modena and Reggio Emilia, 3School of Neuro-Psychiatry, 4School of Psychiatry, University of Modena and Reggio Emilia, 5 “The Medlar”, Villa Igea Hospital, Modena, Italy Background: Psychiatric emergencies of children and adolescents have greatly increased during the last years, but this phenomenon has not been studied in detail. The aim of this study was to analyze the correlation between acute psychiatric hospitalizations of adolescents and selected variables to highlight risk factors for psychiatric emergencies. Methods: This retrospective research was conducted in the acute psychiatric public ward, Service of Psychiatric Diagnosis and Treatment (SPDT, and in the residential facility for adolescents, “The Medlar”, located in Modena. The sample was constituted by all adolescent patients (n=101, age range 14–18 who had acute hospitalizations (n=140 in SPDT and had been successively transferred to “The Medlar” (n=83, from February 2, 2010 to January 31, 2015. From clinical charts, we extracted demographic and anamnestic characteristics of patients and clinical variables related to hospitalizations. Data were statistically analyzed. Results: Sixty-one percent of our patients lived with one divorced parent, with adoptive or immigrant family, or in institutions; 51% had experienced stressful events during childhood; 81% had a normal intellective level, but only 6% presented regular school performance. Parental psychiatric illness was negatively related, in a statistically significantly way, with onset age of adolescent mental disorders (coefficient -2.28, 95% confidence interval [CI]: -3.53 to 1.01, P<0.001, single linear regression; odds ratio: 4.39, 95% CI: 1.43–13.47, P<0.010, single logistic

  7. A comprehensive psychiatric service

    Wang, A G

    1984-01-01

    A comprehensive psychiatric service was established in 1969 in the Faroe Islands. This service was created as a department of a general hospital. The spheres covered by this department, operating in the midst of the community were: acute and chronic patients, a liaison-psychiatric service, and an...... outpatient service. The number of chronic patients has not decreased, due to an influx of unruly senile patients. The close proximity of the service to the community has increased the pressure with regard to the care of such patients. Other services, such as outpatient treatment of alcoholics and neurotics...

  8. PSYCHIATRIC DISORDER

    2004-01-01

    2004536 Association study of clinical presentation in first-episode schizophrenia and possible candidate genes in chromosome 22. MA Xiaohong (马小红), et al. Dept Psychiatr, West China Hosp, Sichuan U-niv, Chengdu 610041. Chin J Psychiatr 2004;37(3): 145-148.

  9. Assesment of psychosocial work conditions of nurses at selected hospital wards

    Iwona Rotter

    2014-04-01

    Full Text Available Background: Good organisation of work, clear division of responsibilities, support from superiors are factors that positively influence the satisfaction of the profession. The purpose of the work was the assessment of psychosocial working conditions of nurses. Material and Methods: The research included 388 nurses working at surgical wards, medical treatment wards, and psychiatric wards. The research method was a diagnostic survey carried out by means of a questionnaire called Psychosocial Work Conditions. The obtained results were statistically analysed. Results: Nearly a half of the nurses considers the requirements at work as moderate, and 36.66% as high. Nurses from medical treatment wards indicate the highest level of requirements. Nurses working at psychiatric wards and in a shift system significantly more often feel the requirements relating to overload and resulting from a conflict of roles. Nurses working in the profession for more than 10 years considerably more often describe the level of behavioural control as high in comparison to those working for a shorter time. Regardless of the character of a ward, nurses most often (44.33% assess the support from co-workers as average, and 1/5 considered this as low. Conclusions: The results indicate the correctness of introducing psychosocial training for professionally active nurses. Med Pr 2014;65(2:173–179

  10. Role of individual psychotherapy of people diagnosed with schizophrenia in the Polish system of psychiatric care

    Łukasz Cichocki

    2015-03-01

    Full Text Available This paper takes up the subject of the place and role of individual psychotherapy of people diagnosed with schizophrenia in the Polish system of psychiatric care. It describes various therapeutic contexts in which such psychotherapy can take place: inpatient ward, outpatient ward, ambulatory care, community care team. It also touches upon the issue of psychotherapy in contact with a chronically ill patient who participates in rehabilitation at occupational therapy workshops or at a day care center. It discusses various needs of patients at specific stages of illness: acute psychosis, postpsychotic depression, symptomatic remission, and a possible response to these needs offered by psychiatric treatment. The paper emphasizes the importance of long-term therapeutic contact for recovery process, which includes the patient’s self-knowledge and awareness of the capability to influence their own life, gained during psychotherapy. The central idea of this paper is the connection of psychotherapy and organizational solutions which would enable its broadest and most effective usage in daily practice. An important element is a reflection concerning the relationships between psychotherapy of people suffering from schizophrenia and usually concurrently administered pharmacotherapy.

  11. Prevalence of delirium among patients at a cancer ward

    Grandahl, Mia Gall; Nielsen, Svend Erik; Koerner, Ejnar Alex;

    2016-01-01

    Background Delirium is a frequent psychiatric complication to cancer, but rarely recognized by oncologists. Aims 1. To estimate the prevalence of delirium among inpatients admitted at an oncological cancer ward 2. To investigate whether simple clinical factors predict delirium 3. To examine the...... Drawing Test, and the Digit Span Test can be used as screening tools for delirium among inpatients with cancer, but even in synergy, they lack specificity. Combining cognitive testing and attention to nurses' records might improve detection, yet further studies are needed to create a more detailed patient...

  12. Attitudes towards patient gender among psychiatric hospital staff: results of a case study with focus groups.

    Krumm, Silvia; Kilian, Reinhold; Becker, Thomas

    2006-03-01

    There is an increasing awareness of gender-related issues in psychiatry. However, empirical findings on attitudes of psychiatric staff towards patient gender are limited. Gender-related issues are particularly relevant in the debate about mixed versus segregated sex wards, yet while the appropriateness of mixed-sex wards is questioned in Great Britain this is not the case in Germany. To investigate attitudes of psychiatric staff towards both patient gender and mixed versus segregated sex wards, we conducted a case study using focus groups with members of professional teams. We evaluated the transition process from two single-sex wards to two mixed-sex wards in a 330-bed psychiatric hospital in a rural area in south Germany. Staff described female patients as more externally oriented, motivating of others, demanding, and even sexually aggressive. Male patients, on the other hand, were described as more quiet, modest, or lazy. Furthermore, participants described the mixing process as a positive development whereas they did not see a need for gender-separated wards in order to protect vulnerable female patients. Some gender descriptions by professionals are "reversed" in comparison with gender stereotypes supposed to be present in wider society. The perception of crossed gender norms may affect staff attitudes towards the vulnerability of female patients in psychiatric settings and the provision of single-sex wards in in-patient psychiatric care. Practical implications are discussed against the background of a high rate of female patients with sexual abuse histories. PMID:16157434

  13. Superconformal Ward identities and the supertorus

    We derive superconformal Ward identities in the context of superspace supergravity. From these Ward identities we extract operator product expansions and the case of a supertorus is studied in some detail. (orig.)

  14. Psychiatric Nurses’ Perceptions about Physical Restraint; A Qualitative Study

    Fereidooni Moghadam, Malek; Fallahi Khoshknab, Masoud; Pazargadi, Mehrnoosh

    2014-01-01

    Background: The use of physical restraint as an intervention in the care of psychiatric patients dates back to the beginning of psychiatry. Although it is a challenging question, it is still one of the common procedures in psychiatry. Considering that very little research has been done in Iran in relation to physical restraint, this qualitative study aimed to investigate the experiences of  nurses working in psychiatric wards regarding physical restraint. Methods: This qualitative study was d...

  15. Light atmosphere in hospital wards

    Stidsen, Lone Mandrup

    Sociocultural aspects of light are important for the user experience of the atmosphere in a ward. According to the Danish Regulation for light in hospitals (DS703, 1983), a home-like feeling is required to support the patients, as they needa pleasant environment for their recovery. The term ‘Light...... Atmosphere’ is explored using methods in the practice of lighting design where qualitative and quantitative methods are used to qualify important aspects of a lighting design. Measurable parameters such as the amount of Lux, composition of CRI and degree of Kelvin is well described so the designer can handle...... Atmosphere' is the focal point developed through the study. Primarily, the model frames the study and serves as a design tool for creating the light atmosphere in hospital wards. First, brain storming is used to open up the field supported by theoretical aspects based on Gernot Böhmes' concept of atmosphere...

  16. Determinants of Seclusion After Aggression in Psychiatric Inpatients

    Vruwink, F.J.; Noorthoorn, E.O.; Nijman, H.L.I.; Nagel, J.E.L. van der; Hox, J.J.C.M.; Mulder, C.L.

    2012-01-01

    ome aggressive incidents in psychiatric wards result in seclusion, whereas others do not. We used the Staff Observation Aggression Scale-Revised and the mental health trust's database to identify determinants that predicted seclusion after aggression. These consisted of demographic, diagnostic, cont

  17. Anatomy of the ward round.

    O'Hare, James A

    2008-07-01

    The ward round has been a central activity of hospital life for hundreds of years. It is hardly mentioned in textbooks. The ward round is a parade through the hospital of professionals where most decision making concerning patient care is made. However the traditional format may be intimidating for patients and inadequate for communication. The round provides an opportunity for the multi-disciplinary team to listen to the patient\\'s narrative and jointly interpret his concerns. From this unfolds diagnosis, management plans, prognosis formation and the opportunity to explore social, psychological, rehabilitation and placement issues. Physical examination of the patient at the bedside still remains important. It has been a tradition to discuss the patient at the bedside but sensitive matters especially of uncertainty may better be discussed elsewhere. The senior doctor as round leader must seek the input of nursing whose observations may be under-appreciated due to traditional professional hierarchy. Reductions in the working hours of junior doctors and shortened length of stay have reduced continuity of patient care. This increases the importance of senior staff in ensuring continuity of care and the need for the joint round as the focus of optimal decision making. The traditional round incorporates teaching but patient\\'s right to privacy and their preferences must be respected. The quality and form of the clinical note is underreported but the electronic record is slow to being accepted. The traditional multi-disciplinary round is disappearing in some centres. This may be regrettable. The anatomy and optimal functioning of the ward round deserves scientific scrutiny and experimentation.

  18. Ward Identities for Hall Transport

    Hoyos, Carlos; Oz, Yaron

    2014-01-01

    We derive quantum field theory Ward identities based on linear area preserving and conformal transformations in 2+1 dimensions. The identities relate Hall viscosities, Hall conductivities and the angular momentum. They apply both for relativistic and non relativistic systems, at zero and at finite temperature. We consider systems with or without translation invariance, and introduce an external magnetic field and viscous drag terms. A special case of the identities yields the well known relation between the Hall conductivity and half the angular momentum density.

  19. Psychiatric emergencies (part I): psychiatric disorders causing organic symptoms.

    Testa, A; Giannuzzi, R; Sollazzo, F; Petrongolo, L; Bernardini, L; Daini, S

    2013-02-01

    Psychiatric emergencies are conditions that mostly destabilize the already frenetic activity of the Emergency Department. Sometimes the emergency is clearly referable to primitive psychiatric illness. Other times, psychiatric and organic symptoms can independently coexist (comorbidity), or develop together in different conditions of substance abuse, including alcohol and prescription drugs. Differentiating between substance induced and pre-existing psychiatric disorder (dual diagnosis) may be difficult, other than controversial issue. Finally, an organic disease can hide behind a psychiatric disorder (pseudopsychiatric emergency). In this review (part I), psychiatric disorders that occur with organic symptoms are discussed. They include: (1) anxiety, conversion and psychosomatic disorders, and (2) simulated diseases. The physiologic mechanisms of the stress reaction, divided into a dual neuro-hormonal response, are reviewed in this section: (1) activation of the sympathetic nervous system and adrenal medulla with catecholamine production (rapid response), and (2) activation of the hypothalamic-pituitary-adrenal axis with cortisol production (slow response). The concept of the fight-or-flight response, its adaptive significance and the potential evolution in paralyzing response, well showing by Yerkes-Dodson curve, is explained. Abnormal short- and long-term reactions to stress evolving toward well codified cluster of trauma and stressor-related disorders, including acute stress disorder, adjustment disorder and post-traumatic stress disorder, are examined. A brief review of major psychiatric disorder and related behaviour abnormalities, vegetative symptoms and cognitive impairment, according to DMS IV-TR classification, are described. Finally, the reactive psychic symptoms and behavioral responses to acute or chronic organic disease, so called "somatopsychic disorders", commonly occurring in elderly and pediatric patients, are presented. The specific conditions of

  20. Correction to Ward et al. (2015).

    Ward, Ryan D; Winiger, Vanessa; Higa, Kerin K; Kahn, Julia B; Kandel, Eric R; Balsam, Peter D; Simpson, Eleanor H

    2015-08-01

    Reports an error in "The impact of motivation on cognitive performance in an animal model of the negative and cognitive symptoms of schizophrenia" by Ryan D. Ward, Vanessa Winiger, Kerin K. Higa, Julia B. Kahn, Eric R. Kandel, Peter D. Balsam and Eleanor H. Simpson (Behavioral Neuroscience, 2015[Jun], Vol 129[3], 292-299). There is a text error in the 4th paragraph of the Discussion section. The explanation for the abbreviation OFC was incorrectly listed as occipitofrontal circumference. It should have been orbitofrontal cortex. (The following abstract of the original article appeared in record 2015-18639-001.) Interactions between motivation and cognition are implicated in producing functional impairments and poor quality of life in psychiatric patients. This interaction, however, is not well understood at either the behavioral or neural level. We developed a procedure for mice in which a cognitive measure, sustained attention, is modulated by a motivationally relevant signal that predicts reward probability on a trial-by-trial basis. Using this paradigm, we tested the interaction between motivation and cognition in mice that model the increased striatal D2 receptor activity observed in schizophrenia patients (D2R-OE mice). In control mice, attention was modulated by signaled-reward probability. In D2R-OE mice, however, attention was not modulated by reward-related cues. This impairment was not due to any global deficits in attention or maintenance of the trial-specific information in working memory. Turning off the transgene in D2R-OE mice rescued the motivational modulation of attention. These results indicate that deficits in motivation impair the ability to use reward-related cues to recruit attention and that improving motivation improves functional cognitive performance. These results further suggest that addressing motivational impairments in patients is critical to achieving substantive cognitive and functional gains. PMID:26214211

  1. Prevalence of Childhood Physical and Sexual Abuse in Veterans With Psychiatric Diagnoses

    Koola, Maju Mathew; Qualls, Clifford; Kelly, Deanna L.; Skelton, Kelly; Bradley, Bekh; Amar, Richard; Duncan, Erica J.

    2013-01-01

    We examined the prevalence of childhood (≤18 years) physical and sexual abuse reported among patients admitted to the psychiatric inpatient service and the differential rates of this abuse associated with psychiatric diagnoses. This study consisted of a retrospective chart review of 603 patients admitted to a psychiatric ward during a period of 1 year at Atlanta Veterans Affairs Medical Center who had data on childhood physical and sexual abuse. The prevalence of reported childhood physical o...

  2. Is it possible to strengthen psychiatric nursing staff's clinical supervision?

    Gonge, Henrik; Buus, Niels

    2015-01-01

    AIM: To test the effects of a meta-supervision intervention in terms of participation, effectiveness and benefits of clinical supervision of psychiatric nursing staff. BACKGROUND: Clinical supervision is regarded as a central component in developing mental health nursing practices, but the evidence...... supporting positive outcomes of clinical supervision in psychiatric nursing is not convincing. DESIGN: The study was designed as a randomized controlled trial. All permanently employed nursing staff members at three general psychiatric wards at a Danish university hospital (n = 83) were allocated to either...

  3. PSYCHIATRIC DISORDER

    2007-01-01

    14.1 Schizophrenia2007133 A comparative study of intramuscular ziprasidone and haloperidol in treating acute agitation in schizophrenia. LI Lehua(李乐华), et al. Mental Health Insit, 2nd Xiangya Hosp, Centr South Univ, Changsha 410011. Chin J Psychiat 2006;39(4):216-219. Objective To evaluate the efficacy and safety of injection ziprasidone in the treatment of acute agitation behavior in schizophrenia.

  4. Implementing a Music Therapy Program at a New 72-Hour Acute Psychiatric Admissions Unit: A Case Study of a Patient Who Was Malingering

    Silverman, Michael J.

    2009-01-01

    Because of the relatively poor treatment available, the high financial costs of hospitalization, multiple and complex issues of persons with severe mental illnesses, and advancements in pharmacotherapy, psychiatric patients are often only hospitalized for a few days before they are discharged. Thus, brief psychosocial interventions for persons who…

  5. Psychiatric Disorder

    2009-01-01

    2009477 The efficacy and safety of flexible doses of paliperidone extended-release tablets in the treatment of acute schizophrenia:a randomized,double blind olanzapine-controlled study.ZHANG Hongyan,et al.Peking Univ Ment Health Instit,Beijing 100191. Chin J Psychiat 2009;42(3):153-156.

  6. Practice of Acute and Maintenance Electroconvulsive Therapy in the Psychiatric Clinic of a University Hospital from Turkey: between 2007 and 2013

    Sengul, Melike Ceyhan Balci; Kenar, Ayse Nur Inci; Hanci, Ezgi; Sendur, İbrahim; Sengul, Cem; Herken, Hasan

    2016-01-01

    Objective Electroconvulsive therapy (ECT) can be given as the form of acute, continuation or maintenance ECT according to the process of administration. We report our 7 years’ observation with acute and maintenance ECT in a university hospital in Turkey. Methods The medical records of the hospitalized patients treated with acute or maintenance ECT between the years 2007 and 2013 was retrospectively analyzed. The sociodemographic characteristics, diagnosis, data of ECT and the co-administered ...

  7. Role of individual psychotherapy of people diagnosed with schizophrenia in the Polish system of psychiatric care

    Łukasz Cichocki

    2015-01-01

    This paper takes up the subject of the place and role of individual psychotherapy of people diagnosed with schizophrenia in the Polish system of psychiatric care. It describes various therapeutic contexts in which such psychotherapy can take place: inpatient ward, outpatient ward, ambulatory care, community care team. It also touches upon the issue of psychotherapy in contact with a chronically ill patient who participates in rehabilitation at occupational therapy workshops or at a day care c...

  8. Ken Kimes & Sandra Ward: New Natives Farm

    Farmer, Ellen

    2010-01-01

    Both Ken Kimes and Sandra Ward grew up in Southern California. They met in the Los Angeles area, but moved to Santa Cruz in 1980. Together they founded New Natives Farm, a greenhouse-based farm certified by California Certified Organic Farmers in 1983, and located in Corralitos, California. There they tend organic sprouts, including alfalfa, wheat grass, pea shoots, sunflower sprouts, broccoli, and beans. In addition to managing their farm full time, Kimes and Ward are both outspoken activist...

  9. Factors affecting staff morale on inpatient mental health wards in England: a qualitative investigation

    Paul Moli

    2011-04-01

    Full Text Available Abstract Background Good morale among staff on inpatient psychiatric wards is an important requirement for the maintenance of strong therapeutic alliances and positive patient experiences, and for the successful implementation of initiatives to improve care. More understanding is needed of mechanisms underlying good and poor morale. Method We conducted individual and group interviews with staff of a full range of disciplines and levels of seniority on seven NHS in-patient wards of varying types in England. Results Inpatient staff feel sustained in their potentially stressful roles by mutual loyalty and trust within cohesive ward teams. Clear roles, supportive ward managers and well designed organisational procedures and structures maintain good morale. Perceived threats to good morale include staffing levels that are insufficient for staff to feel safe and able to spend time with patients, the high risk of violence, and lack of voice in the wider organisation. Conclusions Increasing employee voice, designing jobs so as to maximise autonomy within clear and well-structured operational protocols, promoting greater staff-patient contact and improving responses to violence may contribute more to inpatient staff morale than formal support mechanisms.

  10. Acute intermittent porphyria in the puerperium

    Sparić Radmila

    2010-01-01

    Full Text Available Introduction. Acute intermittent porphyria emerges as a result of partial defect of porphobilinogen deaminase and is manifested by repeated episodes of somatic, psychiatric and neurological disorders. The disease is conducted via the autosomaldominant gene of variable penetration, so most of the carriers never experience seizures. Timely making of diagnosis, screening of blood relatives of the patient and education of patients on avoidance of provoking factors are the key to adequate treatment. Case Outline. A 23-year-old patient having born the third child was hospitalized due to pains in the abdomen and convulsive seizures nine days after the vaginal delivery. At admittance, she suffered a generalized convulsive seizure of clonic-tonic type. The patient immediately underwent a complete clinical, laboratory, bacteriological and ultrasound examination. Bearing in mind the fact that the patient had several convulsive seizures even after the given neurological therapy, haem-arginate was introduced into therapy during four days. The administration of haem-arginate led to the normalization of blood pressure, pulse and bowel function. The administration of haem-arginate led to the normalization of blood pressure, pulse and bowel function. The patient was treated by a team of doctors, in the intensive care ward, with the use of medicaments, which are allowed in the case of acute porphyria. Sixteen days after the admittance, with clean neurological status and gynaecological and ultra-sound findings, she was released for ambulatory treatment. Conclusion. The presented case exhibits the gravity of making a diagnosis of acute intermittent porphyria in puerperium and the necessity of multi-disciplinary approach in treating this disease. Acute intermittent porphyria should be considered in cases of ambiguous abdominal pain, as well as in patients having abdominal pains followed by neuro-psychiatric disorders.

  11. Relation between parasuicide, suicide, psychiatric admissions, and socioeconomic deprivation.

    Gunnell, D. J.; Peters, T. J.; Kammerling, R M; Brooks, J.

    1995-01-01

    OBJECTIVE--To examine the relations between parasuicide, suicide, psychiatric inpatient admissions, and socioeconomic deprivation. DESIGN--Ecological analysis with data from routine information systems and the 1991 census. SETTING--24 localities in the area covered by the Bristol and District Health Authority (population 817,000), consisting of aggregations of neighbouring wards, with an average population of 34,000. SUBJECTS--6089 subjects aged over 10 years admitted to hospital after parasu...

  12. Anomalous N=2 superconformal Ward identities

    The N=2 superconformal Ward identities and their anomalies are discussed in N=2 superspace (including N=2 harmonic superspace), at the level of the low-energy effective action (LEEA) in four-dimensional N=2 supersymmetric field theories. The (first) chiral N=2 supergravity compensator is related to the known N=2 anomalous Ward identity in the N=2 (abelian) vector mulitplet sector. As regards the hypermultiplet LEEA given by the N=2 non-linear sigma-model (NLSM), a new anomalous N=2 superconformal Ward identity is found, whose existence is related to the (second) analytic compensator in N=2 supergravity. The celebrated solution of Seiberg and Witten is known to obey the (first) anomalous Ward identity in the Coulomb branch. We find a few solutions to the new anomalous Ward identity, after making certain assumptions about unbroken internal symmetries. Amongst the N=2 NLSM target space metrics governing the hypermultiplet LEEA are the SU(2)-Yang-Mills-Higgs monopole moduli-space metrics that can be encoded in terms of the spectral curves (Riemann surfaces), similarly to the Seiberg-Witten-type solutions. After a dimensional reduction to three spacetime dimensions (3d), our results support the mirror symmetry between the Coulomb and Higgs branches in 3d, N=4 gauge theories

  13. Psychiatric morbidities in postpartum females: a prospective follow-up during puerperium

    Adya Shanker Srivastava; Bhaskar Mara; Sulekha Pandey; Maheshwar Nath Tripathi; Balram Pandit; Jai Singh Yadav

    2015-01-01

    Aims and objectives: Postpartum psychiatric disturbances pose a significant mental health problem in community because of their impact on parent-infant and couple relationship. This study was carried out with the aim to find out psychiatric morbidities in postpartum females during puerperium so that a proper assessment of mental health and comprehensive management can be planned. Methodology: Hundred females who had delivered in maternity ward of obstetrics and gynaecology department of S...

  14. Psychosocial functioning of individuals with schizophrenia in community housing facilities and the psychiatric hospital in Zurich.

    Jaeger, Matthias; Briner, David; Kawohl, Wolfram; Seifritz, Erich; Baumgartner-Nietlisbach, Gabriela

    2015-12-15

    Individuals with severe mental illness frequently have difficulties in obtaining and maintaining adequate accommodation. If they are not willing or able to adapt to requirements of traditional supported housing institutions they may live in sheltered and emergency accommodation. Adequate mental health services are rarely available in these facilities. The aim of the present study was to evaluate mental health, functional and social status of individuals living in community sheltered housing facilities. A cross-sectional survey of n=338 individuals in sheltered housing compared to a sample of patients at intake in acute inpatient psychiatry (n=619) concerning clinical and social variables was carried out in the catchment area of Zurich. Matched subsamples of individuals with schizophrenia (n=168) were compared concerning functioning and impairments on the Health of the Nation Outcome Scales (HoNOS). Individuals with schizophrenia in sheltered housing (25% of the residents) have significantly more problems concerning substance use, physical illness, psychopathological symptoms other than psychosis and depression, and relationships, daily activities and occupation than patients with schizophrenia at intake on an acute psychiatric ward. Community sheltered accommodation although conceptualized to prevent homelessness in the general population de facto serve as housing facilities for individuals with schizophrenia and other severe mental illness. PMID:26416587

  15. Psychiatric disorders in bone marrow transplant patients

    To identify the psychiatric illnesses in patients with hematological/oncological disorders encountered during blood and bone marrow transplantation. All consecutive patients, aged 15 years and above, who fulfilled inclusion and exclusion criteria and underwent blood and bone marrow transplantation, were enrolled in this study. Psychiatric assessment comprised of a semi-structured interview based on Present Status Examination (PSE). The psychiatric diagnosis was made on the basis of International Classification of Diseases (ICD-10) system of classification devised by W.H.O. Eighty patients, who fulfilled the inclusion criteria, were inducted in this study. Thirty (37.5%) cases were found to have psychiatric disorders. Out of the total, 60 (75%) were males and 20 (25%) females. Adjustment disorder was the most frequent diagnosis (n=12), followed by major depression (n=7). Rest of the diagnoses made were generalized anxiety disorder, acute psychotic disorder, delirium and depressive psychosis. High psychiatric morbidity associated with blood and bone marrow transplantation was observed. It indicates the importance of psychiatric intervention during the isolation period of BMT as well as pre-transplant psychiatric assessment and counseling regarding procedure. (author)

  16. Multidisciplinary case management for patients at high risk of hospitalization: comparison of virtual ward models in the United kingdom, United States, and Canada.

    Lewis, Geraint; Wright, Lorraine; Vaithianathan, Rhema

    2012-10-01

    Virtual wards are a model for delivering multidisciplinary case management to people who are at high predicted risk of unplanned acute care hospitalization. First introduced in Croydon, England, in 2006, this concept has since been adopted and adapted by health care organizations in other parts of the United Kingdom and internationally. In this article, the authors review the model of virtual wards as originally described-with its twin pillars of (1) using a predictive model to identify people who are at high risk of future emergency hospitalization, and (2) offering these individuals a period of intensive, multidisciplinary preventive care at home using the systems, staffing, and daily routines of a hospital ward. The authors then describe how virtual wards have been modified and implemented in 6 sites in the United Kingdom, United States, and Canada where they are subject to formal evaluation. Like hospital wards, virtual wards vary in terms of patient selection, ward configuration, staff composition, and ward processes. Policy makers and researchers should be aware of these differences when considering the evaluation results of studies investigating the cost-effectiveness of virtual wards. PMID:22788975

  17. Psychiatric Disorder

    2007-01-01

    15.1 Schizophrenia2007274 Effect and safety of combination therapy of valproate with lithium on recurrent mania. XU Wenwei(徐文炜), et al. Dept Psychiat, Wuxi Ment Health Center, Wuxi 214151. Chin J Psychiat 2007;40(2):86-89. Objective The study was to explore the effectiveness and safety of chronic combination reatment of valproate with lithium on recurrent mania. Method All 105 patients with mania-onset were andomly assigned to receive sodium valproate plus lithium (n=35), and monotherapy with lithium n=35) or sodium valproate (n=35), and were followed up for 5 years. At baseline, the symptom was valuated with the Bech-Rafaelsen Mania Rating Scale (BRMS). The drug dosage, times of relapse, effects nd safcty was compared among the three groups. Results After the acute therapy, the reductions in BRMS core were(43±29)% in lithium group, (42±27)% in valproate group, and (58±25)% in combination roup, respectively, with significant differences between the three groups (F=3.579, P=0.031). At ollowed-up, tile relapse times was significantly less in combination group than that in lithium and valproate roup(mean times of 2.0±1.5, 3.5±1.8, and 3.5±2.2, P=0.001). The combination therapy had etter effectiveness especially in patients with rapid cycling bipolar disorder(F=4.120, P=0.033) than the ther two monotherapy group. The mean dosage of single drug in combination group was significantly lower han that in lithium and valproate group (P<0.01; P<0.001). There were no significantly statistic differences on side-effects among three groups. Conclusion The efficacy of combination therapy of valproate with lithium on mania is better than the monotherapy of lithium or valproate in the light of safety and reduced occurrence.

  18. Psychiatric disorders after radiation exposure

    This review focuses on the mental and psychological effects of medical radiation exposure, the nuclear accident at Three Mile Island, the Chernobyl disaster, atomic bomb explosions at Nagasaki and Hiroshima, and accidents at nuclear power plants and nuclear waste plants. Studies have shown that anxiety about the adverse effects of radiation in medicine (such as infertility, carcinogenicity, and genotoxicity) and fear for exposure has caused psychiatric disorders. Several studies on the mental health effects of the nuclear accident at Three Mile Island were conducted, and the results indicated that psychiatric distress persisted for a certain period of time, particularly in pregnant women and women who have children, even when no evidence of substantial of radiation exposure is seen clinically. The psychological consequences of the Chernobyl disaster have been investigated continuously, and various problems, e.g., acute stress reaction, neurosis, and psychosis, have been identified, although no physical damage due to the radiation or PTSD have been reported. By contrast, PTSD has been seen in survivors of the Nagasaki and Hiroshima nuclear explosions. A study in Ohio, (United States), which has a nuclear waste plant, investigated PTSD in people living near the plant and found that the symptom level was mild. In general, the most common symptoms among people with mental and psychological disorders due to radiation exposure are depression and anxiety, with many people having associated somatoform disorders, and some people complain of PTSD. Vague anxiety and fear of sequelae, regardless of the exposure dose, appears to cause such psychiatric disorders. Although it is rare for psychiatrists to see such cases of psychiatric disorders due to radiation exposure, their number may increase as psychiatric services become more widely available. (K.H.)

  19. Psychiatric disorders after radiation exposure

    Kokai, Masahiro [Hyogo Coll. of Medicine, Nishinomiya (Japan); Soejima, Toshinori; Wang, Shangdong; Shinfuku, Naotaka

    2001-04-01

    This review focuses on the mental and psychological effects of medical radiation exposure, the nuclear accident at Three Mile Island, the Chernobyl disaster, atomic bomb explosions at Nagasaki and Hiroshima, and accidents at nuclear power plants and nuclear waste plants. Studies have shown that anxiety about the adverse effects of radiation in medicine (such as infertility, carcinogenicity, and genotoxicity) and fear for exposure has caused psychiatric disorders. Several studies on the mental health effects of the nuclear accident at Three Mile Island were conducted, and the results indicated that psychiatric distress persisted for a certain period of time, particularly in pregnant women and women who have children, even when no evidence of substantial of radiation exposure is seen clinically. The psychological consequences of the Chernobyl disaster have been investigated continuously, and various problems, e.g., acute stress reaction, neurosis, and psychosis, have been identified, although no physical damage due to the radiation or PTSD have been reported. By contrast, PTSD has been seen in survivors of the Nagasaki and Hiroshima nuclear explosions. A study in Ohio, (United States), which has a nuclear waste plant, investigated PTSD in people living near the plant and found that the symptom level was mild. In general, the most common symptoms among people with mental and psychological disorders due to radiation exposure are depression and anxiety, with many people having associated somatoform disorders, and some people complain of PTSD. Vague anxiety and fear of sequelae, regardless of the exposure dose, appears to cause such psychiatric disorders. Although it is rare for psychiatrists to see such cases of psychiatric disorders due to radiation exposure, their number may increase as psychiatric services become more widely available. (K.H.)

  20. Dispersion approach to Ward-Takahashi identities

    This is a brief summary of a series of papers on the derivation of various Ward-Takahashi identities. The conventional field theoretical calculations often lead to ambiguities and also miss anomalies. The S matrix theory is free from these objections. But there is not a complete set of dispersion relations so that the theory represents an approximate dynamical scheme. This approach is standing midway. It is based on unitarity and dispersion relations. The object is the complete collection of Green's functions for which there is a complete set of dispersion relations. This provides a convenient basis for deriving various Ward-Takahashi identities unambiguously. (BMS)

  1. Ward identities of higher order Virasoro algebra

    The general formulations of primary fields versus quasi-primary ones in the context of high order Virasoro algebra (HOVA) and the corresponding Ward identity are explored. The primary fields of conformal spins up to 8 are given in terms of quasi-primary fields, and the general features of the higher order expressions are also discussed. It is observed that the local fields, either primary of quasi-primary, carry the same numbers of central charges, and not all the primary fields contribute to the anomalies in the Ward identities. (author). 6 refs

  2. Developing a general ward nursing dashboard.

    Russell, Margot; Hogg, Maggie; Leach, Stuart; Penman, Mags; Friel, Susan

    2014-12-15

    The seventh and final article in the series on Leading Better Care explores some of the challenges in clinical practice relating to the use of data and making information meaningful to senior charge nurses and ward sisters. It describes the collaborative approach taken by NHS Lanarkshire, which involved nursing staff, programme leads and the eHealth team in the development of a general ward nursing dashboard as a means of ensuring safe, effective person-centred care. The article also illustrates how this web-based data-reporting programme is used to support clinical practice. PMID:25492791

  3. Geometrical formulation of the conformal Ward identity

    In this paper we use deep ideas in complex geometry that proved to be very powerful in unveiling the Polyakov measure on the moduli space of Riemann surfaces and lead to obtain the partition function of perturbative string theory for 2, 3, 4 loops. Indeed, a geometrical interpretation of the conformal Ward identity in two dimensional conformal field theory is proposed: the conformal anomaly is interpreted as a deformation of the complex structure of the basic Riemann surface. This point of view is in line with the modern trend of geometric quantizations that are based on deformations of classical structures. Then, we solve the conformal Ward identity by using this geometrical formalism. (author)

  4. Facing the challenges and building solutions in clinical psychiatric nursing in Iran: a qualitative study.

    Zarea, Kourosh; Nikbakht-Nasrabadi, Alireza; Abbaszadeh, Abbas; Mohammadpour, Ali

    2012-10-01

    Psychiatric nurses play an important role in the process of caring for mentally ill patients and are continually faced with the numerous challenges and complex issues related to this field. This study aimed to understand the perspectives of psychiatric nurses regarding the issues they face while providing care and examine the possible solutions for improvement of inpatient care in clinical settings. The study adopted a qualitative approach that utilized a content analysis of audio taped, semi-structured interviews that had been conducted with 24 nurses. Two main themes emerged from the data. The first, Challenges in Providing Care within Psychiatric Wards, had the following subthemes: Politics and Rules of Organization, Safety and Security Issues, Uncertainty about the Role, Lack of Trained Staff, and Sociocultural Issues. The second theme, Solutions for Improving Psychiatric Care, had the subthemes of Empowerment across four domains: Psychiatric Nurses, Mentally Ill Patients and their Families, The Psychiatric Mental Health System, and the Cultural Context. The results indicated that if nurses are expected to provide optimal nursing care within a psychiatric ward, then there is a need for a stable and responsible organizational structure, skilled psychiatric nurses, and community-based care along with an anti-stigma program. PMID:23017047

  5. An observational study of providing structure as a psychiatric nursing intervention

    Voogt, L.A.; Goossens, P.J.J.; Nugter, A.; Achterberg, T. van

    2014-01-01

    PURPOSE: To observe the actions of psychiatric nurses when providing structure and identify results in order to better understand providing structure as a complex nursing intervention. DESIGN AND METHOD: Participant observation data were collected on a dual diagnosis ward and a crisis intervention w

  6. "Ward v. Wilbanks": Counselor Educators Respond

    Burkholder, David; Hall, Stephanie F.; Burkholder, Jessica

    2014-01-01

    This article investigated 71 counselor educators' perspectives and pedagogical practices related to "Ward v. Wilbanks" (2009) and the American Counseling Association (ACA) response to the case. The authors used qualitative content analysis to identify 6 themes from survey data: (a) views on gatekeeping and student training; (b)…

  7. A Note on Ward's Chiral Model

    Ioannidou, Theodora; Zakrzewski, Wojtek

    1998-01-01

    A one parameter generalization of Ward's chiral model in 2+1 dimensions is given. Like the original model the present one is integrable and possesses a positive-definite and conserved energy and $y$-momentum. The details of the scattering depend on the value of the parameter of the generalisation.

  8. Solutions of ward's modified chiral model

    We discuss the adaptation of Uhlenbeck's method of solving the chiral model in 2 Euclidean dimensions to Ward's modified chiral model in (2+1) dimensions. We show that the method reduces the problem of solving the second-order partial differential equations for the chiral field to solving a sequence of first-order partial differential equations for time dependent projector valued fields

  9. Protocol for an exploration of knowledge sharing for improved discharge from a mental health ward

    Rowley, Emma; Wright, Nicola; Waring, Justin; Gregoriou, Kyri; Chopra, Arun

    2014-01-01

    Introduction Strategies to reduce hospital admissions for mental health service users have received vast amounts of attention, yet the transfer of care from hospital to the community has been ignored. The discharge process is complex, messy, disjointed and inefficient, relying on cross-agency and organisational working. Focusing on one acute mental health admission ward, we will investigate whether the discharge process for people with severe mental health problems can be enhanced through the...

  10. Psychiatric treatment and research unit for adolescent intensive care: the first adolescent forensic psychiatric service in Finland.

    Kahila, K; Kilkku, N; Kaltiala-Heino, R

    2004-04-01

    Finland does not have a history of providing forensic adolescent psychiatric units although the need for this kind of service has been established. According to legislation patients who are minors have to be treated separately from adults, however, this has not been possible in practice. Also, adolescent psychiatric wards have not always been able to admit the most severely ill patients, those with impulsive and aggressive behaviours, because of lack of staff resources, problems associated with protecting other vulnerable patients and a shortage of secure environments. A previous report demonstrated the significant increase in adolescent's involuntary treatment within adult psychiatric wards. Data from this report were acknowledged as an important starting point in the planning process for the psychiatric treatment and research unit for adolescent intensive care. This paper describes the background, development process, plan of action, tailor-made education programme and supporting evidence for the first Finnish adolescent forensic service opened in April 2003 in the Department of Psychiatry, Tampere University Hospital. The tool used for planning the unit's activities and staff education programme was the Balanced Score Card approach, the structure and development of which is also outlined within the paper. PMID:15009502

  11. Usage of psychiatric emergency services by asylum seekers

    Reko, Amra; Bech, Per; Wohlert, Cathrine;

    2015-01-01

    given at the initial evaluation was ICD-10 F43.9 "reaction to severe stress, unspecified" (50%). Evaluations were made primarily by non-psychiatrists. No standardized screening or diagnostic instrument was used. CONCLUSION: This first description of the use of an acute psychiatric emergency service by......BACKGROUND: Asylum seekers are found to be at high risk of mental health problems. Little is known about the use of acute psychiatric emergency services by asylum seekers. AIM: To describe the usage of an inpatient/outpatient psychiatric emergency service in Denmark by adult asylum seekers, and...... predominantly male and married. The group consisted primarily (61%) of failed asylum seekers. Most patients (81%) presented with relevant mental health problems. The main reasons for presenting to the acute psychiatric emergency service were suicidal ideation and/or behaviour (60%). The most frequent diagnosis...

  12. Greenlandic adoptees' psychiatric inpatient contact. A comparative register-based study

    Laubjerg, Merete; Petersson, Birgit

    psychiatric admissions and diagnoses related to adoptees and stepchildren compared to non-adoptees with respect to demographic and socio-economic indicators. The psychiatric data material is collected from 1992 to 2008 and the socio-economic indicators are included from 1996. The findings show, contrary to......  The aim is to highlight adoptees' and stepchildren's psychiatric contact and diagnoses compared to non-adoptees. The setting is Greenland and the methodology is a comparative in-ward patient register-based study. The background is the Greenlandic tradition for adoption and community child care...... and international research stressing that adoptees demonstrate reverse health outcomes. The cohort is in-ward patients (> 24 hours), born between 1973 and 2005. Correlation between various dependent and independent variables are analysed. The research makes different comparative statements of...

  13. Psychiatric disorders and pregnancy

    "SH. Akhondzadeh; L. Kashani "

    2006-01-01

    Psychiatric disorders are common in women during their childbearing years. Special considerations are needed when psychotic disorders present during pregnancy. Early identification and treatment of psychiatric disorders in pregnancy can prevent morbidity in pregnancy and in postpartum with the concomitant risks to mother and baby. Nevertheless, diagnosis of psychiatric illnesses during pregnancy is made more difficult by the overlap between symptoms of the disorders and symptoms of pregnancy....

  14. The supersymmetric Ward identities on the lattice

    Supersymmetric (SUSY) Ward identities are considered for the N=1 SU(2) SUSY Yang Mills theory discretized on the lattice with Wilson fermions (gluinos). They are used in order to compute non-perturbatively a subtracted gluino mass and the mixing coefficient of the SUSY current. The computations were performed at gauge coupling β=2.3 and hopping parameter κ=0.1925, 0.194, 0.1955 using the two-step multi-bosonic dynamical-fermion algorithm. Our results are consistent with a scenario where the Ward identities are satisfied up to O(a) effects. The vanishing of the gluino mass occurs at a value of the hopping parameter which is not fully consistent with the estimate based on the chiral phase transition. This suggests that, although SUSY restoration appears to occur close to the continuum limit of the lattice theory, the results are still affected by significant systematic effects. (orig.)

  15. Patients Light Preferences in Hospital Wards

    Stidsen, Lone; Bjerrum, H. S.; Kirkegaard, Poul Henning; Thuesen, Niels; Fisker, Anna Marie

    When designing Danish hospitals in the future, patients, staff and guests are in focus and it is especially important to design an environment with knowledge of users sensory and functionally needs. Likewise, focus should be on how hospital wards can support patients’ experiences or maybe even how...... it can have a positive influence on the recovery process. The present paper introduces the human perspective and the Danish cultural approach in illuminating homes and how it can contribute to innovative lighting design at hospitals. The importance of having a holistic approach to lighting design is...... introduced based on the theory by Gernot Böhmes i.e. “concept of atmosphere” dealing with the effect of experiencing atmosphere. The aim of this study for design of a lighting concept for wards is to get qualified information on patients light preferences for light atmosphere by studying the everyday use of...

