scholarly journals Neuroimaging: a new training issue in psychiatry?

2005 ◽  
Vol 29 (5) ◽  
pp. 189-192 ◽  
Author(s):  
S. Ni Bhriain ◽  
A. W. Clare ◽  
B. A. Lawlor
Keyword(s):  
Psychiatric Disorders ◽  
Old Age ◽  
Image Interpretation ◽  
Specialist Training ◽  
Diagnosis Of Dementia ◽  
Key Competencies ◽  
Old Age Psychiatry ◽  
Competency Based ◽  
Organic Brain

Many studies recently have highlighted the role of neuroimaging in the diagnosis and management of patients with psychiatric disorders (Lewis, 1996; Costa et al, 1999; Longworth et al, 1999). In old age psychiatry, a diagnosis of dementia is facilitated by structural and functional imaging, both of which have been shown to increase the accuracy with which a diagnosis of Alzheimer's disease can be made (Zakzanis et al, 2003). There is also a role for neuroimaging in the differential diagnosis of organic brain syndromes, which are often referred to the old age and liaison psychiatric services. The usefulness of neuroimaging has extended further into the area of the major functional psychiatric disorders by contributing to our understanding of the aetiology and pathophysiology of these illnesses. Despite this, image interpretation has not yet been incorporated into the training of psychiatrists, at junior or senior level. In this, we differ from other specialist areas of medicine where the ability to interpret images is an integral part of training. At present, the Royal College of Psychiatrists is developing a competency-based curriculum for senior trainees that will lead to the certificate of completion of training (CCT). This will replace the existing CCST (certificate of completion of specialist training; http://www.rcpsych.ac.uk/traindev/postgrad/ccst.htm). In order to obtain the CCT, a series of ‘general competencies' will be recommended for all senior trainees, which will involve the trainee developing expertise in a number of roles identified by the College. These include the roles of clinician, researcher and educator, among others. Specific key competencies will be further recommended in the development of these general competencies, with variations in some key competencies according to the sub-specialty.

scholarly journals A new opportunity: three tales of training in liaison psychiatry of old age

2002 ◽  
Vol 26 (11) ◽  
pp. 433-435 ◽  
Author(s):  
John Holmes ◽  
Jon Millard ◽  
Susie Waddingham
Keyword(s):  
General Hospital ◽  
Old Age ◽  
Psychiatric Comorbidity ◽  
Psychiatric Symptoms ◽  
Specialist Training ◽  
Liaison Psychiatry ◽  
Adult Psychiatry ◽  
Old Age Psychiatry ◽  
Hospital Wards ◽  
And Training

Liaison psychiatry has emerged as a sub-speciality within general adult psychiatry, with specific experience and training being required to develop the skills and knowledge to address comorbid physical and psychiatric symptoms and illness (House & Creed, 1993; Lloyd, 2001). Older people often present with significant physical and psychiatric comorbidity (Ames et al, 1994; Holmes & House, 2000) and most old age psychiatry services receive one-quarter to one-third of referrals from general hospital wards (Anderson & Philpott, 1991). Despite this, there are no specific requirements for training in liaison psychiatry for old age psychiatrists at any level. The experience gained in assessing and treating general hospital referrals during basic and higher specialist training is felt to be adequate (Royal College of Psychiatrists, 1998).

PEDAGOGICAL CONFLICT – THE CONTEMPORARY TECHNOLOGY OF THE COMPETENCY-BASED APPROACH

2019 ◽  
Vol 2 ◽  
pp. 70
Author(s):  
Zoja Chehlova ◽  
Mihail Chehlov ◽  
Ina Gode
Keyword(s):  
Moral Education ◽  
Research Problem ◽  
Personal Conflict ◽  
Key Competencies ◽  
Competency Based ◽  
Personal Qualities ◽  
Amount Of Knowledge ◽  
Creative Role ◽  
Contemporary Technology

In the 21st century, the creative role of education in the socio-economic development is increasing. Therefore, education is focused not only on the acquisition of certain amount of knowledge by learners, but also on the development of creative abilities and personal qualities, including the ability and desire to study, the ability and desire to act and the ability and desire to create. These key competencies develop in the process of learning on the basis of the technologies of the competency-based approach.The research problem is the development of positive learning motivation for students as the means of transforming inter-personal conflict into pedagogical conflict, which promotes individual’s moral education. The aim of the article is to analyse the characteristics of pedagogical conflict and elaborate the model of pedagogical conflict on this basis as a contemporary technology of the competency-based approach. The methodology of the research include: the competency-based approach and the activity-based approach;the research methods include: theoretical analysis, interpretation and mathematical statistics.The results of the study – there have been elaborated the theoretical basis of the pedagogical conflict as a technology of the competency-based approach:the nature of the has been analysed, and the content model of pedagogical conflict has been elaborated; there has been determined the organization of the process of learning based on the humanitarian inter-action of teachers and learners, which facilitates the transformation of inter-personal conflict into pedagogical conflict and promotes the moral education of an individual.  

