scholarly journals Acute inpatient psychiatry in England: an old problem and a new priority

2006 ◽  
Vol 15 (2) ◽  
pp. 91-94 ◽  
Author(s):  
Paul Lelliott
Keyword(s):  
Community Care ◽  
Leisure Activities ◽  
International Standards ◽  
Psychiatric Admission ◽  
Admission Ward ◽  
Acute Psychiatric Wards ◽  
Underlying Causes ◽  
The Uk ◽  
Psychiatric Beds ◽  
Bed Numbers

AbstractWith the development of community care, the number of National Health Service psychiatric beds in England has been reduced to between one-fifth and one-quarter of those provided in the mid-1950s. Psychiatric bed numbers are close to the irreducible minimum if they have not already reached it. The problems facing today's acute psychiatric admission wards include: poor design, maintenance and ambience; a lack of therapeutic and leisure activities for patients leading to inactivity and boredom; frequent incidents of aggression and low-level violence and problems with staffing. It is suggested that there are a number of underlying causes: First, there has been failure to plan inpatient services, or to define their role, as attention has focused on new developments in community care. Second, the reduction in bed numbers has led to a change in the casemix of inpatients with a concentration on admission wards of a more challenging group of patients. Third, admission ward environments are permeable to the adverse effects of local street life, including drug taking. After years of neglect, acute inpatient psychiatric services in England are now high on the UK Government agenda. The paper lists a number of national initiatives designed to improve their quality and safety. A recent review of qualitative research suggests that acute psychiatric wards in other countries face similar problems to those reported in England. It is suggested that there might be a need for joint action which might take the form either of international research about acute inpatient care or the development of international standards and a common quality improvement system.

scholarly journals Expert Arguments for Trends of Psychiatric Bed Numbers: A Systematic Review of Qualitative Data

2021 ◽  
Vol 12 ◽  
Author(s):  
Adrian P. Mundt ◽  
Sabine Delhey Langerfeldt ◽  
Enzo Rozas Serri ◽  
Mathias Siebenförcher ◽  
Stefan Priebe
Keyword(s):  
Systematic Review ◽  
Community Care ◽  
Integration Of Care ◽  
Admission Rates ◽  
Expert Opinions ◽  
Psychiatric Beds ◽  
Occupancy Rates ◽  
Mental Health Policies ◽  
Bed Numbers

Introduction: Mental health policies have encouraged removals of psychiatric beds in many countries. It is under debate whether to continue those trends. We conducted a systematic review of expert arguments for trends of psychiatric bed numbers.Methods: We searched seven electronic databases and screened 15,479 papers to identify expert opinions, arguments and recommendations for trends of psychiatric bed numbers, published until December 2020. Data were synthesized using thematic analysis and classified into arguments to maintain or increase numbers and to reduce numbers.Results: One hundred six publications from 25 countries were included. The most common themes arguing for reductions of psychiatric bed numbers were inadequate use of inpatient care, better integration of care and better use of community care. Arguments to maintain or increase bed numbers included high demand of psychiatric beds, high occupancy rates, increasing admission rates, criminalization of mentally ill, lack of community care and inadequately short length of stay. Cost effectiveness and quality of care were used as arguments for increase or decrease.Conclusions: The expert arguments presented here may guide and focus future debate on the required psychiatric bed numbers. The recommendations may help policymakers to define targets for psychiatric bed numbers. Arguments need careful local evaluation, especially when supporting opposite directions of trends in different contexts.