  16. Implementing lean in a surgical ward

    Edwards, Kasper; Nielsen, Anders Paarup; Jacobsen, Peter

    be analyzed and discussed using a number of different theoretical perspectives from, e.g., organization theory, lean and manufacturing management. The paper will conclude by outlining a number of recommendations for the successful implementation of lean in the health care sector.......Using the well-known principles from lean management in an orthopedic surgical ward at a major Danish hospital reorganized their work-flow and processes. The ward has ten operating rooms and performs the complete range of the orthopedic procedures ranging from patients that need simple standard...... procedures to patients in need of complex emergency procedures. The primary result of the lean project has been to split the flow of patients in two. The first flow is concerned with highly standardized and non-emergency procedures, e.g. minor knee surgery. These surgeries are routine, predictable and can be...

  17. Improving fluid balance monitoring on the wards

    Jeyapala, Sobanakumari; Gerth, Alice; Patel, Aarti; Syed, Nazia

    2015-01-01

    Clinical experience and nursing metrics have consistently identified poor documentation of fluid balance monitoring at Milton Keynes University Hospital, compromising patient safety and quality of care. This project aimed to increase the percentage of fluid balance charts correctly completed on the wards. Three areas for improvement were identified: understanding the importance of good fluid balance monitoring, correct identification of patients requiring monitoring, and ease of completion of...

  18. [Comment on “Ward Off?”] More on Ward Valley

    Powers, Dennis W.

    The May 23rd Eos “In Brief” could have been considerably more informative about Ward Valley and the work of the NAS panel in reviewing issues raised about the proposed site. The article should have included more comprehensive discussion by the scientific participants who reviewed the technical issues involved. In addition, the article raised two very different subjects—safety issues at Ward Valley and alleged bias of NAS panels—but did not separate the subjects well. Readers may not have distinguished between the Ward Valley panel and the NAS Board on Radioactive Waste Management in the question of bias. In addition, the nature of the reported-on attacks on scientific and personal integrity of the scientists may well discourage qualified but thinner-skinned geoscientists from public service on panels.

  19. Neurobiology of psychiatric disorders

    Đokić Gorica

    2015-01-01

    Full Text Available Neurobiologically spoken, the supstrate of the mind is formed by neuronal networks, and dysregulated neurocircuitry can cause psychiatric disorders. Psychiatric disorders are diagnosed by symptom clusters that are the result of abnormal brain tissue, and/or activity in specialized areas of the brain. Dysregulated circuitry results from abnormal neural function, or abnormal neural connections from one brain area to another, which leads to neurotransmitter imbalances. Each psychiatric disorder has uniquely dysregulated circuitry and thereby unique neurotransmitter imbalance, such as: prefrontal cortical-limbic pathways in depression or prefrontal cortical-striatal pathways in schizophrenia ie. serotonin-norepinephrin-dopamin imbalance in depression, or dopamine hyperactivity in schizophrenia. Biological psychiatry has completely changed the farmacological treatment of psychiatric disorders, and new foundings in that field are supportive to futher more neuropsychopharmacological and nonpharmacological therapy studies, whish has as a result more safe and effective therapy for psychiatric disorders.

  20. Primary Psychiatric Diseases

    Sibel Mercan

    2010-07-01

    Full Text Available The etiology of these dermatological diseases is entirely psychiatric origin. These patients show overconcern to their skin or self inflicted dermatoses unconsciously instead of facing with their real problems. In this group, delusions, dermatitis artefacta, trichotillomania, body dysmorphic disorder can be seen. They use denial as defence mechanism to their real psychiatric problems and prefer to apply dermatology instead of psychiatry. Dermatologist should be very careful before asking psychiatric consultation. Denial mechanism help patients to overcome agressive impulses like suicide or prevent further psychiatric damage like psychosis. Dermatologist should see these patients with short and frequent intervals with a good empathic approach. This will help to progress a powerful patient doctor relationship which will lead to a psychiatric evaluation.

  1. Psychiatric disorders and pregnancy

    "SH. Akhondzadeh

    2006-07-01

    Full Text Available Psychiatric disorders are common in women during their childbearing years. Special considerations are needed when psychotic disorders present during pregnancy. Early identification and treatment of psychiatric disorders in pregnancy can prevent morbidity in pregnancy and in postpartum with the concomitant risks to mother and baby. Nevertheless, diagnosis of psychiatric illnesses during pregnancy is made more difficult by the overlap between symptoms of the disorders and symptoms of pregnancy. In majority of cases both psychotherapy and pharmacotherapy should be considered. However, psychiatric disorders in pregnancy are often under treated because of concerns about potential harmful effects of medication. This paper reviews findings about the presentation and course of major psychiatric disorders during pregnancy.

  2. Noncompliance and its Causes Resulting in Psychiatric Readmissions

    Mohammad Yaghoubi

    2008-01-01

    Full Text Available "n  "n Objective: "n We aimed to describe psychiatrists' attributions on non-compliance related issues resulting in re-hospitalizations of psychiatric patients. "nMethod: In a cross sectional study, we included 500 randomly selected psychiatric readmitted patients and registered their demographic data (including age, sex, job, marital status, and educational level, and psychiatric clinical data including diagnosis, medications, and presence of psychiatric disorders in family members. Possible noncompliance issues by means of type and causes were asked through a structured interview by a psychiatrist. "nResults: Non-compliance was reported as a possible cause of admission in 441 88.2 of the re-hospitalized cases. No insight to disease (n=295; 59%, and feeling of cure (n=138; 27.6% were the 2 most prevalent causes for noncompliance of the patients . "nConclusion: It seems that non-compliance, as a prevalent factor, possibly causes readmission in psychiatric wards. Providing a better insight to disease and to instruct patients to take their medications even if they have some feeling of cure is important to decrease such problems.

  3. Psychiatric patients turnaround times in the emergency department

    Ohlmeier Martin

    2005-12-01

    Full Text Available Abstract Background To analyze the turnaround times of psychiatric patients within the Emergency Department (ED from registration to discharge or hospitalization in a University Hospital in 2002. Methods Data from a one-year period of psychiatric admissions to the emergency service at a University Hospital were monitored and analyzed focused on turnaround times within the ED. Information on patients variables such as age, sex, diagnosis, consultations and diagnostic procedures were extracted from the patients' charts. Results From 34.058 patients seen in the ED in 2002, 2632 patients were examined by psychiatrists on duty. Mean turnaround time in the ED was 123 (SD 97 minutes (median 95. Patients to be hospitalized on a psychiatric ward stayed shorter within the ED, patients who later were admitted to another faculty, were treated longer in the ED. Patients with cognitive or substance related disorders stayed longer in the ED than patients with other psychiatric diagnoses. The number of diagnostic procedures and consultations increased the treatment time significantly. Conclusion As the number of patients within the examined ED increases every year, the relevant variables responsible for longer or complicated treatments were assessed in order to appropriately change routine procedures without loss of medical standards. Using this basic data, comparisons with the following years and other hospitals will help to define where the benchmark of turnaround times for psychiatric emergency services might be.

  4. Oxytocin and Psychiatric Disorders

    Gokce Nur Say

    2016-06-01

    Full Text Available Oxytocin is a neuropeptide that plays critical role in mother-infant bonding, pair bonding and prosocial behaviors. Several neuropsychiatric disorders such as autism, schizophrenia, affective disorders, anxiety disorders, attention deficit/hyperactivity disorder, alcohol/substance addiction, aggression, suicide, eating disorders and personality disorders show abnormalities of oxytocin system. These findings have given rise to the studies searching therapeutic use of oxytocin for psychi-atric disorders. The studies of oxytocin interventions in psychiatric disorders yielded potentially promising findings. This paper reviews the role of oxytocin in emotions, behavior and its effects in psychiatric disorders. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(2: 102-113

  5. Developing a ward round checklist to improve patient safety

    Hale, Gordon; McNab, Duncan

    2015-01-01

    Checklists have been shown to improve care and reduce morbidity and mortality in the healthcare setting.[1] Their application in safety-critical industries outside of medicine continues to offer a strong argument for their application to medicine.[2] The daily in-patient medical ward round is a complex process and includes multiple potential risks to patient safety. This project aims to evaluate the effectiveness of a ward round review checklist on one general medical ward in a district gener...

  6. The importance of relationships in mental health care: A qualitative study of service users' experiences of psychiatric hospital admission in the UK

    Slade Mike

    2008-04-01

    Full Text Available Abstract Background While a number of studies have looked at life on service users' experiences of life on psychiatric wards, no research exists that have approached these experiences from the user perspective since the introduction of community care. Methods This user-led study uses a participatory approach to develop an understanding of the processes and themes which define the user experience of hospitalisation. Nineteen service users who had all had inpatient stays in psychiatric hospitals in London were interviewed in the community. Results Relationships formed the core of service users' experiences. Three further codes, treatment, freedom and environment defined the role of hospital and its physical aspects. Themes of communication, safety, trust, coercion, and cultural competency contributed to the concept of relationships. Conclusion Relationships with an individual which comprised effective communication, cultural sensitivity, and the absence of coercion resulted in that person being attributed with a sense of trust. This resulted in the patient experiencing the hospital as a place of safety in terms of risk from other patients and staff. Barriers to positive relationships included ineffective and negative communication, a lack of trust, a lack of safety in terms of staff as ineffective in preventing violence, and as perpetrators themselves, and the use of coercion by staff. This unique perspective both acts as a source of triangulation with previous studies and highlights the importance of the therapeutic relationship in providing a safe and therapeutic milieu for the treatment of people with acute mental health problems.

  7. Ideal ward round making in neurosurgical practice.

    Pathak A

    2000-07-01

    Full Text Available The success of a perfect ward round lies in the role of the consultant leading the ′round making group′ (RMG as well as the hallmark of effective questioning and participation of each member. Twelve senior consultants with more than 10 years′ experience in neurosurgical practice at three different university hospitals were observed during round making by a participant observer. Observations were made on the group climate of the RMG, the leadership pattern and language expressed by the clinician conducting the round and the effectiveness in his performance as a leader during clinical discussions. The group climate showed evidence of good productivity and flexibility with 92% and 75% consultants, pleasantness of climate was above average with only 50% (6/12 and poor objectivity with 42% (5/12 consultants. Forty two percent of the consultants were not always very well comprehensible, while only 50% (6/12 spoke exactly fitting the occasion. Only 33% (4/12 of the consultants used humour effectively, while 42% (5/12 spoke unnecessarily in between discussion and were poor in introducing the problems of patient to the round making group. Ward round making in neurosurgical practice needs a holistic approach with motivation, planning, leadership skills and structured curriculum to fulfill its objectives.

  8. Radiation shielding of 131I therapeutic ward in department

    Objective: To rebuild an 131I therapeutic ward of the department of nuclear medicine in the hospital, and design the radiation shielding to make the radiation safety achieve the national standards. Methods: According to the protection demands of national relating standards, the design of the ward was based on the basic principles and methods of radiation shielding of 131I, and combined the distribution of radioactive sources, rooms and people. Results: The design parameters and radioprotection data of the rebuilt ward were obtained and the radiation shielding was safe by monitoring. Conclusion: The design of the 131I therapeutic ward achieved the anticipated target that the radiation safety could be controlled. (authors)

  9. Occupational Psychiatric Disorders in Korea

    Choi, Kyeong-Sook; Kang, Seong-Kyu

    2010-01-01

    We searched databases and used various online resources to identify and systematically review all articles on occupational psychiatric disorders among Korean workers published in English and Korean before 2009. Three kinds of occupational psychiatric disorders were studied: disorders related to job stress and mental illness, psychiatric symptoms emerging in victims of industrial injuries, and occupational psychiatric disorders compensated by Industrial Accident Compensation Insurance (IACI). ...

  10. Hyperthyroidism and psychiatric morbidity

    Brandt, Frans; Thvilum, Marianne; Pedersen, Dorthe Almind; Christensen, Kaare; Green, Anders; Hegedus, Laszlo; Brix, Thomas Heiberg

    2014-01-01

    Thyroid hormones are essential for the normal development of the fetal brain, while hyperthyroidism in adults is associated with mood symptoms and reduced quality of life. We aimed to investigate the association and temporal relation between hyperthyroidism and psychiatric morbidity....

  11. PSYCHIATRIC COMPLICATIONS OF CHLOROQUINE

    Bhatia, M.S.; S.C. Malik

    1994-01-01

    Sixty patients with chloroquine induced psychiatric complications are reported in the present series. Psychosis was the most common complication followed by anxiety state and seizures. The maximum number of patients were between the ages of 6 and 10 years and females (70.0%) outnumbered the males (30.0%). Headache and sleeplessness were found to be more common amongpatients developing psychiatric complications of chloroquine. The symptoms disappeared within 2 to 21 days after the discontinuat...

  12. URINARY INCONTINENCE IN ACUTE PSYCHOSIS

    Choudhury, S.; Augustine, M.

    1993-01-01

    SUMMARY A prospective two year study of consecutive admissions (n=984) to a psychiatry ward revealed that the incidence of temporary urinary incontinence in psychiatric patients without delirium or dementia was 1.63% (n=l6). When compared with controls (n=64) the incontinent patients were more often psychotic, gave a history of childhood enuresis and a past history of temporary incontinence during psychosis. Compared with psychotic controls (n=26), incontinent patients (n=16) had been exposed...

  13. [When should a patient with abdominal pain be referred to the emergency ward?].

    de Saussure, Wassila Oulhaci; Andereggen, Elisabeth; Sarasin, François

    2010-08-25

    When should a patient with abdominal pain be referred to the emergency ward? The following goals must be achieved upon managing patients with acute abdominal pain: 1) identify vital emergency situations; 2) detect surgical conditions that require emergency referral without further diagnostic procedures; 3) in "non surgical acute abdomen patients" perform appropriate diagnostic procedures, or in selected cases delay tests and reevaluate the patient after an observation period, after which a referral decision is made. Clues from the history and physical examination are critical to perform this evaluation. A good knowledge of the most frequent acute abdominal conditions, and identifying potential severity criteria allow an appropriate management and decision about emergency referral. PMID:20873434

  14. Aggressive behaviors in the psychiatric emergency service

    Yves Chaput

    2011-03-01

    Full Text Available Yves Chaput1, Lucie Beaulieu2, Michel Paradis3, Edith Labonté41Department of Psychiatry, McGill University, Montreal (presently in private practice; 2Department of Psychiatry, Haut Richelieu Hospital, Saint-Jean-sur-Richelieu, Quebec; 3Department of Psychiatry, University of Montreal, Montreal; 4Department of Psychiatry, Laval University, Quebec, CanadaIntroduction: Studies of aggressive behaviors in a nonforensic mental health setting have focused primarily on the inpatient ward and, on event prediction, using behavior-based clinical rating scales. Few studies have specifically targeted aggressive behaviors in the psychiatric emergency service or determined whether assessing the demographic and clinical characteristics of such patients might prove useful for their more rapid identification.Methods: We used a prospectively acquired database of over 20,900 visits to four services in the province of Quebec, Canada, over a two-year period from September 2002 onwards. A maximum of 72 variables could be acquired per visit. Visits with aggression (any verbally or physically intimidating behavior, both present and past, were tagged. Binary logistic regressions and cross-tabulations were used to determine whether the profile of a variable differed in visits with aggression from those without aggression.Results: About 7% of visits were marked by current aggression (verbal 49%, physical 12%, verbal and physical 39%. Including visits with a “past only” history of aggression increased this number to 20%. Variables associated with aggression were gender (male, marital status (single/separated, education (high school or less, employment (none, judicial history (any type, substance abuse (prior or active, medication compliance (poor, type of arrival to psychiatric emergency services (involuntary, police, judiciary, landlord, reason for referral (behavioral dyscontrol, diagnosis (less frequent in anxiety disorders, and outcome (more frequently placed under

  15. The opinion of patients with mental disorder about tobacco and its prohibition in psychiatric hospitalization

    Renata Marques de Oliveira

    2014-06-01

    Full Text Available Objective: To identify the opinion of patients with mental disorder about tobacco and its prohibition during psychiatric hospitalization. Method: An exploratory study with 96 patients smokers with mental disorders hospitalized in a psychiatric ward of a general hospital. The interviews were conducted individually, using an instrument designed for this study. The content from the interviews was recorded, transcribed and submitted to a thematic content analysis. Results: The patients with mental disorder were identified as perceiving smoking during the psychiatric hospitalization as a help to support the difficulties in socialization and in the lack of activities. The permission for smoking is seen as a signal of respect to their needs. The subjects mentioned to not accept the total smoking prohibition. Conclusion: Tobacco helps to face difficulties and conflicts in the psychiatric hospitalization. There is resistance regarding the possibility to totally withdraw the smoking permission during hospitalization.

  16. Effective sigma models and lattice Ward identities

    We perform a lattice analysis of the Faddeev-Niemi effective action conjectured to describe the low-energy sector of SU(2) Yang-Mills theory. To this end we generate a particular ensemble of unit vector fields ('color spins') n from the Wilson action. The ensemble does not show long-range order but exhibits a mass gap of the order of 1 GeV. From the distribution of color spins we reconstruct approximate effective actions by means of exact lattice Schwinger-Dyson and Ward identities ('inverse Monte Carlo'). We show that the particular ensemble generated cannot be recovered from a Faddeev-Niemi action, modified in a minimal way by adding an explicit symmetry-breaking term to avoid the appearance of Goldstone modes. (author)

  17. Nurse rostering at a Danish ward

    Bæklund, Jonas

    2014-01-01

    This paper considers a nurse rostering problem from a ward at a Danish hospital.  The problem is highly constrained and comprises a large set of different constraints. A branch-and-price method for solving the problem exactly is proposed. The master problem is to assign schedules to the nurses, and...... its linear relaxation is solved by means of column generation. The pricing sub-problem is to generate feasible schedules for the nurses and -- as a couple of different constraints including several special Danish regulations have to be observed -- is solved by constraint programming. A number of...... specific algorithms for handling these constraints are proposed. The method is very flexible regarding the rules a schedule should comply with, which is a key concern when creating solution methods for nurse rostering problems.  Computational tests show that optimal solutions can be found for instances...

  18. Superconformal Ward identities and their solution

    Superconformal Ward identities are derived for the four point functions of chiral primary BPS operators for N=2,4 superconformal symmetry in four dimensions. Manipulations of arbitrary tensorial fields are simplified by introducing a null vector so that the four point functions depend on two internal R-symmetry invariants as well as two conformal invariants. The solutions of these identities are interpreted in terms of the operator product expansion and are shown to accommodate long supermultiplets with free scale dimensions and also short and semi-short multiplets with protected dimensions. The decomposition into R-symmetry representations is achieved by an expansion in terms of two variable harmonic polynomials which can be expressed also in terms of Legendre polynomials. Crossing symmetry conditions on the four point functions are also discussed

  19. Noise Pollution in Intensive Care Units and Emergency Wards

    Gholamreza Khademi

    2011-03-01

    Conclusion:  The average levels of noise in intensive care units and also emergency wards were  more than the standard levels and as it is known these wards have vital roles in treatment procedures, so more attention is needed in this area.

  20. Prophylactic antimicrobial practice in the Orthopaedic wards of RIPAS Hospital.

    Lah Kheng CHUA

    2012-01-01

    Introduction: Surgical site infections (SSI) are common healthcare associated infections (HAI) that is associated with increased morbidity and cost. Antimicrobial prophylaxis is effective when used appropriately. This study assesses the prophylactic antimicrobial prescribing and practice in the orthopaedic wards based on the Scottish Intercollegiate Guidelines Network (SIGN) guideline on antibiotic prophylaxis in surgery. Materials and Methods: Patients admitted to the Orthopaedics wards over...

  1. 34 CFR 300.45 - Ward of the State.

    2010-07-01

    ... child resides, is— (1) A foster child; (2) A ward of the State; or (3) In the custody of a public child welfare agency. (b) Exception. Ward of the State does not include a foster child who has a foster parent who meets the definition of a parent in § 300.30. (Authority: 20 U.S.C. 1401(36))...

  2. Air monitoring in radioiodine therapy ward

    Full text: In Radioiodine therapy wards, in general the radiation exposure due to air borne activity from patients administered with 925MBq-7.4GBq (25-200mCi) of 131I has to be kept under regulatory limits. The purpose of conducting an air monitoring in our setup was to assess air borne activity levels. If the levels are high then it may lead to increased exposure to the occupational workers and patient's attendants. A total of 22.2GBq (600 mCi) 131I is administered every week to our patients in the isolation ward. After administered of 131I in the dose administration room, patients occupy their respective beds. The isolation beds are provided with attached toilet facility. Six air samples were collected from various regions (high dose room, low dose room, dose administration room, special room, corridor and entrance) in the vacuumized vials (9 ml) using 16 G needle at the breathing zone level. One control sample was also collected from the area with no possible 131I air-contamination. The vials were then counted in the pre-calibrated NaI well counter (known efficiency). The maximum air borne radioiodine concentration was found to be 1.999x10-6 ?Ci/cm3 in the high dose room (which keeps on decreasing with time, being maximum on second day and zero on third and subsequent days). We measured the thyroid counts of the staff and patient's attendants, routinely. The estimated thyroid activity never showed any significant increase in the thyroid uptake of the staff and patient's attendants. In our setup, air monitoring is strictly followed and performed periodically. We conclude that air monitoring program is only one element of the comprehensive radiation protection program and should be a made mandatory practice. (author)

  3. [Dichotomy of psychiatric and somatic emergency care; fundamental flaw should be addressed].

    Tuerlings, Joep H A M; Pelger, E C M Noor; de Pont, Boudewijn J H B; van Waarde, Jeroen A

    2015-01-01

    In the Netherlands, acute psychiatric care is characterised by mind-body dualism. For acute psychiatric patients, the first port of call is the general practitioner (GP); after-hour care is provided by the out-of-hours GP service. In contrast to patients with other medical illnesses, the out-of-hours GP service does not usually refer patients with acute psychiatric issues to the accident and emergency (A&E) department of the general hospital, but to the local ambulant psychiatric 'crisis' service. However, some of these patients still end up at the A&E department, as our three cases demonstrate. Integration of the out-of-hours GP service, A&E and acute psychiatric care, therefore, would enable elimination of the current partitioning of somatic and psychiatric medicine in acute emergency care. This solution would not only improve acute emergency care, but would also ensure a targeted and efficient implementation of services and might even lead to a decreased stigmatisation of psychiatric patients in general. PMID:26230348

  4. Hospital Related Stress Among Patients Admitted to a Psychiatric In-patient Unit in India

    Latha KS

    2011-04-01

    Full Text Available The psychiatric patient’s attitudes towards hospitalization have found an association between patient perceptions of the ward atmosphere and dissatisfaction. The aim of the study was to determine the aspects of stress related to hospitalization in inpatients admitted to a psychiatric facility. Fifty in-patients of both sexes admitted consecutively to a psychiatric unit in a General Hospital were asked to rate the importance of, and their satisfaction with, 38 different aspects of in-patient care and treatment. Results showed that the major sources of stress were related to having a violent patient near to his/her bed; being away from family; having to stay in closed wards; having to eat cold and tasteless food; losing income or job due to illness, being hospitalized away from home; not able to understand the jargons used by the clinical staff and not getting medication for sleep. A well-differentiated assessment of stress and satisfaction has implications for the evaluation of the quality of psychiatric care and for the improvement of in-patient psychiatric care.

  5. Negotiating clinical knowledge: a field study of psychiatric nurses' everyday communication

    Buus, Niels

    2008-01-01

    Nursing practices at psychiatric hospitals have changed significantly over the last decades. In this paper, everyday nursing practices were interpreted in light of these institutional changes. The objective was to examine how mental health nurses' production of clinical knowledge was influenced by...... the particular social relations on hospital wards. Empirical data stemming from an extended fieldwork at two Danish psychiatric hospital wards were interpreted using interactionistic theory and the metaphor: 'the game of clinical knowledge'. The results indicated that the nurses' production of...... clinical knowledge was highly dependent on the individual nurses' practical ability to participate in the game. Furthermore, the nurses colluded in their mutual communication to enable the collective display and sense of knowing that protected them against explicit signs of uncertainty about the clinic...

  6. Creutzfeldt-Jacob’s Disease Presenting with Psychiatric Symptomsand Severe Itching

    Emine Rabia Koç

    2013-03-01

    Full Text Available Creutzfeldt-Jakob disease is a rare and fatal neurodegenerative disease that is characterized by the accumulation of abnormal prion-like proteins in the central nervous system. Clinical features, electroencephalography, brain magnetic resonance imaging and protein 14.3.3 is useful in diagnosis. Protein 14.3.3 may be negative in the early or late stages of the disease. Presentation with psychiatric symptoms and itching is not typical in the beginning of the disease In this paper, we present a patient who was first accepted to the pschiatry ward because of his psychiatric symtpoms and had severe itching, resistant to antihistaminic drugs.

  7. Abortion and psychiatric practice.

    Stotland, Nada L

    2003-03-01

    The subject of abortion is fraught with politics, emotions, and misinformation. A widespread practice reaching far back in history, abortion is again in the news. Psychiatry sits at the intersection of the religious, ethical, psychological, sociological, medical, and legal facets of the abortion issue. Although the religions that forbid abortion are more prominent in the media, many religions have more liberal approaches. While the basic right to abortion has been upheld by the U.S. Supreme Court, several limitations have been permitted, including parental notification or consent (with the possibility of judicial bypass) for minors, waiting periods, and mandatory provision of certain, sometimes biased, information. Before the Roe v. Wade decision legalizing abortion in 1973, many women were maimed or killed by illegal abortions, and psychiatrists were sometimes asked to certify that abortions were justified on psychiatric grounds. Currently, there are active attempts to convince the public and women considering abortion that abortion frequently has negative psychiatric consequences. This assertion is not borne out by the literature: the vast majority of women tolerate abortion without psychiatric sequelae. The psychiatric outcome of abortion is best when patients are able to make autonomous, supported decisions. Psychiatrists need to know the medical and psychiatric facts about abortion. Psychiatrists can then help patients prevent unwanted pregnancies, make informed decisions consonant with their own values and circumstances when they become pregnant, and find appropriate social and medical resources whatever their decisions may be. PMID:15985924

  8. Transporting Forensic Psychiatric Patients.

    Dike, Charles C; Nicholson, Elizabeth; Young, John L

    2015-12-01

    Patients in a forensic psychiatric facility often require escorted transport to medical facilities for investigations or treatments of physical health ailments. Transporting these patients presents significant safety and custody challenges because of the nature of patients housed in forensic psychiatric facilities. A significant proportion of these patients may be transfers from the Department of Corrections (DOC) under legal mandates for psychiatric evaluation and treatment better provided in a hospital setting, and most of them will return to the DOC. Although departments of correction have protocols for escorting these potentially dangerous individuals, it is unclear whether receiving psychiatric hospitals have established procedures for maintaining the safety of others and custody of these individuals during transportation outside the hospital facility. The literature is sparse on precautions to be observed when transporting dangerous forensic psychiatric patients, including those with high escape risk. In this article, we describe one forensic inpatient facility's procedure for determining the appropriate level needed to transport these individuals outside of the forensic facility. We also describe the risk assessment procedure for determining level of transport. These are quality improvement measures resulting from a critical review of an incident of escape from the forensic facility several years ago. PMID:26668224

  9. Psychiatric Aspects of Infertility

    Hacer Sezgin

    2014-06-01

    Full Text Available Infertility can be defined as a crisis with cultural, religious, and class related aspects, which coexists with medical, psychiatric, psychological, and social problems. Relation between psychiatric and psychological factors stem from a mutual interaction of both. Family is an important institution in maintaining human existence and raising individuals in line with society's expectations. Fertility and reproduction are seen as universal functions unique to women with raising children as the expected result of the family institution. Incidence of infertility has increased recently and can become a life crisis for a couple. Even though not being able to have a child affects both sexes emotionally, women feel greater amounts of stress, pressure, anxiety, and depression.Consequences of infertility arise from short and long-term devastating effects on both individual's physical and mental health, and marital system. Many studies focus on infertility related psychological and psychiatric disorders (depression, anxiety, grief, marital conflict, gender differences, relation between the causes of infertility and psychopathology, the effects of psychiatric evaluation and intervention -when necessaryon the course of infertility treatment, pregnancy rates, and childbirth. The most important underlying causes of high levels of stress and anxiety that infertile women experience are the loss of maternity, reproduction, sense of self, and genetic continuity. In this review article is to investigate the relationship between medically unexplained symptoms and psychiatric symptoms. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(2.000: 165-185

  10. FORGING PSYCHIATRIC CATEGORIES: A Philosophical Examination of the Creation and Stabilization of Diagnostic Knowledge

    Roome, Benjamin Reynolds

    2012-01-01

    This dissertation explores the entanglement of ethics and epistemology in the domain of psychiatric research, considering the ways that measurement practices and ethical values interrelate. If psychiatric clinicians, researchers, and patients are not acutely aware of the relationship between experimental configurations and the meaning of scientific data, unhealthy realities that take psychiatric constructs as fixed parts of nature will persist.The core of this work consists of case studies o...

  11. Psychiatric patient and anaesthesia

    Joginder Pal Attri

    2012-01-01

    Full Text Available Many patients with psychiatric illnesses are prescribed long-term drug treatment, and the anaesthesiologist must be aware of potential interactions with anaesthetic agents. Psychotropic drugs often given in combination with each other or with other non-psychiatric drugs generally exert profound effects on the central and peripheral neurotransmitter and ionic mechanisms. Hence, prior intake of these drugs is an important consideration in the management of the patient about to undergo anaesthesia and surgery. This article highlights the effects of anaesthetics on patients taking antipsychotics, tricyclic antidepressants, monoamine oxidase inhibitors and lithium carbonate. The risk that should be considered in the perioperative period are the extent of surgery, the patient′s physical state, anaesthesia, the direct and indirect effects of psychotropics, risk of withdrawal symptoms and risk of psychiatric recurrence and relapse.

  12. Audit of hand hygiene at Broadmoor, a high secure psychiatric hospital.

    Ahmed, K

    2010-06-01

    Increased security measures at high secure psychiatric hospitals can complicate hand hygiene. This audit assessed the availability of appropriate hand hygiene equipment and the practice of good hand hygiene at Broadmoor Hospital using the local hand hygiene policy as the standard for comparison. A data collection tool used to audit the hand hygiene equipment on 23 wards in the hospital showed that there were significant deficits in the supply of hand hygiene equipment on the wards. In addition, a staff survey was conducted using a questionnaire designed to assess awareness, training and hand decontamination practice among nursing staff. This survey identified a need to increase awareness of the hand hygiene policy and the appropriate timing of hand decontamination procedures. As a result of the audit, appropriate equipment was ordered and the duties of infection prevention link nurses on each ward were made more explicit; namely, to check and order equipment for hand hygiene as necessary, to conduct regular reminder sessions of the hand decontamination procedure and to raise awareness of hand hygiene policy. Posters were also placed on wards in patient areas to increase awareness of hand hygiene among patients, and alcohol gel dispensers were introduced into nursing stations. Similar audits may prove beneficial at other psychiatric hospitals. PMID:20304525

  13. Emergency care of the elderly in the short-stay ward of the accident and emergency department.

    Harrop, S.N.; Morgan, W J

    1985-01-01

    Review of a consecutive series of the elderly patients who presented unheralded to the Accident and Emergency Department of the Royal Gwent Hospital showed that a relative minority (11%) were difficult to manage because they had no obvious acute medical condition or injury which qualified them for admission by the firms to whom they were first referred. The difficulty was compounded by the shortage of geriatric beds. Judicious use of short-stay ward beds in the accident and emergency departme...

  14. Use and performance of non-invasive ventilation in Internal Medicine ward: a real-life study

    Francesco Ventrella

    2015-01-01

    Full Text Available Controlled trials demonstrated efficacy and safety of non-invasive ventilation (NIV in treatment of acute respiratory failure, initially in Intensive Care Units, then in other care settings (semi-intensive care units, emergency departments, and also in the wards, more often pneumological ones. Few studies have been published about NIV in Italian wards of Internal Medicine with full self-management of NIV by internists in a normal ward setting. We performed a prospective real-life study about the use of NIV in Internal Medicine ward devoid of a critical area of semi-intensive therapy, with the aim of confirming, in this setting, the effectiveness of NIV. During a period of 13 months, 42 patients with hypercapnic respiratory failure of different etiology and acidosis (pH<7.25were treated by NIV. NIV was successful in 81% of patients. In-hospital mortality was 9.5%. Safety of NIV is demonstrated by the absence of serious complications: only 7 patients showed poor compliance and 2 patients had facial pressure ulcer due to the mask. There were not statistical differences in success rate of NIV according to severity of acidosis at admission (pH<7.25 vs pH>7.25, neither according to the acute physiology and chronic health evaluation II score and the national early warning score, but the modified early warning score only showed statistically significant difference with lower values in the success group: 2.82±1.57 vs 4.13±1.46 (P<0.05. NIV has proven to be effective and safe in Internal Medicine ward.

  15. Psychiatric emergency services in Copenhagen 2012

    Moltke, Katinka; Høegh, Erica B; Sæbye, Ditte;

    2015-01-01

    BACKGROUND: Since the first publication of the psychiatric emergency units (PEUs) in Copenhagen 1985, outpatient facilities have undergone considerable changes. Our aim is to examine how these changes have influenced the activities in the PEUs in the same catchment area. METHODS: We conducted a...... follow-up study to describe this development in the past 27 years by comparing 1985 variables with same measures in 2012. A random sample of all visits every 10 days in 2012 to three PEUs in Copenhagen were registered and compared with data collected, using the same study design in 1985. MAIN RESULTS...... has reduced the number of visits in the PEUs considerably. The results have shown a change of diagnostic distribution and more severe conditions requiring acute admissions for emergency treatment. Close collaboration with the patients' families, GPs, social authorities and specialized psychiatric...

  16. Migraine and its psychiatric comorbidities.

    Minen, Mia Tova; Begasse De Dhaem, Olivia; Kroon Van Diest, Ashley; Powers, Scott; Schwedt, Todd J; Lipton, Richard; Silbersweig, David

    2016-07-01

    Migraine is a highly prevalent and disabling neurological disorder associated with a wide range of psychiatric comorbidities. In this manuscript, we provide an overview of the link between migraine and several comorbid psychiatric disorders, including depression, anxiety and post-traumatic stress disorder. We present data on psychiatric risk factors for migraine chronification. We discuss the evidence, theories and methods, such as brain functional imaging, to explain the pathophysiological links between migraine and psychiatric disorders. Finally, we provide an overview of the treatment considerations for treating migraine with psychiatric comorbidities. In conclusion, a review of the literature demonstrates the wide variety of psychiatric comorbidities with migraine. However, more research is needed to elucidate the neurocircuitry underlying the association between migraine and the comorbid psychiatric conditions and to determine the most effective treatment for migraine with psychiatric comorbidity. PMID:26733600

  17. Pathological Gambling: Psychiatric Models

    Westphal, James R.

    2008-01-01

    Three psychiatric conceptual models: addictive, obsessive-compulsive spectrum and mood spectrum disorder have been proposed for pathological gambling. The objectives of this paper are to (1) evaluate the evidence base from the most recent reviews of each model, (2) update the evidence through 2007 and (3) summarize the status of the evidence for…

  18. CANNABIS AND PSYCHIATRIC DISORDERS

    Loga, Slobodan; Loga-Zec, Svjetlana; Spremo, Mira

    2010-01-01

    There are connection between use of cannabis and many psychiatric disturbances in adolescents, especially “cannabis psychosis", depression, panic attacks and suicide. Negative effects could occur either as a result of a specific pharmacological effect of cannabis, or as the result of stressful experiences during the intoxication of cannabis in young people. Potentially is very dangerous high frequency suicidal ideation among cannabis users.

  19. Psychosocial and medical factors affecting treatment compliance in patients attending psychiatric hospital: a study from Kashmir

    Sheikh Shoib

    2014-02-01

    Results: Out of 200 respondents studied in the study 41.5 % were males and 58.5% were females. Maximum number of patients (31.5% studied were in the age group below the 30 years. 3.5% of respondents were in the age group above 70 years. Out of total 200 respondents in the study 74 % of the respondents are in compliance with recommended medicine whereas non-compliance was found in the 26% of studied population. Complications (13.46% ascending out by usage of psychiatric medicine can be attributed as one of the major case of treatment non-compliance in psychiatric patients, among the psychiatric patients. Accessibility of psychiatric medicine and Financial constrain was also one of the reasons behind the medicine non-compliance (7.69%. Patients with no insight to psychiatric disease also include a good percentage of (5.76 % of medicine non- compliance. Conclusions: Non-compliance is a dominant factor which causes possibly causes readmission in psychiatric wards. Compliance in psychiatric patients in general could be enhanced and improved by adequate intervention via patient counselling and patient medicinal care and education. [Int J Basic Clin Pharmacol 2014; 3(1.000: 220-224

  20. Psychiatric-Mental Health Nursing.

    Reighley, Joan

    A description is provided of a course, "Psychiatric-Mental Health Nursing," designed to teach students at Level 3 of a two-year college nursing program about the role of the nurse in a psychiatric setting and about concepts of mental health and psychiatric disorders, using both classroom and clinical instruction. The first section of the course…

  1. Psychiatric morbidity in patients of pulmonary tuberculosis-an observational study

    Lalit Singh

    2015-01-01

    Full Text Available Background: A lot of stigma and misconceptions about pulmonary tuberculosis still persist, in spite of the advances in treatment. Thus, a mere diagnosis of pulmonary tuberculosis can be a psychological trauma to an individual. The situation has aggravated with the association of tuberculosis with HIV infection. Aim: To study the psychiatric morbidity due to the various psychological stresses faced by a patient of pulmonary tuberculosis. Materials and Methods: The study group consisted of 100 inpatients admitted to pulmonary ward with diagnosis of pulmonary tuberculosis. The control group consisted of 100 inpatients admitted to pulmonary ward with nontuberculous pulmonary diseases. Psychiatric history and mental status were recorded on a specially designed proforma and diagnosis of any psychiatric illness, if present, arrived at as per International Classification of Diseases (ICD-10. The psychiatric tests applied were beck's depression inventory (BDI and Taylor's Manifest Anxiety Scale (TMAS. Results: Of the patients of pulmonary tuberculosis, 24% could be given a diagnostic category, as per ICD-10, as compared to only 8% of the controls (P < 0.005. On BDI, 44% of patients of pulmonary tuberculosis showed depression as compared to 27% of the controls (P < 0.02. On TMAS, 38% of patients of pulmonary tuberculosis showed anxiety as compared to 24% of controls (P < 0.05. A greater incidence of depression (on BDI and anxiety (on TMAS was seen in those with longer duration of illness (P < 0.02 and in those with greater severity of illness (P < 0.02. Conclusion: In view of the high psychiatric morbidity associated with pulmonary tuberculosis, there is enough scope for psychiatric services to be made available to these patients. In addition, personnel involved in the treatment of these patients should be trained for early detection of psychiatric symptoms.

  2. Paediatric early warning scores on a children's ward: a quality improvement initiative.

    Ennis, Linda

    2014-09-09

    The aim of this quality improvement initiative was to incorporate a paediatric early warning score (PEWS) and track and trigger system in the routine care of children in an acute general children\\'s ward at a regional hospital in the Republic of Ireland. In the absence of a nationally recommended specific PEWS strategy, a local plan was developed. The experience of structuring and implementing the PEWS and track and trigger system is presented in this article. Data from the first year of use were collected to evaluate the clinical utility and effectiveness of this system. In the busy acute children\\'s service, the PEWS initiative was found to benefit processes of early detection, prompt referral and timely, appropriate management of children at potential risk of clinical deterioration. Nursing staff were empowered and supported to communicate concerns immediately and to seek rapid medical review, according to an agreed PEWS escalation plan. Outcomes were significantly improved.

  3. Middle-Age Fitness Helps Ward Off Stroke Later

    ... medlineplus.gov/news/fullstory_159287.html Middle-Age Fitness Helps Ward Off Stroke Later Study finds this ... 2016 THURSDAY, June 9, 2016 (HealthDay News) -- Physical fitness in middle age may lower your risk of ...

  4. Middle-Age Fitness Helps Ward Off Stroke Later

    ... gov/medlineplus/news/fullstory_159287.html Middle-Age Fitness Helps Ward Off Stroke Later Study finds this ... 2016 THURSDAY, June 9, 2016 (HealthDay News) -- Physical fitness in middle age may lower your risk of ...

  5. Ward identity and electrical conductivity in hot QED

    We study the Ward identity for the effective photon-electron vertex summing the ladder diagrams contributing to the electrical conductivity in hot QED at leading logarithmic order. It is shown that the Ward identity requires the inclusion of a new diagram in the integral equation for the vertex that has not been considered before. The real part of this diagram is subleading and therefore the final expressions for the electrical conductivity at leading logarithmic order are not affected. (author)

  6. Pharmacovigilance Among Surgeons and in Surgical Wards: Overlooked or Axiomatic?

    Rodrigues, Gabriel Sunil; Khan, Sohil Ahmed

    2010-01-01

    To review the status of pharmacovigilance system among surgeons and in surgical wards with recommendations. Literature search using MEDLINE, cross-reference of published data and review of World Health Organization—Pharmacovigilance transcripts. Pharmacovigilance system is still in its infancy among surgeons and in surgical wards. No major studies have been published addressing this issue, till date. Surgeons are professionals least likely to report adverse drug reactions. Moreover widespread...

  7. Nurses' contradictory hygiene practices in an infection ward

    Sellin, Kira; Rantanen, Sini

    2015-01-01

    Nurses’ contradictory hygiene practices in an infection ward The purpose of this study was to find out why there are contradictory hygiene practices in the field of nursing. The aim of this study was to create discussion and present the findings to the ward. The literature search conducted revealed that the major factors affecting contradictory hygiene practices are incidence of the bacteria, hygiene nurse, education and orientation, students, available equipment, hospital's budget, t...

  8. Design Proposal for Pleasurable Light Atmosphere in Hospital Wards

    Stidsen, Lone; Kirkegaard, Poul Henning; Fisker, Anna Marie;

    2010-01-01

    of staff and guests in the future hospital. This paper introduce the concept of atmosphere based on the theory of Gernot Böhmes and it is dealing with the effect of light in experiencing atmosphere, looking at the importance having a holistic approach to lighting design. The paper displays important design...... parameters for achieving pleasurable light atmosphere in hospital wards and outlines a specific design proposal for an experimental case study in a hospital ward....

