A HISTORY OF THE BUFFALO GENERAL HOSPITAL TRAINING-SCHOOL FOR NURSES

Until the 1880s, hospitals excluded contagious disease patients from admission because of the danger they posed to other patients; by the 1950s, contagious disease care had literally moved into the general hospital. This article correlates the changing isolation facility designs with changing disease incidence and prevention strategies. It argues that isolation moved into the hospital in stages that have consequence for isolation facility design today. Between the 1890s and 1940s, contagious disease care shifted from remote isolation hospitals (commonly known as pest houses) to separate contagious disease hospitals, to contagious disease “units” adjacent to or within a general hospital facility, and to isolation rooms included in nursing units. The architectural history of isolation facility designs shows that the integration of isolation facilities into general hospitals relied on the success of new aseptic nursing procedures that prevented contact transmission but which downgraded the need for spatial separation to prevent airborne transmission. In the second half of the 20th century, federal funding and standards made isolation rooms in the hospital the norm. This migration coincided with a historically unprecedented reduction in contagious disease incidence produced by successful vaccines and antibiotics. By the 1980s, the rise of new and antibiotic resistant diseases led to extensive redesigns of the in-house isolation rooms to make them more effective. This article suggests that it is time to rethink isolation not just at the detail level but in terms of its location in relation to the general hospital.

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Twenty years of electroconvulsive therapy in a psychiatric unit at a university general hospital

Trends in Psychiatry and Psychotherapy ◽

10.1590/s2237-60892013000300010 ◽

2013 ◽

Vol 35 (3) ◽

pp. 229-233 ◽

Cited By ~ 4

Author(s):

Amilton dos Santos Jr. ◽

Maitê Cruvinel Oliveira ◽

Tiago dos Santos Andrade ◽

Rosana Ramos de Freitas ◽

Cláudio Eduardo Muller Banzato ◽

...

Keyword(s):

General Hospital ◽

Electroconvulsive Therapy ◽

Psychiatric Hospitalization ◽

Psychiatric Unit ◽

Telephone Contact ◽

Persistent Memory ◽

History Of ◽

Telephone Calls ◽

Psychiatric Outcome

Objective: To describe the sociodemographic and clinical profile of patients who underwent electroconvulsive therapy (ECT) at a university general hospital. Method: In this retrospective study, records from all patients undergoing ECT between January 1988 and January 2008 at the psychiatric unit of the general hospital of Universidade Estadual de Campinas (UNICAMP) were reviewed. Telephone contact was made with patients/relatives to collect follow-up data. Results: A total of 200 charts were reviewed. The majority of patients were women, with a mean age of 39 years, and history of psychiatric hospitalization. The main indications for ECT were depression and catatonia. Complications were observed in less than half of the cases, and most were temporary and not severe. There was a good psychiatric outcome for 89.7% of the patients, especially for catatonic patients (100%, p = 0.02). Thirty-four percent of the cases were later contacted by telephone calls, at a mean of 8.5 years between the procedure and the contact. Among these, three (1.5%) reported persistent memory disorders and 73% considered ECT a good treatment. Conclusion: ECT has been performed according to international guidelines. In the vast majority of cases, undesirable effects were temporary and not severe. Response to ECT was positive in most cases, particularly in catatonic patients.

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