Auditing electroconvulsive therapy

1998 ◽  
Vol 172 (5) ◽  
pp. 401-405 ◽  
Author(s):  
Richard Duffet ◽  
Paul Lelliott

BackgroundThis is the third large-scale audit in the past 20 years and compares the practice of electroconvulsive therapy (ECT) in England and Wales with the standards derived from the Royal College of Psychiatrists' 2nd ECT handbook.MethodFacilities, equipment, practice, personnel and training were systematically evaluated during visits to all ECT clinics in the former North East Thames and East Anglia regions and Wales. All other English ECT clinics were surveyed with a postal questionnaire. Information was obtained for 184 (84%) of the 220 ECT clinics identified.ResultsAlthough some aspects of ECT administration had improved since the last audit in 1991, overall only one-third of clinics were rated as meeting College standards. Only 16% of responsible consultants attended their ECT clinic weekly and only 6% had sessional time for ECT duties. Fifty-nine per cent of all clinics had machines of the type recommended by the College and 7% were still using machines considered outdated in 1989. Only about one-third of clinics had clear policies to help guide junior doctors to administer ECT effectively.ConclusionsTwenty years of activity by the Royal College of Psychiatrists and three large-scale audits have been associated with only modest improvement in local practice.

1991 ◽  
Vol 7 (03) ◽  
pp. 176-182
Author(s):  
John Walker Hartigan

The naval shipyards are in the process of installing a system for identifying and recording specific job-related skills in their industrial workforce. The system, called the Shipyard Skills Tracking System (SSTS), is intended initially to support middle-level management in allocating their workforce properly for critical tasks and in accurately factoring personnel availability and training requirements into the planning for upcoming work. SSTS is supported by sophisticated computer programs which are integrated into other shipyard administrative programs. Data entry, ever the bugaboo of large-scale tracking programs, is minimized by using data links to other job-related programs for most of the information. The programs have been successfully field-tested at one naval shipyard and, starting in November 1989, began undergoing phased installation at all eight government yards. Discussion John D. Prebula, Pearl Harbor Naval Shipyard This paper is an excellent overview of how shipyards will track qualifications, skills, skill level, and other data needed to assign work. The SSTS is a good example of what can happen when appropriate technology is used to satisfy similar needs at a number of naval shipyards. The naval shipyards had a problem where they knew a great deal about the training and qualifications of individuals but had poor means of retrieving the information on their skill level. Attempts in the past to document and retain the information on skill levels and experience were generally unsuccessful because of the large amount of information and the continuing changes in the information. The SSTS successfully linked new microcomputer technology and training information in the shipyard main-frame computer. This allows information to be maintained currently and easily without the large duplication of effort that had been necessary in the past. Pearl Harbor Naval Shipyard's supervisors are looking forward to full implementation of the SSTS and believe that if properly implemented it will be of benefit to the shipyard. Mr. Hartigan does an excellent job of listing and explaining the important features of the SSTS and uses the example of a new supervisor trying to provide someone for a "tiger team" effort. While such a system is definitely a benefit to new supervisors it is also a great benefit to supervisors who have been on the job and know the people rather well. An experienced supervisor who is familiar with his people is still not likely to know such things as:who has passports, the currency of medical exams, the currency of inoculations, and, the other things necessary to be checked out before someone can be sent overseas or to a specific shipyard job. When the workforce is composed of a large number of temporary or more transient workers (as shipyards are being asked to become), the importance of a system to track skills becomes more important than ever. The SSTS, as the author explains so well, is not just another system of tracking qualifications. Rather, it marries together qualifications, skills, skill levels, some select training, medical qualifications and selected attributes such as the possession of a passport. This database is updated for training and qualification whenever the shipyard's mainframe is updated for these trainings and qualifications. The SSTS is manually updated for the specific attributes and skills. It was the marrying of the microcomputer technology to the shipyard's main-frame computer that allowed such a system to come into existence without the need for the purchase of additional computer equipment. As planned, the shipyard's SSTS system will be applicable to the production department workers for all ships in the shipyard and will be applied to selected engineering and inspection codes. One significant item in the paper is the mention that not only are the skills and experience reported and tracked, but the degree of expertise in each of these skills is also tracked. Mr. Hartigan uses the words "accomplished a battery replacement successfully." This allows the shipyard not only to track who has performed specific skills or tasks, but to know at what level they are capable of performing. This is done by a tie between the timekeeping system and the SSTS, allowing the supervisors to annotate the skill level when an individual has done a specific skill by entering the appropriate coding on the timekeeping sheet. This timekeeping entry also provides direct input into the SSTS.