  9. Noise Pollution in Intensive Care Units and Emergency Wards

    Gholamreza Khademi

    2011-03-01

    Full Text Available Introduction: The improvement of technology has increased noise levels in hospital Wards to higher than international standard levels (35-45 dB. Higher noise levels than the maximum level result in patient’s instability and dissatisfaction. Moreover, it will have serious negative effects on the staff’s health and the quality of their services. The purpose of this survey is to analyze the level of noise in intensive care units and emergency wards of the Imam Reza Teaching Hospital, Mashhad. Procedure: This research was carried out in November 2009 during morning shifts between 7:30 to 12:00. Noise levels were measured 10 times at 30-minute intervals in the nursing stations of 10 wards of the emergency, the intensive care units, and the Nephrology and Kidney Transplant Departments of Imam Reza University Hospital, Mashhad. The noise level in the nursing stations was tested for both the maximum level (Lmax and the equalizing level (Leq. The research was based on the comparison of equalizing levels (Leq because maximum levels were unstable. Results: In our survey the average level (Leq in all wards was much higher than the standard level. The maximum level (Lmax in most wards was 85-86 dB and just in one measurement in the Internal ICU reached 94 dB. The average level of Leq in all wards was 60.2 dB. In emergency units, it was 62.2 dB, but it was not time related. The highest average level (Leq was measured at 11:30 AM and the peak was measured in the Nephrology nursing station. Conclusion:  The average levels of noise in intensive care units and also emergency wards were  more than the standard levels and as it is known these wards have vital roles in treatment procedures, so more attention is needed in this area.

  10. Malnutrition in Surgical Wards: A Plea for Concern

    Offir Ben-Ishay; Haya Gertsenzon; Tanya Mashiach; Yoram Kluger; Irit Chermesh

    2011-01-01

    Background. Malnutrition in hospitalized patients is underdiagnosed, with 30 to 60% of patients admitted being malnourished. The objective of this study was to investigate the nutritional status of patients in a general surgery ward and to define the correlation between the risk of malnutrition and the hospital course and clinical outcome. Study design. The study group included 100 consecutive patients admitted to a general surgery ward who were ambulant and could undergo the Malnutrition...

  11. Study of the effect of humanistic nursing care model wards in Children Caring Ward School on the nurses' caring ability

    Jiao He; De-Ying Hu; Yi-Lan Liu; Li-Fen Wu; Lian Liu

    2016-01-01

    Objective: To understand the effect of humanistic nursing care model wards in Children Caring Ward School (CCWS) on the nurses' caring ability. Methods: Questionnaire 25 nurses of humanistic nursing care model wards in CCWS using the Nkongho Caring Ability Inventory (CAI) before and after implement the humanistic nursing care model, including reform the systems of nursing care, introduce humanistic care model, implement the humanistic care, to measure the nurses' caring ability. Results: The nurses' caring ability had significantly developed on total, cognition dimension, courage dimension and patience dimension after all measures considered (p Conclusions: The humanistic nursing care model wards in CCWS has a positive effect on the nurses' caring ability, not only to help build great relationships between nurses and patients but also to enhance the patients' satisfaction.

  12. [Psychiatric treatment sentences.

    Stevens, Hanne; Nordentoft, Merete; Agerbo, Esben;

    2010-01-01

    INTRODUCTION: Previous Danish studies of the increasing number of sentences to psychiatric treatment (SPT) have compared prevalent populations of persons undergoing treatment with incident measures of reported crimes. Examining the period 1990-2006, we studied incident sentences, taking the type...... and severity of crime into account. MATERIAL AND METHODS: Using data from Statistics Denmark's national crime statistics, we have compared time-trends of SPT with time-trends of suspended and custodial sentences stratified by type of crime. RESULTS: We found that the rise in SPT is primarily......, leading to more confrontations and changes in practices, e.g., for reporting violence against staff. However, if a civil person is the victim of a violent offence, the probability of the perpetrator being a psychiatric patient is small and has remained virtually unchanged since 1990. Udgivelsesdato: 2010...

  13. Ward pharmacy: a foundation for prescribing audit?

    Batty, R; Barber, N

    1992-01-01

    OBJECTIVES--To determine the extent and nature of prescription monitoring incidents by hospital pharmacists and to derive a performance indicator to allow prescription monitoring to be compared among hospitals in North West Thames region. DESIGN--Survey of all self recorded prescription monitoring incidents for one week in June 1990. SETTING--All (31) acute hospitals in the region with pharmacy departments on site, covering 10,337 beds. SUBJECTS--210 pharmacists. MAIN MEASURES--Number of pres...

  14. HIV prevention among psychiatric inpatients: a pilot risk reduction study.

    Meyer, I; Cournos, F; Empfield, M; Agosin, B; Floyd, P

    1992-01-01

    An HIV prevention program was piloted on an acute inpatient admission ward. Patients who volunteered to participate had significantly higher rates of histories of substance use than non-participants, suggesting that patients participated based on rational concerns about past HIV risk behavior. The program consisted of 75 minute sessions once a week for seven weeks and was co-led by an HIV counselor and the ward's social worker. Each session focused on a specific topic and included a short presentation of informational material, viewing of an educational videotape, a discussion, and role play and other educational games. In spite of a wide range in functioning among the participants, discussion was lively and participation was good. The pilot program demonstrates that chronic mentally ill patients can engage in, and benefit from, risk reduction programs and that frank and explicit discussion of sexual issues is well tolerated. Recommendations for improvement in the program are discussed. PMID:1488461

  15. Epidemiological, clinical anf pathogenetic studies of acute intermittent porphyria

    Bylesjö, Ingemar

    2008-01-01

    Porphyrias are inherited metabolic disorders characterised by an impairment of heme biosynthesis. Acute intermittent porphyria (AIP) is the most common of the acute porphyrias in Sweden. Acute attacks of AIP are characterised by neuro-psychiatric symptoms, including epileptic seizures. Environmental and acquired factors are related to the induction of symptoms. Acute attacks of AIP are treated with high doses of glucose and/or hematin infusions. The pathogenesis of the neuro-psychiatric sympt...

  16. Feigning Acute Intermittent Porphyria

    Rania Elkhatib; Modupe Idowu; Gregory S. Brown; Jaber, Yasmeen M.; Reid, Matthew B.; Cheryl Person

    2014-01-01

    Acute intermittent porphyria (AIP) is an autosomal dominant genetic defect in heme synthesis. Patients with this illness can have episodic life-threatening attacks characterized by abdominal pain, neurological deficits, and psychiatric symptoms. Feigning this illness has not been reported in the English language literature to date. Here, we report on a patient who presented to the hospital with an acute attack of porphyria requesting opiates. Diligent assessment of extensive prior treatment r...

  17. To be strategically struggling against resignation: the lived experience of being cared for in forensic psychiatric care.

    Hörberg, Ulrica; Sjögren, Reet; Dahlberg, Karin

    2012-11-01

    To be referred to care in forensic psychiatric services can be seen as one of the most comprehensive encroachments society can impose upon a person's life, as it entails a limitation of the individual's freedom with no time limit. This study focuses upon patients' experiences of their life situation in forensic psychiatric wards. Using a Reflective Lifeworld Research approach founded in phenomenology, we analysed 11 qualitative interviews with patients cared for on a maximum security unit in a Swedish forensic psychiatric service. Results show how forensic psychiatric care can be non-caring with only moments of good care, from the patient's perspective. By using different strategies, the patients attempt to adapt to the demands of the caregivers in order to gain privileges. At the same time the patients are lacking meaningful and close relationships and long to get away from the system of forensic care. Being cared for entails struggling against an approaching overwhelming sense of resignation. PMID:23146008

  18. Munchausen syndrome mimicking psychiatric disease with concomitant genuine physical illness

    Almeida, Jaime; da Silva, Joaquim Alves; Xavier, Miguel; Gusmão, Ricardo

    2010-01-01

    Munchausen syndrome is a disorder in which patients intentionally produce symptoms mimicking physical or psychiatric illnesses with the aim to assume the sick role and to gain medical attention. Once a patient receives a Munchausen syndrome diagnosis every complaint made thence tends to be regarded with scepticism by clinical staff. However, it is possible that a bona fide illness, which might be disregarded, may coexist in these patients. We report a case of MS mimicking psychiatric disease with concomitant genuine acute physical illness. Despite the initial doubts about the veracity of the latter, due to its prompt recognition, treatment was successful. PMID:22798096

  19. Gene therapy for psychiatric disorders

    Thome, Johannes; HÄSSLER, FRANK; ZACHARIOU, VANNA

    2011-01-01

    There is no indication that gene therapy can be applied in psychiatric patients any time soon. However, there are several promising developments on the level of experimental neuroscience indicating that gene therapy approaches have an effect in animal models of several psychiatric disorders including drug addiction, affective disorders, psychoses and dementia, modifying behavioural parameters via interventions on the molecular and cellular level. However, before gene therapy in psychiatric di...

  20. Broader Indications for Psychiatric Consultation

    Steinberg, Paul

    1987-01-01

    A liaison approach to psychiatric consultation increases the patient population who can benefit from psychiatric assessment during hospitalization for medical or surgical conditions. It also broadens the scope of the psychiatric investigation of the individual patient. The meaning of the illness to the patient, and the patient's present methods of adapting to his or her illness are important considerations. Unconscious concerns, which interfere with the patient's compliance to medical treatme...

  1. Parricide: Psychiatric morbidity

    Dunjić Bojana

    2008-01-01

    Full Text Available INTRODUCTION Parricide is defined as a murder of parents by their children; the patricide is murder of father, while matricide is murder of mother. This entity is classified as homicide, but it differs in the fact that victims are parents and the killers are their children. Mostly, it is associated with psychiatric morbidity. OBJECTIVE To describe sociodemographic and psychopathological characteristics of parricide committers and to analyze circumstances of parricide and psychiatric morbidity in order to achieve better recognition and prevention of risks. METHOD This retrospective study included all homicide autopsy records (1991-2005 performed at the Institute of Forensic Medicine, Medical School, University of Belgrade. For further analyses, all parricide records were selected out. The study analyzed all available parameters, which concerned parricide committers, victims and the act itself. Methods of descriptive statistics were used. RESULTS Between 1991 and 2005, there were 948 cases of homicide; of these, 3.5% were parricides. The committers of parricide were on average 31.2±11.9 years old, 87.8% were males, 60.6% with psychiatric symptoms most commonly with schizophrenia, alcohol dependence, personality disorder etc. Victims were on average 63.7±11.9 years old, 54.5% males, and 21.2% had a diagnosed mental illness. CONCLUSION Parricide is a rare kind of homicide accounting for 3% of all homicides. Committers are mostly unemployed males in early adulthood who have mental disorder. The phenomenon of parricide deserves a detailed analysis of the committer (individual bio-psycho-social profile and the environ- mental factors (family, closely related circumstances to enable a precise prediction of the act and prevention of the fatal outcome, which logically imposes the need of further studies.

  2. Psychiatric Comorbidity and Complications.

    Mason, Michael J; Aplasca, Alexis; Morales-Theodore, Rosa; Zaharakis, Nikola; Linker, Julie

    2016-07-01

    This article highlights the prevalence of co-occurring disorders among adolescents and underscores the complexity and opportunities of treating these patients in a systematic, comprehensive approach. As evidenced by this review, the need exists to develop and test models of care that integrate co-occurring disorders into both psychiatric and substance abuse treatment settings. The challenge for pediatric practitioners is to provide detailed assessments linked to evidence-based treatment plans to account for the variations in adolescent development and the unique risk factor profile of each patient. The issues related to co-morbidity are vast and continue to grow with rapidly increasing research literature. PMID:27338972

  3. Psychiatric assessment in transplantation

    Messias Erick

    2000-01-01

    Full Text Available The implementation of the presumptive donor law in Brazil is expected to increase the availability of organs for transplantation. As medical management of end-stage organ dysfunction continues to improve, increasing numbers of potential transplant recipients will be available to meet this supply. There is mounting evidence that supports the involvement of skilled psychiatric practitioners in the selection of transplant candidates. Data supporting the influence of psychosocial factors on compliance and therefore medical outcomes continues to grow. The literature review allows delineating the components and rationale for comprehensive psychosocial evaluations as a component of preoperative transplantation evaluation.

  4. Generalized ward identities for non-local transformation

    Based on the phase-space generating functional of Green function for a system with a singular higher-order Lagrangian, the generalized canonical Ward identities under the local and non-local transformation in phase space for such a system have been derived. Starting from the configuration-space generating functional for a gauge-invariant system, the generalized Ward identities were deduced under the local, non-local and global transformation, respectively. The applications to the non-Abelian Chern-Simons theories with higher derivatives were given. Some relationships among the proper vertices have been deduced, in which one does not need to carry out the integration over canonical momenta in phase-space generating functional. The Ward-Takahashi identities for BRS transformation are also obtained

  5. Ward Identity Constraints on Ladder Kernels in Transport Coefficient Calculations

    Using diagrammatic methods, we show how the Ward identity can be used to constrain the ladder kernel in transport coefficients calculations. More specifically, we use the Ward identity to determine the necessary diagrams that must be resummed (using the usual integral equation). Our main result is an equation relating the kernel of the integral equation with functional derivatives of the full (imaginary) self-energy; it is similar to what is obtained with 2PI effective action methods. However, since we use the Ward identity as our starting point, gauge invariance is preserved. Using power counting arguments, we also show which self-energies must be included in the resummation at leading order, including 2 to 2 scatterings and 1 to 2 collinear scatterings with the Landau-Pomeranchuk-Migdal (LPM) effect. In this study we restrict our discussion to electrical conductivity and shear viscosity in QED, but our method can in principles be generalized to other transport coefficients and other theories

  6. Optimizing Lighting Design for Hospital Wards by Defining User Zones

    Thuesen, Niels; Stidsen, Lone; Kirkegaard, Poul Henning;

    2011-01-01

    Studying Standard and recommendations for lighting in hospital environment its often suggest a uniform light distribution to facilitate the needs of the staff. At the same time the standards recommend a lighting design supporting the patients feeling a homely and pleasant atmosphere, and point out...... comparison of lighting design in private and public settings are often not similar. The purpose of this article is therefore present a approach dividing the hospital ward in 3 user zones for patients, staff and visitors. The main user of the zone should be in control of the light scenario and thereby a...... refining of lighting design, so it has the ability to support the different users activity and behavior on the ward. By using RFID tracking and manual observations we have analyzed and evaluated the ward functionality as working environment for the staff. The method creates a higher understanding of the...

  7. An evaluation of a formative assessment process used on post take ward rounds.

    Caldwell, G

    2013-01-01

    The purpose of clinical training is to develop doctors capable of delivering professional, personal, effective, high quality, safe clinical care with Intelligent Kindness. The processes supporting training must promote development towards excellence. In 2004 a formative assessment process for use on medical post take ward rounds was introduced based on a model of a Driving Instructor and Learner Driver. This process has been evaluated in comparison with the Case based Discussion (CbD) and mini-Cex by 140 of 369 trainees, using online surveys. Ten trainees were interviewed in depth. The majority of trainees reported that this process had helped them more in their development as doctors than the CbD or mini-CEX. Trainees were able to describe positive effects in areas such as diagnosis, prescribing and confidence in their work. In the NHS the assessments are meant to be "trainee driven", however all but one of the trainees stated that they preferred the routine provision of an assessment to having to ask for an assessment. This evaluation of a truly formative assessment process shows that the trainees benefit in their progression towards clinical excellence. Effective formative feedback can be provided on an Acute Medical Unit even within the constraints of busy post take ward rounds. Within a team of Consultants one should be allowed time to develop an extended Clinical Supervisor role. PMID:24364051

  8. Caring for young adults on a paediatric ward.

    Heaton, Paul A J; Routley, Christine; Paul, Siba Prosad

    The need for adolescents and young adults (AYA) to have suitable age-specific inpatient facilities has been recognised for many years, yet has received relatively little attention. This article reports the successful introduction of an inpatient facility for AYA, aged 17-24 years, on a general paediatric ward in a small district general hospital. From December 2010, a young person's unit (YPU) consisting of an 8-bed area was opened within a 24-bed children's ward. Nursing care was provided by the ward staff, all of whom had been trained in the care of young adults. Policies regarding admission criteria, safeguarding, patient choice, visiting and 'house rules' were drafted, implemented and modified as necessary. Discussions with the adult clinicians (for medical care) and site managers were held to ensure smooth running of the system, and to address any concerns or difficulties. Paediatric patients had priority of admission at times of bed crisis. During 2012, there were a total of 2351 inpatient admissions to the paediatric ward, of whom 379 (16%) were YPU patients aged from 17-24 years. Median length of stay was 2 days for patients aged 17-24 years as compared with 1 day for patients aged less than or equal to 16 years. Patients who chose admission to the paediatric ward tended to be younger, in transition from paediatric to adult services for chronic conditions, or with special needs. Patient surveys showed a high level of satisfaction with the facility. Young adults can be cared for safely and effectively on a paediatric ward with minimal additional costs. The essential ingredients for success include discussion with affected parties to address specific concerns, and the establishment of a clear, simple and unambiguous admission policy. PMID:24165407

  9. Functional outcome of pontine infarction in a convalescent rehabilitation ward

    We studied functional outcome of 12 patients with pontine base infarction in our convalescent ward. The mean onset-admission interval is 33.4±14.8 days, and the mean length of stay in the ward is 90.7±53.5 days. The median Brunnstrome stage and Barthel index at discharge was significantly higher compared with those at admission. Functional outcomes of ventromedial pontine infarcts were less favorable than those of ventrolateral pontine infarcts. Infarctions which was considered to involve branch atheromatous disease as the pathogenetic mechanism, tended to demonstrate a poor functional outcome. The areas of infarcts didn't correlate with functional outcome. (author)

  10. Non-perturbative renormalization constants using Ward identities

    We extend the application of vector and axial Ward identities to calculate bA, bP and bT, coefficients that give the mass dependence of the renormalization constants of the corresponding bilinear operators in the quenched theory. The extension relies on using operators with non-degenerate quark masses. It allows a complete determination of the O(a) improvement coefficients for bilinears in the quenched approximation using Ward Identities alone. Only the scale dependent normalization constants Z0P (or Z0S) and ZT are undetermined. We present results of a pilot numerical study using hadronic correlators

  11. Electronic prescribing - how does it affect the ward pharmacist?

    Franklin, B D; O'Grady, K.; Donyai, P.; Jacklin, A.; Barber, N

    2005-01-01

    It is likely that electronic prescribing will be a common feature in tomorrow’s hospitals. However, we do not yet know how its introduction will affect the practice of hospital pharmacists. We are evaluating a closed-loop electronic prescribing, automated dispensing, bar-coded administration system (ServeRx) on one surgical ward. As part of this evaluation, we wanted to explore its impact on the ward pharmacist. Our objectives were to assess the impact of ServeRx on the time spent providing a...

  12. Psychiatric Comorbidities in Restless Legs Syndrome.

    Kallweit, Ulf; Werth, Esther; Seiz, Angela; Sefidan, Sandra; Dahmen, Norbert; Manconi, Mauro; Ehlert, Ulrike; Bassetti, Claudio L A

    2016-01-01

    Restless legs syndrome (RLS) is a neurological sleep disorder with frequent (39%) coexisting psychiatric comorbidities. Patients with any psychiatric comorbidity had fewer periodic leg movements in sleep. Psychiatric disorders should be taken into account in patients with RLS. PMID:27019065

  13. College Students with Psychiatric Disabilities

    Singh, Delar K.

    2011-01-01

    This paper focuses on college students with psychiatric disabilities. It defines and discusses various psychiatric conditions such as mood disorders, anxiety disorders, eating disorders, and personality disorders. It concludes with accommodations that a college professor can make to help these students succeed in higher education. (Contains 1…

  14. Psychiatric diagnosis in attempted suicide

    Baby, Sanjush; P, Manju; KF, Yesudas

    2006-01-01

    This is a retrospective study which assesses the various socio-demographic correlates, the methods adopted to commit suicide and the psychiatric disorders in patients attempting suicide. The most common psychiatric diagnosis was found to be Adjustment disorder followed by Depressive disorder. Organo-phosphorous compounds were the most frequent agent used among suicide attempt patients.

  15. Admission to a psychiatric unit and changes in tobacco smoking

    Owens David

    2008-05-01

    Full Text Available Abstract Smoking and withdrawal from smoking complicates the assessment and treatment of mental illness. We aimed to establish whether psychiatric inpatients smoke different amounts after admission than beforehand and, if so, to find out why. Forty-three inpatients on a working age adult psychiatry ward completed self-report questionnaires about smoking habits. Those who smoked a different amount after admission had a follow-up interview to find out why they thought this had occurred. The interview incorporated qualitative and quantitative aspects which were analysed accordingly. Fifty-six percent of participants were smokers before admission, rising to 70% afterwards. Of the smokers, 17% smoked less after admission, and 63% smoked more. The average number of cigarettes smoked per person per day increased from five to thirteen. The main reasons for smoking more were boredom, stress and the wish to socialise.

  16. Psychiatric aspects of burn

    Dalal P

    2010-10-01

    Full Text Available Burn injuries and their subsequent treatment cause one of the most excruciating forms of pain imaginable. The psychological aspects of burn injury have been researched in different parts of the world, producing different outcomes. Studies have shown that greater levels of acute pain are associated with negative long-term psychological effects such as acute stress disorder, depression, suicidal ideation, and post-traumatic stress disorder for as long as 2 years after the initial burn injury. The concept of allostatic load is presented as a potential explanation for the relationship between acute pain and subsequent psychological outcomes. A biopsychosocial model is also presented as a means of obtaining better inpatient pain management and helping to mediate this relationship.

  17. Psychiatric morbidities in postpartum females: a prospective follow-up during puerperium

    Adya Shanker Srivastava

    2015-07-01

    Full Text Available Aims and objectives: Postpartum psychiatric disturbances pose a significant mental health problem in community because of their impact on parent-infant and couple relationship. This study was carried out with the aim to find out psychiatric morbidities in postpartum females during puerperium so that a proper assessment of mental health and comprehensive management can be planned. Methodology: Hundred females who had delivered in maternity ward of obstetrics and gynaecology department of Sir Sunderlal Hospital, Institute of Medical Sciences, Banaras Hindu University, Varanasi were evaluated for mental status on day one (i.e. day of delivery, and followed-up till four weeks postpartum period. Psychiatric evaluation was done on the basis of structured proforma containing socio-demographic details and the text revision of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR diagnostic criteria for diagnosis. Brief Psychiatric Rating Scale (BPRS, Hamilton Anxiety Rating Scale (HARS, and Hamilton Rating Scale for Depression (HDRS were used to assess the severity of the respective conditions. Result: Psychiatric evaluation during postpartum puerperal stage revealed that 16 (16% females had developed psychiatric morbidity. Twelve (12% cases fulfilled the criteria for major depressive disorder and four (four per cent patients had features of anxiety disorder. In 84 (84% cases, postpartum period was uneventful and no psychiatric disturbance was found.Seventy five per cent females had joint family and good family support. Conclusion: Major depressive disorder is the most common psychiatric morbidity observed in postpartum females during puerperium. The careful observation of females during postpartum puerperal stage may help in identification and proper management of mental state of such females, and also proper care of newborn.perspective.

  18. Demographic and clinical characteristics of patients referred to psychiatric unit in a tertiary care hospital

    Very few studies from Pakistan have examined the profile of patients seen by psychiatrists in general hospital. The aim of this research is to describe the clinical and demographic characteristics of patients referred to the psychiatric unit of a general hospital over a one year period. Methods: This cross-sectional study was conducted at the Ayub Teaching Hospital, Abbottabad, from January 1st to December 31st 2012. All patients being referred to psychiatry were included in the study over one year period. The information was recorded on a structured questionnaire and analysed the data using SPSS-19.0. Results: Out of the 105 patients referred to the psychiatric unit, 74 (72.3%) were females. A total of 69 (68.5%) patients were married. More than half were uneducated and only number 4 (3%) patients had university qualification. Housewives made up 64.4% of the patient population followed by students (11%). Majority 55 (53%) had less than Rs. 5000/ monthly income. About 30% patients were shifted to psychiatry ward while, nearly one tenth were discharged. In 35% cases the psychiatrist was asked to help in the management, while in 50% cases only opinion was sought. Aggressive and threatening behaviour was source of concern in majority of patients for the primary team while 34% exhibited suicidal behaviour. Depression was most frequent diagnosis in 45 43% patients, followed by conversion disorder 19 (17%) and delirium 16 (14%). Conclusion: The rate of psychiatric referrals is dismal with only one third of the patients being transferred to the psychiatric ward. The major psychiatric diagnosis was depression. Patients with aggressive and threatening behaviour were more frequently referred. (author)

  19. Structure of Fluctuation Terms in the Trace Dynamics Ward Identity

    Adler, Stephen L.

    2005-01-01

    We give a detailed analysis of the anti-self-adjoint operator contribution to the fluctuation terms in the trace dynamics Ward identity. This clarifies the origin of the apparent inconsistency between two forms of this identity discussed in Chapter 6 of our recent book on emergent quantum theory.

  20. Ward identities and anomalies in pure W4 gravity

    W4 gravity is treated algebraically, represented by a set of transformations on classical fields. The Ward identities of the theory are determined by requiring the algebra to close. The general forms for the anomalies are found by looking for solutions to the Wess-Zumino consistency conditions, and some specific cases are considered

  1. Transverse Ward-Takahashi Relation to One Loop

    HEHan-Xin

    2005-01-01

    We calculate the transverse Ward-Takahashi relation for the vector vertex in momentum space at one-loop order in four-dimensional Abelian gauge theory. We demonstrate explicitly that the result is exactly the same as that derived by using one-loop vector vertex calculations.

  2. Psychiatric morbidity and pattern of dysfunctions in patients with leprosy

    Bhatia M

    2006-01-01

    Full Text Available BACKGROUND: Leprosy, being a chronic infectious disease with profound social stigma, remains associated with high psychological mortidity. PURPOSES: To find out the pattern of psychiatric morbidity in leprosy patients and the relationship of various factors with the morbidity. METHODS: Ninty patients attending leprosy clinic were randomly chosen for the study group alongwith 40 patients suffering from acute skin problem other than leprosy as control group. The socio-demographic data were recorded in semi-structural proforma; all patients were given Goldbery Health Questioneaire (GHQ. Patients having GHQ score> 2 was assessed by Disability Assessent Questionaire (DAQ. The psychiatric diagnoses was made according to ICD-10 by W ho0 and physical deformity by W ho 0 Disability Scale. FINDINGS: The mean GHQ score of the study grant was 3.44 and that of control group was 1.62. The mean DAQ score was 45.13. Psychiatric disorder was seen in 44.4% and 7.5% of study group and control group respectively. The psychiatric illness was generalised anoxidy disorder (GAD (27.8%. CONCLUSIONS: Leprosis highly associated with psychiatric mobidity. LIMITATIONS: The findings can not be generalised due to small sample size and clinic-based data.

  3. Prevalence of delirium among patients at a cancer ward: Clinical risk factors and prediction by bedside cognitive tests.

    Grandahl, Mia Gall; Nielsen, Svend Erik; Koerner, Ejnar Alex; Schultz, Helga Holm; Arnfred, Sidse Marie

    2016-08-01

    Background Delirium is a frequent psychiatric complication to cancer, but rarely recognized by oncologists. Aims 1. To estimate the prevalence of delirium among inpatients admitted at an oncological cancer ward 2. To investigate whether simple clinical factors predict delirium 3. To examine the value of cognitive testing in the assessment of delirium. Methods On five different days, we interviewed and assessed patients admitted to a Danish cancer ward. The World Health Organization International Classification of Diseases Version 10, WHO ICD-10 Diagnostic System and the Confusion Assessment Method (CAM) were used for diagnostic categorization. Clinical information was gathered from medical records and all patients were tested with Mini Cognitive Test, The Clock Drawing Test, and the Digit Span Test. Results 81 cancer patients were assessed and 33% were diagnosed with delirium. All delirious participants were CAM positive. Poor performance on the cognitive tests was associated with delirium. Medical records describing CNS metastases, benzodiazepine or morphine treatment were associated with delirium. Conclusions Delirium is prevalent among cancer inpatients. The Mini Cognitive Test, The Clock Drawing Test, and the Digit Span Test can be used as screening tools for delirium among inpatients with cancer, but even in synergy, they lack specificity. Combining cognitive testing and attention to nurses' records might improve detection, yet further studies are needed to create a more detailed patient profile for the detection of delirium. PMID:26882016

  4. Quality of interactions influences everyday life in psychiatric inpatient care—patients’ perspectives

    Molin, Jenny; Graneheim, Ulla H.; Lindgren, Britt-Marie

    2016-01-01

    Everyday life consists of daily activities that are taken for granted. It forms the foundation for human efforts and contains elements of both comfort and boredom. Because everyday life escapes no one, life in a psychiatric ward will become ordinary while staying there. This study aims to explore everyday life in psychiatric inpatient care based on patients’ experiences. We individually interviewed 16 participants with experiences of psychiatric inpatient care and analysed the data in accordance with the methods of grounded theory. Data collection and analysis continued in parallel in accordance with the method. Our results showed that everyday life is linked to the core category quality of interactions influences everyday life, and three constructed categories—staff makes the difference, looking for shelter in a stigmatizing environment, and facing a confusing care content—were related to the core category. Our results highlight the importance of ordinary relationships between staff and patients in psychiatric inpatient care. These results can be used to develop nursing interventions to improve psychiatric inpatient care and might also be used as a basis for reflective dialogues among staff. PMID:26806313

  5. Registration of aggressive incidents in an adolescent forensic psychiatric unit and implications for further practice.

    Tremmery, S; Danckaerts, M; Bruckers, L; Molenberghs, G; De Hert, M; Wampers, M; De Varé, J; de Decker, A

    2014-09-01

    Although aggression is part of daily life in psychiatric units for adolescents, empirical data on its prevalence are sparse. Only few studies have described prevalence of aggressive incidents in adolescent psychiatric wards, and data in forensic psychiatric care are even more limited. Available studies reported high prevalence rates of aggression, ranging from 0.4 to 2.4 incidents of aggression per day across (forensic) child and adolescent psychiatric units. Between 27 and 78 % of all admitted youth committed an aggressive act. In this study, we collected systematically registered data of all aggressive incidents from the first 2 years (2010-2012) on a newly established forensic adolescent psychiatric unit, which used a formal aggression management program embedded in the social competence model, which is based on early intervention in the 'chain of behavior' to prevent any further escalation. The inclusion of also minor aggressive incidents is unique in the literature and the clinical relevance is highlighted. A mean of one incident a day took place, with each adolescent involved in at least one incident. Notably, 1.7 aggressive incidents per month made seclusion of restraint use necessary. Based on the social competence theory, the aggression management model suggests intervening early in the cascade of aggression, in order to prevent further escalation and reduce the need for intrusive interventions. Evidence supported that aggression is a contextual event, as external factors clearly influence the incidence of aggression. Aggression management should be built on both relational and structural security. PMID:24682593

  6. Quality of interactions influences everyday life in psychiatric inpatient care--patients' perspectives.

    Molin, Jenny; Graneheim, Ulla H; Lindgren, Britt-Marie

    2016-01-01

    Everyday life consists of daily activities that are taken for granted. It forms the foundation for human efforts and contains elements of both comfort and boredom. Because everyday life escapes no one, life in a psychiatric ward will become ordinary while staying there. This study aims to explore everyday life in psychiatric inpatient care based on patients' experiences. We individually interviewed 16 participants with experiences of psychiatric inpatient care and analysed the data in accordance with the methods of grounded theory. Data collection and analysis continued in parallel in accordance with the method. Our results showed that everyday life is linked to the core category quality of interactions influences everyday life, and three constructed categories-staff makes the difference, looking for shelter in a stigmatizing environment, and facing a confusing care content-were related to the core category. Our results highlight the importance of ordinary relationships between staff and patients in psychiatric inpatient care. These results can be used to develop nursing interventions to improve psychiatric inpatient care and might also be used as a basis for reflective dialogues among staff. PMID:26806313

  7. Quality of interactions influences everyday life in psychiatric inpatient care—patients’ perspectives

    Jenny Molin

    2016-01-01

    Full Text Available Everyday life consists of daily activities that are taken for granted. It forms the foundation for human efforts and contains elements of both comfort and boredom. Because everyday life escapes no one, life in a psychiatric ward will become ordinary while staying there. This study aims to explore everyday life in psychiatric inpatient care based on patients’ experiences. We individually interviewed 16 participants with experiences of psychiatric inpatient care and analysed the data in accordance with the methods of grounded theory. Data collection and analysis continued in parallel in accordance with the method. Our results showed that everyday life is linked to the core category quality of interactions influences everyday life, and three constructed categories—staff makes the difference, looking for shelter in a stigmatizing environment, and facing a confusing care content—were related to the core category. Our results highlight the importance of ordinary relationships between staff and patients in psychiatric inpatient care. These results can be used to develop nursing interventions to improve psychiatric inpatient care and might also be used as a basis for reflective dialogues among staff.

  8. [Psychiatric complications of cannabis use].

    Coscas, Sarah; Benyamina, Amine; Reynaud, Michel; Karila, Laurent

    2013-12-01

    Cannabis is the most widely used illicit substance, especially among young people. Cannabis use is extremely commonplace and frequently comorbid with psychiatric disorders that raise questions about the etiology. The use of cannabis is an aggravating factor of all psychiatric disorders. Psychiatric complications are related to the age of onset, duration of exposure and individual risk factors of the individual (mental and social health). The panic attack is the most common complication. The link with psychosis is narrow that leads to increased prevention for vulnerable populations. Cannabis is also an indicator of increased depressive vulnerability and an aggravating factor for bipolar disorder. PMID:24579344

  9. The cerebellum and psychiatric disorders

    Joseph ePhillips

    2015-05-01

    Full Text Available The cerebellum has been considered for a long time to play a role solely in motor coordination. However, studies over the past two decades have shown that the cerebellum also plays a key role in many motor, cognitive, and emotional processes. In addition, studies have also shown that the cerebellum is implicated in many psychiatric disorders including attention deficit hyperactivity disorder, autism spectrum disorders, schizophrenia, bipolar disorder, major depressive disorder and anxiety disorders. In this review, we discuss existing studies reporting cerebellar dysfunction in various psychiatric disorders. We will also discuss future directions for studies linking the cerebellum to psychiatric disorders.

  10. [Ground-based speleo-climatic wards and the experience with their use in bronchial asthma].

    Krasnoshteĭn, A E; Barannikov, V G; Shchekotov, V V; Lebedeva, T M; Bitinskaia, L N; Khasanova, R B; Surovtseva, M V; Mezentseva, E V; Isaevich, A G; Lysenko, D I

    1999-01-01

    Ambient air in ground wards made to contain natural potassium-sodium salt is close in characteristics to the atmosphere of underground wards but has a number of specificities: daily fluctuations of concentrations of light aeroions and aerosol particles, elevated concentration of light aeroions concentration, low radiation background, minimal bacterial contamination. The stay in ground wards brings great benefit for patients with bronchial asthma. Ground speleo-climatic wards are perspective in nonpharmacological treatment of patients with allergic respiratory diseases. PMID:10429568

  11. Neuropsychological and psychiatric functioning in sheep farmers exposed to low levels of organophosphate pesticides

    Mackenzie Ross, Sarah Jane; Brewin, Chris Ray; Curran, Helen Valerie; Furlong, Clement Eugene; Abraham-Smith, Kelly Michelle; Harrison, Virginia

    2010-01-01

    The study aim was to determine whether low level exposure to organophosphate pesticides (OPs) causes neuropsychological or psychiatric impairment. Methodological weaknesses of earlier studies were addressed by: recruiting participants who had retired on ill health grounds; excluding participants with a history of acute poisoning, medical or psychiatric conditions that might account for ill health; and exploring factors which may render some individuals more vulnerable to the effects of OPs th...

  12. 75 FR 81269 - Ward Transformer Superfund Site Raleigh, Wake County, NC; Notice of Settlements

    2010-12-27

    ... AGENCY Ward Transformer Superfund Site Raleigh, Wake County, NC; Notice of Settlements AGENCY... Ward Transformer Superfund Site located in Raleigh, Wake County, North Carolina for publication. DATES... your comments, identified by Docket ID No. EPA-RO4- SFUND-2010-1053 or Site name Ward...

  13. 78 FR 14543 - Ward Transformer Superfund Site; Raleigh, Wake County, NC; Notice of Settlement

    2013-03-06

    ... AGENCY Ward Transformer Superfund Site; Raleigh, Wake County, NC; Notice of Settlement AGENCY... Agency has entered into a settlement at the Ward Transformer Superfund Site located in Raleigh, Wake... EPA Region 4 contact Ms. Paula V. Painter. Submit your comments by Site name Ward...

  14. Leadership by fragmented destruction after a merger: an example from a facility of acute psychiatry.

    Berg, John E; Grimeland, Jorid

    2013-09-01

    Hospitals are labor intensive facilities based on highly skilled employees. A merger of hospitals is an effort to increase and rationalize this production. Decisions behind a merger are made at the top leadership level. How this might be done is demonstrated by examples from a 36 bed acute psychiatric facility. The aim of the study was to calculate the hidden costs of fragmented destruction of parts of a total hospital supply to patients after a merger. Fragmented destruction is the deliberate stopping of activities deemed not part of the core activities of the hospital without due consideration of the impact on core activities. The proposed changes to operational expenses at a single acute psychiatric hospital were materials for the study. The changes included activities as a reduction in local laboratory service, cleaning services, closure of physiotherapy unit, closing of cultural activities and reduced productivity. The selected activities are calculated as giving an imputed gain of € 630,000 as indicated by the leadership. The not calculated costs of reducing or removing the selected activities are estimated at € 1,955,640. The cost of staff disappointment after a merger is difficult to assess, but is probably higher than assumed in the present calculations. Imputed cost containment is not attained. The calculations indicate that implemented changes may increase cost, contrary to the belief of the leadership at both the hospital level and further up in the hospital trust. Arguments in favor of a merger have to be scrutinized thoroughly for optimistic neglect of uncalculated costs of mergers. Future hospital mergers and selected fragmentation of productive tasks at ward or hospital levels should include calculations of unavoidable costs as shown in the present paper. PMID:25478133

  15. Leadership by fragmented destruction after a merger: an example from a facility of acute psychiatry

    Jorid Grimeland

    2013-09-01

    Full Text Available Hospitals are labor intensive facilities based on highly skilled employees. A merger of hospitals is an effort to increase and rationalize this production. Decisions behind a merger are made at the top leadership level. How this might be done is demonstrated by examples from a 36 bed acute psychiatric facility. The aim of the study was to calculate the hidden costs of fragmented destruction of parts of a total hospital supply to patients after a merger. Fragmented destruction is the deliberate stopping of activities deemed not part of the core activities of the hospital without due consideration of the impact on core activities. The proposed changes to operational expenses at a single acute psychiatric hospital were materials for the study. The changes included activities as a reduction in local laboratory service, cleaning services, closure of physiotherapy unit, closing of cultural activities and reduced productivity. The selected activities are calculated as giving an imputed gain of € 630,000 as indicated by the leadership. The not calculated costs of reducing or removing the selected activities are estimated at € 1,955,640. The cost of staff disappointment after a merger is difficult to assess, but is probably higher than assumed in the present calculations. Imputed cost containment is not attained. The calculations indicate that implemented changes may increase cost, contrary to the belief of the leadership at both the hospital level and further up in the hospital trust. Arguments in favor of a merger have to be scrutinized thoroughly for optimistic neglect of uncalculated costs of mergers. Future hospital mergers and selected fragmentation of productive tasks at ward or hospital levels should include calculations of unavoidable costs as shown in the present paper.

  16. Obstructive lung disease in acute medical patients.

    Seemungal, T.; Harrinarine, R.; Rios, M.; Abiraj, V.; Ali, A.; Lacki, N.; Mahabir, N.; Ramoutar, V.; King, C. P.; Bhowmik, A.; Wedzicha, J A

    2008-01-01

    OBJECTIVES: To determine the proportion of adult medical patients who have chronic obstructive pulmonary disease (COPD), using the Global initiative for Chronic Obstructive Lung Disease guidelines (GOLD), and its relation to vascular disease. METHODS: This is a prospective cross-sectional study of adult patients admitted to acute medical wards. Interviewer administered questionnaire, anthropometric and spirometric measurements were done. RESULTS: Spirometry was performed in 720 acute admissio...

  17. Suicide among older psychiatric inpatients

    Erlangsen, Annette; Zarit, Steven H; Tu, Xin;

    2006-01-01

    OBJECTIVE: Older adults have elevated suicide rates, especially in the presence of a psychiatric disorder, yet not much is known about predictors for suicide within this high-risk group. The current study examines the characteristics associated with suicide among older adults who are admitted to a...... psychiatric hospital. METHOD: All persons aged 60 and older living in Denmark who were hospitalized with psychiatric disorders during 1990-2000 were included in the study. Using a case-control design and logistic regression analysis, the authors calculated the suicide risk associated with specific patient...... characteristics. RESULTS: Affective disorders were found to be associated with an almost twofold higher risk of suicide among psychiatric inpatients than other types of disorders (95% confidence interval [CI]: 1.5-2.6). Patients with dementia had a significantly lower risk ratio of 0.2 (95% CI: 0.1-0.3). In...

  18. A STUDY OF CUTANEOUS MANIFESTATIONS OF PATIENTS WITH PSYCHIATRIC DISORDER

    Shanmugasundaram

    2016-02-01

    Full Text Available Skin is an organ that has a primary function of tactile receptivity and reacts to both external and internal emotional stimuli. Dermatological practice certainly embeds a psychosomatic dimension. A relationship between psychological factors and skin diseases has long been hypothesized. AIMS AND OBJECTIVES The aim of present study is to evaluate the prevalence of cutaneous manifestations in patients with psychiatric disorder. MATERIALS AND METHODS Twenty five psychiatric in-patients admitted in the psychiatry ward of a Tertiary Care Hospital were examined for the presence of cutaneous manifestation over a period of 6 months. Appropriate laboratory investigations such as scraping for Acarus, skin biopsy etc. were performed wherever required. The observations were noted. RESULTS The commonest cutaneous manifestations seen in this study were (i Parasitic infestations like scabies (20%, pediculosis capitis (16%, (ii Xerosis (28 %, (iii Prurigo nodularis (4%, (iv Lichen simplex chronicus (4%, (v Venereophobia (4% and (vi Delusion of parasitosis (4%. CONCLUSION A high incidence of parasitic infestations was noted in our study. The healthcare personnel should be sensitized on the significance of such parasitic infestations in institutionalized patients and the importance of early detection and treatment.

