Irish journal of medical science
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We assess the requesting patterns and overall utility of MRI scans in our institution over a 6-month period for knee pain in an elderly population. ⋯ We suggest that all elderly patients with knee pain undergo plain radiographs before MRI scan and only those with locking should be considered for an MRI scan at all. Primary care physicians are overusing MRI as an imaging modality in this cohort at a cost of over €30,000 per year to our institution.
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Working in maternity hospital is usually a rewarding experience for staff. However, it can also be stressful and emotionally difficult work. Schwartz Rounds are a multidisciplinary forum which provides staff with an opportunity to reflect on the emotional impact of their work and support each other. ⋯ Schwartz Rounds are an effective way to support staff working in a maternity hospital.
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Historical Article
"Dyspepsia," "seduction" and "violent hysteria": reports, reforms and the Irish asylums of the 1850s.
While many countries developed asylums for the mentally ill during the nineteenth century, Ireland's asylum system grew faster than those elsewhere, was larger in size and was slower to decline. This paper focuses on two reports central to this process in the 1850s: the 1854 "Report on the status of disease" and the 1858 "Report of the commissioners of inquiry into the state of the lunatic asylums and other institutions for the custody and treatment of the insane in Ireland." In 1854, the "Report on the status of disease," based on the 1851 census, was published, co-authored by Dr. ⋯ He was knighted in 1864 owing in large part to his work on the census, which highlighted an apparently high rate of mental illness with such diverse causes as "dyspepsia," "seduction" and "violent hysteria." Four years later, in 1858, the "Report of the commissioners of inquiry into the state of the lunatic asylums and other institutions for the custody and treatment of the insane in Ireland" added fuel to the fire by reporting that "the lunatic asylums of Ireland wear more the aspect of places merely for the secure detention of lunatics than of curative hospitals for the insane." Reform, it seemed, was urgently needed. This contribution examines these two key reports in the fevered, panicked context of Ireland's perpetual reform and expansion of its nineteenth-century asylums.