Health trends
-
The Mental Health Act 1983 substantially modified Guardianship, a previously little used facility for the compulsory care of mentally ill and mentally handicapped people in the community. This paper describes the results of a survey of information based on the annual returns from Local Authorities to the Department of Health and Social Security, and examines the impact of the new legislation upon the use of Guardianship in psychiatric practice. Although the number of Guardianship Orders in force remains relatively small compared to hospital admissions, recent trends indicate a significant increase in its application to people with a mental illness, and a decline in its use for people with a mental handicap. Despite the overall increase in use, the Regional differences of cases in England remain essentially unchanged and reflect the differing attitudes and policies of Local Authorities towards Guardianship Orders.
-
Nitrous oxide is now recognised as an important contributor to the 'greenhouse' effect. Each year the medical profession unwittingly adds a very small burden of this gas to the atmosphere. Unfortunately, the long lifetime of nitrous oxide means that all emissions into the atmosphere are significant. By making small changes in their practices, anaesthetists are well-placed to help reduce the potential environmental damage.
-
Consideration of care provision for children with life-threatening and life-limiting illness may be hampered by the lack of an agreed set of working definitions for such basic terms as: child, life-threatening condition, life-limiting condition, palliative care, respite care and hospice care. We suggest definitions to stimulate debate, and hopefully agreement, about terms that are central to the Department of Health's current programme of pilot initiatives in support of children with life-threatening and life-limiting illnesses, and their families.
-
This study was undertaken and completed in 1988, in an attempt to determine the reasons for admission to hospital, and the optimum care required for patients with Human Immunodeficiency Virus related illnesses. Approximately half of the total medical admissions stayed for less than a week, and patients admitted for terminal care and social care occupied a relatively small proportion of the beds. The single largest group of admissions were those for inpatient management of AIDS-related pneumonias. The results of this study provide a greater understanding of the resources currently required for such care, and suggest initiatives for meeting future needs.
-
Junior doctors' knowledge of the content and local implementation of the New Deal for junior doctors was surveyed in one English region. Data were analysed from 254 replies (response rate 60%); a majority (86%) knew that the initiative was intended to reduce their working hours, but detailed knowledge was lacking. Less than half could identify the correct limits on contracted hours for full or partial shift working patterns, while 73% knew that they should not be contracted for more than 72 hours per week for an on-call pattern, the most common and traditional pattern worked. ⋯ Only 13 of 114 doctors who believed their posts conformed to the New Deal knew the correct hours limits. Only 11% knew any member of the hospital local implementation group for the New Deal. The results of the survey indicate that junior doctors are not well informed about the details of the New Deal, or its local implementation-four years into the New Deal, this situation needs to be improved, especially as junior doctors are now to be asked to validate the progress of the initiative.