Attitudes of psychiatric staff toward coercion: nationwide AttCo study.

Background: Attitudes of mental health professionals toward coercion are a potential tool in reducing the use of coercive measures in psychiatry.

Aims: This study, part of the nationwide Attitudes toward Coercion (AttCo) project, aimed to assess staff attitudes on a nationwide and multiprofessional scale across adult, child and adolescent, and forensic psychiatric departments.

Method: During 9 weeks in 2023, 1702 psychiatric staff members across Germany filled out a survey including gender, age, profession, work experience and setting, and the validated Staff Attitude to Coercion Scale (SACS).

Deformation of brain in normal pressure hydrocephalus is more readily associated with slow vasomotion rather than heartbeat related pulsations of intracranial pressure.

Objective: Enlarged brain ventricles, compressed parasagittal cerebrospinal fluid spaces, steep callosal angle, dilated sylvian fissures and focal cortical sulcal dilatation are typical imaging features of idiopathic normal pressure hydrocephalus (iNPH). The pathophysiological mechanisms behind these morphological changes are poorly understood, but the hydrodynamic concepts of communicating hydrocephalus suggest that increased heartbeat related intracranial pulsations are involved in ventricular enlargement. In this cross-sectional study we analysed the association between the radiological findings of iNPH and the physiological intracranial pressure (ICP) waveform components.

Craniospinal compliance depends on the frequency of volume input.

Craniospinal compliance (CC) refers to the ability to maintain stable intracranial pressure (ICP) given changes in intracranial volume. CC can be calculated directly as the change in intracranial volume over change in ICP (Δ/ΔICP). Considering the distinct spectral components of the ICP signal, it is pertinent to explore whether compliance is dependent on the frequency at which it is calculated.

Association between perceived coercion and perceived level of information in involuntarily admitted patients: Results from a multicenter observational study in Switzerland.

Background: Involuntary admissions (IA) to psychiatric hospitals are controversial because they interfere with people's autonomy. In some situations, however, they appear to be unavoidable. Interestingly, not all patients perceive the same degree of coercion during IA.

Surgical anatomy of the lateral femoral cutaneous nerve for meralgia paraesthetica: A simple technical guide for surgeons and trainees alike.

Meralgia paraesthetica is an entrapment neuropathy of the lateral femoral cutaneous nerve, usually due to compression at the inguinal ligament as the nerve passes from the pelvis into the thigh. Surgical decompression of the lateral femoral cutaneous nerve is a simple and effective treatment option, but the surgical anatomy of the area is not always familiar to neurosurgeons and neurosurgical trainees alike. This paper is a simple review of the relevant surgical anatomy and the surgical steps of lateral femoral cutaneous nerve decompression, with the aim of providing the busy surgeon and trainee a quick and easy reference guide to the procedure.

Intracranial pressure waveform characteristics in idiopathic normal pressure hydrocephalus and late-onset idiopathic aqueductal stenosis.

Background: Idiopathic normal pressure hydrocephalus (iNPH) and late-onset idiopathic aqueductal stenosis (LIAS) are two forms of chronic adult hydrocephalus of different aetiology. We analysed overnight intracranial pressure (ICP) monitoring to elucidate ICP waveform changes characteristic for iNPH and LIAS to better understand pathophysiological processes of both diseases.

Methods: 98 patients with iNPH and 14 patients with LIAS from two neurosurgical centres were included.

Psychometric evaluation of the German version of the Opening Minds Stigma Scale for Health Care Providers (OMS-HC).

Background: Healthcare professionals can be a source of stigma and discrimination for people with mental illness, and anti-stigma programs are needed for this target group. However, there is no validated German language scale to assess attitudes of healthcare professionals towards people with mental illness. This study had the aim to validate the German language version of the Opening Minds Stigma Scale for Health Care Providers (OMS-HC), a self-report measure of stigmatizing attitudes.

Psychiatric Emergencies in the Community: Characteristics and Outcome in Switzerland.

Psychiatric emergencies occur frequently in the community setting, e.g. the patient's home or public places.

Transcranial Doppler-derived indices of cerebrovascular haemodynamics are independent of depth and angle of insonation.

Continuous measurement of cerebral blood flow velocity (CBFV) of the middle cerebral artery (MCA) using transcranial Doppler (TCD) and arterial blood pressure (ABP) monitoring enables assessment of cerebrovascular haemodynamics. Further indices describing cerebrovascular function can be calculated from ABP and CBFV, such as the mean index (Mxa) of cerebrovascular autoregulation, the 'time constant of the cerebral arterial bed' (tau), the 'critical closing pressure' (CrCP) and a 'non-invasive estimator of ICP' (nICP). However, TCD is operator-dependent and changes in angle and depth of MCA insonation result in different readings of CBFV.

Complications of elective intracranial pressure monitoring in adult hydrocephalus.

Continuous invasive monitoring of intracranial pressure (ICP) can be used in the diagnosis and management of various types of chronic cerebrospinal fluid (CSF) circulation disorders, such as hydrocephalus, shunt dysfunction and idiopathic intracranial hypertension. The risk profile and incidence of adverse events of this surgical procedure in this patient population is not well established. We aimed to investigate and describe the risks of ICP monitoring in adult patients with chronic CSF circulation disorders.

Tissue oxygenation indices of cerebrovascular autoregulation in healthy volunteers: a comparison of two NIRS devices.

Background: Correlation coefficients between blood pressure and cerebral oxygen saturation measured using near-infrared spectrometry may be used to derive the tissue oximetry index of cerebral autoregulation. Cerebral oxygen saturations demonstrate poor agreement between near-infrared spectrometers however it is unclear if measurements of autoregulation are similarly specific to the equipment used.

