Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

The present report is submitted in response to General Assembly resolution 61/106, by which the Assembly adopted the Convention on the Rights of Persons with Disabilities and the Optional Protocol thereto. As requested by the Assembly, a brief overview of the status of the Convention as at 3 August 2007 is presented. The report also contains a brief description of technical arrangements on staff and facilities made necessary for the effective performance of the functions of the Conference of States Parties and the Committee under the Convention and the Optional Protocol, and a description on the progressive implementation of standards and guidelines for the accessibility of facilities and services of the United Nations system. Recent efforts of the United Nations and agencies to disseminate information on the Convention and the Optional Protocol are also described.

わかりやすい障害者の権利条約 : 知的障害のある人の権利のために = Convention on the rights of persons with disabilities

2005년 대한 생화학·분자생물학회 하계학술대회를 다녀와서

European Resuscitation Council Guidelines for Resuscitation 2015

Michel Foucault takes the reader on a serendipitous journey in tracing the history of madness from the 16th to the 18th centuries. Utilizing original documents, the author recreates the mood, the place, and the proper perspective in the history of madness. Madness or folly is viewed as part of the human condition and to be examined and illuminated through one of its many facets. At the end of the Middle Ages madness was seen either as a tragic or comic phenomenon. The Renaissance, with Erasmus' Praise of Folly , demonstrated how imagination and its derivatives were to thinkers of that day. The French Revolution introduced the so-called medical approach. Madness is a ubiquitous phenomenon that has common roots not only in medicine but in poetry and tragedy. Shakespeare brilliantly describes psychological phenomena with even greater clarity than Tuke or Wills. The author weaves a fascinating history showing the changing pattern of

Madness and Civilization: A History of Insanity in the Age of Reason.

Background Mental capacity is central to legal and ethical debates on the use of compulsion in psychiatry.

Aims To describe the clinical epidemiology of mental incapacity in patients with psychiatric disorders, including interrater reliability of assessments, frequency in the psychiatric population and associations of mental incapacity.

Method Cross-sectional studies of capacity to consent to treatment for psychiatric patients were systematically reviewed from Medline, EMBASE and PsycInfo databases. Information on the reliability of assessments, frequency and associations of mental incapacity was extracted.

Results Out of 37 papers reviewed, 29 different capacity assessment tools were identified. Studies were highly heterogeneous in their measurement and definitions of capacity. Interrater reliabilities between tools were high. Studies indicate incapacity is common (median 29%) but the majority of psychiatric in-patients are capable of making treatment decisions. Psychosis, severity of symptoms, involuntary admission and treatment refusal were the strongest risk factors for incapacity.

Conclusions Mental capacity can be reliably assessed. The majority of psychiatric in-patients have capacity, and socio-demographic variables do not have a major impact but clinical ones do.

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Mental capacity in psychiatric patients: Systematic review.

/pdf/international-experiences-of-using-community-treatment-lpj3t49045.pdf

International experiences of using community treatment orders

Objective To estimate the prevalence of mental capacity to make decisions on treatment in people from different diagnostic and legal groups admitted to psychiatric hospital. Design Cross sectional study. Setting General adult acute psychiatric inpatient units. Participants 350 consecutive people admitted to psychiatric wards from the community over 16 months. Main outcome measure Mental capacity assessed by clinical interview and the MacArthur competence assessment tool for treatment. Results Estimates of mental capacity were obtained on 97% (n=338) of the 350 people admitted. Of those an estimated 60% (95% confidence interval 55% to 65%) lacked mental capacity to make decisions on treatment. This proportion varied according to diagnosis, ranging from 97% (n=36) in people with mania to 4% (n=24) in people with personality disorder. Mental incapacity was common in patients admitted informally to the psychiatric wards (n=188; 39%, 32% to 46%). Incapacity and detention are closely associated under non-capacity based mental health law. Conclusions Mental incapacity to make decisions on treatment is common in people admitted to psychiatric wards from the community but cannot be presumed. It is usual in those detained under the Mental Health Act and common in those admitted voluntarily.

https://www.bmj.com/content/bmj/337/bmj.39580.546597.BE.full.pdf

Mental capacity to make decisions on treatment in people admitted to psychiatric hospitals: cross sectional study

Integrated reporting (IR) is a major development in a number of sustainability-related accounting initiatives and, if widely adopted, will require significant developments in professional and university accounting curricula. These will include: a strategic rather than operational or transactional focus; longer- rather than short-term outlook; prospective rather than retrospective analysis; qualitative commentary as well as quantitative information; and reports on wider business performance metrics rather than on narrower external financial reporting data or audit compliance. This paper reports on ACCA's support of and response to the latest initiatives in IR, in particular the impact this will have on the education and training of accountants in order to reflect these new principles to prepare the twenty-first-century accountant for a much more challenging role in the near future. These developments can only be in the wider public interest of improving the relevance of information for decision-making, for...

Integrated Reporting: A Review of Developments and their Implications for the Accounting Curriculum

Background
Psychiatric disorders can pose problems in the assessment of decision-making capacity (DMC). This is so particularly where psychopathology is seen as the extreme end of a dimension that includes normality. Depression is an example of such a psychiatric disorder. Four abilities (understanding, appreciating, reasoning and ability to express a choice) are commonly assessed when determining DMC in psychiatry and uncertainty exists about the extent to which depression impacts capacity to make treatment or research participation decisions.

/pdf/depression-and-decision-making-capacity-for-treatment-or-4fzj41ko20.pdf

Gareth Owen

Papers

Mental capacity in psychiatric patients: Systematic review.

International experiences of using community treatment orders

Mental capacity to make decisions on treatment in people admitted to psychiatric hospitals: cross sectional study

Integrated Reporting: A Review of Developments and their Implications for the Accounting Curriculum

Depression and decision-making capacity for treatment or research: a systematic review