scholarly journals The interface between general and forensic psychiatry: the present day

2014 ◽  
Vol 20 (5) ◽  
pp. 359-365 ◽  
Author(s):  
Vivek Khosla ◽  
Phil Davison ◽  
Harvey Gordon ◽  
Verghese Joseph
Keyword(s):  
Forensic Psychiatry ◽  
Clinical Care ◽  
Learning Objectives ◽  
List Type ◽  
Type Number ◽  
England And Wales ◽  
Adult Psychiatry ◽  
The Republic ◽  
Definition Of ◽  
The Uk

SummaryWith the subspecialisation of psychiatry in the UK, clinicians encounter problems at the interfaces between specialties. These can lead to tension between clinicians, which can be unhelpful to the clinical care of the patient. This article focuses on the interface between general and forensic psychiatry in England and Wales. The pattern of mental health services in England and Wales differs to an extent from those in Scotland, Northern Ireland and in the Republic of Ireland. Consequently, the interface between general and forensic psychiatry is subject to varying influences. Important interface issues include: the definition of a ‘forensic patient’; the remit and organisation of services; resources; clinical responsibility; and care pathways. This article also discusses a general overview of how to improve collaboration between forensic and general adult psychiatric services.Learning Objectives•Develop an understanding of important issues at the forensic/general adult psychiatry interface.•Be aware of areas of conflict that may arise at the forensic/general adult psychiatry interface.•Be aware of options for optimum cooperation at the interface.

The interface between general and forensic psychiatry: a historical perspective

2014 ◽  
Vol 20 (5) ◽  
pp. 350-358 ◽  
Author(s):  
Harvey Gordon ◽  
Vivek Khosla
Keyword(s):  
Mental Disorder ◽  
Mentally Ill ◽  
Forensic Psychiatry ◽  
Learning Objectives ◽  
List Type ◽  
Type Number ◽  
Mentally Disordered Offenders ◽  
Mentally Disordered ◽  
The Past ◽  
The Uk

SummaryMental disorder and criminality are separate entities but some people with a mental disorder commit criminal offences and some criminals have a mental disorder. Before 1800 there was no separate category of mentally disordered offenders (referred to as criminal lunatics until 1948) in UK legislation. The provision of facilities for mentally disordered offenders in Britain and Ireland overlapped with, but was also separate from, provision for the mentally ill generally. The interface between general and forensic psychiatry is an area of tension and of collaboration. To understand how contemporary general and forensic psychiatry interact, it is useful to have an understanding of how factors have evolved overtime.Learning Objectives•Have an understanding of the evolution of general and forensic psychiatry in the UK over the past 200 years.•Comprehend the similarities and differences between general and forensic psychiatry.•Be aware of some of the roots of conflict between general and forensic psychiatry.

scholarly journals Metabolic syndrome in psychiatry: advances in understanding and management

2014 ◽  
Vol 20 (2) ◽  
pp. 101-112 ◽  
Author(s):  
Cyrus S. H. Ho ◽  
Melvyn W. B. Zhang ◽  
Anselm Mak ◽  
Roger C. M. Ho
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Psychiatric Disorders ◽  
Psychiatric Patients ◽  
Learning Objectives ◽  
List Type ◽  
Type Number ◽  
Unhealthy Lifestyle ◽  
Definition Of ◽  
The Relationship

SummaryMetabolic syndrome comprises a number of cardiovascular risk factors that increase morbidity and mortality. The increase in incidence of the syndrome among psychiatric patients has been unanimously demonstrated in recent studies and it has become one of the greatest challenges in psychiatric practice. Besides the use of psychotropic drugs, factors such as genetic polymorphisms, inflammation, endocrinopathies and unhealthy lifestyle contribute to the association between metabolic syndrome and a number of psychiatric disorders. In this article, we review the current diagnostic criteria for metabolic syndrome and propose clinically useful guidelines for psychiatrists to identify and monitor patients who may have the syndrome. We also outline the relationship between metabolic syndrome and individual psychiatric disorders, and discuss advances in pharmacological treatment for the syndrome, such as metformin.LEARNING OBJECTIVES•Be familiar with the definition of metabolic syndrome and its parameters of measurement.•Appreciate how individual psychiatric disorders contribute to metabolic syndrome and vice versa.•Develop a framework for the prevention, screening and management of metabolic syndrome in psychiatric patients.

