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Emergency department psychiatry

Gerrit I van Schalkwyk, Rachel B Katz, Joseph Resignato, Susan C van Schalkwyk, Robert M Rohrbaugh
OBJECTIVE: Challenges in pursuing research during residency may contribute to the shortage of clinician-scientists. Although the importance of mentorship in facilitating academic research careers has been described, little is understood about early career research mentorship for residents. The aim of this study was to better understand the mentorship process in the context of psychiatry residency. METHOD: Semi-structured interviews were conducted with experienced faculty mentors in a psychiatry department at a large academic medical center...
October 20, 2016: Academic Psychiatry
Charles A Mkony, Ephata E Kaaya, Alex J Goodell, Sarah B Macfarlane
BACKGROUND: Faced with one of the lowest physician-to-population ratios in the world, the Government of Tanzania is urging its medical schools to train more physicians. The annual number of medical students admitted across the country rose from 55 in the 1990s to 1,680 approved places for the 2015/16 academic year. These escalating numbers strain existing faculty. OBJECTIVE: To describe the availability of faculty in medical schools in Tanzania. DESIGN: We identified faculty lists published on the Internet by five Tanzanian medical schools for the 2011/12 academic year and analyzed the appointment status, rank, discipline, and qualifications of faculty members...
2016: Global Health Action
Paola Ferri, Monica Silvestri, Cecilia Artoni, Rosaria Di Lorenzo
BACKGROUND: Workplace violence (WPV) against health professionals is a global problem with an increasing incidence. The aims of this study were as follows: 1) to examine the frequency and characteristics of WPV in different settings and professionals of a general hospital and 2) to identify the clinical and organizational factors related to this phenomenon. METHODS: The study was cross-sectional. In a 1-month period, we administered the "Violent Incident Form" to 745 professionals (physicians, head nurses, nurses, nursing assistants), who worked in 15 wards of a general hospital in northern Italy...
2016: Psychology Research and Behavior Management
Catherine Gigot, Christine Reynaert, Nicolas Zdanowicz
BACKGROUND: In a previous study, we compared the family relationships of patients hospitalized in a psychiatry unit from either psychiatric consultations or after passing emergency room (E.R.). The intensity of depression was statistically comparable in both groups. What distinguishes patients transiting emergencies is that their families and couples are more cohesive and adaptable. In this study, we compare both groups in terms of coping mechanisms and multidimensional health locus of control (MHLC)...
September 2016: Psychiatria Danubina
Nicolas Zdanowicz, Thomas Dubois, Christine Reynaert, Denis Jacques, Pauline Manceaux
BACKGROUND: In a previous study, we investigated the risk of admission to emergency (ER) of depressed patients prior to their hospitalization in psychiatry in comparison with hospitalized patients transferred from the consultations department (Cdpt). In the present study, we compare among the same patients variables affecting the intensity of depression in each group. METHOD: All patients with Major depressive disorder admitted in our department through emergencies (N=146) or consultations (N=2172) between January 1, 2010 and December 31, 2012 were included in an open study...
September 2016: Psychiatria Danubina
Paul Cammell
OBJECTIVES: This article reviews recent trends in the provision of psychiatric services to the emergency departments of tertiary hospitals in Australia, involving the establishment of specialised in-reach or liaison services as well as various forms of short stay unit attached to emergency departments. The Emergency Psychiatry Service at Flinders Medical Centre, South Australia, is described as a case example. Its specialised models of assessment and clinical care are described, highlighting how these are differentiated from more traditional models in inpatient, community and general hospital consultation-liaison psychiatry...
September 6, 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
Jason L Sanders, Ali S Raja, Kohei Hasegawa, Jane Bittner, Janice A Espinola, Brianna Olamiju, Ashley F Sullivan, Carlos A Camargo
STUDY OBJECTIVE: Emergency department (ED) consultation is a common practice. There are few data on consultant availability or changes in availability over time, which may hinder resource planning and allocation. We conduct serial surveys of Massachusetts EDs to investigate these trends. METHODS: We surveyed ED directors in Massachusetts in 2006 (n=61 EDs), 2009 (n=63), and 2015 (n=63) about ED characteristics in the previous year, including specialty-specific consultant availability in person (yes/no) and continuous consultant availability (yes/no)...
