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Sample records for attending outpatient clinics

  1. Patient characteristics affecting attendance at general outpatient clinics.

    OpenAIRE

    McClure, R J; Newell, S J; Edwards, S

    1996-01-01

    A study was carried out to identify the characteristics of children who do not attend appointments at general outpatient clinics. Over six months, 359 children who had an appointment at a general clinic were studied using a questionnaire given to parents (74% response rate) and by inspection of case notes. Based on their first appointment in the study period, children were divided into 'attenders' (n = 262) and 'non-attenders' (n = 97) for analysis. Non-attenders were significantly more likel...

  2. Telephone reminders reduced the non-attendance rate in a gastroenterology outpatient clinic

    DEFF Research Database (Denmark)

    Jeppesen, Maja Haunstrup; Ainsworth, Mark Andrew

    2015-01-01

    in a gastroenterology outpatient clinic like ours. METHODS: This was a comparative intervention study with a historical control group in a gastroenterology outpatient clinic. The study lasted six months. Patients with a scheduled appointment in the first three-month period received no reminder (control group, n = 2......,705). Patients in the following three-month period were reminded by telephone one weekday in advance of their appointment, when possible (intervention group, n = 2,479). Non-attending patients in the intervention group received a questionnaire. Based on the results, a financial cost-benefit analysis was made......-attendees. The most common explanation for non-attendance in the intervention group was forgetfulness (39%). The reminder telephone call was cost-effective. CONCLUSION: In this outpatient clinic, telephone reminders were cost-effective and significantly reduced the non-attendance rate by 43%....

  3. Observational study identifies non-attendance characteristics in two hospital outpatient clinics

    DEFF Research Database (Denmark)

    Blæhr, Emely; Søgaard, Rikke; Kristensen, Thomas;

    2016-01-01

    INTRODUCTION: Non-attended hospital appointments are receiving increasing attention in times when rapid access and efficient service delivery at public hospitals are on the agenda. The aim of this study was to investigate the extent of non-attendance in a Danish outpatient setting and its...... association with user-level and provider-level characteristics. METHODS: The study was based on appointments scheduled from June 2013 to March 2015 at an orthopaedic and a radiologic outpatient clinic. Data on outcomes of cancellation on the part of the user or the provider, and non-attendance without giving...... unattended without notice. The latter was significantly associated with male gender, younger age and longer time since referral. Other characteristics were identified as significant, but differed between departments. CONCLUSION: There seems to be a potential for a targeted effort aiming to reduce non-attendance...

  4. The Prevalence of Pain in Patients Attending Sarcoma Outpatient Clinics

    Directory of Open Access Journals (Sweden)

    P. Y. Kuo

    2011-01-01

    Full Text Available The prevalence of pain in patients with sarcoma is not well documented. We investigated this in outpatients at a tertiary cancer referral centre, assessing the adequacy of pain control and for risk factors leading to higher prevalence and severity of pain. 149 patients were surveyed. Patients with pain within the previous 7 days completed pain assessment tools (BPI, S-LANSS, PMI. 53% of patients had pain within the previous 7 days, and 25% had significant pain. Of those with pain, 63% was inadequately controlled and neuropathic pain was identified in 36%. Age, gender, tumour type, and the type of cancer treatment were not significant predictors of the prevalence or severity of the pain. Based on our results, patients with sarcoma should be actively screened for pain and have regular reviews of their analgesic requirements.

  5. Non-attendance at out-patient clinics: a case study.

    Science.gov (United States)

    Mason, C

    1992-05-01

    Non-attendance at out-patient clinics is a persistent, worldwide problem. In contrast with previous research, a qualitative approach was used in this study to examine reasons for non-attendance at out-patient clinics in one Belfast hospital, by exploring perspectives of general practitioners (GPs), hospital staff and defaulters. Findings revealed conflicts of opinion between GPs and hospital staff on appropriate management of certain medical and postnatal patients. Patients' reasons for defaulting were wide-ranging; however, 32% of those interviewed did not attend, or were recorded as non-attenders, for reasons relating to inefficient hospital administration. It is concluded that the causes of non-attendance were multifactorial, and non-attenders could not be stereotyped as irresponsible. Suggested measures to alleviate the problem include discussion between groups of professionals on responsibility for care of medical and postnatal patients, increased negotiation between patients and physicians in order to develop agreed programmes of care, and, where possible, a shifting of the onus of responsibility for making and cancelling appointments onto patients.

  6. Non-attendance at psychiatric outpatient clinics: communication and implications for primary care.

    OpenAIRE

    Killaspy, H; Banerjee, S.; King, M.; LLOYD, M

    1999-01-01

    BACKGROUND: What should happen when an outpatient fails to attend a psychiatric clinic? Guidelines from the General Medical Services Committee suggest that general practitioners (GPs) have no further responsibility of care for a patient once a referral to a psychiatrist has been made. This raises questions about the formulation of effective management plans for those patients with whom psychiatric services find it difficult to engage due to non-compliance with assessment and follow-up. AIMS: ...

  7. Failure to attend out-patient clinics: is it in our DNA?

    LENUS (Irish Health Repository)

    Roberts, Kinley

    2012-02-01

    PURPOSE: This paper aims to determine the reasons why patients miss clinic appointments and to ascertain patients\\' views on the implementation of reminder systems and penalty fees to reduce the rates of did not attend (DNAs). Overall, the paper seeks to establish novel ways to run a more efficient out-patient department (OPD) service to improve waiting times and access for patients to limited neurology resources. DESIGN\\/METHODOLOGY\\/APPROACH: A questionnaire-based study was approved by the audit committee and was offered to 204 out-patients attending the neurology clinics over a three-month period (July to September 2009). The patients\\' demographic details and non-attendance records were reviewed. The paper aimed to ascertain, from the patients\\' perspective, why people failed to attend clinic appointments. Each participant was asked their views on how they felt their public hospital service might reduce the number of DNAs at their neurology OPD. FINDINGS: A total of 204 patients took part. Participants had a mean age of 31 years (range 25-75 years) with a modal peak in the 26 to 35 age bracket. Almost 10 per cent of those surveyed admitted to missing a hospital out-patient appointment in the past. The most common reason was that they simply "forgot" (28 per cent). DNA rates by age range were proportionally similar to the overall age profile of attenders. Over 55 per cent said they would like a pre-appointment reminder via a mobile telephone text message, 19 per cent preferred a pre-appointment telephone call, and 19 per cent an e-mail. Of those surveyed, 47 per cent said they would be willing to pay a fee on booking that could be refunded on attending for their appointment. The majority of these felt Euro 20 was the most appropriate amount (39 per cent). The rate of acceptance for various fee amounts was uniform across age ranges. Over half (52 per cent) said that they would agree to a "buddy" system whereby the appointment reminder was sent to the patient

  8. Prevalence of Peripheral Arterial Disease among Adult Patients Attending Outpatient Clinic at a General Hospital in South Angola

    OpenAIRE

    Feliciano Chanana Paquissi; Arminda Bimbi Paquissi Cuvinje; Almeida Bailundo Cuvinje

    2016-01-01

    Background. Peripheral arterial disease (PAD) is a common manifestation of atherosclerosis, whose prevalence is increasing worldwide, and is associated with all-cause mortality. However, no study has assessed this disease in Huambo. The aim of this study was to evaluate the prevalence of PAD in patients attending an outpatient clinic at a general hospital in Huambo, South Angola. Methods. A cross-sectional study, including 115 patients aged 40 years and older attending an outpatient service. ...

  9. Telephone reminders reduced the non-attendance rate in a gastroenterology outpatient clinic

    DEFF Research Database (Denmark)

    Jeppesen, Maja Haunstrup; Ainsworth, Mark Andrew

    2015-01-01

    in a gastroenterology outpatient clinic like ours. METHODS: This was a comparative intervention study with a historical control group in a gastroenterology outpatient clinic. The study lasted six months. Patients with a scheduled appointment in the first three-month period received no reminder...

  10. Nonpain symptoms of new and follow-up cancer patients attending a palliative care outpatient clinic in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Mohammad Zafir Al-Shahri

    2012-01-01

    Full Text Available Background : Epidemiology of cancer-related nonpain symptoms receives less attention in literature as compared with cancer pain. Objective : This paper aims at exploring the prevalence and severity of nonpain symptoms in cancer patients attending a palliative care (PC outpatient clinic. Materials and Methods : Over a 5 months period, consecutive adult cancer patients attending PC outpatient clinic at a tertiary hospital were evaluated for the presence and severity of 10 nonpain symptoms. Patients were grouped to new or follow-up cases and were also grouped according to performance status and cancer type. Prevalence and severity of symptoms were compared between groups using t test or analysis of variance as appropriate. Results : Fifty-one males and 73 females were interviewed. The most common cancer is female breast (27.4% followed by head and neck (15.3%. Majority of patients (67% were new to PC clinic. Patients had 5.1 nonpain symptoms on average, with most common symptoms being tiredness (79.8%, loss of appetite (71.8%, dry mouth (69.4%, anxiety (60.5%, and depression (50.8%. The least common symptoms were confusion and nausea (22.6% each. The median scores of severity were highest for tiredness, loss of appetite, dry mouth, and insomnia (5 points each. Symptoms were fewer among patients with good performance status (P = 0.002, whereas age, gender, cancer type, and encounter type were not associated with difference in symptom prevalence. Younger patients, females and those with poor performance status have shown a tendency toward higher severity scores for several symptoms. Conclusion : The significant prevalence and severity of nonpain symptoms among new and follow-up cancer patients seen in a PC outpatient clinic emphasizes the need for comprehensive assessment and routinely audited symptom management plans.

  11. Prevalence of Peripheral Arterial Disease among Adult Patients Attending Outpatient Clinic at a General Hospital in South Angola.

    Science.gov (United States)

    Paquissi, Feliciano Chanana; Cuvinje, Arminda Bimbi Paquissi; Cuvinje, Almeida Bailundo

    2016-01-01

    Background. Peripheral arterial disease (PAD) is a common manifestation of atherosclerosis, whose prevalence is increasing worldwide, and is associated with all-cause mortality. However, no study has assessed this disease in Huambo. The aim of this study was to evaluate the prevalence of PAD in patients attending an outpatient clinic at a general hospital in Huambo, South Angola. Methods. A cross-sectional study, including 115 patients aged 40 years and older attending an outpatient service. The evaluation included a basic questionnaire for lifestyle and medical history and ankle-brachial index (ABI) measurement using hand-held Doppler. PAD was defined as an ABI ≤0.9 in either lower limb. Results. Of 115 patients, 62.60% were women with a median age of 52.5 (range of 40 to 91) years. The prevalence of PAD was 42.6% (95% confidence intervals [CI]: 95%: 33.91-52.17%). Among patients with PAD, 95.92% had mild disease and 4.08% moderate to severe disease. The main risk factor for PAD was age (≥60 years) (χ (2) = 3.917, P ≤ 0.05). The prevalence was slightly higher in men and hypertensive subjects, but without statistical significance with ORs of 1.5 (95% CI: 0.69-3.21) and 1.42 (95% CI: 0.64-3.17), respectively. Hypertension was also high in the group (66.95%). Conclusion. The prevalence of PAD was 42.6%, higher in those aged 60 years and older. More studies, with representative samples, are necessary to clarify PAD prevalence and associated risk factors. PMID:27293966

  12. Prevalence of Peripheral Arterial Disease among Adult Patients Attending Outpatient Clinic at a General Hospital in South Angola

    Directory of Open Access Journals (Sweden)

    Feliciano Chanana Paquissi

    2016-01-01

    Full Text Available Background. Peripheral arterial disease (PAD is a common manifestation of atherosclerosis, whose prevalence is increasing worldwide, and is associated with all-cause mortality. However, no study has assessed this disease in Huambo. The aim of this study was to evaluate the prevalence of PAD in patients attending an outpatient clinic at a general hospital in Huambo, South Angola. Methods. A cross-sectional study, including 115 patients aged 40 years and older attending an outpatient service. The evaluation included a basic questionnaire for lifestyle and medical history and ankle-brachial index (ABI measurement using hand-held Doppler. PAD was defined as an ABI ≤0.9 in either lower limb. Results. Of 115 patients, 62.60% were women with a median age of 52.5 (range of 40 to 91 years. The prevalence of PAD was 42.6% (95% confidence intervals [CI]: 95%: 33.91–52.17%. Among patients with PAD, 95.92% had mild disease and 4.08% moderate to severe disease. The main risk factor for PAD was age (≥60 years (χ2=3.917, P≤0.05. The prevalence was slightly higher in men and hypertensive subjects, but without statistical significance with ORs of 1.5 (95% CI: 0.69–3.21 and 1.42 (95% CI: 0.64–3.17, respectively. Hypertension was also high in the group (66.95%. Conclusion. The prevalence of PAD was 42.6%, higher in those aged 60 years and older. More studies, with representative samples, are necessary to clarify PAD prevalence and associated risk factors.

  13. Prevalence of Peripheral Arterial Disease among Adult Patients Attending Outpatient Clinic at a General Hospital in South Angola

    Science.gov (United States)

    Paquissi, Feliciano Chanana; Cuvinje, Arminda Bimbi Paquissi; Cuvinje, Almeida Bailundo

    2016-01-01

    Background. Peripheral arterial disease (PAD) is a common manifestation of atherosclerosis, whose prevalence is increasing worldwide, and is associated with all-cause mortality. However, no study has assessed this disease in Huambo. The aim of this study was to evaluate the prevalence of PAD in patients attending an outpatient clinic at a general hospital in Huambo, South Angola. Methods. A cross-sectional study, including 115 patients aged 40 years and older attending an outpatient service. The evaluation included a basic questionnaire for lifestyle and medical history and ankle-brachial index (ABI) measurement using hand-held Doppler. PAD was defined as an ABI ≤0.9 in either lower limb. Results. Of 115 patients, 62.60% were women with a median age of 52.5 (range of 40 to 91) years. The prevalence of PAD was 42.6% (95% confidence intervals [CI]: 95%: 33.91–52.17%). Among patients with PAD, 95.92% had mild disease and 4.08% moderate to severe disease. The main risk factor for PAD was age (≥60 years) (χ2 = 3.917, P ≤ 0.05). The prevalence was slightly higher in men and hypertensive subjects, but without statistical significance with ORs of 1.5 (95% CI: 0.69–3.21) and 1.42 (95% CI: 0.64–3.17), respectively. Hypertension was also high in the group (66.95%). Conclusion. The prevalence of PAD was 42.6%, higher in those aged 60 years and older. More studies, with representative samples, are necessary to clarify PAD prevalence and associated risk factors. PMID:27293966

  14. The uptake of influenza and pneumococcal vaccination among immunocompromised patients attending rheumatology outpatient clinics.

    LENUS (Irish Health Repository)

    Haroon, Muhammad

    2011-07-01

    PURPOSE AND OBJECTIVES: The patients using immunosuppressive agents are considered at high risk for acquiring different infections. Accordingly, international guidelines recommend vaccinating such patients against influenza and pneumococcal organisms. The aims of this study were two-fold: (1) to assess the influenza and pneumococcal vaccination uptake among our rheumatology outpatients who are immunosuppressed; (2) to identify the factors influencing immunisation uptake among our sample of patients.

  15. An indirect haemagglutination test for demonstration of gonococcal antibodies using gonococcal pili as antigen. II. Serological investigation of patients attending a dermato-venereological outpatients clinic in Copenhagen

    DEFF Research Database (Denmark)

    Reimann, K; Lind, I; Andersen, Klaus Ejner

    1980-01-01

    A total of 1223 serum specimens were obtained from 649 consecutive patients attending a dermatovenereological out-patient clinic in Copenhagen with a request for venereal disease control. The sera were examined for gonococcal antibodies by both a gonococcal complement fixation test (GCF) and an i...

  16. Predictive indices of empirical clinical diagnosis of malaria among under-five febrile children attending paediatric outpatient clinic

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    Hassan A Elechi

    2015-01-01

    Full Text Available Background: Malaria has remained an important public health problem in Nigeria with children under 5 years of age bearing the greatest burden. Accurate and prompt diagnosis of malaria is an important element in the fight against the scourge. Due to the several limitations of microscopy, diagnosis of malaria has continued to be made based on clinical ground against several World Health Organization (WHO recommendations. Thus, we aim to assess the performance of empirical clinical diagnosis among febrile children under 5 years of age in a busy pediatric outpatient clinic. Materials and Methods: The study was a cross-sectional study. Children aged <5 years with fever or 72 h history of fever were recruited. Children on antimalarial prophylaxis or on treatment for malaria were excluded. Relevant information was obtained from the caregiver and clinical note of the child using interviewer administered questionnaire. Two thick and two thin films were made, stained, and read for each recruited child. Data was analysed using SPSS version 16. Results: Of the 433 children studied, 98 (22.6% were empirically diagnosed as having malaria and antimalarial drug prescribed. Twenty-three (23.5% of these children were confirmed by microscopy to have malaria parasitemia, while 75 (76.5% were negative for malaria parasitemia. Empirical clinical diagnosis show poor predictive indices with sensitivity of 19.2%, specificity of 76.0%, positive predictive value of 23.5% and negative predictive value of 71%. Conclusion and Recommendations: Empirical clinical diagnosis of malaria among the under-five children with symptoms suggestive of acute malaria is highly not reliable and hence the need to strengthen parasitological diagnosis.

  17. Clinical utility of PKD2 mutation testing in a polycystic kidney disease cohort attending a specialist nephrology out-patient clinic

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    Robinson Caroline

    2012-08-01

    Full Text Available Abstract Background ADPKD affects approximately 1:1000 of the worldwide population. It is caused by mutations in two genes, PKD1 and PKD2. Although allelic variation has some influence on disease severity, genic effects are strong, with PKD2 mutations predicting later onset of ESRF by up to 20 years. We therefore screened a cohort of ADPKD patients attending a nephrology out-patient clinic for PKD2 mutations, to identify factors that can be used to offer targeted gene testing and to provide patients with improved prognostic information. Methods 142 consecutive individuals presenting to a hospital nephrology out-patient service with a diagnosis of ADPKD and CKD stage 4 or less were screened for mutations in PKD2, following clinical evaluation and provision of a detailed family history (FH. Results PKD2 mutations were identified in one fifth of cases. 12% of non-PKD2 patients progressed to ESRF during this study whilst none with a PKD2 mutation did (median 38.5 months of follow-up, range 16–88 months, p PKD2 vs. PKD2, 54 yrs vs. 65 yrs; p PKD2 mutations were identified in patients with a FH of ESRF occurring before age 50 yrs, whereas a PKD2 mutation was predicted by a positive FH without ESRF. Conclusions PKD2 testing has a clinically significant detection rate in the pre-ESRF population. It did not accurately distinguish those individuals with milder renal disease defined by stage of CKD but did identify a group less likely to progress to ESRF. When used with detailed FH, it offers useful prognostic information for individuals and their families. It can therefore be offered to all but those whose relatives have developed ESRF before age 50.

  18. Sociodemographic characteristics and frequency of psychiatric disorders in Turkish pilgrims attended to psychiatry outpatient clinics during Hajj

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    Şakir Özen

    2010-03-01

    Full Text Available Objectives: The psychiatric problems of pilgrims fromnon-Arabic speaking countries have not been investigatedsufficiently. The aim of this study was to investigate thefrequency of psychiatric disorders and socio-demographiccharacteristics of Turkish pilgrims in psychiatry departmentof Turkish Mecca Hospital.Methods: A detailed psychiatric interview was performedon 294 Turkish Pilgrims who attended the outpatient clinicof the psychiatric unit at the Turkish hospital in Mecca,Saudi Arabia, during 2008 Hajj period. Information wascollected by using a semi-structured form and the patients’diagnoses were done according to the DSM-IV-TRcriteria.Results: The study group consisted of 175 women (59.5% and 119 men (40.5 % with the mean age of 53.0±13years. A total of 71 % patients had not traveled abroadpreviously, and 60% had received a former psychiatrictreatment. The commonest disorders were found asdepression (26.5%, adjustment disorder with anxiety(16.3% and panic disorder (14% in the patients. Anxietydisorders alone or co-morbid with any other psychiatricdisorder were found in 49% of the patients. Nine percentof the patients had symptoms of acute psychosis, schizophrenia,dementia or mania which could prevent pilgrimsfrom performing Hajj rituals. Suicide attempt, alcohol andillicit drug use were not detected.Conclusions: Previous psychiatric admission and absenceof any foreign travel experience were commonamong Turkish pilgrims who had sought psychiatric helpduring the Hajj. Psychiatric disorders seems to be relatedwith older age, low educational level, and having previousmedical and psychiatric problems.

  19. Prevalence, correlates, attitude and treatment seeking of erectile dysfunction among type 2 diabetic Chinese men attending primary care outpatient clinics

    Institute of Scientific and Technical Information of China (English)

    Wai Hon Lo; Sau Nga Fu; Carlos King Ho Wong; Ee San Chen

    2014-01-01

    To investigate the prevalence, correlates, attitude and treatment seeking behavior of erectile dysfunction(ED) in type2 diabetes mellitus (T2DM) patients in the primary care setting, a multi‑center cross‑sectional survey using a structured anonymous self‑administered questionnaire was performed in 10 general outpatient clinics. Of the 603 subjects(91% response rate), the prevalence of ED men, as deifned by the International Index of Erectile Function, was 79.1%. Most subjects had mild ED(28.9%), followed by mild‑to‑moderate ED(27.9%), then moderate ED(13.4%) and severe ED(9%). Nearly 55% of those with ED did not consider themselves as having ED. Less than 10% of them had ever sought medical treatment, although 76.1% of them wished to receive management from doctor(s) should they be diagnosed with ED. They considered the most important management from doctors to be clinical assessment(41.7%), followed by management of potential underlying cause(37.8%), referral to specialist(27.5%), education(23.9%), prescription of phosphodiesterase type5 inhibitors(16.9%) and referral to counseling service(6.7%). The prevalence of ED was strongly associated with subjects who thought they had ED(odds ratio(OR)= 90.49(20.00–409.48, P<0.001)) and were from the older age group(OR=1.043(1.011–1.076,P=0.008)). In conclusion, ED is highly prevalent among T2DM men. The majority of them wanted management from doctors should they have ED, but only a minority would actually voice out the request. Screening of ED among T2DM men using structural questionnaire allowed the diagnosis of more than half of the ED cases, which otherwise would have gone undiagnosed.