  19. Sleep disorders in psychiatric practice

    Szelenberger, Waldemar; SOLDATOS, CONSTANTIN

    2005-01-01

    Over the last years, a large body of evidence has accumulated showing that complaints of disordered sleep are quite prevalent in the community. Insomnia is by far the most common disturbance and is often associated with concurrent psychiatric illness, in particular anxiety and mood disorders. On the other hand, sleep complaints are frequently present among psychiatric patients and have been incorporated in the official diagnostic criteria for many mental disorders, such as m...

  20. Superconformal Ward Identities for Green Functions with Multiple Supercurrent Insertions

    Erdmenger, J; Erdmenger, Johanna; Rupp, Christian

    1999-01-01

    Superconformal Ward identities for N=1 supersymmetric quantum field theories in four dimensions are convenienty obtained in the superfield formalism by combining diffeomorphisms and Weyl transformations on curved superspace. Using this approach we study the superconformal transformation properties of Green functions with one or more insertions of the supercurrent to all orders in perturbation theory. For the case of two insertions we pay particular attention to fixing the additional counterterms present, as well as to the purely geometrical anomalies which contribute to the transformation behaviour. Moreover we show in a scheme-independent way how the quasi-local terms in the Ward identities are related to similar terms which contribute to the supercurrent two and three point functions. Furthermore we relate our superfield approach to similar studies which use the component formalism by discussing the implications of our approach for the components of the supercurrent and of the supergravity prepotentials.

  1. Modelling of coughed droplets in a hospital ward

    Sadrizadeh, Sasan; Nielsen, Peter Vilhelm

    2016-01-01

    Coughing and its importance for spreading respiratory infectious diseases has been confirmed in many previous studies. The dispersion process of respiratory droplets released by the coughing of a patient in a hospital ward was studied using computational fluid dynamics simulation. Two relatively...... realistic three-dimensional thermal mannequins with a parallel bed arrangement simulated the patients. The maximum dispersion distances in time under ward ventilation conditions were studied. A velocity profile simulated a time-dependent cough with total duration of 0.4 s. The results indicated that the...... transport characteristic of droplets due to coughing is highly influenced by their size. Although the effects of gravity or inertia on small droplets (< 40 μm) are negligible and the indoor airflow mostly influences their transport, droplets of > 40 μm are significantly affected by gravity and soon fall as...

  2. Noether's second theorem and Ward identities for gauge symmetries

    Avery, Steven G.; Schwab, Burkhard U. W.

    2016-02-01

    Recently, a number of new Ward identities for large gauge transformations and large diffeomorphisms have been discovered. Some of the identities are reinterpretations of previously known statements, while some appear to be genuinely new. We use Noether's second theorem with the path integral as a powerful way of generating these kinds of Ward identities. We reintroduce Noether's second theorem and discuss how to work with the physical remnant of gauge symmetry in gauge fixed systems. We illustrate our mechanism in Maxwell theory, Yang-Mills theory, p-form field theory, and Einstein-Hilbert gravity. We comment on multiple connections between Noether's second theorem and known results in the recent literature. Our approach suggests a novel point of view with important physical consequences.

  3. Lighting quality in hospital wards - State of the art

    Stidsen, Lone; Kirkegaard, Poul Henning; Fisker, Anna Marie

    When constructing and designing hospitals for the future, patients, staff and guests are in focus. Designing a healing hospital environment is a very important factor when planning new hospitals. How can aspects such as design, architecture, arts, lights, sounds and materials support and improve......, the furnishing, the acoustics and light are essential in evaluating of the experience of an environment. The light is crucial for the physical and psychological experience of wellbeing and the feeling of safety. The ward is a complex and interesting architectural space to design. It has a wide range...... of functions and a multitude of users with many different needs and requirements. It is a public domain with many references to the design of homes in the private sphere. The aim of the report is to display the existing research in the area of lighting design in hospital wards, and to present new...

  4. Psychotherapy in older adults with major depression in psychogeriatric ward

    Wojciech Mateusz Rachel; Agnieszka Turkot

    2015-01-01

    Summary: Psychotherapy of the elderly appears to be a very important part of comprehensive treatment, and its character should be based on a holistic vision of the patient. The effectiveness of the individual Cognitive-Behavioral Psychotherapy (CBT) and Problem Solving Therapy (PST) is well establish in clinical trial. In treating patients at the psycho geriatric ward, on account of the described clinical state placed in the article, we apply Supportive Therapy (ST) and existential approa...

  5. Ward Identities for Transport in 2+1 Dimensions

    Hoyos, Carlos; Oz, Yaron

    2015-01-01

    We use the Ward identities corresponding to general linear transformations, and derive relations between transport coefficients of $(2+1)$-dimensional systems. Our analysis includes relativistic and Galilean invariant systems, as well as systems without boost invariance such as Lifshitz theories. We consider translation invariant, as well as broken translation invariant cases, and include an external magnetic field. Our results agree with effective theory relations of incompressible Hall fluid, and with holographic calculations in a magnetically charged black hole background.

  6. Ward identities and relations between conductivities and viscosities in holography

    Hoyos, Carlos; Fernández, David Rodríguez

    2016-01-01

    We derive relations between viscosities and momentum conductivity in 2 + 1 dimensions by finding a generalization of holographic Ward identities for the energy-momentum tensor. The generalization is novel in the sense that it goes beyond the usual identities obtained from holographic renormalization. Our results are consistent with previous field theory analysis. The main tools we use are a constant `probability current' in the gravity dual, that we are able to define for any system of linear ODEs, and parity symmetry.

  7. Isolation of Klebsiella planticola from Newborns in a Neonatal Ward

    Podschun, R.; Acktun, H.; Okpara, J.; Linderkamp, O; Ullmann, U.; Borneff-Lipp, M

    1998-01-01

    This is the first report on the isolation of Klebsiella planticola from neonates. Over a period of 1 year, oropharyngeal and rectal swab specimens from 131 newborns on a neonatal ward were monitored for Klebsiella spp. Thirteen strains of K. planticola could be isolated, and these represented 9% of all Klebsiella spp. found. Capsule type K27 predominated, followed by capsule type K68. Our findings suggest a significant rate of colonization by K. planticola among neonates.

  8. Words in Maternity Wards: An Aproximation to Perinatal Psychology

    Alicia Oiberman

    2016-01-01

    The acknowledgment that just born babies interact with human and physical contexts originated changes in behaviors of health teems working in maternity wards settings. Concepts such as initial interactions, attachment, dyads, maternal vulnerability, behavioral competences of the just born babies and their applications to perinatal psychology, marked a transformation in different professionals involved in birth’s approaches. From one side, it can be said that medicalization of the birth act in...

  9. Shielding estimation for nuclear medicine therapy ward: our experience

    Full text: The aim of this study was to calculate and estimate the shielding thickness for a new Nuclear Medicine Therapy Ward. Parameters available for shielding calculation were: ground plan of the ward, radionuclides planned for use, maximum administered activity of I-131, maximum delivered activity of I-131 to the ward per week, average time spent in the hospital after the treatment. The most hazardous and most commonly used radioisotope is I-131. The target dose that needs to be met for occupationally exposed workers is 0.3 mSv per year. There are several factors that could be changed in order to achieve this value: distance from the source, shielding thickness, angle of incidence, occupational and usage factors. The maximum dose rate at 1 meter from the thyroid gland of the patient was considered to be 100 mSv/h. The distances and incidence angles could not be changed since these vales were predetermined in the ground plan. Different usage and occupational factors were used for different rooms in the ward. We used occupational factor 1 for the bed and 1/6 for the bathroom, and usage factor 1 for nurses' room and patient room and 1/6 for the corridors, etc. The easiest way of calculating dose attenuation in material was by introducing the HVL and TVL for broad beams. TVL and HVL were taken from the graph.The results show that shielding thickness should be in the range of 3 mmPb for room doors to 30 mmPb for the wall adjacent to the nurse's office. Most of the walls are 20 mmPb thick. These values were calculated using conservative assumptions and are more then enough to protect staff, patients and public from external radiation. If the construction cannot support the weight of lead some rearrangements regarding patient positions could be made. (author)

  10. Ward identities and relations between conductivities and viscosities in holography

    Hoyos, Carlos

    2015-01-01

    We derive relations between viscosities and momentum conductivity in $2+1$ dimensions by finding a generalization of holographic Ward identities for the energy-momentum tensor. The generalization is novel in the sense that it goes beyond the usual identities obtained from holographic renormalization. Our results are consistent with previous field theory analysis. The main tools we use are a constant `probability current' in the gravity dual, that we are able to define for any system of linear ODEs, and parity symmetry.

  11. Effect of nurse-led medication reviews in psychiatric patients - an interventional study

    Sørensen, Ann Lykkegaard; Nielsen, Lars Peter; Poulsen, Birgitte Klindt;

    2013-01-01

    nurses are the health professionals spending most time directly with the patient and very few studies investigate nurses’ role and potential in improving the appropriateness of medication. Therefore, the main objective of this study is to investigate the effect of educating nurses in general pharmacology...... wards. The study will contribute with information regarding the effect of pharmacological training of nurses and possibly improve medication safety for psychiatric patients. Results from this study could serve as evidence, when hospital management makes decisions on how to accede the need for medication......OBJECTIVES: There is an increasing demand for medication reviews to improve the quality of prescribing for patients with chronic illness such as psychiatric patients. Traditionally, this has been undertaken by physicians. Pharmacists have also proven to be a resource in this field but registered...

  12. Effect of nurse-led medication reviews in psychiatric patients - an interventional study

    Sørensen, Ann Lykkegaard; Mainz, Jan; Poulsen, Birgitte Klindt;

    nurses are the health professionals spending most time directly with the patient and very few studies investigate nurses’ role and potential in improving the appropriateness of medication. Therefore, the main objective of this study is to investigate the effect of educating nurses in general pharmacology...... wards. The study will contribute with information regarding the effect of pharmacological training of nurses and possibly improve medication safety for psychiatric patients. Results from this study could serve as evidence, when hospital management makes decisions on how to accede the need for medication......OBJECTIVES: There is an increasing demand for medication reviews to improve the quality of prescribing for patients with chronic illness such as psychiatric patients. Traditionally, this has been undertaken by physicians. Pharmacists have also proven to be a resource in this field but registered...

  13. Ward identities and high energy scattering amplitudes in string theory

    High-energy limit α'->∼ of stringy Ward identities derived from the decoupling of two types of zero-norm states in the old covariant first quantized (OCFQ) spectrum of open bosonic string are used to check the consistency of saddle point calculations of high energy scattering amplitudes of Gross and Mende and Gross and Manes. Some inconsistencies of their saddle point calculations are found even for the string-tree scattering amplitudes of the excited string states. We discuss and calculate the missing terms of the calculation by those authors to recover the stringy Ward identities. In addition, based on the tree-level stringy Ward identities, we give the proof of a general formula, which was proposed previously, of all high energy four-point string-tree amplitudes of arbitrary particles in the string spectrum. In this formula all such scattering amplitudes are expressed in terms of those of tachyons as conjectured by Gross. The formula is extremely simple which manifestly demonstrates the universal high energy behavior of the interactions among all string states

  14. Medical academia clinical experiences of Ward Round Teaching curriculum

    Fariba Haghani

    2014-01-01

    Full Text Available Background: Medical students spend most of their time in hospital wards and it is necessary to study clinical educational opportunities. This study was aimed to explore faculty members′ experience on Ward Round Teaching content. Methods and Materials: This qualitative study was conducted by purposive sampling with the maximum variation of major clinical departments faculty members in Isfahan University of Medical Sciences (n = 9. Data gathering was based on deep and semi-structured interviews. Data gathering continued till data saturation.Data was analyzed through the Collaizzi method and validated. Strategies to ensure trustworthiness of data (credibility, dependability, conformability, transferability were employed (Guba and Lincoln. Results: Basic codes extracted from the analyzed data were categorized into two main themes and related subthemes, including (1 tangible teachings (analytic intelligence, technical intelligence, legal duties and (2 implied teachings (professionalism, professional discipline, professional difficulties. Conclusion: Ward round teaching is a valuable opportunity for learners to learn not only patient care aspects but also ethical values. By appropriate planning, opportunities can be used to teach capabilities that are expected of general practitioners.

  15. The medication process in a psychiatric hospital: are errors a potential threat to patient safety?

    Soerensen AL

    2013-09-01

    Full Text Available Ann Lykkegaard Soerensen,1,2 Marianne Lisby,3 Lars Peter Nielsen,4 Birgitte Klindt Poulsen,4 Jan Mainz5,6 1Faculty of Social Sciences and of Health Sciences, Aalborg University, Aalborg, Denmark; 2Department of Nursing, University College of Northern Denmark, Aalborg, Denmark; 3Research Centre of Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark; 4Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark; 5Aalborg Psychiatric University hospital, Aalborg, Denmark; 6Department for Health Services Research, University of Southern Denmark, Denmark Purpose: To investigate the frequency, type, and potential severity of errors in several stages of the medication process in an inpatient psychiatric setting. Methods: A cross-sectional study using three methods for detecting errors: (1 direct observation; (2 unannounced control visits in the wards collecting dispensed drugs; and (3 chart reviews. All errors, except errors in discharge summaries, were assessed for potential consequences by two clinical pharmacologists. Setting: Three psychiatric wards with adult patients at Aalborg University Hospital, Denmark, from January 2010–April 2010. The observational unit: The individual handling of medication (prescribing, dispensing, and administering. Results: In total, 189 errors were detected in 1,082 opportunities for error (17% of which 84/998 (8% were assessed as potentially harmful. The frequency of errors was: prescribing, 10/189 (5%; dispensing, 18/189 (10%; administration, 142/189 (75%; and discharge summaries, 19/189 (10%. The most common errors were omission of pro re nata dosing regime in computerized physician order entry, omission of dose, lack of identity control, and omission of drug. Conclusion: Errors throughout the medication process are common in psychiatric wards to an extent which resembles error rates in somatic care. Despite a substantial proportion of errors with potential to harm patients, very

  16. Psychiatric Comorbidity in Alcohol Dependence.

    Fein, George

    2015-12-01

    We review our clinical studies of psychiatric comorbidity in short-term and long-term abstinent and in treatment naïve alcoholics (STAA, LTAA and TNA). TNA ypically have less severe alcoholism than treated abstinent samples and evidence less severe psychiatric disturbance. Lifetime psychiatric diagnoses are the norm for STAA and LTAA but not for TNA. Individuals with alcohol and drug use disorders show greater antisocial personality disturbance, but do not show differences in the mood or anxiety domains or in borderline personality disorder (BPD) symptoms. The studies show that alcoholics can achieve and maintain abstinence in the face of ongoing mood, anxiety, or BPD problems. By contrast, for ASPD, LTAA essentially stop current antisocial behaviors in all seven domains of antisocial behaviors. We believe that ongoing antisocial behavior is not consistent with maintaining abstinence, and that LTAA modify their antisocial behavior despite continued elevated social deviance proneness and antisocial dispositionality. Abstinent individuals without lifetime psychiatric disorders and TNA show more (subdiagnostic threshold) psychiatric symptoms and abnormal psychological measures than non-alcoholic controls in the mood, anxiety, BPD, and antisocial domains. In summary, our studies show that although LTAA have achieved multi-year abstinence, they still report significant psychological distress compared to NAC. We believe this distress may negatively affect their quality of life. This suggests the importance of developing effective care models to address comorbid mental health problems in LTAA. We also show that antisocial personality disorder symptoms decline to the levels seen in normal controls, and that excluding individuals from research with a psychiatric diagnosis does not control for subdiagnostic psychiatric differences between alcoholics and controls. PMID:26590836

  17. Satisfaction of patients hospitalised in psychiatric hospitals: a randomised comparison of two psychiatric-specific and one generic satisfaction questionnaires

    Cléopas Agatta

    2006-08-01

    Full Text Available Abstract Background While there is interest in measuring the satisfaction of patients discharged from psychiatric hospitals, it might be important to determine whether surveys of psychiatric patients should employ generic or psychiatry-specific instruments. The aim of this study was to compare two psychiatric-specific and one generic questionnaires assessing patients' satisfaction after a hospitalisation in a psychiatric hospital. Methods We randomised adult patients discharged from two Swiss psychiatric university hospitals between April and September 2004, to receive one of three instruments: the Saphora-Psy questionnaire, the Perceptions of Care survey questionnaire or the Picker Institute questionnaire for acute care hospitals. In addition to the comparison of response rates, completion time, mean number of missing items and mean ceiling effect, we targeted our comparison on patients and asked them to answer ten evaluation questions about the questionnaire they had just completed. Results 728 out of 1550 eligible patients (47% participated in the study. Across questionnaires, response rates were similar (Saphora-Psy: 48.5%, Perceptions of Care: 49.9%, Picker: 43.4%; P = 0.08, average completion time was lowest for the Perceptions of Care questionnaire (minutes: Saphora-Psy: 17.7, Perceptions of Care: 13.7, Picker: 17.5; P = 0.005, the Saphora-Psy questionnaire had the largest mean proportion of missing responses (Saphora-Psy: 7.1%, Perceptions of Care: 2.8%, Picker: 4.0%; P P Conclusion Despite differences in the intended target population, content, lay-out and length of questionnaires, none appeared to be obviously better based on our comparison. All three presented advantages and drawbacks and could be used for the satisfaction evaluation of psychiatric inpatients. However, if comparison across medical services or hospitals is desired, using a generic questionnaire might be advantageous.

  18. OCCUPATIONAL ROLE AFTER PSYCHIATRIC HOSPITALIZATION

    GH.R GHASSEMI

    2003-03-01

    Full Text Available Introduction: Severe Psychiatricillness is accompanied by gross disturbances in patient's occupational role. This study presents a comparative picture of work performance before and after psychiatric hospitalization. Method: Subjects comprised 440 psychiatric admitters from Noor Medical center - Isfahan - Iran, who were followed from November 1999 to November 2000. Their work adjustment was measured by means of Weiss man's index. Data were computer analyzed using SPSS by running paired t- student and ANOVA. Results: Majority of the patients (53 % were without permanent sources of income before psychiatric hospitalization, about 12 percent of those who were working prior to hospitalization lost their job after being discharged from hospital. Better work adjustment before hospitalization was positively correlated with better work adjustment after discharge for working patients (r =0/66. Working ability of the patients after discharge was lesser than before the attack f9r patients with regular and irregular job (P < 001. Discussion: Job loss or poor working ability after psychiatric admission reported by several researchers and has bean confirmed in this study as well. These observatoins have been discussed in view of the current socio economic problems in the society and nature of psychiatric disturbances.

  19. Excited delirium: Consideration of selected medical and psychiatric issues

    Edith Samuel

    2009-01-01

    Full Text Available Edith Samuel1, Robert B Williams1, Richard B Ferrell21Department of Psychology, Atlantic Baptist University, Moncton, New Brunswick Canada; 2Department of Psychiatry, Dartmouth Medical School, Lebanon, New Hampshire, USAAbstract: Excited delirium, sometimes referred to as agitated or excited delirium, is the label assigned to the state of acute behavioral disinhibition manifested in a cluster of behaviors that may include bizarreness, aggressiveness, agitation, ranting, hyperactivity, paranoia, panic, violence, public disturbance, surprising physical strength, profuse sweating due to hyperthermia, respiratory arrest, and death. Excited delirium is reported to result from substance intoxication, psychiatric illness, alcohol withdrawal, head trauma, or a combination of these. This communication reviews the history of the origins of excited delirium, selected research related to its causes, symptoms, management, and the links noted between it and selected medical and psychiatric conditions. Excited delirium involves behavioral and physical symptoms that are also observed in medical and psychiatric conditions such as rhabdomyolysis, neuroleptic malignant syndrome, and catatonia. A useful contribution of this communication is that it links the state of excited delirium to conditions for which there are known and effective medical and psychiatric interventions.Keywords: excited delirium, excited states, cocaine misuse, restraint or in custody deaths

  20. Psychiatric Adverse Effects of Dermatological Drugs

    Mine Özmen

    2010-07-01

    Full Text Available Dermatological drugs, mostly corticosteroids and isotretinoin, cause different psychiatric adverse effects. During steroid therapy, a wide range of psychiatric conditions, from minor clinical symptoms like insomnia and anxiety to serious psychiatric syndromes like psychosis and delirium might be seen. In medical literature, a causal connection is usually suggested between “isotretinoin”, which is used for treatment of acne vulgaris and depression and suicide attempts. However, there are no statistically significant double-blind randomized studies that support this connection. Clinicians must know patient’s psychiatric history before using any dermatological treatment known as causing psychiatric adverse effects, and psychiatric consultation should be established whenever necessary.

  1. Undergraduate college students' perceptions of psychiatric nurses.

    Wantz, Richard A; Firmin, Michael W; Stolzfus, Melissa J; Ray, Brigitte N; Holmes, Hannah J; Geib, Ellen F

    2012-11-01

    We surveyed undergraduate students' perceptions of psychiatric nurses' effectiveness and analyzed other sources of data. Students reported that psychiatric nurses' strengths include helping in situations that involve psychiatric symptoms, mental health evaluation, and drug abuse. Psychiatric nurses also were said to be effective when helping an individual with psychiatric symptoms, such as delusions and hallucinations. Friends or associates, common knowledge, school and education, and movies are some sources by which students learn about psychiatric nurses. Sources that provided less influential information include insurance carriers, newspapers, and personal experience. PMID:23146011

  2. Cost prediction of antipsychotic medication of psychiatric disorder using artificial neural network model

    Arash Mirabzadeh

    2013-01-01

    Full Text Available Background: Antipsychotic monotherapy or polypharmacy (concurrent use of two or more antipsychotics are used for treating patients with psychiatric disorders (PDs. Usually, antipsychotic monotherapy has a lower cost than polypharmacy. This study aimed to predict the cost of antipsychotic medications (AM of psychiatric patients in Iran. Materials and Methods: For this purpose, 790 patients with PDs who were discharged between June and September 2010 were selected from Razi Psychiatric Hospital, Tehran, Iran. For cost prediction of AM of PD, neural network (NN and multiple linear regression (MLR models were used. Analysis of data was performed with R 2.15.1 software. Results: Mean ± standard deviation (SD of the duration of hospitalization (days in patients who were on monotherapy and polypharmacy was 31.19 ± 15.55 and 36.69 ± 15.93, respectively (P < 0.001. Mean and median costs of medication for monotherapy (n = 507 were $8.25 and $6.23 and for polypharmacy (n =192 were $13.30 and $9.48, respectively (P = 0.001. The important variables for cost prediction of AM were duration of hospitalization, type of treatment, and type of psychiatric ward in the MLR model, and duration of hospitalization, type of diagnosed disorder, type of treatment, age, Chlorpromazine dosage, and duration of disorder in the NN model. Conclusion: Our findings showed that the artificial NN (ANN model can be used as a flexible model for cost prediction of AM.

  3. Delivery of pharmaceutical services at ward level in a teaching hospital.

    Schellack, N; Martins, V; Botha, N; Meyer, J C

    2009-03-01

    Poor management of pharmaceuticals could lead to wastage of financial resources and poor services in the public sector. The main aim of the study was to investigate the quality of pharmaceutical services at ward level in a teaching hospital. The design of the study was descriptive. Three data collection instruments were designed and pilot-tested prior to the actual data collection. Two structured questionnaires were used to interview the sister-in-charge of each ward and the stock and drug controller at the pharmacy. A checklist for the management of pharmaceuticals was completed for each ward. Descriptive statistics were used to describe and summarise the data. Sisters-in-charge of 30 wards and the stock and drug controller at the pharmacy participated in the study. The relationship with the pharmacy was perceived to be average by 54% (n = 30) of the sisters-in-charge of the wards. Communication with the pharmacy was mainly by telephone and 57% of the sisters-in-charge mentioned that they experienced difficulties in conveying messages to the pharmacy. Ten of the wards received regular ward visits by a pharmacist. Expiry dates were checked by all wards but at different intervals. The majority of the wards (90%) used patient cards, which refer to prescription charts, for stock control and ordering from the pharmacy. Fridge temperatures were checked and charted on a daily basis by 30% of the wards. Written standard operating procedures (SOPs) were used by the pharmacy for issuing ward stock. Although 83% of the wards indicated that they used SOPs, evidence of written SOPs was not available. The results indicated that the management of pharmaceutical services at ward level could be improved. Implementation of appropriate communication systems will enhance cooperation between the pharmacy and the wards. A uniform ward stock control system, either by computer or stock cards, should be introduced. Regular ward visits by a pharmacist to oversee ward stock management are

  4. Psychiatric comorbidity of childhood obesity.

    Kalarchian, Melissa A; Marcus, Marsha D

    2012-06-01

    The onset of psychiatric symptoms and disorders is relatively common in childhood, occurring among youths across the weight spectrum. However, available research suggests that certain psychiatric comorbidities are more prevalent in obese children and adolescents than in healthy weight youths. First, we review research on disordered eating, including evidence to suggest that loss of control eating is associated with weight gain and obesity in youths, as well as poor outcome in family-based treatment of paediatric obesity. Second, we highlight evidence on the relationship between depression and obesity, especially in girls. Third, we present data on attention deficit hyperactivity disorder (ADHD), particularly the symptoms of impulsivity and inattention, and childhood obesity. We also consider that some medical conditions and psychotropic medications contribute to weight gain and obesity in children and adolescents. Throughout the review, we emphasize that psychiatric comorbidity may be a cause or consequence of childhood obesity, or they may share common aetiological factors. PMID:22724645

  5. Religious ideas and psychiatric disorders.

    Beit-Hallahmi, B; Argyle, M

    1977-01-01

    The evidence presented above points to the need for considering factors other than purely religious ones in determining the role of religious ideas in psychiatric disorders. The occurrence of religious ideas as part of the content of individual delusional systems in psychiatric patients can be explained on the basis of exposure to religious ideas through the social environment. It may be also related to the prominence of religion, vis-a-vis other belief systems, in the social envirnment. When considering psychopathological explanations for intense religious experiences, one has to be conscious again of the social factors involved. When an unusual experience having religious content becomes normative in a certain group (for whatever reasons), trying to explain its appearance on the basis of individual psychodynamics or psychopathology becomes very difficult. There seems to be an inverse relationship between the social nature of a religious experience and its psychopathological nature, i.e., there is more psychopathology in individuals reporting solitary religious experiences, or individual religious ideas. Thus the solitary experience seems to be more influenced by disturbed individual dynamics, but in other cases social factors seem to be crucial. Our overall conclusion is that a psychiatric analysis of the role of religious factors in psychopathology has to be first a social-psychiatric analysis. An individual presenting psychiatric symptoms and religious ideas has to be evaluated in light of his social background, since the specific content of psychiatric symptoms seems to be determined by social background factors. Individual psychodynamics determine the appearance of symptoms, but their particular form will be the result of these background factors, one of which is religion. PMID:863602

  6. Effects of a humor-centered activity on disruptive behavior in patients in a general hospital psychiatric ward

    Antonio Higueras

    2006-01-01

    Full Text Available El objetivo de este estudio cuasi-experimental es analizar lo efectos de una actividad centrada en el humor sobre las conductas disruptivas de pacientes hospitalizados en un servicio de Psiquiatría. Se han comparado, teniendo en cuenta dos grupos homogéneos de pacientes hospitalizados en un servicio de Psiquiatría de hospital general (unidad de agudos, dos periodos temporales de 83 días cada uno, siendo el período 1 el de línea base, y el período 2, el de intervención. Para ambos periodos, se codificaron y registraron un total de diez conductas disruptivas. En los 83 días del periodo de intervención, y con una frecuencia de dos días semanales, dos actores profesionales llevaban a cabo las actividades centradas en el humor. Se calculó un Indice de Disrupción Global (IGD, teniendo en cuenta conjuntamente todas las conductas disruptivas, al igual que un Indice de Disrupción Específico (IDE para cada una de las conductas disruptivas. Usando para las comparaciones la corrección de Bonferroni, los resultados indican que el IGD descendió significativamente durante el periodo de intervención, siendo tres las conductas disruptivas que mostraron un descenso significativo (intentos de fuga, autolesiones y peleas.

  7. [From monologue towards therapeutic dialogue. Same remarks about systemic family consultation in a psychiatric in-patient ward].

    Rostworowska, Maria; Opoczyńska, Małgorzata

    2008-01-01

    Basing on the example of one patient and her family, the system family consultation--as a way towards therapeutic dialogue--is presented. The patient was hospitalised due to schizophrenia. In the given example, the psychiatrist was an observer of the consultation conducted by the psychologist. A system therapy consultation allowed a "multiple-picture" to be obtained: the family members and the patient presented their own understanding of the situation. This new multi-perspective description--showing the patient's symptoms functionality caused diagnostic uncertainty in the psychiatrist--how far is the diagnosis of schizophrenia a justifiable one. According to the authors, the systemic consultation, giving the possibility to empathize with existential, psychological and family problems of the patient, leads to a dialogue with his/her family and it plays one of the most important roles in the therapeutic and diagnostic process. PMID:18567401

  8. Effects of a humor-centered activity on disruptive behavior in patients in a general hospital psychiatric ward

    Antonio Higueras; Hugo Carretero-Dios; José P. Muñoz; Esther Idini; Ana Ortiz; Francisco Rincón; David Prieto-Merino; María M. Rodríguez del Águila

    2006-01-01

    El objetivo de este estudio cuasi-experimental es analizar lo efectos de una actividad centrada en el humor sobre las conductas disruptivas de pacientes hospitalizados en un servicio de Psiquiatría. Se han comparado, teniendo en cuenta dos grupos homogéneos de pacientes hospitalizados en un servicio de Psiquiatría de hospital general (unidad de agudos), dos periodos temporales de 83 días cada uno, siendo el período 1 el de línea base, y el período 2, el de intervención. Para am...

  9. The nature of psychiatric disorders.

    Kendler, Kenneth S

    2016-02-01

    A foundational question for the discipline of psychiatry is the nature of psychiatric disorders. What kinds of things are they? In this paper, I review and critique three major relevant theories: realism, pragmatism and constructivism. Realism assumes that the content of science is real and independent of human activities. I distinguish two "flavors" of realism: chemistry-based, for which the paradigmatic example is elements of the periodic table, and biology-based, for which the paradigm is species. The latter is a much better fit for psychiatry. Pragmatism articulates a sensible approach to psychiatric disorders just seeking categories that perform well in the world. But it makes no claim about the reality of those disorders. This is problematic, because we have a duty to advocate for our profession and our patients against other physicians who never doubt the reality of the disorders they treat. Constructivism has been associated with anti-psychiatry activists, but we should admit that social forces play a role in the creation of our diagnoses, as they do in many sciences. However, truly socially constructed psychiatric disorders are rare. I then describe powerful arguments against a realist theory of psychiatric disorders. Because so many prior psychiatric diagnoses have been proposed and then abandoned, can we really claim that our current nosologies have it right? Much of our current nosology arose from a series of historical figures and events which could have gone differently. If we re-run the tape of history over and over again, the DSM and ICD would not likely have the same categories on every iteration. Therefore, we should argue more confidently for the reality of broader constructs of psychiatric illness rather than our current diagnostic categories, which remain tentative. Finally, instead of thinking that our disorders are true because they correspond to clear entities in the world, we should consider a coherence theory of truth by which disorders

  10. Validation of the Excited Component of the Positive and Negative Syndrome Scale (PANSS-EC in a naturalistic sample of 278 patients with acute psychosis and agitation in a psychiatric emergency room

    San Luis

    2011-03-01

    Full Text Available Abstract Background Despite the wide use of the Excited Component of the Positive and Negative Syndrome Scale (PANSS-EC in a clinical setting to assess agitated patients, a validation study to evaluate its psychometric properties was missing. Methods Data from the observational NATURA study were used. This research describes trends in the use of treatments in patients with acute psychotic episodes and agitation seen in emergency departments. Exploratory principal component factor analysis was performed. Spearman's correlation and regression analyses (linear regression model as well as equipercentile linking of Clinical Global Impression of Severity (CGI-S, Agitation and Calmness Evaluation Scale (ACES and PANSS-EC items were conducted to examine the scale's diagnostic validity. Furthermore, reliability (Cronbach's alpha and responsiveness were evaluated. Results Factor analysis resulted in one factor being retained according to eigenvalue ≥1. At admission, the PANSS-EC and CGI-S were found to be linearly related, with an average increase of 3.4 points (p Conclusions The factorial analyses confirm the unifactorial structure of the PANSS-EC subscale. The PANSS-EC showed a strong linear correlation with rating scales such as CGI-S and ACES. PANSS-EC has also shown an excellent capacity to detect real changes in agitated patients.

  11. Words in Maternity Wards: An Aproximation to Perinatal Psychology

    Alicia Oiberman

    2016-02-01

    Full Text Available The acknowledgment that just born babies interact with human and physical contexts originated changes in behaviors of health teems working in maternity wards settings. Concepts such as initial interactions, attachment, dyads, maternal vulnerability, behavioral competences of the just born babies and their applications to perinatal psychology, marked a transformation in different professionals involved in birth’s approaches. From one side, it can be said that medicalization of the birth act in Western societies had allowed to minimize risk factors. But this progress had been carried out without taking into account emotional expressions. The introduction of psychological interventions in neonatal periods is a new field of knowledge. History shows that in different periods and cultures there were amulets, potions and other elements associated with magic that were used to swear baby or mother’s death risk during childbirth. All these practices were taken the place of words, in a hard emotional moment: parturition. It was necessary to walk a long and difficult road for Perinatal Psycholy to recuperate the ancient place of old good women and incorporate words in maternity wards, knowing that the main scenery is first occupied by the mother’s body and then by the baby. Our daily job in a maternity ward, working together with pediatricians and neonatologists, allowed us to verify that words come out when psychologists themselves “include their body” as well as do mothers, babies and the medical teem. Words contribute to facilitate emotional expressions related to motherhood and place the baby in the family history, making able his or her “psychological birth”. 

  12. Alcohol Abuse and Other Psychiatric Disorders

    Skip to main content National Institute on Alcohol Abuse and Alcoholism (NIAAA) Main Menu Search Search form ... Health & Health Disparities Other Psychiatric Disorders Other Substance Abuse HIV/AIDS Other Psychiatric Disorders In the current ...

  13. Alcohol Abuse and Other Psychiatric Disorders

    ... Health Disparities Other Psychiatric Disorders Other Substance Abuse HIV/AIDS Other Psychiatric Disorders In the current Diagnostic and Statistical Manual of Mental Disorders (DSM), alcohol abuse and other substance abuse ...

  14. Biofeedback for psychiatric disorders: a systematic review

    Schoenberg, P.L.; David, A.S.

    2014-01-01

    Biofeedback potentially provides non-invasive, effective psychophysiological interventions for psychiatric disorders. The encompassing purpose of this review was to establish how biofeedback interventions have been used to treat select psychiatric disorders [anxiety, autistic spectrum disorders, dep

  15. Measuring the impact of modern matrons in the ward setting.

    Shanley, Oliver

    With the The NHS Plan (Department of Health, 2000) the government made it clear there was a need to reintroduce the role of matron to establish a clear responsibility for standards in the ward setting. The role of modern matron is now considered to be a fundamental part of clinical governance, ensuring the quality of the care provided is of the highest standard. Staff at South Essex Partnership NHS Trust instituted an audit to provide an accurate picture of the impact of modern matrons. PMID:15552487

  16. Ward identities and chiral anomalies for coupled fermionic chains

    Coupled fermionic chains are usually described by an effective model written in terms of bonding and anti-bonding fermionic fields with linear dispersion in the vicinities of the respective Fermi points. We derive for the first time exact Ward Identities (WI) for this model, proving the existence of chiral anomalies which verify the Adler-Bardeen non-renormalization property. Such WI are expected to play a crucial role in the understanding of the thermodynamic properties of the system. Our results are non-perturbative and are obtained analyzing Grassmann functional integrals by means of constructive quantum field theory methods

  17. Divergent IR gluon propagator from Ward-Slavnov-Taylor identities?

    Boucaud, P; Lokhov, A Y; Micheli, J; Pène, O; Rodríguez-Quintero, J; Roiesnel, C; Yaouanc, A L; Boucaud, Ph.

    2007-01-01

    We exploit the Ward-Slavnov-Taylor identity relating the 3-gluons to the ghost-gluon vertices to conclude either that the ghost dressing function is finite and non vanishing at zero momentum while the gluon propagator diverges (although it may do so weakly enough not to be in contradiction with current lattice data) or that the 3-gluons vertex is non-regular when one momentum goes to zero. We stress that those results should be kept in mind when one studies the Infrared properties of the ghost and gluon propagators, for example by means of Dyson-Schwinger equations.

  18. The educational value of ward rounds for junior trainees

    Faidon-Marios Laskaratos

    2015-04-01

    Full Text Available The ward round (WR is a complex task and medical teachers are often faced with the challenge of finding a balance between service provision and clinical development of learners. The educational value of WRs is an under-researched area. This short communication aims to evaluate the educational role of WRs for junior trainees and provides insight into current practices. It also identifies obstacles to effective teaching/training in this setting and provides suggestions for improving the quality of WR teaching.

  19. Ward identities and chiral anomalies for coupled fermionic chains

    Costa, L. C.; Ferraz, A.; Mastropietro, Vieri

    2013-12-01

    Coupled fermionic chains are usually described by an effective model written in terms of bonding and anti-bonding fermionic fields with linear dispersion in the vicinities of the respective Fermi points. We derive for the first time exact Ward Identities (WI) for this model, proving the existence of chiral anomalies which verify the Adler-Bardeen non-renormalization property. Such WI are expected to play a crucial role in the understanding of the thermodynamic properties of the system. Our results are non-perturbative and are obtained analyzing Grassmann functional integrals by means of constructive quantum field theory methods.

  20. SUSY Ward identities in 1-loop perturbation theory

    We present preliminary results of a study of the supersymmetric (SUSY) Ward identities (WIs) for the N = 1 SU(2) SUSY Yang-Mills theory in the context of one-loop lattice perturbation theory. The supersymmetry on the lattice is explicitly broken by the gluino mass and the lattice artifacts. However, the renormalization of the supercurrent can be carried out in a scheme that restores the nominal continuum WIs. The perturbative calculation of the renormalization constants and mixing coefficients for the local supercurrent is presented

  1. On logarithmic solutions to the conformal Ward identities

    A general discussion of the conformal Ward identities is presented in the context of logarithmic conformal field theory with conformal Jordan cells of rank two. The logarithmic fields are taken to be quasi-primary. No simplifying assumptions are made about the operator-product expansions of the primary or logarithmic fields. Based on a very natural and general ansatz about the form of the two- and three-point functions, their complete solutions are worked out. The results are in accordance with and extend the known results. It is demonstrated, for example, that the correlators exhibit hierarchical structures similar to the ones found in the literature pertaining to certain simplifying assumptions

  2. Characteristics of HCV positive patients in an Italian urban psychiatric unit

    Azzoni Antonella

    2006-10-01

    Full Text Available Abstract Objectives 1 to assess the prevalence of hepatitis C virus (HCV infection in a population of acute psychiatric in-patients; 2 to find out relationships between HCV comorbidity and clinical features of psychiatric patients. Methods Prospective observational study in a 6-year period. Results 2396 cases (1492 patients were admitted in the considered period. Forty-two patients (2.8% were affected by HCV infection. HCV infection was more frequent in patients with less years of education, lower social class, lower last year best Global Assessment of Functioning score, more hostile or violent behavior in hospital, with a lifetime history of previous suicide attempt, and with substance-related disorders. Conclusion HCV infection in psychiatric patients constitutes a major threat to the health of psychiatric patients and is related with unfavorable social background, worse global functioning, hostile or violent behavior, substance-related disorders. It appears also to be a significant risk of suicidal behavior.

  3. How to evacuate a psychiatric hospital: a Hurricane Katrina success story.

    Thomas, Joan; Lackey, Nancy

    2008-01-01

    This article describes the successful evacuation of an entire psychiatric hospital from New Orleans, Louisiana, to Memphis, Tennessee, on a weekend night. The destination site was 400 miles away and buses were used for transport. The evacuation occurred shortly before Hurricane Katrina struck New Orleans and included 73 adult, adolescent, and child acute psychiatric patients. Thirty-five staff members also participated in the evacuation with their families and pets. This report is significant because little is known about how to implement a disaster plan that involves the transport of an entire psychiatric hospital-patients, nurses, physicians, staff, and family members--to another city. The knowledge gained can also benefit psychiatric nurses and their organizations when establishing or modifying their disaster plans. PMID:18251350

  4. Legal Considerations of Psychiatric Nursing Practice.

    Barloon, Linda Funk; Hilliard, Wanda

    2016-06-01

    There are major legal issues that affect psychiatric nursing and guidelines for practicing in a legal and responsible manner. Advances in understanding of psychiatric conditions and developments in how nurses care for psychiatric patients result in changes in regulations, case law, and policies that govern nursing practice. Professional development, keeping abreast of current research and literature regarding clinical practice and trends, and involvement in professional organizations are some of the ways that psychiatric nurses can meet the challenges of their profession. PMID:27229273

  5. Psychiatric illness and sexual function.

    Segraves, R T

    1998-05-01

    Impaired sexual function has been noted to occur in various psychiatric illnesses. In affective disorders, disturbances of libido, erection and orgasm have been reported. Disordered sexual behavior has also been noted in patients with schizophrenia and anorexia nervosa. Clinical speculation suggests that anxiety disorders may also be associated with a higher prevalence of sexual problems. PMID:9647976

  6. [Psychiatric evaluation in civil law].

    Foerster, K

    1992-03-01

    Aspects of civil law of importance for the psychiatrist as expert witness are those dealing with disability pensions accident insurance, compensation in civil law and rights of the seriously disabled. The legal basis of each is briefly outlined, and some guidelines given for psychiatric court reports. Some outstanding theoretical and practical problems are mentioned. PMID:1579170

  7. Oral Health in Psychiatric Patients

    Ozlem Gurbuz

    2011-12-01

    Full Text Available Although oral health is a major determinant of general health and quality of life, it has a low priority in the context of mental illness. Chronic mental illness and its treatment carry inherent risks for significant oral diseases. Both the disease itself and its various pharmacologic management modalities lead to a range of oral complications and side effects, with caries, periodontal disease and xerostomia being encountered most frequently. Older age, female gender, length of hospitalization, duration of mental illness, psychiatric diagnosis are the most discussed predictors for adverse dental outcomes in the reviewed studies. Poor oral hygiene, higher intake of carbonates, smoking, poor perception of oral health self-needs, length of psychiatric disorder, length of psychotropic treatment, and less access to dental care pose at high risk for poor oral health among this population. This article emphasizes the importance of preventive dentistry programs to improve dental healthcare psychiatric chronic inpatients and the signifance of bridging dental health education to psychiatric rehabilitation programs. In this review, general information concerning the oral manifestations of mental illness, effect of medication of mental illness on oral health, the factors affecting oral health among this special population have been provided.

