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1.
Med. clín (Ed. impr.) ; 153(5): 205-212, sept. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-183997

RESUMO

El incremento de los viajes internacionales, la creciente presencia de vectores transmisores de arbovirus en nuestro país, las alertas de fiebres hemorrágicas, como el actual brote de ébola en la R. D. del Congo y los casos autóctonos de fiebre hemorrágica de Crimea-Congo en nuestro país, ponen de nuevo en primer plano las enfermedades tropicales. El aislamiento de los casos sospechosos de enfermedades de alta transmisibilidad y letalidad ha de ser una prioridad (fiebres hemorrágicas, MERS-CoV). Al valorar al paciente, una cuidadosa historia clínica basada en los aspectos epidemiológicos de la zona de procedencia, las actividades realizadas, el tiempo de estancia en el mismo y el inicio de los síntomas nos ayudarán finalmente, si no al diagnóstico definitivo, sí al menos a descartar las enfermedades que signifiquen una amenaza para él. Por su frecuencia y gravedad la malaria debe ser descartada, sin olvidar las otras causas habituales de fiebre con las que el médico de urgencias debe estar familiarizado también


The increase in international travel, the growing presence of arbovirus vectors in our country, and notifications of haemorrhagic fever such as the current outbreak of Ebola in D.R. Congo and the cases of Crimea-Congo haemorrhagic fever in our country have again cast the spotlight on tropical diseases Isolating suspected cases of highly contagious and lethal diseases must be a priority (Haemorrhagic fever, MERS-CoV). Assessing the patient, taking a careful medical history based on epidemiological aspects of the area of origin, activities they have carried out, their length of stay in the area and the onset of symptoms, will eventually help us, if not to make a definitive diagnosis, at least to exclude diseases that pose a threat to these patients. Malaria should be ruled out because of its frequency, without forgetting other common causes of fever familiar to emergency doctors


Assuntos
Humanos , Controle Sanitário de Viajantes , Doença Relacionada a Viagens , Isolamento de Pacientes/tendências , Saúde do Viajante , Doenças Transmissíveis Importadas/epidemiologia , Febres Hemorrágicas Virais/epidemiologia , Infecções por Arbovirus/epidemiologia , Arbovirus/isolamento & purificação , Meningite/epidemiologia , Febre Tifoide/epidemiologia , Rickettsia/isolamento & purificação , Coronavirus/isolamento & purificação , Esquistossomose/epidemiologia
2.
Soins Psychiatr ; 38(310): 12-16, 2017.
Artigo em Francês | MEDLINE | ID: mdl-28476249

RESUMO

From confinement to the philosophy of care in the community, the history of psychiatry testifies to the evolution of practices in the matter of the restriction of freedom. The French National Health Authority still too often recommends practices based on restraint. Caregivers, in relation to the clinical aspect of the patients, need clearly identified therapeutic projects. While training can be vital for them, risk management policies can prove to be a hindrance to patients' freedom.


Assuntos
Transtornos Mentais/enfermagem , Transtornos Mentais/psicologia , Isolamento de Pacientes/psicologia , Isolamento de Pacientes/tendências , Restrição Física/psicologia , Gestão de Riscos/tendências , Previsões , França , Necessidades e Demandas de Serviços de Saúde/legislação & jurisprudência , Necessidades e Demandas de Serviços de Saúde/tendências , Humanos , Relações Enfermeiro-Paciente , Isolamento de Pacientes/legislação & jurisprudência , Autonomia Pessoal , Filosofia em Enfermagem , Restrição Física/legislação & jurisprudência , Restrição Física/estatística & dados numéricos , Gestão de Riscos/legislação & jurisprudência
3.
Disaster Med Public Health Prep ; 11(3): 337-342, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-27839521

RESUMO

OBJECTIVES: We sought to better understand the tools used by public health officials in the control of tuberculosis (TB). METHODS: We conducted a series of in-depth interviews with public health officials at the local, state, and federal levels to better understand how health departments around the country use isolation measures to control TB. RESULTS: State and local public health officials' use of social distancing tools in infection control varies widely, particularly in response to handling noncompliant patients. Judicial and community support, in addition to financial resources, impacted the incentives and enablers used to maintain isolation of infectious TB patients. CONCLUSIONS: Instituting social distancing requires authorities and resources and can be impacted by evidentiary standards, risk assessments, political will, and community support. Awareness of these factors, as well as knowledge of state and local uses of social distancing measures, is essential to understanding what actions are most likely to be instituted during a public health emergency and to target interventions to better prepare health departments to utilize the best available tools necessary to control the spread of disease. (Disaster Med Public Health Preparedness. 2017;11:337-342).


