Health-care professionals' attitudes across different hospital departments regarding alcohol-related presentations.

INTRODUCTION AND AIMS: Attitudes to individuals presenting with alcohol-related issues are important in developing therapeutic relationships and applying alcohol-related interventions. This study explores staff attitudes to these individuals across a range of roles and departments. DESIGN AND METHODS: Data were gathered from 204 staff in the Southern Health and Social Care Trust in Northern Ireland. Regression models were used to predict attitudes as measured by the Short Alcohol and Alcohol Problems Perception Questionnaire (SAAPPQ). RESULTS: Two hundred and four people participated in the study. The sample comprised doctors, nurses, allied health professionals and other staff who had face-to-face contact with patients. Staff worked in accident and emergency (A&E), medical, surgical, addiction or psychiatry departments. Staff working in addiction and psychiatry departments had significantly higher levels of role adequacy compared with those in A&E. Staff in addictions also demonstrated higher levels of role legitimacy, motivation and role satisfaction than those in A&E. Doctors had higher role adequacy and role legitimacy than nursing staff. DISCUSSION AND CONCLUSIONS: There are critical differences in staff attitudes to patients presenting with alcohol-related issues in a range of hospital settings; training and working in a specialist setting have a significant positive influence on staff attitudes. This suggests that further training and support would positively enhance the attitudes of staff in a variety of professional roles and across a range of hospital settings in the management of patients presenting with alcohol-related difficulties. [Iqbal N, McCambridge O, Edgar L, Young C, Shorter GW. Health-care professionals' attitudes across different hospital departments regarding alcohol-related presentations. Drug Alcohol Rev 2015;34:487-94].

Home-based treatment and psychiatric admission rates: experience of an adult community mental health service in Ireland.

OBJECTIVES: This study assessed the impact of the introduction of a Home-Based Treatment (HBT) Service on hospital admission rates from two adjacent sectors within a mental health service. METHODS: This study used a naturalistic design to compare admissions into the acute inpatient psychiatric unit of Cavan General Hospital from two differently configured sectors - East and West Cavan Psychiatric sectors (East was a community-based and oriented service while the West was a more hospital-based service) prior to and following the introduction of a shared home-based treatment team. Data including demographics, date of admission, diagnosis at admission and sector of admission were retrospectively collected from a mental health register of hospital admissions between 1995 and 2002. Data was analysed using SPSS version 13 for windows. RESULTS: There was a 50% reduction in admission to the inpatient unit in the first two years of the introduction of HBT. This drop was more marked in the West sector compared to the East. CONCLUSIONS: The introduction of HBT resulted in a marked reduction in overall hospital admission rates and this reduction was also evident in the sector where other elements of a modern community mental health service already existed.

Biting for attention: a case of dental discomfort manifesting in behavioural problems.

There is a dearth of literature describing behaviour that expresses discomfort caused by poor dentition in patients with dementia. In this paper, we report on a patient whose behaviour only abstrusely pointed to his teeth as the source of discomfort. Although changes to his medication over a 2-year period had little effect, eventual extraction of his caries brought about an almost immediate resolution of all antisocial behaviour. Clinicians must be mindful that poor dental care is easily meliorated but remains endemic in patients suffering from dementia.