scholarly journals Managing delirium in everyday practice: towards cognitive-friendly hospitals

2014 ◽  
Vol 20 (6) ◽  
pp. 380-389 ◽  
Author(s):  
Henry O'Connell ◽  
Sean P. Kennelly ◽  
Walter Cullen ◽  
David J. Meagher
Keyword(s):  
Healthcare System ◽  
Clinical Care ◽  
Cognitive Disorder ◽  
Learning Objectives ◽  
Everyday Practice ◽  
List Type ◽  
Type Number ◽  
Hospital Environments ◽  
Cognitive Problems ◽  
The Way

SummaryProviding optimal healthcare for increasingly elderly hospital populations who have high rates of cognitive disorder is a great challenge. Using delirium as an example, we describe how improved management of acute cognitive problems through a multifaceted hospital-wide programme can promote cognitive-friendly hospital environments. A specific plan of action is described that spans interventions in day-to-day clinical care of individual patients all the way to wider organisational practices.Learning Objectives•Understand the concept of cognitive friendliness and how addressing the problem of delirium can contribute to this in our healthcare system.•Become more aware of specific aspects of a cognitive-friendly programme and how these can be implemented in practice.•Explore the key outstanding issues for research that can further enhance our awareness of cognitive-friendly practices.

scholarly journals Assisted dying – the debate: Videtur… sed contra

2014 ◽  
Vol 20 (4) ◽  
pp. 250-257
Author(s):  
Philip Graham ◽  
Julian C. Hughes
Keyword(s):  
Health Professionals ◽  
Empirical Data ◽  
Terminally Ill ◽  
Learning Objectives ◽  
List Type ◽  
Assisted Dying ◽  
Type Number ◽  
The Law ◽  
The Uk

SummaryShould the law be changed to allow health professionals to assist mentally competent, terminally ill people to end their own lives? In this article Philip Graham (P.G.) puts the arguments in favour of such a change in the law and Julian Hughes (J.H.) opposes these arguments. J.H. then sets out why he believes such a law should not be passed and P.G., in turn, sets out counterarguments. Before concluding comments, both P.G. and J.H. independently make brief closing statements supporting their own positions.LEARNING OBJECTIVESUnderstand the differences between various types of ‘assisted dying’.Appreciate some of the ethical arguments in favour of and against changes in the law on assisted dying in the UK.Understand some of the empirical data involved in arguments about assisted dying.

scholarly journals Severe and enduring eating disorders: recognition and management

2014 ◽  
Vol 20 (6) ◽  
pp. 392-401 ◽  
Author(s):  
Paul Robinson
Keyword(s):  
Eating Disorders ◽  
Crisis Management ◽  
Learning Objectives ◽  
Psychological State ◽  
Service Development ◽  
List Type ◽  
Type Number ◽  
Specific Group ◽  
Definition Of

SummaryPatients with severe and enduring eating disorders (SEED) may constitute a specific group. It is proposed that patients with anorexia nervosa (SEED-AN) or bulimia nervosa (SEED-BN) that requires the regular attention of a multidisciplinary team and is of a duration known to have a low recovery rate should be included in the SEED group. These patients present with a combination of severe symptoms and long-term illness, and may experience serious chronic physical sequelae (e.g. osteoporosis and renal failure), marked social isolation and stigma. Their carers suffer from the stress of caring for them over a prolonged period. Symptoms, treatment and crisis management of SEED-AN are discussed. SEED is a relatively recently described area of eating disorders psychiatry that requires research and service development so that patients and carers are helped to cope with very serious chronic, but not incurable, conditions.Learning Objectives•Understand the definition of SEED-AN and SEED-BN.•Be able to assess the physical and psychological state of patients with SEED-AN and SEED-BN.•Be able to plan the monitoring and treatment of patients with SEED, involving their carers and families.

