scholarly journals Psychiatry during the Covid-19 Pandemic: a survey on Mental Health Departments in Italy

2020 ◽  
Author(s):  
Bernardo Carpiniello ◽  
Massimo Tusconi ◽  
Enrico Zanalda ◽  
Guido Di Sciascio
Keyword(s):  
Mental Health ◽  
Psychiatric Patients ◽  
Radical Change ◽  
Fisher Exact Test ◽  
Mental Health Systems ◽  
Chi Square ◽  
Exact Test ◽  
Staff Members ◽  
Set Up ◽  
The Impact

Abstract Background To date, very little knowledge is available with regard to the way in which mental health systems worldwide are facing the current global health emergency. The present paper reports the data emerging from a survey conducted to study the impact of the current emergency on the functioning of the Italian Departments of Mental Health (MHD).Methods Heads of MHDs received a 40-item multiple choice questionnaire relating to Community Mental Health Centres (CMHC) and related facilities, and a 30-item questionnaire focused on General Hospital Psychiatric Wards (GHPW). Statistical analysis was carried out by means of Chi Square test with Yates correction or the Fisher Exact test, as needed.Results: 71 questionnaires returned from the 134 MHDs (52.9%) and 107 of the 318 (32.6%) GHPWs. Less than 20%of CMHCs have been closed; approximately 25% have restricted access hours. The usual mode of operation in CMHCs changed substantially. Urgent psychiatric consultations are continuing as usual, in the same way as interventions for compulsory treatments, and prison consultations. All other activities have been reduced to some extent. Remote contacts with users have been set up in approx. 75% of cases. Cases of COVID positivity were reported amongst both staff members (approx. 50 % of CHMCs), and facility users (52% of CHMCs). 20% of CMHCs reported cases of increased aggressiveness or violence, among community patients, although only 8.6% regarding severe cases. Major issues in the supply of personal protective equipment (PPE) for staff members were reported. A reduced number of GHPWs (-12%), beds (approx.-30%) and of admissions was registered (87% of GHPWs). 8% of GHPWs reported an increase in compulsory admissions, and an increased rate of violence toward self or others among inpatients. Patient swabs were carried out in 50% of GHPWs. 60% of GHPWs have reported the admission of symptomatic, COVID+ psychiatric patients to General COVID-19 Units; severely ill and non-collaborative COVID+ patients are generally admitted to specific “COVID-19” GHPWs, or to purpose-adapted isolated areas of the wards. Conclusions The COVID-19 pandemic has heralded a radical change in the mental health system of Italy, and a consequent series of challenging issues.

scholarly journals Psychiatry during the Covid-19 pandemic: a survey on mental health departments in Italy

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Bernardo Carpiniello ◽  
◽  
Massimo Tusconi ◽  
Enrico Zanalda ◽  
Guido Di Sciascio ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychiatric Patients ◽  
Fisher Exact Test ◽  
Health Departments ◽  
Chi Square ◽  
Exact Test ◽  
Staff Members ◽  
Levels Of Care ◽  
Chi Square Test ◽  
Set Up

