scholarly journals Evaluation of a community based service for urgent psychiatric assessment

1996 ◽  
Vol 20 (10) ◽  
pp. 592-595 ◽  
Author(s):  
M. J. Crawford ◽  
D. Kohen ◽  
J. Dalton
Keyword(s):  
General Practitioner ◽  
Initial Assessment ◽  
Medical Professionals ◽  
Hospital Services ◽  
Community Based ◽  
Psychiatric Assessment ◽  
Assessment And Treatment ◽  
Set Up

The Urgent Assessment Service (UAS) was set up to provide community based urgent psychiatric assessment to a range of referrers. The work of the service was assessed over a six month period. Results show that it was popular with a broad range of medical and non-medical professionals. Patients generally presented with depression or psychotic illnesses and those referred from non-medical sources were more likely to be suffering from schizophrenia and assessed as being at least as unwell as those referred by GPs and hospital based doctors. Rates or referral to hospital services were low with the vast majority of patients being referred back to their general practitioner after initial assessment and treatment.

Complementing the ICC Efforts to Curb the Impunity of International Crimes in Africa

2017 ◽  
Author(s):  
Pacifique Manirakiza
Keyword(s):  
South African ◽  
International Criminal ◽  
Criminal Court ◽  
Potential Contribution ◽  
African Continent ◽  
Community Based ◽  
Academic Literature ◽  
International Crimes ◽  
Set Up ◽  
Thabo Mbeki

A matter raised consistently by eminent personalities asked to report on atrocities in Africa, such as former South African President Thabo Mbeki, is the utilization of traditional justice mechanisms known to Africans. Their use has been limited to Gacaca courts in Rwanda, set up in haste and subject to much criticism. However, there exist several types and models of traditional justice mechanisms at the African level. The contribution of these sui generis mechanisms towards accountability for heinous crimes is largely unaddressed in academic literature. This chapter intends to fill this gap by exploring their potential contribution towards accountability for heinous crimes, alongside the International Criminal Court (ICC). In short, the chapter explores how community-based judicial mechanisms and the ICC, two types of accountability mechanisms with different methodologies and approaches, can work side by side to eradicate impunity regarding, and also to prevent, mass atrocities on the African continent.

scholarly journals 923 Accuracy of Assessment in Hand Trauma; Pre COVID-19 Face to Face Assessment Compared to Virtual Assessment During COVID-19 Lockdown

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Westley ◽  
H Creasy ◽  
R Mistry
Keyword(s):  
Telephone Call ◽  
Initial Assessment ◽  
Accurate Assessment ◽  
Hand Trauma ◽  
Face To Face ◽  
Queen Victoria ◽  
Set Up ◽  
Operation Note ◽  
Similar Accuracy ◽  
Virtual Clinic

Abstract Introduction The Queen Victoria Hospital (QVH) was designated a cancer and trauma hub during the COVID-19 pandemic. With this, a new virtual hand trauma clinic was set up. We assess accuracy of assessment within this virtual set-up with comparison to pre COVID-19 face-to-face assessment. Method Two weeks of clinic sessions during and pre lockdown were analysed. Initial assessment was compared with the patient's operation note. Results In the pre COVID-19 two-week period 129 face-to-face appointments were analysed. Of 99 patients that required surgery 77 (78%) had an accurate assessment. 6 were overestimated, 12 were underestimated. 189 patients were seen over two weeks during lockdown via telephone or video call. Accuracy of assessment increased with seniority of the clinician. Of 126 patients that required an operation 109 (87%) had an accurate assessment; all structures injured were correctly predicted. 12 were overestimated, 5 had their injury underestimated. Conclusions The new virtual clinic allowed patients to be remotely assessed during lockdown, reducing footfall and unnecessary journeys. We found that virtual clinic assessments are accurate, and no patient underwent an unnecessary procedure. Using a telephone call plus photo gave similar accuracy as a video call. Virtual assessment was more accurate than face-to-face assessment.

