RESUMEN
The recent US measles outbreak is the largest since 1992. It is just a matter of time before measles is introduced into a juvenile custodial setting. Are we prepared? Should we be prepared? This short article addresses steps institutional settings should take to prevent the spread of measles in a contained setting.
Asunto(s)
Adolescente Institucionalizado , Control de Enfermedades Transmisibles/métodos , Cuidado en Custodia/métodos , Brotes de Enfermedades/prevención & control , Sarampión/epidemiología , Sarampión/prevención & control , Adolescente , Servicios de Salud del Adolescente/organización & administración , Servicios de Salud del Adolescente/normas , Adolescente Institucionalizado/estadística & datos numéricos , Centers for Disease Control and Prevention, U.S./organización & administración , Control de Enfermedades Transmisibles/organización & administración , Cuidado en Custodia/organización & administración , Cuidado en Custodia/normas , Brotes de Enfermedades/historia , Historia del Siglo XXI , Humanos , Vacuna Antisarampión/uso terapéutico , Vigilancia de la Población/métodos , Prisiones/organización & administración , Prisiones/normas , Estados Unidos/epidemiologíaRESUMEN
Despite concerted effort to rehabilitate and return patients to their homes, the majority of nursing home patients are destined to spend the remainder of their days in institutional settings. These custodial care patients are elderly, have many functional disabilities, and are often demented. The traditional medical approach to care, which emphasizes diagnosis and treatment of specific diseases, is often not appropriate for these patients. Instead, physicians should focus their attention on functional assessment and treatment, nontechnologic management of acute problems, humane terminal care, and the development of an efficient caregiving system within the nursing home.
Asunto(s)
Cuidado en Custodia/normas , Objetivos , Casas de Salud/normas , Anciano , Actitud del Personal de Salud , Cuidados Críticos/normas , Cuidado en Custodia/organización & administración , Atención a la Salud/normas , Femenino , Geriatría , Humanos , Liderazgo , Cuidados a Largo Plazo/organización & administración , Cuidados a Largo Plazo/normas , Masculino , Casas de Salud/organización & administración , Cuidado Terminal , Estados UnidosRESUMEN
The ethical standards of police surgeons are being compromised by conflict between obligations to their paymasters, the police authorities, and their responsibilities to their patients, when these patients are prisoners detained in unacceptable conditions and where even minimum standards of medical care and management are difficult to deliver.
Asunto(s)
Cuidado en Custodia/normas , Ética Médica , Aplicación de la Ley , Defensa del Paciente , Rol del Médico , Policia , Prisioneros , Prisiones , Calidad de la Atención de Salud , Control Social Formal , Conflicto de Intereses , Revelación , Medicina Legal , Humanos , Transferencia de Pacientes , Psiquiatría , Sociedades , Revelación de la Verdad , Reino Unido , Denuncia de IrregularidadesRESUMEN
We examined the use of a staff-completed measure, the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA), to record mental health problems in adolescents in local authority secure accommodation. It proved possible to train staff and implement completion of the HoNOSCA on 64 consecutive admissions. Interrater reliability was high. The HoNOSCA identified high levels of psychological problems on admission (mean 18.5, s.d.=5.5). Follow-up HoNOSCA ratings proved sensitive to change; however, correlation between HoNOSCA and adolescent-completed questionnaires was poor. We concluded that HoNOSCA can be helpful in documenting mental health problems among young people admitted to secure local authority units.
Asunto(s)
Servicios de Salud del Adolescente/normas , Trastornos Mentales/diagnóstico , Escalas de Valoración Psiquiátrica , Adolescente , Psiquiatría del Adolescente/educación , Niño , Cuidado en Custodia/normas , Femenino , Psiquiatría Forense/educación , Humanos , Delincuencia Juvenil/psicología , Londres , Masculino , Servicios de Salud Mental/normas , Variaciones Dependientes del Observador , Reproducibilidad de los ResultadosRESUMEN
Data from a multistate survey of board-and-care homes were used to compare the quality of the residential environment in homes for mentally disabled and developmentally disabled persons. Staffing levels, services, quality of the physical structure, rapport between residents and staff, number of residents, staff training, and fire and safety precautions were analyzed. The global quality of the residential environment was found to be appreciably better in homes serving the developmentally disabled. Implications of the findings for public policy are discussed, with specific reference to advocacy strategies used in behalf of developmentally and mentally disabled persons.
Asunto(s)
Cuidado en Custodia/normas , Discapacidad Intelectual/rehabilitación , Trastornos Mentales/rehabilitación , Calidad de la Atención de Salud/estadística & datos numéricos , Instituciones Residenciales/normas , Adulto , Recolección de Datos/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Defensa del Paciente , Estados UnidosRESUMEN
This article profiles the suicide prevention practices at a large metropolitan jail, a facility that experienced nine inmate suicides in a recent 24-month period. The suicide rate in this facility was found to far exceed the rate for jails of comparable size as well as the national rate of jail suicides. The nine suicides are summarized and common features (including the issue of protective custody) of the deaths and systemic jail deficiencies are discussed. The process by which the jail system developed a suicide prevention program based upon the principles of staff training, identification/screening, communication, levels of supervision, housing, and intervention is offered.