Psychiatric illness and driving: Irish psychiatrists' documentation practices

2009 ◽  
Vol 26 (1) ◽  
pp. 16-19 ◽  
Author(s):  
Camilla Langan
Keyword(s):  
Psychiatric Illness ◽  
Medication Compliance ◽  
Potential Effect ◽  
Driving Ability ◽  
Second Phase ◽  
Clinical Notes ◽  
Anonymous Questionnaire ◽  
Legal Obligations ◽  
Legal Duty ◽  
The Uk

AbstractObjective: Psychiatric illness and the use of psychotropic medication are recognised as factors that may impair driving ability. Clinicians in the UK have a legal duty to advise patients on the effects of illness and prescribed medication on driving ability. Although clinicians in Ireland have no equivalent legal obligations, good medical practice suggests that doctors should be aware of whether patients are active drivers, and issue appropriate advice, supported by adequate documentation in clinical notes.Method: The initial phase of the study analysed 44 outpatient records and 48 discharge records to ascertain the level of documentation regarding driving status, and advice given to patients regarding the effect of illness or medication on driving ability. The second phase involved distribution of an anonymous questionnaire to 18 psychiatrists employed in the acute psychiatric unit setting.Results: Although there was minimal documentation regarding the potential effect of illness on driving ability, more than 50% of case notes revealed documented advice to patients regarding side-effects of medication and driving ability. Over 50% of case notes contained advice about medication compliance, but none contained cautionary advice about operating machinery. All psychiatrists admitted not being aware of the driving status of every patient they reviewed. Over 50% admitted to advising patients of the effect of illness or medication on driving ability, but fewer reported documenting this advice on every occasion. All psychiatrists reported that they would benefit from training in this area.Conclusion: This study suggests that there is underdocumentation of advice given to patients regarding the effect of their symptoms or medication on driving ability. Clinicians need to improve their awareness of patients' driving status, in addition to receiving training on what their responsibilities are in this regard.

Priorities for child health research across the UK and Ireland

2021 ◽  
pp. archdischild-2021-322636
Author(s):  
Katrina Cathie ◽  
Alastair G Sutcliffe ◽  
Srini Bandi ◽  
David Coghlan ◽  
Stephen W Turner ◽  
...  
Keyword(s):  
Child Health ◽  
Research Priorities ◽  
Models Of Care ◽  
Research Network ◽  
Second Phase ◽  
Modified Delphi ◽  
Phase Study ◽  
Child Health Research ◽  
The Uk ◽  
Multicentre Research

BackgroundThe General and Adolescent Paediatric Research Network in the UK and Ireland (GAPRUKI) was established in 2016. The aims of GAPRUKI are to unite general paediatricians around the UK and Ireland, to develop research ideas and protocols, and facilitate delivery of multicentre research.ObjectivesTo undertake a research prioritisation exercise among UK and Ireland general paediatricians.MethodsThis was a four-phase study using a modified Delphi survey. The first phase asked for suggested research priorities. The second phase developed ideas and ranked them in priority. In the third phase, priorities were refined; and the final stage used the Hanlon Prioritisation Process to agree on the highest priorities.ResultsIn phase one, there were 250 questions submitted by 61 GAPRUKI members (66% of the whole membership). For phase two, 92 priorities were scored by 62 members and the mean Likert scale (1–7) scores ranged from 3.13 to 5.77. In a face-to-face meeting (phases three and four), 17 research questions were identified and ultimately 14 priorities were identified and ranked. The four priorities with the highest ranking focused on these three respiratory conditions: asthma, bronchiolitis and acute wheeze. Other priorities were in the diagnosis or management of constipation, urinary tract infection, fever, gastro-oesophageal reflux and also new models of care for scheduled general paediatric clinics.ConclusionResearch priorities for child health in the UK and Ireland have been identified using a robust methodology. The next steps are for studies to be designed and funded to address these priorities.

scholarly journals Resolving international border disputes: The Irish experience

2017 ◽  
Vol 52 (3) ◽  
pp. 377-398 ◽  
Author(s):  
John Coakley
Keyword(s):  
Northern Ireland ◽  
Specific Model ◽  
Second Phase ◽  
Territorial Dispute ◽  
Civil Unrest ◽  
Good Friday ◽  
The United Kingdom ◽  
Third Phase ◽  
The Uk ◽  
International Border

This article explores the value of a specific model of norm replacement in accounting for the circumstances leading to Ireland’s Good Friday agreement (1998), which formally and finally settled the long-running territorial dispute between Ireland and the United Kingdom (UK). Drawing on the theoretical literature, it identifies three phases in this process. First, from the creation of the Irish Free State in 1922 until the civil unrest in Northern Ireland peaked in 1972 the irredentist norm was substantially unchallenged. It was embedded in the 1937 constitution, which defined the national territory as extending over the whole island of Ireland – including Northern Ireland, a part of the UK. The second phase, from about 1972 to 1998, was one of norm competition. The irredentist norm was severely challenged by new political realities in Northern Ireland, and was potentially destabilising for the state itself. It was increasingly challenged by an alternative ‘consent’ norm, one embracing in effect the geopolitical status quo. The third phase, from 1998 onwards, was one of consolidation of the new norm, now written into the Irish constitution to replace the wording of 1937. The article suggests that this model plays a valuable role in accounting for the changing status of the Irish border, but also that the Irish experience has implications for the broad shape of the model.