  20. Prevalence and type of drug-drug interactions involving antiretrovirals in patients attending a specialist outpatient clinic in Kampala, Uganda

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    K Seden

    2012-11-01

    Full Text Available Scale-up of HIV services in countries such as Uganda has resulted in a rapid increase in facilities offering antiretrovirals (ARVs and an increase in healthcare workers trained to deliver care. Consequently, evaluating medication safety is increasingly important in these settings. Data from developed countries suggest that drug-drug interactions (DDIs involving ARVs are common, occurring at rates of 14–58%. Few data are available from low resource settings, however a study of 996 Kenyan patients found that 33.5% were at risk of clinically significant DDIs. We evaluated the prevalence and type of ARV DDIs and the patients most at risk in an African outpatient setting. A random sample of patients taking current ARVs and accessing care at the Infectious Diseases Institute, Makerere University, Kampala was selected from the clinic database. The most recent prescription for each patient was screened for DDIs using www.hiv-druginteractions.org. Clinical significance of DDIs was assessed by two of us using a previously developed technique evaluating: likelihood of interaction, therapeutic index of affected drug and severity of potential adverse effect. From 1000 consecutive patients 99.6% were taking≥1 co-medication alongside their ARV regimen (mean 1.89. 24.5% had≥1 potential DDI, with a total of 335 DDIs observed. Of these, 255 DDIs were considered clinically significant, affecting 18.8% of patients. Only 0.3% of DDIs involved a contraindicated combination. There was a higher rate of potential DDIs observed in patients taking TB treatment (p=0.0047, who were WHO stage 3 or 4 (p=0.001, or patients taking ≥2 co-medications alongside ARVs (p<0.0001 (Fishers exact test. Patient age, gender, CD4 count and weight did not affect risk for DDIs. Co-medications commonly associated with potential DDIs were antibiotics (6.2% of 1000 patients, anthelminthics (4.6% and antifungals (3.5%. Potential DDIs involving ARVs occur at similar rates in resource

  1. Cost-effectiveness study of oral hypoglycemic agents in the treatment of outpatients with type 2 diabetes attending a public primary care clinic in Mexico City

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    Cárdenas-Elizalde MR

    2012-03-01

    Full Text Available Christian Díaz de León-Castañeda, Marina Altagracia-Martínez, Jaime Kravzov-Jinich, Ma del Rosario Cárdenas-Elizalde, Consuelo Moreno-Bonett, Juan Manuel Martínez-NúñezDepartment of Biological Systems and Health Care, Biological and Health Sciences Division, Universidad Autónoma Metropolitana-Xochimilco, Mexico DF, MexicoIntroduction: Worldwide, diabetes mellitus presents a high burden for individuals and society. In Latin America, many people with diabetes have limited access to health care, which means that indirect costs may exceed direct health care cost. Diabetes is Mexico's leading cause of death.Purpose: To evaluate the cost-effectiveness ratios of the most used oral hypoglycemic agents (OHA in the treatment of outpatients with type 2 diabetes attending a public primary care clinic in Mexico City.Design: A cross-sectional and analytic study was conducted in Mexico City.Methodology: Twenty-seven adult outpatients with type 2 diabetes who were treated either with metformin or glibenclamide were included. Acarbose was used as an alternative strategy. The study was carried out from the perspective of Mexican society. Direct medical and nonmedical costs as well as indirect costs were evaluated using a structured questionnaire. Efficacies of all drug treatments were evaluated retrospectively. A systematic search was conducted to select published randomized clinical trials based on predetermined inclusion criteria, and treatment success was defined as glycosylated hemoglobin factor ≤ 7%. Efficacy data of each drug and/or combination were analyzed using meta-analysis. The Monte Carlo Markov model was used. Quality-adjusted life-years (QALY were used as the unit of effectiveness; incremental and sensitive analyses were performed and a 5% discount rate was calculated. A hypothetical cohort of 10,000 patients was modeled.Results: The odds ratios of the success of each drug treatment were obtained from the meta-analyses, and were the

  2. Cost-effectiveness study of oral hypoglycemic agents in the treatment of outpatients with type 2 diabetes attending a public primary care clinic in Mexico City

    Science.gov (United States)

    de León-Castañeda, Christian Díaz; Altagracia-Martínez, Marina; Kravzov-Jinich, Jaime; Cárdenas-Elizalde, Ma del Rosario; Moreno-Bonett, Consuelo; Martínez-Núñez, Juan Manuel

    2012-01-01

    Introduction Worldwide, diabetes mellitus presents a high burden for individuals and society. In Latin America, many people with diabetes have limited access to health care, which means that indirect costs may exceed direct health care cost. Diabetes is Mexico’s leading cause of death. Purpose To evaluate the cost-effectiveness ratios of the most used oral hypoglycemic agents (OHA) in the treatment of outpatients with type 2 diabetes attending a public primary care clinic in Mexico City. Design A cross-sectional and analytic study was conducted in Mexico City. Methodology Twenty-seven adult outpatients with type 2 diabetes who were treated either with metformin or glibenclamide were included. Acarbose was used as an alternative strategy. The study was carried out from the perspective of Mexican society. Direct medical and nonmedical costs as well as indirect costs were evaluated using a structured questionnaire. Efficacies of all drug treatments were evaluated retrospectively. A systematic search was conducted to select published randomized clinical trials based on predetermined inclusion criteria, and treatment success was defined as glycosylated hemoglobin factor ≤ 7%. Efficacy data of each drug and/or combination were analyzed using meta-analysis. The Monte Carlo Markov model was used. Quality-adjusted life-years (QALY) were used as the unit of effectiveness; incremental and sensitive analyses were performed and a 5% discount rate was calculated. A hypothetical cohort of 10,000 patients was modeled. Results The odds ratios of the success of each drug treatment were obtained from the meta-analyses, and were the following: 5.82 (glibenclamide), 3.86 (metformin), 3.5 (acarbose), and 6.76 (metformin–glibenclamide). The cost-effectiveness ratios found were US$272.63/QALY (glibenclamide), US$296.48/QALY (metformin), and US$409.86/QALY (acarbose). Sensitivity analysis did not show changes for the most cost-effective therapy when the effectiveness probabilities or

  3. Peripheral arterial disease among adult diabetic patients attending a large outpatient diabetic clinic at a national referral hospital in Uganda: a descriptive cross sectional study.

    Directory of Open Access Journals (Sweden)

    Raymond Mbayo Mwebaze

    Full Text Available BACKGROUND: Peripheral arterial disease (PAD is one of the recognised diabetic macro vascular complications. It is a marker of generalised systemic atherosclerosis and is closely associated with symptomatic coronary and cerebrovascular disease, hence significant morbidity and mortality. Among African adult diabetic populations, screening and diagnosis of PAD is frequently suboptimal. The aim of this study was to determine the prevalence and associated clinical factors of PAD in adult ambulatory diabetic patients attending the outpatient diabetic clinic of Mulago national referral and teaching hospital, Kampala Uganda. METHODS: In this descriptive cross sectional study, 146 ambulatory adult diabetic patients were studied. Information about their socio-demographic and clinical characteristics, fasting lipid profile status, blood pressure, glycated haemoglobin (HbA1c levels and presence of albuminuria was collected using a pre tested questionnaire. Measurement of ankle brachial index (ABI to assess for PAD, defined as a ratio less than 0.9 was performed using a portable 5-10 MHz Doppler device. Clinical factors associated with PAD were determined by comparing specific selected characteristics in patients with PAD and those without. RESULTS: The mean age/standard deviation of the study participants was 53.9/12.4 years with a male predominance (75, 51.4%. PAD was prevalent in 57 (39% study participants. Of these, 34 (59.6% had symptomatic PAD. The noted clinical factors associated with PAD in this study population were presence of symptoms of intermittent claudication and microalbuminuria. CONCLUSIONS: This study documents a high prevalence of PAD among adult ambulatory Ugandan diabetic patients. Aggressive screening for PAD using ABI measurement in adult diabetic patients should be emphasised in Uganda especially in the presence of symptoms of intermittent claudication and microalbuminuria.

  4. Factors predicting suicidal ideation in the preceding 12 months among patients attending a community psychiatric outpatient clinic.

    LENUS (Irish Health Repository)

    Anyansi, Tochukwu E

    2013-06-01

    Predictive factors are used to alert the clinician to the necessity of carrying out a suicide risk assessment in those patients whose demographic and clinical characteristics suggest the possibility of suicide.

  5. Monitor Preference for Electronic Medical Record in Outpatient Clinic

    OpenAIRE

    Lee, Kee-Hyuck; Bae, Woo Kyung; Han, Jong Soo; Yoo, Sooyoung; Kim, Jon Soo; Yun, Jonghoar; Baek, Hyun Young; Baek, Rong-Min; Hwang, Hee

    2012-01-01

    Objectives The objective of this paper is to assess which wide type monitor configurations are preferred when physicians use an Electronic Medical Record (EMR) system in an outpatient clinic setting. Methods We selected three kinds of monitor configurations available for adoption at outpatient clinics with reference to monitor market trends. Fifteen attending physicians of the Seoul National University Bundang Hospital used each monitor configuration in their outpatient clinics. After complet...

  6. Prevalence and type of drug–drug interactions involving ART in patients attending a specialist HIV outpatient clinic in Kampala, Uganda

    Science.gov (United States)

    Seden, K.; Merry, C.; Hewson, R.; Siccardi, M.; Lamorde, M.; Byakika-Kibwika, P.; Laker, E.; Parkes-Ratanshi, R.; Back, D. J.; Khoo, S. H.

    2015-01-01

    Objectives Scale-up of HIV services in sub-Saharan Africa has rapidly increased, necessitating evaluation of medication safety in these settings. Drug–drug interactions (DDIs) involving antiretrovirals (ARVs) in sub-Saharan Africa are poorly characterized. We evaluated the prevalence and type of ARV DDIs in Ugandan outpatients and identified the patients most at risk. Methods A total of 2000 consecutive patients receiving ARVs at the Infectious Diseases Institute, Kampala were studied. The most recent prescription for each patient was screened for clinically significant DDIs using www.hiv-druginteractions.org. Univariable and multivariable logistic regression were used to identify risk factors for DDIs. A screening tool was developed using significant risk factors and tested in a further 500 patients. Results Clinically significant DDIs were observed in 374 (18.7%) patients, with a total of 514 DDIs observed. Only 0.2% of DDIs involved a contraindicated combination. Comedications commonly associated with DDIs were antibiotics (4.8% of 2000 patients), anthelmintics (2.2%) and antifungals (3.5%). Patient age, gender, CD4 count and weight did not affect risk of DDIs. In multivariable analysis, the patient factors that independently increased risk of DDIs were two or more comedications (P < 0.0001), a PI-containing ARV regimen (P < 0.0001), use of an anti-infective (P < 0.0001) and WHO clinical stage 3–4 (P = 0.04). A scoring system based on having at least two of these risk factors identified between 75% and 90% of DDIs in a validation cohort. Conclusions Significant ARV DDIs occur at similar rates in resource-limited settings and developed countries; however, the comedications frequently causing DDIs differ. Development of tools that are relevant to particular settings should be a priority to assist with prevention and management of DDIs. PMID:26286575

  7. Challenges of caring for children with mental disorders: Experiences and views of caregivers attending the outpatient clinic at Muhimbili National Hospital, Dar es Salaam - Tanzania

    Directory of Open Access Journals (Sweden)

    Ambikile Joel

    2012-07-01

    Full Text Available Abstract Background It is estimated that world-wide up to 20 % of children suffer from debilitating mental illness. Mental disorders that pose a significant concern include learning disorders, hyperkinetic disorders (ADHD, depression, psychosis, pervasive development disorders, attachment disorders, anxiety disorders, conduct disorder, substance abuse and eating disorders. Living with such children can be very stressful for caregivers in the family. Therefore, determination of challenges of living with these children is important in the process of finding ways to help or support caregivers to provide proper care for their children. The purpose of this study was to explore the psychological and emotional, social, and economic challenges that parents or guardians experience when caring for mentally ill children and what they do to address or deal with them. Methodology A qualitative study design using in-depth interviews and focus group discussions was applied. The study was conducted at the psychiatric unit of Muhimbili National Hospital in Tanzania. Two focus groups discussions (FGDs and 8 in-depth interviews were conducted with caregivers who attended the psychiatric clinic with their children. Data analysis was done using content analysis. Results The study revealed psychological and emotional, social, and economic challenges caregivers endure while living with mentally ill children. Psychological and emotional challenges included being stressed by caring tasks and having worries about the present and future life of their children. They had feelings of sadness, and inner pain or bitterness due to the disturbing behaviour of the children. They also experienced some communication problems with their children due to their inability to talk. Social challenges were inadequate social services for their children, stigma, burden of caring task, lack of public awareness of mental illness, lack of social support, and problems with social life. The

  8. Out-patient management and non-attendance in the current economic climate. How best to manage our resources?

    LENUS (Irish Health Repository)

    Hennessy, D

    2010-03-01

    Outpatient non-attendance is a considerable source of inefficiency in the health service, wasting time, resources and potentially lengthening waiting lists, Given the current economic climate, methods need to be employed to reduce non-attendance. The aim was to analyse outpatient non-attendance and determine what factors influence attendance. A prospective audit over a two-month period to a tertiary-referral Urological service was performed to determine the clinical and demographic profile of non-attendees. Of 737 appointments, 148 (20%) patients did not attend (DNA). A benign urological condition was evident in 116 cases (78%). This group of patients also accounted for the majority of new patients not attending 40\\/47, returning patients not attending 101\\/148 and the majority of patients who missed multiple appointments 43\\/49. Patients with benign conditions make up the majority of clinic non-attendance. Consideration may be given to discharging such patients back to their general practitioner after one unexplained non-attendance until other alternatives of follow up are available.

  9. Suicidal behaviour among alcohol-dependent Danes attending outpatient treatment

    DEFF Research Database (Denmark)

    Bjørk Petersen, Christina; Grønbæk, Morten; Bussey Rask, Marie;

    2009-01-01

    The association between alcohol dependence and suicidal behaviour is well established and patients with suicidal behaviour in treatment for alcohol dependence present a considerable challenge for clinical services. The aim of this study is to identify risk factors for suicide attempts...... and to evaluate the outcome of treatment in patients in treatment for alcohol dependence. Semi-structured, detailed interviews were administered at baseline and at three sequential follow-up interviews with a large sample of 1692 patients at an outpatient treatment centre in the county of Funen in Denmark....... Characteristics of, predictors for and outcome among suicidal patients were studied. Alcohol-dependent patients with a history of suicide attempts were found to constitute a highly selected group in alcohol abuse treatment as they often had a more severe course of alcohol dependence, were unemployed, younger...

  10. Factors affecting poor attendance for outpatient physiotherapy by patients discharged from Mthatha General Hospital with a stroke

    Directory of Open Access Journals (Sweden)

    N.P. Ntamo

    2013-12-01

    Full Text Available Background: Stroke is a major cause of disability inthe world and its long term effects require adherence to physiotherapyprotocols for optimal rehabilitation. Clinical impression of data fromMthatha General Hospital (MGH Physiotherapy Department revealedthat there was poor attendance of outpatient physiotherapy by strokepatients discharged from MGH and this had negative effects on outcomesand health care costs.Objective: To determine the extent and the socio-demographic reasonsfor poor attendance for outpatient physiotherapy by stroke patients.Methods: An observational descriptive study was conducted using arandomly selected sample of 103 stroke patients from a population of 139who attended physiotherapy in MGH in 2007. Structured interviews wereconducted and SPSS was used for data analysis.Results: The majority (86% of patients did not attend physiotherapy until discharge from the Physiotherapy Department. Themajor reasons for poor attendance were lack of finances (95%, migration to other areas (36%, and living a long distance fromMGH (38%.Conclusion: Almost 9 out of 10 stroke patients fail to attend for outpatient physiotherapy because of lack of finances.Recommendation: Development of a Provincial Rehabilitation Policy with specific reference to decentralization of rehabilitationservices to address unavailability of physiotherapy services at clinics and health care centers which are proximal to the patients’residential areas is recommended.

  11. Viral and atypical bacterial infections in the outpatient pediatric cystic fibrosis clinic

    DEFF Research Database (Denmark)

    Olesen, Hanne Vebert; Nielsen, Lars P; Schiotz, Peter Oluf

    2006-01-01

    BACKGROUND: Respiratory viral and atypical bacterial infections are associated with pulmonary exacerbations and hospitalisations in cystic fibrosis patients. We wanted to study the impact of such infections on children attending the outpatient clinic. METHODS: Seventy-five children were followed...

  12. Personality disorders among Danish alcoholics attending outpatient treatment

    DEFF Research Database (Denmark)

    Nordholm, Dorte; Nielsen, Bent

    2007-01-01

    The aim of the present study was firstly to describe the characteristics of alcoholic outpatients (A) suffering from co-morbid personality disorder (PD) of either the cluster B (A+PDB) or cluster C (A+PDC) type. Secondly, to investigate the effect of various kinds of treatment to be able to single...

  13. Avaliação cognitiva breve de pacientes atendidos em ambulatórios de neurologia geral Brief cognitive evaluation of patients attended in a general neurological outpatient clinic

    Directory of Open Access Journals (Sweden)

    Ana Paula P. Vitiello

    2007-06-01

    Full Text Available INTRODUÇÃO: O exame das funções cognitivas é habitual na avaliação das demências, porém não é usualmente realizado em pacientes com outras doenças neurológicas. OBJETIVO: Investigar a relevância da semiologia cognitiva sistemática em pacientes com doenças neurológicas diversas. MÉTODO: Foram avaliados 105 pacientes consecutivamente atendidos no período de um ano em ambulatório de neurologia geral de hospital universitário público, sem queixas de alterações cognitivas. Os pacientes foram submetidos aos seguintes testes cognitivos: mini-exame do estado mental (MEEM, extensão de dígitos, testes de memória de figuras, fluência verbal e desenho do relógio. Sempre que possível as notas de corte foram corrigidas em função da escolaridade. RESULTADOS: Cerca de 2/3 dos pacientes apresentaram alterações do desempenho em pelo menos um teste. O MEEM mostrou-se alterado em 20% dos pacientes, o teste da extensão de dígitos apresentou alteração em 50,4% (29,5% na ordem direta e 20,9% na indireta. A evocação tardia esteve alterada em 14,2% dos casos, a fluência verbal esteve abaixo da nota de corte em 27,6% dos pacientes e o desenho do relógio, em 40,0%. CONCLUSÃO: Os dados obtidos comprovam a necessidade da inclusão da avaliação cognitiva como parte obrigatória do exame neurológico, mesmo em pacientes sem queixas relacionadas.INTRODUCTION: Cognitive evaluation is usually performed in the assessment of patients with suspected dementia, but is not generally performed in patients with other neurological diseases. OBJECTIVE: To investigate the relevance of a systematic cognitive examination in patients with different neurological conditions. METHOD: One-hundred and five patients consecutively attended over a one-year period in a general Neurology outpatient clinic from a public-affiliated hospital, with no complaints of cognitive changes, were submitted to the following cognitive tests: Mini-Mental State Examination

  14. Urinary antibiotic activity in paediatric patients attending an outpatient department in north-western Cambodia

    OpenAIRE

    Emary, KR; Carter, MJ; Pol, S; Sona, S; V. Kumar; Day, NP; Parry, CM; Moore, CE

    2014-01-01

    Objective Antibiotic resistance is a prominent public and global health concern. We investigated antibiotic use in children by determining the proportion of unselected children with antibacterial activity in their urine attending a paediatric outpatient department in Siem Reap, Cambodia. Methods Caregiver reports of medication history and presence of possible infection symptoms were collected in addition to urine samples. Urine antibiotic activity was estimated by exposing bacteria to urine s...

  15. An investigation into why patients do not attend for out-patient radiology appointments

    International Nuclear Information System (INIS)

    Introduction: Patients who do not attend (DNA) for out-patient hospital appointments cause delays in the diagnosis and subsequent treatment of their own, and other patient's, illnesses, with potentially hazardous consequences. This also impacts upon waiting lists. Failure to attend is viewed as a specific type of non-compliance and social cognition theories have been applied to previous studies in an attempt to uncover the reasons why patients choose not to keep their appointments. Methods: A case-control study was conducted throughout the X-ray departments of a District General type of NHS Trust, using telephone interview questionnaires based on the Health Belief Model, in an attempt to identify any significant differences between attenders and non-attenders, so that likely non-attenders could be targeted. Results: Principal reasons for non-attendance were that the patient forgot or that they did not receive their appointment. The results differed from previous research, in that specific health beliefs were not the primary reasons for non-attendance. Departments that gave patients the opportunity to arrange their appointments for a mutually convenient time had exceptionally low DNA rates, as did those which had rigorous confirmation systems in place

  16. Eye donation – Awareness and willingness among attendants of patients at various clinics in Melaka, Malaysia

    OpenAIRE

    Bhandary Sulatha; Khanna Rajesh; Rao Krishna; Rao Lavanya; Lingam Kamala; Binu V

    2011-01-01

    Aim: Corneal blindness accounts for 3.42% of blindness in Malaysia; the rate of eye donation is low. The aim of the study was to assess the awareness about eye donation and willingness to donate eyes among attendants of patients at various clinics in Melaka, Malaysia. Materials and Methods: This observational study was conducted on attendants who accompanied patients (n = 400) visiting various outpatient departments of the General Hospital and two peripheral clinics in Melaka between A...

  17. Pure analgesics in a rheumatological outpatient clinic

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    M.A. Cimmino

    2011-09-01

    Full Text Available Objective: Pure analgesics are only rarely used by Italian clinicians and this holds true also for rheumatologists. This work is concerned with an evaluation of the use of analgesics in a rheumatological outpatient clinic during the period 1989-1999. Methods: The records of 1705 patients consecutively seen at the clinic were downloaded on a specifically built website. Results: 4469 visits were considered. In 260 of them (5.8%, analgesics were prescribed to 234 (13.7% patients. The number of patients with a prescription of analgesics steadily increased during the years 1989-1999. The diagnoses in patients assuming analgesics were: osteoarthritis (47.1%, inflammatory arthritis (24.2%, soft tissue rheumatisms (13.7%, nonspecific arthralgia/myalgia (7.5%, and connective tissue diseases (2.6%. Peripheral analgesics were used in 188 (82.5% patients and central analgesics were used in the remaining 40 patients (17.5%. Analgesic drugs were used mainly in degenerative joint conditions. The indications for analgesics in the 55 patients with inflammatory arthrits were: (a partial or total remission of arthritis; for this reason non-steroidal anti-inflammatory drugs were no longer required in 18 patients; (b to increase the analgesic effect of NSAIDs in 23 patients; (c contraindications to NSAIDs in 14 patients (renal failure in 2 patients, gastritis in 10, allergy and bleeding in the remaining two. Conclusions: About 14% of our outpatients were treated with analgesics with an increasing trend in the examined period. The main indications for analgesics are degenerative conditions but they can be used also in selected patients with arthritis.

  18. Eating behavior and body image perception of pregnant women attending a high-risk outpatient center

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    Raquel Guimarães Nobre

    2014-06-01

    Full Text Available Objective: To investigate the eating behavior and body image perception in pregnant women attending a high-risk outpatient center. Methods: A quantitative, cross-sectional, observational study conducted with 28 overweight pregnant women attending the first consultation in the nutrition outpatient center of a maternity hospital in Fortaleza-CE, from December 2010 to February 2011. It has been used a pre-established form containing data on the characterization of the sample (socioeconomic, obstetric, and nutritional, the BES (Binge Eating Scale to assess binge eating and BSQ (Body Shape Questionnaire to assess the severity or absence of body image disorder. The variables were presented as mean ± standard deviation and simple frequency and percentage. The Pearson’s correlation was used to verify the relation between body image and binge eating, considering p <0.05. Results: The pregnant women studied had a mean age of 29.4 ± 6.3 years and mean gestational age of 24.6 ± 8.2 weeks. It was found a prevalence of 71.5% (n=20 of body image disorder and 17.8% (n=5 of binge eating. It was also observed a direct and significant correlation between the body image perception and the degree of binge eating (r=0.4358, p=0.020. Conclusion: The high rate of body image disorder positively related to a significant binge eating indicates an unfavorable adjustment of this group of pregnant women to alterations in weight and body shape and size, which are inherent to pregnancy, standing out as group that needs special attention by the professional team. doi:10.5020/18061230.2014.p256

  19. Anticoagulation control in atrial fibrillation patients present to outpatient clinic of cardiology versus anticoagulant clinics

    Institute of Scientific and Technical Information of China (English)

    DU Xin; MA Chang-sheng; LIU Xiao-hui; DONG Jian-zeng; WANG Jun-nan; CHENG Xiao-jing

    2005-01-01

    @@ Nonvalvular atrial fibrillation (NVAF) is the most common sustained cardiac arrhythmia in clinical practice, which if untreated results in a doubling of cardiovascular morbidity and mortality. AF is an independent predictor of stroke, with an annual risk 5 to 6 times higher than patients in sinus rhythm.1 During recent years, several randomised clinical trials conducted by investigators around the world involving 13 843 participants with NVAF have demonstrated convincingly the value of warfarin therapies for stroke prevention in high risk patients.2-8 However, the dose response of warfarin is complex and its activity is easily altered by concurrent medications, food interactions, alcohol and illnesses. Adherence to medical advice and routine monitoring of the international normalized ratio (INR) is important, because low anticoagulant intensity predisposes the patients to thromboembolic complications and high intensity to haemorrhage. Studies suggested that anticoagulant clinics could improve the quality of anticoagulation control,9 and anticoagulant clinics are common in western countries. However, in China, most AF patients taking warfarin usually attend the outpatient clinic of cardiology, while the quality of anticoagulation control is never investigated. We therefore assessed anticoagulation control in the outpatient clinic of cardiology, and the quality of anticoagulation control since the establishment of anticoagulant clinics.