Assuntos
Isolamento de Pacientes/métodos , Saúde Pública/métodos , Tuberculose/prevenção & controle , Planejamento em Desastres/legislação & jurisprudência , Planejamento em Desastres/métodos , Planejamento em Desastres/tendências , Humanos , Isolamento de Pacientes/legislação & jurisprudência , Isolamento de Pacientes/tendências , Saúde Pública/legislação & jurisprudência , Estados Unidos
4.
Psychiatr Serv ; 67(12): 1321-1327, 2016 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-27364814

RESUMO

OBJECTIVE: In 2006, a goal of reducing seclusion in Dutch hospitals by at least 10% each year was set. More than 100 reduction projects in 55 hospitals have been conducted, with €35 million in funding. This study evaluated the results. METHODS: Data (2008 to 2013) were from a national register. Multilevel logistic regression examined determinants of seclusion. RESULTS: Hospital participation in the register ranged from eight in 2008 to 66 in 2013, and admissions ranged from 11,300 to 113,290. The average yearly nationwide reduction of secluded patients was about 9%. Reduction was achieved in half of the hospitals. Some hospitals saw increased rates. In some hospitals where seclusion decreased, use of forced medication increased. Higher seclusion rates were associated with psychotic and bipolar disorders, male gender, and several ward types. CONCLUSIONS: Seclusion decreased significantly, and forced medication increased. Rates varied widely between hospitals. For many hospitals, more efforts to reduce seclusion are needed.


Assuntos
Coerção , Metas , Hospitais Psiquiátricos/estatística & dados numéricos , Admissão do Paciente/estatística & dados numéricos , Isolamento de Pacientes/estatística & dados numéricos , Adulto , Feminino , Humanos , Modelos Logísticos , Masculino , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Serviços de Saúde Mental/organização & administração , Países Baixos , Isolamento de Pacientes/tendências
5.
J Bioeth Inq ; 13(1): 75-86, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26797512

RESUMO

This paper explores the notion of reciprocity in the context of active pulmonary and laryngeal tuberculosis (TB) treatment and related control policies and practices. We seek to do three things: First, we sketch the background to contemporary global TB care and suggest that poverty is a key feature when considering the treatment of TB patients. We use two examples from TB care to explore the role of reciprocity: isolation and the use of novel TB drugs. Second, we explore alternative means of justifying the use of reciprocity through appeal to different moral and political theoretical traditions (i.e., virtue ethics, deontology, and consequentialism). We suggest that each theory can be used to provide reasons to take reciprocity seriously as an independent moral concept, despite any other differences. Third, we explore general meanings and uses of the concept of reciprocity, with the primary intention of demonstrating that it cannot be simply reduced to other more frequently invoked moral concepts such as beneficence or justice. We argue that reciprocity can function as a mid-level principle in public health, and generally, captures a core social obligation arising once an individual or group is burdened as a result of acting for the benefit of others (even if they derive a benefit themselves). We conclude that while more needs to be explored in relation to the theoretical justification and application of reciprocity, sufficient arguments can be made for it to be taken more seriously as a key principle within public health ethics and bioethics more generally.


