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Eating disorders among under-18s in Scotland soared in lockdown, psychiatrists warn

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The Royal College of Psychiatrists (RCPsych) in Scotland said the figures obtained through Freedom of Information show that there were 217 referrals for eating disorders among children and adolescents under 18 in 2018/19.

This rose to 456 in 2019/20 and almost tripled to 615 in 2020/21.

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RCPsych in Scotland said the emphasis on virtual appointments, the loss of support structures, staff shortages and less access to community services due to Covid-19 had fueled the crisis.

Rob Donaldson, whose 16-year-old daughter was diagnosed with anorexia in 2019.

The College urges Scotland’s new Minister for Mental Wellbeing, Kevin Stewart, to ensure that young people with eating disorders are also funded through new Child and Adolescent Psychiatry (CAMHS) funding.

Rob Donaldson’s 17-year-old daughter is being treated in a youth ward after being diagnosed with an eating disorder in 2019.

The anorexic sufferer was first hospitalized in April last year, shortly after the lockdown began, after struggling to cope when her weekly personal treatment went online due to the pandemic.

Mr Donaldson of Dundee said: “It is worrying that statistics for children and adolescents with eating disorders are increasing across Scotland. Lockdown has had a major negative impact on my daughter’s anorexia.

“We were receiving home care and attending weekly family-based therapy sessions, but that suddenly stopped. The therapy was via video call and it just didn’t work for her.

“There was nothing to motivate her to eat without being isolated without school and at home all day, the disease thrived. Within a few weeks of the lockdown, she quickly felt sick and was admitted to an inpatient youth ward.

“That was a huge shock to all of us and in the early days of the pandemic as we weren’t allowed to see them for three weeks.”

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Covid Scotland: ‘Breakthrough’ Antibody Test Can Detect Variants

His daughter was doing well enough to get home in late summer, but by mid-November she was again very ill and was admitted to a specialized youth ward in Glasgow, more than 160 miles from home, as this was the only bed available was said he was “traumatic” to the family.

Dr. Ereni Skouta, Vice Chair of the CAMHS Faculty at the Royal College of Psychiatrists in Scotland, said: “The truth is that the CAMHS services have been struggling to cope with the prepandemic but now we are seeing a worrying trend and a huge one Increase in the number of children and adolescents with fatal eating disorders.

“An emphasis on virtual appointments, the loss of support structures and staff shortages as well as less access to community services due to Covid-19 have fueled this crisis.”

Kevin Stewart, Secretary of State for Mental Wellbeing, said, “We will shortly be announcing the next steps to improve services after considering the recommendations of the National Review of Eating Disorders Services – which include the services available, the broader support system and the impact of Pandemic and related restrictions for people with an eating disorder and their families.

“Our Mental Health Conversion and Restoration Plan released in October sets out our response to the mental health impact of the Covid-19 pandemic. The plan is supported by a £ 120 million Reconstruction and Renewal Fund announced in February to transform the services.

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Serious gaps in mental health care in Washington prisons, report warns

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Inadequate psychiatric care in Washington prisons puts some prisoners at increased risk of self-harm and suicide and contributes to long stays in solitary confinement, according to a new report from the Ombudsman.

The report, which has been in the works for months, raises the alarm over numerous shortcomings, including high-case psychiatric staff and desperate prisoners waiting to see a psychologist.

Other issues identified by the Office of the Corrections Ombuds (OCO) include problems with prescribing psychiatric drugs and a disciplinary process that often fails to take into account the mental health of the detainee.

“The big realization is that we need more mental health services for incarcerated people,” said Joanna Carns, director of the OCO.

In response to the report, the Department of Corrections (DOC) recognized the continuing challenges in the delivery of mental health care to prisoners and pointed out the way it addresses many of the issues, including by working with outside prison reform groups.

The Ombuds Report is the latest in a series of OCO investigations that focus on the state of mental health care in Washington prisons – a strategic priority for the independent bureau, established in 2018.

Previous reports have focused on prisoners who have died from suicide, the effects of solitary confinement, and concerns related to the quarantine and isolation of prisoners due to COVID-19. Future OCO reports will examine the use of violence and restraints among prisoners with mental illness and the well-being of transgender prisoners.

The latest research paints a picture of a prison system that is ill-equipped to meet the mental health needs of a complex population of approximately 15,000 prisoners, spread across 12 prisons and 12 layoffs. Of particular concern to investigators is anecdotal evidence that inmates of color with mental disorders are treated differently. The report also highlights the particular challenges LQBTQ prisoners face.