  20. THE HIGH DIAGNOSTIC YIELD OF A GERIATRIC OUTPATIENT CLINIC

    OpenAIRE

    Moret F.

    2012-01-01

    Objectives: To determine characteristics of older patients referred to a geriatric outpatient clinic; 2) to determine the prevalence of geriatric syndromes in this population; 3) to identify main recommendations made to referring primary care physicians. Design: Cross-sectional analysis Setting: Outpatient clinic of the service of geriatric medicine at the University of Lausanne Medical Center, Lausanne, Switzerland. Participants: Community-dwelling patients aged 65 and over referred to the c...

  1. Diversifying Residents' Outpatient Psychiatry Experience: A Contemporary Model for Academic Outpatient Psychiatry Clinics

    OpenAIRE

    Huh, John; Goebert, Deborah A

    2010-01-01

    A diversified, outpatient experience is an important part of psychiatric training, yet challenging to attain. We describe a multiple, subspecialty psychiatry clinic model for 3rd year psychiatry residents. Evaluation findings based on its initial implementation indicated improved resident supervision, better therapeutic alliance and an overall increase in satisfaction. This model facilitates resident exposure to diverse patients and treatment modalities as well as faculty development of exper...

  2. Morbidity profile of elderly outpatients attending selected sub-district Siddha health facilities in Tamil Nadu, India

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    Kalaiselvi Selvaraj

    2016-01-01

    Conclusion: Elderly constitute more than one fourth of outpatients load from siddha health facilities. Degenerative diseases like arthritis and non-communicable diseases were the common morbidities in this age group. Geriatric clinics and mobile clinics under siddha system may help in improving health care services.

  3. Effectiveness of Child Psychoanalytic Psychotherapy in a Clinical Outpatient Setting

    Science.gov (United States)

    Deakin, Elisabeth Kuhn; Tiellet Nunes, Maria Lucia

    2009-01-01

    The objective of this study was to evaluate the outcome of child psychoanalytic psychotherapy in a clinical outpatient setting in a city in southern Brazil. Three psychological tests (Rorschach, Bender and WISC III) were administered to 23 children, aged 6-11 years old, and the Child Behaviour Check List (CBCL) was completed by the parents. All…

  4. Fatigue communication at the out-patient clinic of Rheumatology.

    NARCIS (Netherlands)

    Repping-Wuts, J.W.J.; Repping, T.; Riel, P.L.C.M. van; Achterberg, T. van

    2009-01-01

    OBJECTIVE: To describe nurse-patient and rheumatologist-patient interaction in fatigue communication at the rheumatology out-patient clinic. METHODS: Consultations of 20 rheumatoid arthritis (RA) patients with the nurse specialist and the rheumatologist were videotaped and analysed using the Medical

  5. Rheumatology outpatient nurse clinics: a valuable addition?

    NARCIS (Netherlands)

    Temmink, D.; Hutten, J.B.F.; Francke, A.L.; Rasker, J.J.; Huijer Abu-Saad, H.; Zee, J. van der

    2001-01-01

    Objectives: "Transmural rheumatology nurse clinics," where nursing care is provided under the joint responsibility of a home care organization and a hospital, were recently introduced into Dutch health care. This article gives insight into outcomes of the transmural rheumatology nurse clinics. Metho

  6. Outpatient diabetes clinical decision support: current status and future directions.

    Science.gov (United States)

    O'Connor, P J; Sperl-Hillen, J M; Fazio, C J; Averbeck, B M; Rank, B H; Margolis, K L

    2016-06-01

    Outpatient clinical decision support systems have had an inconsistent impact on key aspects of diabetes care. A principal barrier to success has been low use rates in many settings. Here, we identify key aspects of clinical decision support system design, content and implementation that are related to sustained high use rates and positive impacts on glucose, blood pressure and lipid management. Current diabetes clinical decision support systems may be improved by prioritizing care recommendations, improving communication of treatment-relevant information to patients, using such systems for care coordination and case management and integrating patient-reported information and data from remote devices into clinical decision algorithms and interfaces. PMID:27194173

  7. Impact of oral diseases on quality of life in subjects attending out-patient department of a dental hospital, India

    Directory of Open Access Journals (Sweden)

    N Saimadhavi

    2013-01-01

    Full Text Available Context: Currently there is a growing interest in oral health outcomes in how oral health affects quality of life. When oral health related quality of life measures are used alongside traditional clinical methods of measuring oral health status, a more comprehensive assessment of the impact of oral diseases on the several dimensions of subjective wellbeing becomes possible. In this context, we attempted to study the impact of oral diseases on quality of life, so as to address the patient′s needs in an appropriate way and thereby improving one′s quality of life. Aims: To evaluate the impact of different oral diseases on quality of life using a modified OHIP-14 questionnaire, so as to address the patient′s needs in an appropriate way and thereby improving one′s quality of life. Settings and Design: The study was carried out among 302 subjects, attending the outpatient department a dental hospital, India, for check up and treatment of their oral condition. Subjects aged above 20 years, who gave their consent for the study were included. Materials and Methods: The study sample was categorized in to two groups based upon the duration of the affecting disease - group 1 consisted of subjects suffering with chronic diseases and group 2 of subjects suffering with acute diseases. All the subjects were asked to fill up their responses in the given OHIP-14 questionnaires. The completed questionnaires were then collected and statistically analyzed. Statistical Analysis Used: To evaluate the role of age on QOL, age was divided in to 2 groups using median split procedure. For inter and intragroup comparisions, independent sample t test, anova followed by post hoc test and Chi-square tests were employed. Results: Chi square test revealed a moderately impaired quality of life among all the diseases investigated. On comparing the mean domain and total OHIP score between the two groups, the domain of psychological discomfort and disability and the total

  8. Adolescent Substance-Use Frequency following Self-Help Group Attendance and Outpatient Substance Abuse Treatment

    Science.gov (United States)

    Gangi, Jennifer; Darling, Carol A.

    2012-01-01

    Despite the heterogeneity of posttreatment outcomes, the likelihood of relapse is often dependent on several factors, including participation in continuing care services such as self-help groups. However, few studies have examined the use of self-help groups among adolescent outpatients. Therefore, in this study, investigators examined self-help…

  9. Use of complementary therapies by patients attending musculoskeletal clinics.

    OpenAIRE

    Chandola, A; Young, Y.; McAlister, J.; Axford, J S

    1999-01-01

    Patients with musculoskeletal disorders commonly seek treatment outside orthodox medicine (complementary therapy). In patients attending hospital clinics we investigated the prevalence of such behaviour and the reasons for it. Patients attending rheumatology and orthopaedic clinics who agreed to participate were interviewed on the same day by means of a structured questionnaire in three sections: the first section about demographic characteristics; the second about the nature and duration of ...

  10. Hypovitaminosis D among rheumatology outpatients in clinical practice

    OpenAIRE

    Mouyis, M.; Ostor, A. J. K.; Crisp, A J; Ginawi, A.; Halsall, D J; Shenker, N.; Poole, K. E. S.

    2008-01-01

    Objectives. A role for vitamin D in the pathogenesis of autoimmune and inflammatory diseases is emerging. We undertook an audit of 25-hydroxyvitamin D (25OHD) investigation and treatment in rheumatology outpatients. Methods. Serum 25OHD requests were matched to electronic medical records from rheumatology and metabolic bone clinics (April 2006–March 2007). Data were analysed separately for two groups, ‘Documented osteoporosis/osteopaenia’ (Group 1) and ‘General rheumatology outpatients’ (Grou...

  11. Pattern of Dermatological Cases Attending Skin-VD Outpatient Department in a Medical College Hospital of Bangladesh

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    Abu Baker

    2011-07-01

    Full Text Available Background: The pattern of skin diseases varies from one country to another and even from region to region of the same country. We are geographically placed in the tropical region with natural outcome of communicable diseases. We conducted this cross sectional study in a tertiary hospital of Bangladesh keeping the proposition in mind that infectious diseases occupy maximum percentage among skin and venereal diseases in outpatients in Bangladesh. Objectives: To classify the diseases attending the Skin & VD outpatient department of Enam Medical College Hospital (EMCH and to draw comments and recommendations on the basis of findings. Materials and Methods: All patients irrespective of age and sex attending the OPD of Skin-VD Department of Enam Medical College Hospital during a 2-year time-period (from January 2009 to December 2010 were included in the study. Structured questionnaire, check-list and face-to-face interview (whenever necessary were used as tools of data collection. Statistical analyses were done by SPSS version Windows 11.1. Results: Total number of patients was 12100. Most of the patients were aged (>18 years; 64.28%, dominated by male (61.63%, married (56.1%, literate (71.11%, coming from far (>5 km; 63.5% and of middle class origin (59.73%. Out of the total cases, maximum (23.42% were diagnosed as eczema, followed by infectious diseases (17%, acne (8.69% and psoriasis (6.36%. Conclusion: In this study we found infectious diseases to occupy the second position next to eczema and our findings nullify the proposition that infectious diseases occupy maximum percentage among skin and venereal diseases in outpatients in Bangladesh.

  12. Core components of clinical education: a qualitative study with attending physicians and their residents

    Directory of Open Access Journals (Sweden)

    ALIREZA ESTEGHAMATI

    2016-04-01

    Full Text Available Introduction: In medical education, particularly in residency courses, most of the training occurs in real clinical environments. Workplace-based learning profoundly affects students’ knowledge, attitudes, and practice; therefore, it should be properly planned. Due to the extensiveness of the clinical environment and its importance in training residents, investigating how residents learn in these environments and detecting factors that influence effectiveness will help curriculum designers to promote residents’ learning by improving their learning environment. Therefore, our qualitative content analysis study, aimed to examine the experiences and perspectives of internal and surgical residents and their attending physicians about learning in clinical settings. Methods: This qualitative content analysis study was conducted through purposeful sampling. Semi-structured interviews were conducted with 15 internal and surgical residents and 15 of their attending physicians at educational hospitals of Tehran University of Medical Sciences. Results: The main categories explored in this study were hidden curriculum, learning resources, and learning conditions. In the context of clinical environment and under its individual culture, residents learn professionalism and learn to improve their communication skills with patients and colleagues. Because of clinical obligations such as priority of treating the patients for education or workload of the attending physicians, residents acquire most of their practical knowledge from colleagues, fellows, or follow-up patients in different learning conditions (such as: educational rounds, morning reports and outpatient clinics. They see some of their attending physicians as role models. Conclusion: Changing cultural and contextual factors is of prime importance to promote a learning-oriented environment in a clinical setting. The present findings will help curriculum planners and attending physicians to improve

  13. Prevailing breast feeding practices of infants attending paediatric out-patient department

    Directory of Open Access Journals (Sweden)

    Manjunatha Swamy R

    2015-01-01

    Full Text Available Background: Objectives of current study were to know the prevailing infant feeding practices in infants and to identify the problems affecting infant and young child feeding practices and to analyze the environmental factors influence the mothers, families and caregivers in infant feeding. Methods: The present study is a hospital based observation study. A total of 501 mothers and their infants attending new born paediatric OPD, immunization clinic of department of paediatrics for various reasons of health care were recruited for the study after their informed consent and institutional ethical clearance. Information about the first feed after birth, time of initiation of breastfeeding, duration of exclusive breast feeding, time of introduction of complementary feeding, knowledge of feeding skills, mother's concept of adequacy of breast milk were collected in the structured, pre tested proforma by personal one to one interview with the mothers. All the mothers of infants from 0 to 1 year were included. Statistical analysis: The data obtained by the interview were analyzed with regarding to mothers education level, religion and other related parameters pertaining to feeding practices. Percentages of parameters were calculated and analyzed. Results: Majority of the mothers belong to the age group of 18 to 30 years (96.01%, prelacteal feeds were given by a good number of mothers (42.32%, 60.66% mothers were given the sugar water as the prelacteal feed and 71.56% mothers have used cup and spoon to give prelacteal feeds. 75.25% of the mothers have practiced giving colostrum, 72.26% of mothers were breastfeeding their baby for 5 to 10 minutes during each feed at an interval of 0.5 hours to 3.5 hours. Majority of mothers (34.73% had the knowledge of starting of weaning at six months and 46.88% of mothers were giving weaning food twice daily. Conclusion: Significant number of mothers had discarded colostrum and most of the mothers intended to give only

  14. PREVALENCE OF NAIL CHANGES IN PATIENTS ATTENDING DERMATOLOGY OUTPATIENTS AT MAHATMA GANDHI HOSPITAL, JAIPUR: A CROSS SECTIONAL OBSERVATIONAL STUDY

    Directory of Open Access Journals (Sweden)

    Manisha

    2014-04-01

    Full Text Available Evolutionarily, as man developed and manual dexterity increased, nail became an important appendage of the human anatomy. As civilization progressed and social interactions grew, nails, like hair, have also become objects of attention and adornment. However, nail cosmetology as it is evolving today is a fairly recent development. We observed nails of all outpatient attendees at one clinic in Dermatology department, Mahatma Gandhi Hospital, Jaipur over a period of one week in October 2013

  15. PREVALENCE OF NAIL CHANGES IN PATIENTS ATTENDING DERMATOLOGY OUTPATIENTS AT MAHATMA GANDHI HOSPITAL, JAIPUR: A CROSS SECTIONAL OBSERVATIONAL STUDY

    OpenAIRE

    De Manisha; Shifa; Puneet; Dinesh

    2014-01-01

    Evolutionarily, as man developed and manual dexterity increased, nail became an important appendage of the human anatomy. As civilization progressed and social interactions grew, nails, like hair, have also become objects of attention and adornment. However, nail cosmetology as it is evolving today is a fairly recent development. We observed nails of all outpatient attendees at one clinic in Dermatology department, Mahatma Gandhi Hospital, Jaipur over a period of one week in ...

  16. Case Study: Caregiver Perception of Pediatric Multidisciplinary Feeding Outpatient Clinic

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    Thomas F. Fisher PhD, OT, FAOTA

    2014-01-01

    Full Text Available This study explores the perception of satisfaction of caregivers who attended a feeding clinic at a large pediatric hospital in the midwest. The clinic is designed for a multidisciplinary team to meet with the child and the caregiver. Thirty-five participants were involved in the study. Results indicated that most participants were satisfied with the clinic experience. However, there were areas of care not covered by the members of the feeding team, which indicates a need. It is suggested that this need could be filled by occupational therapists.

  17. Clinical Audits in Outpatient Clinics for Chronic Obstructive Pulmonary Disease: Methodological Considerations and Workflow.

    Directory of Open Access Journals (Sweden)

    Jose Luis López-Campos

    Full Text Available Previous clinical audits for chronic obstructive pulmonary disease (COPD have provided valuable information on the clinical care delivered to patients admitted to medical wards because of COPD exacerbations. However, clinical audits of COPD in an outpatient setting are scarce and no methodological guidelines are currently available. Based on our previous experience, herein we describe a clinical audit for COPD patients in specialized outpatient clinics with the overall goal of establishing a potential methodological workflow.A pilot clinical audit of COPD patients referred to respiratory outpatient clinics in the region of Andalusia, Spain (over 8 million inhabitants, was performed. The audit took place between October 2013 and September 2014, and 10 centers (20% of all public hospitals were invited to participate. Cases with an established diagnosis of COPD based on risk factors, clinical symptoms, and a post-bronchodilator FEV1/FVC ratio of less than 0.70 were deemed eligible. The usefulness of formally scheduled regular follow-up visits was assessed. Two different databases (resources and clinical database were constructed. Assessments were planned over a year divided by 4 three-month periods, with the goal of determining seasonal-related changes. Exacerbations and survival served as the main endpoints.This paper describes a methodological framework for conducting a clinical audit of COPD patients in an outpatient setting. Results from such audits can guide health information systems development and implementation in real-world settings.

  18. Clinical Positioning Space: Residents' Clinical Experiences in the Outpatient Oncology Clinic.

    Science.gov (United States)

    Williams, Lars H; Christensen, Mette K; Rytter, Carsten; Musaeus, Peter

    2015-09-01

    In this article, we present a case study of residents' clinical experiences and communication in outpatient oncology consultations. We apply positioning theory, a dynamic alternative to role theory, to investigate how oncology residents and patients situate themselves as persons with rights and duties. Drawing from seven qualitative interviews and six days of observation, we investigate the residents' social positioning and their conversations with patients or supervisors. Our focus is on how (a) relational shifts in authority depend on each situation and its participants; (b) storylines establish acts and positions and narratively frame what participants can expect from a medical consultation viewed as a social episode; and (c) the positioning of rights and duties can lead to misunderstandings and frustrations. We conclude that residents and patients locate themselves in outpatient conversations as participants who jointly produce and are produced by patients' and nurses' storylines about who should take responsibility for treatment. PMID:25288406

  19. Metabolic syndrome: frequency and gender differences at an out-patient clinic

    International Nuclear Information System (INIS)

    To determine the frequency of metabolic syndrome among patients attending an out-patient clinic of a teaching hospital and to compare the clinical features regarding metabolic syndrome among males and females. All adults, above 25 years, attending the clinics for an executive check-up and giving informed consent were included in the study. Data was collected through a structured questionnaire administered to those eligible to participate. Metabolic syndrome was defined according to ATP-III guidelines. There were 250 participants in this study. Mean age of study participants was 48.94 (SD10.62) years, while approximately two-thirds, 157 (62.8%), were male. Metabolic syndrome (those who had 3 or more risk factors) was present in 35.2% of adults. Fasting blood sugar level was raised in 36.4% of study participants while significant number of participants (78.8%) had a Body Mass Index (BMI) Z 25 (p = 0.02). Frequency of metabolic syndrome was significantly high in this study with preponderance of males and prevalence similar to that observed in developed countries. Majority of patients had obesity and high fasting blood sugar levels. Males demonstrated higher levels of triglycerides and low levels of High-density lipoprotein (HDL) compared to females while blood pressure reading was observed to be the same in both males and females. (author)

  20. Chance of psychiatric morbidity amongst recently diagnosed cancer outpatients attending a chemotherapy unit

    Directory of Open Access Journals (Sweden)

    A.C. Chaves

    2005-09-01

    Full Text Available The prevalent rate of psychiatry morbidity amongst patients with cancer reported in various studies ranges from 5 to 50%, a variation that can be attributed to differences in sample size, the disease itself and treatment factors. The objectives of the present study were to determine the frequency of psychiatric morbidity amongst recently diagnosed cancer outpatients and try to identify which factors might be related to further psychological distress. Two hundred and eleven (70.9% female patients and 87 (29.1% male patients from the chemotherapy unit of the Cancer Hospital A.C. Camargo (São Paulo completed a questionnaire that featured data on demographic, medical and treatment details. The Self Reporting Questionnaire (SRQ-20 was administered to the patients to determine their personal psychiatric morbidity. Seventy-two patients (25.8% scored > or = 8 in the SRQ-20, the cut-off point for a patient to be considered a psychiatric case. When the low and high scoring groups were compared no differences were detected regarding age, marital status, tumor site, sex, or previous treatment. Nonetheless, patients in the lowest social class and those who were bedridden less than 50% of the time had a significantly higher probability of being a psychiatric case. Regarding help-seeking behavior in situations in which they had doubts or were frightened, about 64% of the total sample did not seek any type of support and did not talk to anyone. This frequency of psychiatric morbidity agrees with data from the cancer literature. According to many investigators, the early detection of a comorbid psychiatric disorder is crucial to relieve a patient's suffering.

  1. Dermatophytosis Agents in Patients Who Attending to Dermatology Clinic of Fırat University Hospital

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    Nursel Dilek

    2009-06-01

    Full Text Available Objective: We aimed to investigate the types of dermatophytes and dermatophytosis in Elazığ region to provide appropriate information for therapy planning and public health prevention.Methods: A total of 652 patients who attending to outpatient clinic between June 2007 – May 2008 with clinical signs of dermatophytosis were included in this study. All samples, including with negative results on direct microscopy were cultivated in Sabouraud dextrose agar (Oxoid, mycobiotic agar (Acumedia and potato dextrose agar (Oxoid. Results: Dermatophytes were isolated in 142 (21.8% out of all samples. Of the isolates 70.4% were Trichophyton rubrum, 15.4% were Trichophyton mentagrophytes, 4.2% were , 4.2% were Microsporum canis, 2.8% were Epidermophyton floccosum, 2.11% were Trichophyton violaceum, 0.7% were Trichophyton tonsurans.Conclusion: Trichophyton rubrum was most frequently isolated dermatophytosis agent in Elazığ region.

  2. A randomized clinical trial of home-based telepsychiatric outpatient care via videoconferencing: design, methodology, and implementation

    Directory of Open Access Journals (Sweden)

    Ines Hungerbuehler

    2015-06-01

    Full Text Available Background Healthcare providers are continuously challenged to find innovative, cost-effective alternatives and to scale up existent services to meet the growing demand upon mental health care delivery. Due to continuous advances in technologies, telepsychiatry has become an effective tool for psychiatric care. In 2012, the Institute of Psychiatry of the University of São Paulo Medical School started a randomized clinical trial of home-based telepsychiatric outpatient care via videoconferencing. Objective The objective of this article is to describe the design, methodology and implementation of a pilot project, which aimed to verify the applicability and efficiency of psychiatric attendance via Internet-based videoconferencing in a resource-constrained environment. Methods The project consisted of a 12 months follow-up study with a randomized clinical trial, which compared various quality indicators between home-based telepsychiatric aftercare via videoconferencing and face-to-face aftercare. Results The final sample comprised 107 outpatients (53 in the telepsychiatry group and 54 in the control group. Among 1,227 realized consultations, 489 were held by videoconferencing. Satisfaction with the aftercare by videoconferencing and the medication delivery was high among patients. Attending psychiatrists were satisfied with the assistance by videoconferencing. Discussion The experiences during this pilot project have overall been very positive and psychiatric outpatient care by videoconferencing seems viable to treat patients even in a resource-constrained environment.

