scholarly journals Self-referrals to a community psychiatric clinic

1989 ◽  
Vol 13 (9) ◽  
pp. 490-492 ◽  
Author(s):  
A. P. Boardman ◽  
N. Bouras
Keyword(s):  
Psychiatric Services ◽  
Psychiatric Research ◽  
Psychiatric Clinic ◽  
Community Based ◽  
Single View ◽  
The United Kingdom ◽  
Community Psychiatric ◽  
Health Authorities ◽  
Health Centres ◽  
National Unit

Over recent years a number of non-hospital based services have been developed that can be subsumed under the title of Community Mental Health Centres (CMHCs). Conferences held by the King's Fund (McAusland, 1985) and the National Unit for psychiatric Research and Development (Sayce, 1987) have highlighted the importance of CMHC-like services in health authorities' plans to develop community based psychiatric services. There is no single view of CMHCs in the United Kingdom and, while many such centres already exist, they are diverse in nature and their activities have been sparsely documented.

scholarly journals Factors Associated with COVID-19 Vaccine Hesitancy

Vaccines ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 300
Author(s):  
Patricia Soares ◽  
João Victor Rocha ◽  
Marta Moniz ◽  
Ana Gama ◽  
Pedro Almeida Laires ◽  
...  
Keyword(s):  
Health Status ◽  
Vaccine Hesitancy ◽  
Multinomial Regression ◽  
Community Based ◽  
Safety And Efficacy ◽  
Perceived Safety ◽  
Factors Associated ◽  
Health Authorities ◽  
Flu Vaccine ◽  
Release Of Information

It is critical to develop tailored strategies to increase acceptability of the COVID-19 vaccine and decrease hesitancy. Hence, this study aims to assess and identify factors associated with COVID-19 vaccine hesitancy in Portugal. We used data from a community-based survey, “COVID-19 Barometer: Social Opinion”, which includes data regarding intention to take COVID-19 vaccines, health status, and risk perception in Portugal from September 2020 to January 2021. We used multinomial regression to identify factors associated with intention to delay or refuse to take COVID-19 vaccines. COVID-19 vaccine hesitancy in Portugal was high: 56% would wait and 9% refuse. Several factors were associated with both refusal and delay: being younger, loss of income during the pandemic, no intention of taking the flu vaccine, low confidence in the COVID-19 vaccine and the health service response during the pandemic, worse perception of government measures, perception of the information provided as inconsistent and contradictory, and answering the questionnaire before the release of information regarding the safety and efficacy of COVID-19 vaccines. It is crucial to build confidence in the COVID-19 vaccine as its perceived safety and efficacy were strongly associated with intention to take the vaccine. Governments and health authorities should improve communication and increase trust.

scholarly journals Impact of vaccination on new SARS-CoV-2 infections in the United Kingdom

2021 ◽  
Author(s):  
Emma Pritchard ◽  
Philippa C. Matthews ◽  
Nicole Stoesser ◽  
David W. Eyre ◽  
Owen Gethings ◽  
...  
Keyword(s):  
United Kingdom ◽  
Viral Load ◽  
Threshold Value ◽  
Community Based ◽  
National Statistics ◽  
Private Households ◽  
The United Kingdom ◽  
Viral Burden ◽  
General Community ◽  
Nose And Throat

AbstractThe effectiveness of COVID-19 vaccination in preventing new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in the general community is still unclear. Here, we used the Office for National Statistics COVID-19 Infection Survey—a large community-based survey of individuals living in randomly selected private households across the United Kingdom—to assess the effectiveness of the BNT162b2 (Pfizer–BioNTech) and ChAdOx1 nCoV-19 (Oxford–AstraZeneca; ChAdOx1) vaccines against any new SARS-CoV-2 PCR-positive tests, split according to self-reported symptoms, cycle threshold value (<30 versus ≥30; as a surrogate for viral load) and gene positivity pattern (compatible with B.1.1.7 or not). Using 1,945,071 real-time PCR results from nose and throat swabs taken from 383,812 participants between 1 December 2020 and 8 May 2021, we found that vaccination with the ChAdOx1 or BNT162b2 vaccines already reduced SARS-CoV-2 infections ≥21 d after the first dose (61% (95% confidence interval (CI) = 54–68%) versus 66% (95% CI = 60–71%), respectively), with greater reductions observed after a second dose (79% (95% CI = 65–88%) versus 80% (95% CI = 73–85%), respectively). The largest reductions were observed for symptomatic infections and/or infections with a higher viral burden. Overall, COVID-19 vaccination reduced the number of new SARS-CoV-2 infections, with the largest benefit received after two vaccinations and against symptomatic and high viral burden infections, and with no evidence of a difference between the BNT162b2 and ChAdOx1 vaccines.