  8. Comorbidity of Psychiatric Disorders and Parental Psychiatric Disorders in a Sample of Iranian Children with ADHD

    Ghanizadeh, Ahmad; Mohammadi, Mohammad Reza; Moini, Rozita

    2008-01-01

    Objective: To study the psychiatric comorbidity of a clinical sample of children with ADHD and the psychiatric disorders in their parents. Method: Structured psychiatric interviews assessing lifetime psychiatric disorders by "DSM-IV" criteria, using the Farsi version of the Schedule for Affective Disorders and Schizophrenia. Results: The mean age…

  9. Psychiatric morbidity in dermatology patients: Frequency and results of consultations

    Seyhan Muammer

    2006-01-01

    Full Text Available BACKGROUND: Dermatological patients quite commonly depict psychiatric morbidity. PURPOSES: To study the psychiatric morbidity among skin patients of our clinic. METHODS: In the present study, the patients who were treated in the Dermatology Clinic of Inonu University Medical Faculty were evaluated retrospectively. The age, gender, marital status, habits, dermatological and systemic diseases, previously used drugs, current therapy and psychiatric diagnosis of each patient were recorded. FINDINGS: Of 636 patients involved in the study, 15.3% had psychopathological problems, which were depression (32.0%, adjustment difficulty (15.5%, anxiety (13.4%, psychosomatic disorders (10.3%, obsessive-compulsive disorder and conversion (5.1%, dysthymic disorder (4.1%, attention deficit and hyperactivity disorder (2.1%, panic attack (1.0%, premenstrual syndrome, schizophrenia, somatization disorder, insomnia, alcohol dependency, bipolar affective disorder, mental retardation, agoraphobia, social phobia and dementia. The dermatological diseases defined for the patients with psychopathology diagnosis were chronic urticaria (25.8%; psoriasis (15.5%; alopecia areata, totalis and iniversalis (11.3%; acute urticaria, neurodermatitis and Behcet′s disease (5.1%; atopic dermatitis and drug eruptions (4.1%; pemphigus (3.1%; angioedema, contact dermatitis and generalized pruritus (2.1%; folliculitis and the others (1.0%. CONCLUSIONS: Psychiatric morbidity has an affect on the course of dermatological diseases. When required, psychiatric consultation should be sought by dermatology clinics and patients should be followed with the cooperation of dermatologists and psychiatrists. LIMITATION: The indoor-based study had not included any control group and any domicillary patient.

  10. Implementing ward based clinical pharmacy services in an Ethiopian University Hospital

    Mekonnen AB; Yesuf EA; Odegard PS; Wega SS

    2013-01-01

    Background: Clinical pharmacy practice has developed internationally to expand the role of a pharmacist well beyond the traditional roles of compounding, dispensing and supplying drugs to roles more directly in caring for patients. Studies on the activities of the clinical pharmacist in an inpatient ward in resource constrained settings are scarce, however.Objective: To assess ward based clinical pharmacy services in an internal medicine ward of Jimma University Specialized Hospital. Methods:...

  11. Guidance and Orientation Manual : Internal Diseases Ward 11 - Central Finland Central Hospital

    Hirjaba, Marina

    2009-01-01

    The purpose of this Bachelor’s Thesis is to create an initiation manual for the foreign students, foreign visitors or anyone else interested about Internal Diseases ward 11, Central Finland Central Hospital. The aim of the guidance material is to help the foreign students, who are practicing on ward 11, to become acquainted with the Finnish Healthcare System, Central Finland Central Hospital and to offer orientation upon the nursing and organisation of Internal Diseases ward 11. It is taken i...

  12. A comparison of social skills training and contingent attention to improve behavioural deficits of chronic psychiatric patients.

    Matson, J L; Zeiss, A M; Zeiss, R A; Bowman, W

    1980-02-01

    Twelve chronic psychiatric patients were treated with either social skills training or contingent attention to improve behavioural assets or deficits noted on the ward by independently trained raters blind to experimental conditions. Treatment was applied across groups using a multiple-baseline format. Inspection of the data revealed that clinically significant improvements in socially appropriate assets and deficits observed on the ward resulted with social skills training but no substantiative change accrued due to the contingent attention. The behaviours selected for treatment were those which staff were most willing to reinforce. This variable may account, in part at least, for the generalization of treatment effects to the natural environment with persons who received social skills training. PMID:7357230

  13. Dilemmas in private psychiatric practice

    Nanasaheb M Patil

    2011-01-01

    Full Text Available Background: A practicing psychiatrist faces dilemmas on a number of occasions, in deciding the best course of action he/she needs to undertake while treating a patient. At times, this choice may not be in accordance with the ethical and moral principles and may in fact appear to violate patient′s autonomy and rights. Aim: To study the nature of psychiatric practice by the practicing psychiatrist in the areas of admission, discharge, consent, physical restraint, electroconvulsive therapy (ECT, certification, treatment, suicide and psychotherapy. Settings and Design: Cross-sectional observational study. Materials and Methods: Forty-eight psychiatrists gave consent to participate in the study. A special proforma was prepared, which addresses the common dilemmas in the clinical psychiatric practice. All the psychiatrists were given specially designed profoma and were requested to fill the proforma with appropriate answers. Statistical analysis was done using SPSS software. Results: There were 42 male and 6 female psychiatrists. The age of the psychiatrists ranged from 28 to 65 years with a mean of 43.08 years. The mean duration of practice of these psychiatrists was 14.81΁11.07 years. Question and answers related to admission, discharge, consent, physical restraint, ECT, certification, treatment, suicide and psychotherapy are discussed. Conclusions: The present standard and practice especially in private psychiatric set-up does not confirm to the rules, recommendations, and regulations suggested by Mental Health Act 1987, Mental Health Authorities and various guidelines of practice. Indian Psychiatric Society and other professional bodies need to take steps to prepare guidelines for a good psychiatric practice.

  14. Nursing interventions in crisis-oriented and long-term psychiatric home care

    Boomsma, J.; Dassen, T.WN; Dingemans, T.; van den Heuvel, W.J.A.

    1999-01-01

    Psychiatric nurses in The Netherlands are moving out of residential mental health institutions and are pioneering home care for the acutely and chronically mentally ill. The purpose of this study was to identify the interventions nurses currently use and to describe the differences between crisis-or

  15. Psychotherapy in older adults with major depression in psychogeriatric ward

    Wojciech Mateusz Rachel

    2015-03-01

    Full Text Available Summary: Psychotherapy of the elderly appears to be a very important part of comprehensive treatment, and its character should be based on a holistic vision of the patient. The effectiveness of the individual Cognitive-Behavioral Psychotherapy (CBT and Problem Solving Therapy (PST is well establish in clinical trial. In treating patients at the psycho geriatric ward, on account of the described clinical state placed in the article, we apply Supportive Therapy (ST and existential approach. An important element of therapy is a holistic approach to the needs of the patient, an attempt to understand their internal conflicts, a focus on long-term therapy and the setting of realistic goals tailored to the patient's abilities. A positive change in thinking can bear fruit in the patient’s everyday life, their functioning, and in their relationships with other people. It seems, that at elderly people, choice of the psychotherapeutic method should adapt individually to the clinical state, therapeutic readiness to work and one's situation in life of the patient In this article, the authors share their own experiences and reflections from the use of individual and group psychotherapy with elderly patients in the psychogeriatric ward.

  16. Multi-Criteria Knapsack Problem for Disease Selection in an Observation Ward

    The aging population and the introduction of Thailand universal healthcare have increased inpatients and outpatients to public hospitals, particularly to a hospital that provides special and comprehensive health services. Many inpatient wards have experienced large influx of inpatients as the hospitals have to admit all patients regardless their conditions. These overcrowding wards cause stress to medical staffs, block access between medical departments, hospital-acquired infections, and ineffective uses of resources. One way to manage such inundated inpatient is to select some patients whose conditions require less clinical attention or whose lengths of stay are predictable and short and, then, place them at an observation ward. This intermediate ward increases turnover of beds and reduces unnecessary paperwork as patients are considered to be outpatients. In this article, we studied inpatient data of a tertiary care hospital in which an observation ward was considered to alleviate the overcrowding problem at Internal Medicine Department. The analysis of data showed that the hospital can balance inpatient flow by managing a group of patients who is admitted because of treatments ordered by its special clinics. Having explored several alternatives, we suggested patient selection criteria and proposed a layout at an observation ward. The hospital should increase medical beds in a new building ward because the current observation ward can handle 27.3% of total short stay patients, while the observation ward is projected to handle 80% of total short stay patients

  17. Job enrichment, work motivation, and job satisfaction in hospital wards: testing the job characteristics model.

    Kivimäki, M; Voutilainen, P; Koskinen, P

    1995-03-01

    This study investigated work motivation and job satisfaction at hospital wards with high and low levels of job enrichment. Primary nursing was assumed to represent a highly enriched job, whereas functional nursing represented a job with a low level of enrichment. Five surgical wards were divided into these two categories based on the structured interviews with head nurses. Work motivation and job satisfaction among ward personnel were assessed by a questionnaire. The ward personnel occupying highly enriched jobs reported significantly higher work motivation and satisfaction with the management than the personnel occupying jobs with a low level of enrichment. PMID:7735655

  18. An Unusual Psychiatric Emergency: Herpes Simplex Encephalitis

    H. Doyle

    1994-01-01

    Full Text Available A case of fatal herpes simplex virus (HSV encephalitis, presenting as a psychiatric emergency, is reported. The possibility of HSV encephalitis presenting mainly or solely with psychiatric symptoms is highlighted. HSV can cause a severe form of encephalitis which may present with mainly psychiatric symptoms in some cases. Early treatment with anti-viral agents can reduce mortality and morbidity, but accurate early diagnosis may be very difficult. HSV encephalopathy may mimic psychiatric illness and has been likened to syphilis as the great imitator. The case presented here should serve to raise awareness of the psychiatric features and the need to consider this diagnosis in patients with atypical behavioural disturbance.

  19. Ending preventable child deaths in South Africa: What role can ward-based outreach teams play?

    Doherty, Tanya; Kroon, Max; Rhoda, Natasha; Sanders, David

    2016-07-01

    South Africa (SA) has emerged from the Millennium Development Goal era with a mixture of success and failure. The successful national scale-up of prevention of mother-to-child transmission of HIV services with increasingly efficacious antiretroviral regimens has reduced the mother-to-child transmission rate dramatically; however, over the same period there appears to have been no progress in coverage of high-impact interventions for pneumonia and diarrhoea, which are now leading causes of under-5 mortality. SA embarked on a strategy to re-engineer the primary healthcare system in 2011, which included the creation of ward-based outreach teams consisting of community health workers (CHWs). In this article we argue that the proposed ratio of CHWs to population is too low for public health impact and that the role and scope of CHWs should be extended beyond giving of health information to include assessment and treatment of childhood illnesses (particularly diarrhoea and suspected pneumonia). Evidence and experience amply demonstrate that CHWs in sufficient density can have a rapid and positive impact on neonatal and young child mortality, especially when they are allowed to treat common acute conditions. SA's mediocre performance in child survival could be dramatically improved if there were more CHWs who were allowed to do more. PMID:27384356

  20. Psychiatric classification and subjective experience

    Cooper, Rachel

    2012-01-01

    This article does not directly consider the feelings and emotions that occur in mental illness. Rather, it concerns a higher level methodological question: To what extent is an analysis of feelings and felt emotions of importance for psychiatric classification? Some claim that producing a phenomenologically informed descriptive psychopathology is a prerequisite for serious taxonomic endeavor. Others think that classifications of mental disorders may ignore subjective experience. A middle view...

  1. PSYCHIATRIC COMORBIDITY IN FORENSIC PSYCHIATRY

    Žarkovic Palijan, Tija; Mužinić, Lana; Radeljak, Sanja

    2009-01-01

    For the past several years a numerous studies in the field of forensic psychiatry confirmed a close relationship between violent offenders and comorbid substance abuse. The comorbid substance abuse in violent offenders was usually unrecognized and misdiagnosed. Furthermore, comorbidity in forensic psychiatry describes the co-occurrence of two or more conditions or psychiatric disorder known in the literature as dual diagnosis and defined by World Health Organization (WHO). In fact, many vi...

  2. Psychiatric Thoughts in Ancient India

    Ravi Abhyankar

    2015-01-01

    Full Text Available A review of the literature regarding psychiatric thoughts in ancient India is attempted. Besides interesting reading, many of the concepts are still relevant and can be used in day-to-day practice especially towards healthy and happy living. Certain concepts are surprisingly contemporary and valid today. They can be used in psychotherapy and counselling and for promoting mental health. However, the description and classification of mental illness is not in tune with modern psychiatry.

  3. Dilemmas in Private Psychiatric Practice

    Patil, Nanasaheb M.; Nayak, Raghavendra B.; Bhogale, Govind S.; Chate, Sameeran S.

    2011-01-01

    Background: A practicing psychiatrist faces dilemmas on a number of occasions, in deciding the best course of action he/she needs to undertake while treating a patient. At times, this choice may not be in accordance with the ethical and moral principles and may in fact appear to violate patient′s autonomy and rights. Aim: To study the nature of psychiatric practice by the practicing psychiatrist in the areas of admission, discharge, consent, physical restraint, electroconvulsive therapy (ECT)...

  4. Transforming subjectivities in psychiatric care

    Terkelsen, Toril Borch

    2009-01-01

    This paper is based upon ethnographic fieldwork in a Norwegian psychiatric unit practicing a psycho-educational treatment of young adults diagnosed with schizophrenia. An aim of the programme is that patients learn to detect and monitor their 'symptoms' in order to obtain 'insight into their own illness', thus transforming themselves into self-governed and self-responsible subjects who are able to cope with life outside institutions. The programme is constituted within a medical framework wit...

  5. Psychiatric Aspects of Childhood Epilepsy

    Pattanayak, Raman Deep; Sagar, Rajesh

    2012-01-01

    How to Cite this Article: Pattanayak RD, Sagar R. Psychiatric Aspects of Childhood Epilepsy. Iran J Child Neurol 2012;6(2):9-18.Childhood epilepsy is a chronic, recurrent disorder of unprovoked seizures. Theonset of epilepsy in childhood has significant implications for brain growth anddevelopment. Seizures may impair the ongoing neurodevelopmental processes and compromise the child’s intellectual and cognitive functioning, leading totremendous cognitive, behavioral and psychosocial consequen...

  6. Psychiatric aspects of therapeutic abortion *

    Doane, Benjamin K.; Quigley, Beverly G.

    1981-01-01

    A search of the literature on the psychiatric aspects of abortion revealed poor study design, a lack of clear criteria for decisions for or against abortion, poor definition of psychologic symptoms experienced by patients, absence of control groups in clinical studies, and indecisiveness and uncritical attitudes in writers from various disciplines. A review of the sequelae of therapeutic abortion revealed that although the data are vague, symptoms of depression were reported most frequently, ...

  7. Tobacco and psychiatric dual disorders.

    Graham, Noni A; Frost-Pineda, Kimberly; Gold, Mark S

    2007-01-01

    Smoking is a leading cause of morbidity and premature mortality in the United States. The relationship between tobacco smoking and several forms of cancer, heart disease, stroke, chronic lung disease, and other medical diseases is well recognized and accepted. Recent epidemiological studies are now focusing on the link between tobacco use and psychiatric diseases. Experts now suggest that in the differential diagnosis of "smoker," depression, alcohol dependence, and schizophrenia are highest on the list. Studies are also focusing on the role of secondhand tobacco exposure, either in utero or during childhood, in the risk of dual disorders. Prenatal exposure may alter gene expression and change the risk for a variety of life-long psychiatric diseases, e.g., ADD/ADHD, antisocial personality disorders, substance use disorders, and major depression. Considerable time and effort have been devoted to studying the link between smoking and depression and also schizophrenia. We will focus on less well-studied areas in tobacco use and psychiatric dual disorders (including eating disorders), prenatal and early childhood secondhand smoke (SHS) exposure, and the relationship to the genesis of these dual disorders. PMID:19283970

  8. Mitochondrial Dysfunction and Psychiatric Disorders

    Shaw-Hwa Jou

    2009-10-01

    Full Text Available Mitochondria are intracellular organelles crucial in the production of cellular energy.Mitochondrial diseases may result from malfunctions in this biochemical cascade. Severalinvestigators have proposed that mitochondrial dysfunction is related to the pathophysiologyof bipolar disorder (BD, major depressive disorder (MDD and schizophrenia (SZ. Theauthors reviewed recent study findings and tried to delineate the current understanding of thecorrelation between mitochondrial dysfunction and psychiatric disorders. A growing body ofevidence suggests that mitochondrial dysfunction is important in patients with psychiatricdisorders. The evidence include impaired energy metabolism in the brain detected usingresults of magnetic resonance spectroscopy, electron microscopy, co-morbidity with mitochondrialdiseases, the effects of psychotropics on mitochondria, increased mitochondrialDNA (mtDNA deletion in the brain, and association with mtDNA mutations/polymorphismsor nuclear-encoded mitochondrial genes. It is possible that the new information willlead to a focus on psychiatric disorder as a metabolic disease. Treatment with psychotropicsmight ultimately enhance energy metabolism and reduce the damage of oxidative stress. Thenext step in the study of mitochondrial dysfunction in patients with psychiatric disordersshould be clarification of how mitochondrial dysfunction, a nonspecific risk factor, causesspecific symptoms. Further study of mitochondrial dysfunction in patients with psychiatricdisorder is expected to be useful for the development of cellular disease markers and newpsychotropics.

  9. Adult Neurogenesis and Psychiatric Disorders.

    Kang, Eunchai; Wen, Zhexing; Song, Hongjun; Christian, Kimberly M; Ming, Guo-Li

    2016-01-01

    Psychiatric disorders continue to be among the most challenging disorders to diagnose and treat because there is no single genetic or anatomical locus that is causative for the disease. Current treatments are often blunt tools used to ameliorate the most severe symptoms, at the risk of disrupting functional neural systems. There is a critical need to develop new therapeutic strategies that can target circumscribed functional or anatomical domains of pathology. Adult hippocampal neurogenesis may be one such domain. Here, we review the evidence suggesting that adult hippocampal neurogenesis plays a role in emotional regulation and forms of learning and memory that include temporal and spatial memory encoding and context discrimination, and that its dysregulation is associated with psychiatric disorders, such as affective disorders, schizophrenia, and drug addiction. Further, adult neurogenesis has proven to be an effective model to investigate basic processes of neuronal development and converging evidence suggests that aberrant neural development may be an etiological factor, even in late-onset diseases. Constitutive neurogenesis in the hippocampus of the mature brain reflects large-scale plasticity unique to this region and could be a potential hub for modulation of a subset of cognitive and affective behaviors that are affected by multiple psychiatric disorders. PMID:26801682

  10. Acute Psychosis Associated with Subcortical Stroke: Comparison between Basal Ganglia and Mid-Brain Lesions

    Aaron McMurtray; Ben Tseng; Natalie Diaz; Julia Chung; Bijal Mehta; Erin Saito

    2014-01-01

    Acute onset of psychosis in an older or elderly individual without history of previous psychiatric disorders should prompt a thorough workup for neurologic causes of psychiatric symptoms. This report compares and contrasts clinical features of new onset of psychotic symptoms between two patients, one with an acute basal ganglia hemorrhagic stroke and another with an acute mid-brain ischemic stroke. Delusions and hallucinations due to basal ganglia lesions are theorized to develop as a result ...

  11. Supporting breastfeeding mothers on children's wards: an overview.

    Narramore, Naomi

    2007-02-01

    Just under half of all six-week-old babies in the U.K. are breastfed, and just under a quarter are still being breastfed at six months old so it is likely that children's nurses will frequently encounter breastfed babies on children's wards. Support for breastfeeding has traditionally been left to midwives but Department of Health guidance requires that all relevant staff have training in this practice. Children's nurses need to understand the principles and practice of breastfeeding support including correct positioning and attachment, prevention and management of breastfeeding problems, mothers' needs and safe use of breast pumps. Breastfeeding should be part of the curriculum for children's nursing courses, including practical sessions to observe breastfeeding support in the clinical setting. Children's nurses should be aware that literature and learning resources written for midwives might be appropriate for them to access to increase their understanding in this important area of practice. PMID:17326552

  12. Christmas cards workshop in a Restricted Access Ward

    Teresa García

    2003-12-01

    Full Text Available The Christmas cards workshop is an intervention study made in the Restricted Access Ward (RAW of Hospital Gregorio Marañón (Madrid, in December 2001, from the 5th to the 22nd. The object of this study was to assess the effectiveness of this workshop to improve the quality of the RAW patients´ hospital day, through their participation. They made 47 cards, the mean per patient was 1,52. Participation: 91,2% of the patients that fulfilled the inclusion criteria. Drawings and texts alluded to the convict´s perspective of Christmas time, from their own experience. The Christmas cards were exhibited in the hospital and they also were sent to different penitentiary institutions in Madrid, to make the RAW known. The course “Education for health for interdisciplinary projects in penitentiary institutions” was the frame of this workshop.

  13. Ward blanket assembly pre-test predictions by superenergy

    A number of WARD sodium cooled blanket geometry experiments in the mixed convection range were prepredicted by the computer code SUPERENERGY in the original version of this report. Of these tests one was actually run and is re-examined in Revision I. When account is taken of the difference between the assumed and actual test operating conditions and the temperature-induced variation of the Reynolds number with height in the bundle, the code results and test data compare very favorably. Of the other actual test cases examined in Revision I, the comparison with predictions was poor at low flows. Since these low flows however were predicted to be outside the mixed convection regime per Khan's criteria, the validity of the criteria is suspect and will be reassessed

  14. The full Ward-Takahashi Identity for colored tensor models

    Pérez-Sánchez, Carlos I

    2016-01-01

    We derive the full $\\mathrm{U}(\\infty)$-Ward-Takahashi Identities for random colored tensor models. The strategy is to expand the free energy in boundary graphs that determine the combinatorics of the sources. This contributes to the organization of the correlation functions of colored tensor models and is carried out for arbitrary interactions of any rank, $D$, with subsequent focus on the $\\varphi^4$-theories. The result is that the boundary sector of quartic melonic interactions suffices to generate all $D$-colored graphs. For the rank-$3$ $\\varphi^4$-theory we derive the exact integral-like equation for the 2-point function. Our results hold for some Group Field Theories as well. Altogether, our non-perturbative approach trades graph theory for analytical methods.

  15. Nursing safety management in onco-hematology pediatric wards

    Marcelle Miranda da Silva

    2015-02-01

    Full Text Available This study aimed at identifying how safety management is applied by nurses to manage the nursing care, and at analyzing their challenges in onco-hematology pediatric wards. Descriptive and qualitative research, conducted at the Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti, Rio de Janeiro, Brazil, in August 2013. Six nurses were interviewed, and the content analysis was used. The key aspects relate to the importance of training and continuing education, teamwork, with the challenges in the care of hospitalized children and particularities of the disease, and the systematization, use of instruments and protocols. For child safety, the relationship between the administration and support is critical to the quality of care.

  16. Ward identities and gauge independence in general chiral gauge theories

    Anselmi, Damiano

    2015-01-01

    Using the Batalin-Vilkovisky formalism, we study the Ward identities and the equations of gauge dependence in potentially anomalous general gauge theories, renormalizable or not. A crucial new term, absent in manifestly nonanomalous theories, is responsible for interesting effects. We prove that gauge invariance always implies gauge independence, which in turn ensures perturbative unitarity. Precisely, we consider potentially anomalous theories that are actually free of gauge anomalies thanks to the Adler-Bardeen theorem. We show that when we make a canonical transformation on the tree-level action, it is always possible to re-renormalize the divergences and re-fine-tune the finite local counterterms, so that the renormalized $\\Gamma $ functional of the transformed theory is also free of gauge anomalies, and is related to the renormalized $\\Gamma $ functional of the starting theory by a canonical transformation. An unexpected consequence of our results is that the beta functions of the couplings may depend on...

  17. Cross Infection in a Hospital Ward and Deposition of Particles Exhaled from a Source Manikin

    Nielsen, Peter V.; Li, Yuguo; Buus, Morten; Winther, Frederik V.; Qian, Hua

    2009-01-01

    The cross infection in a hospital ward is studied. Deposition of particles exhaled from a source manikin is investigated in a full-scale hospital ward ventilated by downward directed ventilation. Deposition on vertical surfaces close to the source shows distribution of particles directed upwards in...

  18. Incidence, staff awareness and mortality of patients at risk on general wards

    Fuhrmann, L.; Lippert, A.; Perner, A.; Fuhrmann, Lone; Lippert, Anne; Perner, Anders; Østergaard, Doris

    2008-01-01

    The aim of this study was to estimate the incidence, staff awareness and subsequent mortality of patients with abnormal vital signs on general wards in a Danish university hospital.......The aim of this study was to estimate the incidence, staff awareness and subsequent mortality of patients with abnormal vital signs on general wards in a Danish university hospital....

  19. An Abelian Ward identity and the vertex corrections to the color superconducting gap

    XU Hao-Jie; WANG Qun

    2009-01-01

    We derive an Abelian-like Ward identity in the color superconducting phase and calculate vertex corrections to the color superconducting gap. Making use of the Ward identity, we show that subleading order contributions to the gap from vertices are absent for gapped excitations.

  20. Comorbid depression in dementia on psychogeriatric nursing home wards: which symptoms are prominent?

    Verkaik, R.; Francke, A.L.; Meijel, B. van; Ribbe, M. W.; Bensing, J.M.

    2009-01-01

    OBJECTIVE: To provide insight into the prevalence and clinically relevant symptoms of comorbid depression among dementia patients in psychogeriatric nursing home wards, to enhance depression recognition. DESIGN: Cross-sectional analyses of multicenter diagnostic data. SETTING: Psychogeriatric wards of Dutch nursing homes. PARTICIPANTS: Five hundred and eighteen residents with dementia. MEASUREMENTS: 1) Diagnosis of depression in dementia (Provisional Diagnostic Criteria for Depression of Alzh...

  1. Mobile and fixed computer use by doctors and nurses on hospital wards

    Andersen, Pia; Lindgaard, Anne-Mette; Prgomet, M.;

    2009-01-01

    , clinical task, and selection of a computer hardware device in hospital wards. METHODS: Twenty-seven nurses and eight doctors were observed for a total of 80 hours as they used a range of computing devices to access a computerized provider order entry system on two wards at a major Sydney teaching hospital...

  2. The Brazilian psychiatric reform: historical and technical-supportive aspects of experiences carried out in the cities of São Paulo, Santos and Campinas

    Cristina Amélia Luzio

    2007-01-01

    Full Text Available The Brazilian psychiatric reform: historical and technical-supportive aspects of experiences carried out in the cities of São Paulo (capital, Santos and Campinas, in order to understand their material, social and political impacts, the progress in the process of breaking away from the psychiatric ward model, and the establishment of creative and productive groups, required to build up the psychosocial treatment in regard to mental health, as well as to evaluate the contribution that the SUS (Brazilian Public Health System had on the psychiatric reform in the mentioned cities. The research, which is the basis of this paper, is part of a thesis regarding mental health care, whereby the innovative projects implemented in those cities served as framework and basis for comparison to analyze mental health policy in small and medium-sized cities and towns in the state of São Paulo.

  3. Psychiatric and Medical Management of Marijuana Intoxication in the Emergency Department

    Bui, Quan M.

    2015-05-01

    Full Text Available We use a case report to describe the acute psychiatric and medical management of marijuana intoxication in the emergency setting. A 34-year-old woman presented with erratic, disruptive behavior and psychotic symptoms after recreational ingestion of edible cannabis. She was also found to have mild hypokalemia and QT interval prolongation. Psychiatric management of cannabis psychosis involves symptomatic treatment and maintenance of safety during detoxification. Acute medical complications of marijuana use are primarily cardiovascular and respiratory in nature; electrolyte and electrocardiogram monitoring is indicated. This patient’s psychosis, hypokalemia and prolonged QTc interval resolved over two days with supportive treatment and minimal intervention in the emergency department. Patients with cannabis psychosis are at risk for further psychotic sequelae. Emergency providers may reduce this risk through appropriate diagnosis, acute treatment, and referral for outpatient care. [West J Emerg Med. 2015;16(3:414–417.

  4. Particle Removal Efficiency of the Portable HEPA Air Cleaner in a Simulated Hospital Ward

    Qian, Hua; Li, Yuguo; Sun, Hequan; Nielsen, Peter V.; Huang, Xinghua; Zheng, Xiaohong

    2010-01-01

    Use of a HEPA (high efficiency particulate air) filter in a room is believed to assist in reducing the risk of transmission of infectious diseases through removing the particles or large droplets to which pathogens may be attached. Use of a portable HEPA filter(s) in hospital wards is hypothesized...... to increase the effective ventilation rate (for particles only). Use of a portable HEPA filter is also hypothesized to increase the effective airflow rate of the general ward to the standard of an isolation ward for emerging infection diseases. This may be a good solution for housing patients when...... the number of beds in an isolation ward is insufficient. An experiment was conducted in a full scale experimental ward with a dimension of 6.7 m × 6 m × 2.7 m and 6 beds to test these hypotheses for a portable HEPA filter. The removal efficiency for different size particles was measured at different...

  5. Sociodemographic characteristics and frequency of psychiatric disorders in Turkish pilgrims attended to psychiatry outpatient clinics during Hajj

    Şakir Özen

    2010-03-01

    Full Text Available Objectives: The psychiatric problems of pilgrims fromnon-Arabic speaking countries have not been investigatedsufficiently. The aim of this study was to investigate thefrequency of psychiatric disorders and socio-demographiccharacteristics of Turkish pilgrims in psychiatry departmentof Turkish Mecca Hospital.Methods: A detailed psychiatric interview was performedon 294 Turkish Pilgrims who attended the outpatient clinicof the psychiatric unit at the Turkish hospital in Mecca,Saudi Arabia, during 2008 Hajj period. Information wascollected by using a semi-structured form and the patients’diagnoses were done according to the DSM-IV-TRcriteria.Results: The study group consisted of 175 women (59.5% and 119 men (40.5 % with the mean age of 53.0±13years. A total of 71 % patients had not traveled abroadpreviously, and 60% had received a former psychiatrictreatment. The commonest disorders were found asdepression (26.5%, adjustment disorder with anxiety(16.3% and panic disorder (14% in the patients. Anxietydisorders alone or co-morbid with any other psychiatricdisorder were found in 49% of the patients. Nine percentof the patients had symptoms of acute psychosis, schizophrenia,dementia or mania which could prevent pilgrimsfrom performing Hajj rituals. Suicide attempt, alcohol andillicit drug use were not detected.Conclusions: Previous psychiatric admission and absenceof any foreign travel experience were commonamong Turkish pilgrims who had sought psychiatric helpduring the Hajj. Psychiatric disorders seems to be relatedwith older age, low educational level, and having previousmedical and psychiatric problems.

  6. “They can do whatever they want”: Meanings of receiving psychiatric care based on a common staff approach

    Per Enarsson

    2011-02-01

    Full Text Available This study deepens our understanding of how patients, when cared for in a psychiatric ward, experience situations that involve being handled according to a common staff approach. Interviews with nine former psychiatric in-patients were analyzed using a phenomenological–hermeneutic method to illuminate the lived experience of receiving care based on a common staff approach. The results revealed several meanings: discovering that you are as subjected to a common staff approach, becoming aware that no one cares, becoming aware that your freedom is restricted, being afflicted, becoming aware that a common staff approach is not applied by all staff, and feeling safe because someone else is responsible. The comprehensive understanding was that the patient's understanding of being cared for according to a common staff approach was to be seen and treated in accordance with others’ beliefs and valuations, not in line with the patients’ own self-image, while experiencing feelings of affliction.

  7. Non-invasive mechanic ventilation in treating acute respiratory failure

    Federico Lari; Novella Scandellari; Ferdinando De Maria; Virna Zecchi; Gianpaolo Bragagni; Fabrizio Giostra; Nicola DiBattista

    2009-01-01

    Non invasive ventilation (NIV) in acute respiratory failure (ARF) improve clinical parameters, arterial blood gases, decrease mortality and endo tracheal intubation (ETI) rate also outside the intensive care units (ICUs). Objective of this study is to verify applicability of NIV in a general non respiratory medical ward. We enrolled 68 consecutive patients (Pts) with Hypoxemic or Hyper capnic ARF: acute cardiogenic pulmonary edema (ACPE), exacerbation of chronic obstructive pulmonary disease ...

  8. A STUDY OF PSYCHIATRIC FACTORS IN PATIENTS PRESENTED WITH ATTEMPTED SUICIDE IN A STATE CAPITAL MEDICAL COLLEGE HOSPITAL IN CENTRAL INDIA

    Keshav

    2016-01-01

    Full Text Available Suicide is one of the commonest psychiatric emergencies. According to WHO report, 1999 suicide was one of the top three leading causes of death among people aged 15-34 years in all countries. In recent years, attempted suicide has become the focus of research as it has been found to be the predictor of suicide. Psychiatric factors are one of the important determinants in attempted suicide. OBEJCTIVES The aim of the present study was to analyse the psychiatric factors in attempted suicide. METHODS The present study was conducted in the Department of Medicine and Department of Psychiatry, Gandhi Medical College and associated Hamidia Hospital Bhopal. Study based on the patients admitted in Medicine/Psychiatry ward or attending Out Patients Department with history of suicidal attempts, during the period December 2006 to November 2007. RESULTS Psychiatric disorders were present in 74.25%, while no psychiatric disorder was present in rest of 25.75%. CONCLUSION Major depressive disorder accounting for 34.69% cases, was the most common concurrent psychiatric illness among the study group.

  9. Children and adolescents in the Psychiatric Emergency Department: a 10-year survey in Copenhagen County

    Taastrøm, Annette; Klahn, Julie; Staal, Nina;

    2014-01-01

    Background: Knowledge on psychiatric emergencies in children and adolescents is limited. The Psychiatric Emergency Departments (PED) in Copenhagen enable the acute examination of children and adolescents 24 h a day, 7 days a week. However, very little is known about who presents to the PED, and the...... thorough analysis was performed, based on the individual emergency charts. Inter-rater reliability was high. Results: Visits increased nearly threefold during the period. Symptom score for 2003 and 2006 revealed that more than one third of the visitors had suicidal ideation. Depressive and anxiety symptoms...

  10. The day-to-day acute effect of wake therapy in patients with major depression using the HAM-D6 as primary outcome measure: results from a randomised controlled trial.

    Klaus Martiny

    Full Text Available BACKGROUND: This paper reports day-to-day data for from a one-week intervention phase, part of a 9-weeks randomised parallel study with patient having major depression (data from weekly visits have been reported. Wake therapy (sleep deprivation has an established antidepressant effect with onset of action within hours. Deterioration on the following night's sleep is, however, common, and we used daily light therapy and sleep time stabilisation as a preventive measure. In particular, we evaluated the day-to-day acute effect of and tolerance to sleep deprivation and examined predictors of response. METHODS: Patients were assessed at psychiatric inpatient wards. In the wake group (n = 36, patients did three wake therapies in combination with light therapy each morning together with sleep time stabilisation. In the exercise group (n = 38, patients did daily exercise. Hamilton subscale scores were primary outcome (not blinded, secondary outcome was self-assessment data from the Preskorn scale and sleep. RESULTS: Patients in the wake therapy group had an immediate, large, stable, and statistically significant better antidepressant effect than patients in the exercise group with response rates at day5 of 75.0%/25.1% and remission rates of 58.6%/6.0%, respectively. The response and remission rates were diminished at day8 with response rates of 41.9%/10.1% and remission rates of 19.4%/4.7%, respectively. Patients and ward personnel found the method applicable with few side effects. Positive diurnal variation (mood better in the evening predicted a larger response to wake therapy. In the wake group napping on days after intervention predicted greater deterioration on day8. CONCLUSIONS: The intervention induced an acute antidepressant response without relapse between wake nights but with a diminishing effect after intervention. Development is still needed to secure maintenance of response. Avoiding napping in the days after wake therapy is

  11. Porphyria or Catatonia: Diagnostic Dilemma on the Medical Wards.

    Kurkjian, Natalie; Tucker, Phebe

    2016-01-01

    A 24-year-old Caucasian female, DD, was admitted to the medical service at an academic hospital with symptoms of weakness in bilateral lower extremities, falls, headaches, and altered mental status. Psychiatry was consulted to evaluate for psychiatric causes of her symptoms. This case presented a diagnostic challenge as the patient's identified symptoms changed almost daily, depending on what practitioner or medical service she encountered. In this study, we discuss the differential diagnoses, tests and treatments the patient received, with a review of literature helping differentiate between diagnostic parameters. PMID:27027143

  12. Feasibility of Progressive Strength Training Implemented in the Acute Ward after Hip Fracture Surgery

    Kronborg, Lise; Bandholm, Thomas; Palm, Henrik;

    2014-01-01

    IMPORTANCE: Patients with a hip fracture lose more than 50% knee-extension strength in the fractured limb within one week of surgery. Hence, immediate progressive strength training following hip fracture surgery may be rational, but the feasibility unknown. OBJECTIVE: To examine the feasibility of...... sample of 36 patients, 18 with a cervical and 18 with a trochanteric hip fracture (27 women and 9 men, mean (SD) age of 79.4 (8.3) years) were included between June and December 2012. INTERVENTION: A daily (on weekdays) program of progressive knee-extension strength training for the fractured limb, using...... ankle weight cuffs in 3 sets of 10 repetition maximum loadings. MAIN OUTCOMES AND MEASURES: The primary outcome was the change in training load (kg) during the knee-extension strength training. The secondary outcomes were changes in hip fracture-related pain and maximal isometric knee-extension strength...

  13. Relatives' view on collaboration with nurses in acute wards: development and testing of a new measure

    Lindhardt, Tove; Nyberg, Per; Hallberg, Ingalill Rahm

    2008-01-01

    , before testing it among 156 relatives. Construct validity was assessed by principal component analysis and test for correlation between factors. Predictive validity was assessed by comparing factor scores with scores in outcome measures. Internal consistency was assessed by Cronbach's alpha for factors......, item-to-total correlation and item-to-item correlation. Systematic internal dropout was investigated. RESULTS: A five-factor solution labelled "influence on decisions", "quality of contact with nurses", "trust and its prerequisites", "achieved information level" and "influence on discharge" showed...... related to higher age and lower educational level. CONCLUSION: The instrument was mainly valid and reliable. The instrument is, to our knowledge, the first of its kind and should be tested on larger samples in various cultural contexts. The feasibility of the instrument may benefit from a reduction of...

  14. [Treatments for otorhinolaryngological patients with psychiatric disorders].

    Nishio, Ayako; Sumi, Takuro; Yamada, Masato; Kuwahata, Yuko

    2013-02-01

    There are few systems in place for patients with psychiatric disorders who need treatments for physical complications. In Tokyo, "The Tokyo metropolitan psychiatric emergency system" was established in 1981, and Ome Municipal General Hospital participated in it. Under this system, fifteen patients with psychiatric disorders were treated for otorhinolaryngological diseases in our department from April 2005 to March 2011. We reviewed the fifteen patients. The coexisting psychiatric disorders were schizophrenia in twelve patients, and mental retardation, Korsakoff's syndrome, and Alzheimer's dementia in one patient each, respectively. All the patients had been receiving psychiatric treatment. The otorhinolaryngological diseases were head and neck cancer in nine patients, chronic sinusitis in three patients, and benign salivary gland tumor, cholesteatoma, and epistaxis in one patient each, respectively. Among the fifteen patients, thirteen could complete their treatment, but two dropped out due to exacerbation of their psychiatric symptoms. The therapeutic course is uncertain in otorhinolaryngological diseases occurring concomitantly with psychiatric disorders, especially in head and neck cancer, because it may be difficult to prioritize the problem when determining the treatment options and delivering the treatment. Thus, we should treat patients with psychiatric disorders carefully on a case-by-case basis depending on their psychiatric symptoms. It is also important to cooperate with psychiatrists and patients' families. PMID:23539958

  15. GENERAL PRACTITIONERS' ATTITUDE TOWARDS PSYCHIATRIC DISORDERS AND PSYCHIATRIC PATIENTS: A SURVEY OF JAIPUR CITY

    Gupta, Ishwar Dayal; Gautam, Shiv; Kamal, Preet

    1992-01-01

    A survey of 40 randomly selected general practitioners was carried out to find out their attitudes towards psychiatric disorders and psychiatric patients by administering a specially designed proforma which recorded sociodemographic characteristics as well as attitudes. Majority of GPs were of the opinion that psychiatric disorders are inherited, can occur in any normal person living under stress, are treatable. They had positive attitude towards psychiatric illness but showed more social dis...

  16. [The depression ward--a review of the current status].

    Wolfersdorf, M; Bahnmüller, J; Bretschneider, S; Brisch, U H; Freeman, G; Heuft, H; Heuft, G; Hrubesch, C; Jontza, T; Keller, F

    1988-07-01

    New therapeutic concepts are usually developed and realised step by step. Over the past years changes occurred mainly in two ways. There is a trend to reduce the size of the psychiatric hospital as such and/or to section off certain areas by introducing specialised units. From the experience with the so called "Affective Disorder Units" or "Mood Clinics" developed the concept of a Depression Unit, first introduced in Europe for research purposes at the Psychiatric University Hospital in Basle in 1968. In Germany the first Depression Unit was established at the PLK Weissenau in 1976. Similar units followed over the years at the PLK Reichenau, Weinsberg, the BKH Günzburg, the Landesklinik Nordschwarzwald Hirsau/Calw and the Rheinische Landesklinik Bedburg-Hau, other hospitals are planning them. Existing units are described in terms of their structural organisation, staffing situation and the service they provide. The concept of the Depression Unit according to criteria laid down agreed upon in the literature is summed up, and emotional atmosphere, structural organisation, activation, and individual therapeutic measures, discussed. Advantages are mentioned such as better understanding of patients, allowing them to let go and be cared for, aimed regression, the effects of being taken along, improved communication, and a way of dealing with suicidal thoughts and depressive behavior that reduces anxiety. Disadvantages such as the danger of spoiling patients or inducing a sense of resignation both in patients and staff are discussed. PMID:3043523

  17. ASD, a Psychiatric Disorder, or Both? Psychiatric Diagnoses in Adolescents with High-Functioning ASD

    Mazefsky, Carla A.; Oswald, Donald P.; Day, Taylor N.; Eack, Shaun M.; Minshew, Nancy J.; Lainhart, Janet E.

