Aqueous solutions of 0.1 M amino acid and 0.1 M trimetaphosphate maintained at chosen pH values between 8.0 and 10.5 and at room temperature in the presence of imidazole or 1,2,4-triazole give rise after a few days to the corresponding peptides. Yields are highest when the pH is adjusted with concentrated NaOH or KOH instead of ammonia; in some cases glycine is quantitatively transformed within 10-15 days into peptides, mainly di-and tripeptides.

Azoles↗

PubMedDate not supplied

Changes in diagnosis in a 9-year national longitudinal sample.

Studied are changes in diagnosis in a random sample of 10% of all first admissions to psychiatric hospitals and psychiatric wards of general hospitals in Israel from 1983 to 1990 with follow-up evaluation to 1991. This included 4,570 hospitalizations of 2,220 patients. Data were extracted from the National Psychiatric Case Registry of the Ministry of Health. Almost 59% of the sample had one admission, 18% had two, 9% had three, and 14% had four or more. From the first admission to the last discharge (a mean of 2.15 years), 59.2% of the patients' diagnoses did not change. In 89.46% of the cases in which the diagnosis changed, the changes took place during the first admission. Diagnostic change differed between diagnostic groups. In descending order of stability in diagnosis from the first admission to the last discharge were neurotic and personality disorder (73.6%), mental retardation (73.5%), schizophrenia (73.0%), organic conditions (70.6%), affective disorders (66.2%), substance abuse (65.6%), childhood disorders (60%), paranoid disorder (43.6%), other nonorganic psychosis (30.3%), and V-codes (25.0%). The average level of diagnostic agreement between the first admission and the last discharge was a kappa of .52. The average length of stay for patients whose diagnosis became more severe was considerably longer than for patients whose diagnosis became less severe or did not change in level of severity. Older age was related to less change in diagnosis. For patients aged less than 18 years, diagnosis changed in 46.7% of the cases, for patients aged 19 to 44, 31.2%, and for patients older than 45, 27.8%.

Adolescent↗

PubMedDate not supplied

How individual clinicians make admission decisions in psychiatric emergency rooms.

The goal of this study was to understand how individual clinicians make admission decisions in the psychiatric emergency room. Clinical and demographic data were collected on 7485 consecutive visits to four psychiatric hospitals in Israel during 1991 and 1992. This was about one-third of visits to psychiatric emergency rooms in Israel during this time. Twenty-one decision makers who made at least 50 decisions and admitted more than 15 and less than 85% of patients were included. Decision to admit patients was modeled using step-wise discriminant analysis. Clinicians examined different numbers of patients and admitted at different rates. In one hospital one group of clinicians appears to rely primarily on diagnosis and another group on other variables, predominately previous history, and social or referral factors. The most influential background variable was self-referral which favored not admitting patient. The most influential diagnoses were schizophrenia and affective disorder which favored admission. In another hospital the most important variables in most models were legal status of admission, number of previous hospitalizations, violence and suicide as presenting problems and referral source. All variables except referral source favored admission. Some referral sources favored admission and others did not. In the last hospital studied the most salient variable was self-referral which favored not admitting patient. Decisions in one hospital were not modeled because no clinician met study inclusion criteria. There appears to be variability between clinicians in what information they use to make their decisions in the psychiatric emergency room and what percent of patients they admit.

Decision Making↗

PubMedDate not supplied

The Talbieh Brief Distress Inventory: a brief instrument to measure psychological distress among immigrants.

The purpose of this study was to develop and test the Talbieh Brief Distress Inventory (TBDI), a 24-item self-report questionnaire that measures psychological distress among immigrants. The TBDI combines items from the Brief Symptom Inventory (BSI) and the Psychiatric Epidemiology Research Interview Demoralization Scale (PERI-D). It includes a global score and six scales (obsessiveness, hostility, sensitiveness, depression, anxiety, and paranoid ideation). A convenience sample of 966 recent immigrants to Israel from the former Soviet Union were asked to complete a Russian-language version of the BSI and PERI-D as part of a study on immigrants' psychological adjustment. The TBDI is a combination of 13 items from the BSI and 11 items from the PERI-D. Items for inclusion were based on results of a separate factor analysis for the BSI and PERI-D and removal of repetitive items. We compared the total score with the total PERI-D and BSI and developed gender-specific cutoff points of caseness for the TBDI by comparison to known PERI-D and BSI cutoff points. We also checked for reliability using Cronbach's alpha. The TBDI correlated highly with the PERI-D (r = .93) and with the BSI (r = .82). Reliability of the scales and the overall instrument ranged from Cronbach's alpha of .60 to .89. TBDI caseness cutoff points were in close agreement with the BSI and PERI-D as reflected by kappa scores that ranged from .66 to .79. The TBDI is a promising instrument for screening populations for psychological distress and symptomatology. It is available in English, Hebrew, and Russian.

Adult↗

PubMedDate not supplied

Accuracy and confidence in clinical assessment of psychiatric inpatients risk of violence.

Explore the source record for details and available documents.

Adult↗