scholarly journals Beyond year zero: getting the best out of revalidation

2014 ◽  
Vol 20 (4) ◽  
pp. 237-246
Author(s):  
Mary Jane Tacchi
Keyword(s):  
Medical Practice ◽  
Learning Objectives ◽  
List Type ◽  
Type Number ◽  
Good Medical Practice ◽  
The Uk

SummaryMedical revalidation was introduced in the UK in 2012 (‘year zero’) after years of discussion and debate. This article describes what it aims to achieve. The General Medical Council's Good Medical Practice is used as a framework on which to build to provide evidence of competencies. Practical aspects of appraisal and revalidation are discussed, with suggestions of how to get the most out of the process both for patients and doctors.LEARNING OBJECTIVES•Understand the purpose of revalidation.•Understand the role of the responsible officer.•Describe the types of supporting information necessary for revalidation.

The definition of a multi-dimensional generalization of shot noise

1971 ◽  
Vol 8 (01) ◽  
pp. 128-135 ◽  
Author(s):  
D. J. Daley
Keyword(s):  
Stochastic Process ◽  
Probability Distribution ◽  
Absolute Convergence ◽  
List Type ◽  
Type Number ◽  
Homogeneous Poisson Process ◽  
Cauchy Principal ◽  
Principal Value ◽  
Definition Of ◽  
Image Position

The paper studies the formally defined stochastic process where {tj } is a homogeneous Poisson process in Euclidean n-space En and the a.e. finite Em -valued function f(·) satisfies |f(t)| = g(t) (all |t | = t), g(t) ↓ 0 for all sufficiently large t → ∞, and with either m = 1, or m = n and f(t)/g(t) =t/t. The convergence of the sum at (*) is shown to depend on (i) (ii) (iii) . Specifically, finiteness of (i) for sufficiently large X implies absolute convergence of (*) almost surely (a.s.); finiteness of (ii) and (iii) implies a.s. convergence of the Cauchy principal value of (*) with the limit of this principal value having a probability distribution independent of t when the limit in (iii) is zero; the finiteness of (ii) alone suffices for the existence of this limiting principal value at t = 0.

scholarly journals Use of Kodak Tech-Pan Film at the Ukstu

1994 ◽  
Vol 161 ◽  
pp. 129-139 ◽  
Author(s):  
Q.A. Parker ◽  
S. Phillipps ◽  
D.H. Morgan ◽  
D.F. Malin ◽  
K.S. Russell ◽  
...  
Keyword(s):  
High Resolution ◽  
Great Success ◽  
List Type ◽  
Type Number ◽  
Schmidt Telescope ◽  
Fine Grained ◽  
Focal Surface ◽  
Flexible Film ◽  
The Uk ◽  
Reciprocity Failure

Kodak Technical Pan (Tech Pan) emulsion is an extremely fine grained, high resolution, panchromatic negative film with extended red sensitivity. It has been produced under this name since about 1980 (Kodak P–255, 1981) and is available on Kodak's Estar base in a number of thicknesses and sizes. The thick ∗∗base Tech Pan is designated 4415 and has been used with great success by the amateur astronomical community for many years (e.g. Martys 1991). Its astronomical potential was recognised early by Everhart (1981). However, tests at professional telescopes (e.g. West et al. 1981) and early sensitometer tests at the UK Schmidt Telescope (UKST) in 1981 and 1987 were discontinued when the glass and film samples did not respond well to normal hypersensitisation techniques. These and other difficulties led to a lack of interest among the professional astronomical community until quite recently (Russell et al. 1992; Parker & Malin 1992). The first successful use of 14 × 14 inch hypered Tech-Pan 4415 film in the UKST was in March 1991. Films were obtained which exhibited excellent image quality and resolution. Furthermore, in good seeing these appeared to be about 1 magnitude deeper than the equivalent IIIa-F emulsion on glass but with considerably lower grain noise. This result was achieved because two main problems associated with Tech-Pan and film use in the UKST have been resolved. These were: 1) obtaining Tech-Pan film with long exposure speed sufficient for deep astronomical photography (i.e. reduction of low intenstiy reciprocity failure); 2) overcoming the practical difficulties of mounting large-format flexible film at the UKST's curved focal surface.