THE ALLIED NEUTRAL? PORTUGUESE BALANCE OF PAYMENTS WITH THE UK AND GERMANY IN THE SECOND WORLD WAR, 1939-1945

2020 ◽  
Vol 38 (1) ◽  
pp. 79-110
Author(s):  
Eric Golson
Keyword(s):  
Raw Materials ◽  
Second World War ◽  
Balance Of Payments ◽  
International Standards ◽  
Third Party ◽  
World War ◽  
Portuguese Empire ◽  
Active Choice ◽  
The Uk ◽  
Second World

ABSTRACTIn September 1939, Portugal made a realist strategic choice to preserve the Portuguese Empire maintaining by its neutrality and also remaining an ally of Great Britain. While the Portuguese could rely largely on their colonies for raw materials to sustain the mainland, the country had long depended on British transportation for these goods and the Portuguese military. With the British priority now given to war transportation, Portugal's economy and Empire were particularly vulnerable. The Portuguese dictator Antonio Salazar sought to mitigate this damage by maintaining particularly friendly financial relations with the British government, including increased exports of Portuguese merchandise and services and permission to accumulate credits in Sterling to cover deficits in the balance of payments. This paper gives an improved set of comprehensive statistics for the Anglo-Portuguese and German–Portuguese relationships, reported in Pounds and according to international standards. The reported statistics include the trade in merchandise, services, capital flows, loans and third-party transfers of funds in favour of the British account. When compared with the German statistics, the Anglo-Portuguese figures show the Portuguese government favoured the British in financial relations, an active choice by Salazar to maintain the Portuguese Empire.

scholarly journals Trends in educational mobility: How does China compare to Europe and the United States?

2019 ◽  
Vol 5 (2) ◽  
pp. 214-240
Author(s):  
Rob J Gruijters ◽  
Tak Wing Chan ◽  
John Ermisch
Keyword(s):  
Educational Opportunity ◽  
The United States ◽  
International Standards ◽  
Educational Mobility ◽  
The Us ◽  
The Usa ◽  
Economic Boom ◽  
The Uk ◽  
Large Decline ◽  
Inequality Of Educational Opportunity

Despite an impressive rise in school enrolment rates over the past few decades, there are concerns about growing inequality of educational opportunity in China. In this article, we examine the level and trend of educational mobility in China, and compare them to the situation in Germany, the Netherlands, the UK and the USA. Educational mobility is defined as the association between parents’ and children’s educational attainment. We show that China’s economic boom has been accompanied by a large decline in relative educational mobility chances, as measured by odds ratios. To elaborate, relative rates of educational mobility in China were, by international standards, quite high for those who grew up under state socialism. For the most recent cohorts, however, educational mobility rates have dropped to levels that are comparable to those of European countries, although they are still higher than the US level.

scholarly journals Burnout amongst neurosurgical trainees in the UK and Ireland

2021 ◽  
Author(s):  
Nadia Liber Salloum ◽  
Phillip Correia Copley ◽  
Marco Mancuso-Marcello ◽  
John Emelifeonwu ◽  
Chandrasekaran Kaliaperumal
Keyword(s):  
Risk Factors ◽  
Workplace Bullying ◽  
Online Survey ◽  
Medical Profession ◽  
Leisure Activities ◽  
Attrition Rates ◽  
Workplace Stressors ◽  
Potential Risk Factors ◽  
The Uk ◽  
Enhance Patient Care

Abstract Introduction Burnout is becoming an increasingly recognised phenomenon within the medical profession. This study aims to investigate the presence of burnout amongst neurosurgical trainees in the UK and Ireland as well as investigating potential exacerbating and protective factors. Method An online survey was sent to all neurosurgical trainees in the UK and Ireland via the British Neurosurgical Trainees’ Association (BNTA) mailing list. Responding participants anonymously completed the Copenhagen Burnout Inventory (CBI) and answered questions about known risk factors for burnout including workplace environment, workplace bullying, time spent on leisure activities and sleep and reported likelihood of leaving neurosurgery. We also collated data on responders’ demographics. We compared CBI scores for participants with and without risk factors to determine correlation with CBI. Results There were 75 respondents (response rate 42%) from a range of ages and all training grades, 72% of whom were male. The median CBI score was 38.85 (IQR 17.76). Participants showed a higher degree of personal and workplace burnout (median CBIs of 47.02, IQR 25.00; and 49.14, IQR 19.64, respectively) compared with patient-related burnout (median CBI 18.67, IQR 25.00). Participants with the following self-reported risk factors were significantly more likely to have higher CBIs: workplace bullying (p = 0.01), getting on less well with colleagues (p < 0.05), working longer hours (p < 0.05) and insufficient sleep, exercise and leisure time (all p < 0.01). Those with higher CBI scores were more likely to consider leaving neurosurgical training (p = 0.01). Conclusion We identified a high burnout incidence in a cohort representative of UK neurosurgical trainees, although our results may have been skewed somewhat by selection bias. We determined potential risk factors for burnout related to specific workplace stressors and time for non-work activities. In the future, changes to training curricula should address these issues, aiming to improve training, enhance patient care and reduce attrition rates.

