Should severely disturbed psychiatric patients be distributed or concentrated in specialized wards? An empirical study on the effects of hospital organization on ward atmosphere, aggressive behavior, and sexual molestation

1999 ◽  
Vol 14 (5) ◽  
pp. 291-297 ◽  
Author(s):  
R.P. Gebhardt ◽  
T. Steinert
Keyword(s):  
Aggressive Behavior ◽  
Structural Changes ◽  
Psychiatric Patients ◽  
Integration Policy ◽  
Hospital Organization ◽  
Staff Members ◽  
Beneficial Effects ◽  
Ward Atmosphere ◽  
Sexual Molestation ◽  
The Impact

SummaryThis study examines whether ward atmosphere, aggressive behavior, and sexual molestation will change after severely disturbed patients have been distributed over several wards determined by their place of residence, instead of concentrating them in locked single-sex wards. Four wards for predominantly psychotic patients were investigated with the German version of the Ward Atmosphere Scale (WAS), and some further questions about the observation of aggressive behavior and sexual molestation once before and twice after internal sectorisation, partial ward opening, and mixing the sexes were asked. Questionnaires (345: 162 staff members, 183 patients) were evaluated. After the structural changes, a significant improvement of ward atmosphere and a reduction of aggressive behavior was found on average in all wards, whereas the impact on sexual molestation remained unclear. Internal sectorisation and sex integration policy, resulting in distributing rather than concentrating severely disturbed patients, have beneficial effects on the social climate of acute wards.

Sustainable implementation of person-centred care in residential care facilities: hindering and supporting factors when improving incontinence care

2021 ◽  
Vol 23 (1) ◽  
pp. 1-14
Author(s):  
Eirini Alexiou ◽  
Irma Lindström Kjellberg ◽  
Helle Wijk
Keyword(s):  
Residential Care ◽  
Intervention Group ◽  
Control Group ◽  
Residential Care Facilities ◽  
Implementation Phase ◽  
Staff Members ◽  
Ward Atmosphere ◽  
Care Assessment ◽  
Care Facilities ◽  
The Impact

Purpose: The aim of the present study was to focus on the impact of the implementation of a person-centred approach on staff perception of the likelihood of being able to provide person-centred care and strain in the workplace. Design: The study was a controlled prospective cohort study performed at three residential care facilities in western Sweden involving all nursing staff members active from 2013 through 2015 at baseline and at three follow-ups during and after the implementation period. Two of the residential care facilities were assigned to the intervention group and one was assigned to the control group. Method: The study was designed to test the sustainability of a person-centred approach based on three aspects: partnership, narrative and documentation. A cross-section of 20 coworkers were purposively sampled from a total of 100 persons working at the two Intervention nursing homes to participate in the intervention group. The process outcome was measured as: perceived ward atmosphere, using the staff version of the validated Person-Centred Climate Questionnaire; person-centred care, measured using the validated Person-centred Care Assessment Tool; and experience of strain in work, using the Strain in Nursing Care Assessment Scale. Descriptive statistics were calculated for all variables using the SPSS Statistics software package. Findings: The results show that, at the control site, there were lower staff perceptions of the care atmosphere, higher level of strain experienced in their work and a lower likelihood of providing a person-centred care approach, whereas these factors remained rather stable over time at the intervention residential care facilities. Two contrasting results were observed—namely, that the higher the staff's perception of the likelihood of being able to provide individualised care and of a more person-centred ward atmosphere, the higher their stress levels experienced at work. In addition, older ages and long durations of work experience significantly negatively affected the staff's assessment of their ability to create an atmosphere of everydayness and to adopt a person-centred approach in care. Conclusions: The findings show that sustainability of a person-centred ward atmosphere is possible in the care of older people, despite staffing problems and other organisational challenges, according to the staff's assessment, after implementation of a person-centred programme. The more experienced staff members assessed their likelihood of being able to provide a person-centred care as lower after the implementation phase, indicating that despite the ambition of supporting person-centredness and quality of care, staffing and management difficulties that are present at the outset of the programme's implementation can later lead to stress and frustration relating to roles and routines.

