scholarly journals Changing Ethnic and Social Characteristics of Patients Admitted for Self-Poisoning in West London during 1971/2 and 1983/4

1987 ◽  
Vol 80 (3) ◽  
pp. 145-148 ◽  
Author(s):  
S P Lockhart ◽  
J H Baron
Keyword(s):  
Inner City ◽  
Indian Population ◽  
Psychiatric Care ◽  
District General Hospital ◽  
Epidemiological Studies ◽  
Social Characteristics ◽  
West Indians ◽  
Ethnic Variation ◽  
Self Injury ◽  
Number Of Patients

The characteristics of adult patients admitted for self-poisoning to an inner London district general hospital were examined during 1971/72 and 1983/84. The incidence of self-poisoning halved over the 12 years, from 326 to 178 per 100 000. Although no West Indians were admitted in the first period, they comprised 7% of such admissions 12 years later. The West Indian population in the catchment area remained constant at around 6%. Amongst all patients admitted for self-poisoning, there was a fall in the number of patients diagnosed as depressed, having a personality disorder or admitting to prior psychiatric care, but an increase in alcoholism. Paracetamol became more common as a drug used in self-poisoning and barbiturates were taken less often. Only one patient died in the series. These results should stimulate more soundly based epidemiological studies on ethnic variation in self-poisoning, and on self-injury in inner-city areas.

The comparative analysis of clinical and social characteristics of patients with schizophrenia and organic mental disorders receiving care in partial inpatient units

2021 ◽  
pp. 394-403
Author(s):  
George Petrovich Kostyuk ◽  
Burygina Larisa Andreevna Burygina Larisa Andreevna ◽  
Andrey Yurevich Berezantsev ◽  
Valeriya Vasilyevna Surikova
Keyword(s):  
Comparative Analysis ◽  
Mental Disorders ◽  
Psychiatric Care ◽  
Psychiatric Inpatient ◽  
Inpatient Unit ◽  
Social Characteristics ◽  
Organic Mental Disorders ◽  
Spectrum Disorders ◽  
Day Hospitals ◽  
Inpatient Units

The article presents the results of a comparative analysis of the clinical and social characteristics of patients with schizophrenic spectrum disorders (SSD) and organic mental disorders (OMD) who received care in day hospitals and intensive psychiatric care units (Moscow). During the study, a random sample of 487 discharge epicrises was studied, of which 392 (80,49%) were patients with SSD and OMD, who were subjected to further analysis. The study revealed gender differences and low rates of labor and family adaptation in both nosological groups of patients. The highest percentage of patients observed on a long-term basis in neuropsychiatric dispensaries and the rate of hospitalization in a round-the-clock inpatient unit were among the patients with diagnoses of schizophrenic spectrum disorders who were treated in intensive psychiatric care units. There were significant differences in the routing of patients depending on the pathology: district psychiatrists more often refer patients with a diagnosis of schizophrenia to the intensive psychiatric care unit in order to prevent hospitalization and patients with organic mental disorders - to day hospitals for therapy selection and medical and social rehabilitation, while doctors of the round-theclock hospital – vice versa (in order to continue treatment or follow up in out-of-hospital conditions). There was also a circulation of patients between the intensive psychiatric care unit and the day hospitals. Isolated episodes of compliance violations were noted. Indicative indicators such as hospitalization in a round-the-clock psychiatric inpatient unit within a year after the discharge from partial inpatient units was low and was usually due to severe continuous forms of the disease and the formation of therapy resistance in patients. Day hospitals and departments (offices) of intensive psychiatric care in general effectively perform the functions of inpatient unit substitution.

The assessment of cognitive function in the elderly using videoconferencing

1998 ◽  
Vol 4 (1_suppl) ◽  
pp. 36-38 ◽  
Author(s):  
Chris Ball ◽  
Alison Puffett
Keyword(s):  
Cognitive Function ◽  
Inner City ◽  
The Elderly ◽  
Structured Interview ◽  
The Other ◽  
Initial Assessment ◽  
Face To Face ◽  
Number Of Patients ◽  
Old Age Psychiatry ◽  
Videoconferencing System

People over the age of 65 were recruited from an inner-city old-age psychiatry service. Subjects had a structured interview (the CAMCOG test) by videoconferencing, and also face to face, by an investigator blind to the results of the test in the other mode. Reassessments were carried out within one week of the initial assessment. Eleven subjects were initially enrolled in the study and eight completed both modes. The number of patients in this study is very small but the results suggest that the CAMCOG test can be used reliably over a videoconferencing system without major modification.

scholarly journals Monitoring inner London mental illness services

1995 ◽  
Vol 19 (5) ◽  
pp. 276-280 ◽  
Author(s):  
◽  
Bernard Audini ◽  
Michael Crowe ◽  
Joan Feldman ◽  
Anna Higgitt ◽  
...  
Keyword(s):  
Mental Illness ◽  
Psychiatric Care ◽  
Bed Occupancy ◽  
Local Data ◽  
Catchment Population ◽  
The Poor ◽  
Number Of Patients ◽  
The Mean ◽  
Acute Psychiatric Care ◽  
The Impact

