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Biomedical subjects

M Lipsedge

Publications and source records attributed to M Lipsedge.

At least 19 recordsLinked to original sources
PubMed2004

Understanding the social context of violent and aggressive incidents on an inpatient unit.

The English National Service Framework for Mental Health stipulates that the highest quality of health care should be provided for mental health service users. Incidents of aggression and violence militate against achieving that goal, yet such incidents are frequently reported in inpatient settings. Much research in this area reflects a dualistic, perpetrator/victim conceptualization of incidents. This study aimed to take a more systemic approach by treating violent and aggressive incidents as social interactions and by seeking to understand the social contexts in which they took place. In this paper we describe and discuss the main themes to emerge from 15 staff accounts of 11 incidents on one ward. A striking theme reflected throughout the interview data was the lack of staff engagement with clients, and particularly an inability to look at the world through clients' eyes in interpreting their behaviour. We conclude that the 'zero tolerance' campaigns currently being conducted in the UK in relation to aggression towards NHS staff are unlikely to succeed without attention to understanding why aggressive behaviour arises and identifying features of the caring environment that may contribute to it. Rather than adopting a position of 'zero tolerance', we argue that three steps are required following an aggressive incident: emotional support; critical reflection and learning; and the pursuit of accountability.

Aggression↗
PubMed1995

An evaluation of the use of interactive television in an acute psychiatric service.

This study reports the results of the use of a low-cost videoconferencing system (LCVC) for communication in an acute psychiatric service. Qualitative research methodology was used to examine the use of the LCVC in interactions between psychiatrists, patients and nursing staff, including information on refusals. One hundred and five clinical interactions were studied over four months. The LCVC proved technically reliable and compatible with the performance of a wide range of clinical tasks. However, the results suggest the need for better understanding of the nature and origins of the attitudes that users bring to the use of such communications technology. A framework is presented for the classification of user responses in terms of preexisting attitudes of the users, technological limitations of the system and the mental state of the users. The study demonstrated the potential for interactive television to support many of the communication tasks necessary in a dispersed psychiatric service and for telepsychiatry to become a major method of service provision.

Community Mental Health Services↗
PubMed1993

A preliminary survey of Italian intravenous heroin users in London.

The present study analyses the phenomenon of the migration to London of Italian intravenous drug users. Using structured questionnaires and prevalence data it was estimated that a significant number of Italian intravenous drug users (at least 1000) were living in London at the time of the study (1990), of whom 30% were HIV positive. Risk-taking behaviour was disturbingly high. The reasons for migrating were identified, and the implications of recent Italian legislation are briefly discussed. The data indicated that the living conditions of these immigrants in London were precarious and that these vulnerable individuals had little access to services. As the barriers to travel within the European Community disappear, the public health problems represented by the migration of problem-drug users are likely to become more acute.

Adult↗
PubMed1992

Preliminary evaluation of a low cost videoconferencing system for teaching in clinical psychiatry.

The use of a digitized low cost videoconferencing system (LCVC) for the teaching of clinical medical students on clinical attachment to a psychiatric ward is described. This work was performed as part of the Telemed project which is evaluating the use of the LCVC in a range of tasks in clinical psychiatry. Any move towards greater reliance on communications technology in psychiatry should take account of the requirements of clinical teaching. The case presentation was used as a teaching paradigm in a controlled study comparing teaching face-to-face with teaching mediated via the LCVC. A questionnaire was developed for student evaluation of the case presentation. General user responses to the LCVC are reported. No significant differences were found between the conditions. User responses were favourable, suggesting that remote interactive teaching via the LCVC warrants further investigation.

Costs and Cost Analysis↗
PubMed1987

The butterfly and the serpent: culture, psychopathology and biomedicine.

Cultural explanations of psychopathology in the West have rarely employed models derived by anthropologists for small-scale non-literate communities. Some general features of those ritual patterns usually classed as 'culture-bound syndromes' are applicable to Western neurosis. Such reactions articulate both personal predicament and public concerns, usually core structural oppositions between age groups or the sexes. They gain their power by relying on certain unquestionable assumptions which, although beyond everyday jural relationships, articulate such relationships. In the case of Western reactions, such 'mystical sanction' is provided by biomedicine. Theoretical paradigms emphasize either the individual pragmatic or expressive aspects, or social homeostasis.

Agoraphobia↗