scholarly journals Establishment and preliminary evaluation of a teaching hospital-based dementia consultation service for rurally-based regional district general hospitals

2021 ◽  
Author(s):  
Björn Hendrik Schott ◽  
Jakob Christian Voetlause ◽  
Juliana Lisa Amoah ◽  
Alexander Kratzenberg ◽  
Michael Belz ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Rural Areas ◽  
Psychiatric Inpatient ◽  
Initial Evaluation ◽  
Preliminary Evaluation ◽  
Consultation Service ◽  
Behavioral Disturbances ◽  
General Hospitals ◽  
Psychiatric Inpatient Treatment ◽  
Diagnosis Of Dementia

The treatment of patients with dementia poses a considerable challenge to regional district general hospitals, particularly in rural areas. Here we report the establishment and initial evaluation of a dementia-specific consultation service provided by a teaching hospital-based Psychiatry Department to regional district general hospitals in smaller surrounding towns. The service was provided to patients both with pre-existing and newly diagnosed or suspected dementia, who were in acute hospital care for concurrent conditions. An initial evaluation of 61 consultations - 49 on-site and 12 via telemedicine - was performed to assess the needs of the participating hospitals and the specific nature of the referrals to the consultation service. Suspected dementia or cognitive dysfunction was the primary reason for consultation requests (>50% of cases). Other common requests concerned suspected delirium, behavioral disturbances, and therapeutic recommendations. During the consultations, a diagnosis of dementia was reached in 52.5% of cases, with other common diagnoses including delirium and depression. Recommendations related to pharmacotherapy were given in 54.1% of consultations. Other recommendations included referral for outpatient neurological or psychiatric follow-up, further diagnostic assessment, or assessment in a memory clinic. Geriatric psychiatric inpatient treatment was recommended in only seven cases (11.5 %). Our initial evaluation demonstrates the feasibility of providing a dementia-specific consultation service in a rural area. The service has the potential to reduce acute transfers to inpatient geriatric psychiatry and enables older patients with dementia or delirium to be treated locally by helping and empowering rurally-based regional hospitals to manage these problems and associated complications.

Substance Abuse in Older Psychiatric Inpatients

2017 ◽  
Vol 63 (2) ◽  
pp. 115-121 ◽  
Author(s):  
Tilman Wetterling ◽  
Klaus Junghanns
Keyword(s):  
Substance Abuse ◽  
Substance Abusers ◽  
Psychiatric Inpatient ◽  
Psychiatric Inpatients ◽  
Severe Withdrawal ◽  
Psychiatric Inpatient Treatment ◽  
Clinical Diagnoses ◽  
Multiple Substance ◽  
Icd 10 ◽  
Substance Abuse Disorders

Abstract. Aim: This study investigates the characteristics of older patients with substance abuse disorders admitted to a psychiatric department serving about 250.000 inhabitants. Methods: The clinical diagnoses were made according to ICD-10. The data of the patients with substance abuse were compared to a matched sample of psychiatric inpatients without substance abuse as well as to a group of former substance abusers with long-term abstinence. Results: 19.3 % of the 941 patients aged > 65 years showed current substance abuse, 9.4 % consumed alcohol, 7.9 % took benzodiazepines or z-drugs (zolpidem and zopiclone), and 7.0 % smoked tobacco. Multiple substance abuse was rather common (30.8 %). About 85 % of the substance abusers had psychiatric comorbidity, and about 30 % showed severe withdrawal symptoms. As with the rest of the patients, somatic multimorbidity was present in about 70 % of the substance abusers. Remarkable was the lower rate of dementia in current substance abusers. Conclusion: These results underscore that substance abuse is still a challenge in the psychiatric inpatient treatment of older people.

An Epidemiological, Diagnostic and Therapeutic Study of Giardia lamblia in Anbar Province – Iraq

2019 ◽  
Vol 9 (01) ◽  
pp. 39-45
Author(s):  
Suad Shallal Shahatha
Keyword(s):  
Teaching Hospital ◽  
Rural Areas ◽  
Giardia Lamblia ◽  
Urban Areas ◽  
Culture Media ◽  
Age Groups ◽  
Stool Samples ◽  
Women And Children ◽  
Teucrium Polium L ◽  
Therapeutic Study