Abstract Background To date, very few nationwide studies addressing the way in which mental health services are addressing the current pandemics have been published. The present paper reports data obtained from a survey relating to the Italian mental health system conducted during the first phase of the Covid-19 epidemic. Methods Two online questionnaires regarding Community Mental Health Centres (CMHC) and General Hospital Psychiatric Wards (GHPW), respectively, were sent to the Heads of all Italian Mental Health Departments (MHDs). Statistical analysis was carried out by means of Chi Square test with Yates correction or the Fisher Exact test, as needed. Results Seventy-one (52.9%) of the 134 MHDs and 107 (32.6%) of the 318 GHPWs returned completed questionnaires. Less than 20% of CMHCs were closed and approx. 25% had introduced restricted access hours. A substantial change in the standard mode of operation in CMHCs was reported with only urgent psychiatric interventions, compulsory treatments and consultations for imprisoned people continuing unchanged. All other activities had been reduced to some extent. Remote contacts with users had been set up in about 75% of cases. Cases of COVID positivity were reported for both staff members (approx. 50% of CHMCs) and service users (52% of CHMCs). 20% of CMHCs reported cases of increased aggressiveness or violence among community patients, although only 8.6% relating to severe cases. Significant problems emerged with regard to the availability of personal protective equipment (PPE) for staff members. A reduced number of GHPWs (− 12%), beds (approx.-30%) and admissions were registered (87% of GHPWs). An increase in compulsory admissions and the rate of violence towards self or others among inpatients was reported by 8% of GHPWs. Patient swabs were carried out in 50% of GHPWs. 60% of GHPWs registered the admission to general COVID-19 Units of symptomatic COVID+ non-severe psychiatric patients whilst COVID+ severe psychiatric patients who were non-collaborative were admitted to specifically set up “COVID-19” GHPWs or to isolated areas of the wards purposely adapted for the scope. Conclusions The pandemic has led to a drastic reduction in levels of care, which may produce a severe impact on the mental health of the population in relation to the consequences of the expected economic crisis and of the second ongoing wave of the pandemic.

scholarly journals Frequency of metabolic syndrome in stroke: a study in a tertiary health care centre in north Kerala

2017 ◽  
Vol 5 (9) ◽  
pp. 4143
Author(s):  
Swapna P. K.
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Young Adults ◽  
Fisher Exact Test ◽  
Chi Square ◽  
Health Care Centre ◽  
Exact Test ◽  
Obesity Epidemic ◽  
The Metabolic Syndrome ◽  
The Impact

Background: Stroke is a leading cause of death and disability in developing countries beginning to affect young adults. Key components of the metabolic syndrome are important risk factors for stroke. This study intended to study the prevalence of metabolic syndrome in patients with stroke. Screening adolescents and young adults for components of metabolic syndrome will prove useful in clinical management, and its elements ultimately become important therapeutic targets for the reduction of stroke burden in the general population.Methods: Data was collected from 150 patients who were admitted with cerebrovascular accident (CVA) in the Department of Medicine. Frequency tests were conducted for various risk factors. Chi-square and Fisher exact test were used to test the significance of proportion of study parameters in the classes. The observations in this study were analysed using SPSS software.Results: Metabolic syndrome was present in 46% of the study population. Among the components of the metabolic syndrome, Hypertension was the most prevalent risk factor (68%). 67.14% of the population had 2 components of metabolic syndrome which predisposes them to a greater risk of developing metabolic syndrome over a period of few months to years.Conclusions: With the obesity epidemic, the impact of the metabolic syndrome is likely to increase. Thus, diagnosing and adequately managing metabolic syndrome is an important step in the preventing cerebrovascular disease. This study emphasises the need to target the population with one or more components of the metabolic syndrome as they are at high risk of developing stroke in the future.

Venous Thromboembolism and High Grade Gliomas

1993 ◽  
Vol 70 (03) ◽  
pp. 393-396 ◽  
Author(s):  
Mandeep S Dhami ◽  
Robert D Bona ◽  
John A Calogero ◽  
Richard M Hellman
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Medical Center ◽  
Significant Risk ◽  
Bleeding Complications ◽  
Fisher Exact Test ◽  
High Grade ◽  
Chi Square ◽  
Exact Test ◽  
High Grade Gliomas

SummaryA retrospective study was done to determine the incidence of and the risk factors predisposing to clinical venous thromboembolism (VTE) in patients treated for high grade gliomas. Medical records of 68 consecutive patients diagnosed and treated at Saint Francis Hospital and Medical Center from January 1986 to June 1991 were reviewed. The follow up was to time of death or at least 6 months (up to December 1991). All clinically suspected episodes of VTE were confirmed by objective tests. Sixteen episodes of VTE were detected in 13 patients for an overall episode rate of 23.5%. Administration of chemotherapy (p = 0.027, two tailed Fisher exact test) and presence of paresis (p = 0.031, two tailed Fisher exact test) were statistically significant risk factors for the development of VTE. Thrombotic events were more likely to occur in the paretic limb and this difference was statistically significant (p = 0.00049, chi square test, with Yates correction). No major bleeding complications were seen in the nine episodes treated with long term anticoagulation.We conclude that venous thromboembolic complications are frequently encountered in patients being treated for high grade gliomas and the presence of paresis and the administration of chemotherapy increases the risk of such complications.