A new report from the Office of Corrections Ombudsman finds evidence of numerous shortcomings in the availability of mental health care in Washington prisons. According to the report, prisoners in distress often have to wait to see a psychologist, and a lack of robust treatment options means that some prisoners end up in solitary confinement.

Washington State Department of Corrections /

The report is based on an analysis of more than 300 mental health complaints at the OCO between November 2018 and November 2020. In addition, investigators interviewed detainees, checked mental health data and spoke to DOC employees and administrations.

Countless problems

A key finding is that mental health professionals who are responsible for initial examinations of new prisoners are overwhelmed. According to the report, employees have to do an “extremely high” number of screenings each day and sometimes the location where the screenings are held is not private. This is an issue that the OCO previously reported.

Another persistent problem the report identifies is the lack of access to mental health professionals. This can manifest itself in a variety of ways, from delays after a prisoner sends a letter asking for a counselor to a lack of group therapy options.

Prisoners have also complained that DOC doctors reduced or stopped their existing psychiatric medication, or prescribed medication that was ineffective.

In terms of discipline, the report notes that when prisoners break the rules and get into trouble, “the process does not provide an adequate opportunity to take full account of a person’s mental health,” the report said.

In particular, the report describes a cycle in which an incarcerated person acts based on their mental health and then receives a sanction that does not address the root of the behavior. In some cases, individual prisoners suffer numerous violations due to untreated mental illness.

An example of this was included in the OCO’s 2020 annual report. It was a prisoner who injured himself. When the prison staff tried to hold the person, he hit one of the staff and attacked him. As a punishment, the prisoner was placed in solitary confinement and lost part of his “good time” credit for an earlier release.

Another major concern of the OCO is suicide in prison. Since last year, the OCO has published a number of reports of suicide in prisons, along with several recommendations on how to address the problem. This latest report urges the DOC to adopt these earlier recommendations and warns that in some cases the agency has not properly tracked and tracked prisoners who have harmed themselves or on suicide watch.

Another ongoing concern of the OCO is the use of solitary confinement, also known as intensive management or segregation. The report notes that people with serious mental illnesses are often kept in solitary cells for long periods of time.

“This practice contradicts years of research that have shown that time in solitary confinement exacerbates mental symptoms,” the report said.

DOC has worked with the Vera Institute of Justice, a national prison reform group, for the past few years to reduce the use of solitary confinement.

To address mental health deficiencies, the OCO report makes a number of recommendations, including that the DOC reduce the number of cases for staff examining incoming prisoners for mental health issues.

The report also calls on the DOC to increase its mental health staff to ensure timely treatment and expand opportunities for group therapy. As part of this effort, the report says, it is important that clinical staff reflect the racial and ethnic diversity of prison inmates.

Regarding the disciplining of inmates with severe mental illness, the report suggests that the DOC suggest alternatives to the standard sanctions and, if necessary, seek input from mental health workers.

The report also urges the DOC to reduce the time detainees with severe mental illnesses spend in solitary confinement and to investigate best practices for accommodation and treatment options that do not include segregation.

In addition to hiring more mental health staff, the OCO would also like the DOC to train its frontline detainees to better support the mental health needs of detainees. This includes training on mental health awareness and de-escalation tactics. In response, DOC said it is already prioritizing de-escalation, but there are recognized opportunities for more specific training for people in specialized occupational classes.

One final recommendation urges the DOC to work with the Department of Social and Health Services (DHSH) to facilitate the “temporary transfer” of prisoners in need of inpatient psychiatric care to western or eastern state hospitals.

DOC answers

In a lengthy, formal response to the report, DOC said it plans to ask lawmakers to fund two additional psychology positions as well as funds to improve the prisoner reception process next year.

In the meantime, the agency hopes to have a new assessment of the physical space available in prisons for group therapy sessions by September 30. However, DOC warned that finding suitable rooms and then staffing groups with a correctional officer to ensure security is an ongoing challenge. COVID-19 was another barrier to convening groups.

Next year, DOC plans to broadly roll out a new disciplinary program for people with severe mental illness that it has tested in two prisons. The program is modeled after a similar program by the Oregon Department of Corrections and requires the involvement of the inmate’s primary therapist in the disciplinary process.

The ministry also noted that since 2012 it has reduced the use of administrative segregation by a third and reduced the median stay in isolation by 33 percent. DOC said it has also stopped the use of segregation as a form of sanction and is trying alternatives to solitary confinement such as “transitional pods.”

In a statement on Wednesday, DOC said it was working with the OCO, acknowledging “known challenges related to the delivery of mental health services.”