  3. SELF WOUND MANAGEMENT PRACTICES BEFORE ATTENDING ANTIRABIES VACCINE CLINIC

    Directory of Open Access Journals (Sweden)

    Amit Kumar Mishra, Smita Panda, Prakash Chandra Panda

    2015-07-01

    Full Text Available Introduction: In INDIA almost 20000 people die (40% of world death each year from rabies. Most of these deaths could be prevented by post exposure prophylaxis with wound washing, rabies immunoglobulin & vaccination. Local wound management alone can reduce viral load by up to 80%. Objective: To study self-wound management practices in animal exposure patients before attending a tertiary level ARV clinic. Methodology: Data regarding wound management was collected by individual interview of patients attending the ARV clinic during OCT 2011 to MAR 2012. The data collected in the form of a questionnaire. Analysis of data was done in the Department Of Community Medicine, V.S.S. Medical College, Burla. Results: Total 493 cases of animal exposure were attended during the study period. Most common biting animal was dog (94.5%. 31% of cases were under the age of 10 years & 23% belongs to the age of 10-19 years. Male to female ratio was 3:1. Most of the cases (91% were of category III exposure. Immediate management of wound was practiced by 63-77% of cases before visiting ARV clinic; only 2% wash the wound with running water & soap for 15 minutes. 39% of cases applied Dettol/savlon at the wound side & other 38% applied turmeric, red chilli, kerosene, Band-Aid & ghee locally. Most cases (61% reported to ARV clinic within 24hours.

  4. Profiles of the parents of adolescent CSA perpetrators attending a voluntary outpatient treatment programme in Ireland

    OpenAIRE

    Duane, Yvonne; Carr, Alan; Cherry, Joan; et al

    2003-01-01

    A group of 22 parents of adolescent sexual offenders (PASO) was compared with a group of 19 normal controls (NC) and 10 clinical controls (CC) on demographic, developmental, personal adjustment and family environment variables. The assessment protocol included the General Health Questionnaire –12, the Culture-Free Self-Esteem Inventory, the Child Behaviour Checklist, the Family Assessment Device, the Parent Satisfaction Scale, and the Multidimensional Scale of Perceived Social Support. Compar...

  5. 42 CFR 447.321 - Outpatient hospital and clinic services: Application of upper payment limits.

    Science.gov (United States)

    2010-10-01

    ... SERVICES Payment Methods for Other Institutional and Noninstitutional Services Outpatient Hospital and Clinic Services § 447.321 Outpatient hospital and clinic services: Application of upper payment limits...: Application of upper payment limits. 447.321 Section 447.321 Public Health CENTERS FOR MEDICARE &...

  6. Guideline Adherence in Outpatient Clinics for Chronic Obstructive Pulmonary Disease: Results from a Clinical Audit

    Science.gov (United States)

    López-Campos, Jose L.; Abad Arranz, Maria; Calero-Acuña, Carmen; Romero-Valero, Fernando; Ayerbe-García, Ruth; Hidalgo-Molina, Antonio; Aguilar-Pérez-Grovas, Ricardo I.; García-Gil, Francisco; Casas-Maldonado, Francisco; Caballero-Ballesteros, Laura; Sánchez-Palop, María; Pérez-Tejero, Dolores; Segado, Alejandro; Calvo-Bonachera, Jose; Hernández-Sierra, Bárbara; Doménech, Adolfo; Arroyo-Varela, Macarena; González-Vargas, Francisco; Cruz-Rueda, Juan J.

    2016-01-01

    Objectives Previous clinical audits of COPD have provided relevant information about medical intervention in exacerbation admissions. The present study aims to evaluate adherence to current guidelines in COPD through a clinical audit. Methods This is a pilot clinical audit performed in hospital outpatient respiratory clinics in Andalusia, Spain (eight provinces with more than 8 million inhabitants), including 9 centers (20% of the public centers in the area) between 2013 and 2014. Cases with an established diagnosis of COPD based on risk factors, clinical symptoms, and a post-bronchodilator FEV1/FVC ratio of less than 0.70 were deemed eligible. The performance of the outpatient clinics was benchmarked against three guidance documents available at the time of the audit. The appropriateness of the performance was categorized as excellent (>80%), good (60−80%), adequate (40−59%), inadequate (20−39%), and highly inadequate (<20%). Results During the audit, 621 clinical records were audited. Adherence to the different guidelines presented a considerable variability among the different participating hospitals, with an excellent or good adherence for symptom recording, MRC or CAT use, smoking status evaluation, spirometry, or bronchodilation therapy. The most outstanding areas for improvement were the use of the BODE index, the monitoring of treatments, the determination of alpha1-antitrypsin, the performance of exercise testing, and vaccination recommendations. Conclusions The present study reflects the situation of clinical care for COPD patients in specialized secondary care outpatient clinics. Adherence to clinical guidelines shows considerable variability in outpatient clinics managing COPD patients, and some aspects of the clinical care can clearly be improved. PMID:26985822

  7. Health profiles of foreigners attending primary care clinics in Malaysia

    OpenAIRE

    Ab Rahman, Norazida; Sivasampu, Sheamini; Mohamad Noh, Kamaliah; Khoo, Ee Ming

    2016-01-01

    Background The world population has become more globalised with increasing number of people residing in another country for work or other reasons. Little is known about the health profiles of foreign population in Malaysia. The aim of this study was to provide a detailed description of the health problems presented by foreigners attending primary care clinics in Malaysia. Methods Data were derived from the 2012 National Medical Care Survey (NMCS), a cross sectional survey of primary care enco...

  8. Advancing Medication Reconciliation in an Outpatient Internal Medicine Clinic through a Pharmacist-Led Educational Initiative

    OpenAIRE

    Sarah M. Westberg, Pharm.D.; Kathrine Beeksma, R.N.

    2010-01-01

    Objectives: To develop and deliver an effective pharmacist-led educational initiative to clinic staff to advance medication reconciliation in the electronic medical record of an outpatient internal medicine clinic.Methods: An educational initiative designed to improve the ability of nursing staff in medication reconciliation was launched in the outpatient internal medicine clinic of a regional healthcare system. The education was provided by the pharmacist to clinic nursing staff, includ...

  9. PELVIC FLOOR DYSFUNCTIONS: CLINICAL AND SOCIODEMOGRAPHIC PROFILE OF UROGYNECOLOGIC OUTPATIENTS

    Directory of Open Access Journals (Sweden)

    Cássia Fernandes Coelho

    2013-01-01

    Full Text Available This study aimed to assess the socio-demographic and clinical profile of urogynecologic outpatients of a public tertiary hospital in Fortaleza, Ceará. This is a cross-sectional study whose sample consisted of 85 women with pelvic floor dysfunction. The age ranged from 27 to 86 years old (mean: 53.8±14.2. Most patients were married (54.9%, weren’t working formally (40.0% and didn’t smoke (82.4%. Approximately half was in postmenopausal period (48.2%. Most of them were multiparous (89.4% by vaginal delivery (92.9%. The main complaint reported was urinary incontinence (74.1%, and mixed urinary incontinence (MUI was the most frequent (60.0%. Over half of the patients also had pelvic organ prolapse (75.3%, and the most common defect was from the anterior vaginal wall (55.3%. The majority (57.6% had some form of anorectal dysfunction: constipation (40%, tenesmus (37.6%, fecal incontinence (16.5%. Most of the patients lost urine several times a day (57.3%, with impact on quality of life. The risk factors found are in agreement with literature data, as well as the prevalence of MUI. Given the concomitant disorders, it’s important to address all pathologies, because they are prevalent conditions with medical, social, psychological and economic implications.

  10. Computerized recording of visits to an outpatient sports clinic.

    Science.gov (United States)

    Kannus, P; Aho, H; Järvinen, M; Niittymäki, S

    1987-01-01

    At the Tampere Research Station of Sports Medicine (TRSSM) a continuous coding system of patient visits was started on March 1, 1985. The registration form contained 25 variables including all essential information about the patient's identification, sports, time of and reason for the visit, physician, examinations, diagnosis, treatment, and possible further measures. To classify and number the diagnosis, a specific classification of sports injuries and diseases was drawn up. The data were stored and analyzed using a DEC-2060 computer at the University of Tampere. During 6 months a total of 814 visits were recorded. The three most common sports were soccer, long-distance running, and orienteering. Competitive athletes totalled 337 (62%); 43 of these were top-ranking athletes. The most common reasons for visits were problems of the knee (266 visits, 33%), ankle (80, 10%), and low back (71, 9%). Knee sprains accounted for 10% of all visits. Problems related to the musculoskeletal system were the reason for 751 (92%) of all visits. Operative treatment was needed by 49 patients (6%). The continuous coding system of patient visits at an outpatient sports clinic showed great advantages as a basic data bank for scientific research, annual statistics, and patient identification and filing. The system described has been adopted as part of the daily routine at the TRSSM. PMID:3812865

  11. Mental health and other clinical correlates of euthanasia attitudes in an Australian outpatient cancer population.

    Science.gov (United States)

    Carter, G L; Clover, K A; Parkinson, L; Rainbird, K; Kerridge, I; Ravenscroft, P; Cavenagh, J; McPhee, J

    2007-04-01

    A majority of patients with cancer have been reported to endorse euthanasia and physician assisted suicide (PAS) in general and a substantial proportion endorse these for themselves. However, the potential influence of mental health and other clinical variables on these decisions is not well understood. This study of 228 outpatients attending an oncology clinic in Newcastle, Australia used a cross-sectional design and logistic regression modelling to examine the relationship of demographic, disease status, mental health and quality of life variables to attitudes toward euthanasia and PAS. The majority reported support for euthanasia (79%, n=179), for PAS (69%, n=158) and personal support for euthanasia/PAS (68%, n=156). However, few reported having asked their doctor for euthanasia (2%, n=5) or PAS (2%, n=5). Three outcomes were modelled: support for euthanasia was associated with active religious belief (adjusted odds ratio (AOR) 0.21, 95% CI: 0.10-0.46); support for PAS was associated with active religious belief (AOR 0.35, 95% CI: 18-0.70) and recent pain (AOR 0.87, 95% CI: 0.0.76-0.99); and personal support for euthanasia/PAS was associated with active religious belief (AOR 0.26, 95% CI: 0.14-0.48). Depression, anxiety, recent suicidal ideation, and lifetime suicide attempt were not independently associated with any of the three outcomes modelled.

  12. Predictors of skilled attendance at delivery among antenatal clinic attendants in Ghana: a cross-sectional study of population data

    OpenAIRE

    Amoakoh-Coleman, Mary; Ansah, Evelyn K.; Agyepong, Irene Akua; Grobbee, Diederick E; Gbenga A Kayode; Klipstein-Grobusch, Kerstin

    2015-01-01

    Objective To identify demographic, maternal and community predictors of skilled attendance at delivery among women who attend antenatal clinic at least once during their pregnancy in Ghana. Design A cross-sectional study using the 2008 Ghana Demographic and Health Survey (DHS) data. We used frequencies for descriptive analysis, χ2 test for associations and logistic regression to identify significant predictors. Predictive models were built with estimation of area under the receiver operating ...

  13. Measurement of nurses' workload in an oncology outpatient clinic

    Directory of Open Access Journals (Sweden)

    Célia Alves de Souza

    2014-02-01

    Full Text Available The growing demand and the degree of patient care in oncological outpatient services, as well as the complexity of treatment have had an impact on the workload of nurses. This study aimed at measuring the workload and productivity of nurses in an oncological outpatient service. An observational study using a work sampling technique was conducted and included seven nurses working in an oncological outpatient service in the south-eastern region of Brazil. A total of 1,487 intervention or activity samples were obtained. Nurses used 43.2% of their time on indirect care, 33.2% on direct care, 11.6% on associated activities, and 12% on personal activities. Their mean productivity was 88.0%. The findings showed that nurses in this service spend most of their time in indirect care activities. Moreover, the productivity index in this study was above that recommended in the literature.

  14. Relationship between practice counselling and referral to outpatient psychiatry and clinical psychology.

    OpenAIRE

    Cape, J; Parham, A.

    1998-01-01

    BACKGROUND: Although reduction in the use of secondary care mental health services is a suggested benefit of counselling in general practice, there has been little empirical investigation of this relationship. AIM: To investigate the relationship between the provision of counselling in general practice and the use of outpatient psychiatry and clinical psychology services across a geographical area. METHOD: Information on referrals to outpatient psychiatry and clinical psychology from all gene...

  15. Missing Clinical Information in NHS hospital outpatient clinics: prevalence, causes and effects on patient care

    Directory of Open Access Journals (Sweden)

    Moorthy Krishna

    2011-05-01

    Full Text Available Abstract Background In Britain over 39,000 reports were received by the National Patient Safety Agency relating to failures in documentation in 2007 and the UK Health Services Journal estimated in 2008 that over a million hospital outpatient visits each year might take place without the full record available. Despite these high numbers, the impact of missing clinical information has not been investigated for hospital outpatients in the UK. Studies in primary care in the USA have found 13.6% of patient consultations have missing clinical information, with this adversely affecting care in about half of cases, and in Australia 1.8% of medical errors were found to be due to the unavailability of clinical information. Our objectives were to assess the frequency, nature and potential impact on patient care of missing clinical information in NHS hospital outpatients and to assess the principal causes. This is the first study to present such figures for the UK and the first to look at how clinicians respond, including the associated impact on patient care. Methods Prospective descriptive study of missing information reported by surgeons, supplemented by interviews on the causes. Data were collected by surgeons in general, gastrointestinal, colorectal and vascular surgical clinics in three teaching hospitals across the UK for over a thousand outpatient appointments. Fifteen interviews were conducted with those involved in collating clinical information for these clinics. The study had ethics approval (Hammersmith and Queen Charlotte's & Chelsea Research Ethics Committee, reference number (09/H0707/27. Participants involved in the interviews signed a consent form and were offered the opportunity to review and agree the transcript of their interview before analysis. No patients were involved in this research. Results In 15% of outpatient consultations key items of clinical information were missing. Of these patients, 32% experienced a delay or disruption

  16. Assessing Nutrient Intake and Nutrient Status of HIV Seropositive Patients Attending Clinic at Chulaimbo Sub-District Hospital, Kenya

    Directory of Open Access Journals (Sweden)

    Agatha Christine Onyango

    2012-01-01

    Full Text Available Background. Nutritional status is an important determinant of HIV outcomes. Objective. To assess the nutrient intake and nutrient status of HIV seropositive patients attending an AIDS outpatient clinic, to improve the nutritional management of HIV-infected patients. Design. Prospective cohort study. Setting. Comprehensive care clinic in Chulaimbo Sub-District Hospital, Kenya. Subjects. 497 HIV sero-positive adults attending the clinic. Main Outcome Measures. Evaluation of nutrient intake using 24-hour recall, food frequency checklist, and nutrient status using biochemical assessment indicators (haemoglobin, creatinine, serum glutamate pyruvate (SGPT and mean corpuscular volume (MCV. Results. Among the 497 patients recruited (M : F sex ratio: 1.4, mean age: 39 years ± 10.5 y, Generally there was inadequate nutrient intake reported among the HIV patients, except iron (10.49 ± 3.49 mg. All the biochemical assessment indicators were within normal range except for haemoglobin 11.2 g/dL (11.4 ± 2.60 male and 11.2 ± 4.25 female. Conclusions. Given its high frequency, malnutrition should be prevented, detected, monitored, and treated from the early stages of HIV infection among patients attending AIDS clinics in order to improve survival and quality of life.

  17. Managing mood disorders in patients attending pulmonary rehabilitation clinics

    Directory of Open Access Journals (Sweden)

    Selvarajah S

    2013-01-01

    Full Text Available Colleen Doyle,1–3 David Dunt,2 David Ames,1 Suganya Selvarajah11National Ageing Research Institute, Royal Melbourne Hospital Royal Park Campus, Parkville, Victoria, Australia; 2Centre for Health Policy, Programs and Economics, University of Melbourne, Parkville, Victoria, Australia; 3Australian Catholic University, Fitzroy, Victoria, AustraliaBackground: There is good evidence for the positive benefits of pulmonary rehabilitation (PR in the prevention of hospital admissions, lower mortality, and improved health-related quality of life. There is also increasing evidence about the impact of PR on mental health and, in particular, mood disorders. We aimed to identify how depression in chronic obstructive pulmonary disease (COPD patients in Victoria, Australia, is being managed in PR, to identify the prevalence of depressive symptoms among COPD patients who attend PR, and to determine whether patients with depressive symptoms or anxiety symptoms dropped out of PR early.Method: Of 61 PR clinics, 44 were invited and 22 agreed to participate. Telephone interviews were conducted to see how depression and anxiety in COPD patients were being recognized and managed in these clinics. A total of 294 questionnaires were distributed to patients by clinic coordinators to determine the prevalence of anxiety/depression, as measured by the Hospital Anxiety and Depression Scale. Coordinators were contacted to provide information on whether respondents dropped out of rehabilitation early or continued with their treatment at 2–4 months post program.Results: Seven clinics were not aware of local guidelines on assessment/treatment/management of mood. Four clinics did not use any screening tools or other aids in the recognition and management of depression and/or anxiety. Overall, eight clinics participating in this study requested advice on suitable screening tools. The patient survey indicated that the mean depression score on the Hospital Anxiety and Depression

  18. The Assessment of the Applications to University Hospital Urology Outpatient Clinic

    Directory of Open Access Journals (Sweden)

    Adnan Gucuk

    2013-04-01

    Full Text Available Introduction: Provision of health care services to persons where it is needed required for the production of quality service in the organization of health services. The purpose of this study, determine the reason for admission and factors affecting admission and evaluate the current status for the patients admitted to a tertiary health care center. Materials and methods: The study was planned descriptive. Participants were determined among the patients were admitted to urology clinic between December 2011-March 2012 for any reason on a voluntary basis. Fourteen item questionnaire was completed by the physician. The survey asked the age, educational status, initial complaint, elapsed time from the beginning of complaints, whether was the previous treatment from another institution, reasons for choosing a university hospital polyclinics for participants. Results: A total of 337 participants attended, and their gender were 23.7% female, 76.3% male. 61.7% participants had received earlier medical attention because of complaints, 38.3% of had not received previously medical attention in any health institution and had to apply directly to the tertiary health care center. Apply directly to the university hospital outpatient clinic was significantly higher in men (p:0.11(table 1. Direct applications are increasing significantly in participant has higher education level. Compared to complexity of required investigations for patients had received and had not received earlier medical attention were no significant differences (p:0.134. Conclusion: For more effective use of health resources and results-oriented, training must be relevant to users of health care services to increase health literacy as well as a number of legal arrangements. [TAF Prev Med Bull 2013; 12(2.000: 165-168

  19. Evaluation of a hand carried cardiac ultrasound device in an outpatient cardiology clinic

    NARCIS (Netherlands)

    E.C. Vourvouri (Eleni); D. Poldermans (Don); G.E. Parharidis; J.R.T.C. Roelandt (Jos); J.W. Deckers (Jaap)

    2005-01-01

    textabstractOBJECTIVE: To determine the diagnostic potential of a hand carried cardiac ultrasound (HCU) device (OptiGo, Philips Medical Systems) in a cardiology outpatient clinic and to compare the HCU diagnosis with the clinical diagnosis and diagnosis with a full featured standar

  20. The one-stop clinic as the standard of out-patient care in a hospital urology department

    Directory of Open Access Journals (Sweden)

    Alvaro Páez

    2011-10-01

    Full Text Available PURPOSE: To evaluate the performance of a 'one-stop' clinic in terms of proportion of discharges or inclusion in surgical waiting lists. MATERIALS AND METHODS: All patients were referred from primary care facilities (population 220.646 and from different departments in the hospital. Eight senior urologists, two registered nurses and two nurse attendants participated in the experience. Prior to the start of the project, referral protocols had been agreed with the primary care physicians involved. Compliance with the protocols was periodically tested. Eventually 5537 first visits (January-December 2009 where evaluable. RESULTS: Overall, the 'one-stop' format proved feasible in 74.2% of the patients (4108/5537. Patients, who successfully used the 'one-stop' format, were significantly younger than those who required additional consultations (43 vs 50 years old, respectively, Student's t test < 0.001. For obvious reasons the 'one-stop' format was universally possible in male sterilization and penile phimosis patients. Similarly, the 'one-stop' policy was applied in most consultations due to male sexual dysfunction (75% and urinary tract infection (73%. Other health problems, such as haematuria (62% and renal colic (46%, required more than one visit so that care of the patient reverted to the traditional, outpatient care model. CONCLUSION: A 'one-stop' philosophy is feasible for a number of procedures in a urological outpatient clinic. The costs to implement such an approach would be limited to managerial expenditure.

  1. Developing an outpatient wound care clinic in an acute rehabilitation setting.

    Science.gov (United States)

    Sheehan, Diane Dudas; Zeigler, Mary H

    2010-01-01

    People with disability are at high risk for skin breakdown,which requires ongoing prevention and management. An outpatient rehabilitation wound clinic was developed to handle a variety of acute and chronic wounds for this unique population. This article describes how two advanced practice nurses proposed the idea for the wound care clinic and formulated a business plan, which was critical to successfully administering an outpatient wound care service. Essential components of the business plan included the goals, scope of service, professional practice model, benefits, rationale, marketing analysis, predicted volumes, regulatory imperatives, and financial needs.

  2. Change in quality management in diabetes care groups and outpatient clinics after feedback and tailored support

    NARCIS (Netherlands)

    Campmans-Kuijpers, Marjo J.; Baan, Caroline A.; Lemmens, Lidwien C.; Rutten, Guy E.

    2015-01-01

    OBJECTIVE: To assess the change in level of diabetes quality management in primary care groups and outpatient clinics after feedback and tailored support. RESEARCH DESIGN AND METHODS: This before-and-after study with a 1-year follow-up surveyed qualitymanagers on six domains of quality management. Q

  3. No-show at a forensic psychiatric outpatient clinic : risk factors and reasons

    NARCIS (Netherlands)

    Feitsma, W. Nathalie; Popping, Roel; Jansen, Danielle E. M. C.

    2012-01-01

    Nonattendance for and late cancellations of scheduled appointments, that is no-show, is a well-known phenomenon in psychiatric outpatient clinics. Research on the topic of no-show for initial and consecutive appointments in the field of forensic psychiatry is scarce. This study therefore aims to det

  4. Changes in Emotion Work at Interdisciplinary Conferences Following Clinical Supervision in a Palliative Outpatient Ward

    DEFF Research Database (Denmark)

    Nordentoft, Helle Merete

    2008-01-01

    In this article, I describe changes in emotion work at weekly interdisciplinary conferences in a palliative1 outpatient ward following clinical supervision (CS). I conceive emotions as constantly negotiated in interaction, and I researched the similarity between how this is done during CS and at ...... conclude that CS enhances professional development and may prevent burnout in palliative care....

  5. Aggression Replacement Training for Violent Young Men in a Forensic Psychiatric Outpatient Clinic

    NARCIS (Netherlands)

    Hornsveld, R.H.; Kraaimaat, F.W.; Muris, P.; Zwets, A.J.; Kanters, T.

    2015-01-01

    The effects of Aggression Replacement Training (ART) were explored in a group of Dutch violent young men aged 16 to 21 years, who were obliged by the court to follow a treatment program in a forensic psychiatric outpatient clinic. To evaluate the training, patients completed a set of self-report que

  6. Exploring the Unmet Needs of the Patient in the Outpatient Respiratory Medical Clinic

    DEFF Research Database (Denmark)

    Jensen, Lone Birgitte; Brinkkjær, Ulf; Larsen, Kristian;

    2015-01-01

    observations with a sample of 43 patients, 11 doctors, and 11 nurses, as well as 30 interviews with patients, conducted through theoretical sampling from three outpatient respiratory medical clinics in Denmark. Findings. The patients’ efforts to share their significant stories triggered predominantly...