Characteristics of Physician Relocation Following Hurricane Katrina

2009 ◽  
Vol 95 (1) ◽  
pp. 6-12
Author(s):  
Kusuma Madamala ◽  
Claudia R. Campbell ◽  
Edbert B. Hsu ◽  
Yu-Hsiang Hsieh ◽  
James James
Keyword(s):  
Hurricane Katrina ◽  
Gulf Coast ◽  
General Medicine ◽  
The United States ◽  
Lessons Learned ◽  
Bivariate Analysis ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Factors Associated ◽  
The Impact

ABSTRACT Introduction: On Aug. 29, 2005, Hurricane Katrina made landfall along the Gulf Coast of the United States, resulting in the evacuation of more than 1.5 million people, including nearly 6000 physicians. This article examines the relocation patterns of physicians following the storm, determines the impact that the disaster had on their lives and practices, and identifies lessons learned. Methods: An Internet-based survey was conducted among licensed physicians reporting addresses within Federal Emergency Management Agency-designated disaster zones in Louisiana and Mississippi. Descriptive data analysis was used to describe respondent characteristics. Multivariate logistic regression was performed to identify the factors associated with physician nonreturn to original practice. For those remaining relocated out of state, bivariate analysis with x2 or Fisher exact test was used to determine factors associated with plans to return to original practice. Results: A total of 312 eligible responses were collected. Among disaster zone respondents, 85.6 percent lived in Louisiana and 14.4 percent resided in Mississippi before the hurricane struck. By spring 2006, 75.6 percent (n = 236) of the respondents had returned to their original homes, whereas 24.4 percent (n = 76) remained displaced. Factors associated with nonreturn to original employment included family or general medicine practice (OR 0.42, 95 percent CI 0.17–1.04; P = .059) and severe or complete damage to the workplace (OR 0.24, 95 percent CI 0.13–0.42; P < .001). Conclusions: A sizeable proportion of physicians remain displaced after Hurricane Katrina, along with a lasting decrease in the number of physicians serving in the areas affected by the disaster. Programs designed to address identified physician needs in the aftermath of the storm may give confidence to displaced physicians to return.

A year of hepatocellular carcinoma at a glance. Demographics, biochemical and radiological characteristics and treatment modalities from a specialized facility of Pakistan

2021 ◽  
pp. 1-6
Author(s):  
Laima Alam
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cross Sectional Study ◽  
Treatment Modalities ◽  
Fisher Exact Test ◽  
Tumour Staging ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Team Meetings ◽  
Contrast Enhanced Ct

Objectives:Relation of demographics of hepatocellular-carcinoma with the aetiology.Tumour characteristics in relation to anti-viral therapy and presence of viral-DNA/RNATreatment modalities offeredMethods: This cross-sectional study enrolled all the patients aged 18-70 years with diagnosed hepatocellular carcinoma either through Triphasic Contrast-Enhanced-CT scan and/or Magnetic Resonance Imaging or biopsy presenting to the Outpatient-Department or multi-disciplinary-team meetings for the year 2019. Demographic variables, biochemical analysis including liver profile and stage of cirrhosis, viral-status, tumour staging and the treatment modalities offered were all noted. ANOVA (normal) and Kruskal-Wallis (non-normal) tests were used to compare quantitative data whereas chi-square-test and fisher-exact-test were used to compare qualitative-data.Results: Out of 195 patients with hepatocellular carcinoma, 76% were males in their fifth to sixth decades of life, 96% had cirrhosis, 94% corresponded to viral hepatocellular-carcinoma (82% Hepatitis-C-Virus, 9% Hepatitis-B-Virus and 3% coinfection), 60% of the cirrhotics landed in Child-Pugh A category with tumour staging BCLC-B being the predominant one (43.6%) and single and multiple bilateral nodules were the commonest lesions encountered. Platelets and Alanine-Transaminase had a significant relation across aetiological groups. Lymph-nodes were the most common extra-hepatic organs for metastasis and the presence of viral PCR had a significant impact on the tumour aggressiveness. Thirty-two percent of the patients were amenable to curative treatment.Conclusion: Viral infection is the main cause of rising prevalence of this tumour in Pakistan. Treatment modalities are expensive and expertise are lacking. A nationwide cancer registry is required for the exact disease burden and tumour behaviour for our population. Continuous....