October 2016: Annals of Emergency Medicine
Rebecca Jacob, Mai Luen Wong, Catherine Hayhurst, Peter Watson, Cecily Morrison
Frequent attendance to the emergency department (ED) is a growing public health concern. Designing services for frequent attenders poses challenges, given the heterogeneous nature of this group. This was a two-part observational study identifying frequent attenders from ED records. The first stage studied trends and developed personas with emphasis on differentiating moderate frequent attenders (attending between 5 and 20 times per year) and extreme frequent attenders (attending more than 20 times). Stage 2 included a case note review of 100 consecutive frequent attenders...
August 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
Nik Wahidah Hashim, Mitch Wilkes, Ronald Salomon, Jared Meggs, Daniel J France
OBJECTIVE: The aim of the present study was to determine if acoustic measures of voice, characterizing specific spectral and timing properties, predict clinical ratings of depression severity measured in a sample of patients using the Hamilton Depression Rating Scale (HAMD) and Beck Depression Inventory (BDI-II). STUDY DESIGN: This is a prospective study. METHODS: Voice samples and clinical depression scores were collected prospectively from consenting adult patients who were referred to psychiatry from the adult emergency department or primary care clinics...
July 26, 2016: Journal of Voice: Official Journal of the Voice Foundation
Jinjiao Wang, Haomiao Jia, Jingjing Shang, Joan A Kearney
The current study examined longitudinal associations between mental disorders and all-cause subsequent medical events in a 5% random sample of records in the 2010 national Outcome and Assessment Information Set. Records of older adults (N = 28,475) receiving home health care (HHC) services were examined with respect to mental disorders and medical events, including acute care hospitalization, emergency department admission, and 30-day rehospitalization. Predominant mental disorders were depression and anxiety identified by formal diagnoses, symptom clusters, and/or prescription of related mental health services...
October 1, 2016: Journal of Gerontological Nursing
Lindell K Weaver, Kayla Deru
Carbon monoxide (CO) poisoning is common, but it has rarely been reported to cause ischemic colitis. In this case, a 34-year-old female with depression presented to an emergency department after a period of unconsciousness, with urinary and bowel incontinence, following exposure to car exhaust. Her carboxyhemoglobin level was 23%. She had metabolic acidosis. She was transferred to our facility for hyperbaric oxygen treatment, where she had intractable nausea/vomiting with abdominal pain and bright-red bleeding per rectum...
March 2016: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
Francisco J García-Peñalvo, Manuel Franco Martín, Alicia García-Holgado, José Miguel Toribio Guzmán, Jesús Largo Antón, Ma Cruz Sánchez-Gómez
The treatment of psychiatric patients requires different health care from that of patients from other medical specialties. In particular, in the case of Department of Psychiatry from the Zamora Hospital (Spain), the period of time which patients require institutionalized care is a tiny part of their treatment. A large part of health care provided to the patient is aimed at his/her rehabilitation and social integration through day-care centres, supervised flats or activities. Conversely, several reports reveal that approximately 50 % of Internet users use the network as a source of health information, which has led to the emergence of virtual communities where patients, relatives or health professionals share their knowledge concerning an illness, health problem or specific health condition...
July 2016: Journal of Medical Systems
Keiko Inui, Takaaki Hanafusa, Takeshi Namiki, Makiko Ueno, Ken Igawa, Hiroo Yokozeki
A 50-year-old Japanese woman consulted the emergency department of our hospital for bleeding due to an intractable postoperative wound on the lower abdomen; the postoperative wound was owing to a laparoscopic cholecystectomy performed 1 year previously for acute cholecystitis. She presented with a painful ulcer on her right lower abdomen. She also presented with multiple scars, skin grafts on the extremities, and a missing left lower leg, the causes for all of which were unexplained. The results of her blood test were normal, except for the hemoglobin level...