Measuring Ward Milieu and the Impact of Staff Turnover on a Psychiatry Unit

1982 ◽  
Vol 50 (3) ◽  
pp. 879-885 ◽  
Author(s):  
Joseph C. Kobos ◽  
Franklin Redmond ◽  
John Sterling
Keyword(s):  
Health Science ◽  
Staff Turnover ◽  
Science Center ◽  
University Of Texas ◽  
Staff Members ◽  
Ward Atmosphere ◽  
Texas Health ◽  
Support Autonomy ◽  
Ward Atmosphere Scale ◽  
The Impact

The psychosocial environment of the psychiatric unit of a teaching hospital affiliated with the University of Texas Health Science Center at San Antonio was assessed using Moos' Ward Atmosphere Scale, which measures social dimensions such as Support, Autonomy, Practical Orientation, and Program Clarity. The population included 65 staff members and 55 patients, all above 17 yr. of age. Both patients and staff were asked to complete the scale at two times during the research period. Between the two administrations the ward experienced a 44% turnover in staff and a 100% turnover in patients. Results showed this ward to be stable over time and to maintain its stability despite rapid staff turnover. Also, the scale assisted the staff in performing a self-analysis of the ward.

scholarly journals Psychiatry during the Covid-19 Pandemic: a survey on Mental Health Departments in Italy

2020 ◽  
Author(s):  
Bernardo Carpiniello ◽  
Massimo Tusconi ◽  
Enrico Zanalda ◽  
Guido Di Sciascio
Keyword(s):  
Mental Health ◽  
Psychiatric Patients ◽  
Radical Change ◽  
Fisher Exact Test ◽  
Mental Health Systems ◽  
Chi Square ◽  
Exact Test ◽  
Staff Members ◽  
Set Up ◽  
The Impact

Abstract Background To date, very little knowledge is available with regard to the way in which mental health systems worldwide are facing the current global health emergency. The present paper reports the data emerging from a survey conducted to study the impact of the current emergency on the functioning of the Italian Departments of Mental Health (MHD).Methods Heads of MHDs received a 40-item multiple choice questionnaire relating to Community Mental Health Centres (CMHC) and related facilities, and a 30-item questionnaire focused on General Hospital Psychiatric Wards (GHPW). Statistical analysis was carried out by means of Chi Square test with Yates correction or the Fisher Exact test, as needed.Results: 71 questionnaires returned from the 134 MHDs (52.9%) and 107 of the 318 (32.6%) GHPWs. Less than 20%of CMHCs have been closed; approximately 25% have restricted access hours. The usual mode of operation in CMHCs changed substantially. Urgent psychiatric consultations are continuing as usual, in the same way as interventions for compulsory treatments, and prison consultations. All other activities have been reduced to some extent. Remote contacts with users have been set up in approx. 75% of cases. Cases of COVID positivity were reported amongst both staff members (approx. 50 % of CHMCs), and facility users (52% of CHMCs). 20% of CMHCs reported cases of increased aggressiveness or violence, among community patients, although only 8.6% regarding severe cases. Major issues in the supply of personal protective equipment (PPE) for staff members were reported. A reduced number of GHPWs (-12%), beds (approx.-30%) and of admissions was registered (87% of GHPWs). 8% of GHPWs reported an increase in compulsory admissions, and an increased rate of violence toward self or others among inpatients. Patient swabs were carried out in 50% of GHPWs. 60% of GHPWs have reported the admission of symptomatic, COVID+ psychiatric patients to General COVID-19 Units; severely ill and non-collaborative COVID+ patients are generally admitted to specific “COVID-19” GHPWs, or to purpose-adapted isolated areas of the wards. Conclusions The COVID-19 pandemic has heralded a radical change in the mental health system of Italy, and a consequent series of challenging issues.

International trade: Research of the reasons for the fall

2019 ◽  
pp. 79-91 ◽  
Author(s):  
V. S. Nazarov ◽  
S. S. Lazaryan ◽  
I. V. Nikonov ◽  
A. I. Votinov
Keyword(s):  
Growth Rate ◽  
International Trade ◽  
Exchange Rate ◽  
Global Economy ◽  
Structural Changes ◽  
Global Value Chains ◽  
Value Chains ◽  
Negative Contribution ◽  
Basic Commodity ◽  
The Impact

The article assesses the impact of various factors on the growth rate of international trade. Many experts interpreted the cross-border flows of goods decline against the backdrop of a growing global economy as an alarming sign that indicates a slowdown in the processes of globalization. To determine the reasons for the dynamics of international trade, the decompositions of its growth rate were carried out and allowed to single out the effect of the dollar exchange rate, the commodities prices and global value chains on the change in the volume of trade. As a result, it was discovered that the most part of the dynamics of international trade is due to fluctuations in the exchange rate of the dollar and prices for basic commodity groups. The negative contribution of trade within global value chains in 2014 was also revealed. During the investigated period (2000—2014), such a picture was observed only in the crisis periods, which may indicate the beginning of structural changes in the world trade.

