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Abstract. In the five years after the Phipps Psychiatric Clinic opened in 1913 at Johns Hopkins, its 88 beds were consistently in high demand. Exploiting the biographical information and the [...]

Objectives To examine to what extent availability of social integration affects health-related quality of life (HRQoL) in former intensive care unit (ICU) patients and how it relates to corresponding findings in a general reference group. Design Controlled, multicenter, prospective, explorative study. Setting and patients HRQoL data (SF-36) were collected from three combined medical and surgical ICUs in the south-east of Sweden. Social integration was assessed by the Availability of Social Integration (AVSI) instrument (seven questions related to the social interaction of the patient). As reference group, a random sample (n = 6,093) of people from the uptake area of the hospitals was used. Social integration (AVSI), HRQoL (SF-36), and comorbidity were examined also in the reference group. Interventions None. Measurements and results The level of social integration significantly affected HRQoL for the former ICU patients, whereas no such effect was seen for the general reference group. For the ICU patients, social integration affected HRQoL to a larger extent than age, sex, and the ICU-related factors examined, but to a lower extent than the pre-existing diseases. Conclusions For a comprehensive assessment of HRQoL in former ICU patients, it is mandatory to include the effect of social integration., Author(s): Lotti Orwelius [sup.1] [sup.3], Carl Bäckman [sup.4] [sup.6], Mats Fredrikson [sup.4], Eva Simonsson [sup.7], Peter Nordlund [sup.7], Anders Samuelsson [sup.1] [sup.3], Folke Sjöberg [sup.1] [sup.2] [sup.4] Author Affiliations: (1) [...]

This article applies a Foucauldian approach to an examination of contemporary policy and practice towards older people, specifically a model of case management designed to manage older people 'at risk' of hospital admission. The article proceeds by reviewing old age policy over three historical time periods, emphasizing discontinuities and mutations, in an attempt to problematize the principles underlying case management. It then draws on empirical data from a study of the micro-practices of case management, focusing on the construction of expertise, the subjectification of the 'at risk' older person and the interplay between expert and patient. The productive and repressive aspects of this interaction are both discussed and resistances to it by the older people are seen to take the nuanced form of imposing family values upon the professional encounter. KEY WORDS case management / Foucault / old age / resistance subjectivities

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2006.01.014 Byline: Alexander M. Ponizovsky (a), Alexander Grinshpoon (a), Anatoly Margolis (b), Rami Cohen (c), Paula Rosca (a)(b) Keywords: Buprenorphine; Clonidine; Inpatient detoxification; Side-effects; Well-being; Self-efficacy; Social support Abstract: Previous studies comparing buprenorphine and clonidine provided little information about subjective factors associated with the effective management of opioid withdrawal. This study sought to compare detoxification programs using these medications with regard to side-effects and related distress, general well-being, perceived self-efficacy and social support. A total of 200 treatment-seeking heroin-dependent patients, aged 18-50, were randomly assigned to buprenorphine or clonidine inpatient withdrawal treatments over 10days followed by 11days of relapse prevention measures. A semi-structured interview and a battery of self-rating scales assessing parameters of the interest were administered to the patients who completed the 10-day detoxification protocol with buprenorphine (n =90) and clonidine (n =50). Chi-square statistics and analysis of covariance were performed to examine between-group differences. Compared with patients treated with clonidine, patients who received buprenorphine developed significantly less side-effects and related distress, and had higher senses of well-being, self-efficacy and social support. The findings suggest that buprenorphine is preferable for inpatient detoxification due to its side-effects profile and positive effects on well-being and psychosocial variables. These early benefits of buprenorphine could enable consequent maintenance treatment. Author Affiliation: (a) Mental Health Services, Ministry of Health, 2 Ben Tabai St., Jerusalem, 93591, Israel (b) Department of Substance Dependence Treatment, Ministry of Health, Jerusalem, Israel (c) Association for Public Health Services, Jerusalem, Israel

The authors examined psychosocial correlates of drug and alcohol abuse in 462 hospitalized adolescents, and the extent to which these associations may be affected by gender or by substance type. Participants completed a battery of psychometrically-sound, self-report measures of psychological functioning, environmental stress, drug abuse, and alcohol abuse. Four multiple regression analyses were conducted to determine the joint and independent predictors of drug abuse and alcohol abuse, for males and for females. Multiple regression analysis revealed that seven variables--age, depression, impulsivity, low self-esteem, delinquent predisposition, low peer insecurity, and history of child abuse--jointly predicted both drug and alcohol abuse, for both males and females. However, several differences were found with respect to which variables made independent contributions to the predictive models--with only delinquent predisposition making a significant independent contribution for all four conditions. We found distinct patterns of psychosocial predictor variables for drug and alcohol abuse, as well as distinct patterns for males and females. These results may reflect differing risk factors for drug abuse and alcohol abuse in adolescent psychiatric patient--and differing risk factors for males and females. Such differences have potential implications for prevention and treatment. Keywords: Adolescents; Alcohol abuse; Drug abuse; Gender

Issues concerning gender differentiation, sex role, feminism, and the sharing of power are examined, focusing on the female identity issues that are raised by the hospital practice of placing male and female patients in the same hospital room. Topics include the physical body as a social determinant, language and performative notions of gender, and Michel Foucault's concept of power.

We reviewed patients' hospital records and surveyed patients after hospital discharge to determine whether the experience of being hospitalized differentially affected the health status of persons with different socioeconomic backgrounds (as measured by income level and education level) and to determine whether the association between socioeconomic status (SES) and change in health status varied depending upon the reason for hospital admission. We studied patients admitted to six university-affiliated teaching hospitals in Massachusetts and California for chest pain (N = 797) and surgery (N = 1.165). We compared the health status scores of patients for a variety of outcomes: basic activities of daily living, instrumental activities of daily living, social activities, mental well-being, work performance and housework performance. Lower-SES patients entered the hospital with worse health status than higher-SES patients. Change in health status, statistically adjusted for case-mix, varied by reason for admission. Patients with chest pain generally reported either no improvement or a decline in functioning with the amount of decline equivalent for low- and high-SES patients. Surgical patients reported improvement in functioning following hospitalization. For several measures, lower-income surgical patients reported greater improvement than did higher-income patients, but still did not reach the same level of health status as higher-income patients. Key words - socioeconomic status, quality of life, health outcomes, hospitalized patients

SUMMARY Helping patients keep in touch with relatives and friends is the objective of justvisiting.com, a website being piloted in Gateshead. Keywords Justvisiting.com * Secure website * Online visiting room [...]

Patient-patient interaction is an aspect of significant impact in hospital organizations. While staff members are present for only a short part of the day, most patients are surrounded by other patients all the time. Even in hospitals where length of stay is short, the interaction is intense. Talking is the most important type of activity and has several functions for the patients, including helping pass time, and finding out about their illnesses, examinations, treatment, and staff members. In addition, patients offer practical services to each other. The interpatient activities create an informal help system. Interpatient talking is important because the medical frame of interpretation is not sufficient for them. The frame of interpretation and knowledge which patients develop through their interaction is better suited to their experiences of being ill and being hospitalized.