Setting up a Ward-Based Group Therapy Programme for Psychiatric Inpatients

1988 ◽  
Vol 51 (1) ◽  
pp. 22-24 ◽  
Author(s):  
Keith Miller ◽  
Debby Matthews
Keyword(s):  
Group Therapy ◽  
Occupational Therapists ◽  
Psychiatric Inpatients ◽  
Psychiatric Admission ◽  
Planning Phase ◽  
Admission Ward ◽  
Therapy Intervention ◽  
Therapy Programme ◽  
Made In

This article describes the steps involved in planning and running a group therapy intervention on an acute psychiatric admission ward. A model of group therapy based on the work of Yalom was adopted as the basis for a series of planning meetings, during which the viability of the intervention in the authors' particular setting was assessed. Following the planning phase, the group ran successfully and an example of a typical session's structure is discussed in some detail in the second part of this article. Some comments about the role of occupational therapists within psychiatry are made in the light of the authors' experience.

scholarly journals Do History Lessons Ever Pay off? A Diplomat’s Memoir

2020 ◽  
Vol 8 (2) ◽  
Author(s):  
Rodric Braithwaite
Keyword(s):  
Foreign Policy ◽  
Soviet Union ◽  
Russian Language ◽  
University Of Cambridge ◽  
The Soviet Union ◽  
Underlying Causes ◽  
The Uk ◽  
The Russian Language ◽  
Insight Into ◽  
Moscow River

Sir Rodric Braithwaite was educated at Christ’s College, University of Cambridge, from where he went to serve in HM Diplomatic Service, having worked in Jakarta, Moscow, Washington, Warsaw, Rome, and Brussels, where he was a member of the British delegation to the European Community. From 1988 to 1992, Sir Rodric served as HM Ambassador in the Soviet Union during the decisive years of the Perestroika and the first British ambassador in Russia. Subsequently, he was appointed foreign policy adviser to the Prime Minister in the second John Major ministry and chaired the UK Joint Intelligence Committee between 1992 and 1993. He was appointed Knight Grand Cross of the Order of St Michael and St George (GCMG) in 1994. As a career diplomat, Sir Rodric gained decades of insight into the troubled relations between Russia and West, having taken part in numerous negotiations on arms control. His affinity with the decision-making circles in both Russia and Britain alongside with the mastery of the Russian language allow him to skillfully dissect the underlying causes of ups-and-downs in Moscow’s relationship with the West, employing the works of both English- and Russian-speaking analysts. Among his recent books are Across the Moscow River (2002), Moscow 1941: A City and Its People at War (2006), Afgantsy: The Russians in Afghanistan, 1979–1989 (2012), Armageddon and Paranoia: The Nuclear Confrontation (2017). In this essay, Sir Rodric reminisces of the years spent as a diplomat and provides his view on the usefulness and applicability of historical lessons while devising a foreign policy course.

scholarly journals CONCEPTUAL APPROACHES TO CLASSIFICATION OF NATIONAL ACCOUNTING SYSTEMS

2020 ◽  
Vol 384 (2) ◽  
pp. 111-118
Author(s):  
Y. E. Putihin ◽  
Y. N. Akimova ◽  
N. V. Ostrovskaya ◽  
I. A. Manvelova ◽  
E. V. Negashev
Keyword(s):  
Accounting Standards ◽  
International Standards ◽  
International Accounting ◽  
Accounting System ◽  
International Accounting Standards ◽  
Accounting Systems ◽  
National Accounting ◽  
The Uk ◽  
The Eu

