RESUMO
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.
Assuntos
Adolescente Institucionalizado , Controle de Doenças Transmissíveis/métodos , Assistência de Custódia/métodos , Surtos de Doenças/prevenção & controle , Sarampo/epidemiologia , Sarampo/prevenção & controle , Adolescente , Serviços de Saúde do Adolescente/organização & administração , Serviços de Saúde do Adolescente/normas , Adolescente Institucionalizado/estatística & dados numéricos , Centers for Disease Control and Prevention, U.S./organização & administração , Controle de Doenças Transmissíveis/organização & administração , Assistência de Custódia/organização & administração , Assistência de Custódia/normas , Surtos de Doenças/história , História do Século XXI , Humanos , Vacina contra Sarampo/uso terapêutico , Vigilância da População/métodos , Prisões/organização & administração , Prisões/normas , Estados Unidos/epidemiologiaRESUMO
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.
Assuntos
Serviços de Saúde do Adolescente/normas , Transtornos Mentais/diagnóstico , Escalas de Graduação Psiquiátrica , Adolescente , Psiquiatria do Adolescente/educação , Criança , Assistência de Custódia/normas , Feminino , Psiquiatria Legal/educação , Humanos , Delinquência Juvenil/psicologia , Londres , Masculino , Serviços de Saúde Mental/normas , Variações Dependentes do Observador , Reprodutibilidade dos TestesRESUMO
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.
Assuntos
Serviços de Saúde Mental/organização & administração , Prisões/organização & administração , Desenvolvimento de Programas/métodos , Gestão de Riscos/organização & administração , Prevenção do Suicídio , Assistência de Custódia/métodos , Assistência de Custódia/normas , Humanos , Masculino , Estudos de Casos Organizacionais , Inovação Organizacional , Prisões/métodos , Gestão de Riscos/métodos , Desenvolvimento de Pessoal/métodos , Estados Unidos , Serviços Urbanos de Saúde/organização & administraçãoRESUMO
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.
Assuntos
Assistência de Custódia/normas , Ética Médica , Aplicação da Lei , Defesa do Paciente , Papel do Médico , Polícia , Prisioneiros , Prisões , Qualidade da Assistência à Saúde , Controle Social Formal , Conflito de Interesses , Revelação , Medicina Legal , Humanos , Transferência de Pacientes , Psiquiatria , Sociedades , Revelação da Verdade , Reino Unido , Denúncia de IrregularidadesRESUMO
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.
Assuntos
Assistência de Custódia/normas , Deficiência Intelectual/reabilitação , Transtornos Mentais/reabilitação , Qualidade da Assistência à Saúde/estatística & dados numéricos , Instituições Residenciais/normas , Adulto , Coleta de Dados/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Defesa do Paciente , Estados UnidosRESUMO
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.