2014 ◽  
Vol 20 (4) ◽  
pp. 293-294
Author(s):  
Cyrus S. H. Ho ◽  
Roger C. M. Ho ◽  
Rathi Mahendran

SummarySingapore is a multi-ethnic Asian society with a unique sociocultural and economic background. This is an overview of the characteristics of psychiatry in this nation in terms of service provision, mental health funding, education and training, and the challenges it faces in the midst of an evolving mental health landscape. Over the past 5 years, Singapore has maintained a closer tie with the Royal College of Psychiatrists through the the College's Membership examination.


2019 ◽  
Vol 34 (s1) ◽  
pp. s132-s132
Author(s):  
Jenifer Luman ◽  
Benjamin Luman

Introduction:Disaster Medical Response is a challenging field where opportunities for advancement are welcomed. Small Unmanned Aerial Vehicle (sUAV) technology (i.e., drones) has made enormous strides in the past few years and is poised for utilization in the early disaster response phase.Aim:To discuss current uses of UAVs, proposed utilization and logistical details, technological advancements, current deficits, and training.Methods:Our Foundation, Luman Medical, is working in the field of UAV integration for small to large scale disaster response. The concept is to equip first responders with small, relatively inexpensive, programmable drones that come equipped with hardware and software that are easy to use for inexperienced as well as skilled sUAV pilots.Discussion:These UAVs could increase ease and speed of deployment for early assessments of disaster area mapping, thermal imaging, ingress and egress routes, the discovery of survivors, communications, and delivery of supplies. Drone technology offers a new and growing type of tool in the disaster response arena. It is our hope to explore an integration that is easy, safe, and affordable to augment and enhance existing disaster response planning.


2008 ◽  
Vol 32 (3) ◽  
pp. 85-87 ◽  
Author(s):  
Claire Dibben ◽  
Rory O'Shea ◽  
Ricci Chang ◽  
Joanna Woodger

Aims and MethodsTo assess safe practice in psychiatry and self-perceptions of safety among trainees (Senior House Officers (SHOs) and Specialist Registrars (SpRs)) and consultants, a questionnaire was sent out to all general adult and old age psychiatrists, including trainees, in a teaching hospital and a district general hospital in East Anglia.ResultsA total of 29 SHOs, 11 SpRs and 27 consultants were approached (response rate 92%). In the past year 69% SHOs, 45% SpRs and 11% consultants attended breakaway training. Interview rooms were frequently below the Royal College of Psychiatrists' standards; 87% of the rooms did not have a panic button and 62% were isolated. Most doctors had felt threatened over the past 6 months but only 31% carried a personal alarm. Despite similar frequencies of assaults, consultants felt safer at work than trainees.Clinical ImplicationsSafety is important for doctors throughout their careers and should be regularly reviewed by individuals as well as audited by hospital trusts.


2007 ◽  
Vol 4 (2) ◽  
pp. 31-33 ◽  
Author(s):  
P. Kulhara ◽  
A. Avasthi

Education in modern medicine in India began in 1835 with the establishment of the Madras Medical College, in what is now Chennai. Initially the growth of new medical schools was slow but it gathered pace after independence in 1947. In the past decade or so, the growth in terms of the creation of new medical schools has been phenomenal.


2013 ◽  
Vol 95 (6) ◽  
pp. 7-11
Author(s):  
AJ Batchelder ◽  
MJ McCarthy

Over the past decade training pathways in the UK have been subject to extensive changes. Concerns regarding the supervision and training of junior doctors led to a number of reforms that were implemented through the Modernising Medical Careers programme and these mandated formalisation of curricula for all specialties. Consequently, the surgical royal colleges of the UK and Ireland designed the Intercollegiate Surgical Curriculum Programme (ISCP), which delineates the framework for surgical training from core trainee level through to the award of a Certificate of Completion of training.