New World of Mental Health Legislation England and Wales David Jolley and Reinhard Heun

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
D. Jolley ◽  
R. Heun
Keyword(s):  
Mental Health ◽  
Mental Disorder ◽  
Mental Illnesses ◽  
Community Treatment ◽  
List Type ◽  
Type Number ◽  
England And Wales ◽  
Use Of Resources ◽  
Mental Health Legislation ◽  
Health Legislation

After eight years of tortured negotiations between government, professional psychiatrists and lay pressure groups, England and Wales will begin to use new Mental Health Legislation November 2008. This will not be a new Mental Health Act, but a substantial modification of the 1983 act. There are nine key changes:1.A single definition of mental disorder: ‘any disorder of mind or brain’.2.Criteria for compulsion: ‘appropriate medical treatment’ test.3.Age-appropriate services: special arrangements for under 18 years.4.Professional roles: approved clinicians and responsible clinicians (non-medical).5.Nearest relative: recognises Civil Partnerships, allows displacement.6.Supervised Community Treatment Orders.7.Mental health Review Tribunal: unified.8.Advocacy: Independent Mental Health Advocates.9.ECT: new safeguards.The Code of Practice identifies five key principles:1.Purpose - to minimise adverse effects of Mental Disorder.2.Least Restriction.3.Respect - diverse needs, values and circumstances.4.Participation - involving patient in planning, developing and reviewing treatment and care.5.Effectiveness, efficiency and equity - optimal use of resources.Earlier drafts had been described as: ‘little more than a Public Oder Bill dressed up as Mental Health legislation’; ‘ethically unworkable and practically unworkable’. Much of the dissent related to suggestions that people with Personality Disorder behaving in a dangerous or antisocial way should be subject to compulsory detention. Fears included breach of liberties and Human Rights and transformation of Mental Health Services disadvantaging people with major mental illnesses.

scholarly journals Charitable Incorporated Organisations: An Analysis of the Three UK Jurisdictions

2015 ◽  
Vol 6 (1) ◽  
pp. 25-44
Author(s):  
Gareth G. Morgan
Keyword(s):  
Northern Ireland ◽  
Limited Liability ◽  
Legal Form ◽  
England And Wales ◽  
Corporate Body ◽  
Legal Forms ◽  
Charitable Associations ◽  
Definition Of ◽  
The Uk ◽  
Charity Regulation

AbstractThe specific legal forms available for charitable organisations have received much less attention by scholars as compared to work on the definition of charity, the boundaries of charitable status and the duties of charity trustees. Under each of the three UK jurisdictions, it could be argued that all charitable property is held on trust (in the sense that it is held for interests of the charity’s beneficiaries) but many charities are no longer formed using the structure of a trust. Charitable organisations can have many possible structures including charitable trusts, charitable associations, charitable companies and now charitable incorporated organisations (CIOs). Until recently the UK lacked any specific legal form for charities. The CIO was created to remedy this: a corporate body with limited liability, formed purely by registration with the appropriate charity regulator. Since 2008 it has been enshrined in statute in all three UK jurisdictions, though implementation dates only from 2011 in Scotland and from 2013 in England and Wales. The focus of this paper is a comparison of the CIO form in the three UK charity law jurisdictions. It analyses the frameworks for CIOs established in England and Wales, Scottish CIOs (SCIOs) and the (yet to be implemented) CIOs in Northern Ireland. It concludes that whilst the CIO concept is effectively reflected in all three jurisdictions, the differences between these three types of CIOs are much more than just those needed to comply with the different regimes of charity regulation – the differences raise important choices for those seeking to establish new charities operating UK-wide.

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