  7. Evaluation of clinical pharmacist interventions on drug interactions in outpatient pharmaceutical HIV-care

    NARCIS (Netherlands)

    de Maat, M M R; de Boer, A; Koks, C H W; Mulder, J W; Meenhorst, P L; van Gorp, E C M; Mairuhu, A T A; Huitema, A D R; Beijnen, J H

    2004-01-01

    OBJECTIVE: To evaluate the usefulness of intervention in drug interactions of antiretroviral drugs with coadministered agents by a clinical pharmacist in outpatient HIV-treatment. METHODS: The study design included two intervention arms (A and B), which were both preceded by a control observation pe

  8. Evaluation of clinical pharmacist interventions on drug interactions in outpatient pharmaceutical HIV-care.

    NARCIS (Netherlands)

    Maat, M.M. de; Boer, A.T. den; Koks, C.H.W.; Mulder, J.W.; Meenhorst, P.L.; Gorp, E. van; Mairuhu, A.T.; Huitema, A.D.; Beijnen, J.H.

    2004-01-01

    OBJECTIVE: To evaluate the usefulness of intervention in drug interactions of antiretroviral drugs with coadministered agents by a clinical pharmacist in outpatient HIV-treatment. METHODS: The study design included two intervention arms (A and B), which were both preceded by a control observation pe

  9. Maintaining a Distinction Between Possible and Impossible Topics of Conversation in the Outpatient Respiratory Medical Clinic

    DEFF Research Database (Denmark)

    Birgitte Skov Jensen, Lone; Larsen, Kristian; Konradsen, Hanne

    2016-01-01

    The aim of this study is to generate a grounded theory explaining patterns of behavior among health care professionals (HCPs) during interactions with patients in outpatient respiratory medical clinics. The findings suggest that the HCPs managed contradictory expectations to the interaction...

  10. Telephone-Administered Cognitive Behavioral Therapy for Veterans Served by Community-Based Outpatient Clinics

    Science.gov (United States)

    Mohr, David C.; Carmody, Timothy; Erickson, Lauren; Jin, Ling; Leader, Julie

    2011-01-01

    Objective: Multiple trials have found telephone-administered cognitive behavioral therapy (T-CBT) to be effective for the treatment of depression. The aim of this study was to evaluate T-CBT for the treatment of depression among veterans served by community-based outpatient clinics (CBOCs) outside of major urban areas. Method: Eighty-five veterans…

  11. Determinants of tinnitus’ impact in Quality of Life in an outpatient clinic protocol.

    NARCIS (Netherlands)

    Magali Roggerone, [No Value

    2010-01-01

    Summary Background: Tinnitus is a chronic condition that can cause substantial handicap for certain patients and affects their Quality of Life. Our study focuses on Quality of Life for the tinnitus patients who participated in the protocol of an outpatient clinic established at the ENT department of

  12. Pattern of dental diseases among patients attending outpatient department of dental: a hospital based cross-sectional study

    Directory of Open Access Journals (Sweden)

    Pitamber Datt Garkoti

    2015-06-01

    Full Text Available Introduction: The public health problems associated with oral disease are a serious burden in India and other countries of the world. The causes of oral diseases are primarily rooted in poor socioeconomic and physical environment; unhealthy lifestyles and oral health related behaviour accordingly the action towards improvement of oral health should be directed towards modification of unhealthy environment and behaviours. Objective: To know the pattern of dental diseases among the patients attending Dental OPD. Materials and Methods: A hospital based cross sectional study among patients attending dental OPD in a tertiary care centre of Kumaun region during a period of one year i.e. from 1st January 2012 to 31st December 2012. Results: A total of 8928 patients attended dental OPD. Majority of the patients (25.3% were in the age group 30-39 years. Mostly were males (51.54%. Most common disease was dental caries (54.54%, followed by gingivitis (37.62%, abrasion (3.82%, malocclusion (3.05%, pericoronitis (0.53% and jaw fracture (0.44%. Conclusion: Dental Caries was the most common disease. Majority of the patients were in 30-39 years of age group. Health education and awareness at school level and in the community might prevent tooth loss in later life. [Natl J Med Res 2015; 5(2.000: 112-115

  13. The prevalence of medical/clinical technology over psychosocial care actions in outpatient mental health services

    OpenAIRE

    Regina Celia Fiorati; Toyoko Saeki

    2013-01-01

    The scope of this study was to evaluate how aspects of mental health policy in Brazil have been conceived and implemented in outpatient services, such as the Regional Outpatient Mental Health Clinic and the Psychosocial Care Center II, both in Ribeirão Preto, São Paulo. Semi-direct interviews and focus groups were conducted with 22 health professionals. The theoretical method and data analysis were supported by the dialectical hermeneutic framework of Jürgen Habermas. The following aspects we...

  14. Clinical management methods for out-patients with alcohol dependence

    Directory of Open Access Journals (Sweden)

    Boulze Isabelle

    2006-02-01

    Full Text Available Abstract Background In France outpatient centres for the care of alcoholics are healthcare establishments providing medical, psychological and social support. Although they meet the practical needs of these patients, their degree of use in each of these domains and the respective mobilisation of different skills by the care team are not well understood. Our aim was therefore to determine in detail the management involved as a function of the severity of alcohol dependence. For this purpose, all the procedures involved were compiled in a thesaurus describing its type (psychological, medical, social, reception, its scheduled or unscheduled nature, its method (face-to-face, telephone, letter and its duration. The severity of dependence was evaluated using the Addiction Severity Index (ASI. Results 45 patients were included and followed-up during 291 ± 114 days. The mean initial ASI scores (± SD were: medical (M = 0.39 ± 0.3, working-income (ER = 0.5 ± 0.3, alcohol (A = 0.51 ± 0.2, illicit drugs (D = 0.07 ± 0.08, legal (L = 0.06 ± 0.13, familial and social environment (FS = 0.34 ± 0.26, psychological (P = 0.39 ± 0.22. The total number of procedures was 1341 (29.8 per patient corresponding to 754.4 hours (16.7 per patient. The intensity of management peaked during the first month of treatment, and then declined rapidly; the maximum incidence of abstinence was observed during the 3rd month of management. Interviews with patients, group therapy and staff meetings represented 68.7%, 9.9% and 13.9% of all procedures, respectively. In patients with severe dependence, as compared to moderate, management was twice as intense in the psychological and social domains, but not in the medical domain. The ASI questionnaire was completed a second time by 24 patients, after an average of 3.2 months. The improvement was significant in the M, A, D and P domains only. Conclusion This study provided an overview of the methods employed in managing a sample of

  15. The impact of introducing a satellite dispensary service at an outpatient HIV clinic

    OpenAIRE

    S Vekeria; Jalali, F.; S Sonecha; Bates, I.

    2012-01-01

    Background: Studies have demonstrated the potential impact of pharmaceutical services in HIV care [1]. We sought to extend HIV pharmacy services at the Dean Street outpatient HIV/GUM clinic to improve efficiency and enhance client satisfaction. The pharmacy team was expanded and a satellite dispensary was opened in the clinic. This project compares the new dispensary service with the previous one offered. Method: Comparisons were made between the pre- and post-change period across a range of ...

  16. Clinical way method in treatment of out-patients with ischemic heart disease after cardiosurgery

    OpenAIRE

    Vardosanidze S.L.; Galstyan A.S.

    2010-01-01

    158 patients with ischemic heart disease (IHD) have been understudy during the period of 12 months in out-patient conditions. After completion of the primary examination all the patients of basic group (118 patients) received clinical way method of treatment. Patients of the comparison group (40 patients) after provided treatment were cared by their local therapeutists (cardiologists). The findings proved the fact that treatment of patients after cardiosurgery by clinical way method in out-pa...

  17. Driving cessation in patients attending a memory clinic.

    OpenAIRE

    Cunningham, Conal

    2005-01-01

    PUBLISHED BACKGROUND: Driving is an increasingly important form of transport for older people. Dementia is common in later life and will eventually lead to driving cessation, which reduces the public health risk of impaired driving but also impairs access to services. The factors associated with driving cessation in dementia are uncertain. OBJECTIVE: To examine the demographic, psychometric and personal factors associated with driving cessation in patients attending a memory cli...

  18. Psychiatric Morbidity and Subjective Burden Among Carers of Outpatients of a Psychogeriatric Clinic in Southwestern Nigeria.

    Science.gov (United States)

    Abayomi, Olukayode; Akinhanmi, Akinwande O; Adelufosi, Adegoke O

    2015-12-01

    Few studies in Nigeria have investigated the burden of caring for elderly persons with mental illness. The aim of this study was to examine psychiatric morbidity and burden of care among caregivers of outpatients of a psychogeriatric clinic. Burden of care was evaluated with Zarit Burden Interview. A questionnaire was also used to elicit caregivers' sociodemographic and caregiving variables while psychological well-being was assessed with the General Health Questionnaire (GHQ). Overall, 52.3% had high care burden. High care burden was associated with financial difficulty (χ(2) = 9.37; df = 1; p = 0.002; OR = 3.1; 95% CI = 1.50-6.4), restrictions on caregivers' social activity (χ(2) = 4.87; df = 1; p = 0.027; OR = 2.4; 95% CI = 1.09-5.27), lack of support from relatives (χ(2) = 6.85; df = 1; p = 0.009; OR = 6.3; 95% CI = 1.35-29.6), physical health problems (χ(2) = 10.52; df = 1; p = 0.001; OR = 4.7; 95% CI = 1.75-12.7), and psychiatric morbidity (χ(2) = 4.05; df = 1; p = 0.044; OR = 2.62; 95% CI = 1.00-6.85). Psychiatric morbidity was predicted by physical health problems (OR = 3.0; 95% CI = 1.1-8.1), financial difficulty (OR = 17.2; 95% CI = 3.8-77.5), and job loss (OR = 5.3; 95% CI = 2.0-13.8). Care burden is a significant problem among caregivers of elderly persons with mental illness attending the clinic. This may have important implications for the mental well-being of the patients. PMID:26497309

  19. Myopathy during statin therapy in the daily practice of an outpatient cardiology clinic : prevalence, predictors and relation with vitamin D

    NARCIS (Netherlands)

    Riphagen, Ineke J.; van der Veer, Eveline; Muskiet, Frits A. J.; DeJongste, Mike J. L.

    2012-01-01

    Objective: The mechanism of statin-related myopathy is unknown, while its prevalence is probably underestimated. An association between statin-related myopathy and vitamin D deficiency has been reported. In this pilot study we assessed the prevalence of myopathy in statin users attending the outpati

  20. Prevalence of Antipsychotic Polypharmacy and Associated Factors among Outpatients with Schizophrenia Attending Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia

    Directory of Open Access Journals (Sweden)

    Siranesh Tesfaye

    2016-01-01

    Full Text Available Background. Despite recommendations by guidelines to avoid combinations of antipsychotics unless after multiple trials of antipsychotic monotherapy, it is quite a common practice to use combinations. This practice leads to unnecessary expenses and exposes the patient to severe drug adverse effects. Methods. An institution based cross-sectional study was conducted from April to May 2014. Systematic random sampling technique was used to select 423 study subjects. Logistic regression analysis was conducted to identify associated factors of antipsychotic polypharmacy among schizophrenia outpatients. Result. The overall prevalence of antipsychotic polypharmacy was found to be 28.2%. Extra pyramidal side effects (AOR = 2.80; 95% CI: 1.38, 5.71, repeated psychiatric hospitalization (AOR = 2.83; 95% CI: 1.45, 5.50, history of substance use (AOR = 2.82; 95% CI: 1.36, 5.88, longer duration of treatment (AOR = 2.10; 95% CI: 1.14, 3.87, and drug nonadherence (AOR = 1.84; 95% CI: 1.14, 2.98 were found to be significantly associated with antipsychotic polypharmacy. Conclusion. Prevalence of antipsychotic polypharmacy was found to be high among the current study participants. Individuals who had extra pyramidal side effects, admission, substance use, duration of treatment, and drug nonadherence were associated with antipsychotic polypharmacy.

  1. Value and Clinical Impact of an Infectious Disease-Supervised Outpatient Parenteral Antibiotic Therapy Program

    Science.gov (United States)

    Petrak, Russell M.; Skorodin, Nathan C.; Fliegelman, Robert M.; Hines, David W.; Chundi, Vishnu V.; Harting, Brian P.

    2016-01-01

    Background. Outpatient parenteral antibiotic therapy (OPAT) is a safe and effective modality for treating serious infections. This study was undertaken to define the value of OPAT in a multicentered infectious disease (ID) private practice setting. Methods. Over a period of 32 months, 6120 patients were treated using 19 outpatient ID offices in 6 states. Analysis included patient demographics, indications of OPAT, diagnoses, therapeutic agent, duration of therapy, and site of therapy initiation. Outcomes were stratified by therapeutic success, clinical relapse, therapeutic complications, and hospitalizations after initiating therapy. Statistical analysis included an ordinal logistic regression analysis. Results. Forty-three percent of patients initiated therapy in an outpatient office, and 57% began therapy in a hospital. Most common diagnoses treated were bone and joint (32.2%), abscesses (18.8%), cellulitis (18.5%), and urinary tract infection (10.8%). Ninety-four percent of patients were successfully treated, and only 3% were hospitalized after beginning therapy. Most common cause of treatment failure was a relapse of primary infection (60%), progression of primary infection (21%), and therapeutic complication (19%). Conclusions. An ID-supervised OPAT program is safe, efficient, and clinically effective. By maximizing the delivery of outpatient care, OPAT provides a tangible value to hospitals, payers, and patients. This program is a distinctive competency available to ID physicians who offer this service to patients.

  2. THE ATTITUDE TOWARDS TREATMENT OF CARDIOVASCULAR DISEASES: A SURVEY OF PATIENTS OF STATE OUTPATIENT CLINICS AND PRIVATE MEDICAL CENTERS

    Directory of Open Access Journals (Sweden)

    O. N. Semenova

    2015-09-01

    Full Text Available Aim. To study the differences in views on treatment among patients with cardiovascular diseases in state and private outpatient clinics, as well as the motivation for choosing one of these outpatient clinics.Material and methods. Anonymous and voluntary survey of cardiology patients (n=90 in 2 state (57.7% and 3 private outpatient clinics (42.2% was conducted in Saratov.Results. 33.3% of respondents were men; the median age was 65 years. Patients of state outpatient clinics were more likely to have retirement age (p=0.0008, low income (p=0.0006, history of hypertensive crises (p=0.0129 and chronic heart failure (p=0.0001. Patients of private outpatient clinics were more likely to have mental work (p=0.0001, higher education (p=0.0001, moderate income (p=0.0006. The difference in views on the disease and the attitude towards a doctor among patients of state and private clinics was shown.Conclusion. Patients of private outpatient clinics were more active, young, aimed at continuation of life. They are more likely to have higher education, mental work and moderate income. Patients of state outpatient clinics are "infatuated with their illness"; it is their “lifestyle”. Paternalistic model of communication with doctors is expressed in all the patients.

  3. Clinical way method in treatment of out-patients with ischemic heart disease after cardiosurgery

    Directory of Open Access Journals (Sweden)

    Vardosanidze S.L.

    2010-12-01

    Full Text Available 158 patients with ischemic heart disease (IHD have been understudy during the period of 12 months in out-patient conditions. After completion of the primary examination all the patients of basic group (118 patients received clinical way method of treatment. Patients of the comparison group (40 patients after provided treatment were cared by their local therapeutists (cardiologists. The findings proved the fact that treatment of patients after cardiosurgery by clinical way method in out-patient conditions enabled to raise patient motivation to treatment, thereby assisting them to feel better, promoting normalization of arterial pressure data. The research results stated that clinical way method of treatment may be considered as rational and effective

  4. Clinical Management of an Increasing Threat: Outpatient Urinary Tract Infections Due to Multidrug-Resistant Uropathogens.

    Science.gov (United States)

    Walker, Emily; Lyman, Alessandra; Gupta, Kalpana; Mahoney, Monica V; Snyder, Graham M; Hirsch, Elizabeth B

    2016-10-01

    Urinary tract infections (UTIs) are among the most commonly treated bacterial infections. Over the past decade, antimicrobial resistance has become an increasingly common factor in the management of outpatient UTIs. As treatment options for multidrug-resistant (MDR) uropathogens are limited, clinicians need to be aware of specific clinical and epidemiological risk factors for these infections. Based on available literature, the activity of fosfomycin and nitrofurantoin remain high for most cases of MDR Escherichia coli UTIs. Trimethoprim-sulfamethoxazole retains clinical efficacy, but resistance rates are increasing internationally. Beta-lactam agents have the highest rates of resistance and lowest rates of clinical success. Fluoroquinolones have high resistance rates among MDR uropathogens and are being strongly discouraged as first-line agents for UTIs. In addition to accounting for local resistance rates, consideration of patient risk factors for resistance and pharmacological principles will help guide optimal empiric treatment of outpatient UTIs.

  5. Cost differentials of dental outpatient care across clinical dentistry branches

    OpenAIRE

    Jovana Rančić; Nemanja Rančić; Nemanja Majstorović; Vladimir Biočanin; Marko Milosavljević; Mihajlo Jakovljević

    2015-01-01

    Background: Dental care presents affordability issues in Central & Eastern European transitional economies due to lack of insurance coverage in most countries of the region and almost complete out-of-pocket payments by citizens.Objective: Real world estimates on cost differentials across clinical dentistry branches, ICD-10 diagnostic groups and groups of dental services.Methods: Prospective case-series cost analysis was conducted from the patient perspective. A six months time horizon was...

  6. Treatment compliance of self-reported dog bite cases attending outpatient department of Tertiary Care Hospital, Maharashtra

    Directory of Open Access Journals (Sweden)

    Vijay Kishanrao Domple

    2015-01-01

    Full Text Available Objectives: To assess treatment compliance of self-reported dog bite cases and to assess associated demographic and exposure factors. Materials and Methods: The present prospective study was conducted during January 2013 to July 2013 among 260 dog bite cases by purposive sampling at the outpatient department of a tertiary hospital. After obtaining verbal informed consent, a predesigned questionnaire was used. The assessment of treatment compliance of postexposure prophylaxis (PEP regimen was considered on the basis of intramuscular anti-rabies vaccine (ARV regimen by classifying completed PEP and defaulted PEP. At the end of PEP regimen of every participant, we obtained information about received ARV doses using telephone survey method. Data were analyzed using statistical software Epi info Version 7. Results: Of 260 dog bite cases, 76.5% cases were completed PEP. The majority, 22.3% cases from age group ≤10 years, 56.2% males, 48.1% from urban area, 25% had primary school education, 32.7% students, 53.8% had bite mark on lower limb, 58.5% were category III exposure, and 70.8% who had received previously immunization against rabies, were completed PEP. The bite due to 54.6% pet dog, 58.1% observable dog, 40% provoked bite, 71.9% cases who had not known about the rabid status of the dog, were completed PEP. The unconditional logistic regression analysis found that demographic and exposure factors were not independently associated with treatment compliance (P > 0.05 except literacy status (P < 0.05. The present study showed maximum completed PEP cases, however, it showed the demographic and exposure factors of dog bite cases were not independently associated with treatment compliance except literacy status.

  7. Panic disorder among Vietnamese refugees attending a psychiatric clinic: Prevalence and subtypes

    OpenAIRE

    Hinton, Devon; Chau, Ha; Nguyen, Lim; Nguyen, Mai; Pham, Van Thang; Quinn, Sarah; Tran, Minh

    2001-01-01

    This study surveys Vietnamese refugees attending two psychiatric clinics to determine both the prevalence of panic disorder (PD) as well as panic attack subtypes in those suffering PD. A culturally valid adaptation of the SCID-panic module (the Vietnamese Panic Disorder Survey or VPDS) was administered to 100 Vietnamese refugees attending two psychiatric clinics. Utilizing culturally sensitive panic probes, the VPDS provides information regarding both the presence of PD and panic attack subty...

  8. Panic Disorder Among Cambodian Refugees Attending a Psychiatric Clinic: Prevalence and Subtypes

    OpenAIRE

    Hinton, Devon; Ba, Phalnarith; Peou, Sonith; Um, Khin

    2000-01-01

    This study surveys Khmer refugees attending two psychiatric clinics to determine both the prevalence of panic disorder as well as panic attack subtypes in those suffering panic disorder. A culturally valid adaptation of the SCID-panic module, the Cambodian Panic Disorder Survey (CPDS), was administered to 89 consecutive Cambodian refugees attending these psychiatric clinics. Utilizing culturally sensitive panic probes, the CPDS provides information regarding both the presence of panic disorde...

  9. Cost differentials of dental outpatient care across clinical dentistry branches

    Directory of Open Access Journals (Sweden)

    Jovana Rančić

    2015-03-01

    Full Text Available Background: Dental care presents affordability issues in Central & Eastern European transitional economies due to lack of insurance coverage in most countries of the region and almost complete out-of-pocket payments by citizens.Objective: Real world estimates on cost differentials across clinical dentistry branches, ICD-10 diagnostic groups and groups of dental services.Methods: Prospective case-series cost analysis was conducted from the patient perspective. A six months time horizon was adopted. Sample size was 752 complete episodes of treatment in 250 patients, selected in 2012/2013 throughout several specialist state- and private-owned dental clinics in Serbia. All direct costs of dental care were taken into account and expressed in Euros (€.Results: Mean total costs of dental care were € 46 ± 156 per single dentist visit while total costs incurred by this population sample were € 34,424. Highest unit utilization of services belongs to conservative dentistry (31.9%, oral surgery (19.5% and radiology (17.4%, while the resource with the highest monetary value belongs to implantology € 828 ± 392, orthodontics € 706 ± 667 and prosthetics € 555 ± 244. The most frequently treated diagnosis was tooth decay (33.8% unit services provided, pulpitis (11.2% and impacted teeth (8.5%, while most expensive to treat were anomalies of tooth position (€ 648 ± 667, abnormalities of size and form of teeth (€ 508 ± 705 and loss of teeth due to accident, extraction or local periodontal disease (€ 336 ± 339.Conclusion: Although the range of dental costs currently falls behind EU average, Serbia’s emerging economy is likely to expand in the long run while market demand for dental services will grow. Due to threatened financial sustainability of current health insurance patterns in Western Balkans, getting acquainted with true size and structure of dental care costs could essentially support informed decision making in future

  10. Health Anxiety Levels in Patients Admitted to Internal Medicine Outpatient Clinic for Several Times

    Directory of Open Access Journals (Sweden)

    Ali Gul

    2014-12-01

    Full Text Available Aim: Health anxiety (HA in patients consist of incorrect reference to normal bodily sensations as a signs of a serious disease. The aim of this study is to investigate the HA in patients admitted to internal medicine outpatient clinic for several times within one year. Material and Method: 60 patients who admitted more than one time to internal medicine outpatient clinic within one year and the control group consisted of 60 people were enrolled in this study. Short-form of health anxiety inventory (SAE-KF was given to these groups, The results were compared statistically. Results: SAE-KF scores were significantly higher in the patient group (11.17 ± 6.07 than the control group (10.71±4.44 (Z=-5.96, P

  11. Prevalence of cognitive impairment and depression among elderly patients attending the medicine outpatient of a tertiary care hospital in South India

    OpenAIRE

    Naveen Kumar D; Sudhakar TP

    2013-01-01

    Background: Cognitive impairment is an important clinical issue among elderly patients with depression and has a more complex etiology. The aim of the present work was to examine the prevalence of cognitive impairment and depression in elderly subjects above 60 years. Methods: A cross-sectional study on the prevalence of cognitive impairment and depression on elderly people (n=525) attending the General Medicine OPD of Sri Venkateswara Ram Narain Ruia Government General Hospital, Tirupati. Co...

