A longitudinal description of incompetent to stand trial admissions to a state hospital

CNS Spectrums ◽  
2019 ◽  
Vol 25 (2) ◽  
pp. 223-236
Author(s):  
Barbara E. McDermott ◽  
Katherine Warburton ◽  
Chloe Auletta-Young
Keyword(s):  
Psychiatric Hospitalization ◽  
The Body ◽  
Psychiatric Facility ◽  
Department Of State ◽  
State Hospitals ◽  
Time Period ◽  
Forensic Inpatient ◽  
Incompetent To Stand Trial ◽  
Inpatient Psychiatric Facility ◽  
Growing Population

Objective.Evidence is clear that the nation is experiencing an increasing number of incompetent to stand trial (IST) admissions to state hospitals. As a result, defendants in need of treatment can wait in jail for weeks for admission for restoration. This study was conducted to better understand this growing population and to inform hospital administration about the characteristics of IST admissions.Methods.The study was conducted at the Department of State Hospitals (DSH) facility in Napa (DSH-Napa), a 1200-bed primarily forensic inpatient psychiatric facility located in northern California. The records of patients found IST and admitted to DSH-Napa for restoration of competence between the dates of 1/1/2009 and 12/31/2016 were eligible for inclusion in the study.Results.There were a total of 3158 unduplicated IST admissions available during the specified time period. Our data indicate that the number of admissions with more than 15 prior arrests increased significantly, from 17.7% in 2009 to 46.4% in 2016. In contrast, the percent of patients reporting prior inpatient psychiatric hospitalization evidenced a consistent decrease over time from over 76% in 2009 to less than 50% in 2016.Conclusion.Our data add to the body of literature on the potential causes of the nationwide increase in competency referrals. The literature is clear that jails and prisons are now the primary provider of the nation’s mental health care. Our data suggest that another system has assumed this role: state hospitals and other providers charged with restoring individuals to competence.

Impact of a Crisis Assessment and Treatment Service on Admissions into an Acute Psychiatric Unit

2005 ◽  
Vol 13 (2) ◽  
pp. 135-139 ◽  
Author(s):  
Adesina Adesanya
Keyword(s):  
Psychiatric Hospitalization ◽  
Psychiatric Facility ◽  
Treatment Service ◽  
Treatment Services ◽  
Before And After ◽  
Assessment And Treatment ◽  
Adult Inpatient ◽  
Clinical Records ◽  
The Impact ◽  
Inpatient Psychiatric Facility

Objective: To assess the impact of a regional/rural crisis assessment and treatment service (CAT) on admissions into an acute adult inpatient psychiatric facility. Methods: Relevant data for admissions into an acute adult inpatient psychiatric facility in the 18 month periods before and after the establishment of a CAT were compared. Data extracted from available clinical records were transferred into an appropriately structured pro forma for statistical analysis. Results: There were 69 and 53 index inpatient unit admissions in the two time periods. The majority of these were for single, unemployed men aged in their 30s. Although statistically non-significant, the results appear to suggest that there were proportionately fewer readmissions and that admissions were likely to be influenced by illness severity and diagnostic considerations in the period following the establishment of the CAT. The establishment of CAT did not appear to have had much impact on the duration of psychiatric hospitalization. Conclusions: Crisis assessment and treatment services operating within a re-gional/rural integrated mental health setting appear to have only limited impact on hospitalization for psychiatric crisis presentations. There is a need for further studies looking at a broader range of outcome variables in the assessment of the impact of CAT on psychiatric hospitalization in such settings.

Critical Review on Standard Operative Procedure of Yapana Basti Karma

2018 ◽  
Vol 3 (5) ◽  
Author(s):  
Dr. Rishu Sharma ◽  
Dr. Gyanendra Datta Shukla ◽  
Dr. Alok Kumar Srivastava
Keyword(s):  
Side Effects ◽  
Critical Review ◽  
Treatment Modality ◽  
Operative Procedure ◽  
The Body ◽  
Dosage Schedule ◽  
Dual Function ◽  
Time Period ◽  
Curative Action