International Accounting Practice Accounting is multifaceted and heterogeneous. First distinguish between international standards and national standards. National accounting standards for each country is being developed independently. The leading countries in the field of national accounting standards are the United Kingdom and the United States, which is determined by the role of these countries in international financial markets. In different countries, national accounting standards are called differently; in addition, various bodies are involved in their development: in some these are state bodies, in other countries professional organizations. International accounting standards are implemented and developed at 2 levels: international, global and regional. In the regional aspect, the main role belongs to the EU Accounting Commission, which regulates these matters in the EU countries. World standards are developed by several organizations: International Federation of Accountants, Committee on International Accounting Standards, Intergovernmental Group of Experts on International Standards Reporting and Accounting Center for Transnational United Nations Corporation, Economic development and cooperation. There is a great variety of accounting systems around the world. The differences between them are explained mainly by the different business environments in which they operate. Among many classifications, which are based on various principles, two main classifications can be distinguished. The first one is based on the “geographical” principle, i.e.: the UK-US system, the Continental system, the Latin American system. In the second classification, systems are clustered based on their typical properties and hierarchy. The upper level defines the objectives that the accounting system focuses on. Next, systems are rated based on whether the state insists on applying the theoretical approach or the actual legislative requirements and business needs. It might be difficult to classify a system as belonging to a specific group if the country’s accounting system is unstable. Thus, in the 60s of the 20th century, New Zealand started to separate from the UK, although many provisions of its accounting system were taken directly from the standards developed by the English Institute of Financial Accountants. In view of the existing challenges and various approaches to the classification of national accounting systems, the importance of such classification can hardly be overestimated. The proximity of national accounting systems in countries that belong to the same model suggests the possibility of harmonization of accounting principles at the international level. Based on the above: - the possibility of grouping national accounting systems into clusters makes it possible to level out the differences between them during standardization; - the convergence of economies of different countries due to the globalization of the world economy contributes to the unification of accounting principles at the global level.

scholarly journals Locked doors or sentinel nurses?

2000 ◽  
Vol 24 (9) ◽  
pp. 327-328 ◽  
Author(s):  
Bob Adams
Keyword(s):  
Psychiatric Care ◽  
Acute Psychiatric Wards ◽  
The Uk ◽  
Locked Doors ◽  
Park Hospital ◽  
The Doors

Towards the end of 1998 we decided to introduce a facility to lock the doors of the acute psychiatric wards at Bootham Park Hospital, York. At first sight this would appear to be a retrograde step for modern psychiatric care in the UK. But this was a reasoned and planned move which has resulted in improved care for patients overall.

The changing context of advanced practice nursing within the UK community care setting

2021 ◽  
Vol 26 (12) ◽  
pp. 581-586
Author(s):  
Barry Hill ◽  
Sadie Diamond-Fox ◽  
Aby Mitchell
Keyword(s):  
Community Care ◽  
Advanced Practice Nursing ◽  
Advanced Practice ◽  
Advanced Level ◽  
The Public ◽  
Independent Prescribing ◽  
Consultation Skills ◽  
The Uk ◽  
Additional Education ◽  
And Training

Advanced practice nursing (APN) roles have developed partly to address demand and workforce issues. In community care settings and general practice, an advanced nursing practitioner is generally understood to mean a nurse who has undertaken additional education and training in clinical assessment, including history-taking and physical examination, clinical reasoning and independent prescribing, so they can safely manage patients presenting with undifferentiated and undiagnosed conditions. Capabilities in the Skills for Health framework cover everything from communication and consultation skills, practising holistically and personalised care, to working with colleagues and in teams. The framework is intended to ensure advanced nursing practitioners work to an advanced level. It is also designed to support them to demonstrate and evidence their capabilities to service commissioners, employers, people accessing healthcare and the public.

Sign in / Sign up

Export Citation Format

Share Document