  12. Italian translation and cultural adaptation of the communication assessment tool in an outpatient surgical clinic

    OpenAIRE

    Scala, Daniela; Menditto, Enrica; Armellino, Mariano Fortunato; Manguso, Francesco; Monetti, Valeria Marina; Orlando, Valentina; Antonino, Antonio; Makoul, Gregory; De Palma, Maurizio

    2016-01-01

    Background The aim of the study is to translate and cross-culturally adapt, for use in the Italian context, the Communication Assessment Tool (CAT) developed by Makoul and colleagues. Methods The study was performed in the out-patient clinic of the Surgical Department of Cardarelli Hospital in Naples, Italy. It involved a systematic, standardized, multi-step process adhering to internationally accepted and recommended guidelines. Corrections and adjustments to the translation addressed both l...

  13. Prevalence and Risk Factors of Obesity among Elderly Attending Geriatric Outpatient Clinics in Mansoura City

    Science.gov (United States)

    Shebl, Amany Mohamed; Hatata, El Sayed Zaki; Boughdady, Aziza Mahmoud; El-Sayed, Sally Mohammed

    2015-01-01

    Obesity is a major public health problem affecting all ages in both developed and developing countries. It is considered the fifth leading risk factor for deaths all over the world as about 2.8 million people die due to obesity each year directly or indirectly. Obesity in elderly is considered one of the most serious public health challenges for…

  14. Prevalence of enteric parasites in homosexual patients attending an outpatient clinic.

    Science.gov (United States)

    Peters, C S; Sable, R; Janda, W M; Chittom, A L; Kocka, F E

    1986-10-01

    A total of 372 pooled stool specimens from 274 homosexual men with diarrhea were submitted for parasitologic examination over a 2.5-year period. Each two-vial pooled specimen set contained portions of stool from 3 consecutive days in Formalin and polyvinyl alcohol. Of the 274 patients, 133 (48.5%) harbored one or more intestinal protozoa, with 161 (43.3%) of the 372 specimens submitted being positive for one or more organisms. The parasites identified included Entamoeba histolytica (71 patients), Giardia lamblia (22 patients), Endolimax nana (106 patients), Entamoeba coli (39 patients), Entamoeba hartmanni (25 patients), Dientamoeba fragilis (3 patients), Iodamoeba bütschlii (2 patients), and Chilomastix mesnili (2 patients). Cryptosporidium sp. (2 patients) and Isospora belli (1 patient) were also detected. Results of this study support the experience of other workers regarding high rates of infection with intestinal parasites in the homosexual population and also indicate that symptomatic individuals belonging to this acquired immunodeficiency syndrome risk group be screened for both common and uncommon intestinal pathogens. PMID:2877006

  15. Atraumatic restorative treatment and dental anxiety in outpatients attending public oral health clinics in South Africa.

    NARCIS (Netherlands)

    Mickenautsch, S.; Frencken, J.E.F.M.; Hof, M.A. van 't

    2007-01-01

    OBJECTIVES: This study was undertaken to test the hypotheses that using the atraumatic restorative treatment (ART) approach results in lower patient anxiety and that lower anxiety leads to higher restoration/extraction ratios. METHODS: The test group of dental operators (n = 9) was trained in ART Th

  16. The prevalence of post-extraction complications in an outpatient dental clinic in Kuala Lumpur Malaysia--a retrospective survey.

    Science.gov (United States)

    Jaafar, N; Nor, G M

    2000-02-01

    The aim of this retrospective study is to report on the prevalence of post-extraction complications among patients attending the Oral Surgery outpatient clinic of the Faculty of Dentistry, University of Malaya over a 12-month period from January to December, 1992. The prevalence of post-extraction complications which required further treatment was only 3.4% (n = 100), out of a total of 2968 patients who had extraction of one or more permanent teeth. Analysis based on complete clinical reports (n = 79) showed that dry socket accounted for nine out of ten cases of post-extraction complications. However the aetiology was largely unknown. No obvious association with medical history could be made. Lower teeth were more likely to have complications. The most common teeth associated with dry socket were the molars (76%) and premolars (19%). The most common molars to be affected are the first, followed by the third and lastly the second molars. A brief review of current aetiological factors of dry socket was discussed.

  17. Seroprevalence of human T cell leukaemia/lymphoma virus type I (HTLV-I) in pregnant women, patients attending venereological outpatient services and intravenous drug users from Slovenia.

    Science.gov (United States)

    Poljak, M; Bednarik, J; Rednak, K; Seme, K; Kristancic, L; Celan-Lucu, B

    1998-01-01

    To establish current seroprevalence of human T cell leukaemia/lymphoma virus type I (HTLV-I) infection in some low- and high-risk populations from Slovenia, 10,369 and 869 serum samples collected during Slovenian 1994 unlinked surveys of human immunodeficiency viruses seroprevalence in pregnant women and patients attending venereological outpatient services, respectively, and 219 serum samples collected from Slovenian intravenous drug abusers during 1995 and 1996, were screened for the presence of anti-HTLV-I antibodies using commercial particle agglutination test Serodia HTLV-I (Fujirebio, Tokyo, Japan). Only one sample obtained from a pregnant woman was found repeatedly positive in the screening test. Presence of anti-HTLV-I antibodies in the reactive sample was undoubtedly confirmed with supplemental Western blot test. The prevalence of antibodies to HTLV-I in the Slovenian population might be somewhere between one in 10,000 (0.01%) and one in 15,000 (0.0066%), which is similar or even higher to prevalence rates in other European countries.

  18. A LONGITUDINAL STUDY OF SERUM URIC ACID LEVEL IN NORMAL PREGNANCY AND PREGNANCY INDUCED HYPERTENSION AMONG PATIENTS ATTENDING ANTENATAL OUTPATIENT DEPARTMENT OF GA UHATI MEDICAL COLLEGE, GUWAHATI

    Directory of Open Access Journals (Sweden)

    Santana

    2015-07-01

    Full Text Available AIMS AND OBJECTIVES: To estimate serum uric acid level in normal pregnancy and pregnancy induced hypertension at different duration as pregnancy advances and to evaluate its place in determining severity of pregnancy induced hypertension. MATERIALS AND METHODS: A longitudinal study was carried out among forty cases of normal pregnancy and forty cases of pregnancy induced hypertension attending antenatal outpatient department of Gauhati Medical College and Hospital. Serum uric acid level was estimated colorimetrically by using Uricase method in the Department of Physiology, Gauhati Medical College. Statistical analysis was carried out applying ANOVA test using IBM SPSS 16. RESULTS: Serum Uric Acid level was found to be significantly higher in study group as compared to control g roup. The mean values of serum uric acid level in study group were 4.07 mg/dl, 4.44 mg/dl and 5.27mg/dl as compared to 3.14mg/dl, 3.11 mg/dl and 3.71 mg/dl in control group at 20 - 24 weeks, 24 - 28 weeks and 32 - 40 weeks of gestation respectively. Also, the leve l of serum uric acid was found to be increased with increasing severity of pregnancy induced hypertension. CONCLUSION: A definite rise in serum uric level was found in cases of pregnancy induced hypertension and its level increases with increasing severity of the disease.

  19. Detection of pulmonary tuberculosis among patients with cough attending outpatient departments in Dar Es Salaam, Tanzania: does duration of cough matter?

    Directory of Open Access Journals (Sweden)

    Wandwalo Eliud R

    2009-07-01

    Full Text Available Abstract Background According to WHO estimates, tuberculosis case detection rate in Tanzania is less than 50% and this poses a major challenge to control tuberculosis in the country. Currently, one of the defining criteria for suspecting tuberculosis is cough for two weeks or more. We wanted to find out whether the prevalence of tuberculosis was different in patients who reported cough for two weeks or more, compared to patients with cough for less than two weeks. Methods We conducted a cross sectional study in six health facilities in Dar es Salaam, between September and October 2007. All patients aged five years and above with cough were screened for pulmonary tuberculosis (PTB by smear microscopy. Patients were divided into two groups, those who coughed for less than two weeks ( Results A total of 65,530 patients attended outpatients department (OPD. Out of these, 2274 (3.5% patients reported cough. Among patients who reported cough, 2214 (97.4% remembered their cough duration. One thousand nine hundred and seventy three patients (89.1% coughed for ≥ 2 wks as compared to 241 (10.9% patients who coughed for Conclusion Detection of smear positive PTB among patients who coughed for less than two weeks was as high as for those who coughed for two weeks or more.

  20. Patients' experience of choosing an outpatient clinic in one county in Denmark: results of a patient survey

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    Gut Rikke

    2011-10-01

    Full Text Available Abstract Background Research on patients' choice of hospital has focused on inpatients' rather than outpatients' choice of provider. We have investigated Danish outpatients' awareness and utilisation of freedom of choice of provider; which factors influence outpatients' choice of hospital, and how socio-demographic variables influence these factors in a single uptake area, where patients were free to choose any public hospital, where care was provided free at the point of delivery, and where distance to the closest hospitals were short by international standards. Methods Retrospective questionnaire study of 4,232 outpatients referred to examination, treatment, or follow-up at one of nine somatic outpatient clinics in Roskilde County in two months of 2002, who had not been hospitalised within the latest 12 months. The patients were asked, whether they were aware of and utilised freedom of choice of hospital. Results Fifty-four percent (2,272 patients filled in and returned the questionnaire. Forty-one percent of respondents were aware of their right to choose, and 53% of those patients utilised their right to choose. Awareness of freedom of choice of provider was reported to be especially high in female outpatients, patients with longer education, salaried employees in the public sector, and in patients referred to surgical specialties. Female outpatients and students were especially likely to report that they utilised their right to choose the provider. Short distance was the most important reason for outpatients' choice, followed by the GP's recommendations, short waiting time, and the patient's previous experience with the hospital. Conclusions Outpatients' awareness and utilisation of free choice of health care provider was low. Awareness of freedom of choice of provider differed significantly by specialty and patient's gender, education and employment. Female patients and students were especially likely to choose the clinic by themselves

  1. Improving the quality of NHS out-patient clinics: the applications and misapplications of TQM.

    Science.gov (United States)

    Hart, M

    1996-01-01

    Presents and discusses the results of a monitoring programme instituted to comply with the objectives laid down in The Patient's Charter. Explores the dangers inherent in attempting to assess the quality of out-patient clinics by the use of single, simplistic indicators such as a waiting time. Examines the ways in which total quality management has been deployed in a health-service context and pays particular attention to the way in which the concept of ¿the customer¿ may need considerable refinement. Suggests incorporating more user-centered approaches into evaluations of quality in the National Health Service, such as the patient satisfaction survey and the application of the SERVQUAL model of consumer satisfaction. Refines the concept of ¿ecological validity¿ in an attempt to capture the perceptions and world views of all of the participants in episodes of out-patient care in order to derive more complete measures of quality. PMID:10157561

  2. Improving the quality of NHS out-patient clinics: the applications and misapplications of TQM.

    Science.gov (United States)

    Hart, M

    1996-01-01

    Presents and discusses the results of a monitoring programme instituted to comply with the objectives laid down in The Patient's Charter. Explores the dangers inherent in attempting to assess the quality of out-patient clinics by the use of single, simplistic indicators such as a waiting time. Examines the ways in which total quality management has been deployed in a health-service context and pays particular attention to the way in which the concept of ¿the customer¿ may need considerable refinement. Suggests incorporating more user-centered approaches into evaluations of quality in the National Health Service, such as the patient satisfaction survey and the application of the SERVQUAL model of consumer satisfaction. Refines the concept of ¿ecological validity¿ in an attempt to capture the perceptions and world views of all of the participants in episodes of out-patient care in order to derive more complete measures of quality.

  3. Same-day physical therapy consults in an outpatient neuromuscular disease physician clinic

    Science.gov (United States)

    Pucillo, Evan M; Christensen-Mayer, Nancy; Poole, Shelly D; Whitten, Denise M; Freeman, Danielle; Bohe, Blake R; Swensen, Brandon R; Smith, A Gordon; Johnson, Nicholas E

    2016-01-01

    Background Team-based care has been shown to offer more comprehensive benefits to patients when compared to standard physician-based care alone in clinics for chronic conditions. However, apart from grant-funded multidisciplinary clinics, there are no reports on the usage of same-day physical therapy (PT) consults within a daily outpatient neuromuscular disease (NMD) physician clinic. Objective To determine the impact of same-day PT consults at the University of Utah’s outpatient Clinical Neurosciences Center. Design A qualitative assessment and survey of patient satisfaction. Methods An eight question Health Insurance Portability and Accountability Act-compliant patient satisfaction survey using a 5-point Likert scale was administered. Demographic data and Press-Ganey Provider Satisfaction surveys were retrospectively collected from electronic medical records for patients receiving same-day PT encounters in the neuromuscular division over 1 year. Results Mean (standard deviation) age was 54.22 (19.81) years for 134 patient encounters, median age was 60 years, with 76 male (57%) and 58 female (43%) patients. Mean Likert score for 61 self-reported patient satisfaction surveys for same-day PT consults was 4.87 (97.4%). Press-Ganey Provider Satisfaction scores improved from 89.9% (N=287) for the year prior to 90.8% (N=320) for the corresponding year (P=0.427). A total of 46 (75.4%) patients have either never before received PT care or never before received PT care for their NMD, 67.4% of whom were male. Conclusion Same-day PT consults in an outpatient NMD physician clinic demonstrated excellent patient satisfaction and improved access to specialty care. This model could potentially be implemented in other academic medical centers to improve access to rehabilitation services for patients with NMD. PMID:27757040

  4. Outpatient clinic waiting time, provider communication styles and satisfaction with healthcare in India.

    Science.gov (United States)

    Mehra, Payal

    2016-08-01

    Purpose - The purpose of this paper is to evaluate the impact of extended waiting time on patients' perceptions of provider communication skills and in-clinic satisfaction, in three major cities in India. Design/methodology/approach - In total, 625 patients were interviewed. The multivariate general linear model was used to determine the causality and relationship between the independent and the dependent variable. A moderation analysis was also conducted to assess waiting time role as a potential moderator in doctor-patient communication. Findings - Results show that patients with higher waiting time were less satisfied with health care quality. Male patients and patients of male providers were more affected by extended waiting time than female patients and patients of female providers. The advanced regression analysis, however, suggests weak support for waiting time and its effect on overall satisfaction with clinic quality. Waiting time did not moderate the relationship between satisfaction with dominant communication style, and overall satisfaction at the outpatient clinic. Research limitations/implications - A cross-sectional study does not easily lend itself to explaining causality with certainty. Thus, sophisticated techniques, such as structural equation modelling may also be utilized to assess the influence of extended waiting time on satisfaction with healthcare at outpatient clinics. Practical implications - Findings are relevant for providers as the onus is on them to ensure patient satisfaction. They should initiate a workable waiting time assessment model at the operational level. Originality/value - There has been a relatively lesser focus on patient waiting time in patient-provider satisfaction studies. In India, this aspect is still vastly unexplored especially in the context of outpatient clinics. Gender wise pattern of patient satisfaction and waiting time is also missing in most studies. PMID:27477932

  5. Glycemia and Levels of Cerebrospinal Fluid Amyloid and Tau in Patients Attending a Memory Clinic

    NARCIS (Netherlands)

    Exalto, Lieza G.; van der Flier, Wiesje M.; Scheltens, Phillip; Biessels, Geert Jan

    2010-01-01

    OBJECTIVES: To determine the association between markers of glycemia and cerebrospinal fluid (CSF) amyloid beta 1-42 (A beta 42) and tau levels in patients attending a memory clinic. DESIGN: Cross-sectional study. SETTING: Memory clinic. PARTICIPANTS: Two hundred forty-five consecutive patients atte

  6. Same-day physical therapy consults in an outpatient neuromuscular disease physician clinic

    Directory of Open Access Journals (Sweden)

    Pucillo EM

    2016-10-01

    Full Text Available Evan M Pucillo,1 Nancy Christensen-Mayer,2 Shelly D Poole,2 Denise M Whitten,2 Danielle Freeman,3 Blake R Bohe,4 Brandon R Swensen,3 A Gordon Smith,1 Nicholas E Johnson1 1Department of Neurology, School of Medicine, 2Department of Physical Medicine & Rehabilitation, 3Outpatient Neurology, University of Utah Hospitals and Clinics, 4Business Support, University of Utah Information Technology, Salt Lake City, UT, USA Background: Team-based care has been shown to offer more comprehensive benefits to patients when compared to standard physician-based care alone in clinics for chronic conditions. However, apart from grant-funded multidisciplinary clinics, there are no reports on the usage of same-day physical therapy (PT consults within a daily outpatient neuromuscular disease (NMD physician clinic.Objective: To determine the impact of same-day PT consults at the University of Utah’s outpatient Clinical Neurosciences Center.Design: A qualitative assessment and survey of patient satisfaction.Methods: An eight question Health Insurance Portability and Accountability Act-compliant patient satisfaction survey using a 5-point Likert scale was administered. Demographic data and Press-Ganey Provider Satisfaction surveys were retrospectively collected from electronic medical records for patients receiving same-day PT encounters in the neuromuscular division over 1 year.Results: Mean (standard deviation age was 54.22 (19.81 years for 134 patient encounters, median age was 60 years, with 76 male (57% and 58 female (43% patients. Mean Likert score for 61 self-reported patient satisfaction surveys for same-day PT consults was 4.87 (97.4%. Press-Ganey Provider Satisfaction scores improved from 89.9% (N=287 for the year prior to 90.8% (N=320 for the corresponding year (P=0.427. A total of 46 (75.4% patients have either never before received PT care or never before received PT care for their NMD, 67.4% of whom were male.Conclusion: Same-day PT consults in an

  7. Pre-dialysis clinic attendance improves quality of life among hemodialysis patients

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    Lam Miu

    2002-04-01

    Full Text Available Abstract Background Although previous research has demonstrated that referral to pre-dialysis clinics is associated with favourable objective outcomes, the benefit of a pre-dialysis clinic from the perspective of patient-perceived subjective outcomes, such as quality of life (QOL, is less well defined. Methods A retrospective incident cohort study was conducted to determine if pre-dialysis clinic attendance was a predictor of better QOL scores measured within the first six months of hemodialysis (HD initiation. Inclusion criteria were HD initiation from January 1 1998 to January 1 2000, diagnosis of chronic renal failure, and completion of the QOL questionnaire within six months of HD initiation. Patients receiving HD for less than four weeks were excluded. An incident cohort of 120 dialysis patients was identified, including 74 patients who attended at least one pre-dialysis clinic and 46 patients who did not. QOL was measured using the SF 36-Item Health Survey. Independent variables included age, sex, diabetes, pre-dialysis clinic attendance and length of attendance, history of ischemic heart disease, stroke, peripheral vascular disease, heart failure, malignancy, and chronic lung disease, residual creatinine clearance at dialysis initiation, and kt/v, albumin and hemoglobin at the time of QOL assessment. Bivariate and multivariate linear regression analyses were used to identify predictors of QOL scores. Results Multivariate analysis suggested that pre-dialysis clinic attendance was an independent predictor of higher QOL scores in four of eight health domains (physical function, p Conclusions We conclude that pre-dialysis clinic attendance favourably influences patient-perceived quality of life within six months of dialysis initiation.

  8. Prevalence of depression and its associated factors among elderly patients in outpatient clinic of Universiti Sains Malaysia Hospital.

    Science.gov (United States)

    Imran, A; Azidah, A K; Asrenee, A R; Rosediani, M

    2009-06-01

    Depression among elderly primary care patients is a serious problem with significant morbidity and mortality. This is a cross sectional study to determine the prevalence of depression and its associated factors among the elderly patients attending the outpatient clinic, Universiti Sains Malaysia Hospital. This study utilized Malay version Geriatric Depression Scale 14 (M-GDS 14) to screen for elderly depression among Malaysian population. It also looked into associated risk factors for elderly depression using sociodemographic, family dynamics, and medically related questionnaires. Out of 244 subjects, 34 or 13.9% were found to have depression. Three variables were found to be significantly associated with depression. Elderly patient with any illness that limits the patient's activity or mobility has more risk of developing depression (OR 2.68 CI 1.15 - 6.24). Elderly patients who were satisfied with their personal incomes (OR 0.29 CI 0.10 - 0.85), and who had children or son/daughter-in-law to take care of them when they are sick (OR 0.10 CI 0.01 - 0.83) have a lower chance of having depression. Screening the elderly for depression, would help in diagnosing the elderly depression better and offer them the treatment needed.

  9. Dental emergencies in a university-based pediatric dentistry postgraduate outpatient clinic: a retrospective study.

    Science.gov (United States)

    Agostini, F G; Flaitz, C M; Hicks, M J

    2001-01-01

    The purpose of this retrospective study was to determine the prevalence and types of dental emergencies occurring in a university-based, pediatric dentistry postgraduate outpatient clinic. All patients presenting for emergency dental care during scheduled clinic hours over a three year were identified, and their charts were retrieved. Each record was reviewed for demographic information, chief complaint and clinical diagnosis. Only those charts with both chief complaints and clinical diagnoses recorded were included in this study. A total of 816 patients received emergency care, representing 15.3 percent of all patient treated during the study period. The patient population had a slight female predilection (53 percent female, 47 percent male) and a mean age of 5.1 years (range 10 days to 15 years). Ethnicity (39 percent African-American, 36 percent Hispanic, 24 percent Caucasian space maintainers [10 percent]; and 6) lost restorations [2 percent]. Pain and bleeding were the most common reasons for seeking emergency dental care. Most causes for seeking outpatient emergency dental care are disease processes which may be avoided by infant oral health and preventive dentistry programs and early treatment intervention.

  10. Variables influencing presenting symptoms of patients with eating disorders at psychiatric outpatient clinics.

    Science.gov (United States)

    Tseng, Mei-Chih Meg; Chen, Kuan-Yu; Chang, Chin-Hao; Liao, Shih-Cheng; Chen, Hsi-Chung

    2016-04-30

    Eating disorders (EDs) have been underdiagnosed in many clinical settings. This study investigates the influence of clinical characteristics on presenting symptoms of patients with EDs. Psychiatric outpatients, aged 18-45, were enrolled sequentially and received a two-phase survey for EDs in August 2010-January 2013. Their primary reasons for seeking psychiatric help were obtained at their first encounter with outpatient psychiatrists. Patients' clinical and demographic characteristics were compared according to presenting symptoms with or without eating/weight problems. Of 2140 patients, 348 (16.3%) were diagnosed with an ED (22.6% of women and 6.3% of men). The three most common reasons for seeking psychiatric help were eating/weight problems (46.0%), emotional problems (41.3%), and sleep disturbances (19.3%). The multivariate analyses suggest that when patients with EDs presented symptoms that were less related to eating/weight problems, they were significantly more likely to be those having diagnoses other than anorexia nervosa or bulimia nervosa and less severe degree of binge-eating. Further, patients with EDs who demonstrated more impulsive behaviors and poorer functioning were less likely to report their eating problems when visiting psychiatric clinics. Thus, ED should be assessed routinely in patients with complex psychopathology to facilitate comprehensive treatment. PMID:27086254

  11. Reasons patients leave their nearest healthcare service to attend Karen Park Clinic, Pretoria North

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    Agnes T. Masango- Makgobela

    2013-01-01

    Full Text Available Background: Many patients move from one healthcare provider or facility to another, disturbing the continuity that enhances holistic patient care.Objectives: To investigate the reasons given by patients for attending Karen Park Clinic rather than the clinic nearest to their homes.Methods: A cross-sectional descriptive study was conducted during 2010. Three hundred and fifty patients attending Karen Park Clinic were given questionnaires to complete, with the following variables: place of residence; previous attendance at the clinic nearest their home; services available at their nearest clinic; and their willingness to attend their nearest clinic in future.Results: Respondents were from Soshanguve (153; 43.7%, Mabopane (92; 26.3%, Garankuwa (29; 8.3% and Hebron (20; 5.7% and most were women (271; 77.4% aged 26–45 (177; 50.6%. Eighty per cent (281 of the patients had visited their nearest clinic previously and 54 of these (19.2% said they would not return. The reasons for this were: long waiting time (88; 25.1%; long queues (84; 24%; rude staff (60; 17%; and no medication (39; 11.1%.Conclusion: The majority of patients who had attended their nearest clinic were adamant that they would not return. It is necessary to reduce waiting times, thus reducing long queues. This can be achieved by having adequate, satisfied healthcare providers to render a quality service and by organising training for management. Patients can thus be redirected to their nearest clinic and the health centre’s capacity can be increased by procuring adequate drugs. There is a need to follow up on patients’ complaints about staff attitudes.

