scholarly journals Discriminating levels of alcohol use associated with self-harm in individuals presenting to a district general hospital

2010 ◽  
Vol 34 (6) ◽  
pp. 226-230 ◽  
Author(s):  
Nicholas Holdsworth ◽  
Hugh Griffiths ◽  
David Crawford
Keyword(s):  
Alcohol Use ◽  
General Hospital ◽  
Screening Tool ◽  
District General Hospital ◽  
Alcohol Screening ◽  
Screening Tools ◽  
Psychosocial Assessment ◽  
Different Types ◽  
Self Harm ◽  
Problematic Alcohol Use

Aims and methodAlthough alcohol is reported as commonly associated with self-harm, there is nothing in the literature that bases the association on validated screening tools. We sought to discern the different types of alcohol use as discriminated by the Alcohol Use Disorders Identification Test (AUDIT). Completed AUDITs from a 2-year period were analysed, all relating to people who had presented to a district general hospital in Northumberland following self-harm.ResultsThe proportion of dependent, harmful and hazardous drinkers identified using AUDIT was many times higher than previously estimated in similar studies that had not used a validated alcohol screening tool.Clinical implicationsThe routine use of an alcohol screening tool should be part of any standard psychosocial assessment of self-harm, to guide appropriate interventions for problematic alcohol use that might otherwise be overlooked.

scholarly journals A four-stage evaluation of the Paediatric Yorkhill Malnutrition Score in a tertiary paediatric hospital and a district general hospital

2010 ◽  
Vol 104 (5) ◽  
pp. 751-756 ◽  
Author(s):  
Konstantinos Gerasimidis ◽  
Orla Keane ◽  
Isobel Macleod ◽  
Diana M. Flynn ◽  
Charlotte M. Wright
Keyword(s):  
High Risk ◽  
General Hospital ◽  
Nursing Staff ◽  
Screening Tool ◽  
Nutritional Assessment ◽  
District General Hospital ◽  
Screening Tools ◽  
Lower Sensitivity ◽  
Tertiary Referral Hospital ◽  
Rater Reliability

Paediatric in-patients are at high risk of malnutrition but validated paediatric screening tools suitable for use by nursing staff are scarce. The present study aimed to assess the diagnostic accuracy of the new Paediatric Yorkhill Malnutrition Score (PYMS). During a pilot introduction in a tertiary referral hospital and a district general hospital, two research dietitians assessed the validity of the PYMS by comparing the nursing screening outcome with a full dietetic assessment, anthropometry and body composition measurements. An additional PYMS form was completed by the research dietitians to assess its inter-rater reliability with the nursing staff and for comparison with the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) and the Paediatric Subjective Global Nutritional Assessment (SGNA). Of the 247 children studied, the nurse-rated PYMS identified 59 % of those rated at high risk by full dietetic assessment. Of those rated at high risk by the nursing PYMS, 47 % were confirmed as high risk on full assessment. The PYMS showed moderate agreement with the full assessment (κ = 0·46) and inter-rater reliability (κ = 0·53) with the research dietitians. Children who screened as high risk for malnutrition had significantly lower lean mass index than those at moderate or low risk, but no difference in fat. When completed by the research dietitians, the PYMS showed similar sensitivity to the STAMP, but a higher positive predictive value. The SGNA had higher specificity than the PYMS but much lower sensitivity. The PYMS screening tool is an acceptable screening tool for identifying children at risk of malnutrition without producing unmanageable numbers of false-positive cases.

Online interventions for people hospitalized for deliberate self-harm and problematic alcohol use: Lessons learned from the iiAIM trial

2021 ◽  
Vol 85 (2) ◽  
pp. 123-142 ◽  
Author(s):  
Jacob J. Crouse ◽  
Kirsten C. Morley ◽  
Nicholas Buckley ◽  
Andrew Dawson ◽  
Devanshi Seth ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Research Team ◽  
Alcohol Misuse ◽  
Mental Health Problems ◽  
Age Groups ◽  
Lessons Learned ◽  
Deliberate Self Harm ◽  
Problematic Alcohol ◽  
Self Harm ◽  
Problematic Alcohol Use

Deliberate self-harm and suicide affect all age groups, sexes, and regions, and their prevention is a global health priority. Acute alcohol misuse and chronic alcohol misuse are strong, modifiable risk factors, and Internet interventions aiming to reduce alcohol misuse and comorbid mental health problems (e.g., depression) are a promising and effective treatment modality. The research team aimed to evaluate the feasibility and effectiveness of an Internet-based comorbidity intervention primarily aiming to reduce alcohol consumption, and secondarily to reduce readmission for deliberate self-harm and improve psychological outcomes among people hospitalized for deliberate self-harm who also engage in problematic alcohol use. However, due to several barriers to recruitment, the trial could not be completed and was discontinued. The authors present a “Lessons Learned” discussion and describe the Internet Intervention for Alcohol Improvement (iiAIM) trial, discuss the key barriers experienced by the research team, and recommend potential solutions that may help future trials in this area.