“The department continues to work to equip and train its staff with the knowledge and skills necessary to support people with mental illness, and continues to review and revise its workforce to achieve adequate caseloads to maintain mental health services and to provide where the greatest patient needs are, ”the press release said.

The agency also said it is working with the University of California San Francisco’s AMEND program to bring a public health culture into the prison system. The DOC is also developing intensive outpatient treatment options that allow people with severe mental illness to receive treatment in the general prison population while in residence.

The current DOC secretary is Cheryl Strange, who previously ran DSHS and was previously CEO of Western State Hospital. Strange was appointed to the position in April. Carns, the ombudswoman, said she hoped Strange would prioritize the recommendations in the report given her mental health background.

“The goal is that people who are incarcerated are better off than when they entered Germany and receive psychiatric care [are] a critical component of that, ”said Carns.

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Oregon health care workers will be required to get vaccinated or face frequent testing

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Oregon Governor Kate Brown speaks during the June 30, 2021 press conference announcing the end of the state mask mandate.

Kristyna Wentz-Graff

Oregon health workers will need to get vaccinated against COVID-19 or undergo weekly tests, which Governor Kate Brown usually plans to introduce in late September.

As an alarming surge in case numbers and hospital admissions threatens to overwhelm public health authorities and local hospitals, Brown announced Wednesday that it has directed the Oregon Health Authority to enact new rules designed to put pressure on health workers. You can either get vaccinated by September 30th or have frequent tests for the virus.

“The more contagious Delta variant changed everything,” Brown said in a press release. “This new security measure is necessary to prevent Delta from causing serious illness on our first line of defense: our doctors, nurses, medical students and health workers on the front lines.”

The new rule falls short of what the state’s largest hospital association had called for: a new rule or regulation that gives individual health systems the power to require Covid-19 vaccination if they so choose. That would have brought Oregon in line with most other states.

Brown feared that vaccination with no alternative could lead to staff shortages, her spokesman said.

The upcoming rules are similar to the testing requirements President Joe Biden and California Governor Gavin Newsom put in place for federal and state employees during the COVID-19 resurgence. But rather than addressing all state or federal employees, Brown limits her focus to health care workers “who have direct or indirect contact with patients or infectious materials.”

Brown’s office is still considering vaccination and testing requirements for government employees, the statement said. The governor, who in recent weeks has emphasized more localized decision-making over state mandates, urged private and public employers across the state to introduce masking requirements and “facilitate employee access to vaccines” with guidelines such as paid time off for vaccinations and others Incentives.

While vaccination assignments are acceptable as a condition of employment in most sectors, Oregon law prohibits health care providers from making them mandatory unless vaccinations are required by state or federal regulations. The governor’s office said Brown plans to “address” this ban when lawmakers meet early next year.

In the meantime, not all providers are waiting. Kaiser Permanente announced Monday that it will make vaccines mandatory for all employees. PeaceHealth’s medical system announced Tuesday that all of its caregivers must be vaccinated against COVID-19 or submit a qualified medical exemption. Those who do not can be removed from patient care.

Health systems across the state have said they support a change in the law, while the Oregon Nurses Association has warned that if nurses are not part of the contract negotiations, they could result in resignation when morale is low and hospitals and long-term care facilities last are already scarce.

The increased demands come as COVID-19 patients are being hospitalized at a worrying rate. As of Wednesday, 393 people with the virus had been hospitalized in the state, 95 more than last Friday and 14 more than the day before.

State health officials released modeling results last week that suggested that nearly 100 people a day could be hospitalized by mid-August if steps are not taken to contain the spread of the Delta variant. The same modeling suggested that the daily case numbers could rise to nearly 1,200 over the same period. The state reported 1,575 new cases on Tuesday.

The state had 393 available beds in a non-intensive care unit and 110 free beds in the intensive care unit as of Wednesday morning.

Despite worrying trends and calls from their own health advisors to get vaccinated as soon as possible, the new requirements for health workers won’t go into effect until September 30th. Brown’s office said an eight week delay will “give employers time” to prepare for implementation and will give currently unvaccinated health care workers time to fully vaccinate.

Vaccination rates for health care workers are higher than rates for the general population, but they vary widely by region, ranging from a low of 43% in Harney County to a high of 81% in Washington County.

Vaccinations for long-term care facilities are particularly critical, the residents of which were responsible for around half of the deaths in the first year of the pandemic.

Approximately 68% of Oregon long-term care workers have been vaccinated – about 10% more than the national average, according to the Oregon Health Care Association, which represents the industry.