Placing sustainable development at the heart of government in the UK: the role of law in the evolution of sustainable development as the central organising principle of government

Legal Studies ◽  
2002 ◽  
Vol 22 (4) ◽  
pp. 578-601 ◽  
Author(s):  
Victoria Jenkins
Keyword(s):  
Sustainable Development ◽  
Audit Committee ◽  
Legal Framework ◽  
Legal Obligations ◽  
Statutory Duty ◽  
The Government ◽  
The Uk ◽  
Clear Statement ◽  
Close Investigation

The government has made a commitment to ensure that sustainable development is placed at the heart of decision-making. The UK's strategy has primarily involved the development of voluntary measures to achieve sustainable development in policy-making. These measures are monitored by a Sustainable Development Commission and, most importantly, a parliamentary Environmental Audit Committee. However, a number of public bodies also have a statutory duty in respect of sustainable development. These duties do not create enforceable legal obligations, but may have significant value as a clear statement of policy on the achievement of sustainable development – providing political leadership at the highest level. It is essential to this aim that the government provides a clear message regarding the objective of sustainable development. However, close investigation of these duties reveals not only a partial legal framework, but a number of inconsistencies in the government's approach to the achievement of sustainable development.

scholarly journals Evolution of case fatality rates in the second wave of coronavirus in England: effects of false positives, a Variant of Concern and vaccination.

2021 ◽  
Author(s):  
James A Ackland ◽  
Graeme J Ackland ◽  
David J Wallace
Keyword(s):  
False Positive ◽  
Age Groups ◽  
Case Fatality ◽  
Potential Effect ◽  
Time To Death ◽  
New Variant ◽  
Government Data ◽  
The Uk ◽  
Second Wave ◽  
Over Time

Objective: To track the statistical case fatality rate (CFR) in the second wave of the UK coronavirus outbreak, and to understand its variations over time. Design: Publicly available UK government data and clinical evidence on the time between first positive PCR test and death are used to determine the relationships between reported cases and deaths, according to age groups and across regions in England. Main Outcome Measures: Estimates of case fatality rates and their variations over time. Results: Throughout October and November 2020, deaths in England can be broadly understood in terms of CFRs which are approximately constant over time. The same CFRs prove a poor predictor of deaths when applied back to September, when prevalence of the virus was comparatively low, suggesting that the potential effect of false positive tests needs to be taken into account. Similarly, increasing CFRs are needed to match cases to deaths when projecting the model forwards into December. The growth of the S gene dropout VOC in December occurs too late to explain this increase in CFR alone, but at 33% increased mortality, it can explain the peak in deaths in January. On our analysis, if there were other factors responsible for the higher CFRs in December and January, 33% would be an upper bound for the higher mortality of the VOC. From the second half of January, the CFRs for older age groups show a marked decline. Since the fraction of the VOC has not decreased, this decline is likely to be the result of the rollout of vaccination. However, due to the rapidly decreasing nature of the raw cases data (likely due to a combination of vaccination and lockdown), any imprecisions in the time-to-death distribution are greatly exacerbated in this time period, rendering estimates of vaccination effect imprecise. Conclusions: The relationship between cases and deaths, even when controlling for age, is not static through the second wave of coronavirus in England. An apparently anomalous low case-fatality ratio in September can be accounted for by a modest 0.4% false-positive fraction. The large jump in CFR in December can be understood in terms of a more deadly new variant B1.1.7, while a decline in January correlates with vaccine roll-out, suggesting that vaccine reduce the severity of infection, as well as the risk.

