Social class and pathways to care among psychiatric clinic referrals at the University Hospital of the West Indies [abstract]

OBJECTIVE: To determine the effects of social class on the pathways to outpatient psychiatric care at the University Hospital of the West Indies. METHODS: This was a prospective cohort study of patients attending the psychiatric screening clinic of the University Hospital of the West Indies. Demographic, clinical and outcome variables were collected over the period February to July 2001. RESULTS: The cohort consisted of 306 patients of whom 150 were male, 156 were female and 85.4 percent were from social classes III to V. Most of the patients came from urban St.Andrew (57 percent). More than half (51 percent) took the bus, 61 percent were brought by family members, 31.8 percent came alone. More than three-quarters (76.4 percent) were seen in the emergency outpatient department prior to being referred. Most (66.4 percent) patients presented within six months of onset symptoms. Once seen, 47.3 percent (142) were referred the government community mental health service while an equal number was distributed within the psychiatric service of the hospital. There was a statistically significant relationship between social class and method of transportation (p= 0.001). No association was found with social class and any other variable. CONCLUSIONS: For the majority of these patients, with the exception of the method of transportation to the clinic, there is no effect of social class on all the variables studied. The transporattion variable, which was significant, was not related to the services offered. (AU)

The organisation of helicopter emergency services for the rescue of aircraft crash victims in the tropical forest

The purpose of this report was to describe lessons learned from experience in the tropical forest of Guyana and one helicopter rescue mission in that hostile environment. With previous data reported in the literature several guidelines for organizing these operations can be proposed. These rescue operations involve hoisting the victim to helicopter, medical treatment itself, and penetration into a hostile environment. Effectiveness and safety mandate that the physicians involved receive regular training in the techniques of helicopter evacuation, first aid, and survival. It is necessary to adapt conventional first aid kits for the purpose and to develop light and adequate survival equipment as listed exhaustively by the author.(AU)

The utilisation and organisation of the aeromedical transportation service in Jamaica

Data on aeromedical transportation for the period 1974 - 1978 carried out by the Air Wing of the Jamaica Defence Force have been analysed. A 400 percent increase in utilisation of the service has been noted. Some of the problems involved have been discussed and recommendations made to increase the overall efficiency of aeromedical transportation in Jamaica. (AU)

Aeromedical evacuation of patients in Jamaica

Data on 153 patients who were transported by helicopter from rural hospitals in Jamaica during the period July - December 1978, is presented. The majority of the patients transported were trauma victims. The overall mortality in this series was 26 per cent. Not all of the patients transported were critically ill; consequently, some could have been sent by road while others need not have been sent at all. The need for the referring hospital to be more selective in the type of patient transferred by helicopter is pointed out. The importance of preliminary stabilization and the continuation of resuscitative measures during transfer is emphasized. The study indicates that the JDF Air Wing is playing a useful and often vital role in patient transport in Jamaica (AU)