scholarly journals A physicians' compliance in identifying patients’ as drivers and providing advice on the Driver & Vehicle Licencing Agency (DVLA) guidelines

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S78-S78
Author(s):  
Christiana Elisha-Aboh ◽  
Amy Seukeran ◽  
Phuong Pham ◽  
Mohammad Musabbir ◽  
Helen Turner
Keyword(s):  
Mental Health ◽  
Data Collection ◽  
Elderly Patients ◽  
Psychiatric Ward ◽  
Microsoft Excel ◽  
Written Information ◽  
Raising Awareness ◽  
Acute Psychiatric Ward ◽  
The Impact ◽  
Health Diagnosis

AimsThe DVLA has strict guidelines regarding how long a driver should stay off driving when they have certain mental health illnesses or severity of symptoms. It is difficult to give such advice if we are unaware of the patients’ that drive; especially when they do not volunteer this information for various reasons.This audit was aimed at identifying people who have been admitted to the Ward 3 at the Mount Hospital and if they were asked about driving. The audit also looked at whether there were discussions around the driving requirements and DVLA guidelines in terms of their mental health diagnosis. The expected outcome of this project was to improve information gathering when clerking in a new patient and to ensure that elderly patients’ who drive are made aware of the DVLA guidelines.MethodThis audit retrospectively examined the care of 50 patients on Ward 3 at the Mount Hospital, a mixed acute psychiatric ward for older people, between 1st April 2020 and 11th November 2020. All patients’ aged 65 years and over who were on admission within that period were audited. Data collection took place between 17th November and 17th December 2020; this involved reviewing patient records throughout their inpatient stay including paper notes and electronic records (on Care Director). Results were compiled using a pre-determined data collection tool and analysed using Microsoft Excel. The audit used the standards within the DVLA Guidance- Psychiatric Disorders: Assessing fitness to drive.ResultOnly 1 (2%) patient had sufficiently documented evidence around driving and the impact of psychotropic medication on driving. DVLA information was given verbally in 3 (9%) patients and only 2 patients had this information passed on to their General Practitioner (GP). Only 3 (6%) patients were made aware of the DVLA guidelines and 2 (4%) patients made aware of their obligation to inform the DVLAConclusionGenerally, the compliance of psychiatrists in identifying all patients’ who drive is poor and seems even worse with elderly patients’. There was little documented evidence that patients were asked about their driving status on or during their admission, were given verbal or written information, had discussions around the impact of medication on driving or informed about their obligation to notify the DVLA. This study provides opportunity to improve practice by educating the medical workforce and raising awareness within the wider team. There also needs to be greater involvement and communication with GPs when completing discharge summaries.

First psychiatric hospitalization in patients older than 65 years

2016 ◽  
Vol 33 (S1) ◽  
pp. S184-S184
Author(s):  
J. Ballesteros ◽  
A. Uría ◽  
P. Rico
Keyword(s):  
Mental Health ◽  
Elderly Patients ◽  
Mental Health Problems ◽  
Psychiatric Hospitalization ◽  
Manic Episode ◽  
Psychiatric Ward ◽  
Inpatient Psychiatry ◽  
General Average ◽  
Competing Interest ◽  
Acute Psychiatric Ward

IntroductionMedical assistance for elderly people with mental health problems increases at the same time that life expectancy does.ObjectivesThe aim of this work is to describe several demographic and clinical characteristics of elderly patients admitted for the first time to an acute inpatient psychiatry unit.MethodsObservational, descriptive, and retrospective study from June 2013 to May 2015, where it is analysed patients older than 65 years admitted to the acute psychiatric ward of Hospital de Getafe in that period without psychiatric hospitalization in their personal background.ResultsSeventeen patients were included of a total of 428 patients admitted in that period (3.97%). Mean age: 70.7 ± 4.7. A total of 10 male (58.9%). The average stay in the studied group was 18.5 days, slightly lower than general average stay in that period (19.2 days). No psychiatric background was found in 4 patients. The most common diagnoses was depressive episode (5 patients) followed by manic episode (4 patients) and delusional disorder. Every of them but one, were taking at least one antipsychotic drug at discharge.ConclusionsElderly patients represent a low percentage of the total of patients admitted to an acute inpatient psychiatry unit. Many of them, despite having long-term ambulatory psychiatric follow-up, require a first psychiatric hospitalization after 65 years, as well as other patients begin their treatment in the mental health services in that hospitalization. It is noteworthy that antipsychotic drugs are used very commonly in those patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Unlocking an acute psychiatric ward: The impact on unauthorised absences, assaults and seclusions