scholarly journals COVID-19 in Latin America: a first glance to the mortality

2020 ◽  
pp. 1-3 ◽  
Author(s):  
Nubia Muñoz
Keyword(s):  
Latin America ◽  
Latin American ◽  
Mortality Rates ◽  
European Countries ◽  
Death Rates ◽  
Death Toll ◽  
The United Kingdom ◽  
Health Authorities ◽  
The Us ◽  
Latin American Countries

It is too early to know which will be the final death toll from the Covid-19 or SARS-CoV-2 virus epidemy in Latin America since the epidemy is still active and we will not know when it will end. The curve for new infections and deaths has not reached yet a peak (Figure 1). In addition, we know little about the epidemiology of this new virus. The daily litany of the number of people infected with the number of admissions to hospitals and intensive care units and the number of deaths guides health authorities to plan health services and politicians to gauge the degree of confinement necessary to control the transmission of the virus, but it says little about the magnitude of the problem if we do not relate it to the population at risk. At the end of the pandemic, we will be able to estimate age-standardized death rates for the different countries, but until then the crude death rates will provide a first glance or snapshot of the death toll and impact of the pandemic from March to May 2020. These rates are well below those estimated in other countries in Europe and North America: Belgium (82.6), Spain (58.0), the United Kingdom (57.5), Italy (55.0), France (42.9), Sweden (41.4), and the US (30.7). (Johns Hopkins CSSE, May 30, 2020). However, in the European countries and the US the number of deaths has reached a peak, while this is not the case in Latin American countries. (Figure 1). It should be taken into account that the above rates are crude and therefore, some of the differences could be due to the fact that European countries have a larger proportion of the population over 70 years of age in whom higher mortality rates have been reported.

scholarly journals Effect of Delta variant on viral burden and vaccine effectiveness against new SARS-CoV-2 infections in the UK

2021 ◽  
Author(s):  
Koen B. Pouwels ◽  
Emma Pritchard ◽  
Philippa C. Matthews ◽  
Nicole Stoesser ◽  
David W. Eyre ◽  
...  
Keyword(s):  
Natural Infection ◽  
Absolute Difference ◽  
Community Based ◽  
Symptomatic Infection ◽  
The United Kingdom ◽  
Viral Burden ◽  
Alpha Variant ◽  
The Uk ◽  
Prior Infection ◽  
Similar Peak

AbstractThe effectiveness of the BNT162b2 and ChAdOx1 vaccines against new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections requires continuous re-evaluation, given the increasingly dominant B.1.617.2 (Delta) variant. In this study, we investigated the effectiveness of these vaccines in a large, community-based survey of randomly selected households across the United Kingdom. We found that the effectiveness of BNT162b2 and ChAdOx1 against infections (new polymerase chain reaction (PCR)-positive cases) with symptoms or high viral burden is reduced with the B.1.617.2 variant (absolute difference of 10–13% for BNT162b2 and 16% for ChAdOx1) compared to the B.1.1.7 (Alpha) variant. The effectiveness of two doses remains at least as great as protection afforded by prior natural infection. The dynamics of immunity after second doses differed significantly between BNT162b2 and ChAdOx1, with greater initial effectiveness against new PCR-positive cases but faster declines in protection against high viral burden and symptomatic infection with BNT162b2. There was no evidence that effectiveness varied by dosing interval, but protection was higher in vaccinated individuals after a prior infection and in younger adults. With B.1.617.2, infections occurring after two vaccinations had similar peak viral burden as those in unvaccinated individuals. SARS-CoV-2 vaccination still reduces new infections, but effectiveness and attenuation of peak viral burden are reduced with B.1.617.2.

scholarly journals The Impact Of COVID-19 On Out-Of-Hours Adult Hospice Care: An Online Survey

2021 ◽  
Author(s):  
Felicity Hasson ◽  
Paul Slater ◽  
Anne Fee ◽  
Tracey McConnell ◽  
Sheila Payne ◽  
...  
Keyword(s):  
Palliative Care ◽  
United Kingdom ◽  
Personal Protective Equipment ◽  
Protective Equipment ◽  
Community Based ◽  
Out Of Hours ◽  
Care Services ◽  
The United Kingdom ◽  
Palliative Care Services ◽  
The Impact

Abstract BackgroundGlobally COVID-19 has had a profound impact on the provision of healthcare, including palliative care. However, there is little evidence about the impact of COVID-19 on delivery of out-of-hours specialist palliative care services in the United Kingdom. The aim of the study is to investigate the impact of the COVID-19 pandemic on the delivery of out-of-hours community-based palliative care services.Methods A national online census survey of managers of adult hospices in the United Kingdom was undertaken. Survey were emailed to managers of adult hospices (n=150) who provided out-of-hours community palliative care services. Fifteen questions related specifically to the impact of COVID-19 and data were analysed thematically.ResultsEighty-one responses to the survey were returned (54% response rate); 59 were complete of which 47 contained COVID-19 data. Findings indicated that COVID-19 impacted on out-of-hours community-based palliative care. To meet increased patient need, hospices reconfigured services; redeployed staff; and introduced new policies and procedures to minimize virus transmission. Lack of integration between charitably and state funded palliative care providers was reported. The interconnected issues of the use and availability of Personal Protective Equipment (n=21) and infection control screening (n=12) resulted in changes in nursing practices due to fear of contagion for patients, carers and staff. Conclusions Survey findings suggest that due to increased demand for community palliative care services, hospices had to rapidly adapt and reconfigure services. Even though this response to the pandemic led to some service improvements, in the main, out-of-hours service reconfiguration resulted in challenges for hospices, including workforce issues, and availability of resources such as Personal Protective Equipment. These challenges were exacerbated by lack of integration with wider healthcare services. More research is required to fully understand the implications of such changes on the quality of care provided.