Assuntos
Antituberculosos/administração & dosagem , Antituberculosos/efeitos adversos , Controle de Doenças Transmissíveis , Terapia Diretamente Observada , Teoria Ética , Obrigações Morais , Isolamento de Pacientes , Saúde Pública/ética , Justiça Social , Responsabilidade Social , Tuberculose Laríngea/prevenção & controle , Tuberculose Pulmonar/prevenção & controle , Virtudes , Beneficência , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/normas , Controle de Doenças Transmissíveis/tendências , Congressos como Assunto , Diarilquinolinas/administração & dosagem , Diarilquinolinas/efeitos adversos , Terapia Diretamente Observada/ética , Terapia Diretamente Observada/tendências , Análise Ética , Saúde Global , Humanos , Nitroimidazóis/administração & dosagem , Nitroimidazóis/efeitos adversos , Oxazóis/administração & dosagem , Oxazóis/efeitos adversos , Isolamento de Pacientes/ética , Isolamento de Pacientes/legislação & jurisprudência , Isolamento de Pacientes/métodos , Isolamento de Pacientes/tendências , Autonomia Pessoal , Farmacovigilância , Pobreza , Saúde Pública/métodos , Saúde Pública/normas , Saúde Pública/tendências , Tuberculose Laríngea/tratamento farmacológico , Tuberculose Resistente a Múltiplos Medicamentos/prevenção & controle , Tuberculose Pulmonar/tratamento farmacológico
6.
Psychiatr Prax ; 42(7): 377-83, 2015 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-25068687

RESUMO

OBJECTIVE: To evaluate multiple efforts of the last decade to reduce the use of coercive measures in psychiatric hospitals. METHOD: A working group for the prevention of violence and coercion in psychiatric hospitals has compared several outcome indicators since the year 2000 and repeatedly has provided evidence-based recommendations for clinical practice. We present data from those 5 hospitals with complete data sets recorded by an identical method over 9 years. RESULTS: The percentage of admissions exposed to any kind of coercive measure decreased from 8.2 % in 2004 to 6.2 % in 2012. The standard deviation of outcomes between hospitals decreased by 20 %. Changes in the duration of measures were mostly insignificant. CONCLUSIONS: Measures to reduce the use of coercion are effective in clinical practice, but to less extent than in clinical studies. A ban on all forced and non-consensual medical interventions, as being stipulated by the UN Special Rapporteur on Torture, has so far not materialized in the participating psychiatric institutions.


Assuntos
Coerção , Hospitais Psiquiátricos/legislação & jurisprudência , Hospitais Psiquiátricos/estatística & dados numéricos , Isolamento de Pacientes/legislação & jurisprudência , Isolamento de Pacientes/tendências , Restrição Física/legislação & jurisprudência , Restrição Física/estatística & dados numéricos , Violência/legislação & jurisprudência , Violência/prevenção & controle , Violência/tendências , Estudos Transversais , Medicina Baseada em Evidências/legislação & jurisprudência , Previsões , Alemanha , Hospitais Psiquiátricos/tendências , Humanos , Isolamento de Pacientes/psicologia , Revisão da Utilização de Recursos de Saúde/estatística & dados numéricos , Violência/psicologia
7.
Nihon Hansenbyo Gakkai Zasshi ; 83(3): 15-9, 2014 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-25826851

RESUMO

Leprosy, or Hansen's disease, has long been regarded as an incurable and dreadful contagious disease. The patients have been forcefully hospitalized and deprived of many basic human rights. Their family members have often been discriminated against due to stigma associated with this disease. Soon after the Second World War, a specific remedy called "multi-drug therapy" (MDT) was discovered and leprosy became a relatively easily curable disease. Despite this medical development, it took time to change the policy and legislation of forceful hospitalization of leprosy patients. The stigma surrounding leprosy and consequent discrimination have continued. In Japan, it was only in 1996 that the legislation requiring forceful hospitalization of leprosy patients was repealed. The Government decided to provide remedies to the former patients who had suffered from this policy. At the United Nations, the General Assembly adopted a resolution to eradicate discrimination against persons affected by leprosy and their family members. It is hoped that discrimination associated with Hansen's disease will soon be overcome by the efforts of all concerned, particularly doctors and nurses who are specialists of this disease.