2017 ◽  
Vol 41 (2) ◽  
pp. 92-96 ◽  
Author(s):  
Ben Beaglehole ◽  
John Beveridge ◽  
Warren Campbell-Trotter ◽  
Chris Frampton
Keyword(s):  
Psychiatric Inpatient ◽  
Psychiatric Ward ◽  
Inpatient Service ◽  
Positive Effects ◽  
Adverse Event Data ◽  
Before And After ◽  
Acute Psychiatric Ward ◽  
Restrictive Environment ◽  
Open Wards ◽  
The Impact

Aims and methodThe acute psychiatric inpatient service in Christchurch, New Zealand, recently changed from two locked and two unlocked wards to four open wards. This provided the opportunity to evaluate whether shifting to an unlocked environment was associated with higher rates of adverse events, including unauthorised absences, violent incidents and seclusion. We compared long-term adverse event data before and after ward configuration change.ResultsRates of unauthorised absences increased by 58% after the change in ward configuration (P = 0.005), but seclusion hours dropped by 53% (P = 0.001). A small increase in violent incidents was recorded but this was not statistically significant.Clinical implicationsAlthough unauthorised absences increased, the absence of statistically significant changes for violent incidents and a reduction in seclusion hours suggest that the change to a less restrictive environment may have some positive effects.

scholarly journals Attitudes About COVID-19 and Health: A Mixed-Methods Smartphone-App and Online Survey Study (Preprint)

2021 ◽  
Author(s):  
Anna M. Hood ◽  
Hanne Stotesbury ◽  
Jennifer Murphy ◽  
Melanie Kölbel ◽  
April Slee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Data Collection ◽  
Physical Health ◽  
Online Survey ◽  
Smartphone App ◽  
The Uk ◽  
The Impact ◽  
Monthly Survey

BACKGROUND Behavioral mitigation strategies to slow the spread of COVID-19 have resulted in sweeping lifestyle changes, with short and long-term psychological, well-being, and quality of life implications. The Attitudes About COVID-19 and Health (ATTACH) study focuses on understanding attitudes and beliefs whilst considering the impact on mental and physical health and the influence of broader demographic and geographic factors on attitudes, beliefs, and mental health burden. OBJECTIVE In this assessment of our first wave of data collection, we provide baseline cohort descriptives of ATTACH study participants in the United Kingdom (UK), United States of America (USA), and Mexico. Additionally, we assess responses to daily poll questions related to COVID-19 and conduct a cross-sectional analysis of baseline assessments collected in the UK between June 26 and October 31, 2020. METHODS The ATTACH study uses smartphone-app technology and online survey data collection. Participants completed poll questions twice daily related to COVID-19 and a monthly survey assessing mental health, social isolation, physical health, and quality of life. Poll question responses were graphed using 95% Clopper-Pearson (exact) tests with 95% confidence intervals. Pearson correlations, hierarchical linear regression analyses, and generalized linear models assessed relationships, predictors of self-reported outcomes, and group differences, respectively. RESULTS By October 31, 2020, 1405, 80, and 90 participants had consented to participate in the UK, USA, and Mexico, respectively. Descriptive data for the UK daily poll questions indicated that participants were generally following social distancing measures, but worry and negative impacts on families increased as the pandemic progressed. Although participants generally reported feeling that the reasons for current measures had been made clear, there was low trust that the government was doing everything in its power to meet public needs. In the UK, 1282 participants also completed a monthly survey (95% white, 72% female, 21% key or essential workers). Nineteen percent of UK participants reported a pre-existing mental health disorder, 31% reported a pre-existing chronic medical illness, and 35% were over 65. Fifty-seven percent of participants reported being more sedentary since the pandemic began, and 41% reported reduced access to medical care. Those with poorer mental health outcomes lived in more deprived neighborhoods, in larger households (ps < .05), had more pre-existing mental health disorders and medical conditions, and were younger than 65 years (all ps < .001). CONCLUSIONS Communities who have been exposed to additional harm during the COVID-19 pandemic were experiencing worse mental outcomes. Factors including having a medical condition, or living in a deprived neighborhood or larger household were associated with heightened risk. Future longitudinal studies should investigate the link between COVID-19 exposure, mental health, and sociodemographic and residential characteristics.