    2012-01-01

    Varied presentations of emotion dysregulation in autism complicate diagnostic decision making and may lead to inaccurate psychiatric diagnoses or delayed autism diagnosis for high-functioning children. This pilot study aimed to determine the concordance between prior psychiatric diagnoses and the results of an autism-specific psychiatric interview…

  18. Holomorphic Vector Bundles Corresponding to some Soliton Solutions of the Ward Equation

    Holomorphic vector bundles corresponding to the static soliton solution of the Ward equation were explicitly presented by Ward in terms of a meromorphic framing. Bundles (for simplicity, “bundle” is to be taken throughout to mean “holomorphic vector bundle”) corresponding to all Ward k-soliton solutions whose extended solutions have only simple poles, and some Ward 2-soliton solutions whose extended solutions have only a second-order pole, were explicitly described by us in a previous paper. In this paper, we go on to present some bundles corresponding to soliton-antisoliton solutions of the Ward equation, and Ward 3-soliton solutions whose extended solutions have a simple pole and a double pole. To give some more interpretation of the bundles, we study the second Chern number of the corresponded bundles and find that it can be obtained directly from the patching matrices. We also point out some information about bundles corresponding to Ward soliton solutions whose extended solutions have general pole data at the end of the paper

  19. Holomorphic Vector Bundles Corresponding to some Soliton Solutions of the Ward Equation

    Zhu, Xiujuan, E-mail: yzzhuxiujuan@sina.com [Jiangsu Second Normal University, School of Mathematics and Information Technology (China)

    2015-12-15

    Holomorphic vector bundles corresponding to the static soliton solution of the Ward equation were explicitly presented by Ward in terms of a meromorphic framing. Bundles (for simplicity, “bundle” is to be taken throughout to mean “holomorphic vector bundle”) corresponding to all Ward k-soliton solutions whose extended solutions have only simple poles, and some Ward 2-soliton solutions whose extended solutions have only a second-order pole, were explicitly described by us in a previous paper. In this paper, we go on to present some bundles corresponding to soliton-antisoliton solutions of the Ward equation, and Ward 3-soliton solutions whose extended solutions have a simple pole and a double pole. To give some more interpretation of the bundles, we study the second Chern number of the corresponded bundles and find that it can be obtained directly from the patching matrices. We also point out some information about bundles corresponding to Ward soliton solutions whose extended solutions have general pole data at the end of the paper.

  20. Cannabis abuse : a phenomenological study of the causative factors as perceived by patients with a history of Cannabis use, admitted at Bophelong Psychiatric Hospital in the North West Province / Boitumelo Susan Patricia Ramphomane

    Ramphomane, Boitumelo Susan Patricia

    2005-01-01

    A phenomenological study was carried out to find out from patients with a history of cannabis use. admitted at Bophelong Psychiatric Hospital, reasons or factors that caused them to use/abuse cannabis. An original sample of 30 male patients between the ages of 16-30 years was selected from chronic (rehabilitation) wards of mentally stable patients awaiting discharge. Out of the 30 subjects, 10 protocols were selected for phenomenological explication. An unstructured type of interview was c...

  1. Psychotherapy in Contemporary Psychiatric Practice

    Hadjipavlou, George; Hernandez, Carlos A Sierra; Ogrodniczuk, John S

    2015-01-01

    Objective: American data suggest a declining trend in the provision of psychotherapy by psychiatrists. Nevertheless, the extent to which such findings generalize to psychiatric practice in other countries is unclear. We surveyed psychiatrists in British Columbia to examine whether the reported decline in psychotherapy provision extends to the landscape of Canadian psychiatric practice. Method: A survey was mailed to the entire population of fully licensed psychiatrists registered in British Columbia (n = 623). The survey consisted of 30 items. Descriptive statistics were used to characterize the sample and psychotherapy practice patterns. Associations between variables were evaluated using nonparametric tests. Results: A total of 423 psychiatrists returned the survey, yielding a response rate of 68%. Overall, 80.9% of psychiatrists (n = 342) reported practicing psychotherapy. A decline in the provision of psychotherapy was not observed; in fact, there was an increase in psychotherapy provision among psychiatrists entering practice in the last 10 years. Individual therapy was the predominant format used by psychiatrists. The most common primary theoretical orientation was psychodynamic (29.9%). Regarding actual practice, supportive psychotherapy was practiced most frequently. Professional time constraints were perceived as the most significant barrier to providing psychotherapy. The majority (85%) of clinicians did not view remuneration as a significant barrier to treating patients with psychotherapy. Conclusions: Our findings challenge the prevailing view that psychotherapy is in decline among psychiatrists. Psychiatrists in British Columbia continue to integrate psychotherapy and pharmacotherapy in clinical practice, thus preserving their unique place in the spectrum of mental health services. PMID:26175328

  2. Time Perception and Psychiatric Disorders

    Hatice Ceviz

    2013-09-01

    Full Text Available Time perception is an ability which we use in every moment of daily life, that guides the formation and continuation of our behaviors and from an evolutionary perspective ensures survival. Internal clock models help us to understand time perception. Time perception is known to vary between individuals and particular situations. This variability is explained with the mechanisms which is associated with the processes related to attention, the speed of the internal clock and the memory unit. It is suggested that time perception is mainly associated with the activities of dopamine and acetylcholine. Some dopaminergic psychoactive substances like cocaine and amphetamine have all been shown to change time perception by increasing the speed of internal clock while on the other hand some antipsychotic drugs make an opposite change in time perception by descreasing the speed of the clock. Similarly, time perception is affected in some psychiatric disorders and an ethiopathological relationship between time perception disturbances and psychiatric disorders is suggested. In this article time perception changes in schizophrenia, attention deficit/hyperactivity syndrome, depression, anxiety disorders and personality disorders are briefly reviewed.

  3. Psychiatric rehabilitation education for physicians.

    Rudnick, Abraham; Eastwood, Diane

    2013-06-01

    As part of a rapidly spreading reform toward recovery-oriented services, mental health care systems are adopting Psychiatric/Psychosocial Rehabilitation (PSR). Accordingly, PSR education and training programs are now available and accessible. Although psychiatrists and sometimes other physicians (such as family physicians) provide important services to people with serious mental illnesses and may, therefore, need knowledge and skill in PSR, it seems that the medical profession has been slow to participate in PSR education. Based on our experience working in Canada as academic psychiatrists who are also Certified Psychiatric Rehabilitation Practitioners (CPRPs), we offer descriptions of several Canadian initiatives that involve physicians in PSR education. Multiple frameworks guide PSR education for physicians. First, guidance is provided by published PSR principles, such as the importance of self-determination (www.psrrpscanada.ca). Second, guidance is provided by adult education (andragogy) principles, emphasizing the importance of addressing attitudes in addition to knowledge and skills (Knowles, Holton, & Swanson, 2011). Third, guidance in Canada is provided by Canadian Medical Education Directives for Specialists (CanMEDS) principles, which delineate the multiple roles of physicians beyond that of medical expert (Frank, 2005) and have recently been adopted in Australia (Boyce, Spratt, Davies, & McEvoy, 2011). PMID:23750768

  4. Psychiatric disorders and sexual dysfunction.

    Waldinger, Marcel D

    2015-01-01

    Sexual problems are highly prevalent among patients with psychiatric disorders. They may be caused by the psychopathology of the psychiatric disorder but also by its pharmacotherapy. Both positive symptoms (e.g., psychosis, hallucinations) as well as negative symptoms (e.g., anhedonia) of schizophrenia may negatively interfere with interpersonal and sexual relationships. Atypical antipsychotics have fewer sexual side-effects than the classic antipsychotics. Mood disorders may affect libido, sexual arousal, orgasm, and erectile function. With the exception of bupropion, agomelatine, mirtazapine, vortioxetine, amineptine, and moclobemide, all antidepressants cause sexual side-effects. Selective serotonin reuptake inhibitors (SSRIs) may particularly delay ejaculation and female orgasm, but also can cause decreased libido and erectile difficulties. SSRI-induced sexual side-effects are dose-dependent and reversible. Very rarely, their sexual side-effects persist after SSRI discontinuation. This is often preceded by genital anesthesia. Some personality characteristics are a risk factor for sexual dysfunction. Also patients with eating disorders may suffer from sexual difficulties. So far, research into psychotropic-induced sexual side-effects suffers from substantial methodologic limitations. Patients tend not to talk with their clinician about their sexual life. Psychiatrists and other doctors need to take the initiative to talk about the patient's sexual life in order to become informed about potential medication-induced sexual difficulties. PMID:26003261

  5. Purinergic receptors in psychiatric disorders.

    Krügel, Ute

    2016-05-01

    Psychiatric disorders describe different mental or behavioral patterns, causing suffering or poor coping of ordinary life with manifold presentations. Multifactorial processes can contribute to their development and progression. Purinergic neurotransmission and neuromodulation in the brain have attracted increasing therapeutic interest in the field of psychiatry. Purine nucleotides and nucleosides are well recognized as signaling molecules mediating cell to cell communication. The actions of ATP are mediated by ionotropic P2X and metabotropic P2Y receptor subfamilies, whilst the actions of adenosine are mediated by P1 (A1 or A2) adenosine receptors. Purinergic mechanisms and specific receptor subtypes have been shown to be linked to the regulation of many aspects of behavior and mood and to dysregulation in pathological processes of brain function. In this review the recent knowledge on the role of purinergic receptors in the two most frequent psychiatric diseases, major depression and schizophrenia, as well as on related animal models is summarized. At present the most promising data for therapeutic strategies derive from investigations of the adenosine system emphasizing a unique function of A2A receptors at neurons and astrocytes in these disorders. Among the P2 receptor family, in particular P2X7 and P2Y1 receptors were related to disturbances in major depression and schizophrenia, respectively. This article is part of the Special Issue entitled 'Purines in Neurodegeneration and Neuroregeneration'. PMID:26518371

  6. Acute Dystonia Due to Citalopram Treatment: A Case Series

    Moosavi, S. Mohammad; Ahmadi, Mahshid; Monajemi, Mani B.

    2014-01-01

    Introduction: Abnormal movements such as acute dystonia, dyskinesia, parkinsonism, exacerbation of Parkinson disease, akathisia and possibly neuroleptic malignant syndrome may be associated with the use of selective serotonin reuptake inhibitors (SSRIs) rarely. Citalopram, a typical SSRI, used in serotonergic dysfunction related disorders, potentially can cause extrapyramidal symptoms such as acute dystonia. Methods: In a retrospective survey on patients referred to psychiatric clinic between...

  7. Supporting Information Access in a Hospital Ward by a Context-Aware Mobile Electronic Patient Record

    Skov, Mikael B.; Høegh, Rune Thaarup

    2006-01-01

    Context-awareness holds promise for improving the utility of software products. Context-aware mobile systems encompass the ability to automatically discover and react to changes in an environment. Most contemporary context-aware mobile systems aim to support users in private situations, for example......Ward is to support nurses in conducting morning procedures in a hospital ward. MobileWard is context-aware as it is able to discover and react autonomously according to changes in the environment and since it integrates the ability to provide information and services to the user where the relevancy...

  8. Participatory Action Research in clinical nursing practice in a medical ward

    Kjerholt, Mette; Wagner, Lis; Lindhardt, Tove;

    2016-01-01

    Background: Action research with a participatory approach (PAR) was used as research design in a medical ward but stopped midway because of lack of active actor participation in the actions. Aim: To describe challenges and barriers influencing lack of participation. Setting: A medical hospital ward...... framework and conditions are present not only prior to but during the entire project process. Implications. The study shows that PAR is not always suitable as research approach in a busy hospital ward. Furthermore, the study outlines methodological questions in relation to use of PAR....

  9. Acute psychosis induced by isotretinoin

    Rajagopal, Sundararajan

    2014-01-01

    Isotretinoin is used for the treatment of severe acne. Psychiatric side-effects, particularly depression, have been well-documented. This dramatic case report is about a young male patient who developed acute psychosis within a few days of starting isotretinoin. Due to his persecutory delusions, the patient, who was an Indian engineer working in Germany, decided to immediately return to India fearing for his life in Germany. Careful history taking established the cause of the psychosis. Isotr...

  10. Antimicrobial stewardship: Improving antibiotic prescribing practice in a respiratory ward

    Yeo, Jing Ming

    2016-01-01

    International efforts have mandated guidelines on antibiotic use and prescribing, therefore the focus is now on encouraging positive behavioral changes in antibiotic prescribing practice. Documentation of indication and intended duration of antibiotic use in drug charts is an evidence-based method of reducing inappropriate antibiotic prescribing. It is also a standard detailed in our local antimicrobial guidelines. We collected baseline data on compliance with documentation of indication and duration in drug charts in a respiratory ward which revealed compliance rates of 24% and 39% respectively. We introduced interventions to improve accessibility to the guideline and to increase awareness by distributing antibiotic guardian pocket cards with a three-point checklist and strategically-placed mini-posters. We also aim to increase team motivation by obtaining their feedback in multidisciplinary team meetings and by introducing certificates for their involvement in the quality improvement process. The results of the second cycle post-intervention showed an increase in compliance rates for documentation of indication and duration of 97% and 69% respectively. After a further awareness and discussion session at the multidisciplinary team meeting with the local antimicrobial management team audit nurses, a third cycle showed compliance rates of 94% and 71% for indication and duration respectively. This project has highlighted the importance of improving accessibility and of encouraging interventions that would bring about a change in personal value and subsequently in behavior and individual practice. PMID:26893898

  11. Caring for cancer patients on non-specialist wards.

    Gill, Finola

    2012-02-01

    As cancer is the leading cause of death worldwide, every nurse will be required to care for patients with the condition at some point in his\\/her career. However, non-specialized oncology nurses are often ill-prepared to nurse patients suffering from cancer. This literature review aims to provide an overview of current trends and developments in cancer care nursing in an attempt to identify the range of previous research pertaining to caring for patients with cancer on non-specialist wards. The review finds that non-specialized cancer nurses report a lack of education and training with regard to cancer care and cancer treatments, which acts as a barrier to providing quality nursing care. Emotional and communication issues with patients and their families can also cause non-specialist nurses significant distress. International research has shown that specialist oncology nurses make a considerable difference to physical and psychosocial patient care. It is therefore paramount that non-speciality nurses\\' educational needs are met to develop clinical competence and to provide supportive holistic care for both patients and their families.

  12. Enabling coordination within medical settings: case of a maternity ward

    Fouzi LEZZAR

    2013-06-01

    Full Text Available Purpose: This study evaluates the planning process issues in healthcare institutions that can be considered as a high risk environment. Most recent healthcare research has focused on methods mainly based on communication, rather than collaboration supports. Material Methods: We followed then a collaborative-based planning approach which constitutes an evolution of planning environment toward new shared workspaces supporting collaboration. Our work led us first, to analyse the related tasks in an Algerian maternity ward in order to highlight the vital collaborative medical tasks that need to be modelled. Results: the paper summaries basic design concepts of our collaborative planning system that is designed to make group interaction support flexible for care coordination and continuity. Conclusion: after development and test of our collaborative planning system, we noticed that our collaborative and planning system can increase awareness and hence decrease coordination breakdowns, reduce costs of information collecting and sharing. All these factors constitute a crucial aspect of an efficient management of a hospital.

  13. Ward identities and gauge independence in general chiral gauge theories

    Anselmi, Damiano

    2015-07-01

    Using the Batalin-Vilkovisky formalism, we study the Ward identities and the equations of gauge dependence in potentially anomalous general gauge theories, renormalizable or not. A crucial new term, absent in manifestly nonanomalous theories, is responsible for interesting effects. We prove that gauge invariance always implies gauge independence, which in turn ensures perturbative unitarity. Precisely, we consider potentially anomalous theories that are actually free of gauge anomalies thanks to the Adler-Bardeen theorem. We show that when we make a canonical transformation on the tree-level action, it is always possible to re-renormalize the divergences and re-fine-tune the finite local counterterms, so that the renormalized Γ functional of the transformed theory is also free of gauge anomalies, and is related to the renormalized Γ functional of the starting theory by a canonical transformation. An unexpected consequence of our results is that the beta functions of the couplings may depend on the gauge-fixing parameters, although the physical quantities remain gauge independent. We discuss nontrivial checks of high-order calculations based on gauge independence and determine how powerful they are.

  14. Antimicrobial stewardship: Improving antibiotic prescribing practice in a respiratory ward.

    Yeo, Jing Ming

    2016-01-01

    International efforts have mandated guidelines on antibiotic use and prescribing, therefore the focus is now on encouraging positive behavioral changes in antibiotic prescribing practice. Documentation of indication and intended duration of antibiotic use in drug charts is an evidence-based method of reducing inappropriate antibiotic prescribing. It is also a standard detailed in our local antimicrobial guidelines. We collected baseline data on compliance with documentation of indication and duration in drug charts in a respiratory ward which revealed compliance rates of 24% and 39% respectively. We introduced interventions to improve accessibility to the guideline and to increase awareness by distributing antibiotic guardian pocket cards with a three-point checklist and strategically-placed mini-posters. We also aim to increase team motivation by obtaining their feedback in multidisciplinary team meetings and by introducing certificates for their involvement in the quality improvement process. The results of the second cycle post-intervention showed an increase in compliance rates for documentation of indication and duration of 97% and 69% respectively. After a further awareness and discussion session at the multidisciplinary team meeting with the local antimicrobial management team audit nurses, a third cycle showed compliance rates of 94% and 71% for indication and duration respectively. This project has highlighted the importance of improving accessibility and of encouraging interventions that would bring about a change in personal value and subsequently in behavior and individual practice. PMID:26893898

  15. Structure and process factors that influence patients' perception of inpatient psychiatric nursing care at Mathari Hospital, Nairobi.

    Wagoro, M C A; Othieno, C J; Musandu, J; Karani, A

    2008-04-01

    To explore structure and process factors which influence patients' perception of quality inpatient psychiatric nursing care at Mathari hospital. This was a cross-sectional study of 236 inpatients selected by stratified random sampling. Competence to give consent was determined by a minimum score of 24 on Mini Mental State Examination. Patients were interviewed using a semi-structured questionnaire. Differences in proportions of variables were determined by calculating confidence interval and summary chi-squared statistics. P-values of < or =0.05 were considered significant. Majority of patients (87%) were aged 20-49 years with 43% having stayed in the ward for over a month. Structure factors related to patients' perception of care included physical environment, being happy with the way the ward looked was significantly related to satisfaction with care (chi(2) = 5.506, P = 0002). Process factors significantly related to patients' satisfaction with care included nurses providing patients with information on prescribed medicines (chi(2) = 10.50, P = 00012). Satisfaction with care was positively related to ability to recommend someone for admission in the same ward (chi(2) = 20.2, P = 00001). Structure and process factors identified as influencing patients' perception of care were physical environment and nurses' qualities that fit within the characteristics of Peplau's Interpersonal Relations Theory. PMID:18307654

  16. Application of the MIT two-channel model to predict flow recirculation in WARD 61-pin blanket tests

    The preliminary application of MIT TWO-CHANNEL MODEL to WARD sodium blanket tests was presented in this report. Our criterion was employed to predict the recirculation for selected completed (transient and steady state) and proposed (transient only) tests. The heat loss was correlated from the results of the WARD zero power tests. The calculational results show that our criterion agrees with the WARD tests except for WARD RUN 718 for which the criterion predicts a different result from WARD data under bundle heat loss condition. However, if the test assembly is adiabatic, the calculations predict an operating point which is marginally close to the mixed-to-recirculation transition regime

  17. Application of the MIT two-channel model to predict flow recirculation in WARD 61-pin blanket tests

    The preliminary application of MIT two-channel model to WARD sodium blanket tests was presented in this report. The criterion was employed to predict the recirculation for selected completed (transient and steady state) and proposed (transient only) tests. The heat loss was correlated from the results of the WARD zero power tests. The calculational results show that the criterion agrees with the WARD tests except for WARD RUN 718 for which the criterion predicts a different result from WARD data under bundle heat loss condition. However, if the test assembly is adiabatic, the calculations predict an operating point which is marginally close to the mixed-to-recirculation transition regime

  18. Psychiatric disorders in women with fertility problems

    Baldur-Felskov, Birgitte; Kjaer, S K; Albieri, V;

    2013-01-01

    Do women who don't succeed in giving birth after an infertility evaluation have a higher risk of psychiatric disorders compared with women who do?......Do women who don't succeed in giving birth after an infertility evaluation have a higher risk of psychiatric disorders compared with women who do?...

  19. Establishment of a local psychiatric service

    Wang, A G

    1981-01-01

    The Faroe Islands are a group of islands in the North Atlantic Ocean between Norway and Iceland inhabited by about 42,000 people. They are considered a nation with home rule within the Danish Kingdom. A Psychiatric Department was not established on the islands until 1969. Before this, psychiatric...

  20. Psychiatric disorders of patients seeking obesity treatment

    Lin Hung-Yen

    2013-01-01

    Full Text Available Abstract Background Obese and overweight people have a higher risk of both chronic physical illness and mental illness. Obesity is reported to be positively associated with psychiatric disorders, especially in people who seek obesity treatment. At the same time, obesity treatment may be influenced by psychological factors or personality characteristics. This study aimed to understand the prevalence of mental disorders among ethnic Chinese who sought obesity treatment. Methods Subjects were retrospectively recruited from an obesity treatment center in Taiwan. The obesity treatments included bariatric surgery and non-surgery treatment. All subjects underwent a standardized clinical evaluation with two questionnaires and a psychiatric referral when needed. The psychiatric diagnosis was made thorough psychiatric clinic interviews using the SCID. A total of 841 patients were recruited. We compared the difference in psychiatric disorder prevalence between patients with surgical and non-surgical treatment. Results Of the 841 patients, 42% had at least one psychiatric disorder. Mood disorders, anxiety disorders and eating disorders were the most prevalent categories of psychiatric disorders. Females had more mood disorders and eating disorders than males. The surgical group had more binge-eating disorder, adjustment disorder, and sleep disorders than the non-surgical group. Conclusion A high prevalence of psychiatric disorders was found among ethnic Chinese seeking obesity treatment. This is consistent with study results in the US and Europe.

  1. Nursing 302: An Introduction to Psychiatric Nursing.

    Blaustein, Jenna Rose

    A description is provided of "Introduction to Psychiatric Nursing," a 7-week course offered to juniors and seniors in a bachelor of science nursing program. The first sections present information on curricular placement, time assignments, and the targeted student population, and define psychiatric/mental health nursing. Next, the course…

  2. Minor psychiatric morbidity and labour turnover.

    Jenkins, R

    1985-01-01

    The relation of minor psychiatric morbidity with labour turnover is examined, using data from a study of young, predominantly middle class, white collar men and women. The results suggest that the presence of psychiatric symptomatology is at least as important as occupational attitudes in identifying individuals who would subsequently leave the organisation.

  3. Perceived sleep quality of psychiatric patients

    de Niet, G. J. (Gerrit); Tiemens, B. G. (Bea); Lendemeijer, H. H. G. M. (Bert); Hutschemaekers, G. J. M. (Giel)

    2008-01-01

    This paper aims at acquiring knowledge about the quality of sleep of adult and elderly psychiatric patients who receive clinical or outpatient nursing care, and identifying key factors in perceiving a sleep problem. To do so, a sample of 1699 psychiatric patients were asked whether they perceived a

  4. Cultural Issues in Psychiatric Administration and Leadership.

    Aggarwal, Neil Krishan

    2015-09-01

    This paper addresses cultural issues in psychiatric administration and leadership through two issues: (1) the changing culture of psychiatric practice based on new clinician performance metrics and (2) the culture of psychiatric administration and leadership in light of organizational cultural competence. Regarding the first issue, some observers have discussed the challenges of creating novel practice environments that balance business values of efficient performance with fiduciary values of treatment competence. This paper expands upon this discussion, demonstrating that some metrics from the Centers for Medicare & Medicaid Services, the nation's largest funder of postgraduate medical training, may penalize clinicians for patient medication behaviors that are unrelated to clinician performance. A focus on pharmacotherapy over psychotherapy in these metrics has unclear consequences for the future of psychiatric training. Regarding the second issue, studies of psychiatric administration and leadership reveal a disproportionate influence of older men in positions of power despite efforts to recruit women, minorities, and immigrants who increasingly constitute the psychiatric workforce. Organizational cultural competence initiatives can diversify institutional cultures so that psychiatric leaders better reflect the populations they serve. In both cases, psychiatric administrators and leaders play critical roles in ensuring that their organizations respond to social challenges. PMID:26071640

  5. Sleep in Children With Psychiatric Disorders.

    Ramtekkar, Ujjwal; Ivanenko, Anna

    2015-06-01

    Sleep disturbances are common in pediatric psychiatric disorders and constitute key elements in diagnostic symptomatology of various primary psychiatric disorders including bipolar disorder, depression, and anxiety disorder. Although sleep is not included in key defining criteria of some impairing illnesses such as obsessive-compulsive disorder and schizophrenia, these disorders present with a very high prevalence of sleep disturbances. The interaction between sleep and psychopathology is very complex with significant interrelationship in development, severity, and prognosis of psychiatric disorders and comorbid sleep disturbances. The research ranging from small intervention case series to large epidemiologic studies have demonstrated the role of specific sleep complaints in specific psychiatric diagnoses. However, the research using objective instruments such as polysomnography and actigraphy remains limited in youth with psychiatric disorders. The intervention studies using pharmaceutical treatment specifically focusing on sleep disturbances in psychiatric disorders are also sparse in the pediatric literature. Early identification of sleep disturbances and behavioral management using cognitive behavior therapy-based tools appear to be the most effective approach for treatment. The use of psychotropic medications such as selective serotonin reuptake inhibitors for the treatment of primary psychiatric disorder often alleviate the psychological barriers for sleep but may lead to emergence of other sleep issues such as restless leg syndrome. The safety and efficacy data of hypnotics for primary sleep disorders are limited in pediatrics and should be avoided or used with extreme caution in children with comorbid sleep and psychiatric problems. PMID:26072345

  6. Smartphone apps as a new psychiatric treatment

    Dalum, Anette Ellegaard; Arnfred, Sidse Marie

    2014-01-01

    Søg 1 - 1 ud af 1 Smartphone apps as a new psychiatric treatment. Anette Ellegaard Dalum, Sidse Arnfred, 2014, vol. 176, nummer 34, 2014. Ugeskrift for laeger Artikel Importer Fjern......Søg 1 - 1 ud af 1 Smartphone apps as a new psychiatric treatment. Anette Ellegaard Dalum, Sidse Arnfred, 2014, vol. 176, nummer 34, 2014. Ugeskrift for laeger Artikel Importer Fjern...

  7. VIDEOCARE: Decentralised psychiatric emergency care through videoconferencing

    Trondsen Marianne V

    2012-12-01

    Full Text Available Abstract Background Today the availability of specialists is limited for psychiatric patients in rural areas, especially during psychiatric emergencies. To overcome this challenge, the University Hospital of North Norway has implemented a new decentralised on-call system in psychiatric emergencies, by which psychiatrists are accessible by videoconference 24/7. In September 2011, the new on-call system was established in clinical practice for patients and health staff at three regional psychiatric centres in Northern Norway. Although a wide variety of therapies have been successfully delivered by videoconference, there is limited research on the use of videoconferenced consultations with patients in psychiatric emergencies. The aim of this study is to explore the use of videoconference in psychiatric emergencies based on the implementation of this first Norwegian tele-psychiatric service in emergency care. Methods/design The research project is an exploratory case study of a new videoconference service in operation. By applying in-depth interviews with patients, specialists and local health-care staff, we will identify factors that facilitate and hinder use of videoconferencing in psychiatric emergencies, and explore how videoconferenced consultations matter for patients, professional practice and cooperation between levels in psychiatric care. By using an on-going project as the site of research, the case is especially well-suited for generating reliable and valid empirical data. Discussion Results from the study will be of importance for understanding of how videoconferencing may support proper treatment and high-quality health care services in rural areas for patients in psychiatric emergencies.

  8. The influence of dysfunctional impulsivity and alexithymia on aggressive behavior of psychiatric patients.

    de Schutter, Marja A M; Kramer, Hein J M Th; Franken, Ernest J F; Lodewijkx, Hein F M; Kleinepier, Tom

    2016-09-30

    Current approaches in Dutch mental health care institutions towards inpatients' aggression have focused predominantly on environmental factors, such as training the staff in aggression management. However, personality traits might be an important factor in patients' aggression - as shown by incidents in the wards. This study explores the influence of dysfunctional impulsivity and alexithymia on psychiatric patients' aggressive behavior, through self-reports and through involvement in aggressive incidents. Personality traits influencing patients' aggression emphasize the importance of a more direct approach to their aggression. Clinical patients at Dutch mental health care institution Emergis (n=84) filled out questionnaires about their aggressiveness (using Buss and Perry's Aggression Questionnaire Short Form), dysfunctional impulsivity and alexithymia. Multiple regression analyses indicated that dysfunctional impulsivity positively related to self-reported aggressive behavior. The relationship, however, could not be confirmed for inpatients' aggression as reported by the staff on the wards. Unexpectedly affective alexithymia negatively related to hostility. Gender differences in self-reported aggression were found. Female patients showed higher levels of hostility. Regression analyses indicated that the male gender positively related to physical aggression. Findings emphasize the importance of a new approach in Dutch mental health care, in which patients may engage in aggression-regulation training programs. PMID:27387554

  9. The Mind-Body Connection - How to Fight Stress and Ward Off Illness

    ... Navigation Bar Home Current Issue Past Issues The Mind-Body Connection How to Fight Stress and Ward ... take more seriously the popular notions of the mind-body connection," says Esther M. Sternberg, M.D., ...

  10. Extended ward identities and the generator of the supersymmetric structure of the bosonic string

    We show that the supersymmetric structure of the bosonic string introduced by M. Werneck de Olivera et al. is related to the extended Ward identities satisfied by the gauge fixed action. (author). 13 refs

  11. Ward-Takahashi identity for vertex functions of sQED

    Ward-Takahashi identity is an useful tool for calculating amplitude of scattering processes. In the high-order perturbative theory of sQED, propagator and vertex functions contain many high-order corrections. By using Ward-Takahashi identity, each vertex function is separated into two parts: “longitudinal” and “transverse” part. The longitudinal part can be directly calculated from Ward-Takahashi identity. The transverse part depends on the expanding of specific orders of the theory. In this report, we present one method based on the Ward-Takahashi identity, to calculate this part of vertex functions at the one-loop order in arbitrary gauge and dimensions in sQED. (author)

  12. Validation of a checklist to assess ward round performance in internal medicine

    Nørgaard, Kirsten; Ringsted, Charlotte; Dolmans, Diana

    2004-01-01

    construct validity, an observer assessed 4 groups of doctors during performance of a complete ward round (n = 32). The nurse who accompanied the doctor on rounds made a global assessment of the performance. RESULTS: The response rate to the questionnaire was 80.7%. The respondents found that all 10 items on...... supported by the higher scores of experienced doctors compared to those with less experience and the significant correlation between the observer's and nurses' global scores. The developed checklist should be valuable in guiding and assessing trainees on ward round performance.......BACKGROUND: Ward rounds are an essential responsibility for doctors in hospital settings. Tools for guiding and assessing trainees' performance of ward rounds are needed. A checklist was developed for that purpose for use with trainees in internal medicine. OBJECTIVE: To assess the content and...

  13. Cognitive changes in patients with acute phase psychosis - Effects of illicit drug use

    Helle, Siri; Gjestad, Rolf; Johnsen, Erik; Kroken, Rune; Jørgensen, Hugo A; Løberg, Else-Marie

    2014-01-01

    Illicit drug use may influence cognition in non-affective psychosis. Previous studies have shown better cognition in psychosis with illicit drug use as compared to psychosis only. Possibly, illicit drug using patients have more transient drug-related cognitive deficits. Thus, the aim of the present study was to examine cognitive change the first weeks after admission to a psychiatric emergency ward, expecting more cognitive improvement at follow-up in the illicit drug group as compared to psy...

  14. Molecular pathways towards psychiatric disorders

    The observed fibrillar-neuronal organization of the cerebral cortex suggests that in the aetiology of certain psychiatric disorders the genomic response of the neuron to the challenge presented by stress or insults at various stages of development, is to set off a programmed chain of molecular events (or ''pathways''), as demonstrated in previous genetic studies. The understanding of these pathways is important in order to enhance our ability to influence these illnesses, and are hypothesized to be initiated by a nucleolar mechanism for inducing abnormal synthesis of the nerve growth factor (NGF). The hypothesis is used to approach tentatively the still open question regarding the pathogenesis of mental retardation (MR) and senile dementia (SD). (author). 25 refs

  15. Calming an escalated psychiatric milieu.

    Delaney, K R

    1994-01-01

    On inpatient psychiatric units, nurses control the tone, pace, and activity level of the environment. But under the influence of factors such as high patient acuity and negative group contagion, a milieu can become unacceptably loud and chaotic. A volatile milieu is a potentially dangerous environment because patients' anxiety and agitation can quickly lead to acting out and aggression. This article focuses on how nurses can regain control of a milieu spiralling into chaos by tightening the structure of the routine, anticipating potential problems, and maintaining a confident calm manner. The charge nurse orchestrates the staff group's response to escalation through detailed planning, decisive interventions, and strategic use of every available resource. PMID:7697316

  16. Classifying nursing organization in wards in Norwegian hospitals: self-identification versus observation

    Helgeland Jon

    2010-02-01

    Full Text Available Abstract Background The organization of nursing services could be important to the quality of patient care and staff satisfaction. However, there is no universally accepted nomenclature for this organization. The objective of the current study was to classify general hospital wards based on data describing organizational practice reported by the ward nurse managers, and then to compare this classification with the name used in the wards to identify the organizational model (self-identification. Methods In a cross-sectional postal survey, 93 ward nurse managers in Norwegian hospitals responded to questions about nursing organization in their wards, and what they called their organizational models. K-means cluster analysis was used to classify the wards according to the pattern of activities attributed to the different nursing roles and discriminant analysis was used to interpret the solutions. Cross-tabulation was used to validate the solutions and to compare the classification obtained from the cluster analysis with that obtained by self-identification. The bootstrapping technique was used to assess the generalizability of the cluster solution. Results The cluster analyses produced two alternative solutions using two and three clusters, respectively. The three-cluster solution was considered to be the best representation of the organizational models: 32 team leader-dominated wards, 23 primary nurse-dominated wards and 38 wards with a hybrid or mixed organization. There was moderate correspondence between the three-cluster solution and the models obtained by self-identification. Cross-tabulation supported the empirical classification as being representative for variations in nursing service organization. Ninety-four per cent of the bootstrap replications showed the same pattern as the cluster solution in the study sample. Conclusions A meaningful classification of wards was achieved through an empirical cluster solution; this was, however, only

  17. Psoriasis and Associated Psychiatric Disorders

    Abreu, José Luís Pio Da Costa; Reis, José Pedro Gaspar Dos; Figueiredo, Américo Manuel Da Costa

    2016-01-01

    Introduction and objective: Psoriasis is a chronic skin disease with a high impact on self-esteem and patients’ health-related quality of life. In the last decades some studies have pointed out mental disorders associated with psoriasis and the etiopathogenic mechanisms behind that co-existence. This work compiles psychopathology associated with psoriasis and further analyzes the etiopathogenesis of psoriasis and mental disorders. Methods: A systematic review of the literature was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and using the “5S” levels of organization of evidence from healthcare research, as previously described. Results: Psoriasis is linked with many mental disorders, both in the psychotic and neurotic sprectrum. Chronic stress diminishes hypothalamic-pituitary-adrenal axis and upregulates sympathetic-adrenal-medullary responses, stimulating pro-inflammatory cytokines. Then, it maintains and exacerbates psoriasis and some of its mental disorders. High levels of pro-inflammatory cytokines connect psoriasis, psychiatric conditions, and other comorbidities of psoriasis (such as atherosclerosis) within a vicious cycle. Furthermore, the etiopathogenesis of the link between each psychiatric comorbidity and psoriasis has its own subtleties, including the cooccurrence of other comorbidities, the parts of the body affected by psoriasis, treatments, and biological and psychosocial factors. Conclusion: The study of psychopathology can amplify our understanding about the etiopathogenesis of psoriasis and associated mental disorders. Patients would benefit from a psychodermatologic approach. The adequate treatment should take into account the mental disorders associated with psoriasis as well as the circumstances under which they occur.

  18. A rehabilitation ward in a district general hospital: first three years' experience.

    Walsh, K. J.; Barnes, M P; McLellan, D. L.

    1988-01-01

    The experience of the first three years' work on a ward for the rehabilitation of patients was reviewed. Adults with physical disabilities or mixed physical and psychological disabilities, including unstable or deteriorating conditions, were accepted for intensive rehabilitation. Most patients had neurological disorders. The ward policy was that each patient had considerable time with the therapist, maximum personal independence was encouraged, and multidisciplinary staff meetings were held t...

  19. Drinking Water Quality Surveillance in a Vulnerable Urban Ward of Ahmedabad

    Veena Iyer; Nandini Choudhury; Gulrez Shah Azhar; Bhushan Somvanshi

    2014-01-01

    The World Bank estimates that 21% of all communicable diseases in India are related to unsafe water with diarrhoea alone causing more than 0.1 million deaths annually. The WHO drinking water surveillance parameters of quality, quantity, accessibility, affordability and continuity were assessed in one vulnerable ward of Ahmedabad—a fast growing city in Western India. Interviews with key informants of the ward office, health centre and water supply department, secondary analysis and mapping of ...

  20. Closed pelvic fractures: characteristics and outcomes in older patients admitted to medical and geriatric wards

    Morris, R.; Sonibare, A.; Green, D.; Masud, T.

    2000-01-01

    OBJECTIVE—To investigate the characteristics and outcomes of older patients with pelvic fracture admitted to medical and geriatric wards.
METHODS—All patients admitted to medical and geriatric wards with a pelvic fracture over a four year period were identified using the hospital clinical coding database. Data were collected from casenotes, hospital and Family Health Services Authority databases. Where available, pelvic radiographs were graded according to the Singh index.
RESULTS—The casenot...

  1. Prescription and cost-analysis of antiemetic medication use in pediatric wards: a prospective observational study

    Maulik M. Patel; Rana, Devang A.; Patel, Varsha J.; Manish Patel

    2014-01-01

    Background: Use of anti-emetic drugs in pediatric population is often warranted, but choice of drug remains questionable within pediatricians. Objective of current study is: to study prescribing pattern and to calculate cost of antiemetic drug therapy in pediatric wards. Methods: A prospective, observational study was conducted in pediatric wards of a tertiary care hospital of over 14 month’s duration. Institutional ethics committee approval was obtained and written informed consent o...

  2. Ontology-Based Model For The "Ward-round" Process in Healthcare (OMWRP)

    Ali, Abid

    2010-01-01

    Abstract In the current arena, rapid changes are required to address dynamic patient’s treatment process needs according to the patient’s demand in the healthcare sector. This research work addresses existing problems about information flow in ward-round, what is the optimal information need for an individual with his/her competences according to their role during ward-round in healthcare area. This work also mentions what are the certain activities which are required during the patient treat...

  3. On gauge invariance and Ward identities for the Wilsonian Renormalisation Group

    We investigate non-Abelian gauge theories within a Wilsonian Renormalisation Group approach. The cut-off term inherent in this approach leads to a modified Ward identity (mWI). It is shown that this mWI is compatible with the flow and that the full effective action satisfies the usual Ward identity (WI). The universal 1-loop β-function is derived within this approach and the extension to the 2-loop level is briefly outlined

  4. Surveillance of Hospital Acquired Infection in Surgical Wards in Tertiary Care Centre Ahmedabad, Gujarat

    Patel Disha A, Patel Kiran B, Bhatt Seema K, Shah Hetal S

    2011-01-01

    Present study was undertaken to know the rate of Hospital acquired infection in general surgical wards with special reference to surgical site infections with their antibiotic resistance pattern and to find out the source of the infection to develop preventive measures to reduce the risk of hospital acquired infection. Prospective surveillance for hospital acquired infections was performed during period from January 2006 to June 2006 in the wards of general surgery. One day prevalence study w...

  5. Training program conference of "Good Pain Management Ward" was launched in Wuhan

    Yi Cheng

    2012-01-01

    @@ On March 6th, the training program conference of "Good Pain Management Ward" (GPM ward) was launched in the conference hall of Westin Hotel, Wuhan.The conference was hosted by Clinics Medical Secretary, Ministry of Health, and undertaken by CSCO and Mundipharma (China) Pharmaceutical Co., Ltd.Three hundreds experts, doctors and nurses, from departments of oncology, pain, anesthesiology and pharmacy, in 6 provinces (including Hubei, Hunan, Jiangxi, Shanxi, Shanxi, Henan), attended the conference.

  6. Medication prescribing errors and associated factors at the pediatric wards of Dessie Referral Hospital, Northeast Ethiopia

    Zeleke, Abebe; Chanie, Tesfahun; Woldie, Mirkuzie

    2014-01-01

    Background Medication error is common and preventable cause of medical errors and occurs as a result of either human error or a system flaw. The consequences of such errors are more harmful and frequent among pediatric patients. Objective To assess medication prescribing errors and associated factors in the pediatric wards of Dessie Referral Hospital, Northeast Ethiopia. Methods A cross-sectional study was carried out in the pediatric wards of Dessie Referral Hospital from February 17 to Marc...

  7. Neonatal abstinence syndrome: Diagnostic dilemmas in the maternity ward

    Lazić-Mitrović Tanja

    2015-01-01

    Full Text Available Introduction. Neonatal abstinence syndrome (NAS refers to a newborn neurological, gastrointestinal and/or respiratory disorder if a newborn was exposed to psychoactive substances in the intrauterine period. NAS is difficult to diagnose due to unreliability of the data on addictive substances use during pregnancy, limited possibilities of the prenatal exposure diagnosis and postnatal substance detection, which all lead to diagnostic dilemmas. Objective. The aim of this study was to indicate the problems in patients with early NAS diagnosis in the maternity ward and the importance of clinical presentation used as a guide toward the diagnosis. Methods. This retrospective study included five term eutrophic newborns with high Apgar score, good adaptation in the first day and with clinical presentation of NAS during the second day of life. The clinical presentation was dominated by irritability, increased wakefulness, increased muscle tone, shrilly crying, tremors, problems with accepting food, tachypnea, subfebrility and hyperhidrosis. Finnegan scale was introduced in order to diagnose NAS and apply the therapy. Single-medication therapy of phenobarbitone was applied in four cases and a combination of phenobarbitone and morphine in one case. For toxicological analysis newborns’ urine samples were used. Results. Conditions such as perinatal asphyxia, infection, hunger, polycythemia, hypoglycemia or hypocalcemia were excluded. Finnegan score implied that pharmacological treatment had to be administered. The discrepancy between the NAS anamnesis and toxicological analysis existed. Response to the treatment was positive in all cases. Conclusion. NAS is a multisystemic disorder and should be suspected when it is noticed that children exhibit characteristic signs. However, other pathological conditions have to be excluded. Quantification according to the adopted scales for NAS leads toward appropriate treatment and recovery of the newborns.