Assuntos
Direitos Humanos/tendências , Internacionalidade , Hanseníase , Discriminação Social/tendências , Direitos Humanos/legislação & jurisprudência , Humanos , Japão , Isolamento de Pacientes/legislação & jurisprudência , Isolamento de Pacientes/tendências , Discriminação Social/legislação & jurisprudência
8.
Australas Psychiatry ; 19(6): 498-501, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22011225

RESUMO

OBJECTIVE: This paper describes how a significant reduction in restraint and seclusion rates was achieved in an acute aged person's mental health unit. METHOD: We analysed seclusion and restraint data in 2009. This was supplemented with a random audit of patient files and qualitative data obtained from a survey of nursing staff. We also obtained management views on changes in management practice. RESULTS: Four major factors were found to reduce rates of restraints and seclusion. These included: (i) leadership and support from management in nursing practices, (ii) increased multidisciplinary team input, (iii) renovations to the inpatient setting, and (iv) changes in treatment-related factors such as collection of behaviour management history and improving documentation in patient files. CONCLUSION: Experiences such as this provide insights and practical strategies that can be applied in other aged inpatient units to reduce or eliminate rates of seclusion and restraints.


Assuntos
Idoso , Serviços de Saúde Mental/estatística & dados numéricos , Isolamento de Pacientes/estatística & dados numéricos , Restrição Física/estatística & dados numéricos , Atitude do Pessoal de Saúde , Humanos , Liderança , Serviços de Saúde Mental/tendências , Enfermagem/métodos , Enfermagem/tendências , Isolamento de Pacientes/psicologia , Isolamento de Pacientes/tendências , Restrição Física/psicologia
9.
Psychiatr Prax ; 38(7): 348-51, 2011 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-21811957

RESUMO

BACKGROUND: Mechanical restraint and seclusion are not therapeutic interventions but procedures to safeguard patients or staff representing a failure of therapeutic approaches. Quality management including benchmarkings yields considerable variations between different hospitals. However, an enduring and significant decrease in the frequency and duration of such coercive measures so far has not been achieved by means of quality management. A new set of approaches is therefore required. RESULTS: Amending the British practice of "physical restraint" for German conditions, a technique of holding the patient was developed accompanied by manualised interventions of verbal de-escalation. In contrast to mechanical restraint, the technique represents a therapeutic intervention and is usually of short duration. An implementation is planned in a group of hospitals collaborating in the prevention of violence and coercion in psychiatry. CONCLUSIONS: This new technique appears a promising approach to fundamentally change the practice of mechanical restraint in Germany. Evidence of the effect of this technique on frequency and duration of mechanical restraints needs to be gathered.


Assuntos
Coerção , Hospitais Psiquiátricos/tendências , Restrição Física/estatística & dados numéricos , Internação Compulsória de Doente Mental/tendências , Comparação Transcultural , Ética Médica , Alemanha , Fidelidade a Diretrizes/ética , Hospitais Psiquiátricos/ética , Humanismo , Humanos , Isolamento de Pacientes/ética , Isolamento de Pacientes/tendências , Segurança do Paciente , Ensaios Clínicos Controlados Aleatórios como Assunto , Restrição Física/ética , Reino Unido , Revisão da Utilização de Recursos de Saúde/estatística & dados numéricos
10.
Rev. Rol enferm ; 34(4): 290-292, abr. 2011. tab
Artigo em Espanhol | IBECS | ID: ibc-86576

RESUMO

Se quiere conocer el método que menos daño producirá realizar una extracción de sangre venosa al paciente. Para ello se compara el sistema de extracción que provoca menos hematomas y disminuye el dolor en los enfermos. Fueron estudiados 175 individuos y se recogieron, entre otras, las variables edad, duración de la técnica, aparición de hematoma, dolor percibido según escala numérica. El resultado desvela que no existe relación entre la aparición de hematomas y el catéter con el que se realiza la punción venosa, al menos, no entre catéteres de calibres 21 G y 20 G. A pesar de esto sí se observó que el paciente siente menos dolor cuando se le punciona con aguja de calibre 21 G (palomilla). El tiempo de extracción es ligeramente superior con este sistema, pero si queremos ofrecer unos cuidados de calidad debemos realizar las extracciones sanguíneas con el sistema de palomilla (agujas de 21 G)(AU)