4 Return to golf post arthroplasty

2021 ◽  
Vol 55 (16) ◽  
pp. 941.2-941
Author(s):  
S Frankland ◽  
L Hoggett ◽  
P Hughes ◽  
C Nevill
Keyword(s):  
Mental Health ◽  
Open Access ◽  
Joint Replacement ◽  
Population Data ◽  
Initial Increase ◽  
Physical And Mental Health ◽  
Microsoft Excel ◽  
Significant Difference ◽  
The Impact ◽  
Mental And Physical Health

AimTo determine the impact of arthroplasty on player handicap, frequency of golf played, return to club competitions and overall mental and physical health using the SF-12.MethodA three page, 30 item, open access survey was sent to a community of over 500,000 golfers via the newsletter for the HowDidIDo® app between 18/04/2019–30/04/2019, inviting users who had undergone a joint replacement to complete. Responses were analysed using Microsoft excel and StatsDirect.ResultsA total of 3043 valid responses were received, the majority were male (n=2392). Mean age was 70 years (25–92). Most respondents had only a single joint replacement (n=1977). Within the cohort, there were mostly hips (n=2092) and knees (n=2069) replaced with far fewer shoulders (n=101), although this concurred with NJR population data. Across the whole cohort, most respondents were playing more (40%) or the same (44%) amount of golf following arthroplasty. Across the cohort only 4% were assumed unable to return to club competitions, while 76% of respondents returned to competitions within six months. Mean handicap prior to arthroplasty was increased (17.6 to 18.9) with no significant difference between hips, knees and shoulders. The SF-12 results were completed for 1094 respondents which when matched for age, demonstrated higher physical (48.59 vs. 43.65) and mental health (55.59 vs.52.10) scores.ConclusionsJoint replacement enables the vast majority of patients to continue or increase the amount of golf played with most returning to club competitions within six months. A slight increase in handicap is demonstrated following surgery in this cohort, with stabilisation after this initial increase. Patients playing golf following arthroplasty demonstrate better physical and mental health than their age matched counterparts.

scholarly journals The Southside Simple Suppers Scale-Up (S4): Effects of a Family Meals Program on Head Start Caregivers

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 279-279
Author(s):  
Amy Sharn ◽  
Leah May ◽  
Miranda Westrick ◽  
Ashley Walther ◽  
Carolyn Gunther
Keyword(s):  
Mental Health ◽  
Blood Pressure ◽  
Waist Circumference ◽  
Data Collection ◽  
Head Start ◽  
Perceived Stress ◽  
Low Income ◽  
Family Meals ◽  
Post Test ◽  
The Impact

Abstract Objectives Assess the impact of an 8-week Head Start family meals intervention (Simple Suppers) on participating caregiver's weight status and health outcomes. Methods This is a single arm pre- to post-test study. The intervention is occurring during the 2019–20 school year (fall, winter, and spring sessions) at 3 Head Start sites. Caregiver outcomes include: BMI (kg/m2), waist circumference (cm), blood pressure (mm Hg), and mental health measures (depression (Patient Health Questionnaire-9 (PHQ-9)), perceived stress (Perceived Stress Scale (PSS)), and anxiety (Generalized Anxiety Disorder-7 (GAD-7))). Regression models factoring in attendance will be used to examine pre- to post-test changes. Results Nineteen caregivers completed data collection for the fall session. 55.6% of families were low-income and 21.1% had low/very low food security. Mean (SD) caregiver age was 37.6 (12.1) yr, 94.7% were female, and 84.2% were non-Hispanic Black. There were no significant changes in BMI, blood pressure, waist circumference, depression, or perceived stress from pre- to post-test according to attendance level, however anxiety significantly decreased with increasing attendance (P &lt; 0.05). Data collection for the remaining sessions will be completed in spring 2020. Conclusions This study can be expected to have a positive impact by understanding the role of healthy family mealtime routines in caregiver's physical and mental health among racial minorities residing in low-income households. Funding Sources USDA NIFA.

