Musical obsession or pseudohallucination: Electrophysiological standpoint

Reported herein is a case of obsessive–compulsive disorder with persistent and distressing musical obsessions along with other symptoms. Advanced source analysis of electroencephalographic data indicated high spectral power over the bifrontal region. The musical symptoms were resistant to pharmacotherapy but there was some reduction in frequency and duration of musical obsessions with thought-stopping technique.     

Mental health crisis and respite services: service user and carer aspirations

There is emerging evidence that crisis resolution services can provide alternatives to hospital admission, reducing demand on inpatient beds. Following a public consultation exercise in Lancashire (England), a team of nurses undertook a study, using interactive research methodology, to gain an understanding of how users and carers define a crisis and what range of crisis services, resources and interventions service users and carers thought would help avoid unnecessary hospital admission. Data collection comprised postal questionnaires and 24 group meetings with service users and carers, which were held during 2006. Data were analysed, and seven themes were identified: (1) definitions of a crisis; (2) access to services; (3) interventions; (4) range of services required ( before , during and after crisis); (5) place of treatment; (6) recovery and rehabilitation; and (7) community support. We conclude that expressed preferences of service users and carers for pre-emptive services that are delivered flexibly will present a challenge for service commissioners and providers, particularly where stringent access criteria are used. Home-based pre-emptive services that reduce the need for unnecessary hospital treatment may avoid progression to social exclusion of service users.     

An educational evaluation of supervisor and mentor experiences when supporting Primary Care Graduate Mental Health Workers

This paper reports on the findings of a postal survey used to enhance understanding into the backgrounds, experiences and support offered to supervisors and mentors of Primary Care Graduate Mental Health Workers (PCGMHWs). A postal questionnaire was sent to the total population of supervisors and mentors who had supported PCGMHW students from three universities in the Northwest of England, during the period of their introduction 2004–2006. Most supervisors and mentors had previous experience of supervision and mentorship with other types of students but not PCGMHWs. Data suggest that there were difficulties due limited understanding of the role of PCGMHWs and how it was to be operationalized. Respondents reported staff shortages, time constraints and competing commitments, which limited support available to students. The lack of organizational readiness and infrastructure to support the role was widely reported. However, the role has developed and is generally well received. The implications for future development of the PCGMHW and the preparation and support of supervisors and mentors are discussed.     

Predictive validity of a modified fall assessment tool in nursing homes: Experience from Slovenia

The aim of the study was to evaluate the predictive validity of the Modified Fall Assessment Tool (MFAT) in a nursing home setting. The study involved 83 residents from a nursing home in Slovenia with an average age of 81 years. To determine the predictive characteristics of the MFAT, a receiver operating characteristic curve analysis was applied. During the observation period of 12 weeks, 18 residents fell. The fallers had a significantly higher history of falls, a higher number of diagnoses, more medication, and a higher MFAT score than the non-fallers. Using the estimated criterion of 20 points, the sensitivity of the MFAT score was 61%, its specificity was 80%, its classification accuracy was 64%, its positive likelihood ratio was 3.1, its negative likelihood ratio was 0.5, its positive predictive value was 46%, and its negative predictive value was 88%. The results showed that the MFAT is suitable for the prediction of falls and, hence, also the prevention of falls in nursing homes, whereby the recommended criterion score is 20 points.     

Family experiences of home caring for patients with HIV/AIDs in rural Limpopo Province, South Africa

The increasing rate of patients with HIV/AIDS brings a burden to the already weakened health care delivery systems in Limpopo Province, South Africa. Hospitals alone cannot deal with the needs of AIDS patients effectively; the patients are discharged to be cared for at home. A qualitative study was conducted to explore and describe the experiences of the family members that are caring for patients with HIV/AIDS at home. Interviews were conducted with 12 participants who were purposively selected as the caregivers of patients suffering from AIDS at home. Ethical measures were adhered to for the protection of the participants. The findings revealed that the family members experience negative feelings, characterized by sadness, pain, anger, depression, and frustration, as they care for their loved one within the context of extreme poverty. Quality care was compromised in situations where basic resources were not available. Guidelines to assist families in caring for their loved one with HIV/AIDS at home were developed.