2008 ◽  
Vol 12 (3-4) ◽  
pp. 347-357
Author(s):  
Peter Mörtenböck ◽  
Helge Mooshammer

In the past two decades numerous large-scale informal markets have emerged on the fringes of European cities in the wake of global geopolitical transformations. Relying on individualised long-distance connections and adapting to diverse local situations, they produce a proliferating array of unregulated urban architectures while providing habitats for millions of undocumented existences. One such case is the infamous Arizona Market not far from the north Bosnian town of Brc̆ko, a place that has been transformed from a border guard post into a major hub for people trafficking and prostitution and now into a multi-ethnic centre of ubiquitous consumption. Another one, Izmailovo Market in the north-east of Moscow, the largest informal trading centre in the region with links to all parts of the Russian Federation and beyond, has grown into a Babylonian site of 15 specialised trading areas that rivals the Moscow Kremlin both in terms of size and visitor attractiveness. And when the 22nd World Congress of Architecture was held in Istanbul under the motto ‘Grand Bazaar of Architectures’, a bazaar of a very different kind traded outside the tourist centres: a vast network of provisional, informal street markets that establish themselves right alongside the building sites of official urban regeneration, beneath terraces of motorways and next to newly constructed tram lines. Before exploring the dynamics of these spaces in more detail, let us address briefly the socio-economic conditions underlying the rise of informal markets.


1999 ◽  
Vol 23 (7) ◽  
pp. 419-421 ◽  
Author(s):  
Farida Yousaf ◽  
Martin Lee ◽  
Jose King

Aims and methodsA re-audit of the current practice of electroconvulsive therapy (ECT) was carried out over a period of five months using the new guidelines produced by the Royal College of Psychiatrists. The areas audited included obtaining consent from the patients, information recording, training and supervision of the junior doctors and the practical aspects of ECT administration, including dose titration.ResultsAn improvement in the training and supervision of junior doctors was seen since the last audit but shortcomings were identified in areas of pre- and post-ECT preparation, information recording and correct use of stimulus-dosing policy.Clinical implicationsRecommendations include the need to improve clinical practice and recording of information.


2020 ◽  
Author(s):  
Lungwani Muungo

The purpose of this review is to evaluate progress inmolecular epidemiology over the past 24 years in canceretiology and prevention to draw lessons for futureresearch incorporating the new generation of biomarkers.Molecular epidemiology was introduced inthe study of cancer in the early 1980s, with theexpectation that it would help overcome some majorlimitations of epidemiology and facilitate cancerprevention. The expectation was that biomarkerswould improve exposure assessment, document earlychanges preceding disease, and identify subgroupsin the population with greater susceptibility to cancer,thereby increasing the ability of epidemiologic studiesto identify causes and elucidate mechanisms incarcinogenesis. The first generation of biomarkers hasindeed contributed to our understanding of riskandsusceptibility related largely to genotoxic carcinogens.Consequently, interventions and policy changes havebeen mounted to reduce riskfrom several importantenvironmental carcinogens. Several new and promisingbiomarkers are now becoming available for epidemiologicstudies, thanks to the development of highthroughputtechnologies and theoretical advances inbiology. These include toxicogenomics, alterations ingene methylation and gene expression, proteomics, andmetabonomics, which allow large-scale studies, includingdiscovery-oriented as well as hypothesis-testinginvestigations. However, most of these newer biomarkershave not been adequately validated, and theirrole in the causal paradigm is not clear. There is a needfor their systematic validation using principles andcriteria established over the past several decades inmolecular cancer epidemiology.


1987 ◽  
Vol 19 (5-6) ◽  
pp. 701-710 ◽  
Author(s):  
B. L. Reidy ◽  
G. W. Samson

A low-cost wastewater disposal system was commissioned in 1959 to treat domestic and industrial wastewaters generated in the Latrobe River valley in the province of Gippsland, within the State of Victoria, Australia (Figure 1). The Latrobe Valley is the centre for large-scale generation of electricity and for the production of pulp and paper. In addition other industries have utilized the brown coal resource of the region e.g. gasification process and char production. Consequently, industrial wastewaters have been dominant in the disposal system for the past twenty-five years. The mixed industrial-domestic wastewaters were to be transported some eighty kilometres to be treated and disposed of by irrigation to land. Several important lessons have been learnt during twenty-five years of operating this system. Firstly the composition of the mixed waste stream has varied significantly with the passage of time and the development of the industrial base in the Valley, so that what was appropriate treatment in 1959 is not necessarily acceptable in 1985. Secondly the magnitude of adverse environmental impacts engendered by this low-cost disposal procedure was not imagined when the proposal was implemented. As a consequence, clean-up procedures which could remedy the adverse effects of twenty-five years of impact are likely to be costly. The question then may be asked - when the total costs including rehabilitation are considered, is there really a low-cost solution for environmentally safe disposal of complex wastewater streams?


Sign in / Sign up

Export Citation Format

Share Document