scholarly journals Impact of clinical pharmacist’s interventions on pharmacotherapy management in elderly patients on polypharmacy with mental health problems including quality of life: A prospective non-randomized study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Matej Stuhec ◽  
Nika Bratović ◽  
Aleš Mrhar
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Elderly Patients ◽  
Mental Health Problems ◽  
Randomized Study ◽  
The Elderly ◽  
Health Problems ◽  
Potentially Inappropriate Medications ◽  
The Impact

AbstractMental health problems (MHPs) are very common in the elderly and can have an important influence on their quality of life (QoL). There is almost no data on the impact of clinical pharmacists’ (CPs) interventions on the QoL including elderly patients and MHPs. The main aim of this study was to determinate the impact of (CP’s) interventions on the QoL and quality of pharmacotherapy. A prospective non-randomized pre-post study was designed which included residents of a nursing home aged 65 age or more with at least one MHP. Each patient also filled out the EQ-5D questionnaire. The medical review MR included drug-related problems (DRPs) and potentially drug-drug interactions (pDDIs), as well as potentially inappropriate medications (PIMs). After 2 months, the participants were interviewed again. The mean number of medications before the intervention was 12,2 ± 3,1 per patient and decreased to 10,3 ± 3,0 medications per patient (p < 0,05) (n = 24). The total number of PIMs and pDDIs was also reduced and QoL was also significantly higher (p < 0,05). A collaborative care approach with a CP led to a decrease of DRPs, pDDIs, PIMs, the total number of medications and to an improvement in the patients’ QoL.

Interactive television for an urban adult mental health service: The Guy's psychiatric intensive care unit telepsychiatry project

2000 ◽  
Vol 6 (1_suppl) ◽  
pp. 50-52 ◽  
Author(s):  
Richard Haslam ◽  
Paul Mclaren
Keyword(s):  
Mental Health ◽  
Intensive Care ◽  
Health Service ◽  
Interactive Television ◽  
Psychiatric Ward ◽  
Care Services ◽  
Assessment And Monitoring ◽  
Adult Mental Health Service ◽  
Acute Psychiatric Ward ◽  
Health Trust

We carried out a feasibility study of an interactive television (IATV) system to enhance the provision of psychiatric intensive care services to a remote adult acute psychiatric ward in the same National Health Service mental health trust. The system used videoconferencing equipment connected by ISDN at 128 kbit/s. The system was used for patient referral, assessment and monitoring by staff at the remote site 8 km away.

Emergency department use at the end of life in elderly patients with gastrointestinal malignancies and mental health comorbidities.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 811-811
Author(s):  
Mehr Kashyap ◽  
Jeremy Phillip Harris ◽  
Daniel Tandel Chang ◽  
Erqi L. Pollom
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Substance Abuse ◽  
Mental Disorders ◽  
Elderly Patients ◽  
End Of Life ◽  
Health Care Expenditures ◽  
Gastrointestinal Malignancies ◽  
The Impact