Abstract 3446: Inpatient Code Stroke Protocol: A Quality Improvement and Knowledge Translation Strategy for a Challenging Scenario

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Jacqueline D Willems ◽  
Krsytyna Skrabka ◽  
Roseane Nisenbaum ◽  
Judith Barnaby ◽  
Pawel Kostyrko ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Acute Stroke ◽  
Robust Regression ◽  
Stroke Care ◽  
Initial Assessment ◽  
Stroke Severity ◽  
Care Hospital ◽  
Presenting Symptoms ◽  
Number Of Patients ◽  
Assessment And Treatment

Background: Stroke care faces a clinical challenge in treating inhospital strokes, which account for about 15% of all strokes. Prior studies showed an inequity in the assessment and treatment of inpatients who suffer a stroke versus out-of hospital. For example, inpatients have longer time to initial assessment, CT and are less likely (wait longer) to receive tissue plasminogen activator (t-PA). There is limited research evaluating the efficacy of inpatient code stroke protocols (ICSP) on access to and quality of hyper-acute stroke care. Objective: To evaluate the efficacy of the ICSP in a large tertiary care hospital. Methods: This prospective study evaluated a quality improvement strategy involving ICSP implementation at St Michael’s Hospital in 2009. The ICSP focuses on the identification of stroke symptoms and timely notification of most responsible physician, then leverages the Emergency Department code stroke process. A 3-month hospital-wide implementation period involved 60 min. education sessions with a minimum of 2 sessions per unit. Demographic factors, presenting symptoms, stroke severity, vascular risk factors as well as time of: symptoms onset, CT; and physician assessment were collected by chart abstraction after ethics approval. The primary outcomes was time from last seen normal (LSN) to CT scan. Secondary outcomes include time from LSN to initial assessment (IA), medical complications and number of patients receiving endovascular interventions or intravenous thrombolysis. The analysis was completed by comparing unadjusted and adjusted outcomes pre and post implementation of the ICSP. Descriptive statistics and robust regression was completed using SAS 9.0. Results: Overall, there were 245 inhospital strokes during the study period (152 pre and 93 post ICSP implementation). Mean age was 69.8 yrs, 60% were male. Most inpatient strokes occurred on cardiovascular services (42.9%). Main results summarized in table . There was no difference in the number of patients receiving thrombolysis or endovascular treatment. After adjustment for covariates, the ICS was associated with a significant reduction of 288 minutes (95%CI -566, -10) in time from LSN to CT. Similarly, there was significant reduction of 307 (95%CI -532, -82) in time from LSN to IA. Conclusions: Implementation of the ICSP resulted in improvements in the process indicators related to assessment and treatment of hyper-acute stroke. Similar quality improvement strategies can be implemented to ameliorate disparities between care for inpatients and outpatient presenting with an acute ischemic stroke.

Arthur Conan Doyle and Medical London: Reading the Topography of Round the Red Lamp

2021 ◽  
Vol 11 (3) ◽  
pp. 295-313
Author(s):  
Roger Luckhurst
Keyword(s):  
General Practitioner ◽  
Full Time ◽  
Medical Institutions ◽  
Short Period ◽  
Arthur Conan Doyle ◽  
Set Up

This essay explores the short period of time that Arthur Conan Doyle spent between March and June 1891 when he moved his family into rooms in Bloomsbury and took a consulting room near Harley Street in an attempt to set up as an eye specialist. This last attempt to move up the professional hierarchy from general practitioner to specialist tends to be seen as a final impulsive move before Conan Doyle decided to become a full-time writer in June 1891. The essay aims to elaborate a little on the medical contexts for Conan Doyle’s brief spell in London, and particularly to track the medical topography in which he placed himself, situated between the radical, reformist Bloomsbury medical institutions and the fame and riches of the society doctors of Harley Street. These ambivalences are tracked in the medical fiction he published in Round the Red Lamp, his peculiar collection of medical tales and doctoring in 1894.

scholarly journals THE INITIAL ASSESSMENT OF A COMMUNITY-BASED INTERVENTION WITH MEXICAN-HERITAGE PARENTS IN BOOSTING THE EFFECTS OF A SUBSTANCE USE PREVENTION INTERVENTION WITH YOUTH