Panchakarma therapy is one of the vital branch of Ayurveda, which deals mainly with purification of the provoked Doshas from the body. Basti Chikitsa is regarded as the prime treatment modality among the Panchakarma. It is having not only curative action but also preventive and promotive actions. It is considered as best treatment for Vata Dosha. Yapana Basti is a subtype of Asthapana Basti, which is having the property to support life and promote longevity and widely used in various disorders. Rajayapana Basti is superior amongst all the Yapana Bastis described by Acharya Charaka as it is the king of Yapana. This Rasayana Yapana Basti performs dual function of both Anuvasana and Niruha; hence this is Srotoshodhaka and Brimhana at the sametime. That’s why there is no need to administer separate Anuvasana while giving Yapana Basti. There is an urgent need of standardizing the classical Panchakarma procedures in consideration of the need of today. The dosage schedule, exact procedures, medicaments, effects, and side effects are to be standardized so that uniform procedure of practice should be followed all over nation. Standardization is the need of hour for physicians, to prevent Atiyoga (over activity), Ayoga (less or no activity) and to get adequate effects in a systematic and sophisticated manner within desired time period.

Effects of the CMS’ Public Reporting Program for Inpatient Psychiatric Facilities on Targeted and Nontargeted Safety: Differences Between For-Profits and Nonprofits

2021 ◽  
pp. 107755872199892
Author(s):  
Morgan C. Shields
Keyword(s):  
Spillover Effect ◽  
Public Reporting ◽  
Unintended Consequences ◽  
Psychiatric Facility ◽  
Quality Reporting ◽  
Performance Reporting ◽  
Reporting Programs ◽  
Using Data ◽  
Inpatient Psychiatric Facility ◽  
Psychiatric Facilities

The Centers for Medicare and Medicaid Services implemented the Inpatient Psychiatric Facility Quality Reporting Program in 2012, which publicly reports facilities’ performance on restraint and seclusion (R-S) measures. Using data from Massachusetts, we examined whether nonprofits and for-profits responded differently to the program on targeted indicators, and if the program had a differential spillover effect on nontargeted indicators of quality by ownership. Episodes of R-S (targeted), complaints (nontargeted), and discharges were obtained for 2008-2017 through public records requests to the Commonwealth of Massachusetts. Using difference-in-differences estimators, we found no differential changes in R-S between for-profits and nonprofits. However, for-profits had larger increases in overall complaints, safety-related complaints, abuse-related complaints, and R-S-related complaints compared with nonprofits. This is the first study to examine the effects of a national public reporting program among psychiatric facilities on nontargeted measures. Researchers and policymakers should further scrutinize intended and unintended consequences of performance-reporting programs.

Esophageal Diameters in Children Correlated to Body Weight

2018 ◽  
Vol 29 (06) ◽  
pp. 528-532
Author(s):  
Thomas Sebastian Bott ◽  
Thekla von Kalle ◽  
Alexander Schilling ◽  
Oliver Heinz Diez ◽  
Sarah Besch ◽  
...  
Keyword(s):  
Body Weight ◽  
Pediatric Surgery ◽  
The Body ◽  
Lateral Aspect ◽  
Arithmetic Average ◽  
Upper Gi ◽  
Time Period ◽  
Upper Gastrointestinal ◽  
Weight Groups ◽  
Weight Percentile

Introduction The development of stenoses after correction of an esophageal atresia or acid and lye burn of the esophagus are well-known problems in pediatric surgery. Currently, stenoses are treated in the majority of cases by repeated balloon dilatations. The diameter of the balloons used is not standardized; standard curves do not exist. The aim of this study was to evaluate the diameter of the esophagus correlated to the body weight of the children as measured in upper gastrointestinal (GI) studies to answer the important question to what extent a stenosis should be dilated. Materials and Methods Within the time period from 2011 through 2016, 60 patients with upper GI studies were selected. Evaluations were blinded to two different examiners. The diameters were measured under maximum contrast filling between the second and third rib (cranial point of measurement) and between the seventh and eighth rib (caudal point of measurement). For both, the anteroposterior and lateral aspect was examined. The diameter was calculated as the arithmetic average of both measurements within one level. The diameters were correlated to the weight of the children. Results All children (n = 38) within the 3rd to 97th weight percentile were analyzed. Linear correlation and coefficients of 0.67 at the cranial point and 0.70 at the caudal point were found. Mean diameter at the cranial point of measurement was 6.75 mm at the lowest weight (2.6 kg) and 14 mm at 74 kg. Mean weight of these children (standard deviation [SD]) was 25.3 (18.8) kg and median age was 7 years. Within weight groups (0–10 kg; 10–20 kg; 20–35 kg; 35–50 kg; >50 kg), we calculated SD and two side tested critical 95% confidence interval for all measurements (n = 74). Conclusion Although the variation in measurements is considerable, this evaluation gives a reliable hint to which extent esophageal stenoses should be dilated in relation to the body weight. To the best of our knowledge, this is the first investigation to evaluate the diameter of the esophagus in children in relation to the body weight.