scholarly journals Patients’ Experiences of Seclusion during Admission in Psychiatric Settings in KwaZulu-Natal: A Qualitative Study

2020 ◽  
Vol 3 (3) ◽  
pp. 342-361
Author(s):  
Benoite Umubyeyi ◽  
Gilbert Banamwana ◽  
Pacifique Mukangabire ◽  
Innocent Kagabo ◽  
Jeanne D’Arc Jeanne D’Arc ◽  
...  
Keyword(s):  
Psychiatric Clinic ◽  
Care Providers ◽  
Open Communication ◽  
Negative Experiences ◽  
Community Psychiatric ◽  
Policies And Procedures ◽  
Kwazulu Natal ◽  
Qualitative Descriptive ◽  
Continued Use ◽  
Depth Interviews

Background In South Africa, seclusion is one of the practices used in the management of disruptive behaviors in psychiatric settings. Despite its continued use, seclusion is always subject to controversial debates, and patients who undergo it express a range of negative experiences. Objective To explore the experiences of patients regarding seclusion during their admission in a psychiatric hospital. Methods A qualitative descriptive design was used. In-depth interviews were conducted with ten patients attending a community psychiatric clinic in KwaZulu-Natal. Interviews were analyzed using content analysis. Results Two themes emerged from the findings: controversial views of seclusion and negative experiences of seclusion. Seclusion was considered more as a punishment measure which was often used abusively, than a therapeutic intervention. Participants expressed loneliness, humiliation, and powerlessness following their seclusion experience. Limited patient-staff interaction and communication worsened patients’ negativity towards seclusion. Conclusion Findings from this study underscore the need to review practices, policies and procedures regarding the use of seclusion. Seclusion should be only used when the need is absolute and as the last treatment option. Open communication between the care providers and the patients should be emphasized during the time of seclusion. Rwanda J Med Health Sci 2020;3(3):342-361

scholarly journals Organization of Community Psychiatric Services in Finland

10.17816/cp64 ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 55-64
Author(s):  
Jyrki Korkeila
Keyword(s):  
Psychiatric Treatment ◽  
Psychiatric Patients ◽  
Economic Recession ◽  
Psychiatric Services ◽  
Severe Mental Disorders ◽  
Community Based ◽  
Institutional Settings ◽  
Primary Organization ◽  
Methods Of Treatment ◽  
Rapid Transformation

Background. The Finnish psychiatric treatment system has undergone a rapid transformation from operating in institutional settings to a adopting a community-based approach, through implementation of national plans; this process was carried out quickly, due to a severe economic recession in the early 1990s. Methods. This paper is a narrative review, based on relevant documents by national authorities, academic dissertations and published scientific literature, between 1984 and 2018, as well as the interviews of key experts in 2019. Results. The municipality is currently the primary organization, responsible for all health services. Municipalities may also work together in organizing the services, either through unions of municipalities or hospital districts. Services are to a great extent outpatient-oriented. The number of beds is one fifth of the previous number, around four decades ago, despite the increase in population. In 2017, 191,895 patients in total (4% of Finns) had used outpatient psychiatric services, and the number of visits totalled 2.25 million. Psychotherapy is mainly carried out in the private sector by licensed psychotherapists. Homelessness in relation to discharged psychiatric patients has not been in evidence in Finland and deinstitutionalization has not caused an increase in the mortality rate among individuals with severe mental disorders. Conclusion. Psychiatric patients have, in general, benefitted greatly from the shift from institutions to the community. This does not preclude the fact that there are also shortcomings. The development of community care has, to date, focused too heavily on resource allocation, at the expense of strategic planning, and too little on methods of treatment.

Psychiatric research and primary care in Britain – past, present and future

1982 ◽  
Vol 12 (3) ◽  
pp. 493-499 ◽  
Author(s):  
Michael Shepherd
Keyword(s):  
Primary Care ◽  
United Kingdom ◽  
Psychiatric Morbidity ◽  
Practical Importance ◽  
Psychiatric Research ◽  
The United Kingdom ◽  
Post War

SYNOPSISA brief review of post-war developments indicates the course of research into psychiatric morbidity at the level of primary care in the United Kingdom. The theoretical and practical importance of such work has now been demonstrated and some major lines of future enquiry are outlined.

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