We want to know the method that less damage produced in the patient when making a venous blood extraction. The objective of this study is to compare the system of extraction that provokes less hematomas and reduces pain in the patients. We studied 175 patients; the variables studied were age, duration of the technique, occurrence of haematoma, pain perceived according to numerical scale of the pain. The study shows that does not exist relation between the appearance of haematomas and the catheter with which the venous puncture is realized, at least, not between catheters of 21 and 20 gauge. It was noted that the patients feel less pain when needles of calibre 21 gauge (butterflies) were used. The extraction time is lightly bigger with this system, but if we want to offer some quality care, we must perform the extraction of blood with the butterfly device (needles of 21 G)(AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Isolamento de Pacientes/métodos , Isolamento de Pacientes , Hospitalização/estatística & dados numéricos , Hospitalização/tendências , Criança Hospitalizada/estatística & dados numéricos , Unidades Hospitalares/organização & administração , Unidades Hospitalares/normas , Isolamento de Pacientes/tendências , Unidades Hospitalares , Unidades Hospitalares/tendências
11.
Nephron Clin Pract ; 111(2): c133-40, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19147995

RESUMO

Hepatitis C virus (HCV) infection is the most common blood-borne viral infection in haemodialysis. It causes significant morbidity and long-term mortality. Practice of universal precautions has been reported to be sufficient to prevent HCV seroconversion in dialysis units. However, the seroconversion rate remains very high in many dialysis units. A previous study from 1995 to 1998 at our own hospital without isolation showed that nosocomial transmission is the major cause of HCV seroconversion. The present study was therefore conducted with the aim to study the impact of isolation on HCV seroconversion. In this prospective cohort study, with non-probability consecutive sampling, patients with HCV infection were dialysed in an isolated room. In addition, standard universal precautions were practiced. HCV seroconversion rate was compared with the previous study. All patients with end-stage kidney disease (ESKD) admitted to our hospital for renal replacement therapy were included in the present study. At the time of admission, HCV screening was done. All anti-HCV-positive patients were dialysed in an isolated room. While on maintenance haemodialysis, all patients were monthly tested for anti-HCV, aspartate aminotransferase and alanine aminotransferase. Any patient who had HCV seroconversion was transferred to an isolated room for maintenance haemodialysis. Patients with HCV infection were managed by further testing for HCV-RNA and liver biopsy. Every patient who ultimately received renal transplantation at our hospital was also tested for HCV just prior to renal transplantation as well as 3 months after renal transplantation. HCV infection was diagnosed by detecting anti-HCV antibodies using an ELISA-based third-generation diagnostic test kit. Serum bilirubin, aspartate aminotransferase and alanine aminotransferase were assayed using standard laboratory techniques. From March 2003 to February 2006, 1,417 patients were admitted for haemodialysis in our unit. Of these 1,077 (76%) had ESKD. Mean age of patients was 42.47 +/- 16.2 (14-94) and 70.39% were males. Patients with ESKD had had more dialysis sessions (10.9 +/- 39.5 vs. 4.4 +/- 5.95, p = 0.009), more blood transfusions and more pre-existing HCV infections (4.72 vs. 1.5%, p = 0.009) than patients with acute renal failure. Of the ESKD patients, 65.7% were discharged, 9.47% died, 1.85% were shifted to chronic ambulatory peritoneal dialysis and 22.46% patients received renal transplantation. Of the patients who received renal transplantation, HCV seroconversion was detected in 2.75%. In the previous study without isolation practices, the HCV seroconversion rate in transplanted patients was 36.2%. The hazard of HCV seroconversion was 0.97 (95% CI 0.93-1.02, p = 0.2) for each additional dialysis and 1.09 (95% CI 0.88-1.36, p = 0.37) for each additional blood transfusion. The study concludes that isolation of HCV-infected patients during haemodialysis significantly decreases the HCV seroconversion rate.