Self-injurious behaviour in forensic mental health care: a study into the prevalence and characteristics of incidents of self-injury

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Vivienne de Vogel ◽  
Nienke Verstegen
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Suicide Attempts ◽  
Psychiatric Patients ◽  
Forensic Mental Health ◽  
Content Type ◽  
Self Injury ◽  
Forensic Psychiatric ◽  
The Impact

Purpose Incidents of self-injury by forensic psychiatric patients often have a deleterious impact on all those involved. Moreover, self-injurious behaviour is an important predictor for violence towards others during treatment. The aim of this study is to analyse methods and severity of incidents of self-injury of patients admitted to forensic psychiatry, as well as the diagnoses of self-injuring patients. Design/methodology/approach All incidents of self-injury during treatment in a forensic psychiatric centre recorded between 2008 and 2019 were analysed and the severity was coded with the modified observed aggression scale+ (MOAS+). Findings In this period, 299 incidents of self-injury were recorded, displayed by 106 patients. Most of these incidents (87.6%) were classified as non-suicidal. Methods most often used were skin cutting with glass, broken plates, a razor or knife and swallowing dangerous objects or liquids. Ten patients died by suicide, almost all by suffocation with a rope or belt. The majority of the incidents was coded as severe or extreme with the MOAS+. Female patients were overrepresented and they caused on average three times more incidents than male patients. Practical implications More attention is warranted for self-injurious behaviour during forensic treatment considering the distressing consequences for both patients themselves, supervisors and witnesses. Adequate screening for risk of self-injurious behaviour could help to prevent this behaviour. Further research is needed in different forensic settings into predictors of self-injurious behaviour, more specifically, if there are distinct predictors for aggression to others versus to the self. Originality/value Incidents of self-injury occur with some regularity in forensic mental health care and are usually classified as severe. The impact of suicide (attempts) and incidents of self-injurious behaviour on all those involved can be enormous. More research is needed into the impact on all those involved, motivations, precipitants and functions of self-injurious behaviour and effective treatment of it.

scholarly journals Phlebitis associated with peripheral intravenous catheters in adults admitted to hospital in the Western Brazilian Amazon

2016 ◽  
Vol 50 (2) ◽  
pp. 263-271 ◽  
Author(s):  
Sandra Maria Sampaio Enes ◽  
Simone Perufo Opitz ◽  
André Ricardo Maia da Costa de Faro ◽  
Mavilde de Luz Gonçalves Pedreira
Keyword(s):  
Intermittent Infusion ◽  
Brazilian Amazon ◽  
Fisher Exact Test ◽  
Intravenous Therapy ◽  
Chi Square ◽  
Significance Level ◽  
Exact Test ◽  
Dorsal Hand Vein ◽  
Mean Time ◽  
Intravenous Catheters