Our objective was to establish a mechanism for monitoring indicators of the state of health of inner London's mental illness services. Data were collected for a census week around 15 June 1994. Local data collection was coordinated by consultant pyschiatrists working in inner London services. Twelve services participated with a combined catchment population of 2.6 m. They included ten London services which were among the 17 most socially deprived areas of England. Main indicators were admission bed occupancy levels (including an estimate of the total requirement), proportion of patients detained under the Mental Health Act, number of assaults committed by inpatients, number of emergency assessments and CPN caseloads. The mean true bed occupancy (which reflects the number of patients who were receiving, or required, in-patient care on census day) was 130%. To meet all need for acute psychiatric care, including for patients who should have been admitted and those discharged prematurely because beds were full, a further 426 beds would have been required. Fifty per cent of patients were legally detained. Physical assaults were virtually a daily occurrence on the admission units. Average community pyschiatric nurse caseloads were 37, suggesting that the majority were not working intensively with limited caseloads of patients with severe mental illness. These indicators, although imperfect, will allow for some measurement of the impact of local and central initiatives on the poor state of London's mental illness services.

scholarly journals Protecting patients from infection: Improving topical prophylaxis compliance on surgical wards

2019 ◽  
Vol 21 (2) ◽  
pp. 47-51
Author(s):  
Holly Slyne ◽  
Natalie Clews ◽  
Sid Beech ◽  
Elizabeth Smilie
Keyword(s):  
Quality Improvement ◽  
Infection Prevention ◽  
Communication Strategies ◽  
District General Hospital ◽  
Site Infection ◽  
Improvement Project ◽  
Medication Prescription ◽  
Improvement Plan ◽  
Number Of Patients ◽  
Improve Compliance

Background: At a medium-sized district general hospital in the heart of England, it was identified that compliance to the administration of topical prophylaxis on three general surgery wards had reduced to 23%, following implementation of an electronic medication prescription record. Therefore, a quality improvement project was commenced to improve this compliance to protect patients from meticillin-resistant Staphylococcus aureus (MRSA) colonisation and associated bacteraemia. Aim: To improve compliance of topical prophylaxis administration on three surgical wards to protect patients from infection. Method: Quality improvement plan – do – study – act (PDSA) cycles evaluated the effectiveness of four different strategies from baseline data which was 23% compliant in December 2016. These included teaching and communication strategies, prompts in medical notes, discontinuation of Mupirocin 2% nasal ointment as part of the topical prophylaxis regime and discontinuation of the topical wash lotion from requiring a prescription. Results: The compliance of prophylaxis administration increased consistently throughout from 23% in December 2016 to 92% in March 2018. Consequently, the number of patients that developed a MRSA colonisation on the three wards reduced by 54%, from 13 in the 12 months before the study to six in the 12 months after the study. Discussion: This study led to a change in the Trust MRSA Policy to better protect patients from infection, particularly surgical site infection and MRSA bacteraemia. It suggests that quality improvement methodology has a place in infection prevention practice.

Mental Health in the Inner City

1984 ◽  
Vol 16 (1) ◽  
pp. 115-121 ◽  
Author(s):  
H L Freeman
Keyword(s):  
Mental Health ◽  
Social Networks ◽  
Psychiatric Disorder ◽  
Inner City ◽  
Epidemiological Studies ◽  
Social Planning ◽  
Measurable Effect ◽  
Differential Migration ◽  
Early Nineteenth Century ◽  
Industrial Community

Salford, an urban industrial community that dates from the early nineteenth century, has been used as the population base for extensive epidemiological studies of psychiatric disorder. Population fall, differential migration, and massive redevelopment have had a measurable effect in recorded rates for schizophrenia, but the likely adverse consequences in terms of less severe disorders cannot yet be estimated. Psychiatry may contribute to social planning through an emphasis on the value of continuity and preservation of social networks.

The Relationship Between Problem-Solving and Autobiographical Memory in Parasuicide Patients

1997 ◽  
Vol 25 (2) ◽  
pp. 195-202 ◽  
Author(s):  
Gary L. Sidley ◽  
Kim Whitaker ◽  
Rachel M. Calam ◽  
Adrian Wells
Keyword(s):  
Problem Solving ◽  
Inner City ◽  
Autobiographical Memory ◽  
General Hospital ◽  
Drug Overdose ◽  
District General Hospital ◽  
Autobiographical Memories ◽  
City District ◽  
Interpersonal Problem Solving ◽  
The Relationship

The relationship between effectiveness of interpersonal problem-solving and specificity of autobiographical memory was examined for 35 patients admitted to an inner-city District General Hospital following a deliberate drug-overdose. The results replicated those of Evans, Williams, O'Loughlin and Howells (1992) in finding a significant correlation between ineffective problem-solving and the over-general retrieval of autobiographical memories, giving further support to the suggestion that an over-general memory database may underpin the problem-solving deficits characteristic of parasuicide patients. However, the correlation coefficient computed was notably lower than in the Evans et al. study and an attempt is made to explain this discrepancy on the basis of differences in the levels of psychopathology between the patients involved in each study.