Deliberate Self-Harm Patients Who Discharge Themselves from the General Hospital Without Adequate Psychosocial Assessment

Crisis ◽  
2004 ◽  
Vol 25 (4) ◽  
pp. 183-186 ◽  
Author(s):  
Rachel Crowder ◽  
Rohan Van Der Putt ◽  
Ceri-Anne Ashby ◽  
Andrew Blewett
Keyword(s):  
General Hospital ◽  
Care Pathway ◽  
Alcohol Intoxication ◽  
Psychosocial Assessment ◽  
Hospital Environment ◽  
Control Group ◽  
Deliberate Self Harm ◽  
Increased Risk ◽  
Self Harm ◽  
Integrated Care Pathway

Abstract: Deliberate self-harm patients who leave the acute hospital environment before the completion of psychiatric assessment have an increased risk of subsequent self-harm. We considered the available data on 50 premature self-discharges identified prospectively in a general hospital with a well-developed integrated-care pathway for self-harm patients, and compared them to a control group. The self-discharge group was found to be more likely to have attempted self-poisoning without alcohol intoxication or other forms or combinations of self-harm, and an absence of identifiable previous self-harm or prior contact with local specialist psychiatric services. The two groups showed no difference in age, sex, or area of residence based on community mental health team sectors. It is proposed that these findings indicate hypotheses for further studies of why people leave the hospital without adequate assessment, and how service design could be improved in order to help them.

scholarly journals Investigating Relationships Between Drinking Venues, Drinking Companions, and Corporal Punishment of Children

2018 ◽  
Vol 24 (1) ◽  
pp. 45-55
Author(s):  
Jennifer Price Wolf ◽  
Elinam D. Dellor
Keyword(s):  
Alcohol Use ◽  
Corporal Punishment ◽  
Mixed Mode ◽  
Alcohol Screening ◽  
Screening Tools ◽  
Physical Discipline ◽  
Limited Evidence ◽  
Poisson Models ◽  
Drinking Frequency ◽  
Zero Inflated Poisson Models

Limited evidence suggests that how much a parent drinks in a particular venue, such as a bar, restaurant, or a friend’s home, is associated with use of corporal punishment. However, these relationships could differ depending on their drinking companions (e.g., spouse or friends). In this study, weighted zero-inflated Poisson models were used to examine whether the relationships between venue-specific drinking frequency, heavier drinking, and corporal punishment are moderated by drinking companions in a mixed-mode sample of parents ( n = 1,599). The relationships between drinking frequency, heavier drinking, and corporal punishment varied by drinking companions, with some combinations being protective and others conferring risk. While most alcohol screening tools focus on individual alcohol use, more nuanced assessment examining where and with whom parents are drinking could be helpful in understanding risk of physical discipline.

Poverty in practice: using quality improvement in paediatrics to improve identification and support of families living in poverty

2020 ◽  
pp. edpract-2019-318259 ◽  
Author(s):  
Guddi Singh ◽  
Hannah Zhu
Keyword(s):  
Quality Improvement ◽  
General Hospital ◽  
Child Poverty ◽  
District General Hospital ◽  
Screening Tools ◽  
Clinical Screening ◽  
Local Resources

We used quality improvement (QI) methodology in the acute paediatric setting to develop clinical screening tools and local resources for addressing child poverty in practice in a London district general hospital between March and August 2019.

scholarly journals Deliberate self-harm: service development in Kettering

1995 ◽  
Vol 19 (8) ◽  
pp. 475-477 ◽  
Author(s):  
Catherine Gordon ◽  
Andrew Blewett
Keyword(s):  
General Hospital ◽  
Service Provision ◽  
Public Health Problem ◽  
District General Hospital ◽  
Service Development ◽  
Paracetamol Poisoning ◽  
Deliberate Self Harm ◽  
Threefold Increase ◽  
Self Harm ◽  
Recent Trends

Services for deliberate self-harm patients in the general hospital are unsatisfactory in many respects. A survey of activity and quality in a district general hospital confirmed recent trends observed elsewhere and highlights areas in which service provision can be improved.High rates of deliberate self-harm (DSH) are a public health problem. A study in Oxford showed rising rates among young women during the late 1980s, and a threefold increase in the proportion due to paracetamol poisoning between 1976 and 1990 (Hawton & Fagg, 1992). A multicentre European study found a trend of increasing peak age, a declining female to male ratio, and unexplained differences between regions (Platt, 1992). In the year following DSH, 9% repeat (Hawton & Fagg, 1992); and suicide rates reach 1.1 to 1.3% of patients in the three years following an episode of DSH (Owens et al. 1991).

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