January 2016: Case Reports in Dermatology
Howard J Osofsky, Anthony Speier, Tonya Cross Hansel, John H Wells, Kristopher E Kaliebe, Nicole J Savage
OBJECTIVE: This paper provides a report of an academic department of psychiatry's journey into the change process associated with addressing the new requirements in health-care delivery, the emphasis on person-centered treatment models, and the implications for residency training programs. Louisiana State University Health Sciences Center Department of Psychiatry's experience is based on responding to real-world shifts in which academic departments can play a leadership role. METHODS: Importantly, methods are based on person-centered collaboration being central to a successful change process and include a description of the training, with data supporting implementation of the model...
October 2016: Academic Psychiatry
Andrea H Kline-Simon, Constance Weisner, Stacy Sterling
OBJECTIVE: To examine the point prevalence of behavioral health conditions (BHCs) and co-occurring chronic medical conditions among adolescents in an integrated health system. METHOD: The sample consisted of adolescents in an integrated health care system diagnosed with at least 1 of the 5 most prevalent BHCs in 2014 (n = 30,643), and patients without a BHC matched on age, sex, and medical home facility (n = 30,643). Electronic health record data was used to identify all adolescents aged 11 to 18 years with at least 1 BHC diagnosis on their diagnosis list, which included current and pre-existing diagnoses from an outpatient (including psychiatry and chemical dependency specialty treatment), inpatient, or emergency department visit at a Kaiser Permanente Northern California (KPNC) facility between January 1, 2014, and December 31, 2014...
May 2016: Journal of the American Academy of Child and Adolescent Psychiatry
Q Bensa, Y Auxéméry
BACKGROUND: Somatic suffering concerns mental health in many ways, but numerous psychiatrists are still reluctant to take an interest in somatic care due to a supposed lack of expertise and an alteration of the psychotherapeutic link, whilst in parallel numerous fellow physicians are quite apprehensive about treating patients with mental disorders. OBJECTIVES: We have undertaken a targeted clinical audit regarding the somatic treatment of in-patients in a psychiatric unit to propose the implementation of measures of improvement...
April 25, 2016: L'Encéphale
L Martinerie, M-F Le Heuzey, R Delorme, J-C Carel, A Bargiacchi
Gender dysphoria, originally called gender identity disorder, is characterized by the dissociation between one's expressed gender and the gender of rearing as assigned at birth, which generates significant clinical distress and social, academic, and other important forms of isolation. This state is also known as transgender or transsexualism and is recognized as a medical disease. Adults with gender dysphoria can benefit from psychological, medical, and surgical care. However, gender dysphoria rarely occurs in adulthood but rather emerges in childhood or adolescence, generating deep social and academic difficulties, especially at puberty...
June 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Michal Juhás, Vincent I O Agyapong
OBJECTIVE: To describe the characteristics of liaison psychiatric patients in the emergency department (ED) of a medium sized hospital in the oil sands region of Northern Alberta. METHODS: ED psychiatry services users were evaluated using a data assessment tool designed to capture all relevant demographic and clinical characteristics. RESULTS: Overall, 477 patients (48.2% male) were assessed by the psychiatric team over the 12 month period...
September 2016: International Journal of Psychiatry in Clinical Practice
Jim Bolton, Lucy Palmer, Rohanna Cawdron
Aims and method We aimed to estimate the proportion of UK emergency departments with a psychiatric assessment room and to determine whether such rooms met criteria for conducting high-risk assessments. Liaison psychiatry services were asked whether their hospital had such a room, whether it met the criteria and whether respondents judged it to be sufficiently safe and private. Results Of the 60 emergency departments included in the survey, 23% had a psychiatric assessment room that met all the safety criteria and was judged to be safe and private...
April 2016: BJPsych Bulletin
Marc E Wolf, Anastasios Chatzikonstantinou, Joachim Grüttner, Anne D Ebert, Thomas Walter, Michael G Hennerici, Marc Fatar
BACKGROUND: Acute stroke is a medical emergency with various clinical presentations. Since the introduction of systemic thrombolytic treatment, stroke diagnosis has been made quickly and with great caution, and the trend of rapid presentation at hospitals has increased. METHODS: In our multidisciplinary Emergency Department, we prospectively collected and analysed data of consecutive patients presenting with suspected acute stroke (SAS) or transient ischemic attack (TIA)...
2016: European Neurology
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