  12. ASSESSMENT OF KNOWLEDGE ABOUT IMMUNIZATION OF UNDER FIVE CHILDREN AMONG MOTHERS ATTENDING OUTPATIENT DEPARTMENT OF PEDIATRICS IN A TERTIARY CARE HOSPITAL IN KOLLAM, KERALA

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    Ahmad Nadeem

    2015-07-01

    Full Text Available BACKGROUND : Immunization is the most cost effective public health intervention to reduce childhood morbidity and mortality. Thousands of children can be saved from vaccine preventable diseases each year by immunization. The knowledge of mothers’ is an important factor for better immunization coverage. Less knowledge affects decision making regarding immunization. OBJECTIVES: To assess the knowledge about immunization of under five children among mothers a ttending outpatient department of paediatrics in a tertiary care hospital in Kollam, Kerala and to find out the association of the knowledge level of mothers with some selected variables. MATERIAL AND METHODS : A Cross sectional study was done among mothers of under five children attending the OPD of pediatrics in a tertiary care hospital in Kollam, Kerala from 1 st to 30 th May, 2014. The sample size was 210 and simple random sampling was used. Statistical analysis was done and chi - square test & percentages w ere calculated. RESULT: 93.8% of mothers knew that vaccines are beneficial for their child. 58% were aware about the side effects of few vaccines. 50% of mothers believed that as polio is eradicated from India, there is no need to give polio vaccine. 35% o f mothers acquired knowledge regarding immunization through health workers. All of them had knowledge about polio vaccine but only half of them knew about rotavirus vaccine. 60% mothers believed that multiple vaccines are beneficial although 26% hold their view that it has no benefit at all. 39.5% of mothers’ had adequate knowledge about immunization. It was positively associated with education, working class and high socio - economic status of mothers. CONCLUSION: There are several loopholes in the mother’s knowledge regarding immunization. Many of them had no knowledge about optional vaccines. There is a need to improve knowledge regarding immunization among general population. Adequate information about completin g the

  13. The prevalence of medical/clinical technology over psychosocial care actions in outpatient mental health services

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    Regina Celia Fiorati

    2013-10-01

    Full Text Available The scope of this study was to evaluate how aspects of mental health policy in Brazil have been conceived and implemented in outpatient services, such as the Regional Outpatient Mental Health Clinic and the Psychosocial Care Center II, both in Ribeirão Preto, São Paulo. Semi-direct interviews and focus groups were conducted with 22 health professionals. The theoretical method and data analysis were supported by the dialectical hermeneutic framework of Jürgen Habermas. The following aspects were detected: considerable technological advancement in health actions and centrality of clinical-medical technology in relation to other nonmedical therapeutic actions; the prioritization of treatment options emphasizing pathology and drug therapy, and a process of mounting precariousness in labor relations. With respect to psychosocial rehabilitation, analysis revealed that instrumental and technically-oriented treatment is imposed upon the practical and dialogical rationale proposed by Brazilian Psychiatric Reform. As an alternative, participatory evaluative research is required in order to unify clinical and psychosocial rehabilitation actions in therapeutic projects, while establishing mechanisms to promote the improvement of care based on the psychosocial care model.

  14. The prevalence of medical/clinical technology over psychosocial care actions in outpatient mental health services.

    Science.gov (United States)

    Fiorati, Regina Celia; Saeki, Toyoko

    2013-10-01

    The scope of this study was to evaluate how aspects of mental health policy in Brazil have been conceived and implemented in outpatient services, such as the Regional Outpatient Mental Health Clinic and the Psychosocial Care Center II, both in Ribeirão Preto, São Paulo. Semi-direct interviews and focus groups were conducted with 22 health professionals. The theoretical method and data analysis were supported by the dialectical hermeneutic framework of Jürgen Habermas. The following aspects were detected: considerable technological advancement in health actions and centrality of clinical-medical technology in relation to other nonmedical therapeutic actions; the prioritization of treatment options emphasizing pathology and drug therapy, and a process of mounting precariousness in labor relations. With respect to psychosocial rehabilitation, analysis revealed that instrumental and technically-oriented treatment is imposed upon the practical and dialogical rationale proposed by Brazilian Psychiatric Reform. As an alternative, participatory evaluative research is required in order to unify clinical and psychosocial rehabilitation actions in therapeutic projects, while establishing mechanisms to promote the improvement of care based on the psychosocial care model. PMID:24061022

  15. Validity Evidences for the Dimensional Clinical Personality Inventory in Outpatient Psychiatric Sample

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    Roberta Katz Abela

    2015-08-01

    Full Text Available The Dimensional Clinical Personality Inventory (IDCP was developed in Brazil for the assessment of pathological personality traits. This study aimed to seek validity evidence for the dimensions of IDCP based on external criteria, psychiatric diagnosis. We examined the profile in IDCP of 105 psychotherapy outpatients, previously diagnosed with personality disorders. The profiles were compared with the profile of the normative non-clinical sample and we conducted the repeated measures analysis to investigate whether the IDCP is able to discriminate consistent profiles for different diagnoses and compared the general population. The results suggest validity evidence based on external criteria for the IDCP dimensions and points to the clinical effectiveness of the instrument.

  16. Characteristics in patients with headache in an outpatient clinic in Japan

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    Okumura Toshikatsu

    2010-11-01

    Full Text Available Abstract Background Little is known about the prevalence of primary and secondary headache in clinics in Japan. The aim of this study is to characterize patients with headache in an outpatient unit where primary care physicians are working in Japan. Methods Consecutive outpatients who newly visited the Department of General Medicine, Asahikawa Medical College Hospital, Asahikawa, Japan between April 2005 and March 2009 were analyzed. Each parameter such as age, sex or diagnosis was investigated. Results Out of 4693 patients, 418 patients visited to our department because of headache. Primary headache was found in 167 patients (39.9%. The rate of tension-type headache (TTH (30.8% was highest, followed by migraine (9.1%. Approximately 3 times higher rate of migraine was observed in female patients when compared with male patients. In female patients, migraine was observed more frequently in younger patients. On the other hands, TTH was observed in almost all aged patients in males and females, and the rate of TTH peaks between the ages of 40 and 49 years in both sex. The present study also demonstrated that 8.4% of patients who chiefly complained of headache had been diagnosed as depression while 1.7% of remained patients had been diagnosed as depression, indicating 5-times higher rate of depression in patients with headache. Conclusion All these results suggest that primary headache, especially TTH, is highly observed and depression should be considered in patients with headache in an outpatient clinic where primary care physicians are working in Japan.

  17. Clinic Attendance for Medication Refills and Medication Adherence amongst an Antiretroviral Treatment Cohort in Uganda: A Prospective Study

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    Setor Kunutsor

    2010-01-01

    Full Text Available Background. Regular clinic attendance for antiretroviral (ARV drug refills is important for successful clinical outcomes in HIV management. Methods. Clinic attendance for ARV drug refills and medication adherence using a clinic-based pill count in 392 adult patients receiving antiretroviral therapy (ART in a district hospital in Uganda were prospectively monitored over a 28-week period. Results. Of the 2267 total scheduled clinic visits, 40 (1.8% were missed visits. Among the 392 clients, 361 (92% attended all appointments for their refills (regular attendance. Clinic attendance for refills was statistically significantly associated with medication adherence with regular attendant clients having about fourfold greater odds of achieving optimal (≥95% medication adherence [odds ratio (OR=3.89, 95% CI: 1.48 to 10.25, exact P=.013]. In multivariate analysis, clients in age category 35 years and below were less likely to achieve regular clinic attendance. Conclusion. Monitoring of clinic attendance may be an objective and effective measure and could be a useful adjunct to an adherence measure such as pill counting in resource-constrained settings. Where human resource constraints do not allow pill counts or other time-consuming measures, then monitoring clinic attendance and acting on missed appointments may be an effective proxy measure.

  18. Comparison of Clinical Teaching by Residents and Attending Physicians in Inpatient and Lecture Settings.

    Science.gov (United States)

    Bergen, Merlynn R.; And Others

    1993-01-01

    A study examined differences in the clinical teaching of 21 medical residents and 19 attending physicians in 2 settings: inpatient care and lectures. Results indicated that ratings were generally similar for the two groups, but setting was a significant source of variance. Self-assessments were similar. Implications for instruction are discussed.…

  19. Cost-effectiveness of HIV screening of patients attending clinics for sexually transmitted diseases in Amsterdam

    NARCIS (Netherlands)

    Bos, JM; Fennema, JSA; Postma, MJ

    2001-01-01

    Objective: To estimate the cost-effectiveness of universal HIV screening of patients attending a clinic for sexually transmitted diseases (STD) in Amsterdam. Design: Cost effectiveness analysis. Methods: A Bernoulli model for the secondary transmission of HIV was linked with epidemiological data on

  20. Prognostic factors for clinical failure of exacerbations in elderly outpatients with moderate-to-severe COPD

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    Wilson R

    2015-06-01

    Full Text Available Robert Wilson,1 Antonio Anzueto,2 Marc Miravitlles,3 Pierre Arvis,4 Daniel Haverstock,5 Mila Trajanovic,6 Sanjay Sethi7 1Host Defence Unit, Royal Brompton Hospital, London, UK; 2University of Texas Health Science Center, South Texas Veterans Health Care System, San Antonio, TX, USA; 3Pneumology Department, Hospital Universitari Vall d’Hebron, CIBER de Enfermedades Respiratorias (CIBERES, Barcelona, Spain; 4Bayer HealthCare Pharmaceuticals, Loos, France; 5Bayer HealthCare Pharmaceuticals, Whippany, NJ, USA; 6Bayer HealthCare Pharmaceuticals, Toronto, ON, Canada; 7University at Buffalo, Buffalo, NY, USA Background: Acute exacerbations represent a significant burden for patients with moderate-to-severe chronic obstructive pulmonary disease. Each exacerbation episode is frequently associated with a lengthy recovery and impaired quality of life. Prognostic factors for outpatients that may predict poor outcome after treatment with antibiotics recommended in the guidelines, are not fully understood. We aimed to identify pretherapy factors predictive of clinical failure in elderly (≥60 years old outpatients with acute Anthonisen type 1 exacerbations.Trial registration: NCT00656747.Methods: Based on the moxifloxacin in AECOPDs (acute exacerbations of chronic obstructive pulmonary disease trial (MAESTRAL database, this study evaluated pretherapy demographic, clinical, sputum bacteriological factors using multivariate logistic regression analysis, with internal validation by bootstrap replicates, to investigate their possible association with clinical failure at end of therapy (EOT and 8 weeks posttherapy.Results: The analyses found that the independent factors predicting clinical failure at EOT were more frequent exacerbations, increased respiratory rate and lower body temperature at exacerbation, treatment with long-acting anticholinergic drugs, and in vitro bacterial resistance to study drug. The independent factors predicting poor outcome at 8

  1. Fuzzy logic-based approach to detecting a passive RFID tag in an outpatient clinic.

    Science.gov (United States)

    Min, Daiki; Yih, Yuehwern

    2011-06-01

    This study is motivated by the observations on the data collected by radio frequency identification (RFID) readers in a pilot study, which was used to investigate the feasibility of implementing an RFID-based monitoring system in an outpatient eye clinic. The raw RFID data collected from RFID readers contain noise and missing reads, which prevent us from determining the tag location. In this paper, fuzzy logic-based algorithms are proposed to interpret the raw RFID data to extract accurate information. The proposed algorithms determine the location of an RFID tag by evaluating its possibility of presence and absence. To evaluate the performance of the proposed algorithms, numerical experiments are conducted using the data observed in the outpatient eye clinic. Experiments results showed that the proposed algorithms outperform existing static smoothing method in terms of minimizing both false positives and false negatives. Furthermore, the proposed algorithms are applied to a set of simulated data to show the robustness of the proposed algorithms at various levels of RFID reader reliability.

  2. Quality of COPD care in hospital outpatient clinics in Denmark: The KOLIBRI study

    DEFF Research Database (Denmark)

    Lange, P.; Andersen, Klaus Kaae; Munch, E.;

    2009-01-01

    Background: We studied the quality of care for COPD patients in 22 hospital-based outpatient clinics in Denmark and evaluated if participation by the staff in an educational programme could improve the quality of care and adherence to the COPD guidelines. Methods: We performed two audits of the h......Background: We studied the quality of care for COPD patients in 22 hospital-based outpatient clinics in Denmark and evaluated if participation by the staff in an educational programme could improve the quality of care and adherence to the COPD guidelines. Methods: We performed two audits...... of the hospital records one year apart before and after the educational programme for the participating doctors and nurses. A total of 941 patient records were included in the first audit and 927 in the second. The indicators of quality of care comprised amongst others referral to pulmonary rehabilitation...... and not in accordance with the recently published guidelines both in the 1st and the 2nd audit. Yet, we observed a substantial improvement from the 1st to the 2nd audit. For example, referral to rehabilitation improved from 56.3 to 62.7% (p = 0.006) Assessment of BMI improved from 7.8 to 56.1% and assessment...

  3. ASSESSMENT OF UTI IN POSTMENOPAUSAL WOMEN ATTENDING OPD CLINIC OF CHITWAN MEDICAL COLLEGE, BHARATPUR, CHITWAN, NEPAL

    OpenAIRE

    Mamata Sharma Neupane; Kalpana Dhakal Sharma; Sangharshila Basnet; Pratik Adhikary; Harish Chandra Neupane; Bijay Aryal

    2013-01-01

    Urinary tract infection (UTI) is the most common bacterial infection in young and elderly women. Despite the higher incidence of bacteriuria in elderly women, most UTI research has been conducted in young women. Hence, the present paper investigates the assessment of UTI in postmenopausal women attending OPD Clinic of Chitwan Medical College, Bharatpur, Chitwan, Nepal. A cross-sectional study was conducted in OPD clinic of Chitwan Medical College Teaching Hospital from December, 2012 to April...

  4. Mental health problems of men attending district-level clinical psychology services in South Africa.

    Science.gov (United States)

    Evans, Dylan J; Pillay, Anthony L

    2009-06-01

    Over a 1-yr. period, 70 men attended district level clinical psychology services in Msunduzi, South Africa. The mean age was 35.9 yr., and 80% had secondary education. Only 65.7% attended of their own accord. 51% were unemployed, 71.4% had financial problems, 44.3% admitted to substance abuse, 74.3% reported relationship problems, and 14.3% admitted to being violent toward their partners. Suicidal ideation was the commonest referral problem, while mood disorder was the most frequent diagnosis. Clinicians estimated that 75.7% of these men had low self-esteem. 45.8% (34) perceived their partner as disengaged, enmeshed, or oppressive.

  5. A Generic Discrete-Event Simulation Model for Outpatient Clinics in a Large Public Hospital

    Directory of Open Access Journals (Sweden)

    Waressara Weerawat

    2013-01-01

    Full Text Available The orthopedic outpatient department (OPD ward in a large Thai public hospital is modeled using Discrete-Event Stochastic (DES simulation. Key Performance Indicators (KPIs are used to measure effects across various clinical operations during different shifts throughout the day. By considering various KPIs such as wait times to see doctors, percentage of patients who can see a doctor within a target time frame, and the time that the last patient completes their doctor consultation, bottlenecks are identified and resource-critical clinics can be prioritized. The simulation model quantifies the chronic, high patient congestion that is prevalent amongst Thai public hospitals with very high patient-to-doctor ratios. Our model can be applied across five different OPD wards by modifying the model parameters. Throughout this work, we show how DES models can be used as decision-support tools for hospital management.

  6. Bloodstream infection among children presenting to a general hospital outpatient clinic in urban Nepal.

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    Rahul Pradhan

    Full Text Available BACKGROUND: There are limited data on the etiology and characteristics of bloodstream infections in children presenting in hospital outpatient settings in South Asia. Previous studies in Nepal have highlighted the importance of murine typhus as a cause of febrile illness in adults and enteric fever as a leading bacterial cause of fever among children admitted to hospital. METHODS: We prospectively studied a total of 1084 febrile children aged between 2 months and 14 years presenting to a general hospital outpatient department in Kathmandu Valley, Nepal, over two study periods (summer and winter. Blood from all patients was tested by conventional culture and by real-time PCR for Rickettsia typhi. RESULTS: Putative etiological agents for fever were identified in 164 (15% patients. Salmonella enterica serovar Typhi (S. Typhi was identified in 107 (10%, S. enterica serovar Paratyphi A (S. Paratyphi in 30 (3%, Streptococcus pneumoniae in 6 (0.6%, S. enterica serovar Typhimurium in 2 (0.2%, Haemophilus influenzae type b in 1 (0.1%, and Escherichia coli in 1 (0.1% patient. S. Typhi was the most common organism isolated from blood during both summer and winter. Twenty-two (2% patients were PCR positive for R. typhi. No significant demographic, clinical and laboratory features distinguished culture positive enteric fever and murine typhus. CONCLUSIONS: Salmonella infections are the leading cause of bloodstream infection among pediatric outpatients with fever in Kathmandu Valley. Extension of immunization programs against invasive bacterial disease to include the agents of enteric fever and pneumococcus could improve the health of children in Nepal.

  7. AETIOLOGY OF SUBACUTE COUGH IN PATIENTS PRESENTING AT SLIMS ENT OUTPATIENT CLINIC – A CLINICAL STUDY

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    Santhosh Kumar

    2013-12-01

    Full Text Available Cough is one of the most common complaint of patients seeking medical attention. A number of patients attend our OPD for complaint of Subacute cough lasting 3-8 weeks. Majority of such cough are due to ENT pathologies. This study aims to evaluate the Otolaryngological causes of Cough in these patients.

  8. Evaluation of factors associated with psychiatric patient dropout at a university outpatient clinic in Japan

    Science.gov (United States)

    Minamisawa, Atsumi; Narumoto, Jin; Yokota, Isao; Fukui, Kenji

    2016-01-01

    Background Patient dropout from treatment can lead to a deterioration in clinical condition, thereby increasing the need for more intensive therapy that incurs substantial social and economic losses. The aim of this study was to identify factors related to psychiatric patient dropout at a university outpatient clinic in Japan. Methods We retrospectively examined the medical charts of new psychiatric patients who were diagnosed with either a mood disorder (International Classification of Diseases, 10th revision, code: F3) or an anxiety disorder (F4) in the outpatient clinic at Kyoto Prefectural University of Medicine Hospital in Kyoto, Japan, between April 2010 and March 2013. The baseline characteristics of the patients (age, sex, Global Assessment of Functioning score, Clinical Global Impression–Severity of Illness score, education, occupation, marital status, duration of treatment, and prior treatment history), treating psychiatrist experience in years, and sex concordance between the patients and their treating psychiatrists were analyzed using Cox regression models. Results From among 1,626 eligible new patients during the study period, 532 patients were enrolled in the study (F3: n=176; F4: n=356). The dropout rate was 35.7%, which was similar to that of previous studies. Higher educational level, being married, and lower Global Assessment of Functioning scores were associated with a lower dropout rate. Although psychiatrist experience was not significantly associated with patient dropout in the multivariate analysis, patients treated by less experienced psychiatrists had a higher hazard ratio for dropout (1.31; 95% confidence interval: 0.94–1.85). Conclusion In order to reduce the dropout rate, special focus should be placed on patients with the factors identified in this study, and young psychiatrists should undergo further education to foster adherence.

  9. A qualitative study on why did the poorly-educated Chinese elderly fail to attend nurse-led case manager clinic and how to facilitate their attendance

    OpenAIRE

    Hung, Susanna Lok Lam; Fu, Sau Nga; Lau, Po Shan; Wong, Samuel Yeung Shan

    2015-01-01

    Objectives This study explored the views, barriers and facilitators of the poorly-educated elderly who were non-attendee of the nurse-led case manager clinic. The case managers provide assessment for diabetes complication screening and can refer patients to the appropriate multidisciplinary team in public outpatient primary care setting. Methods We adopted qualitative research method by individual semi-structured face to face interviews. Nineteen Chinese type 2 diabetes mellitus subjects aged...

  10. Self-assessed and clinically diagnosed periodontal health status among patients visiting the outpatient department of a dental school in Bangalore, India

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    Nagarajan Sripriya

    2008-01-01

    Full Text Available Background: The purpose of the present cross-sectional study was to assess the extent of agreement between clinical and self-assessed periodontal health status among patients visiting the outpatient department of M.S. Ramaiah Dental College, Bangalore, India. Materials and Methods: The study population included 216 patients aged between 20 and 44 years who attended the outpatient department of the M.S. Ramaiah Dental College, Bangalore. The study population was subjected to a self-administered questionnaire (questions regarding bleeding gums, deposits on teeth, receding gums, swelling of gums, loose teeth, which was followed by periodontal examination. The clinical examination included an assessment of the periodontal condition, using the criteria of Loe and Silness Gingival Index, the Community Periodontal Index, and Mobility, respectively. Conclusion: The present study showed that the perceived periodontal health status was low and the discrepancy between the subjectively and objectively assessed needs was very distinct. The awareness of the periodontal problems has been reported to increase with increasing severity of the disease due to the destructive changes that set in.

  11. STDS in women attending family planning clinics: a case study in Addis Ababa.

    Science.gov (United States)

    Duncan, M E; Tibaux, G; Kloos, H; Pelzer, A; Mehari, L; Perine, P L; Peutherer, J; Young, H; Jamil, Y; Darougar, S; Lind, I; Reimann, K; Piot, P; Roggen, E

    1997-02-01

    For cultural reasons modern contraception has been slow to gain acceptance in Ethiopia. Knowledge about contraception and abortion is still limited in many family and community settings in which it is socially disapproved. By 1990 only 4% of Ethiopian females aged 15-49 used contraception. Little is known of sexually transmitted disease (STD) prevalence in family planning (FP) attenders in Africa in general and Ethiopia in particular, even though attenders of family planning clinics (FPCs) are appropriate target groups for epidemiological studies and control programmes. A study of 2111 women of whom 542 (25.7%) attended FPCs in Addis Ababa showed utilisation rates to be highest in women who were: Tigre (33%) or Amhara (31%), aged 20-34 years (30%), age 16 or older at first marriage/coitus (28%:38% in those first married after 25 years); who had a monthly family income of 10 Ethiopian Birr (EB) or more (33%:36% for those with income 100-500 EB), three or more children (37%), more than five lifetime husbands/sexual partners (39%); or were bargirls (73%) or prostitutes (43%). The seroprevalence rates for all STDs, higher in FPC attenders compared with other women, were syphilis (TPHA) 39%, Neisseria gonorrhoeae 66%, genital chlamydia 64%, HSV-2 41%, HBV 40% and Haemophilus ducreyi 20%. Only 4% of FPC attenders had no serological evidence of STD: 64% were seropositive for 3 or more different STD. Clinical evidence of pelvic inflammatory disease (PID) was also more common in the FPC attenders (54%), 37% having evidence of salpingitis. The FPC provides a favourable setting for screening women likely to have high seroprevalence of STD, who for lack of symptoms will not attend either an STD clinic nor a hospital for routine check up. We recommend that measures be taken to adequately screen, treat and educate FPC attenders, their partners, and as appropriate and when possible their clients, in an attempt to control STDs and ultimately HIV in the community. Social, economic

  12. [Women in outpatient treatment for alcohol abuse: sociodemographic and clinical characteristics].