Assuntos
Hepacivirus , Hepatite C/terapia , Isolamento de Pacientes/métodos , Diálise Renal/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Hepatite C/complicações , Hepatite C/virologia , Humanos , Falência Renal Crônica/complicações , Falência Renal Crônica/terapia , Falência Renal Crônica/virologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Isolamento de Pacientes/tendências , Diálise Renal/tendências , Adulto Jovem
14.
Nihon Hansenbyo Gakkai Zasshi ; 76(1): 29-65, 2007 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-17315749

RESUMO

The leprosy policy of Japan began from when the government enacted "law No. 11 (The leprosy prevention act)" in 1907 (Meiji 40) and several leprosy sanatoriums were built to receive previously homeless patients. Then, with the rise of totalitarianism, the isolation policy of Japan gained national support under the slogan "Patient Relief", which would become a major factor behind the enactment of "Leprosy Prevention Law" in 1931 (Showa 6) by which the leprosy policy was changed to one of absolute isolation aimed at the internment of all leprosy patients. From recent research on the leprosy policy of Japan, the internment of all leprosy patients, isolation for life, social defense, and neglect of patients' human-rights had tragic results in many cases. However, there is little research which can reply clearly to the question of whether the leprosy policy of Japan was really original and what factors led to the formation of the absolute isolation policy. This paper focuses on the relation between leprosy policy and treatment, and from this, I make clear the similarities, or peculiarities, of the isolation policy between Japan and the rest of the world, while clarifying the factors associated with the progress of the absolute isolation policy. The processes involved were historical and medical historical in that the relation between the formation of a national health system and the progress of the isolation policy of Meiji Era, the proposal of the isolation policy by Dr. Keizo Dohi, Dr. Shibasaburo Kitasato, and Dr. Masatsugu Yamane; the practical application of this policy by Dr. Kensuke Mitsuda, and the decision to enact this policy and its support by the Health and Medical Bureau and the Department of the Interior, as well as many other factors, all contributed to the final implementation of the absolute isolation policy.


Assuntos
Hanseníase/prevenção & controle , Isolamento de Pacientes/legislação & jurisprudência , Isolamento de Pacientes/tendências , Dapsona/uso terapêutico , Europa (Continente) , Hawaii , Humanos , Japão , Hanseníase/tratamento farmacológico , Hanseníase/psicologia , Hanseníase/transmissão , Mycobacterium leprae/isolamento & purificação , Mycobacterium leprae/patogenicidade , Isolamento de Pacientes/ética
15.
Psychiatr Serv ; 57(5): 610-2, 2006 May.
Artigo em Inglês | MEDLINE | ID: mdl-16675751

RESUMO

The authors describe "collaborative problem solving," a cognitive-behavioral approach for working with aggressive children and adolescents. The model conceptualizes aggressive behavior as the byproduct of lagging cognitive skills in the domains of flexibility, frustration tolerance, and problem solving. The goal is to train staff to assess specific cognitive skills that may be contributing to challenging behavior and to teach children new skills through collaborative problem solving. The authors present results from an inpatient unit that dramatically reduced rates of seclusion and restraint.


Assuntos
Sintomas Comportamentais/prevenção & controle , Terapia Cognitivo-Comportamental/métodos , Hospitalização , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Adolescente , Agressão/psicologia , Sintomas Comportamentais/psicologia , Criança , Comportamento Cooperativo , Humanos , Isolamento de Pacientes/estatística & dados numéricos , Isolamento de Pacientes/tendências , Resolução de Problemas , Restrição Física/normas , Restrição Física/estatística & dados numéricos , Violência/prevenção & controle
16.
Nihon Hansenbyo Gakkai Zasshi ; 75(1): 3-22, 2006 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-16562495