scholarly journals Alcohol withdrawal-related outcomes associated with gabapentin use in an inpatient psychiatric facility

2019 ◽  
Vol 9 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Taylor A. Nichols ◽  
Sophie Robert ◽  
David J. Taber ◽  
Jeffrey Cluver
Keyword(s):  
Alcohol Withdrawal ◽  
Length Of Hospital Stay ◽  
Control Cohort ◽  
Psychiatric Facility ◽  
Therapeutic Uses ◽  
Significant Difference ◽  
Benzodiazepine Use ◽  
The Impact ◽  
Hospital Stay Duration ◽  
Inpatient Psychiatric Facility

Abstract Introduction Limited evidence exists evaluating the impact of gabapentin in conjunction with benzodiazepines for the management of alcohol withdrawal. A review of outcomes associated with combination gabapentin and benzodiazepine therapy may illuminate new therapeutic uses in clinical practice. Methods This retrospective study evaluated the impact of gabapentin on as-needed use of benzodiazepines in inpatients being treated for acute alcohol withdrawal. The treatment cohort consisted of patients prescribed gabapentin while on a symptom-triggered alcohol withdrawal protocol. The control cohort consisted of patients on symptom-triggered alcohol withdrawal protocol without concurrent gabapentin use. Secondary objectives included length of hospital stay, duration on alcohol withdrawal protocol, frequency of complicated withdrawal, and use of additionally prescribed as-needed or scheduled benzodiazepines. Results The gabapentin cohort was on the alcohol withdrawal protocol for a similar duration, compared with the control cohort (median of 4 [interquartile range: 2,6] days vs 3 [2,4] days, P = .09, respectively). Similarly, the gabapentin cohort required a median of 1 [1,2] benzodiazepine dose for alcohol withdrawal symptoms compared with a median of 1 [1,2] dose in the control cohort, P = .89. No significant difference was found between cohorts for as-needed and scheduled benzodiazepine use. Length of stay in hospital was similar between groups. Discussion These results suggest that gabapentin use, in conjunction with benzodiazepines, impacts neither the time on alcohol withdrawal protocol or the number of benzodiazepine doses required for withdrawal. Larger, prospective studies are needed to detect if gabapentin alters benzodiazepine usage and to better elucidate gabapentin's role in acute alcohol withdrawal.

Abstract 1129: Obesity-related Elevations in Soluble P-selectin are Derived From Endothelium and Dependent on Expression of Leukocyte P-selectin Glycoprotein Ligand-1

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Kevin J Wickenheiser ◽  
Peter F Bodary ◽  
Kristina Bahrou ◽  
Daniel T Eitzman
Keyword(s):  
Bone Marrow ◽  
Body Weight ◽  
Leptin Receptor ◽  
The Body ◽  
Wild Type ◽  
Post Transplant ◽  
Time Period ◽  
Increased Risk ◽  
Soluble P ◽  
Deficient Mice

Background : Obesity is associated with proinflammatory changes and an increased risk for vascular disease complications. The tissue source and mechanism by which soluble P-selectin (sPsel) is generated in obesity are unclear. Methods and Results : Soluble p-selectin (sPsel) levels were measured in the circulation from lean wild type and obese leptin receptor deficient mice (LepR−/−) at 4 and 10 weeks of age. In wild-type mice body weight increases from 13+/−2 to 20+/−3 grams over this time period while the body weight increases from 15+/−2 to 38+/−5 grams in LepR−/− mice. At 4 weeks of age sPsel levels were 103+/−8mg/mL in wild-type mice vs. 138+/−9 ng/mL in LepR−/− mice, p=0.048. By 10 wks of age sPsel increased to 112 +/− 2 in wild-type mice and 182 +/− 9 in LepR−/− mice, p=0.00005. In order to determine if the obesity-induced rise in sPsel is regulated by leukocyte Psgl-1, bone marrow transplantation was performed from Psgl+/+ or Psgl−/− donors into irradiated LepR−/−recipients. At 4 weeks post-transplant, sPsel levels were 166 +/−6 ng/mL in LepR−/− mice receiving Psgl+/+ marrow and 45 +/− 4 ng/mL in LepR−/− mice receiving Psgl−/− marrow, p=0.0000004. In order to determine if the sPsel in LepR−/− mice originated from the endothelium versus platelets, we transplanted Psel−/− bone marrow into irradiated LepR−/−mice. At 4 weeks post transplant, sPsel levels were 153 +/−3 ng/mL in LepR−/− mice receiving Psel−/− bone marrow and were not significantly different from LepR−/− mice receiving Psel+/+ bone marrow (166 +/−6 ng/mL, p=0.06). By 10 weeks post transplant, mice gained even more weight and levels were 377+/−51 ng/mL in LepR−/− mice receiving Psel+/+ bone marrow and 370+/−73 ng/mL in LepR−/− mice receiving Psel−/− bone marrow, p=0.87. Conclusions : These data suggest that the increase in sPsel observed in obesity is primarily derived from the endothelium and that this process is regulated by leukocyte Psgl-1.