Methods: Cerebral oxygen saturation was monitored bilaterally in 74 healthy volunteers using both the FORE-SIGHT and EQUANOX monitors in random order.

[Acceptance of Psychiatric and Somatic Advance Directives: A Comparison in Psychiatric Patients and Professionals].

Objective: Assessment of the attitudes towards somatic and psychiatric advance directives in the German speaking part of Switzerland.

Methods: Questionnaire for psychiatric patients, psychiatrists, psychologists, psychiatric nurses and peers assessing the attitudes towards three exemplary advance directives.

Results: The attitudes were mainly positive in all participating groups.

Psychiatric advance directives in Switzerland: Knowledge and attitudes in patients compared to professionals and usage in clinical practice.

Background: Psychiatric advance directives (PAD) were shown to be effective in the reduction of coercion and strengthening of the patients` autonomy. Therefore, the Swiss legislation was revised and stipulates that PAD must be taken into account during involuntary hospitalization. This study aimed to analyze knowledge on and attitudes towards this instrument in patients and healthcare practitioners and their usage in clinical practice.

Challenges and Opportunities in Building and Maintaining a Good Therapeutic Relationship in Acute Psychiatric Settings: A Narrative Review.

The therapeutic relationship and its importance for psychotherapy outcome have been the subject of extensive research over the last decades. An acute psychiatric inpatient setting is a unique environment where severely ill patients receive intensive treatment over a limited, relatively short, period of time. This renders establishing a good therapeutic relationship difficult for various reasons.

Understanding outcome metrics of the revised NIOSH lifting equation.

The interpretation of the calculated result of the revised NIOSH Lifting Equation (RNLE) has been problematic because the relationship of the calculated result to back injury risk has not always been either well understood nor consistently interpreted. During the revision of the ISO standard 11228-1 (Manual lifting, lowering and carrying), an extensive literature review was conducted on validation studies of the RNLE. A systematic review of exposure-risk associations between the LI metrics and various low-back health outcomes from peer-reviewed epidemiological studies was conducted.

Involuntary admission of psychiatric patients: Referring physicians' perceptions of competence.

Background: Involuntary admissions can be detrimental for patients. Due to legal, ethical and clinical considerations, they are also challenging for referring physicians. Nevertheless, not much is known about the subjective perceptions of those who have to decide whether to conduct an involuntary admission or not.

Involuntary admission for psychiatric treatment: Compliance with the law and legal considerations in referring physicians with different professional backgrounds.

Background: Involuntary admission (IA) for psychiatric treatment is a massive restriction of human rights. Therefore, its execution is regulated by law. During executing IAs referring physicians find themselves in a dual role: support of patients in the recovery process but also safe-keeper of society.

Clinical and socio-demographic characteristics associated with involuntary admissions in Switzerland between 2008 and 2016: An observational cohort study before and after implementation of the new legislation.

Background: Involuntary admission (IA) for psychiatric treatment has a history of controversial discussions. We aimed to describe characteristics of a cohort of involuntarily compared to voluntarily admitted patients regarding clinical and socio-demographic characteristics before and after implementation of the new legislation.

Methods: In this observational cohort study, routine data of 15'125 patients who were admitted to the University Hospital of Psychiatry Zurich between 2008 and 2016 were analyzed using a series of generalized estimating equations.

Attitudinal variance among patients, next of kin and health care professionals towards the use of containment measures in three psychiatric hospitals in Switzerland.

Background: In psychiatric treatment containment measures are used to de-escalate high-risk situations. These measures can be characterized by their immanent amount of coercion. Previous research could show that the attitudes towards different containment measures vary throughout countries.

Comparing Attitudes to Containment Measures of Patients, Health Care Professionals and Next of Kin.

In clinical psychiatric practice, health care professionals (HCP) must decide in exceptional circumstances after the weighing of interests, which, if any, containment measures including coercion are to be used. Here, the risk for patients, staff, and third parties, in addition to therapeutic considerations, factor into the decision. Patients' preference and the inclusion of relatives in these decisions are important; therefore, an understanding of how patients and next of kin (NOK) experience different coercive measures is crucial for clinical decision making.

Knowledge on types of treatment pressure. A cross-sectional study among mental health professionals.

Treatment pressure restricts patients' voluntary and autonomous decisions. Yet interventions involving treatment pressure are widely used in mental health and psychosocial services. This cross-sectional study explored whether mental health professionals' knowledge on five types of treatment pressure (no coercion, persuasion or conviction, leverage, threat, and formal coercion) was associated with sociodemographic, professional and contextual factors.

Noninvasive Monitoring of Dynamic Cerebrovascular Autoregulation and 'Optimal Blood Pressure' in Normal Adult Subjects.

Background: Cerebrovascular autoregulation can be continuously monitored from slow fluctuations of arterial blood pressure (ABP) and regional cerebral oxygen saturation (rSO). The purpose of this study was to evaluate the index of dynamic cerebrovascular autoregulation (TOx) and the associated 'optimal' ABP in normal adult healthy subjects.

Methods: Twenty-eight healthy volunteers were studied.

Is cerebrovascular autoregulation associated with outcomes after major noncardiac surgery? A prospective observational pilot study.

Background: Studies have identified multiple risk factors for development of cognitive decline after surgery. Impaired cerebrovascular autoregulation may be a contributor to postoperative cognitive decline.

Methods: One hundred and forty patients admitted for major elective noncardiac surgery were recruited.