The Beneficial Effects of Short-Term Exposure to Scuba Diving on Human Mental Health

Exposure to outdoor blue spaces can help improve human health by reducing stress, promoting social relationships, and physical activity. While most studies have focused on the adverse health effects of scuba diving, very few have assessed its health benefits. Moreover, when scuba diving is done in large groups with no diving instructor or pre-dive briefing, negative environmental impacts are generated and negative impacts on human health may also occur due to overcrowding, which may create stress. This is the first study to evaluate the effects of scuba diving on divers’ mental health using their diving practices to estimate the impacts on the ecosystem. In the marine-protected area of Cap de Creus and adjacent areas, we assessed the mental health of 176 divers and 70 beach users (control group) by employing a 29-item version of Profile of Mood State (POMS) questionnaires. According to the parameters associated with reduced environmental impacts, two scuba diving experiences were established. Poisson regression models were performed to assess both the contribution of the activity and diving experiences to POMS scores. Both groups (scuba divers and beach goers) reduced their POMS scores after carrying out the activities. Although no significant differences were found between beach and scuba diving activities, nor between the two different scuba diving experiences, our results showed that subjects with regular medication intake due to a chronic or psychiatric illness had a POMS reduction score significantly higher than other subjects. We conclude that both beach and scuba diving activities have positive effects for human mental health, particularly among subjects with regular medication intake.

Achieving Royal Pharmaceutical Society competencies: a frailty nurse's perspective

Frailty is related to the ageing process and describes how a person's inbuilt reserve struggles to withstand major changes in health, such as infection, a change to medication or a new environment. The British Geriatric Society (2014) approximate that around 10% of people over the age of 65 years have frailty rising to between a quarter to a half of those aged over 85 years. Patients who are deemed frail are often at risk of adverse outcomes; therefore, it is important to seek out these individuals and care for them appropriately. This includes carrying out regular medication reviews and deprescribing where necessary. This article will discuss prescribing for frail patients using the Royal Pharmaceutical Society's Competency Framework for all Prescribers.

Instytucja przymusowego leczenia jednostki w aspekcie przepisów prawnych i teorii psychologicznych

FORCED TREATMENT OF AN INDIVIDUAL. LEGAL AND PSYCHOLOGICAL ASPECTThis article is intended to provide a summary of legal and psychological considerations on issues related to the forced treatment of people who suffer from mental disorders and addicted person. The presented subject has interdisciplinary connotations, which are interpreted in a multidimensional manner. These groups of people are exposed to many difficulties in the professional, interpersonal or family environment. Forced treatment involves many limitations, deficits, self-control of emotional control, regular medication and the potential side effects of therapy. What is more, difficulties arise within the planning itself and actions. In some cases, it is necessary to forced treatment people who are dangerous to themselves and their environment. The legal regulations are helpful to undertake these activities. Focusing on the proposed topic may outline the course of action and provide a framework for people who works with individuals and institutions dealing with that kind of problems.

P21 The level of compliance with medication reconciliation on discharge for paediatric patients at hospital