Abstract OBJECTIVE To identify the presence of phlebitis and the factors that influence the development of this complication in adult patients admitted to hospital in the western Brazilian Amazon. METHOD Exploratory study with a sample of 122 peripheral intravenous catheters inserted in 122 patients in a medical unit. Variables related to the patient and intravenous therapy were analyzed. For the analysis, we used chi-square tests of Pearson and Fisher exact test, with 5% significance level. RESULTS Complication was the main reason for catheter removal (67.2%), phlebitis was the most frequent complication (31.1%). The mean duration of intravenous therapy use was 8.81 days in continuous and intermittent infusion (61.5%), in 20G catheter (39.3%), inserted in the dorsal hand vein arc (36.9 %), with mean time of usage of 68.4 hours. The type of infusion (p=0.044) and the presence of chronic disease (p=0.005) and infection (p=0.007) affected the development of phlebitis. CONCLUSION There was a high frequency of phlebitis in the sample, being influenced by concomitant use of continuous and intermittent infusion of drugs and solutions, and more frequent in patients with chronic diseases and infection.

scholarly journals FAKTOR-FAKTOR YANG MEMENGARUHI NEUROPATI PERIFER TERKAIT HIV DI MANADO

2018 ◽  
Vol 35 (3) ◽  
Author(s):  
Deivy Cirayow ◽  
Arthur Hendrik Philips Mawuntu ◽  
Herlyani Khosama
Keyword(s):  
Neuropathic Pain ◽  
Peripheral Neuropathy ◽  
Influencing Factors ◽  
Categorical Variables ◽  
Fisher Exact Test ◽  
Hiv Dementia ◽  
Chi Square ◽  
Exact Test ◽  
International Hiv Dementia Scale ◽  
Hiv Aids

FACTORS THAT INFLUENCE HIV ASSOCIATED PERIPHERAL NEUROPATHY IN MANADOABSTRACTIntroduction: There are  several sociodemographic and clinical factors that influence the development of HIV associated peripheral  neuropathy (HIV-PN). Manado has different sociodemographic and clinical characteristics  from other regions. However, the percentage of HIV-PN and its influencing factors are unknown.Aims: To know the percentage of HIV-PN and factors that influence this disorder in Manado.Methods: A crosssectional study conducted in HIV/AIDS clinic R.D. Kandou hospital Manado between November2016–January 2017. Neuropathy evaluation was performed using brief peripheral neuropathy screening (BPNS), neuropathic pain diagnostic questionnaire (DN4), and electroneurography. A Chi-square or Fisher exact test was done to analyze categorical variables, independent T or Mann-Whitney test was done for numerical variables, and linear regression was done in multivariate analysis.Results: 50 subjects were included, most were male (70%), and the mean age was 32.98 (±9.726) years, with HIV- NP percentage was 46%. Age >30 years old, low hemoglobin count, CD4, and low international  HIV dementia scale (IHDS) significantly associated with HIV-NP. Working subjects were 13.6 times more likely to have HIV-PN.Discussion: HIV-PN prevalence was relatively high, influenced by age >30 years old an low hemoglobin, CD4, andIHDS. As a factor, working was escalating the likelihood of NP-HIV by 13.9 times.Keywords: HIV/AIDS, influencing factors, peripheral neuropathyABSTRAKPendahuluan: Neuropati perifer terkait human immunodeficiency virus/HIV (NP-HIV) dapat dipengaruhi oleh beberapa faktor klinis dan sosiodemografis. Manado mempunyai karakteristik yang berbeda dengan daerah lain, namun belum diketahui persentase NP-HIV dan faktor-faktor yang memengaruhinya.Tujuan: Mengetahui persentase NP-HIV dan faktor-faktor yang memengaruhinya di Manado.Metode: Penelitian potong lintang terhadap pasien HIV/AIDS di poliklinik HIV/AIDS RSUP Prof. dr. R.D. Kandou, Manado, pada November 2016–Januari 2017.  Evaluasi neuropati dilakukan menggunakan brief peripheral  neuropathy screening (BPNS), neuropathic pain diagnostic questionnaire (DN4), dan elektroneurografi. Digunakan uji Chi-square atau Fisher exact untuk menganalisis variabel kategorik, uji T independen atau Mann-Whitney untuk variabel numerik, dan regresi linear untuk analisis multivariat.Hasil: Didapatkan 50 subjek yang memenuhi kriteria penelitian dengan mayoritas laki-laki (70%), rerata usia32,98±9,726 tahun, dan mengalami NP-HIV sebanyak 46%. Usia >30 tahun, kadar hemoglobin, jumlah CD4, dan skor international  HIV dementia scale (IHDS) yang rendah berhubungan secara bermakna dengan adanya NP-HIV. Adapun subjek yang bekerja berisiko 13,6 kali lebih besar mengalami NP-HIV.Diskusi: Didapatkan prevalensi NP-HIV yang cukup tinggi dengan dipengaruhi oleh usia >30 tahun serta kadar hemoglobin, CD4, dan skor IHDS yang rendah. Faktor bekerja juga meningkatkan kecenderungan 13,9 kali mengalami NP terkait HIV.Kata kunci: Faktor-faktor yang memengaruhi, HIV/AIDS, neuropati perifer