scholarly journals Reducing Diagnostic Errors in Musculoskeletal Trauma by Reviewing Non-Admission Orthopaedic Referrals in the Next-Day Trauma Meeting

2007 ◽  
Vol 89 (7) ◽  
pp. 692-695 ◽  
Author(s):  
H Sharma ◽  
S Bhagat ◽  
WJ Gaine
Keyword(s):  
False Positive Rate ◽  
False Negative ◽  
Diagnostic Errors ◽  
District General Hospital ◽  
X Rays ◽  
Out Of Hours ◽  
Accident And Emergency ◽  
Number Of Patients ◽  
Positive Rate ◽  
Musculoskeletal Trauma

INTRODUCTION Diagnostic errors in orthopaedics are usually caused by missing a fracture or misreading radiographs. The aim of this study was to document the pick-up rate of the wrong diagnoses by reviewing X-rays and casualty notes in the next-day trauma meeting. PATIENTS AND METHODS The casualty notes and radiographs of 503 patients were prospectively reviewed in the daily trauma meeting between August 2002 and December 2002 in a district general hospital. The relevant data were collected and analysed by a single assessor. RESULTS The false positive rate for making an orthopaedic diagnosis was 12.6% (i.e.) diagnosing a fracture, when none existed). The false negative (missing) rate was 4%, while 2.4% incidental findings were missed, or at least not documented, after reading the X-rays. There were 7.8% wrong diagnoses made. The majority of the patients were seen by the senior house officers. CONCLUSIONS The medicolegal significance of false negative diagnosis is obviously greater. In a busy emergency department, where a large number of patients are seen, there is a greater risk. This study shows the importance in a small-to-medium sized accident and emergency unit as well, where there is no senior cover available out-of-hours for final radiological interpretation. A morning trauma meeting which covers reviewing admitted patients as well as non-admission orthopaedic referrals has an effective risk management solution to early detection of missed and wrong diagnoses.

scholarly journals The impact of COVID-19 on elective and trauma spine service in a district general hospital

2020 ◽  
Vol 1 (6) ◽  
pp. 281-286
Author(s):  
Wajiha Zahra ◽  
Monil Karia ◽  
Daniel Rolton
Keyword(s):  
General Hospital ◽  
District General Hospital ◽  
Acute Hospital ◽  
Retrospective Data ◽  
Spine Trauma ◽  
Clinical Criteria ◽  
Time Period ◽  
Number Of Patients ◽  
Acute Hospital Admission ◽  
The Impact

Aims The aim of this paper is to describe the impact of COVID-19 on spine surgery services in a district general hospital in England in order to understand the spinal service provisions that may be required during a pandemic. Methods A prospective cohort study was undertaken between 17 March 2020 and 30 April 2020 and compared with retrospective data from same time period in 2019. We compared the number of patients requiring acute hospital admission or orthopaedic referrals and indications of referrals from our admission sheets and obtained operative data from our theatre software. Results Between 17 March to 30 April 2020, there were 48 acute spine referrals as compared to 68 acute referrals during the same time period last year. In the 2019 period, 69% (47/68) of cases referred to the on-call team presented with back pain, radiculopathy or myelopathy compared to 43% (21/48) in the 2020 period. Almost 20% (14/68) of spine referrals consisted of spine trauma as compared to 35% (17/48) this year. There were no confirmed cases of cauda equine last year during this time. Overall, 150 spine cases were carried out during this time period last year, and 261 spine elective cases were cancelled since 17 March 2020. Recommendations We recommend following steps can be helpful to deal with similar situations or new pandemics in future: 24 hours on-call spine service during the pandemic. Clinical criteria in place to prioritize urgent spinal cases. Pre-screening spine patients before elective operating. Start of separate specialist trauma list for patients needing urgent surgeries. Conclusion This paper highlights the impact of COVID-19 pandemic in a district general hospital of England. We demonstrate a decrease in hospital attendances of spine pathologies, despite an increase in emergency spine operations. Cite this article: Bone Joint Open 2020;1-6:281–286.

scholarly journals Suicide following discharge from in-patient psychiatric care

2004 ◽  
Vol 10 (6) ◽  
pp. 434-438 ◽  
Author(s):  
Mike J. Crawford
Keyword(s):  
Risk Factors ◽  
Social Support ◽  
Patient Care ◽  
Hospital Discharge ◽  
Continuity Of Care ◽  
Suicidal Behaviour ◽  
Psychiatric Care ◽  
Epidemiological Studies ◽  
Clinical Risk Factors ◽  
Service Organisation

The risk of suicide is higher during the period immediately following discharge from in-patient psychiatric care than at any other time in a service user's life. Demographic and clinical risk factors for suicide in this period are similar to those for suicide at other times and may not be specific enough to enable identification of those at greatest risk. Epidemiological studies suggest that factors related to service organisation and delivery (e.g. social support and continuity of care) are also important in the aetiology of suicide following hospital discharge. Interventions aimed at helping people in the period immediately following discharge from in-patient care have been developed. Although the effect of these interventions on suicidal behaviour has not been examined, available evidence suggests that efforts to increase patients' confidence and level of social support may be of value.

Sign in / Sign up

Export Citation Format

Share Document