scholarly journals Liaison Old Age Psychiatry Service in a Medical Setting: Description of the Newcastle Clinical Service

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
E. B. Mukaetova-Ladinska ◽  
G. Cosker ◽  
M. Coppock ◽  
M. Henderson ◽  
Y. Ali Ashgar ◽  
...  
Keyword(s):  
Old Age ◽  
Clinical Activity ◽  
Medical Setting ◽  
Qualitative And Quantitative ◽  
Quantitative Studies ◽  
Old Age Psychiatry ◽  
The Uk ◽  
Multidisciplinary Model ◽  
Further Development

Liaison Old Age Psychiatry services (LOAP) have begun to emerge in the UK and further development of the service is supported by the latest health policies. Since qualitative and quantitative studies in this area are lacking, we have undertaken a detailed quantitative prospective review of referrals to the Newcastle LOAP to evaluate the clinical activity of the service. We report high referral rates and turnover for the LOAP service. Reasons for referral are diverse, ranging from requests for level of care and capacity assessments and transfer to other clinical services to management of behaviour, diagnosis, and treatment. We outline the value of a multidisciplinary model of LOAP activity, including the important role of the liaison nursing team, in providing a rapid response, screening, and followup of high number of clinical referrals to the service.

scholarly journals Role and responsibility of the speciality tutor

1999 ◽  
Vol 23 (3) ◽  
pp. 170-172
Author(s):  
Jane Garner ◽  
Yong Lock Ong
Keyword(s):  
Old Age ◽  
Clinical Implications ◽  
Job Description ◽  
Old Age Psychiatry ◽  
Training Programmes

Aims and methodIn order to identify the role and responsibility of the speciality tutor, the tutors' post in old age psychiatry was compared across two regions.ResultsThe role was narrow; but different in the two regions depending on training programmes.Clinical implicationsTutors in all faculties should have an expanded and standardised job description, separate from the role of the regional representative, in order to strengthen the input of the specialisms to training at all levels.

scholarly journals Use of the Care Programme Approach register by an inner-city old age psychiatry team

1998 ◽  
Vol 22 (8) ◽  
pp. 489-491 ◽  
Author(s):  
Jeremy Wallace ◽  
C. J. Ball
Keyword(s):  
Young Adult ◽  
Inner City ◽  
Old Age ◽  
Adult Population ◽  
Care Programme ◽  
Diagnosis Of Dementia ◽  
Young Adult Population ◽  
Old Age Psychiatry

The Care Programme Approach and its accompanying register were introduced in response to difficulties encountered in a young adult population. This paper describes the use of the register by an old age psychiatry service who do not routinely accept ‘graduate’ patients. Few patients had a diagnosis of dementia and most had psychiatric histories in excess of 10 years.

scholarly journals The value of cranial computed tomography in old age psychiatry: A review of the results of 178 consecutive scans

2005 ◽  
Vol 29 (1) ◽  
pp. 21-23 ◽  
Author(s):  
Sian Fielding
Keyword(s):  
Computed Tomography ◽  
Old Age ◽  
Small Vessel Disease ◽  
Cranial Computed Tomography ◽  
Clinical Prediction ◽  
Clinical Prediction Rules ◽  
Prediction Rules ◽  
High Incidence ◽  
Old Age Psychiatry ◽  
Organic Brain

Aims and MethodTo assess the value of computed tomography (CT) in patients presenting to an old age psychiatry service over a 2-year period, and to evaluate a set of clinical prediction rules and the recommendations of the Royal College of Psychiatrists on the selection of patients for scanning. A retrospective review of the reports of 178 consecutive scans and case note reviews was carried out.ResultsFour scan reports (2.3%) suggested potentially reversible causes (PRCs) of dementia. of these, only two showed unequivocal organic brain lesions. Both of these patients were identified by each of the prediction rules tested. There was a high incidence of small vessel disease (32.8%) and infarcts (11.9%).Clinical ImplicationsCT is a low-yield investigation in terms of identifying patients with PRCs of dementia. The tested clinical prediction rules appear sensitive in detection of PRCs. CT may demonstrate unsuspected cerebrovascular disease.