This study was carried out to investigate the epidemiology of Giardia lamblia parasites in patients who visited some of the hospitals in Anbar province, which included (Fallujah Teaching Hospital, Ramadi Teaching Hospital, Ramadi Teaching Hospital for Women and Children and Hit Hospital) during by examining 864 stool samples in a direct examination method, The results revealed the infection rate was 41.7 % and the percentage of infection among males 47.8% is higher than that of females 35.4% with significant differences (p≤0.05). The age groups (1-9) years recorded the highest rates 55.4% and the lowest rate 13.6% in the age group (40-49) years. The highest rate of infection was 62.5% during the month of June, while the month of October was the lowest rate 5% and significant differences. The incidence rate in rural areas was 50.6% higher than in the urban areas 32.5%. The study also included the effect of Teucrium polium L. on the parasite in the culture media HSP-1, the concentrations of 0.5-3 mg / mL significantly affected Giardia, it was noted whenever the greater the concentration, the greater the effect during different treatment periods (1-4) days, as the highest concentration 3 mg/ml killed all Giardia parasites on the fourth day of treatment.

Child Psychiatric Consultation Service to Community Agencies: A Collaborative Approach Involving Three Community Agencies

1997 ◽  
Vol 42 (6) ◽  
pp. 656-658 ◽  
Author(s):  
Arthur Froese ◽  
Patrice Dwyer-Sepic ◽  
Kevin Parker
Keyword(s):  
Rural Areas ◽  
Early Experience ◽  
Collaborative Approach ◽  
Psychiatric Consultation ◽  
Consultation Service ◽  
Safety Issues ◽  
Community Agencies ◽  
Child Psychiatric ◽  
Effective Training ◽  
Management Issues

Objective: To report the early experience of a multiagency child psychiatric consultation service. Method: The program is described, and the demographic characteristics of clients referred to the consultation program over the first 25 months of operation are presented. Referrals were examined for demographics and the questions consultees wanted to have answered. Results: In 59 of 100 consultations, physical and/or sexual abuse was proved or highly suspected. In 82 of the 100 cases, consultees had questions pertaining to management issues. Questions related to diagnostic issues numbered 62, and there were 45 questions about safety issues. Conclusion: Effective psychiatric consultations services to rural areas can be established. Once established, the questions of consultees can provide an effective training ground for future community-oriented child psychiatrists.

A multidistrict audit on the management of Chlam ydia trachomatis in genitourinary medicine clinics in Yorkshire

1997 ◽  
Vol 8 (12) ◽  
pp. 792-795 ◽  
Author(s):  
Eric F Monteiro ◽  
Janet Harris ◽  
Paul Gilliatt
Keyword(s):  
Teaching Hospital ◽  
Contact Tracing ◽  
General Hospitals ◽  
Male And Female ◽  
Female Patients ◽  
Genitourinary Medicine ◽  
Chlamydial Infections

Summary: Nine genitourinary clinics (one teaching hospital and 8 district general hospitals) within the Yorkshire Deanery audited the management of uncomplicated genital chlamydial infections in male and female patients attending between January and December 1995. Standards set included: 100% of chlamydia-positive patients to be treated within 2 weeks of diagnosis; 100% of patients to return for test of cure within one month of treatment; 100% of patients to be referred for contact tracing. Four hundred and thirty-six of a total 1356 cases were audited. Eighty-nine per cent received treatment within 2 weeks; 64% returned for a test of cure within one month; 93% were referred for contact tracing. Changes in practice and a regionwide multidisciplinary audit initiative resulted from the study.

PRN Medication for Psychiatric Inpatients

1987 ◽  
Vol 32 (3) ◽  
pp. 199-203 ◽  
Author(s):  
John L. Craven ◽  
Peter M. Voore ◽  
George Voineskos
Keyword(s):  
Personality Disorder ◽  
Drug Use ◽  
Psychotropic Drug ◽  
Teaching Hospital ◽  
Psychotropic Medication ◽  
Psychotropic Drugs ◽  
Psychiatric Inpatient ◽  
Psychiatric Inpatients ◽  
Psychotropic Medications ◽  
Inpatient Units

Little is known about the extent of the use of prn psychotropic medication in psychiatric inpatient units. A survey of the prn prescription and administration of psychotropic drugs in a psychiatric teaching hospital revealed that a large number of inpatients were prescribed and administered such drugs on a prn basis. Although 50% of the prescriptions were never administered, only 25% were actively discontinued by physicians. A diagnosis of personality disorder was the factor most frequently associated with the rate of prn prescriptions and of administrations. A large number of prn prescriptions had no instructions for indications, minimum time spacing between doses or maximum daily dosage. It is suggested that hospitals monitor the prn use of psychotropic medications in their inpatient units, and explore the reasons for such use. Psychotropic drug use on a prn basis should preferably be reserved for emergencies, and the instructions of prn prescriptions should be clear and detailed.

Sign in / Sign up

Export Citation Format

Share Document