2018 ◽  
Vol 47 (2) ◽  
pp. 195-209
Author(s):  
Flavio F. Marsiglia ◽  
Stephanie L. Ayers ◽  
Danielle Robbins ◽  
Julie Nagoshi ◽  
Adrienne Baldwin-White ◽  
...  
Keyword(s):  
Substance Use ◽  
Initial Assessment ◽  
Substance Use Prevention ◽  
Community Based ◽  
Prevention Intervention ◽  
Mexican Heritage

scholarly journals Nafsiyat: a psychotherapy centre for ethnic minorities

1989 ◽  
Vol 13 (7) ◽  
pp. 358-360 ◽  
Author(s):  
Sourangshu Acharyya ◽  
Sharon Moorhouse ◽  
Jafar Kareem ◽  
Roland Littlewood
Keyword(s):  
Ethnic Minorities ◽  
Community Based ◽  
Cultural Minority ◽  
Set Up

Nafsiyat, a community based ‘intercultural therapy centre’, was set up in London in 1983 to provide psychotherapy for people from ethnic and cultural minority backgrounds.

Forensic Mental Health Services and Competence to Stand Trial

2018 ◽  
pp. 127-142
Author(s):  
Ronald Roesch
Keyword(s):  
Mental Hospital ◽  
Early Years ◽  
Competence To Stand Trial ◽  
State Mental Hospital ◽  
Diversion Program ◽  
Community Based ◽  
Psychology And Law ◽  
Assessment And Treatment ◽  
1960S And 1970S ◽  
State Mental

This chapter traces the author’s entry into the field of psychology and law in the late 1960s and 1970s. His interests began when he was an undergraduate working in a state mental hospital during the early years of the deinstitutionalization movement, followed by his involvement in creating a pretrial diversion program while he was a graduate student. The chapter then turns to the author’s seminal studies of competence to stand trial and reviews the advances in the field that have led to more structured, reliable, and valid assessments of competence as well as community-based alternatives for assessment and treatment. The chapter concludes with an assessment of progress and ongoing challenges.

Diversion from Custody. I: Psychiatric Assessment at the Magistrates' Court

1993 ◽  
Vol 162 (3) ◽  
pp. 325-330 ◽  
Author(s):  
Philip L. A. Joseph ◽  
Mark Potter
Keyword(s):  
Psychiatric Disorder ◽  
Hospital Admission ◽  
Patient Treatment ◽  
Initial Assessment ◽  
Psychiatric Assessment ◽  
Mentally Disordered ◽  
The Mean

The homeless mentally disordered defendant facing minor charges poses considerable problems regarding appropriate disposal. Psychiatric assessment may be required in order to facilitate the court's decision, but this is often available only after remand in custody. A psychiatric assessment service based at two inner-London magistrates' courts is described. Over 18 months, 201 defendants were referred. They were predominantly male, single, and of no fixed abode, suffering from serious psychiatric disorder; these defendants had often received previous in-patient treatment, frequently as detained patients. They typically were recidivists charged with minor offences. Following initial assessment, 25% were admitted to hospital, 50% were released, and 25% returned to custody. The Crown Prosecution Service discontinued 29% of cases. For those admitted directly to hospital, the mean (s.d.) time from arrest to hospital admission was 5.8 (6.8) days, significantly quicker than with prison-based assessments.

Private Provision of ‘outreach’ Clinics to Fundholding General Practices in England

1998 ◽  
Vol 3 (1) ◽  
pp. 20-22 ◽  
Author(s):  
Susan Kerrison ◽  
Roslyn Corney
Keyword(s):  
General Practitioner ◽  
Postal Survey ◽  
Medical Specialist ◽  
Private Provision ◽  
Private Practitioners ◽  
General Practices ◽  
Outreach Clinic ◽  
Set Up ◽  
Second Wave ◽  
Relative Quality

Objectives: To establish the contribution of the private sector in providing outpatient ‘outreach’ clinics in general practitioner fundholding practices. Method: Postal survey of all 13 first-wave fundholders and four of the 13 second-wave fundholders in the former South East Thames Region of the National Health Service in 1995. Results: Fourteen practices responded. Ten practices had set up at least one medical specialist ‘outreach’ clinic and 12 at least one paramedical clinic since becoming fundholders. Eight practices reported their arrangements for consultant ‘outreach’ clinics and ten practices their arrangements for paramedical clinics. Forty-nine per cent of the total medical specialist hours and 46% of total paramedical hours were provided by private practitioners. The largest number of hours provided privately was in gynaecology. Conclusion: This small study identified considerable private provision of fundholders' ‘outreach’ clinics. However, there is no system in the NHS to monitor the extent of this market, the types of activities undertaken or the relative quality and cost of the services provided.

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