  8. Assessing and Treating the Patient with Acute Psychotic Disorders.

    Jensen, Lisa; Clough, Rebecca

    2016-06-01

    Patients with acute psychosis often present to emergency departments. Management of acute agitation and psychosis can be a challenge for the staff. Medical stabilization, appropriate assessment, and diagnosis are important. Verbal de-escalation and other psychosocial interventions are helpful in creating a safe and therapeutic environment. Psychiatric and emergency room nurses are poised to treat patients presenting with acute psychosis and must be knowledgeable of evidence-based approaches to treat these complex disorders. PMID:27229275

  9. Connectomics in psychiatric research: advances and applications

    Cao M

    2015-10-01

    Full Text Available Miao Cao,* Zhijiang Wang,* Yong He State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, People’s Republic of China *These authors contributed equally to this work Abstract: Psychiatric disorders disturb higher cognitive functions and severely compromise human health. However, the pathophysiological mechanisms underlying psychiatric disorders are very complex, and understanding these mechanisms remains a great challenge. Currently, many psychiatric disorders are hypothesized to reflect “faulty wiring” or aberrant connectivity in the brains. Imaging connectomics is arising as a promising methodological framework for describing the structural and functional connectivity patterns of the human brain. Recently, alterations of brain networks in the connectome have been reported in various psychiatric disorders, and these alterations may provide biomarkers for disease diagnosis and prognosis for the evaluation of treatment efficacy. Here, we summarize the current achievements in both the structural and functional connectomes in several major psychiatric disorders (eg, schizophrenia, attention-deficit/hyperactivity disorder, and autism based on multi-modal neuroimaging data. We highlight the current progress in the identification of these alterations and the hypotheses concerning the aberrant brain networks in individuals with psychiatric disorders and discuss the research questions that might contribute to a further mechanistic understanding of these disorders from a connectomic perspective.Keywords: psychiatric disorders, connectome, graph theory, functional connectivity, structural connectivity

  10. Brain tumors in patients primarly treated psychiatrically

    Ignjatović-Ristić Dragana

    2011-01-01

    Full Text Available Introduction. Psychiatric symptoms are not rare manifestations of brain tumors. Brain tumors presented by symptoms of raised intracranial pressure, focal neurological signs, or convulsions are usually first seen by the neurologist or less frequently by the neurosurgeon in routine diagnostic procedures. On the other hand, when psychiatric symptoms are the first manifestation in “neurologically silent” brain tumors, the patients are sent to the psychiatrist for the treatment of psychiatric symptoms and brain tumors are left misdiagnosed for a long period of time. Case Report. We presented three patients with the diagnosed brain tumor where psychiatrist had been the first specialist to be consulted. In all three cases neurological examination was generally unremarkable with no focal signs or features of raised intracranial pressure. CT scan demonstrated right insular tumor in a female patient with obsessive-compulsive disorder (OCD; right parietal temporal tumor in a patient with delusions and depression and left frontal tumor in a patient with history of alcohol dependency. Conclusion. Psychiatric symptoms/disorders in patients with brain tumors are not specific enough and can have the same clinical presentation as the genuine psychiatric disorder. Therefore, we emphasize the consideration of neuroimaging in patients with abrupt beginning of psychiatric symptoms, in those with a change in mental status, or when headaches suddenly appear or in cases of treatment resistant psychiatric disorders regardless the lack of neurological symptoms.

  11. Psychiatric comorbidities in dystonia: emerging concepts.

    Zurowski, Mateusz; McDonald, William M; Fox, Susan; Marsh, Laura

    2013-06-15

    Psychiatric disorders are highly prevalent in patients with dystonia and have a profound effect on quality of life. Patients with dystonia frequently meet criteria for anxiety disorders, especially social phobia, and major depressive disorder. Deficits in emotional processing have also been demonstrated in some dystonia populations. Onset of psychiatric disturbances in patients with dystonia often precedes onset of motor symptoms, suggesting that the pathophysiology of dystonia itself contributes to the genesis of psychiatric disturbances. This article examines the hypothesis that mood and anxiety disorders are intrinsic to the neurobiology of dystonia, citing the available literature, which is derived mostly from research on focal isolated dystonias. Limitations of studies are identified, and the role of emotional reactivity, especially in the context of pain secondary to dystonia, is recognized. Available evidence underscores the need to develop dystonia assessment tools that incorporate psychiatric measures. Such tools would allow for a better understanding of the full spectrum of dystonia presentations and facilitate research on the treatment of dystonia as well as the treatment of psychiatric illnesses in the context of dystonia. This article, solicited for a special Movement Disorders issue on novel research findings and emerging concepts in dystonia, addresses the following issues: (1) To what extent are psychiatric disturbances related to the pathophysiology of dystonia? (2) What is the impact of psychiatric disturbances on outcome measures of current assessment tools for dystonia? (3) How do psychiatric comorbidities influence the treatment of dystonia? Answers to these questions will lead to an increased appreciation of psychiatric disorders in dystonia, a better understanding of brain physiology, more nuanced research questions pertaining to this population, better clinical scales that can be used to further patient management and research, and improved

  12. Urgent and Nonurgent Presentations to a Psychiatric Emergency Service in Nigeria: Pattern and Correlates

    Increase Ibukun Adeosun; Abosede Adekeji Adegbohun; Oyetayo Oyewunmi Jeje; Olufemi Oyeleke Oyekunle; Modupeola Olugbemisola Omoniyi

    2014-01-01

    Psychiatric emergencies are acute mental health disturbances that require immediate intervention. However, the emergency department is increasingly being utilised for nonurgent mental health problems, thereby compromising the quality of care available for patients with urgent problems. This study assessed the level and correlates of urgency of mental health problems among patients presenting to an emergency department in Nigeria. The Crisis Triage Rating Scale, Clinical Global Impression Scal...

  13. Technological Advances in Psychiatric Nursing: An update.

    Bostrom, Andrea C

    2016-06-01

    Understanding and treating mental illness has improved in many ways as a result of the fast pace of technological advances. The technologies that have the greatest potential impact are those that (1) increase the knowledge of how the brain functions and changes based on interventions, (2) have the potential to personalize interventions based on understanding genetic factors of drug metabolism and pharmacodynamics, and (3) use information technology to provide treatment in the absence of an adequate mental health workforce. Technologies are explored for psychiatric nurses to consider. Psychiatric nurses are encouraged to consider the experiences of psychiatric patients, including poor health, stigmatization, and suffering. PMID:27229272

  14. Affective responses across psychiatric disorders-A dimensional approach.

    Hägele, Claudia; Friedel, Eva; Schlagenhauf, Florian; Sterzer, Philipp; Beck, Anne; Bermpohl, Felix; Stoy, Meline; Held-Poschardt, Dada; Wittmann, André; Ströhle, Andreas; Heinz, Andreas

    2016-06-01

    Studying psychiatric disorders across nosological boundaries aims at a better understanding of mental disorders by identifying comprehensive signatures of core symptoms. Here, we studied neurobiological correlates of emotion processing in several major psychiatric disorders. We assessed differences between diagnostic groups, and investigated whether there is a psychopathological correlate of emotion processing that transcends disorder categories. 135 patient with psychiatric disorders (alcohol dependence, n=29; schizophrenia, n=37; major depressive disorder (MDD), n=25; acute manic episode of bipolar disorder, n=12; panic disorder, n=12, attention deficit/hyperactivity disorder (ADHD), n=20) and healthy controls (n=40) underwent an functional magnetic resonance imaging (fMRI) experiment with affectively positive, aversive and neutral pictures from the International Affective Picture System (IAPS). Between-group differences were assessed with full-factorial ANOVAs, with age, gender and smoking habits as covariates. Self-ratings of depressed mood and anxiety were correlated with activation clusters showing significant stimulus-evoked fMRI activation. Furthermore, we examined functional connectivity with the amygdala as seed region during the processing of aversive pictures. During the presentation of pleasant stimuli, we observed across all subjects significant activation of the ventromedial prefrontal cortex (vmPFC), bilateral middle temporal gyrus and right precuneus, while a significant activation of the left amygdala and the bilateral middle temporal gyrus was found during the presentation of aversive stimuli. We did neither find any significant interaction with diagnostic group, nor any correlation with depression and anxiety scores at the activated clusters or with amygdala connectivity. Positive and aversive IAPS-stimuli were consistently processed in limbic and prefrontal brain areas, irrespective of diagnostic category. A dimensional correlate of these

  15. Bullying behaviour in relation to psychiatric disorders, suicidality and criminal offences:a study of under-age adolescent inpatients in Northern Finland

    Luukkonen, A.-H. (Anu-Helmi)

    2010-01-01

    Abstract Bullying behaviour is present in the daily life of many adolescents, but research into the serious problems related to this behaviour is still scarce. The aim of this work was to investigate the putative associations of bullying behaviour with psychiatric disorders, substance use, suicidality and criminal offences in a sample of under-age adolescent inpatients in Northern Finland. The epidemiologically unselected sample of 12–17-year-old inpatients in need of acute psychiatr...

  16. Acute psychological effects of one high intensity exercise

    Kleppe, Kim Daniel

    2011-01-01

    The aim of this study was to examine if there are positive acute mood effects of one high intensity exercise. Method: self-completion questionnaires were used to measure the state mood of the participants. 20 persons with a diagnosis of a psychotic disorder (group one), 22 persons with a psychiatric diagnosis of a non-psychotic disorder (group two) and 20 persons with no psychiatric disorder (group three) performed one high intensity exercise while completing the same questionnaire before and...

  17. Prevalence of the catatonic syndrome in an acute inpatient sample

    Mirella eStuivenga; Manuel eMorrens

    2014-01-01

    OBJECTIVE: In this exploratory open label study we investigated the prevalence of catatonia in an acute psychiatric inpatient population. In addition, differences in symptom presentation of catatonia depending on the underlying psychiatric illness were investigated.METHODS: 130 patients were assessed with the Bush-Francis Catatonia Rating Scale (BFCRS), the Positive and Negative Syndrome Scale (PANSS), the Young Mania Rating Scale (YMRS) and the Simpson-Angus Scale (SAS). A factor analysis wa...

  18. Psychological aspects of acute low back pain in general practice

    Gilchrist, Iain C.

    1983-01-01

    A prospective controlled study of acute low back pain in general practice was carried out. The presence of psychiatric illness was measured by use of the general health questionnaire (GHQ), by clinical assessment, and personality factors by use of the Eysenck personality inventory (EPI). It was found that overall the amount of psychiatric illness did not differ between patients with back pain and their controls at the time of presentation, although there was a higher prevalence of previous ps...

  19. Acute Bronchitis

    ... of bronchitis: acute and chronic. Most cases of acute bronchitis get better within several days. But your cough ... that cause colds and the flu often cause acute bronchitis. These viruses spread through the air when people ...

  20. Medical and surgical ward rounds in teaching hospitals of Kuwait University: students’ perceptions

    AlMutar S

    2013-09-01

    Full Text Available Sara AlMutar,1 Lulwa AlTourah,1 Hussain Sadeq,2 Jumanah Karim,2 Yousef Marwan3 1Department of Medicine, 2Department of Pediatrics, Mubarak Al-Kabeer Hospital, 3Department of Orthopedic Surgery, Al-Razi Orthopedic Hospital, Kuwait City, Kuwait Background: Teaching sessions for medical students during ward rounds are an essential component of bedside teaching, providing students with the opportunity to regard patients as actual people, and to observe their physical conditions directly, allowing a better understanding of illnesses to be developed. We aim to explore medical students’ perceptions regarding medical and surgical ward rounds within the Faculty of Medicine at Kuwait University, and to evaluate whether this teaching activity is meeting the expectation of learners. Methods: A pretested questionnaire was used to collect data from 141 medical students during the 2012–2013 academic year. They were asked to provide their current and expected ratings about competencies that were supposed to be gained during ward rounds, on a scale from 1 (lowest to 5 (highest. Mean scores were calculated, and the Student t-test was used to compare results. P < 0.05 was the cut-off level for significance. Results: Only 17 students (12.1% declined to participate in the study. The students' current competency scores (for competencies taught within both disciplines – medical and surgical were significantly lower than the scores indicating students’ expectations (P < 0.001. The best-taught competency was bedside examination, in both medical (mean: 3.45 and surgical (mean: 3.05 ward rounds. However, medical ward rounds were better than surgical rounds in covering some competencies, especially the teaching of professional attitude and approach towards patients (P < 0.001. Conclusion: Both medical and surgical ward rounds were deficient in meeting the students’ expectations. Medical educators should utilize the available literature to improve the bedside

  1. Training in Psychiatric Genomics during Residency: A New Challenge

    Winner, Joel G.; Goebert, Deborah; Matsu, Courtenay; Mrazek, David A.

    2010-01-01

    Objective: The authors ascertained the amount of training in psychiatric genomics that is provided in North American psychiatric residency programs. Methods: A sample of 217 chief residents in psychiatric residency programs in the United States and Canada were identified by e-mail and surveyed to assess their training in psychiatric genetics and…

  2. [Sleep disorders associated with psychiatric diseases].

    Sachs, Gabriele

    2013-12-01

    Sleep is a sensitive indicator of well-being and a helpful early-warning symptom in many psychiatric disorders. Healthy sleep and a balanced sleep-wake rhythm are desirable goals of a salutary conduct of life. Preventive and psychoeducational measures should take up this point. Non-organic sleep disorders are commonly associated with psychiatric diseases such as major depressive disorder, hypomania, mania, schizophrenia, anxiety disorders, alcoholism and other substance related disorders as well as dementias. Sleep disturbances are often the first symptoms of a psychiatric disorder and thus important early warning signs. Polysomnography is a useful tool to show the characteristic patterns of sleep disturbances in different psychiatric disorders. PMID:24247059

  3. Supported Education for youth with psychiatric disabilities

    Korevaar, Lies

    2014-01-01

    Higher and advanced vocational education prepare young adults for a career and enhance their life goals.The onset of mental illness generally occurs between 17 and 25 years. For young adults with psychiatric disabilities, educational resources are largely unavailable

  4. Supported education for youth with psychiatric disabilities

    Korevaar, E.L.

    2014-01-01

    Higher and advanced vocational education prepare young adults for a career and enhance their life goals.The onset of mental illness generally occurs between 17 and 25 years. For young adults with psychiatric disabilities, educational resources are largely unavailable

  5. Chromosomal abnormalities in a psychiatric population

    Lewis, K.E.; Lubetsky, M.J.; Wenger, S.L.; Steele, M.W. [Univ. of Pittsburgh Medical Center, PA (United States)

    1995-02-27

    Over a 3.5 year period of time, 345 patients hospitalized for psychiatric problems were evaluated cytogenetically. The patient population included 76% males and 94% children with a mean age of 12 years. The criteria for testing was an undiagnosed etiology for mental retardation and/or autism. Cytogenetic studies identified 11, or 3%, with abnormal karyotypes, including 4 fragile X positive individuals (2 males, 2 females), and 8 with chromosomal aneuploidy, rearrangements, or deletions. While individuals with chromosomal abnormalities do not demonstrate specific behavioral, psychiatric, or developmental problems relative to other psychiatric patients, our results demonstrate the need for an increased awareness to order chromosomal analysis and fragile X testing in those individuals who have combinations of behavioral/psychiatric, learning, communication, or cognitive disturbance. 5 refs., 1 fig., 2 tabs.

  6. Barriers in the treatment of psychiatric disorders

    Anil Kumar

    2016-07-01

    Full Text Available Psychiatric illnesses are very common in prevalence. But not everyone who has a mental illness gets a psychiatric consultation. The causes are many. First, many time people don’t recognise and accept mental illnesses in them as a result of lack of insight and awareness. Secondly, even if they know they have a mental illness, they don’t feel comfortable in disclosing it. Third, after knowing that they have some problems which require help from a doctor, they don’t know whom to consult, where to consult, and how to consult. Fourth, in spite of all possible awareness, there may not be psychiatric facilities nearby. Thus, it becomes utmost necessary to discuss those factors which stop people with psychiatric illnesses to get adequate help so that remedial steps could be taken.

  7. Inpatient Psychiatric Prospective Payment System (IPF PPS)

    U.S. Department of Health & Human Services — This file contains case level data for inpatient psychiatric stays and is derived from 2011 MEDPAR data file and the latest available provider specific file. The...

  8. Neuroreceptor imaging in psychiatric disorders

    Molecular imaging, the study of receptors, transporters and enzymes, as well as other cellular processes, has grown in recent years to be one of the most active neuroimaging areas. The application of single photon emission tomography (SPECT) and positron emission tomography (PET) techniques to the study of psychiatric illness has lead to increased understanding of disease processes as well as validated, in vivo, theories of illness etiology. Within the field of psychiatry these techniques have been applied most widely to the study of schizophrenia. Studies within schizophrenia are largely limited to either the dopamine or serotonin system. This is due in large part to the availability of suitable radiotracers as well as the current theories on the etiology of the illness. Two basic study designs are used when studying schizophrenia using molecular imaging and make up the majority of studies reviewed in this manuscript. The first type, termed ''clinical studies'', compares the findings from PET and SPECT studies in those with schizophrenia to normal controls in an attempt to understand the pathophysiology of the illness. The second study design, termed ''occupancy studies'', uses these techniques to enhance the understanding of the mechanism of action of the medications used in treating this illness. This review will focus on the findings of molecular imaging studies in schizophrenia, focusing, for the most part, on the serotonin and dopamine systems. Emphasis will be placed on how these findings and techniques are currently being used to inform the development of novel treatments for schizophrenia. (author)

  9. Excited delirium: A psychiatric review.

    Lipsedge, Maurice

    2016-04-01

    The term 'excited delirium' (ED) is used to explain sudden and unexpected restraint-related deaths. Since the 1990s, ED has often been identified as the principal cause of death in restrained individuals, rather than the restraint procedure itself. Forensic pathologists and psychiatrists attach different meanings to the term delirium. For psychiatrists, delirium is a specific technical term, which implies a grave and potentially life-threatening underlying physical illness. If a patient dies during a bout of delirium, psychiatrists assume that there will be autopsy evidence to demonstrate the primary underlying organic cause. Conversely, pathologists appear to be using the term ED to refer to restraint-related deaths in either highly disturbed cocaine users or psychiatric patients in a state of extreme agitation. In these cases, there is no underlying physical disorder other than a terminal cardiac arrhythmia. As the term ED has different meanings for psychiatrists and for pathologists, it would be helpful for these two professional groups to develop a mutually agreed terminology. PMID:26055153

  10. Post-partum psychiatric disorders

    Tanvi Vijay Tuteja

    2016-08-01

    Full Text Available Post-partum period is demanding period characterized by overwhelming biological, social and emotional changes. It requires significant personal and interpersonal adaptation, especially in case of primigravida. Childbearing from the standpoint of psychological medicine is the most complex event in human experience. Traditionally Inwood has classified post-partum psychiatric disorders (PPPD as maternity blues, post-partum (postnatal depression and puerperal psychosis (PP. However the spectrum of postpartum phenomenology is widely characterized by range of emotions from transient mood liability, irritability and weepiness to marked agitation, delusions, confusion and delirium. Untreated post-partum depression can have adverse long term effects. For the mother, the episode can be the precursor of chronic recurrent depression. For her children a mother's ongoing depression can contribute to emotional, cognitive and interpersonal problems in later life. And therefore a thorough knowledge of the same is important for all obstetrician and gynecologists. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2497-2502

  11. The psychiatric interview: validity, structure, and subjectivity

    NORDGAARD, JULIE; Sass, Louis A.; Parnas, Josef

    2012-01-01

    There is a glaring gap in the psychiatric literature concerning the nature of psychiatric symptoms and signs, and a corresponding lack of epistemological discussion of psycho-diagnostic interviewing. Contemporary clinical neuroscience heavily relies on the use of fully structured interviews that are historically rooted in logical positivism and behaviorism. These theoretical approaches marked decisively the so-called “operational revolution in psychiatry” leading to the creation of DSM-III. T...

  12. PSYCHIATRIC SEQUELAE OF AMPUTATION : I IMMEDIATE EFFECTS

    Mall, C.P.; Trivedi, J.K.; U.S. Mishra; Sharma, V. P.; Dalal, P.K.; Katiyar, M.; Srivastava, Shrikant; Sinha, P.K.

    1997-01-01

    Twenty-five subjects, who had undergone amputation within last 6 weeks, were studied for psychiatric complications, including phantom limb phenomena. The patients were interviewed on SCID, HRSD and HARS. Out of a total of 25 subjects, 8 (34.6%) developed psychiatric disorders - PTSD and major depression. The whole sample was thus divided into 2 groups-sick and nonsick. Phantom limb was seen in 88% subjects. No significant difference was present between the two groups with regard to presence o...

  13. Psychiatric morbidity among inmates of leprosy homes

    K C Jindal

    2013-01-01

    Full Text Available Context: Leprosy affected people are having high psychological distress and it in turn leads to psychiatric disorders. There is a paucity of literature from our country in this significant health problem. Aims: The aim of this study was to find the prevalence of psychiatric morbidity and its association with sociodemographic and clinical factors among the inmates of leprosy homes. Settings and Design: Study sample was obtained from individuals residing in two leprosy homes of malwa belt of Punjab. Materials and Methods: In screening stage, the study subjects were administered sociodemographic proforma and general health questionnaire (GHQ-12. In the confirmation stage, the study subjects were interviewed in detail and disability assessment was done using World Health Organization disability scale. Final psychiatric diagnosis was made as per ICD-10 criteria′s. Statistical Analysis: Statistical analysis was performed using the descriptive statistics, Chi-square test, analysis of variance, and correlation analysis. Results: Majority of the subjects was in the age group 41-50 years, female, married, illiterate, Hindu and were from nuclear families. Nearly, 50.38% of subjects were having GHQ-12 score more than twelve. Nearly, 55.6% subjects were having psychiatric disorders out of which a large number of patients was diagnosed as having dysthymia. The other psychiatric disorders found in the study population were moderate depressive episode, generalized anxiety disorder, mixed anxiety and depressive disorder and schizophrenia unspecified. Psychiatric morbidity was found to be significantly related to age, family status, and duration of leprosy illness and presence of deformities among inmates. Conclusions: This study highlighted that psychiatric disorders were found in a large number among inmates of leprosy homes. Leprosy eradication program must place specific emphasis on psychiatric care of these patients.

  14. A STUDY OF PSYCHIATRIC ASPECTS OF HYSTERECTOMY

    Vyas, J.N.; R. S. Rathore; P.Sharma; Singhal, A.K.

    1989-01-01

    SUMMARY Thirty women patients who were hysterectomized for non-malignant pathologies were compared with thirty comparable patients who underwent other gynaecological operations. Each patient was subjected to semistructured psychiatric interview, standardised Hindi version of G.H.Q., Hindi version of PEN, I.P.I.S. and BDRI. The diagnosis was made according to I.C.D. - 9. It was observed that patients undergoing hysterectomy do suffer significantly higher psychiatric morbidity (60%), had higher...

  15. Insomnia comorbid to severe psychiatric illness

    Soehner, Adriane M.; Kaplan, Katherine A; Harvey, Allison G.

    2013-01-01

    In psychiatric illness, there is a growing body of evidence indicating that sleep disturbances exert a detrimental influence on the course of these disorders and contribute to impaired function. Even when psychiatric disorders are successfully treated or stabilized, insomnia and other sleep disturbances often fail to remit. The present review focuses on sleep in two severe mental illnesses, namely bipolar disorder and schizophrenia. This article discusses the role of sleep disturbances and al...

  16. Psychiatric Morbidity Among Inmates of Leprosy Homes

    K C Jindal; Gurvinder Pal Singh; Varinder Mohan; Mahajan, B. B.

    2013-01-01

    Context: Leprosy affected people are having high psychological distress and it in turn leads to psychiatric disorders. There is a paucity of literature from our country in this significant health problem. Aims: The aim of this study was to find the prevalence of psychiatric morbidity and its association with sociodemographic and clinical factors among the inmates of leprosy homes. Settings and Design: Study sample was obtained from individuals residing in two leprosy homes of malwa belt of Pu...

  17. Psychiatric syndromes associated with atypical chest pain

    Nikolić Gordana; Tasić Ivan; Manojlović Snežana; Samardžić Ljiljana; Tošić Suzana; Ćirić Zoran

    2010-01-01

    Background/Aim. Chest pain often indicates coronary disease, but in 25% of patients there is no evidence of ischemic heart disease using standard diagnostic tests. Beside that, cardiologic examinations are repeated several times for months. If other medical causes could not be found, there is a possibility that chest pain is a symptom of psychiatric disorder. The aim of this study was to determine the presence of psychiatric syndromes, increased somatization, anxiety, stress life events expos...

  18. Liver Transplant—Psychiatric and Psychosocial Aspects

    Grover, Sandeep; Sarkar, Siddharth

    2012-01-01

    Liver transplantation is a life saving surgical procedure that is associated with improved longevity and enhanced quality of life. The number of successful liver transplants is growing worldwide. The procedure requires a dedicated and trained team of experts. A psychiatrist plays an important role in such a team. Psychiatric and psychosocial assessment is considered imperative to evaluate the candidate's suitability as a transplant recipient. Many psychiatric disorders may lead to the need fo...

  19. Suicide attempts and emergency room psychiatric consultation.

    Zeppegno, Patrizia; Gramaglia, Carla; Castello, Luigi Mario; Bert, Fabrizio; Gualano, Maria Rosaria; Ressico, Francesca; Coppola, Isabella; Avanzi, Gian Carlo; Siliquini, Roberta; Torre, Eugenio

    2015-01-01

    Background Suicidal behaviours are major public health concerns worldwide. They are associated with risk factors that vary with age and gender, occur in combination, and may change over time. The aim of our study was to investigate how frequently patients visiting a hospital emergency room (ER) require a psychiatric consultation for attempted suicide, and to outline the characteristics of this population. Methods Determinants of emergency room visits for psychiatric reasons were studied prosp...

  20. The Geriatric Population and Psychiatric Medication

    Sannidhya Varma; Himanshu Sareen; JK Trivedi

    2010-01-01

    With improvement in medical services in the last few years, there has been a constant rise in the geriatric population throughout the world, more so in the developing countries. The elderly are highly prone to develop psychiatric disorders, probably because of age related changes in the brain, concomitant physical disorders, as well as increased stress in later life. Psychiatric disorders in this population may have a different presentation than in other groups and some of psychopathologies m...

  1. Psychiatric disorders in general paediatric referrals.

    Garralda, M E; Bailey, D.

    1989-01-01

    Detailed interviews with parents of 128 children aged 7 to 12 years consecutively referred to general paediatric clinics identified psychiatric disturbance in 36 (28%) of the children. Emotional disorders were the commonest psychiatric diagnoses (present in two thirds); less frequent diagnoses were conduct disorders (5/36, 14%), mixed conduct/emotional disorders (six, 17%), and hyperkinetic syndrome (three, 8%). Disturbance was related to level of energy, with disturbed children being describ...

  2. Forensic Psychiatric Aspects of Impulse Control Disorders

    Huseyin Soysal

    2015-03-01

    Full Text Available Impulse control disorders is an important psychiatric disorder group which draws attention in recent years. Attention deficit hyperactivity disorder and other classical disorders like pyromania, kleptomania, intermittent explosive disorder and compulsive buying could be evasuated under this topic. The aim of this article is to review forensic psychiatric aspects of impulse control disorders and evaluate the disorders in terms of their legal status. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2015; 7(1: 16-29

  3. Persistence of Impaired Functioning and Psychological Distress After Medical Hospitalization for Men with Co-Occurring Psychiatric and Substance Use Disorders

    Booth, Brenda M; Blow, Frederic C; Loveland Cook, Cynthia A

    2001-01-01

    OBJECTIVE To measure the persistence of impaired health-related quality of life (HRQL) and psychological distress associated with co-occurring psychiatric and substance use disorders in a longitudinal sample of medically hospitalized male veterans. DESIGN A random sample followed observationally for 1 year after study enrollment. SETTING Inpatient medical and surgical wards at three university-affiliated Department of Veterans Affairs Medical Centers. PATIENTS/PARTICIPANTS A random sample of 1,007 admissions to medical and surgical inpatient services, excluding women and admissions for psychiatric reasons. A subset of participants (n = 736) was designated for longitudinal follow-up assessments at 3 and 12 months after study enrollment. This subset was selected to include all possible participants with study-administered psychiatric diagnoses (52%) frequency-matched by date of study enrollment to approximately equivalent numbers of participants without psychiatric diagnoses (48%). MEASUREMENTS AND MAIN RESULTS All participants were administered a computerized structured psychiatric diagnostic interview for 13 psychiatric (include substance use) disorders and received longitudinal assessments at 3 and 12 months on a multidimensional measure of HRQL, the SF-36, and a measure of psychological distress, the Symptom Checklist, 90-item version. On average, HRQL declined and psychological distress increased over time (P < .05). Psychiatric disorders were associated with significantly greater impairments in functioning and increased distress on all measures (P < .001) except physical functioning (P < .05). These results were replicated in the patients (n = 130) who received inpatient or outpatient mental health or substance abuse services. CONCLUSIONS General medical physicians need to evaluate the mental health status of their hospitalized and seriously ill patients. Effective mental health interventions can be initiated posthospitalization, either immediately in primary

  4. Caring potentials in the shadows of power, correction, and discipline - Forensic psychiatric care in the light of the work of Michel Foucault.

    Hörberg, Ulrica; Dahlberg, Karin

    2015-01-01

    The aim of this article is to shed light on contemporary forensic psychiatric care through a philosophical examination of the empirical results from two lifeworld phenomenological studies from the perspective of patients and carers, by using the French philosopher Michel Foucault's historical-philosophical work. Both empirical studies were conducted in a forensic psychiatric setting. The essential results of the two empirical studies were reexamined in a phenomenological meaning analysis to form a new general structure in accordance with the methodological principles of Reflective Lifeworld Research. This general structure shows how the caring on the forensic psychiatric wards appears to be contradictory, in that it is characterized by an unreflective (non-)caring attitude and contributes to an inconsistent and insecure existence. The caring appears to have a corrective approach and thus lacks a clear caring structure, a basic caring approach that patients in forensic psychiatric services have a great need of. To gain a greater understanding of forensic psychiatric caring, the new empirical results were further examined in the light of Foucault's historical-philosophical work. The philosophical examination is presented in terms of the three meaning constituents: Caring as correction and discipline, The existence of power, and Structures and culture in care. The philosophical examination illustrates new meaning nuances of the corrective and disciplinary nature of forensic psychiatric care, its power, and how this is materialized in caring, and what this does to the patients. The examination reveals embedded difficulties in forensic psychiatric care and highlights a need to revisit the aim of such care. PMID:26319100

  5. Caring potentials in the shadows of power, correction, and discipline—Forensic psychiatric care in the light of the work of Michel Foucault

    Hörberg, Ulrica; Dahlberg, Karin

    2015-01-01

    The aim of this article is to shed light on contemporary forensic psychiatric care through a philosophical examination of the empirical results from two lifeworld phenomenological studies from the perspective of patients and carers, by using the French philosopher Michel Foucault's historical–philosophical work. Both empirical studies were conducted in a forensic psychiatric setting. The essential results of the two empirical studies were reexamined in a phenomenological meaning analysis to form a new general structure in accordance with the methodological principles of Reflective Lifeworld Research. This general structure shows how the caring on the forensic psychiatric wards appears to be contradictory, in that it is characterized by an unreflective (non-)caring attitude and contributes to an inconsistent and insecure existence. The caring appears to have a corrective approach and thus lacks a clear caring structure, a basic caring approach that patients in forensic psychiatric services have a great need of. To gain a greater understanding of forensic psychiatric caring, the new empirical results were further examined in the light of Foucault's historical–philosophical work. The philosophical examination is presented in terms of the three meaning constituents: Caring as correction and discipline, The existence of power, and Structures and culture in care. The philosophical examination illustrates new meaning nuances of the corrective and disciplinary nature of forensic psychiatric care, its power, and how this is materialized in caring, and what this does to the patients. The examination reveals embedded difficulties in forensic psychiatric care and highlights a need to revisit the aim of such care. PMID:26319100

  6. Caring potentials in the shadows of power, correction, and discipline—Forensic psychiatric care in the light of the work of Michel Foucault

    Ulrica Hörberg

    2015-08-01

    Full Text Available The aim of this article is to shed light on contemporary forensic psychiatric care through a philosophical examination of the empirical results from two lifeworld phenomenological studies from the perspective of patients and carers, by using the French philosopher Michel Foucault's historical–philosophical work. Both empirical studies were conducted in a forensic psychiatric setting. The essential results of the two empirical studies were reexamined in a phenomenological meaning analysis to form a new general structure in accordance with the methodological principles of Reflective Lifeworld Research. This general structure shows how the caring on the forensic psychiatric wards appears to be contradictory, in that it is characterized by an unreflective (non-caring attitude and contributes to an inconsistent and insecure existence. The caring appears to have a corrective approach and thus lacks a clear caring structure, a basic caring approach that patients in forensic psychiatric services have a great need of. To gain a greater understanding of forensic psychiatric caring, the new empirical results were further examined in the light of Foucault's historical–philosophical work. The philosophical examination is presented in terms of the three meaning constituents: Caring as correction and discipline, The existence of power, and Structures and culture in care. The philosophical examination illustrates new meaning nuances of the corrective and disciplinary nature of forensic psychiatric care, its power, and how this is materialized in caring, and what this does to the patients. The examination reveals embedded difficulties in forensic psychiatric care and highlights a need to revisit the aim of such care.

  7. Resilience of 'Nightingale' hospital wards in a changing climate

    Lomas, K. J.; Giridharan, R; Short, C. A.; Fair, Alistair

    2012-01-01

    The National Health Service (NHS) Estate in England comprises more than 30 Mm2 with 18.83 Mm2 of acute hospital accommodation on 330 sites. There is concern about the resilience of these buildings in a changing climate, informed by the experience of recent heatwaves. However, the widespread installation of air conditioning would disrupt the achievement of ambitious energy reduction targets. The research project ‘Design and Delivery of Robust Hospital Environments in a Changing Climate’ is att...

  8. Connectomics in psychiatric research: advances and applications.

    Cao, Miao; Wang, Zhijiang; He, Yong

    2015-01-01

    Psychiatric disorders disturb higher cognitive functions and severely compromise human health. However, the pathophysiological mechanisms underlying psychiatric disorders are very complex, and understanding these mechanisms remains a great challenge. Currently, many psychiatric disorders are hypothesized to reflect "faulty wiring" or aberrant connectivity in the brains. Imaging connectomics is arising as a promising methodological framework for describing the structural and functional connectivity patterns of the human brain. Recently, alterations of brain networks in the connectome have been reported in various psychiatric disorders, and these alterations may provide biomarkers for disease diagnosis and prognosis for the evaluation of treatment efficacy. Here, we summarize the current achievements in both the structural and functional connectomes in several major psychiatric disorders (eg, schizophrenia, attention-deficit/hyperactivity disorder, and autism) based on multi-modal neuroimaging data. We highlight the current progress in the identification of these alterations and the hypotheses concerning the aberrant brain networks in individuals with psychiatric disorders and discuss the research questions that might contribute to a further mechanistic understanding of these disorders from a connectomic perspective. PMID:26604764

  9. A study of suicide and attempted suicide by self-immolation in an Irish psychiatric population: an increasing problem.

    O'Donoghue, J M

    2012-02-03

    In the Western World self-immolation is an uncommon but dramatic method of attempting suicide. In-patients who attempt suicide by fire-setting tend to be female with severe psychopathology. In a previous study from the South of Ireland, seven cases from a psychiatric and prison population were identified in a five year period from 1984 to 1989. This would represent an annual rate of 1.07 per cent of burns treated in the burns unit at Cork University Hospital. In this study 12 cases were identified for the years 1994 and 1995. This represents an increase of 3.5 per cent from 1.07 to 4.6 per cent of all burns treated at the same institution. Ten of these patients had a previous psychiatric history and eight of them were resident on a psychiatric ward when they committed the act. Seven of the patients were found to have a high degree of suicide intent of whom four died of their injuries, which gives a mortality rate for this group of 33 per cent. Effective prevention policies are necessary if this increasing problem is to be curtailed.

  10. Neuroreceptor imaging in psychiatric disorders

    Frankle, W.G. [Columbia Univ., New York, NY, (United States). Coll. of Physicians and Surgeons; Laruelle, M. [Columbia Univ., New York, NY (United States). New York State Psychiatric Inst.

    2002-11-01

    Molecular imaging, the study of receptors, transporters and enzymes, as well as other cellular processes, has grown in recent years to be one of the most active neuroimaging areas. The application of single photon emission tomography (SPECT) and positron emission tomography (PET) techniques to the study of psychiatric illness has lead to increased understanding of disease processes as well as validated, in vivo, theories of illness etiology. Within the field of psychiatry these techniques have been applied most widely to the study of schizophrenia. Studies within schizophrenia are largely limited to either the dopamine or serotonin system. This is due in large part to the availability of suitable radiotracers as well as the current theories on the etiology of the illness. Two basic study designs are used when studying schizophrenia using molecular imaging and make up the majority of studies reviewed in this manuscript. The first type, termed ''clinical studies'', compares the findings from PET and SPECT studies in those with schizophrenia to normal controls in an attempt to understand the pathophysiology of the illness. The second study design, termed ''occupancy studies'', uses these techniques to enhance the understanding of the mechanism of action of the medications used in treating this illness. This review will focus on the findings of molecular imaging studies in schizophrenia, focusing, for the most part, on the serotonin and dopamine systems. Emphasis will be placed on how these findings and techniques are currently being used to inform the development of novel treatments for schizophrenia. (author)

  11. Torture: psychiatric sequelae and phenomenology.

    Doerr-Zegers, O; Hartmann, L; Lira, E; Weinstein, E

    1992-05-01

    Torture has been defined by the United Nations (declaration of December 9, 1975) as "every act by which a public functionary (or another person at his instigation) intentionally inflicts on another person serious pain or suffering, ...physical or mental, with the object of obtaining information or of punishing him...or of intimidating that person or others." In Chile, from the 1973 military coup d'Etat up to the 1988 plebiscite, torture was practiced in a systematic way, as a method of interrogation and as a means of intimidation of detainees and, indirectly, of the population at large. In the beginning, torture was applied in military station units and in police stations, in the facilities of sport fields and prisoners' camps; but above all, in clandestine detention centers and prisons belonging to the secret police (Amnesty International 1977, 1983; CODEPU 1984, 1985, 1986; Lira and Weinstein 1987; Muñoz 1986; Rodríguez de Ruiz-Tagle 1978). In spite of the bloodshed of the 1973 coup d'Etat, the phenomenon of torture came as a total surprise for the detainees, who had very often voluntarily surrendered themselves to the new authorities, and who, given the civil traditions of the country, expected treatment in accordance with a society subject to the law. The military government regularly denied having undertaken the practice of torture. According to Lira and Weinstein (20), this denial of such an extreme experience or horror made it even more difficult to overcome the trauma and fostered the development of chronic psychiatric pathology. PMID:1603873

  12. Acquired CNS Demyelinating Syndrome in Children Referred to Shiraz Pediatric Neurology Ward

    Soroor INALOO*

    2014-04-01

    Full Text Available How to Cite This Article: Inaloo S, Haghbin S, Moradi M, Dashti H, Safari N. Acquired CNS Demyelinating Syndrome in Children Referred to Shiraz Pediatric Neurology Ward. Iran J Child Neurol. 2014 Spring; 8(2:18-23.ObjectiveIncidence of CNS acquired demyelinating syndrome (ADS, especially multiple sclerosis (MS in children, appears to be on the rise worldwide. The objective of this study was to determine prevalence, clinical presentation, neuroimagingfeatures, and prognosis of different types of ADS in Iranian children.Materials & MethodsDuring the period 2002-2012, all the patients (aged 1-18 years with ADS, such as MS, acute disseminated encephalomyelitis (ADEM, optic neurotic (ON, Devic disease, and transverse myelitis (TM, referred to the pediatric neurology ward, Nemazee Hospital, Shiraz University of Medical Sciences, were includedin this study. Demographic data, clinical signs and symptoms, past and family history, preclinical findings, clinical course, and outcome were obtained.ResultsWe identified 88 patients with ADS in our center. The most prevalent disease was MS with 36.5% (n=32, followed by AEDM 26.1% (n=31, ON 17% (n=13, TM 15.9% (n=14, and Devic disease 4.5% (n=4. MS, ON, TM were morecommon among females while ADEM was more common in males. Children with ADEM were significantly younger than those with other types of ADS.Family history was positive in 10% of patients with MS.Previous history of recent infection was considerably seen in cases with ADEM.Clinical presentation and prognosis in this study was in accordance with those in previous studies on children.ConclusionIn this study, the most common type of ADS was MS, which was more common in female and older age cases. ADEM was more common in male and younger children. ADEM and ON had the best and Devic disease had the worst prognosis.References1. Longer-Gould A, Zhaug JL, Chung J, Yeung Y, Wanbant E, Yao J. Incidence of acquired CNS demyelinating syndrome in a

  13. Psychiatric Aspects of Childhood Epilepsy

    Raman Deep PATTANAYAK

    2012-06-01

    Full Text Available How to Cite this Article: Pattanayak RD, Sagar R. Psychiatric Aspects of Childhood Epilepsy. Iran J Child Neurol 2012;6(2:9-18.Childhood epilepsy is a chronic, recurrent disorder of unprovoked seizures. Theonset of epilepsy in childhood has significant implications for brain growth anddevelopment. Seizures may impair the ongoing neurodevelopmental processes and compromise the child’s intellectual and cognitive functioning, leading totremendous cognitive, behavioral and psychosocial consequences. Children with epilepsy are at increased risk for emotional and behavioral problems. In addition to the direct effects of epilepsy, there are multiple contributory factors including the underlying neurological abnormalities and adverse effects of medication. This review discusses the current understanding of various psychiatric aspects of childhood epilepsy, including the neuropsychological, behavioral and psychosocial concomitants of childhood epilepsy.References1. Shinnar S, Pellock JM. Update on the epidemiology and prognosis of pediatric epilepsy. J Child Neurol 2002;7 suppl 1:4-17.2. Murphy CC, Trevathan E, Yeargin-Allsopp M. Prevalence of epilepsy and epileptic seizures in 10-year-old children: results from the Metropolitan Atlanta Developmental Disabilities Study. Epilepsia 1995;36(9:866-72.3. Placencia M, Shorvon SD, Paredes V, Bimos C, Sander JW, Suarez J, et al. Epileptic seizures in an Andean region of Ecuador ncidence and prevalence and regional variation. Brain 1992;115:771-82.4. Henkin Y, Sadeh M, Kivity S, Shabtai E, KishonRabin L, Gadoth N. Cognitive function in idiopathic generalized epilepsy of childhood. Dev Med Child Neurol 2005;47:126-32.5. Rodenburg R, Stams GJ, Meijer AM, Aldenkamp AP, Dekovic M. Psychopathology in children with epilepsy: a meta-analysis. J Pediatr Psychol 2005;30(6:453-68.6. Caplan R, Siddarth P, Gurbani S, Ott D, Sankar R, Shields WD. Psychopathology and pediatric complex partial seizures: seizure

  14. Aggressive behaviors in the psychiatric emergency service

    Yves Chaput; Lucie Beaulieu; Michel Paradis; et al, ...

