The powers of guardianship under the 1983 Mental Health Act confer on the guardian powers to require the patient to reside in a specified place, to require attendance for treatment and to require access to the patient for appropriate health and social services personnel. This paper presents a descriptive study and analysis of the use of guardianship over a 5-year period in four geographical areas. Cases were collected retrospectively from a variety of sources and scrutinized systematically. Three cases of guardianship for mental impairment were excluded from the analysis leaving 23 patients with mental illness. All but two of the patients were female. Older patients, mostly with dementia, accounted for three-quarters of the sample and the majority of orders in this group were to require residence in an old people's home (usually with an apparently good outcome), though three were intended to facilitate home care. In most of the younger patients a functional psychiatric illness was diagnosed and powers were used to maintain the patient at home. The absence of a specific 'power to convey' needs to be resolved for elderly patients needing residential care. The use of guardianship orders to maintain older patients in the community needs further exploration.
The performance of a prototype differential TEOM monitor (Rupprecht and Patashnick Co., NY) and its ability to measure the "actual" ambient near-continuous PM-2.5 mass in an area often high in semivolatile particulate matter has been evaluated. Measurements were made within a mobile particle instrumentation trailer (PIU) located in Claremont, CA-a "receptor" site in the Los Angeles Basin. The Differential TEOM monitor has been developed to directly measure ambient PM mass concentrations while accounting for collection artifacts, including loss of semivolatile aerosols and temperature changes. The Differential TEOM monitors used in this study were self-referencing, providing mass concentration measurements at 5 min intervals. To reference the semicontinuous mass measured by the Differential TEOM monitor, its 24 h time-integrated mass concentrations were compared to those determined by collocated filter-based samplers, i.e., MOUDI (Model 110) and Partisol (Model 2025). A HEADS was used to evaluate ammonium nitrate losses from the time-integrated samplers. The results show that PM-2.5 mass measurements using the Differential TEOM monitor are consistent with those of the MOUDI and Partisol, while differences can be generally explained by loss of ammonium nitrate from the reference samplers. The field results also demonstrate the ability of the Differential TEOM monitor to track adsorption and desorption processes from its sample filter. Although adsorption and evaporation can be dynamic processes,
This article reviews what has been reported in literature about the use of Guardianship Orders under the Mental Health Act 1983. Guardianship Orders were used infrequently in comparison with Sections 2, 3 and 4 of the Mental Health Act although the number of guardianship cases has increased three-fold since 1982. Elderly female patients with organic brain disease were the group on whom guardianship was most used either to support them in the community or to facilitate admission to residential care. Guardianship was rarely used to prevent hospitalization. Despite its many drawbacks, for a selected group of patients guardianship did appear to have advantages and was found to be worthy of consideration for practising clinicians and approved social workers.
The pattern of use of Section 5(2) of the Mental Health Act 1983 was examined over a 12-year period at one psychiatric hospital. Although there was a national trend for Section 5(2) to be used more frequently, the local pattern was of a fluctuating number of patients being placed on this Section, but without there being any upward trend towards its increased use. As has been seen in other studies, Section 5(2), however, tended to be used for a younger group of patient who had often only been admitted within the previous 24 hours.
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