Development of a Seabed Geomorphology classification approach; aspiring towards a robust tool to support comprehensive and consistent seabed mapping 

2021 ◽  
Author(s):  
Dayton Dove ◽  
Rachel Nanson ◽  
Lilja Bjarnadóttir ◽  
Janine Guinan ◽  
Joana Gafeira ◽  
...  
Keyword(s):  
Classification Scheme ◽  
Primary Objective ◽  
Second Phase ◽  
The Novel ◽  
New Classification ◽  
British Geological Survey ◽  
Origin And Evolution ◽  
Initial Application ◽  
Seabed Mapping ◽  
The Uk

<p>In 2016, through a collaboration between marine mapping programmes in Norway, Ireland, and the UK, we published a new classification scheme to aid the characterisation of seabed geomorphology (Dove et al., 2016). The classification scheme was developed to address shared objectives and challenges in seabed mapping, particularly to enable more consistent classification where required. The novel aspect of this framework was the effort to independently describe seabed features according to their observed physical 1-Morphology, and the more subjective interpretation of their origin and evolution (2-Geomorphology). Initial application of the approach within our own groups and externally proved promising, and through the welcome involvement of colleagues from Geoscience Australia, we continued to progress and improve the approach.</p><p>We are now within the second phase of the project, which involves the development of glossaries for both parts of the classification scheme. The glossary for part-1 Morphology was recently completed and published (Dove et al., 2020). This glossary includes a revised list of feature names, with definitions and representative diagrams for each feature. Feature definitions are in-part drawn from the International Hydrographic Organization (IHO) guide for undersea feature names, which were modified and augmented with additional terms to ensure the final feature catalogue and glossary encompasses the diversity of morphologies observed at the seabed.</p><p>Part-2 Geomorphology glossary is now in development. We anticipate it to be more complicated than the Morphology glossary due to the (often) variable meaning of different terms between different fields and individual scientists. But as for Part 1, our primary objective is to produce a useful and robust framework (applicable from the coastal zone to the abyss), that minimises duplication and/or ambiguity as much as possible. The Geomorphology glossary will include example bathymetry images to add further value.</p><p>Dove, D., Bradwell, T., Carter, G., Cotterill, C., Gafeira Goncalves, J., Green, S., Krabbendam, M., Mellett, C., Stevenson, A., Stewart, H. and Westhead, K., Scott, G., Guinan, J., Judge, M., Monteys, X., Elvenes, S., Maeten, N., Dolan, M., Thorsnes, T., Bjarnadottir, L., Ottesen, D., 2016. Seabed geomorphology: a two-part classification system. British Geological Survey, Open Report OR/16/001.</p><p>Dove, D., Nanson, R., Bjarnadóttir, L.R., Guinan, J., Gafeira, J., Post, A., Dolan, M.F.J., Stewart, H., Arosio, R. and Scott, G., 2020. A two-part seabed geomorphology classification scheme:(v. 2). Part 1: morphology features glossary.</p>

Psychiatry

2018 ◽  
Author(s):  
Isabel McMullen
Keyword(s):  
Mental Health ◽  
Psychiatric Illness ◽  
Mental Health Problems ◽  
Ethical Issues ◽  
Behavioural Therapy ◽  
Outpatient Clinics ◽  
Personal Stories ◽  
Cognitive Behavioural ◽  
The Uk ◽  
State Examination

Mental health problems are estimated to affect one in four people each year in the UK, making mental illness one of the commonest presentations to GP surgeries, outpatient clinics, and Emergency Departments. Yet many doctors and medical students feel uncertain about how to approach patients with a psychiatric disorder. The key to becoming a good psychiatrist lies in the clinical interview. There are few physical signs or investigations that allow doctors to diagnose psychiatric illness, so a detailed history and mental state examination are important. As a psychiatrist, you are in the privileged position of having patients tell you their personal stories, and the skill is in listening attentively and asking relevant questions to help to clarify parts of the story. The best way to practise these techniques is to watch experienced clinicians at work and to interview patients yourself. Obviously diagnosis is important, so you need to be aware of the types of symptoms that fit with each type of disorder, as well as the medical conditions that may mimic psychiatric illness. Investigations may be necessary to rule out other diseases, and you need to be able to request these appropriately. Psychiatrists have access to a range of treatments—medical (e.g. antidepressants), psychological (e.g. cognitive behavioural therapy), and physical (e.g. electroconvulsive therapy)—and you need to know which ones to recommend. Most of these treatments are delivered in conjunction with the multidisciplinary team, so you should be clear about the roles of each team member. Finally, there is overlap between psychiatry and the law, which can raise interesting ethical issues. It is sometimes necessary to treat a person against their will, for the safety of that person or others, so you need to know about mental health law. Psychiatrists are also often requested to provide a second opinion in difficult capacity assessments.

