Medical attitudes towards transgender patients.

Background/aims: Those identifying as transgender make up a significant and growing number of individuals. They face discrimination in healthcare and have been known to have adverse physical and mental health outcomes because of stigma. A study was carried out to ascertain how doctors perceive and interact with their transgender patients.

Self-Amputation in Two Non-Psychotic Patients.

Self-amputation, the extreme form of self-mutilation, is uncommon. The vast majority of cases are associated with psychosis, with a small number being assigned the controversial diagnosis of body identity integrity disorder. In this article, we report two cases of non-psychotic self-amputation and their similarities with a view to highlighting the risk factors and formulating an appropriate management plan.

Failing hospitals: mission statements to drive service improvement?

Purpose: This paper aims to consider whether the hospital mission statement can be used as a management tool to improve service provision in failing hospitals.

Design/methodology/approach: A literature search into the potential value and harm of hospital mission statements was done, followed by a survey of initial attitudes within a failing hospital. Do they indicate likely success of the tool?

Findings: Mission statement is a potentially valuable leadership tool in the hospital environment.

Alcohol misuse among elderly psychiatric patients: a pilot study.

The aim of this pilot study was to ascertain the frequency of alcohol misuse among the elderly (> 65) psychiatric referrals. Consecutive referrals to a suburban elderly psychiatric team were screened for alcohol misuse by using the CAGE questionnaire as a part of psychiatric assessment. Gamma-glutanyl transpeptidase (GGT) was measured in those showing evidence of alcohol misuse.

Substitution therapy for heroin addiction.

Substitution treatment for heroin addiction, defined here as maintenance prescribing of opioid agonist drugs to opioid dependent subjects, has increased in the last decade. The recent history of substitution treatment in five countries--Canada, the U.K.