Practical application of family and systems theory in old age psychiatry: three case reports

2006 ◽  
Vol 18 (2) ◽  
pp. 345-353 ◽  
Author(s):  
Carmelle Peisah
Keyword(s):  
Systems Theory ◽  
Old Age ◽  
Psychological Symptoms ◽  
Case Reports ◽  
Home Based ◽  
The Family ◽  
Potential Benefits ◽  
Old Age Psychiatry ◽  
Family Based

The role of the family or carer in old age psychiatry is well acknowledged. However, carer interventions are often focused on addressing carer burden alone and are usually individually rather than family based. Interpersonal conflict and family dynamics are rarely addressed. This is not surprising as there is a paucity of literature in family and systems theory applied to the older person, and clinicians are often skeptical about the efficacy of this treatment mode or daunted by the complexity of family and systems theory. Three cases are presented to illustrate the potential benefits of family-based interventions in the setting of commonly encountered clinical situations: (i) the treatment of chronically depressed older people in the community; (ii) the management of behavioral and psychological symptoms of dementia (BPSD) in residential care; and (iii) home-based support and care of the older patient with dementia.

Liaison old age psychiatry

2020 ◽  
pp. 347-360
Author(s):  
Fiona Thompson ◽  
Elena Baker-Glenn
Keyword(s):  
Old Age ◽  
Older Adult ◽  
Screening Tools ◽  
Physical And Mental Health ◽  
Liaison Psychiatry ◽  
General Hospitals ◽  
Old Age Psychiatry ◽  
The Uk ◽  
Hospital Team

Liaison psychiatry is a sub-specialty of psychiatry that specializes in the interface between physical and mental health, and involves treating patients who are attending general hospitals. This chapter provides an overview of the development of old age liaison psychiatry with consideration of the commissioning and funding of services. It discusses the importance of liaison psychiatry services being integrated within the general hospital team. It outlines different models of liaison psychiatry and provides examples of different services in the UK. It describes common conditions seen within older adult liaison psychiatry and considers screening tools and outcomes. Finally, it covers other aspects of the role of liaison psychiatry, such as teaching, training, governance and accreditation of services and considers interfaces with other services and the future of liaison psychiatry.

Special features of psychiatric treatment for the elderly

2012 ◽  
pp. 1571-1579
Author(s):  
Catherine Oppenheimer
Keyword(s):  
Older People ◽  
Old Age ◽  
Health Care Providers ◽  
Psychiatric Treatment ◽  
Developed Countries ◽  
Social Construct ◽  
Excellent Health ◽  
Old Age Psychiatry ◽  
The Individual

Three themes underlie the topics in this chapter. Physical, psychological, and social problems often occur together, linked by chance or causality in the life of the old person. Very rarely can one problem be dealt with in isolation, and many different sources of expertise may be engaged with a single individual. Therefore good coordination between different agents is essential in old age psychiatry, both for the individual patient and in the overall planning of services. Many of the pathologies characteristic of old age are gradual in onset and degenerative in nature, and more due to failures in processes of repair than to an ‘external foe’, so the distinction between disease and health is often quantitative rather than qualitative. ‘Normality’ becomes a social construct with fluid borderlines, containing the overlapping (but not identical) concepts of ‘statistically common’ and ‘functionally intact’. Thus the popular perception of normal old age includes the ‘statistically common’ facts of dependence and failing function, whereas ‘intactness’ (excellent health and vigorous social participation) is seen as remarkable rather than the norm. But the boundaries of ‘old age’ are also socially constructed—in developed countries good health at the age of 65 would nowadays be regarded as a normal middle-aged experience, whereas superb health at 95 would still be something noteworthy. Since some degree of physical dependence, forgetfulness, and vulnerability to social exclusion is expected in old age, meeting those needs is also regarded as a ‘normal’ demand on families and community agencies such as social services, rather than the responsibility of health care providers. As the severity of the needs increases, however, so also does the perceived role of health professionals, both as direct service providers and in support of other agencies. Because of the high prevalence of cognitive impairment in old age (especially among the ‘older old’), questions frequently arise as to the competence of patients to make decisions. Older people who cannot manage decisions alone may come to depend increasingly on others for help; or, resisting dependence, they become vulnerable through neglect of themselves or through the injudicious decisions they make. When an incompetent person is cared for by a spouse or family member, the danger of self-neglect or of ill-considered decisions is lessened, but instead, there are the risks of faulty decisions by the caregiver (whether through ignorance or malice), and also risks to the health of the caregiver from the burden of dependence by the incompetent person. Legal mechanisms, differing from one country to another, exist to safeguard the interests of incompetent people. These three themes will be developed further, and with them the following special topics: 1 multiple problems: including sleep disorders in old age, medication in old age psychiatry, and psychological treatments in old age psychiatry; 2 blurred boundaries of normality: including the role of specialist services and support between agencies; 3 incapacity and dependence: including balancing the needs of patients and caregivers, abuse of older people, ethical issues, and medico-legal arrangements for safeguarding decisions.

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