RESUMO

The leprosy policy of Japan began from when the government enacted "law No. 11 (The leprosy prevention act)" in 1907 (Meiji 40) and several leprosy sanatoriums were built and the patient who wanders about was received. Then, in rise of totalitarianism, the isolation policy of Japan gained national support under a slogan "Patient Relief", and it would become the big factor to which enactment of "Leprosy Prevention Law" in 1931 (Showa 6) and leprosy policy changed to segregation which aimed at internment of all leprosy patients. From today's research on the leprosy policy of Japan, it is internment of all leprosy patients, whole life isolation, social defense and neglect of patients' human-rights and led to many tragedy of patient. However, there is little research which can reply clearly to the question of whether the leprosy policy of Japan was really original and what the factors of led to the formation of the segregation policy. This paper focuses on the relation between leprosy policy and medicine, and from this, I make clear the similarity, or peculiarity of the isolation policy between Japan and the vest of the world, and clarify the factors of progress of the absolute isolation policy. The processes are historical and medical historical the verification of the relation between the formation of the national medicine and the progress of the isolation policy of Meiji Era, the proposal of the isolation policy by Dr. Keizo Dohi, Dr. Shibasaburo Kitasato, and Dr. Masatsugu Yamane, and the application by Dr. Kensuke Mitsuda, the decision to enact this policy and its support by the Health and Medical Bureau and the Department of the Interior, as well as many factors.


Assuntos
Política de Saúde/história , Hanseníase/história , Isolamento de Pacientes/história , História do Século XIX , História do Século XX , Humanos , Japão , Hanseníase/prevenção & controle , Hanseníase/terapia , Isolamento de Pacientes/legislação & jurisprudência , Isolamento de Pacientes/tendências , Direitos do Paciente/história , Saúde Pública/história
18.
Psychiatr Serv ; 56(9): 1105-8, 2005 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16148325

RESUMO

Reliance on seclusion, restraint, and psychotropic PRN (as needed) medication for behavior management has been tied to a variety of untoward outcomes that detract from the quality of care in public psychiatric hospitals. A large body of evidence has accumulated to demonstrate that behavioral approaches to care can provide useful alternatives to reliance on seclusion, restraint, and psychotropic PRN medications. This article draws from the research to outline how behavioral approaches to psychiatric care can assist in realizing alternatives to these restrictive interventions. Strategies to assess the behavioral competence of direct care staff, improve it, and establish ward programmatic structures that facilitate competent behavioral applications are discussed as well as methods to enable expert consultation and demonstrate clinical and administrative support. These steps have had a positive impact in reducing reliance on seclusion, restraint and psychotropic PRN medication in the inpatient psychiatric setting. Given the wealth of supportive data to confirm the value of behavioral applications, there is no excuse for failing to aggressively pursue these options.


Assuntos
Hospitais Psiquiátricos/estatística & dados numéricos , Hospitais Públicos/estatística & dados numéricos , Transtornos Mentais/terapia , Isolamento de Pacientes/estatística & dados numéricos , Isolamento de Pacientes/tendências , Psicotrópicos/administração & dosagem , Restrição Física/estatística & dados numéricos , Terapia Comportamental/tendências , Previsões , Humanos , Encaminhamento e Consulta/tendências , Resultado do Tratamento
20.
Nihon Hansenbyo Gakkai Zasshi ; 72(3): 217-37, 2003 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-14598631

RESUMO

There was a village which was called Yunosawa, lots of leprosy patients lived, existed from 1887 to 1941, Kusatu town, Gunnma Prefecture, Japan. It was the only place continued securing self-government to the last as area was free from the isolation policy of State in prewar days there. The aim of this study will make clear the dynamism of "The protection from the tension of the society of leprosy patient currently persecuted" to "The defense of the society from the leprosy patient who is a source of infection". In this study, explained the history of the Yunosawa village and the shift of the policy of leprosy by State had relation to the village. In addition, showed worth of free medical-treatment area here.


Assuntos
Política de Saúde/história , Hospitais de Dermatologia Sanitária de Patologia Tropical/história , Hanseníase/história , História do Século XIX , História do Século XX , Humanos , Japão , Hospitais de Dermatologia Sanitária de Patologia Tropical/legislação & jurisprudência , Hospitais de Dermatologia Sanitária de Patologia Tropical/tendências , Hanseníase/prevenção & controle , Isolamento de Pacientes/história , Isolamento de Pacientes/legislação & jurisprudência , Isolamento de Pacientes/tendências
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