Psychiatric consultation to a general hospital medical evaluation service

Psychiatric consultation to a general hospital medical evaluation service was reviewed and compared with consultation patterns for general hospital inpatients and psychiatric emergency service patients. Results of a questionnaire survey indicated nearly 1 in 5 patients admitted to this acute medical service (24-hour maximum stay) required psychiatric consultation. A study of those patients seen by psychiatric consultants is reported. The prevalence of depressive illness as well as the psychiatric hospitalization referral rate was substantially greater than in general hospital inpatient or psychiatric emergency service evaluations. The implications of this relatively new area of consultation-liaison for hospital staffing and medical education are discussed.     

Resource-use analysis of a medical toxicology consultation service

In contrast to the wealth of knowledge about the organizational rules of adult central pattern generators, far less is known about how these networks are assembled during development. The basic architecture for adult central pattern generators appears early in development but different generators may follow completely different developmental pathways to reach maturity. Recent evidence suggests that neuromodulatory inputs, in addition to their short-term adaptive control of central pattern generator activity, play a crucial role in both the final developmental tuning and the long-term maintenance of adult network function.     

Neurologic consultation practice in a general hospital of a rural area

The purpose of this ongoing study is to evaluate the safety and efficacy of new minimally invasive pervaginam cystourethropexy and sling procedures for the treatment of female genuine stress urinary incontinence. A total of 75 women (mean age, 52.8 years) underwent either a cystourethropexy or a sling procedure. A miniature bone anchor and a staple-like bone anchor driver were used for the fixation of periurethral tissue or a xenogenic sling to the pubic bone. With a mean follow-up of eight months, 61 patients (82%) were completely cured of stress incontinence, 10 (14%) reported a more than 50% decrease in pad usage, and 4 patients showed failure early following surgery. The exclusively pervaginam cystourethropexy and sling procedures are minimally invasive, safe, and effective. Further experience and longer follow-up are necessary to establish their role in the treatment of women with stress urinary incontinence.     

Psychological consultation and services in a general medical hospital.

When psychologists need to see patients who have been admitted to a general medical hospital or are asked to see a patient in a general medical hospital, they must be aware of, and in compliance with, the rules governing consultation, privileging, and privacy. Psychological treatment for patients is an important part of the treatment of patients with medical conditions that may be exacerbated by psychosocial stressors, preexisting anxiety, or depressive symptoms. The role of the psychologist is to have an integrated role with the medical team and work with the patient in effectively managing these symptoms. Models for promoting psychological services to all patients, especially those who are medically ill, have emerged as one of the few growth areas in psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Medical consultation in the patient with multiple trauma

Medical consultation is frequently requested to assist the trauma team in the management of the patient with multiple traumatic injuries. Four areas are commonly encountered as problems for management in this patient population. In this article, myocardial contusion, stress ulceration, seizure prophylaxis, and deep vein thrombosis prevention are addressed with respect to incidence, assessment, and management.     

Survey-guided process consultation in a Veterans Administration medical center psychology service.

During an assessment of an organizational effectiveness intervention in a psychology service in a Veterans Administration hospital, 13 psychologists assigned to the psychology service provided survey, Work Environment Scale (WES), and structured interview data. A written evaluation report was provided to all Ss, and a feedback session was scheduled involving the chief, the consultants, and the staff. Three subsequent group consultations involving all Ss were conducted, with consultants serving as process commentators, not content experts. To assess the impact, the WES was readministered following consultation. Four scales showed significant differences in a positive-change direction. 24 mo later, a 2nd administration of the WES was completed. On 7 of 10 scales, the reported increase in job satisfaction between August 1982 and July 1984 was significant. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mandatory toxicology testing and chemical dependence consultation follow-up in a level-one trauma center

Comparative morphological study of 10 nominal species of pronocephalids forming a clade diagnosed by plump rounded bodies, sinuous ceca, and short esophagi supports the recognition of 7 species, with Pyelosomum longicaecum a junior synonym of P. renicapite, and P. solum and Myosaccus chelonei species incertae sedis. Phylogenetic analysis of the 7 recognized species, based on 18 morphological transformation series, produced a single tree with a consistency index of 86%. That tree suggests that Pyelosomum is paraphyletic unless Astrorchis, Epibathra, and Myosaccus are included in it. Accordingly, all are considered junior synonyms of Pyelosomum. Epibathra stenobursata is designated Pyelosomum stenobursata comb. n.     