scholarly journals IS SPIRITUALITY HELPING TO OVERCOME ANXIETY, DEPRESSION AND MENTAL STRESS AMONG BLIND ADOLESCENTS? : A CROSS SECTIONAL STUDY OF A BLIND SCHOOL, MEERUT

2020 ◽  
pp. 63-65
Author(s):  
Anuradha Davey ◽  
Kaynat Nasser ◽  
Sanjeev Davey
Keyword(s):  
Mental Health ◽  
Low Vision ◽  
Cross Sectional Study ◽  
Vision Impairment ◽  
Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
General Mental Health ◽  
Coping Ability ◽  
The Impact

Background Vision impairment can extend from no vision – visual impairment – or exceptionally low vision to not having the option to see specific hues. Serious vision misfortune or visual deficiency can influence your kid's development and learning. Early mediation can enable your kid to contact his maximum capacity. Otherworldliness gives an individual a feeling of rising above their prompt conditions and an intrapersonal development of direction and importance for their own life, with an inward feeling of association and trust in their own interior assets. Objective The goals of this study were to examine the impact of spirituality on both coping skills and vision-specific health-related quality of life (HRQOL) and the effect of psychological manifestations among Sparsh Govt. Blind Inter College, Partapur Meerut. Methods A cross sectional study was conducted and purposive sampling was used. Percentages and chi square test was used to find the most common and association of different psychological manifestations. Result In our study, 13.8% had depression of varying degree. The most common psychological manifestation was anxiety (46.7%) among them and 11.7% of students were feeling stress in their life. Students with depression and stress affected coping ability while stress had no affect Conclusion It was found in the study that spirituality was positively associated with coping ability and hence with general mental health. Moreover, spirituality was associated significantly with vision-specific HRQOL. The results showed that spirituality played a mediating role in the linkage between vision impairment and general mental health among adolescents of Sparsh Govt. Blind Inter College, Partapur, Meerut.

scholarly journals The Impact of Watching Television Sports Channels in Promotion of Sports Activities among the Students of University of Sargodha

2019 ◽  
Vol IV (I) ◽  
pp. 95-107
Author(s):  
Sajjad Ali ◽  
Muhammad Saqib Ilmas ◽  
Shajee Hassan
Keyword(s):  
Statistical Tests ◽  
Sampling Technique ◽  
Chi Square ◽  
Uses And Gratification ◽  
Uses And Gratification Theory ◽  
Chi Square Test ◽  
Set Up ◽  
The University ◽  
The Impact ◽  
Sports Activities

This study analyzes the impact of watching television sports channels on the promotion of sports activities among the students of the University of Sargodha. The aim of the study is to explore the impact of sports channels on students. Previous researches are used to set up the concepts of the present study. In this research, a survey technique is used to collect the data. The population of the study consists of male and female students of the University of Sargodha. In this research, the Stratified and Purposive sampling technique is used, through which specification characteristics of the respondent's demographics. The study explores the impact of sports channels in the view of Uses and Gratification Theory. The data for this study is collected through the use of a well-designed questionnaire. Chi-square test and other statistical tests like ANOVA and t-Test are applied to test the hypothesis. The finding shows that more the exposure to TV sports channels more the information level of students of the University of Sargodha.

Sign in / Sign up

Export Citation Format

Share Document