Although there have been previous reports of decreased sexual capacity as a side effect of antidepressants (1-3), the authors know of no previous records of increased capacity of the type described in the following reports, or of reports of side effects associated with yawning. Observation of unusual yawning-associated side effects is now reported, in order to alert clinicians to a possible side effect that can influence patient-compliance with the prescribed medication regimen.
A systematic effort is underway to rationalize the planning of physician supply. This paper summarizes the current methodologies available and focuses on the attempts to determine the optimal psychiatrist-to-population ratio in Canada. The impact of several variables influencing this ratio is discussed. An outline of the correlation between target physician supply and requirements of future trainees is presented. While the relevant methodology is rapidly evolving, an improved process of data collection is urgently required. A number of challenges for our profession lay ahead, such as the need for sensitive and reliable measures of the adequacy of psychiatrist and subspecialist supply and public issues arising from the poor geographic distribution of psychiatric manpower.
A general hospital psychiatric inpatient department which had been regarded as efficient and effective in its functioning, underwent rapid deterioration after the introduction of a computerized system of charting and record keeping. The deterioration was attributed to: 1) Impeded communication among the staff; 2) Loss of time available for patient care; 3) Staff frustration with the system and subsequent feelings of anger and helplessness being communicated to the patients. The authors describe the development of this deterioration and discuss possible psychodynamic factors and suggested corrective-preventative measures.
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