THE IMPACT OF UKRAINE'S EXCISE DUTY POLICY ON THE TRANSFORMATION PROCESSES OF THE TOBACCO MARKET

2020 ◽  
Vol 2020 (10) ◽  
pp. 19-33
Author(s):  
Nadiia NOVYTSKA ◽  
◽  
Inna KHLIEBNIKOVA ◽  
Keyword(s):  
Structural Changes ◽  
Tax Avoidance ◽  
Transformation Process ◽  
State Regulation ◽  
Tobacco Products ◽  
Excise Duty ◽  
Increasing Demand ◽  
High Level ◽  
The Impact ◽  
Transformation Processes

The market of tobacco products in Ukraine is one of the most dynamic and competitive. It develops under the influence of certain factors that cause structural changes, therefore, the aim of the article is to conduct a comprehensive analysis of transformation processes in the market of tobacco and their alternatives in Ukraine and identify the factors that cause them. The high level of tax burden and the proliferation of alternative products with a potentially lower risk to human health, including heating tobacco products and e-cigarettes, are key factors in the market’s transformation process. Their presence leads to an increase in illicit turnover of tobacco products, which accounts for 6.37% of the market, and the gradual replacement of cigarettes with alternative products, which account for 12.95%. The presence on the market of products that are not taxed or taxed at lower rates is one of the reasons for the reduction of excise duty revenues. According to the results of 2019, the planned indicators of revenues were not met by 23.5%. Other reasons for non-fulfillment of excise duty revenues include: declining dynamics of the tobacco products market; reduction in the number of smokers; reorientation of «cheap whites» cigarette flows from Ukraine to neighboring countries; tax avoidance. Prospects for further research are identified, namely the need to develop measures for state regulation and optimization of excise duty taxation of tobacco products and their alternatives, taking into account the risks to public health and increasing demand of illegal products.

Effekt of blood flow shutdown on the vein damage when exposed to HIFU

2017 ◽  
pp. 46-50
Author(s):  
Н.Н. Петрищев ◽  
Д.Ю. Семенов ◽  
А.Ю. Цибин ◽  
Г.Ю. Юкина ◽  
А.Е. Беркович ◽  
...  
Keyword(s):  
Blood Flow ◽  
Structural Changes ◽  
Focused Ultrasound ◽  
Vena Cava ◽  
Posterior Wall ◽  
High Intensity Focused Ultrasound ◽  
Vein Wall ◽  
Ultrasound Exposure ◽  
Isolated Segment ◽  
The Impact

The purpose. In the study we investigated the impact of the partial blood flow shutdown on structural changes in the rabbit vena cava posterior wall after exposure to high-intensity focused ultrasound (HIFU). Methods. Ultrasound Exposure: frequency of 1.65 MHz, the ultrasound intensity in the focus of 13.6 kW/cm, the area of the focal spot 1 mm, continuous ultrasound, exposure for 3 seconds. Results. Immediately after HIFU exposure all layers of the vein wall showed characteristic signs of thermal damage. A week after exposure structural changes in the intima, media and adventitia was minimal in the part of vessel with preserved blood flow, and after 4 weeks the changes were not revealed. A week after HIFU exposure partial endothelium destruction, destruction of myocytes, disorganization and consolidation of collagen fibers of the adventitia were observed in an isolated segment of the vessel, and in 4 weeks endothelium restored and signs of damage in media and adventitia persisted, but were less obvious than in a week after exposure. Conclusion. The shutdown of blood flow after exposure to HIFU promotes persistent changes in the vein wall. Vein compression appears to be necessary for the obliteration of the vessel, when using HIFU-technology.

'Planning Economic Integration7, by L.B.M. Mennes, Rotterdam University Press, 1973.

1973 ◽  
Vol 12 (4) ◽  
pp. 438-439
Author(s):  
G. M. Radhul
Keyword(s):  
Economic Integration ◽  
Point Of View ◽  
Planning Model ◽  
Integration Policy ◽  
Medium Term ◽  
Future Production ◽  
Planning Models ◽  
Partici Pant ◽  
The Impact ◽  
Integration Area

The book under review deals with economic integration among deve¬loping countries from the point of view of planning. The author believes that it is useful to approach economic integration from a planning point of view and to develop planning models for it, because the theory of economic integration relevant for developing countries should be directed towards the impact of integration on future investments and future production. The type of models used in the book are the multisector linear programming models and the method of analysis is essentially a comparison of two situations; one with economic integration and the other without. For each prospective partici¬pant a medium term planning model is drawn up taking account of its economic situation in some base year. The results of these single country planning models are analysed and compared to those of a similar planning model for the integration area as a whole. The consequences of the integration policy are then evaluated.

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