In Oregon, by July 3, 70% of all health workers were vaccinated. The rates vary depending on the profession: 87% of vaccinated doctors, 74% of registered nurses and 57% of certified nursing assistants.

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It’s time to expand the definition of ‘women’s health’

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Common diseases such as cardiovascular disease are under-researched in women, making diagnosis, prognosis and treatment difficult in women.Photo credit: BSIP / UIG / Getty

More than one eighth of the world’s population has a condition that can cause pain, profuse bleeding, and decreased fertility, all possible consequences of benign tumors known as uterine leiomyomas or fibroids. Fibroids can be debilitating and are a common reason for surgical removal of the uterus.

Still, fibroids have received relatively little attention from scientists, either in academia or in pharmaceutical companies. The cause of the disease – and how to reduce its impact on fertility – has been debated for decades, leaving doctors unsure how best to treat people.

Unfortunately, fibroids are just one of many underrated aspects of health in people who were female at birth. (This includes cis women, transgender men, and some non-binary and intersex people; the term “women” in the remainder of this editorial refers to cis women.) Clinical and preclinical studies tend to focus equally on men: a third of the Individuals participating in cardiovascular disease clinical trials are women, and an analysis of neuroscientific studies published in six journals in 2014 found that 40% of them used male animals only. Two studies and an article published in Nature on Aug. 5 shed light on the advances in women’s health research – and the need for more.

A study examines the molecular origins of fibroids and reveals a possible mechanism by which tumors form. Drugs targeting key molecular actors in this process could open up new treatment options with further studies.

The other study takes a multidisciplinary approach, examining both the genetic mechanisms and epidemiological factors involved in ovarian aging, which leads to menopause and fertility loss. The age at which women experience menopause varies widely – with a range of around 20 years for healthy women – and fertility can drop dramatically for up to a decade before it begins.

This work expanded the list of genes that contribute to early ovarian aging and highlights the importance of DNA repair mechanisms in determining the age at which women experience menopause.

Both studies illustrate the advances that can be made if the health challenges of women are brought to the fore. However, advocates of women’s health warn that the field is often too narrowly considered. The study of health and disease in women should not be limited to conditions that affect women only. Conditions like type 2 diabetes, Alzheimer’s disease, and heart disease affect men and women differently. Such diseases need to be investigated in both men and women, and the diagnosis, prognosis, and treatment may need to differ between the sexes.

Heart attacks, for example, are one of the leading causes of death in both women and men, but women do not always have the “typical” symptoms that men normally experience. Women are also more prone to blood clots after a heart attack, but are less likely to be prescribed anticoagulant drugs by their doctors. Women are 50% more likely to get an initial misdiagnosis after a heart attack than men and are less likely to be prescribed medication to reduce the risk of a second attack, according to the British Heart Foundation.

When it comes to exercise, women are at risk of serious long-term injury if we continue to model head injury training and management on data from men. As our News Feature reports, it is becoming increasingly clear that women experience head injuries and recover from them very differently than men. Understanding why women are nearly twice as likely to experience concussions as men in sports like soccer and rugby requires multi-disciplinary research – and to understand why women take longer to recover from such injuries.

So far, the evidence is sparse, but preliminary data suggest structural differences in the brain. Axons in the brain of women are wired to thinner microtubules that tear more easily; Hormonal fluctuations should also contribute to this. Biomechanics could also play a role – in rugby, for example, it seems that women fall differently when attacked, which could increase the risk of a concussion. Exercise programs designed specifically for women can help alleviate these injuries.

But the clear message from sports researchers is that it is no longer acceptable to exclusively use data from men in these studies. And when women are included, the data needs to be broken down by gender and include a sufficient number of women. A recent study examining MRI images of elite rugby players included women (KA Zimmerman Brain Commun. 3, fcab133; 2021) but of the 44 elite players, only 3 were women.

But the relative lack of women on committees and scientific advisory boards has meant that few of these decision-makers have direct personal experiences with women’s health needs or research gaps. It is all the more important that funders consult the public when determining research priorities.

Since 2016, the US National Institutes of Health has required researchers to conduct preclinical studies in both male and female animals, tissues and cells, or to provide an explanation as to why it is not appropriate to study both sexes. Now it is up to other funders, researchers, and journals to amplify the impact of this change by making sure to include gender-specific data in publications. Funders should also strengthen the resources allocated to support studies of health and disease in women and keep track of how much money is being used to support such research in all areas, not just gynecological diseases. What is measured is done.

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