Adicciones. Situación actual / Drug-dependece. Present-day situation

Se realiza un análisis de la situación actual de las adicciones (fármaco dependencia), tomando como núcleo fundamental los tres últimos informes realizados por la Oficina de las Naciones Unidas contra la Droga y el Delito (ONUDD), conjuntamente con otros factores para brindar una visión actualizada, objetiva y que aporte pautas para continuar ampliando y profundizando en los logros obtenidos en los años recientes. Se brinda una panorámica de la extensión y apreciaciones de elementos claves como el factor droga, usuario y tratamiento. También se analiza el comportamiento alcanzado y riesgos presentes y futuros de las sustancias lícitas e ilícitas más perjudiciales según las últimas informaciones y algunas valiosas estadísticas disponibles(AU)

An analysis of the present-day drug dependence is made taking into account as its nucleus the three last reports issued by the United Nations Office against Drug and Crime, as well as other factors in order to offer an up-to-date and objective vision that can provide guidelines to continue going deeper into the achievements of the recent years. Also a panoramic of the extension and appreciations of key elements such as drug factor, user and treatment is presented. As well as the behaviour and present and future riks of the licit and illicit substances that are considered more dangerous according to the most recent information and some valuable statistics available(AU)

Residential treatment of children and adolescents: past, present, and future.

This paper reviews the history of residential treatment, examines the central concepts that define the therapeutic modality, and shows how those concepts provide means of addressing criticisms that have been raised about it in the past and adapting residential programs to meet challenges facing them in the future.

[Structures and changes in the combined modality treatment concept at a gerontopsychiatric Europakanal Erlangen Day Care Clinic]. / Strukturen und Veränderungen im multimodalen Behandlungskonzept der Gerontopsychiatrischen Tagesklinik des Klinikums am Europakanal Erlangen.

OBJECTIVES: The aim is to describe and analyse the concepts of multimodal clinical work and the impact of changing patient trends on clinical work practices in our Psychogeriatric Day Hospital since it opened in 1986. METHOD: Day hospital statistics concerning length of stay, referral rates and readmission over the years were analysed. In two evaluation studies, client satisfaction and daily living activities were assessed. RESULTS: There is firm evidence for the effectiveness of day hospital treatment, as demonstrated by the results of the evaluation studies. In the last two years the average length of day hospital stay reduced significantly, while referrals for day hospital treatment increased rapidly. Despite these changes, the number of staff has stayed the same from 1986 to now. CONCLUSION: For day hospital intervention to remain effective in the light of changing patients trends, adequate time needs to be given for diagnostic and therapeutic procedures including psycho-educational work with patients' family members. This is not only a question of cost-effectiveness, but also an ethical approach bearing in mind future trends towards an increasingly aging population where demand will increase for this type of provision.

Milieu therapy: a therapeutic loophole.

TOPIC: The confusion over, and ultimate demise of, milieu therapy. SOURCE: Literature review. GOAL: To chronicle the conceptual problems and other events leading to the decline in the use of milieu therapy. CONCLUSION: Inpatient nurses would do best to leave the concept of milieu therapy behind and focus on clarifying how specific nursing interventions are operationalized and tied to patient outcomes.

Milieu therapy: a review of development of this concept and its implications for psychiatric nursing.

Milieu therapy has long existed as an effective treatment modality for the mentally ill. It has also been a significant aspect of psychiatric-mental health nursing practice for several decades. This article reviews the history of milieu therapy and the role that psychiatric-mental health nursing staffs have in its implementation. The authors suggest strategies for milieu management and future implications for milieu therapy.

Deinstitutionalization and the private general hospital inpatient unit: implications for clinical care.

Deinstitutionalization has led to a rapid shift from reliance on state hospitals to use of community-based inpatient psychiatric services. While these inpatient units were initially envisioned as an integral part of the community mental health system, a number of sociopolitical and clinical pressures have caused general hospitals to respond to their new responsibilities in different ways. The authors review trends in deinstitutionalization, the diverging interests of public and private general hospitals, and problems in patient care that result. Based on a discussion of how Beth Israel Hospital, a nonprofit private general hospital in Boston, has dealt with such issues, they describe adaptive responses in four areas: admission criteria, patient management approaches, aftercare planning, and staff training.