Psychiatric patients and their response to experimental stress

Serum levels of Epinephrine (E), norepinephrine (NE), heart rate (HR), skin conductance reaction (SCR) and skin conductance level (SCL) were measured in schizophrenic, endogenous depressed and anxiety patients as well as in normal controls. Conditions were rest, noise and a mental arithmetic (MA) task. Schizophrenic and depressed patients had an attenuated HR response to MA. Moreover, Schizophrenic patients also had higher NE base level and the highest NE secretion during noise. Anxiety and depressed patients showed significantly lower phasic electrodermal activity (SCR) throughout the whole trial, exclusively anxiety patients had significantly higher tonic electrodermal activity (SCL). These findings indicate that autonomous reactions discriminate between patient groups and controls as well as between each other.     

Semmelweis’ present day follow-up: Updating bacterial sampling and enrichment in clinical hygiene

Potentially dangerous antibiotic resistant contaminants have permanently penetrated at least well-off western populations. The danger is so evident that some hospitals have started to refuse accepting patients who carry such bacteria. Sampling and enrichment measures in hygiene monitoring must be updated as they are corner stones in handling the problems and safeguarding the health care units. Their patients, when exposed to microorganisms are strenuous to treat. Sometimes even this fails, if the infections are spreading in weakened patients. The present review summarizes currently used technologies and the abilities of bacteria to avoid detection. Improved protocols on environmental monitoring in healthcare units are required. They should be comparable with contamination control in industries. Actually these measures in health care should be even stricter because human lives are directly endangered as the resistance of especially elderly patients is low.     

Learning to Observe Relationships and Coping

Milieu relationships provide the critical background presence to staff's attempts to motivate, regulate, and teach patients how to cope with stress. Forging a connection with hospitalized children and adolescents demands attention to how they respond to adults and engage with staff around milieu expectations. Assessment guides that deal with these issues are presented. Important aspects of children's relatedness are presented in the context of their working models of adults and the influence of these representations on their response to staff. Coping skills are explained with particular emphasis on behavioral coping strategies. Tied to the assessment process are interventions that emphasize staff's role in helping patients manage strong affects and avoid the use of nonproductive behavior regulation strategies.     

基层医院重症监护病房的医院感染特点及其对策

目的分析基层医院重症监护病房(ICU)的医院感染特点,提出相应的防范措施,以有效降低医院感染发生率. 方法以主动监测与系统回顾相结合的方法,对2003年全年入住ICU 383例患者的相关临床资料进行分析评判,并与全院住院患者进行对比. 结果 ICU的医院感染率是28.8%,显著高出同期的医院平均感染率23.6个百分点;因医院感染而导致死亡的占ICU总死亡的36%;ICU医院感染的病原菌以G-菌为主,占50%,而双重感染达78.7%;下呼吸道感染为医院感染的主要部位占61.7%,但多部位多器官感染占29.6%. 结论 ICU医院感染的特点是高发病率、高死亡率、高耐药性;其相关因素有病情重、年龄大、基础疾病多、侵入性诊疗操作多与交叉感染等.     

Respondent and informant accounts of psychiatric symptoms in a sample of patients with learning disability

This paper investigates differences in the nature and frequency of psychiatric symptoms reported by patients with learning disability and by key informants. The study involved psychiatric assessment of 100 patients with learning disabilities and key informants using the Psychiatric Assessment Schedule for Adults with a Developmental Disability (PAS-ADD), a semi-structured psychiatric interview developed specifically for people who have a learning disability. There was considerable disagreement between respondent and informant interviews; only 40.7% of cases were detected by both interviews. Respondents were more likely to report on autonomic symptoms and certain psychotic phenomena. Other anxiety and depression symptoms were more frequently reported by infcrnnants. The results indicate that it is crucial for sensitive case detection to complete both interviews where possible. If the respondent cannot be interviewed, panic disorder or phobias may be particularly difficult to detect.     

An acute psychiatric rating scale for the clinical assessment of functionally disturbed inpatients

A 28-item behavioral rating scale, the Acute Psychiatric Rating Scale (APRS), was developed using factor-analytic methods for the assessment of functionally disturbed psychiatric inpatients. Fifty-eight staff rated 74 patients on the scale. Seven factorial dimensions were extracted comprising neuroticism, aggression, emotional withdrawal, cognitive impairment, schizophrenia, hypomania and self-injuriousness. The scale was evaluated in 4 different psychiatric inpatient units: two acute admission wards, an intensive care unit and a regional secure unit. Behavioral ratings on the scale were related to several patient demographic and treatment variables, including age, sex, marital status, legal status, length of admission and electroconvulsive therapy. The scale was found to possess a clear factorial structure, good interrater reliability and promising clinical validity for further research use in psychiatric inpatient settings.