This investigation sought to establish how both child and parent from the same family viewed psychiatric input, its functioning and effects, and whether they shared similar perceptions. It was intended to redress the balance regarding an earlier study which focused on how staff attitudes, education, training, values and philosophies might affect therapeutic relationships in a child psychiatric unit (Chesson, 1996). A survey of children attending the inpatient psychiatric unit at the Royal Aberdeen Children's Hospital, as well as of their parents, was carried out over an 18-month period. Interviews were held prior to hospitalization and during inpatient stay, and took place on at least one occasion in the children's homes. Main findings were that a third of the children had not been informed by parents about admission (a view supported by parental comments), only two children saw the unit as a hospital, and that parents and children were not able to provide a clear reason for admission. Limited understanding of treatment and the work of the multidisciplinary team was evident, and parents seldom reported receiving any professional help themselves. A graduation emerged from younger/less intelligent children having a less accurate perception of reasons for inpatient stay to older/more intelligent children having one of greater accuracy. Children's satisfaction appeared related to outcome as measured by parental perception, but not scores on the Rutter's (1967) Child Behavioural Questionnaire. Parents' and children's views on several issues were incongruent, and it is suggested that this has significant implications for treatment.
Response to a large-scale radiological incident could require timely medical interventions to minimize radiation casualties. Proper medical care requires knowing the victim's radiation dose. When physical dosimetry is absent, radiation-specific chromosome aberration analysis can serve to estimate the absorbed dose in order to assist physicians in the medical management of radiation injuries. A mock exercise scenario was presented to six participating biodosimetry laboratories as one individual acutely exposed to Co under conditions suggesting whole-body exposure. The individual was not wearing a dosimeter and within 2-3 h of the incident began vomiting. The individual also had other medical symptoms indicating likelihood of a significant dose. Physicians managing the patient requested a dose estimate in order to develop a treatment plan. Participating laboratories in North and South America, Europe, and Asia were asked to evaluate more than 800 electronic images of metaphase cells from the patient to determine the dicentric yield and calculate a dose estimate with 95% confidence limits. All participants were blind to the physical dose until after submitting their estimates based on the dicentric chromosome assay (DCA). The exercise was successful since the mean biological dose estimate was 1.89 Gy whereas the actual physical dose was 2 Gy. This is well within the requirements for guidance of medical management. The exercise demonstrated that the most labor-intensive step in the entire process (visual evaluation of images) can be accelerated by taking advantage of world-wide expertise available on the Internet.
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