811 Background: Aggressive care at the end-of-life can contradict patients’ wishes, negatively impact patient quality of life, and contribute to overall health care expenditures. Patients with mental disorders (MD) often experience disparities in medical care and have poorer clinical outcomes. We investigated the impact of mental disorders on emergency department (ED) use at the end of life among elderly patients with gastrointestinal (GI) malignancies. Methods: We conducted a retrospective cohort study using the SEER-Medicare database. We identified patients aged 66 years and older with GI malignancies (colorectal, pancreatic, gastric, hepatic, biliary, esophageal, small bowel, and anal cancer) diagnosed between 2004 and 2013 who had recorded death. We assessed the association between MD (depression, bipolar disorder, psychotic disorder, anxiety, dementia, and substance abuse) and ED use within 30 days of death using logistic regression models. Results: Of the 160,367 decedents included, 54,461 (34.1%) had at least one MD diagnosis between one year prior to cancer diagnosis and death. Those with MD were more likely to use the ED more than once in the last 30 days of life (14.7% vs. 12.4% p < 0.01). ED use was highest among decedents with anxiety disorder (15.8%) and substance abuse (16.3%). Among decedents with mental disorders, risk factors associated with ED use at end of life include being male (adjusted odds ratio [aOR] 1.16, 95% confidence interval [CI] 1.10 – 1.22), younger (aOR 1.14, 95% CI 1.06 - 1.23), and black (aOR 1.33, 95% CI 1.23 – 1.45), living in a lower income zip code (1.21, 95% CI 1.13 – 1.30), and having a higher Charlson comorbidity score (aOR 1.71, 95% CI 1.56 – 1.87). ED use was also associated with pancreatic (aOR 1.16, 95% CI 1.08 - 1.25), hepatic (aOR 1.21, 95% CI 1.11 - 1.33), biliary (aOR 1.16, 95% CI 1.03 - 1.30) and esophageal (aOR 1.16, 95% CI 1.04 - 1.29) cancer compared to colorectal cancer. Conclusions: MD is associated with increased ED use at the end of life among elderly patients with GI cancer. Palliative and supportive care including mental health services early in the disease course may improve quality of end-of-life care in this vulnerable population.

The Effects of Prescribing Minimal Barbiturates in an Acute Psychiatric Ward

1966 ◽  
Vol 112 (488) ◽  
pp. 733-735 ◽  
Author(s):  
Neil Mitchell ◽  
Christopher Turton
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Mental Health Problem ◽  
Health Problem ◽  
Neurological Impairment ◽  
Psychiatric Ward ◽  
Basic Character ◽  
Character Disorder ◽  
Morphine Addiction ◽  
Acute Psychiatric Ward

The deleterious effects of barbiturates on the vulnerable addictive personality have been well recognized for some years. The first warning came as far back as sixty-one years ago (Clarke, 1904) only a year after the introduction of the first barbiturate drug. Goodman and Gilman (1956) state that habituation to the barbiturates in the sense of psychic dependence is not infrequent, and point out the important fact that most persons addicted to barbiturates have some basic character disorder or psychoneurosis. These authors even go on to say that barbiturate addiction is a more serious public health and mental health problem than morphine addiction because it produces greater mental, emotional and neurological impairment, and because withdrawal entails real hazards.

Report2: Impact of Covid-19 on young people aged 13-24 in the UK- preliminary findings

2020 ◽  
Author(s):  
Liat Levita ◽  
Jilly Gibson Miller ◽  
Todd K. Hartman ◽  
Jamie Murphy ◽  
Mark Shevlin ◽  
...  
Keyword(s):  
Mental Health ◽  
Young People ◽  
Data Collection ◽  
Additional Data ◽  
Well Being ◽  
Survey Study ◽  
Anxiety And Depression ◽  
Adult Study ◽  
The Uk ◽  
The Impact

A brief follow on report (from Report 1, see https://psyarxiv.com/uq4rn/). This report presents data on parents and their children's well being as a result of the COVID-19 pandemic from our adult survey study. In addition to presenting additional data showing a potentially significant increase in anxiety and depression in young people aged 13-24, as a consequence of COVID-19. Data collection for our Adult Study (Wave 2) took place between 22nd April and was ended on Friday, May 1st, here we report headline figures for the impact of Covid-19 on parents and their children. We have described our methods in a separate report (https://psyarxiv.com/wxe2n) and released two reports on our mental health outcomes from wave 1 (https://psyarxiv.com/hb6nq, https://psyarxiv.com/ydvc7).

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