ABSTRACT
Gait is recognized as a key item related to mental function. Anomalous gait in psychotic individuals has been described for the lower extremities, whereas irregularities for upper body dynamics are not described, explained or verified with unbiased methods. Reduced walking velocity and increased somatic tension defined in this patient category may influence upper body dynamics during gait. The aim of this pilot-study was to describe upper body kinematics and investigate the biomechanical association with walking velocity and muscle tension. Twelve inpatients in a psychiatric ward with first-episode psychosis and 18 healthy control subjects walked at different self-chosen velocities. Movement and walking velocity were registered, and 3D kinematics was analysed for thorax and shoulder joint. Time-synchronized EMG from the trapezius muscle, chosen as indicator for general somatic tension, was analysed for maximal amplitude and variability. Results showed that patients walked with reduced arm swing at the shoulder joint and increased lateral thorax movements. Thorax rotations about the vertical axis, walking velocity and EMG measures were similar in patients and healthy subjects. The present study could not provide a biomechanical explanation for kinematic findings based on walking velocity or somatic tension.
Subject(s)
Gait Disorders, Neurologic/physiopathology , Movement Disorders/physiopathology , Movement/physiology , Psychotic Disorders/physiopathology , Schizophrenia/physiopathology , Adult , Arm/physiopathology , Biomechanical Phenomena/physiology , Female , Gait Disorders, Neurologic/diagnosis , Gait Disorders, Neurologic/etiology , Humans , Male , Movement Disorders/diagnosis , Movement Disorders/etiology , Muscle, Skeletal/physiopathology , Pilot Projects , Psychotic Disorders/complications , Psychotic Disorders/diagnosis , Schizophrenia/complications , Schizophrenia/diagnosis , Thorax/physiopathology , Young AdultABSTRACT
Psychiatric acute units use different levels of segregation to satisfy needs for containment and decrease in sensory input for behaviourally disturbed patients. Controlled studies evaluating the effects of the procedure are lacking. The aim of the present study was to compare effects in acutely admitted patients with the use of a psychiatric intensive care unit (PICU) and not in a psychiatric acute department. In a naturalistic study, one group of consecutively referred patients had access only to the PICU, the other group to the whole acute unit. Data were obtained for 56 and 62 patients using several scales. There were significant differences in reduction of behaviour associated with imminent, threatening incidents (Broset Violence Checklist), and actual number of such incidents (Staff Observation Aggression Scale-Revised) in favour of the group that was treated in a PICU. The principles of patient segregation in PICUs have favourable effects on behaviours associated with and the actual numbers of violent and threatening incidents.
Subject(s)
Intensive Care Units , Mental Disorders/diagnosis , Mental Disorders/therapy , Psychiatric Department, Hospital , Acute Disease , Adult , Female , Humans , Male , Mental Disorders/psychology , Norway , Psychiatric Nursing , Treatment Outcome , Violence/psychologyABSTRACT
The article discusses exposure to blood and other human body fluids at medical school. 230 of 303 students in the last year of medical school answered a questionnaire. The average number of reported contacts with blood or certain other human body fluids per student during medical school was 15, of which two referred to inoculations. One or more inoculations were reported by 63% of the students, and 13% reported five or more inoculations. Of 32 not previously vaccinated students one was anti-HBsAg antibody positive and one was anti-HBcAg antibody positive. The paper discusses whether medical students in Norway should be offered free hepatitis B vaccination before embarking on the clinical part of their training.