BackgroundMedicines reconciliation (MR) is the process of creating the most accurate list possible of all medications a patient is taking.1 The National Institute of Excellence (NICE) published guidance in 2015 on MR for all care settings which advise health and social care practitioners to proactively share and complete accurate information about medication, ideally within 24 hours of the patient being transferred.2ObjectiveTo determine if NICE guidance for MR and communication on discharge is being followed on the paediatric inpatient wards at this HospitalStandards100% of discharge summaries (DSUMs) include any known drug allergy status100% of patients have their medicines accurately reconciled by a pharmacist and/or doctor at discharge100% of relevant DSUMs include the reason for the stop, start or change to medication100% of patients have their DSUM sent to the GP within 24 hours of discharge100% of relevant DSUMs include the appropriate supply information for special/unlicensed medications.MethodologyData was collected retrospectively for 2 weeks on the paediatric wards. Each patient discharged was assessed for eligibility for the audit. The inclusion criteria were: Any patient admitted for ≥24 hour stay in hospital with ≥1 regular medication from the drug history. DSUMs were printed for each patient and a data collection form completed to assess compliance with audit standards using the electronic prescribing system. The data collection form was piloted and amended as appropriate. Ethics approval was not required. Trust approval was obtained. The sample size was 30 DSUMs.ResultsStandard 1 was met. All other standards were not met. For standard 2, 63% DSUMs did have regular medication reconciled at discharge. Not having this record will cause errors especially for patients receiving care from different specialist centres. For standard 3, 71% of DSUMs had documented change and standard 4, 83% DSUMs where sent in time. In order for healthcare professionals in primary care to continue medications correctly they need to be fully informed with respect to ongoing treatment in a timely manner; including medication that have been stopped, started or changed and the reason for this. Communication is essential to improve adherence to treatment plans and reduce the likelihood of adverse events caused by failure to prescribe and monitor. For standard 5, 40% included supply information. Seamless care letters are available for special/unlicensed products that can be easily attached to the DSUM and send to the GP and community pharmacy to aid with further supply.ConclusionThis audit has emphasised that MR should take place for every patient on discharge as it is a vital part of communication for all transfer settings. Unintended changes to medication regimens can jeopardise treatment, and increase the risk of re-admission to hospital.ReferencesChief name. Section: 10. Discharge medicines. Trust medicines policy(1st ed.) 2015:7–9.Medicines optimisation: The safe and effective use of medicines to enable best possible outcomes. http://www.nice.org.uk/guidance/ng5/evidence/full-guideline-6775454

Airway Safety in a Patient with Submandibular Swelling

A fifty-eight year old gentleman (CH) with a five-day history of toothache presented to the emergency department (ED) with increasing pain with associated submandibular swelling over the last 24-hours. He was an unkempt gentleman who had not consulted his general practitioner or dentist in many years, was unaware of any significant past medical history and was not on any regular medication. He was an obese gentleman with a BMI of 56.

First-generation antipsychotics: not gone but forgotten

Aims and methodTo identify training needs of the next generation of psychiatrists and barriers in prescribing first-generation antipsychotics (FGAs). We have surveyed psychiatry trainees in East Anglia with regard to their training experience, knowledge and attitudes to the use of oral FGAs as regular medication.ResultsTwo-thirds of trainees were aware that first- and second-generation antipsychotics (SGAs) have similar efficacy, and a similar proportion perceived the older drugs to have more or ‘stronger’ side-effects. Lack of training experience was noted as the second leading concern for prescribing FGAs. A quarter of trainees received no training exposure to the older drugs and two-thirds had never initiated these drugs themselves. Although nearly 90% of trainees felt confident about initiating an oral SGA as a regular medication, only about 40% felt confident with FGAs (P<0.001).Clinical implicationsThe survey highlights worrying gaps in training. FGAs can be used effectively, minimising side-effects, by careful dose titration, avoiding antipsychotic polypharmacy, high-dose, and high-potency drugs, thus ensuring they are not lost to future generations of psychiatrists.

Somatic Comorbidity in Chronic Constipation: More Data from the GECCO Study

Background. Comorbidity in chronic constipation has rarely been investigated, despite the fact that constipation can occur as one symptom in a number of neurological, systemic, and other nonintestinal and intestinal disorders.Methods. Of 1037 individuals with constipation identified during a telephone survey, 589 returned a postal questionnaire with valid data, asking for sociographic data, clinical symptoms, comorbid conditions, medication intake, and health care behavior related to constipation. Among them, 245 reported some somatic diagnoses and another 120 regular medication intake. They were compared to individuals without comorbid condition and presumed functional constipation (n=215).Results. Individuals reporting a somatic comorbid condition and/or regular medication were significantly older than those with functional constipation (63.8±15.8and43.7±15.5years, resp.,p<0.001) and had lower health and social status (bothp<0.001), but similar general life satisfaction (n.s.). Their quality-of-life was lower for the physical (p<0.001) but not for the mental health domain (n.s.), while among those with functional constipation, the mental health domain distinguished IBS-C individuals from those with functional constipation but without pain (p<0.001).Conclusion. In an unselected population sample with constipated individuals, those with a somatic comorbid condition outnumber those with functional constipation alone and are distinctly different with respect to age and health status.