    2011-01-01

    Yves Chaput1, Lucie Beaulieu2, Michel Paradis3, Edith Labonté41Department of Psychiatry, McGill University, Montreal (presently in private practice); 2Department of Psychiatry, Haut Richelieu Hospital, Saint-Jean-sur-Richelieu, Quebec; 3Department of Psychiatry, University of Montreal, Montreal; 4Department of Psychiatry, Laval University, Quebec, CanadaIntroduction: Studies of aggressive behaviors in a nonforensic mental health setting have focused primarily on the inpatient ward ...

  15. Outbreak of respiratory syncytial virus (RSV) infection in immunocompromised adults on a hematology ward.

    Jensen, Tomas Ostergaard; Stelzer-Braid, Sacha; Willenborg, Christiana; Cheung, Carol; Andresen, David; Rawlinson, William; Clezy, Kate

    2016-10-01

    We describe an outbreak of respiratory syncytial virus (RSV) infection on a hematology ward without allogeneic stem cell transplant patients. Twelve patients and one staff member infected with RSV were identified from the laboratory database. Five patients had lower respiratory tract infection, seven had upper respiratory tract infection, one was asymptomatic, and there were two (15.4%) deaths. Most patients had overlapping periods of potential infectiousness on the ward. Sequencing was possible on eight specimens and five of these had identical sequences. Results were consistent with transmission occurring both on the ward and by introduction of RSV from the community. J. Med. Virol. 88:1827-1831, 2016. © 2016 Wiley Periodicals, Inc. PMID:26990584

  16. Implementation and Evaluation of a Ward-Based eLearning Program for Trauma Patient Management.

    Curtis, Kate; Wiseman, Taneal; Kennedy, Belinda; Kourouche, Sarah; Goldsmith, Helen

    2016-01-01

    The majority of trauma nursing education is focused on the emergency phases of care. We describe the development and evaluation of a trauma eLearning module for the ward environment. The module was developed using adult learning principles and implemented in 2 surgical wards. There were 3 phases of evaluation: (1) self-efficacy of nurses; (2) relevance and usability of the module and; (3) application of knowledge learnt. The majority indicated they had applied new knowledge, particularly when performing a physical assessment (85.7%), communicating (91.4%), and identifying risk of serious illness (90.4%). Self-efficacy relating to confidence in caring for patients, communication, and escalating clinical deterioration improved (p = .023). An eLearning trauma patient assessment module for ward nursing staff improves nursing knowledge and self-efficacy. PMID:26745537

  17. The Master Ward Identity and generalized Schwinger-Dyson Equation in classical field theory

    In the framework of perturbative quantum field theory a new, universal renormalization condition (called Master Ward Identity) was recently proposed by one of us (M.D.) in a joint paper with F.-M. Boas. The main aim of the present paper is to get a better understanding of the Master Ward Identity by analyzing its meaning in classical field theory. It turns out that it is the most general identity for classical local fields which follows from the field equations. It is equivalent to a generalization of the Schwinger-Dyson Equation and is closely related to the Quantum Action Principle of Lowenstein and Lam. The validity of the Master Ward Identity makes possible a local construction of quantum gauge theories. (orig.)

  18. The effects of introducing a clinical pharmacist on orthopaedic wards in Denmark

    Buck, Thomas Croft; Brandstrup, Lene; Brandslund, Ivan;

    2007-01-01

    OBJECTIVE: To assess the effects and cost effects of introducing clinical pharmacists on hospital wards. METHODS: Comparative prospective study on four orthopaedic surgical wards in two hospitals. The primary effect variables were 10 target areas widely considered to be indicators of good...... sub-optimal prescriptions were changed, 43% resulted in cost reductions. The reductions achieved could cover 47% of the costs of clinical pharmacy service. CONCLUSION: Clinical pharmacy services offered to four orthopaedic surgical wards resulted in reduction of sub-optimal prescriptions. Every time...... the pharmacist screened seven patients one sub-optimal prescription was found and adjusted. The reduction in medicine costs due to adjusted sub-optimal prescriptions could not cover the whole cost of clinical pharmacy service....

  19. Light-front zero-mode contribution to the Ward Identity

    In a covariant gauge we implicitly assume that the Green's function propagates information from one point of the space-time to another, so that the Green's function is responsible for the dynamics of the relativistic particle. In the light front form one would naively expect that this feature would be preserved. In this manner, the fermionic field propagator can be split into a propagating piece and a non-propagating ('contact') term. Since the latter ('contact') one does not propagate information, and therefore, supposedly can be discarded with no harm to the field dynamics we wanted to know what would be the impact of dropping it off. To do that, we investigated its role in the Ward identity in the light front. Here we use the terminology Ward identity to identify the limiting case of photon's zero momentum transfer in the vertex from the more general Ward-Takahashi identity with nonzero momentum transfer.

  20. Insider action research and the microsystem of a Danish surgical ward

    Paltved, Charlotte; Mørcke, Anne Mette; Musaeus, Peter

    2015-01-01

    This insider action research project aimed to improve interprofessional team performance at a surgical ward. The purpose of the project was (1) to critically appraise potential deficiencies in staffs’ identification, clinical judgment, and management of deteriorating ward patients, (2) to develop...... an interprofessional change model, and (3) evaluate the impact of the change model and the AR process. The insider AR project took place at a large Danish surgical ward with 60 participating physicians and nurses. The study was conducted in three interconnected action and reflection cycles using mixed methods. Staff...... with microsystems, this study highlights the importance of senior leaders to recognize the nature and power of using the microsystem approach for strategy, excellence, innovation, and research. Staff was able to formulate an overarching vision of interprofessionalism and this helped inspire changes in clinical...

  1. External equivalent type Ward aiming optimization studies in power systems; Equivalentes externos tipo Ward visando estudos de otimizacao em sistemas de potencia

    Nepomuceno, Leonardo

    1993-07-01

    The execution of functions such as contingency analysis, optimization, reactive dispatch, etc, at the control centers requires appropriate models representing the non-observable parts (external system). The classical external equivalents have been developed considering basically the contingency analysis. This work points out the performance of the Extended Ward Equivalent (W.E.), which currently represents the state of art concerning reduced circuit based models. the work analyzes the W.E. response to changes occurred in optimization studied. Moreover, a new model, named INTERNAL REACTIVE WARD (WRINT), resulting from an adaptation of the W.E. is proposed focusing on the improvement of the equivalent in case of changes occurs in optimization studies. The model's general idea is to reflect the equivalent's capacity of reactive response into the internal system. Comparative computational test results are shown. The details of routines implementation are also pointed out. (author)

  2. Does doctors’ workload impact supervision and ward activities of final-year students? A prospective study

    Celebi Nora

    2012-06-01

    Full Text Available Abstract Background Hospital doctors face constantly increasing workloads. Besides caring for patients, their duties also comprise the education of future colleagues. The aim of this study was to objectively investigate whether the workload arising from increased patient care interferes with student supervision and is associated with more non-medical activities of final-year medical students. Methods A total of 54 final-year students were asked to keep a diary of their daily activities over a three-week period at the beginning of their internship in Internal Medicine. Students categorized their activities – both medical and non-medical - according to whether they had: (1 only watched, (2 assisted the ward resident, (3 performed the activity themselves under supervision of the ward resident, or (4 performed the activity without supervision. The activities reported on a particular day were matched with a ward specific workload-index derived from the hospital information system, including the number of patients treated on the corresponding ward on that day, a correction factor according to the patient comorbidity complexity level (PCCL, and the number of admissions and discharges. Both students and ward residents were blinded to the study question. Results A total of 32 diaries (59 %, 442 recorded working days were handed back. Overall, the students reported 1.2 ± 1.3 supervised, 1.8 ±1.6 medical and 3.6 ± 1.7 non-medical activities per day. The more supervised activities were reported, the more the number of reported medical activities increased (p  Conclusions There was a significant association between ward doctors’ supervision of students and the number of medical activities performed by medical students. The workload had no significant effect on supervision or the number of medical or non-medical activities of final-year students.

  3. Predicting Spatial Distribution of Infection Risk of Airborne Transmission Diseases in a Hospital Ward

    Qian, Hua; Li, Yuguo; Nielsen, Peter V.; Huang, Xinghuang

    2007-01-01

    This study attempt to integrate the Wells-Riley equation and computational fluid dynamics for analyzing the risk of airborne transmission diseases in a building. The new method can predict the spatial distribution of the infection risk of the airborne transmission diseases in a large hospital ward......, while the Wells-Riley equation alone can only predict the overall infection risk in the whole building assuming a uniform distribution of the droplet nuclei concentration. This new method is applied to analyze the transmission risk in the well documented 8A ward SARS outbreak in a Hong Kong hospital in...

  4. Functional flows in QED and the modified Ward-Takahashi identity

    Igarashi, Yuji; Pawlowski, Jan M

    2016-01-01

    In the functional renormalisation group approach to gauge theory, the Ward-Takahashi identity is modified due to the presence of an infrared cutoff term. It take the most accessible form for the Wilsonian effective action. In the present work we solve these identities, partially, for the Wilson effective action of QED. In particular, we compute the longitudinal part of the photon two point vertex function as a momentum- dependent function in the presence of the cutoff k. The resultant Wilsonian effective action carries form factors that originate from the modified Ward-Takahashi identity. We show how this result carries over to the one-particle-irreducible effective action.

  5. Evaluation of the new ward housekeeper role in UK NHS Trusts

    May, D.; Smith, L., Shacklady-Smith, A., Boyd, A., and Johnson, C.

    2003-01-01

    In the year 2000, the UK government promoted the concept that hospital services be shaped around the needs of the patient to make their stay in hospital as comfortable as possible and advocated the introduction of a ward housekeeper role in at least 50 per cent of hospitals by 2004. This is a ward-based non-clinical role centred on cleaning, food service and maintenance to ensure that the basics of care are right for the patient. In 2002 the Facilities Management Graduate Centre at Sheffield ...

  6. Risk Factors and Scoring System for Predicting Bacterial Resistance to Cefepime as Used Empirically in Haematology Wards

    Hicham El Maaroufi

    2015-01-01

    Full Text Available Objectives. Bacterial resistance is of growing concern in haematology wards. As the inappropriate administration of empirical antibacterial may alter survival, we studied risk factors for resistance to our usual empirical first-line antibacterial therapy, cefepime. Methods. We retrospectively studied 103 first episodes of bacteraemia recorded in our haematology department over 2.5 years. Risk factors for cefepime-resistance were identified by multivariate logistic regression with backward selection (P<0.05. A scoring system for predicting cefepime-resistance was built on independent factor, with an internal validation by the bootstrap resampling technique. Results. 38 (37% episodes were due to Gram-negative bacteria. Fifty (49% were due to bacteria resistant to cefepime. Cefepime resistance was significantly associated with a decreased survival at day 30 (P<0.05. Three risk factors were independently associated with cefepime-resistance: acute lymphoblastic leukaemia; ≥18 days since hospital admission; and receipt of any β-lactam in the last month. Patients with ≥2 of these risk factors had a probability of 86% (CI 95%, 25 to 100% to carry a cefepime-resistant strain. Conclusion. Using our scoring system should reduce the indication of very broad antibacterial regimens in the empirical, first-line treatment of febrile hematology patients in more than 80% of the cases.

  7. Less is more: a project to reduce the number of PIMs (potentially inappropriate medications) on an elderly care ward.

    Aung, Tin Htun; Judith Beck, Adèle; Siese, Thomas; Berrisford, Richard

    2016-01-01

    Potentially inappropriate prescribing in healthcare of the elderly (HCE) is associated with avoidable adverse drug events (ADEs).1(,)2 A recent set of prescribing criteria has been designed and validated, called "Screening Tool of Older Persons' Prescriptions" (STOPP), to rationalise prescribing in hospitalised patients on HCE wards.1(,)3 The aim of this quality improvement project was to identify how many potentially inappropriate medications (PIMs) were prescribed on these wards, and remove them. This was executed by implementing a ward round checklist, which incorporated STOPP criteria, for the twice weekly, consultant led ward rounds. This quality improvement project was carried out over four months. In a pilot study, we identified eight inappropriate medical prescriptions among 148 medications (5.4% ) prescribed on one ward. After applying a checklist for a structured ward round, we reviewed the medications prescribed on that ward, and found 10 PIMs out of 192 (5.2% ). Utilising the increasingly recognised "plan, do, study, act" (PDSA) cycle,4 we implemented departmental teaching and meetings with other members of the multidisciplinary team, which raised awareness of PIMs among junior doctors, as well as involving our pharmacists in drug chart screening. During this process we continued with a further six cycles on a bi-weekly basis, and saw a gradual decrease in PIM to 1.5%. In conclusion, a structured ward round, facilitated by a checklist that included review of drug charts based on STOPP criteria, demonstrated a considerable reduction of PIMs. It would be interesting to apply this quality improvement project to non-HCE wards, including general surgical wards or adult psychiatry wards, as a means of not only reducing the effects of ADEs, but also the expenditure associated with unnecessary drug prescriptions, and the costs associated with additional care arising from associated ADEs. PMID:27096089

  8. Helicobacter pylori seropositivity in subjects with acute myocardial infarction.

    Rathbone, B; Martin, D.; Stephens, J.; Thompson, J. R.; Samani, N.J.

    1996-01-01

    OBJECTIVE: To determine whether Helicobacter pylori infection increases the risk of myocardial infarction. DESIGN: Case-control study. SETTING: University teaching hospital. METHODS: Serological evidence of H pylori infection was determined in 342 consecutive patients with acute myocardial infarction admitted into the coronary care unit and in 236 population-based controls recruited from visitors to patients on medical and surgical wards. RESULTS: 206/342 (60.2%) of cases were H pylori positi...

  9. Receptor study of psychiatric disorders using PET

    Recent receptor studies of psychiatric disorders using PET have been focused on the change in the number of D2 dopamine receptors in the striatum of drug-naive schizophrenic patients. One study confirmed an increase in D2 receptors, while another study denied it. Although there were some differences in the approaches of the two groups, the reason for the discrepancy is not clear yet. Looking to psychiatric disorders other than schizophrenia, our recent study revealed a possible role of dopamine D1 receptors in bipolar mood disorders. However, some problems must be resolved for further receptor studies with PET. For example, our recent study shows that desipamine decreases the in vivo binding of dopramine D1 and D2 receptors whereas these is no effect on dopamine D1 and D2 receptors in vitro. Additionally significant methodological problems lie in the method of evaluation of the non-specific binding and the effect of endogenous neurotransmitters. Moreover, difficulties in the diagnosis of psychiatric disorders and ethical problems in psychiatric research are critical factors in receptor studies with PET in psychiatric disorders. (author)

  10. Clinical impact of potentially inappropriate medications during hospitalization of acutely ill older patients with multimorbidity

    Kersten, Hege; Hvidsten, Lara T; Gløersen, Gløer; Wyller, Torgeir Bruun; Wang-Hansen, Marte Sofie

    2015-01-01

    Objective: To identify potentially inappropriate medications (PIMs), to compare drug changes between geriatric and other medical wards, and to investigate the clinical impact of PIMs in acutely hospitalized older adults. Setting and subjects: Retrospective study of 232 home-dwelling, multimorbid older adults (aged ≥75 years) acutely admitted to Vestfold Hospital Trust, Norway. Main outcome measures. PIMs were identified by Norwegian general practice (NORGEP) criteria and Beers’ 2012 criteria....

  11. Post-acute patient: what is the real meaning?

    C. Volpe

    2013-05-01

    Full Text Available AIM OF THE STUDY The study is about Medicine ward inpatients in one acute hospital, before and after the implementation of the Post Acute Care Unit (PACU. Clinical parameters to be accepted in PACU and clinical and assistential needs are defined. METHODS The selection of patients relies on the absence of criteria for staying in acute hospital, as defined in the Hospital Utilization Evaluation Protocol (PRUO, and excluding patients with end stage tumors. The care burden is calculated applying the Care Complexity Score (CCS at time of take in charge. We present data related to the first 100 consecutive patients managed in PACU, compared with those of Medicine staying obtained in 3 different days during the month antecedent the activation of PACU. RESULTS Among the in-patients in the medical ward, 17.3% can be managed in PACU. Compared to all in-patients, post acute population resulted older, with greater CCS and need of care support at discharge. The high number of deaths (24% is due to patients with several end stage co-morbidities, which are very difficult to manage at home, with adequate tools. CONCLUSIONS Octogenarians who overcrowd acute-patient hospitals demonstrate increased care demands and may need a prolonged hospital stay to achieve clinical stabilization or functional independence after an acute event. This goal can be obtained in a specifically oriented hospital setting. The same area could also manage the end of life of patients with multiple co-morbidities, even if not with neoplastic disease.

  12. Survey of the management of acute asthma in children.

    Widger, J

    2009-12-01

    Acute asthma is one of the most common reasons for children presenting to the emergency department. International guidelines for the management of acute paediatric asthma are widely available. In this study we examined how acute asthma in children is managed across hospitals in Ireland and compared Irish practice with standard international guidelines. We surveyed 54 paediatricians across 18 centres in Ireland. A total of 30 (55.5%) individual paediatricians across 17 (94%) centres replied. The majority of centres had a written protocol for the management of acute asthma. A large number of centres use MDI and spacer devices in acute management although doses used varied widely. Only 29% of centres had written asthma action plans available from the emergency department and 53% had plans available from the ward. Irish practice is largely inline with established guidelines. A national asthma strategy could further help to improve asthma care.

  13. The role of Tc-99m HMPAO brain perfusion SPECT in the psychiatric disability evaluation of patients with chronic traumatic brain injury

    We studied whether brain perfusion SPECT is useful in the psychiatric disability evaluation of patients with chronic traumatic brain injury (TBI). Sixty-nine patients (M:F=58:11, age 39 ± 14 years) who underwent Tc-99m HMPAO brain SPECT, brain MRI and neuropsychological (NP) tests during hospitalization in psychiatric wards for the psychiatric disability evaluation were included; the severity of injury was mild in 31, moderate in 17 and severe in 21. SPECT, MRI, NP tests were performed 6 ∼ 61 months (mean 23 months) post-injury. Diagnostic accuracy of SPECT and MRI to show hypoperfusion or abnormal signal intensity in patients with cognitive impairment represented by NP test results were compared. Forty-two patients were considered to have cognitive impairment on NP tests and 27 not. Brain SPECT showed 71% sensitivity and 85% specificity, while brain MRI showed 62% sensitivity and 93% specificity (p>0.05, McNemar test). SPECT found more cortical lesions and MRI was superior in detecting white matter lesions. sensitivity and specificity of 31 mild TBI patients were 45%, 90% for SPECT and 27%, 100% for MRI (p>0.05, McNemar test). Among 41 patients with normal brain MRI, SEPCT showed 63% sensitivity (50% for mild TBI) and 88% specificity (85% for malingerers). Brain SPECT has a supplementary role to neuropsychological tests in the psychiatric disability evaluation of chronic TBI patients by detecting more cortical lesions than MRI

  14. Diagnosis and management of acute heart failure.

    Ural, Dilek; Çavuşoğlu, Yüksel; Eren, Mehmet; Karaüzüm, Kurtuluş; Temizhan, Ahmet; Yılmaz, Mehmet Birhan; Zoghi, Mehdi; Ramassubu, Kumudha; Bozkurt, Biykem

    2015-11-01

    Acute heart failure (AHF) is a life threatening clinical syndrome with a progressively increasing incidence in general population. Turkey is a country with a high cardiovascular mortality and recent national statistics show that the population structure has turned to an 'aged' population.As a consequence, AHF has become one of the main reasons of admission to cardiology clinics. This consensus report summarizes clinical and prognostic classification of AHF, its worldwide and national epidemiology, diagnostic work-up, principles of approach in emergency department,intensive care unit and ward, treatment in different clinical scenarios and approach in special conditions and how to plan hospital discharge. PMID:26574757

  15. Regionalization of psychiatric services for the elderly.

    Shulman, K I

    1991-02-01

    This overview addresses issues related to psychiatric services for the elderly in Canada. The author reviews the developments in the United Kingdom that have led to the establishment of guiding principles which may be applied to the Canadian health care system. These include the clear definition of a target population, a comprehensive approach to services, availability and accessibility, and clear accountability. A model for the establishment of regionalized psychiatric services is proposed, including the integration of hospital-based and community-based services with clearly defined areas of responsibility. In light of the changing demographics in Canada and the prevalence of psychiatric illness in the elderly, this is a matter of growing urgency for the health care system. PMID:2029681

  16. Negative rumor: contagion of a psychiatric department.

    Novac, Andrei; McEwan, Stephanie; Bota, Robert G

    2014-01-01

    Over the past few decades, a sizable body of literature on the effects of rumors and gossip has emerged. Addressing rumors in the workplace is an important subject, as rumors have a direct impact on the quality of the work environment and also on the productivity and creativity of the employees. To date, little has been written on the effect of rumors and gossip in psychiatric hospitals. This article presents case vignettes of rumors spread in psychiatric hospitals and the impact on team cohesion and morale among the staff implicated in these, too often, neglected occurrences. Dynamic aspects with particular focus on rumors in psychiatric units and suggestions for remedy and treatment are presented. PMID:25133051

  17. Parental psychiatric hospitalisation and offspring schizophrenia

    Sørensen, Holger J; Mortensen, Erik L; Reinisch, June M;

    2009-01-01

    in both parents were associated with elevated risk of offspring schizophrenia; in addition, maternal schizophrenia, affective disorder and personality disorder were associated with elevated risk. Controlling for parental age, parental social status, and parental psychiatric co-diagnosis, offspring risk...... of schizophrenia and a range of psychotic and non-psychotic psychiatric diagnoses in parents. Psychiatric admission data after 1969 were available for 7047 cohort members born between 1959 and 1961, and for 7006 mothers and 6993 fathers. Univariate analysis showed that neurosis, alcohol and substance dependence...... of schizophrenia was associated with maternal schizophrenia (OR = 15.41 with 95% CI 5.96-39.81) and, independently, with paternal hospitalisation with neurosis (OR = 5.90 with 95% CI 2.23-15.62). The risk of schizophrenia associated with paternal neurosis remained significant after excluding offspring of parents...

  18. Ethical Challenges in Psychiatric Administration and Leadership.

    Moffic, H Steven; Saeed, Sy Atezaz; Silver, Stuart; Koh, Steve

    2015-09-01

    As with all professional ethical principles, those in psychiatry have to evolve over time and societal changes. The current ethical challenges for psychiatric administration and leadership, especially regarding for-profit managed care, need updated solutions. One solution resides in the development by the American Association of Psychiatric Administrators (AAPA) of the first set of ethical principles designed specifically for psychiatric administrators. These principles build on prior Psychological Theories of leadership, such as those of Freud, Kernberg, and Kohut. Supplementing these theories are the actual real life models of psychiatrist leadership as depicted in the memoirs of various psychiatrists. Appreciating these principles, theories, and models may help emerging leaders to better recognize the importance of ethical challenges. A conclusion is that psychiatrists should have the potential to assume more successful leadership positions once again. In such positions, making the skills and well-being of all in the organization seems now to be the foremost ethical priority. PMID:26024739

  19. Acute Pancreatitis and Pregnancy

    ... Acute Pancreatitis > Acute Pancreatitis and Pregnancy test Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is ... of acute pancreatitis in pregnancy. Reasons for Acute Pancreatitis and Pregnancy While acute pancreatitis is responsible for ...

  20. Conflicting priorities: evaluation of an intervention to improve nurse-parent relationships on a Tanzanian paediatric ward

    Manongi, Rachel N; Nasuwa, Fortunata R; Mwangi, Rose;

    2009-01-01

    on a paediatric ward in a busy regional hospital in Tanzania. METHODS: The intervention consisted of six workshops, attended by 29 of 31 trained nurses and nurse attendants working on the paediatric ward. Parental satisfaction with nursing care was measured with 288 parents before and six weeks after...

  1. Acute Methylenedioxypyrovalerone Toxicity.

    Froberg, Blake A; Levine, Michael; Beuhler, Michael C; Judge, Bryan S; Moore, Philip W; Engebretsen, Kristin M; Mckeown, Nathanael J; Rosenbaum, Christopher D; Young, Amy C; Rusyniak, Daniel E

    2015-06-01

    The objective of this study was to characterize the acute clinical effects, laboratory findings, complications, and disposition of patients presenting to the hospital after abusing synthetic cathinone. We conducted a retrospective multicenter case series of patients with synthetic cathinone abuse by searching for the terms bath salts, MDPV, methylenedioxypyrovalerone, mephedrone, methcathinone, methylone, methedrone, and cathinone within the "agent" field of a national clinical toxicology database (ToxIC). The medical records of these patients were obtained and abstracted by investigators at each study site. Patients with confirmatory testing that identified a synthetic cathinone in either blood or urine were included in the series. Patients who had either an undetectable synthetic cathinone test or no confirmatory testing were excluded. A data abstraction sheet was used to obtain information on each patient. We entered data into an Excel spreadsheet and calculated descriptive statistics. We identified 23 patients with confirmed synthetic cathinone exposure--all were positive for methylenedioxyprovalerone (MDPV). Eighty-three percent were male and 74 % had recreational intent. The most common reported clinical effects were tachycardia (74 %), agitation (65 %), and sympathomimetic syndrome (65 %). Acidosis was the most common laboratory abnormality (43 %). Seventy-eight percent of patients were treated with benzodiazepines and 30 % were intubated. Ninety-six percent of patients were hospitalized and 87 % were admitted to the ICU. The majority (61 %) of patients was discharged home but 30 % required inpatient psychiatric care. There was one death in our series. The majority of patients presenting to the hospital after abusing MDPV have severe sympathomimetic findings requiring hospitalization. A number of these patients require inpatient psychiatric care after their acute presentation. PMID:25468313

  2. 综合医院老年住院患者联络会诊精神医学服务模式探讨%Consultation-liaison psychiatric service for elderly inpatients in a general hospital

    洪霞; 赵晓晖; 曾平; 史丽丽; 曹锦亚; 魏镜

    2015-01-01

    psychiatric service for these patients. Methods All the patients over 65 years old or more hospitalized in the demonstration wards of a general hospital during September 2009 to August 2012 were recruited in this study. They were assessed with CGA by Zung’s Self-rating Depression Scale and Zung’s Self-rating Anxiety Scale at admission. Ward round by geriatric multidisciplinary team and CLPS were offered when necessary. Psychiatric diagnoses were made by a psychiatrist according to the International Classification of Diseases-10 (ICD-10). Their outcomes were compared with those of the elderly inpatients aged 65 years old or more in other wards in the same time frame (control group). Results There were 146 patients from geriatric ward receiving psychiatric service, with a consultation rate of 28.2%, while 520 patients from the other wards receiving the service, with a rate of 1.5% (P=0.000). In geriatric ward, the top 3 reasons for referral were emotional problems (44.5%), follow-up problems (16.4%), and medical unexplained symptoms (10.3%). But for those of other wards, the reasons were emotional problems (37.9%), psychiatric problems (20.4%) and medical unexplained symptoms (10.1%) (P=0.000). The major psychiatric diagnoses were neurosis and stress related disorders (29.7%), mood disorders (26.9%) and organic psychiatric disorders (21.4%) in geriatric ward; while, neurosis and stress related disorders (35.0%), organic psychiatric disorders (28.8%) and mood disorders (16.5%) in other wards (P=0.001). Conclusion CLPS based on CGA, psychiatric consultation and ward round of multidisciplinary team can promote consultation rate for psychiatric consultation in the elderly inpatients in a general hospital, and worth of wildly application in clinical practice.

  3. [For a society without secure psychiatric hospitals].

    Santos, Ana Luiza Gonçalves Dos; Farias, Francisco Ramos de; Pinto, Diana de Souza

    2015-12-01

    The article explores the possibility of defending a society without secure psychiatric hospitals in Brazil. These hospitals have been sustained by persistent legal and psychiatric paradigms, including the notions "safety measure" and "dangerousness," in conjunction with particular social and historical circumstances. The open repression of so-called dangerous individuals is still practiced in the name of the principle of social defense, outdated concepts notwithstanding. Together, law and psychiatry constructed spaces of power/knowledge within these workings of social control. Addressing this topic from the transdisciplinary field of social memory means identifying the struggles within particular power/knowledge arrangements, which play out in a state of ongoing tension. PMID:26625915

  4. The Impact of Psychiatric Patient Boarding in Emergency Departments

    B. A. Nicks

    2012-01-01

    Full Text Available Objectives. Studies have demonstrated the adverse effects of emergency department (ED boarding. This study examines the impact of resource utilization, throughput, and financial impact for psychiatric patients awaiting inpatient placement. Methods. The authors retrospectively studied all psychiatric and non-psychiatric adult admissions in an Academic Medical Center ED (>68,000 adult visits from January 2007-2008. The main outcomes were ED length of stay (LOS and associated reimbursement. Results. 1,438 patients were consulted to psychiatry with 505 (35.1% requiring inpatient psychiatric care management. The mean psychiatric patient age was 42.5 years (SD 13.1 years, with 2.7 times more women than men. ED LOS was significantly longer for psychiatric admissions (1089 min, CI (1039–1140 versus 340 min, CI (304–375; <0.001 when compared to non-psychiatric admissions. The financial impact of psychiatric boarding accounted for a direct loss of ($1,198 compared to non-psychiatric admissions. Factoring the loss of bed turnover for waiting patients and opportunity cost due to loss of those patients, psychiatric patient boarding cost the department $2,264 per patient. Conclusions. Psychiatric patients awaiting inpatient placement remain in the ED 3.2 times longer than non-psychiatric patients, preventing 2.2 bed turnovers (additional patients per psychiatric patient, and decreasing financial revenue.

  5. Proposed Reference Model for Guiding Teachers to Perform Ward Round Teaching

    Luís Alberto Corona Martínez

    2014-06-01

    Full Text Available Ward round teaching is an essential professional medical activity as an organizational form of teaching in undergraduate medical education. Its great importance for shaping a professional "personality" is well recognized by the faculty; as well as its extremely complex implementation and development of the necessary skills. The problem to be solved in this paper is related to the need to help younger clinical teachers in undergraduate medical education to develop the skills to conduct ward round teaching; which would be achieved through appropriate guidance on how to perform this activity. Based on this, the teaching staff in the Department of Clinical Sciences of the Dr. Raúl Dorticós Torrado Faculty of Medical Sciences in Cienfuegos has designed a model or representation of ward round teaching to be used as a guide. The main results include the development of a model with two variants, according to the care provided to a recently admitted patient or an already known patient; and the definition of conditions, both in practical and educational areas, which should be considered for the proper implementation of the activity. The model is not a complete representation of the ward round teaching, thus the proposal is open to review and improvement; and its use is based on its adaptation to the particularities of the different disciplines and learning scenarios.

  6. SUSY Ward identities for multi-gluon helicity amplitudes with massive quarks

    We use supersymmetric Ward identities to relate multi-gluon helicity amplitudes involving a pair of massive quarks to amplitudes with massive scalars. This allows to use the recent results for scalar amplitudes with an arbitrary number of gluons obtained by on-shell recursion relations to obtain scattering amplitudes involving top quarks

  7. Information Needs Assessment for a Medicine Ward-Focused Rounding Dashboard.

    Aakre, Christopher A; Chaudhry, Rajeev; Pickering, Brian W; Herasevich, Vitaly

    2016-08-01

    To identify the routine information needs of inpatient clinicians on the general wards for the development of an electronic dashboard. Survey of internal medicine and subspecialty clinicians from March 2014-July 2014 at Saint Marys Hospital in Rochester, Minnesota. An information needs assessment was generated from all unique data elements extracted from all handoff and rounding tools used by clinicians in our ICUs and general wards. An electronic survey was distributed to 104 inpatient medical providers. 89 unique data elements were identified from currently utilized handoff and rounding instruments. All data elements were present in our multipurpose ICU-based dashboard. 42 of 104 (40 %) surveys were returned. Data elements important (50/89, 56 %) and unimportant (24/89, 27 %) for routine use were identified. No significant differences in data element ranking were observed between supervisory and nonsupervisory roles. The routine information needs of general ward clinicians are a subset of data elements used routinely by ICU clinicians. Our findings suggest an electronic dashboard could be adapted from the critical care setting to the general wards with minimal modification. PMID:27307266

  8. Design Parameters for Evaluating Light Settings and Light Atmosphere in Hospital Wards

    Stidsen, Lone; Kirkegaard, Poul Henning; Fisker, Anna Marie

    2010-01-01

    When constructing and designing Danish hospitals for the future, patients, staff and guests are in focus. It is found important to have a starting point in healing architecture and create an environment with knowledge of users sensory and functionally needs and looks at how hospital wards can...

  9. Inappropriate use of urinary catheters and its common complications in different hospital wards

    Parivash Davoodian

    2012-01-01

    Full Text Available Inappropriate use of indwelling urinary catheters (IUCs and their related complications is one of the most important problems in hospital wards. The aim of this study was to evaluate inappropriate use of IUCs and their complications among patients in Tehran, Iran. Two hundred and six consecutive patients hospitalized in the intensive care unit (ICU as well as medical and surgical wards at the Shahid Mohammadi Hospital in Bandarabbas from September 1 to 30, 2005 and in whom IUCs were used, were studied. Data collected included age of the patients, diagnoses, reason for use of IUC and the complications related to it. Overall, 164 patients (79.6% had IUCs used appropriately while 42 of them (20.6% were catheterized unjustifiably. Inappropriate use of IUCs in the ICU, medical and surgical wards was reported in 12 (18.5%, 16 (19.0% and 14 patients (24.6%, respectively. The most common complication of IUCs was urinary tract infection, which occurred in 91 patients (44.2% and hematuria, which was seen in 3.9% of the patients. Our study suggests that inappropriate use of IUCs is prevalent, particularly in the surgical wards, and the most common complication observed was catheter-associated urinary tract infection.

  10. Two-particle renormalizations in many-fermion perturbation theory: the importance of the Ward identity

    Janiš, Václav

    2003-01-01

    Roč. 15, - (2003), s. L311-L317. ISSN 0953-8984 R&D Projects: GA ČR GA202/01/0764 Institutional research plan: CEZ:AV0Z1010914 Keywords : Ward identity * electron correlations * conservation laws Subject RIV: BE - Theoretical Physics Impact factor: 1.757, year: 2003

  11. Missed Opportunities for Nutritional Rehabilitation in Children Admitted to Surgical Wards

    Dave, Pooja; Nimbalkar, Somashekhar; Phatak, Ajay; Desai, Rajendra; Srivastava, Shirish

    2016-01-01

    Background. Malnutrition in children has serious health and economic consequences. We studied documentation of malnutrition, actual prevalence, and treatment given in children admitted to surgical wards. Methods. Retrospective study of 154 patients aged <5 yrs admitted to general surgical, orthopedic, and otorhinolaryngology wards. Records were evaluated for completeness of data, way of documentation, and data quality. Descriptive analysis was done. If malnutrition was not identified and/or proper action was not taken, it was defined as a “missed opportunity.” Results. Of 154 records audited, 100 (64.94%) were males, 108 (70.13%) were from general surgery ward, and 78 (50.65%) were residing in suburban area. The mean (SD) age of the study population was 2.32 (1.16) years whereas mean (SD) duration of stay was 5.84 (6.29) days. Weight and height were mentioned in 116 (75.32%) and 8 (5.19%) records, respectively, mostly by nonsurgical personnel. Documentation and treatment of malnutrition were poor. Out of 106 apparently correct weight records, 19 (17.93%) children were severely undernourished and 30 (28.30%) were moderately undernourished whereas 20 (18.87%) children were not undernourished but required nutritional attention. Conclusion. There is poor documentation of nutritional indicators of children admitted to surgical wards. From data that was available, it is apparent that malnutrition is at high levels. “Identification” and hence management of malnutrition need more attention.

  12. Spatial Distribution of Infection Risk of SARS Transmission in a Hospital Ward

    Qian, Hua; Li, Yuguo; Nielsen, Peter V.;

    2009-01-01

    The classical Wells-Riley model for predicting risk of airborne transmission of diseases assumes a uniform spatial distribution of the infected cases in an enclosed space. A new mathematical model is developed here for predicting the spatial distribution of infection risk of airborne transmitted ......, such as inpatients in a hospital ward, passengers in an airplane etc....

  13. Constructing and Evaluating a Validity Argument for the Final-Year Ward Simulation Exercise

    Till, Hettie; Ker, Jean; Myford, Carol; Stirling, Kevin; Mires, Gary

    2015-01-01

    The authors report final-year ward simulation data from the University of Dundee Medical School. Faculty who designed this assessment intend for the final score to represent an individual senior medical student's level of clinical performance. The results are included in each student's portfolio as one source of evidence of the student's…

  14. Neonatal Intensive Care Unit Nurses Working in an Open Ward: Stress and Work Satisfaction.

    Lavoie-Tremblay, Mélanie; Feeley, Nancy; Lavigne, Geneviève L; Genest, Christine; Robins, Stéphanie; Fréchette, Julie

    2016-01-01

    There is some research on the impact of open-ward unit design on the health of babies and the stress experienced by parents and nurses in neonatal intensive care units. However, few studies have explored the factors associated with nurse stress and work satisfaction among nurses practicing in open-ward neonatal intensive care units. The purpose of this study was to examine what factors are associated with nurse stress and work satisfaction among nurses practicing in an open-ward neonatal intensive care unit. A cross-sectional correlational design was used in this study. Participants were nurses employed in a 34-bed open-ward neonatal intensive care unit in a major university-affiliated hospital in Montréal, Quebec, Canada. A total of 94 nurses were eligible, and 86 completed questionnaires (91% response rate). Descriptive statistics were computed to describe the participants' characteristics. To identify factors associated with nurse stress and work satisfaction, correlational analysis and multiple regression analyses were performed with the Nurse Stress Scale and the Global Work Satisfaction scores as the dependent variables. Different factors predict neonatal intensive care unit nurses' stress and job satisfaction, including support, family-centered care, performance obstacles, work schedule, education, and employment status. In order to provide neonatal intensive care units nurses with a supportive environment, managers can provide direct social support to nurses and influence the culture around teamwork. PMID:27455363

  15. Audit of a ward-based patient-controlled epidural analgesia service in Ireland.

    Tan, T

    2012-02-01

    BACKGROUND: Ward-based patient-controlled epidural analgesia (PCEA) for postoperative pain control was introduced at our institution in 2006. We audited the efficacy and safety of ward-based PCEA from January 2006 to December 2008. METHOD: Data were collected from 928 patients who received PCEA in general surgical wards for postoperative analgesia using bupivacaine 0.125% with fentanyl 2 mug\\/mL. RESULTS: On the first postoperative day, the median visual analogue pain score was 2 at rest and 4 on activity. Hypotension occurred in 21 (2.2%) patients, excessive motor blockade in 16 (1.7%), high block in 5 (0.5%), nausea in 5 (0.5%) and pruritus in only 1 patient. Excessive sedation occurred in two (0.2%) patients but no intervention was required. There were no serious complications such as epidural abscess, infection or haematoma. CONCLUSION: Effective and safe postoperative analgesia can be provided with PCEA in a general surgical ward without recourse to high-dependency supervision.

  16. Heterotic massive Einstein-Yang-Mills-type symmetry and Ward identity

    Lee, Jen-Chi

    2005-01-01

    We show that there exist spontaneously broken symmetries for massive modes with transformation parameters containing both Einstein and E8xE8 (or SO(32)) Yang-Mills indices in the 10D Heterotic string. The corresponding on-shell Ward identities are also constructed.

  17. [Medical economics in tuberculosis management: what will come after the TB ward?].

    Yotsumoto, Hideki

    2009-11-01

    Current unprofitability of medical services in tuberculosis (TB) ward in Japan has been induced by low medical fee and long-term hospital stays, aggravated by unoccupied beds due to the decrease in the number of patients. For the solution of this issue, the increase of medical fee, shortening of the length of hospital stay and drastic reduction of oversupplied beds are essential. An increment of medical fee by the change in the system would be appreciated, but even under the current system, the balance between revenue and expenditure could be obtained by reducing the length of hospital stay toward 4 weeks, and the elimination of deficit in TB ward could be accomplished by these efforts; shortening of length of hospital stay and reduction of TB beds. Although the latter might result in the difficulty of sustaining TB wards, these patients could be treated in the infectious disease ward. The integration of TB Control Law to Infectious Disease Control Law suggests that TB is not a special disease in Japan. If a true "short course therapy" era would be realized by novel anti-tuberculosis drugs, a dramatic change in TB management would occur in the near future. PMID:19999596

  18. Applying mobile and pervasive computer technology to enhance coordination of work in a surgical ward

    Hansen, Thomas Riisgaard; Bardram, Jakob Eyvind

    2007-01-01

    unnecessary stress. To accommodate this situation and to increase the quality of work in operating wards, we have designed a set of pervasive computer systems which supports what we call context-mediated communication and awareness. These systems use large interactive displays, video streaming from key...

  19. Applying Mobile and Pervasive Computer Technology to Enhance Coordination of Work in a Surgical Ward

    Hansen, Thomas Riisgaard; Bardram, Jakob

    2007-01-01

    unnecessary stress. To accommodate this situation and to increase the quality of work in operating wards, we have designed a set of pervasive computer systems which supports what we call context-mediated communication and awareness. These systems use large interactive displays, video streaming from key...

  20. Incidence of nutritional support complications in patient hospitalized in wards. multicentric study

    Gloria María Agudelo Ochoa; Nubia Amparo Giraldo Giraldo; Nora Luz Aguilar; Beatriz Elena Restrepo; Marcela Vanegas; Sandra Alzate; Mónica Martínez; Sonia Patriacia Gamboa; Eliana Castaño; Janeth Barbosa; Juliana Román; Angela María Serna; Gloria Marcela Hoyos

    2012-01-01

    Introduction: Nutritional support generates complications that must be detected and treated on time. Objective: To estimate the incidence of some complications of nutritional support in patients admitted to general hospital wards who received nutritional support in six high-complexity institutions. Methods: Prospective, descriptive and multicentric study in patients with nutritional support; the variables studied were medical diagnosis, nutritional condition, nutritional support duration, app...