Experience with a clinical pharmacological service in a teaching hospital

The clinical functions of our Pharmacology department involves teaching, research and patient service. Patient service is rendered at two levels. 1. Clinical Pharmacologists: These are medically trained people and one of them is available for 24 hours a day for therapeutic and toxicological consultation, for channeling requests for laboratory aid and for interpretation and distribution of laboratory results. At the time of preparing this report we received an average of 34 consultations per day (1/3 therapeutic, 2/3 toxicological) of which about 38% are personally seen. 2. Laboratory based Pharmacologists: These people have basic training in Pharmacology, Chemistry and Biochemistry and are involved in qualitative and quantitative investigation of body fluids in cases of poisoning and therapeutic problems. A laboratory-based pharmacologist is available for 24 hours per day but clinicians do not have direct access to him but have to channel their requests through the clinical pharmacologist on call. The laboratory handled 2302 specimens of body fluids during 1975 of which about 75% were of a therapeutic and 25% of a toxicological nature.     

Impact of a district-wide behavioral consultation prereferral intervention service on patterns of school psychological service delivery.

Investigated the impact of behavioral consultation prereferral intervention services on patterns of school psychology service delivery in a school district with a school-aged (kindergarten through Grade 12) population of 2,800 children, 50% of whom were Hispanic. Data from 2 yrs prior to initiation were compared with data from 4 yrs during implementation of a prereferral model. Analyses indicated that during the time period consultative prereferral intervention services were offered (a) more children were served by school psychologists, (b) a higher proportion of referred children achieved their educational objectives in regular classrooms, (c) a lower proportion of referred children were tested for special education services, and (d) a higher proportion of children tested were found eligible for special education programs' services. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Consultation-liaison psychiatry: a psychosomatic service in the general hospital

Consultation psychiatry, an outgrowth of the tenets of psychosomatic medicine that followed the departure from mental-hospital psychiatry to the general-hospital-based psychiatric units, is similar to those consultation services in other specialties available on medical-surgical wards. Its primary aim is to interpret the psychosocial phenomena of health and illness and to redirect the physician from disease- to patient-orientation and to a comprehensive approach. Its functions are diagnostic-therapeutic, instructional and research directed. The psychosomatic orientation is a sine qua non in the understanding of the psychosocial meaning of physical illness, its effect on psychic disability, the psychosocial adjustment of the patient and his family and his ability to adapt to illness and the hospital. An essential feature is the evaluation of the doctor-patient relationship, especially when severe illness requires serious interventions, including the consultation and its reciprocal effect upon the doctor-patient relationship. Liaison activity consists of interpretive-therapeutic mediation between the patient and the therapeutic team when strain endangers their satisfactory cooperation. The therapeutic activity must be short-term and so construed as not to interfere with the primary treatment. The instructional aspect is for the sake of the usual recipients of the service, as well as residents and students. Teaching the interview techniques, especially to students, should demonstrate the holistic approach, comprehensive diagnosis and the need of avoiding orthodox one-sidedness. This paper reviews briefly the scope and role of consultation psychiatry, compares its North American model with its status elsewhere and explores the resistances to it.     

Initial experience of clinical pharmacology and clinical pharmacy interactions in a clinical pharmacokinetics consultation service

International statistics indicate that there is a close correlation between the consumption of saturated fats (dairy fats and meat fats) and the mortality from coronary heart disease (CHD), and this conception has been confirmed by many epidemiological studies. Such studies alone, however, cannot prove the existence of a cause-and-effect relationship between these two variables; dietary intervention trials are needed. The Finnish Mental Hospital Study was such a trial, conducted in two hospitals near Helsinki in 1959--1971. Practically total replacement of dairy fats by vegetable oils in the diets of these hospitals was followed by a substantial reduction in the mortality of men from CHD. Total mortality also appeared to be reduced. As to the causes of death other than CHD, none was significantly influenced by dietary change. This was also true for malignant neoplasms. To alleviate the burden of CHD on public health, many investigators have recommended important changes in the quantity and quality of dietary fats.     

Tri-level service delivery: An alternative consultation model.

Presents an alternative model for delivering school consultative service. School psychologists provide consultative training and support to teacher consultants, who then become consultants to their teaching colleagues. All respondent groups perceived the knowledge base of teacher consultants favorably, particularly in areas of children's social–emotional functioning, special education placement guidelines, community resources, and consultative skills. Although consumers had a preference for indirect services, they also desired greater involvement of teacher consultants in direct intervention activities outside the classroom. Overall ratings of teacher consultants' skills and the program were high. Potential advantages of this model are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)