Эволюция корпуса первых секретарей Калмыцкой организации ВКП(б) в 1921–1943 гг.

2020 ◽  
pp. 42-50
Author(s):  
Evgeniya V. Sartikova ◽  
Keyword(s):  
Communist Party ◽  
Central Committee ◽  
Close Relation ◽  
National Archive ◽  
The Body ◽  
Party Committee ◽  
Time Period ◽  
Regional Committee ◽  
The Republic ◽  
Poor Peasant

The article discusses the main trends in the rotation of the executive (the first) secretaries of the Kalmyk regional party committee in 1921–1943. The study is based on the documents from the fund of the Kalmyk regional committee of the USSR Communist Party kept at the National Archive of the Republic of Kalmykia. The principles of objectivism and historicism were used for the analysis of the archive materials that allowed to examine the problem in its relation to the existing specific historical circumstances. The goal of the article is to investigate the body of the first secretaries of the Russian Communist Party — All-Russia Communist Party in Kalmykia. The use of the common in the historical research methods (the broadside examination of the archive sources, historical description, chronological method) allowed to investigate the historical phenomena in the close relation to the historical situation. The author concludes that the specific feature of the rotation of the first secretaries of the Kalmyk regional party committee was the appointment of people from other regions of the country to this position. Mainly these were formal representatives, supervisors recommended by the Central Committee of the Russian Communist Party — All-Russia Communist Party for the positions of the first or second secretaries of the regional party committee. The analysis of the characteristics of the body of the first secretaries of the Kalmyk regional party in the given time period showed that all these people were from poor peasant families, without high education but with sufficient party service record who combined party and soviet activities.

scholarly journals A Generational Approach to Somatic Cultures: Modes of Attention to the Young Body in Contemporary Portuguese Society

Societies ◽  
2018 ◽  
Vol 8 (4) ◽  
pp. 102
Author(s):  
Vitor Ferreira
Keyword(s):  
Research Data ◽  
The Body ◽  
Recent History ◽  
Generational Change ◽  
Youth Cultures ◽  
Time Period ◽  
Body Design ◽  
History Of ◽  
Portuguese Society ◽  
The 1960S

The aims of this article are to identify, describe, and sociologically understand the different somatic cultures in contemporary Portuguese society—i.e., the distinct ways in which different generations have thought about, used and lived the body from the time of the Estado Novo (the New State, which was the regime that governed Portugal from 1933 to 1974) until the present day. Beginning with the hypothesis that there are different, historically institutionalized, somatic modes of attention to the “young body”, the author uses the most relevant institutions of the socialization of the body as analytical dimensions and investigates their main incorporation strategies and models of corporality. This hypothesis is informed by different generational conditions that change people’s uses of their body, their experiences of living in it, and their thoughts on the matter. Using these analytical dimensions, the article presents a typology that identifies, describes, and comprehends the three somatic cultures in the recent history of Portuguese society: the culture of physical invigoration that forms part of the legacy of the New State; the culture of physical rejuvenation inherited from youth cultures of the 1960s and 70s, along with the growth of body design industries in the 1980s; and the culture of physical perfection inherited from the biotech culture in the 1990s, accompanied by the radicalization of the body design industry. This approach entails the discussion and reinterpretation of a corpus of historical literature, presenting research data on the body in a defined time period (1930 to date) and space (Portugal), analyzed from an embodied perspective of generational change.

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