Occupational safety

2020 ◽  
pp. 1652-1656
Author(s):  
Lawrence Waterman
Keyword(s):  
Occupational Safety ◽  
Safety Management ◽  
Good Practice ◽  
Health And Safety ◽  
Working Environment ◽  
Legal Obligations ◽  
Work Health ◽  
Minor Injuries ◽  
The Uk ◽  
Serious Injuries

Any approach to occupational health must acknowledge that accidents in the workplace result in many injuries. Construction, agriculture, and primary extraction are the main causes of fatalities and serious injuries, but many more minor injuries result from all types of work. Health and safety law has developed with an emphasis on accident prevention that is based on designing and managing the working environment. Establishing this approach to safety management begins with an organization committing itself to a policy influenced by legal obligations and current good practice. While this chapter draws heavily on the UK situation, where there has been considerable experience and development of approaches to health and safety, it is incumbent on any physician to consider the work environment and whether changes to the workplace might improve not only the lot of their patients, but others potentially at risk in the workplace.

scholarly journals Childhood in the digital age: a socio-cultural and legal analysis of the UK’s proposed virtual legal duty of care

2019 ◽  
Vol 27 (4) ◽  
pp. 311-338 ◽  
Author(s):  
Conrad Nyamutata
Keyword(s):  
White Paper ◽  
Duty Of Care ◽  
Legal Analysis ◽  
Digital Space ◽  
Participation Rights ◽  
Legal Duty ◽  
The Subject ◽  
Legal Contexts ◽  
The Uk ◽  
Legal Interventions

Abstract In 2019, the UK government issued an ambitious White Paper as a precursor to the regulation of ‘online harms’. This article adopts a socio-cultural and legal approach to analysing the proposed law in the context of children. How childhood is conceptualized influences public policy and legal interventions, including on the digital space. This remains a contested terrain with different conclusion on the effects of the cyberspace. The biggest challenge with legal interventions on the digital realm is the need to achieve a balance between protection and participation rights of children. The dominant conception of childhood as a period of vulnerability has meant ‘protection’ often overrides participation rights. However, such focus is the subject of challenge, with some suggesting that regulation is the product of moral panic. A further strand is the potential of disproportionate punitive measures against Internet companies against the backdrop of human rights obligations. The UK proposition is discussed within this socio-cultural and legal contexts with the objective of highlighting challenges and legal pitfalls. This article argues that Internet governance ought to give serious consideration to the new sociology of childhood.

A human rights perspective on the use of social media by the ambulance services

2019 ◽  
Vol 11 (12) ◽  
pp. 532-537
Author(s):  
Chris Jones
Keyword(s):  
Social Media ◽  
Human Rights ◽  
Media Use ◽  
Legal Framework ◽  
Ambulance Service ◽  
Social Media Use ◽  
The Public ◽  
Legal Duty ◽  
Use Of Social Media ◽  
The Uk

Social media use on behalf of ambulance services by paramedics, student paramedics and ancillary staff—‘corporate tweeting’, as it has become known—has in recent times been the subject of much debate in the paramedic profession. It has been argued that social media use is an unstoppable tide and a necessary means of imparting information to members of the public about the work the ambulance service performs. Conversely, others have argued that by tweeting about their patients, the ambulance service is breaching a fundamental code of professional ethics due to the use of confidential patient data. This article explores the UK legal framework of privacy and confidence in the healthcare context, from a human rights perspective, and seeks to demonstrate that some corporate tweeting has breached not only ethical standards, but may also have crossed the line into unlawfulness owing to the public nature of the organisations involved, and their legal duty to protect the human rights of their service users.

scholarly journals Vitamin C intake and susceptibility to the common cold

1997 ◽  
Vol 77 (1) ◽  
pp. 59-72 ◽  
Author(s):  
Harri Hemilä
Keyword(s):  
Vitamin C ◽  
Common Cold ◽  
Potential Effect ◽  
Dietary Vitamin ◽  
High Dose ◽  
Plasma Vitamin ◽  
Vitamin C Supplementation ◽  
The Common ◽  
The Uk

Although the role of vitamin C in common cold incidence had been studied extensively, the level of vitamin C intake has not been unequivocally shown to affect the incidence of colds. In the present study the six largest vitamin C supplementation (≥ 1 g/d) studies, including over 5000 episodes in all, have been analysed, and it is shown that common cold incidence is not reduced in the vitamin C-supplemented groups compared with the placebo groups (pooled rate ratio (RR) 0·99; 95% CI 0·93, 1·04). Consequently these six major studies give no evidence that high-dose vitamin C supplementation decreases common cold incidence in ordinary people. Nevertheless, the analysis was continued with the hypothesis that vitamin C intake may affect common cold susceptibility in specific groups of people. It was assumed that the potential effect of supplementation might be most conspicuous in subjects with low dietary vitamin C intake. The average vitamin C intake has been rather low in the UK and plasma vitamin C concentrations are in general lower in males than in females. In four studies with British females vitamin C supplementation had no marked effect on common cold incidence (pooled RR 0·95; 95% CI 0·86, 1·04). However, in four studies with British male schoolchildren and students a statistically highly significant reduction in common cold incidence was found in groups supplemented with vitamin C (pooled RR 0·70; 95% CI 0·60, 0·81). Thus, these studies with British males indicate that vitamin C intake has physiological effects on susceptibility to common cold infections, although the effect seems quantitatively meaningful only in limited groups of people and is not very large.

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