    Science.gov (United States)

    Esper, Larissa Horta; Corradi-Webster, Clarissa Mendonça; Carvalho, Ana Maria Pimenta; Furtado, Erikson Felipe

    2013-06-01

    Quantitative and descriptive study aimed to identify sociodemographic and clinical characteristics of women undergoing outpatient treatment for alcohol abuse. Data were collected from medical records of women with alcohol-related disorders who were treated at a psychiatric outpatient service We performed a reading and descriptive analysis of such data. The sample was composed of 27 medical records, the average age of women was 50 years, mostly married (59.6%), not working (70.4%) with incomplete primary education (70.4%), with an alcoholic family (81.5%) and other psychiatric diagnoses (70.3%). Losses physical, social and emotional was the most common symptoms resulting from alcohol withdrawal syndrome (66.7%), family conflicts (72%) and "sadness" (79.2%). Family violence was recorded in 11 records (40.7%). There was low education, unemployment, psychiatric comorbidities and the presence of other family members with alcohol abuse as common characteristics. We emphasize the importance of professional knowledge about the peculiarities of female alcoholism for health activities more effective. PMID:24015467

  13. Evaluation of the Roche CoaguChek XS handheld coagulation analyzer in a cardiac outpatient clinic.

    Science.gov (United States)

    Nam, Myung-Hyun; Roh, Kyoung Ho; Pak, Hui-Nam; Lee, Chang Kyu; Kim, Young-Hoon; Lee, Kap No; Cho, Yunjung

    2008-01-01

    This study evaluated the performance of a handheld coagulation analyzer for measurements of capillary blood specimens of 93 outpatient cardiology patients with atrial fibrillation who were receiving oral anti-coagulant therapy. The international normalized ratio (INR) results of the CoaguChek XS system (Roche Diagnostics) were compared with those obtained in the central laboratory with citrated venous blood specimens using the ACL9000 coagulation analyzer (Instrumentation Laboratory). The INR results for prothrombin time by the CoaguChek XS analyzer were closely correlated with the central laboratory's results in the INR range of 0.96 approximately 8.53 (r = 0.964). A statistically significant difference was noted between 2 lots of test strips, but the difference was miniscule (mean +/- 95% confidence interval: 0.04+/-0.02). The CV of 8 replicate assays with the CoaguChek XS for a blood specimen with high INR value (INR=3.9) was 1.4%; for a blood specimen with medium INR value (INR=1.3), the CV of 8 replicate assays was XS analyzer is precise and reliable for assessment of INR results at clinically significant ranges in cardiac outpatients.

  14. High rate of smoking in female patients with Mondor's disease in an outpatient clinic in Japan

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    Okumura T

    2012-09-01

    Full Text Available Toshikatsu Okumura,1 Masumi Ohhira,1 Tsukasa Nozu21Department of General Medicine, 2Department of Regional Medicine and Education, Asahikawa Medical University, Asahikawa, Hokkaido, JapanPurpose: Little is known about the epidemiology of Mondor's disease. The aim of this study was to analyze the clinical features of Mondor's disease in an outpatient clinic where primary care physicians are working in Japan, to better understand the epidemiological characteristics of the disease.Patients and methods: The data for consecutive outpatients who were new visitors to the Department of General Medicine in the teaching hospital (Asahikawa Medical University Hospital at Asahikawa Medical University, Asahikawa, Hokkaido, Japan, between April 2004 and March 2012 were analyzed. Parameters such as age, sex, diagnosis, and clinical presentation were investigated.Results: During the 8-year period covered in this study, six (0.07% out of 8767 patients were diagnosed as having Mondor's disease. All of these patients with Mondor's disease were female, and the mean age was 41 plus or minus 12 years; the overall rate of Mondor's disease in all female patients involved in this study was 0.12%. The patients complained of pain and a cord-like structure in the anterolateral thoracoabdominal wall. The painful mass had persisted for 1–4 weeks before presenting at the Department of General Medicine and it disappeared within a couple of weeks. Current smoking was significantly higher in the patients with Mondor's disease than in the age-matched female patients without Mondor's disease who were also evaluated in this study.Conclusion: These results suggest that a high rate of smoking in middle-aged females may be a characteristic feature of Mondor's disease. These epidemiological data may be useful in detection of the disease in the primary care setting in Japan.Keywords: primary care, epidemiology, current smoking, women

  15. Routine HIV screening of sexually transmitted disease clinic attenders has favourable cost-effectiveness ratio in low HIV prevalence settings

    NARCIS (Netherlands)

    Bos, JM; van der Meijden, WI; Swart, W; Postma, MJ

    2002-01-01

    HIV screening for attenders of clinics for sexually transmitted disease (STD) may identify individuals with high-risk sexual behaviour and avert HIV infections in partners. Extending our previous analysis in AIDS, we performed an economic evaluation of HIV screening of STD-clinic attenders in Rotter

  16. Viral Respiratory Tract Infections in Adult Patients Attending Outpatient and Emergency Departments, Taiwan, 2012-2013: A PCR/Electrospray Ionization Mass Spectrometry Study.

    Science.gov (United States)

    Shih, Hsin-I; Wang, Hsuan-Chen; Su, Ih-Jen; Hsu, Hsiang-Chin; Wang, Jen-Ren; Sun, Hsiao Fang Sunny; Chou, Chien-Hsuan; Ko, Wen-Chien; Hsieh, Ming-I; Wu, Chi-Jung

    2015-09-01

    Viral etiologies of respiratory tract infections (RTIs) have been less studied in adult than in pediatric populations. Furthermore, the ability of PCR/electrospray ionization mass spectrometry (PCR/ESI-MS) to detect enteroviruses and rhinoviruses in respiratory samples has not been well evaluated. We sought to use PCR/ESI-MS to comprehensively investigate the viral epidemiology of adult RTIs, including testing for rhinoviruses and enteroviruses. Nasopharyngeal or throat swabs from 267 adults with acute RTIs (212 upper RTIs and 55 lower RTIs) who visited a local clinic or the outpatient or emergency departments of a medical center in Taiwan between October 2012 and June 2013 were tested for respiratory viruses by both virus isolation and PCR/ESI-MS. Throat swabs from 15 patients with bacterial infections and 27 individuals without active infections were included as control samples. Respiratory viruses were found in 23.6%, 47.2%, and 47.9% of the 267 cases by virus isolation, PCR/ESI-MS, and both methods, respectively. When both methods were used, the influenza A virus (24.3%) and rhinoviruses (9.4%) were the most frequently identified viruses, whereas human coronaviruses, human metapneumovirus (hMPV), enteroviruses, adenoviruses, respiratory syncytial virus, and parainfluenza viruses were identified in small proportions of cases (old age, and immunosuppression were independently associated with lower RTIs. In conclusion, PCR/ESI-MS improved the diagnostic yield for viral RTIs. Non-influenza respiratory virus infections were associated with patients with comorbidities and with lower RTIs. Additional studies that delineate the clinical need for including non-influenza respiratory viruses in the diagnostic work-up in these populations are warranted. PMID:26402811

  17. Risk stratification by endocrinologists of patients with type 2 diabetes in a Danish specialised outpatient clinic

    DEFF Research Database (Denmark)

    Munch, Lene; Arreskov, Anne B; Sperling, Michael;

    2016-01-01

    assessments, 3 % were stratified to level 1, 58 % to level 2 and 39 % to level 3. The concordance rate between endocrinologists' and objective assessments was 63 % among newly referred (kappa 0.39; fair agreement) and 67 % for long-term follow-up (kappa 0.45; moderate agreement). Among newly referred patients......BACKGROUND: To target optimised medical care the Danish guidelines for diabetes recommend stratification of patients with type 2 diabetes (T2D) into three levels according to risk and complexity of treatment. The aim was to describe the T2D population in an outpatient clinic, measure the compliance...... of the endocrinologists' to perform risk stratification, and investigate the level of concordance between stratification performed by the endocrinologists and objective assessments. METHODS: A cross-sectional study with data collected from medical records and laboratory databases. The Danish risk stratification model...

  18. Family Nursing Therapeutic Conversations in Heart Failure Outpatient Clinics in Denmark: Nurses’ Experiences

    DEFF Research Database (Denmark)

    Voltelen, Barbara; Konradsen, Hanne; Østergaard, Birte

    2016-01-01

    conducted. Content analysis was performed using a combined deductive and inductive process. Nurses reported developing a distinct, closer, and more constructive relationship with the patients and their families and reported FNTC increased family bonding and strengthened family relationships. The nurses......As part of the Heart Failure Family Trial presently being conducted in Denmark, this qualitative process evaluation explored the perceptions of seven practicing cardiac nurses who offered family nursing therapeutic conversations (FNTC) to families in three heart failure outpatient clinics. FNTC...... were guided by the Calgary Family Assessment and Intervention Models. Data consisted of 34 case reports written by the nurses which documented the use of FNTC, including family responses to the FNTC. A focus group interview with the six of the nurses about their experience of offering FNTC was also...

  19. Hypertension Education Intervention with Ugandan Nurses Working in Hospital Outpatient Clinic: A Pilot Study

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    Godfrey Katende

    2014-01-01

    Full Text Available Noncommunicable diseases (NCDs pose a significant global burden in both developed and developing countries. It is estimated that, by 2025, 41.7% of males and 38.7% of females in Sub-Saharan Africa will develop high blood pressure (HBP. This is particularly true in Uganda with hypertensive prevalence rates estimated to range from 22.5% to 30.5%. Coupled with low levels of detection, treatment, and control, hypertension represents a Ugandan public health crisis. An innovative WHO-ISH education program culturally was adapted in a pilot study and focused on knowledge, skills, and attitudes (KSA of nurses caring for hypertensive patients in an outpatient clinic. Pre-post intervention data was collected and analyzed in which significant improvements were noted on all the three outcome measures. This pilot study demonstrated that nurses’ knowledge, skills, and attitudes could be significantly improved with a multimodal education program implemented in a low resource environment.

  20. Prevalence and correlates of cannabis use in an outpatient VA posttraumatic stress disorder clinic.

    Science.gov (United States)

    Gentes, Emily L; Schry, Amie R; Hicks, Terrell A; Clancy, Carolina P; Collie, Claire F; Kirby, Angela C; Dennis, Michelle F; Hertzberg, Michael A; Beckham, Jean C; Calhoun, Patrick S

    2016-05-01

    Recent research has documented high rates of comorbidity between cannabis use disorders and posttraumatic stress disorder (PTSD) in veterans. However, despite possible links between PTSD and cannabis use, relatively little is known about cannabis use in veterans who present for PTSD treatment, particularly among samples not diagnosed with a substance use disorder. This study examined the prevalence of cannabis use and the psychological and functional correlates of cannabis use among a large sample of veterans seeking treatment at a Veterans Affairs (VA) PTSD specialty clinic. Male veterans (N = 719) who presented at a VA specialty outpatient PTSD clinic completed measures of demographic variables, combat exposure, alcohol, cannabis and other drug use, and PTSD and depressive symptoms. The associations among demographic, psychological, and functional variables were estimated using logistic regressions. Overall, 14.6% of participants reported using cannabis in the past 6 months. After controlling for age, race, service era, and combat exposure, past 6-month cannabis use was associated with unmarried status, use of tobacco products, other drug use, hazardous alcohol use, PTSD severity, depressive symptom severity, and suicidality. The present findings show that cannabis use is quite prevalent among veterans seeking PTSD specialty treatment and is associated with poorer mental health and use of other substances. It may be possible to identify and treat individuals who use cannabis in specialty clinics (e.g., PTSD clinics) where they are likely to present for treatment of associated mental health issues. (PsycINFO Database Record PMID:27214172

  1. THE EFFICACY OF CELLULAR ADHESIVE (HISTOACRYL IN THE MANAGEMENT OF LACERATED WOUNDS IN CHILDREN ATTENDING AN OUT-PATIENT SETTING, AN OBSERVATIONAL STUDY

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    Jeya Balaji1

    2014-06-01

    Full Text Available Apart from traditional Traditionally suturing for wound closure, other options for wound closure like staples, adhesive tapes and tissue adhesives came into existence and are gaining popularity in clinical practice in recent times. There is an increasing amount of literature supporting the use of TAs for various minor lacerations, including a number of randomized controlled trials (RCTs. Even though TAs are ideal choice for resource poor settings like India, studies documenting the efficacy of tissue adhesives, especially in pediatric population are rare from India. AIMS & OBJECTIVE: To study the efficacy of wound healing, occurrence of complications and cost of treatment following cellular Adhesive (Histoacryl use in children with laceration wounds. METHODOLOGY: The study was a cross sectional study, conducted in outpatient setting of department of pediatrics , in a tertiary care teaching hospital, between June 2011 to December 2012. RESULTS: A total of 62 children were included in the study. Clean wounds constituted 93.5% of the wounds. Average amount of glue required was 3 to 4 drops. Majority wounds (91.9% started healing well by the third day of follow-up and they healed well after 7 days. The final outcome was good in 88.7% of the subjects and fair in 3.2% of the subjects. Only 11.3% of participants had some complication. The quantity of tissue adhesive glue used per cm of wound surface was 1.77 drops and the expenditure incurred per cm of wound surface was 44.5 INR. CONCLUSIONS: Tissue adhesive glue is effective method of wound closure in pediatric laceration wounds. The complication rates and the need for antibiotic is very minimal with tissue adhesive glue use and it is very economical way of wound closure in pediatric laceration wounds.

  2. DRUG SAFETY MONITORING IN PATIENTS ATTENDING EPILEPSY CLINIC IN A TERTIARY CARE TEACHING HOSPITAL IN RURAL BENGAL

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    Sourav

    2016-02-01

    Full Text Available BACKGROUND Epilepsy is the second most common neurological disorder affecting fifty million people globally. Antiepileptic Drugs (AEDs are the mainstay of management in epilepsy. Use of AEDs over prolonged duration makes occurrence of multiple Adverse Drug Reactions (ADRs frequently, especially with polytherapy. OBJECTIVES To estimate the incidence of all the ADRs among patients taking AEDs and to assess their causalities and to quantify their severity. MATERIAL AND METHODS This prospective, observational study was carried out at an Outpatient Referral Epilepsy Clinic at Neurology Department at Bankura Sammilani Medical College, West Bengal, between 1st June and 30th September 2015. The demographic data, diagnosis, drugs prescribed and ADRs experienced by the patients were recorded. Causality and severity assessment was done using Naranjo’s Scale and Hartwig’s Severity Assessment Scale respectively. RESULTS Incidence of ADRs among the patients who attended the clinic was 3.3% (105 patients among 3146 experienced at least one ADR. Total 161 ADRs were detected, among which 55.3% were CNS adverse events followed by 15.5% gastrointestinal, 14.3% endocrine, 10.6% psychiatric abnormalities and 4.3% related to dermatological and allergic manifestations. Nearly one-third of the ADRs (32.3% were found to be possible and 109 (67.7% are of probable category, whereas none were deemed to be doubtful or definite. The most commonly implicated suspect drug was valproate (51.5% followed by Phenytoin (22.9%. Most of the ADRs were mild (93.2%, 5.6% were moderate and only 1.2% were deemed severe. CONCLUSION Incidence of ADRs is found to be common in patients on AEDs. Though rare, but they can be life-threatening. Routine safety assessments and pharmacovigilance is necessary in this set up to reduce the incidence and also improve pharmacotherapy and patient compliance

  3. Time-driven activity-based costing in an outpatient clinic environment: development, relevance and managerial impact.

    Science.gov (United States)

    Demeere, Nathalie; Stouthuysen, Kristof; Roodhooft, Filip

    2009-10-01

    Healthcare managers are continuously urged to provide better patient services at a lower cost. To cope with these cost pressures, healthcare management needs to improve its understanding of the relevant cost drivers. Through a case study, we show how to perform a time-driven activity-based costing of five outpatient clinic's departments and provide evidence of the benefits of such an analysis.

  4. Impact of a Metabolic Screening Bundle on Rates of Screening for Metabolic Syndrome in a Psychiatry Resident Outpatient Clinic

    Science.gov (United States)

    Wiechers, Ilse R.; Viron, Mark; Stoklosa, Joseph; Freudenreich, Oliver; Henderson, David C.; Weiss, Anthony

    2012-01-01

    Objective: Although it is widely acknowledged that second-generation antipsychotics are associated with cardiometabolic side effects, rates of metabolic screening have remained low. The authors created a quality-improvement (QI) intervention in an academic medical center outpatient psychiatry resident clinic with the aim of improving rates of…

  5. A Brief Experimental Analysis of Reinforcer and Response Dimensions Related to Self-Control in an Outpatient Clinic

    Science.gov (United States)

    Falcomata, Terry S.; Cooper-Brown, Linda J.; Wacker, David P.; Gardner, Andrew W.; Boelter, Eric W.

    2010-01-01

    We conducted an assessment of self-control and impulsivity with 9 children referred to an outpatient clinic for impulsive, inattentive, and hyperactive behaviors. Each condition of the assessment consisted of a choice between 2 concurrently presented math or writing tasks, with 1 alternative reflecting impulsive responding and 1 alternative…

  6. Supporting adherence and healthy lifestyles in leg ulcer patients: systematic development of the Lively Legs program for dermatology outpatient clinics.

    NARCIS (Netherlands)

    Heinen, M.M.; Bartholomew, L.K.; Wensing, M.J.P.; Kerkhof, P.C.M. van de; Achterberg, T. van

    2006-01-01

    OBJECTIVES: The objective of our project was to develop a lifestyle program for leg ulcer patients at outpatient clinics for dermatology. METHODS: We used the intervention-mapping (IM) framework for systematically developing theory and evidence based health promotion programs. We started with a need

  7. Prevalence and predictors of unexplained neurological symptoms in an academic neurology outpatient clinic--an observational study.

    NARCIS (Netherlands)

    Snijders, T.J.; Leeuw, H.F. de; Klumpers, U.M.H.; Kappelle, L.J.; Gijn, J. van

    2004-01-01

    OBJECTIVES: (a) To determine the prevalence of unexplained symptoms among newly referred patients in a Dutch academic outpatient clinic for general neurology; (b) To identify factors that can serve as characteristics and possibly as screening instruments for unexplained symptoms in this population.

  8. The Radiologist Will See You Now: Patients' Perceptions of an Outpatient Interventional Clinic.

    Science.gov (United States)

    Abboud, Salim; Partovi, Sasan; Nakamoto, Dean; Azar, Nami

    2016-01-01

    Patient satisfaction is becoming an increasingly important part of America's healthcare system. Patient satisfaction is now a metric assessed for value-based incentive payments by the Center for Medicare and Medicaid Services, and the healthcare market is becoming increasingly consumer-driven as patients are provided with more options regarding where they receive care as well as improved access to medical information. Radiologists, while less involved with direct patient care than other medical specialties, are not immune to the changing medical landscape and need to adapt to a progressively value- and patient-oriented healthcare system. At our institution, first-year radiology residents take an active role in our outpatient interventional radiology clinic by performing clinical histories and physical exams in a dedicated radiology clinic examination rooms. Stressing the various opportunities for patient interaction and the potential benefits of patient- centered radiology in the evolving healthcare system may increase its perceived value among both radiology residents as well as practicing radiologists. ​Directly engaging patients may be unfamiliar territory for the practicing radiologist and an unexpected prospect for current residents, but available data suggests that patients do value direct interaction with radiologists during the course of their care. PMID:26596560

  9. CLINICAL PROFILE OF DIABETIC FOOT ULCERS OF PATIENTS ATTENDING SURGICAL OPD IN RURAL MEDICAL COLLEGE

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    Sanjeev

    2015-12-01

    Full Text Available OBJECTIVE To study the clinical profile of dibetic foot ulcers of patients attending surgical OPD in rural medical college. MATERIAL AND METHODS Clinical profile of 40 patients of diabetic foot ulcers was studied. All the patients were subjected to complete haemogram, fasting and PP blood sugar, LFT, KFT, lipid profile, urine R/E, pus c/s, colour doppler of lower limb and x-ray foot. RESULTS Majority of patients with diabetic foot ulcers were of age group 41–70, male, diabetes mellitus of duration more than 6 years, had intermittent claudication and single ulcer.

  10. Evaluating Fluoroquinolone Use in Patients Admitted to the Tuberculosis Outpatient Clinic

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    Sinem İliaz

    2016-08-01

    Full Text Available Objective: Inelaborate use of new quinolones with strong anti-tuberculosis (TB activity leads to difficulty in diagnosis and more importantly, quinolone-resistant Mycobacterium tuberculosis. We aimed to determine the frequency of quinolone use in patients who were referred to our hospital for suspected TB and to evaluate the association between quinolone use and different clinical laboratory parameters. Methods: Between November 15 and December 15, 2013, all patients who were admitted to the TB outpatient clinic with no previous diagnosis of TB were included in this study. Demographic and clinical laboratory findings and history of antibiotic use were recorded. Patients’ quinolone use were questioned by showing fluoroquinolone antibiotic boxes’ photographs available on the market. The departments of the doctors who prescribed quinolones were recorded. Results: The mean age of 179 patients included in the study was 37±16 (15–89 years. Among these, 113 patients (63.1% were male. Seventy five patients (41.9% were diagnosed as tuberculosis according to the clinical-radiological and/or bacteriological findings. Of 179 patients, 58.1% (n=104 had been prescribed antibiotics for current complaints before referral to our clinic. Sixteen patients (15% had been recommended fluoroquinolones. Fluoroquinolones were prescribed by seven internal medicine specialists, five pulmonologists, three emergency medicine specialists, and one family medicine practitioner. Among 16 fluoroquinolones prescribed, nine were moxifloxacin, four were levofloxacin, and three were gemifloxacin. Quinolone use revealed a significant inverse relationship only with the presence of hemoptysis (p=0.04. Conclusion: Besides increased educational activities regarding the rational use of antibiotics in recent years, the quinolone group of antibiotics is still prescribed for suspected TB cases. To avoid quinolone-resistant M. tuberculosis strains, further education is required.

  11. Prevalence of pulmonary tuberculosis among HIV positive patients attending antiretroviral therapy clinic

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    Purushottam A Giri

    2013-01-01

    Full Text Available Background: Tuberculosis (TB is the most common serious opportunistic infection in HIV positive patients and is the manifestation of AIDS in more than 50% of cases in developing countries. TB can occur at any time during the course of HIV infection. Aim: To describe the socio-demographic profile and prevalence of pulmonary tuberculosis (HIV/TB co-infection among HIV positive patients been attended at the antiretroviral therapy clinic (ART clinic at tertiary care teaching hospital of western Maharashtra, India. Materials and Methods: A cross-sectional study was carried out at the ART clinic of Pravara Rural Hospital, Loni, from June 2011 to May 2012. A total of 1012 HIV positive patients, who attended ART clinic, receiving ART treatment during the study period, were included in the analysis. The statistical analysis was performed using SPSS software (Version 17.0. Results: This study showed 1012/172 (17% prevalence of pulmonary tuberculosis among HIV positive patients, of which 87 (50.58% were males and 85 (48.42% were females. Low CD4 count (< 50/μl had statistically significant association with HIV/TB co-infection as compared to HIV infection only ( P < 0.0001. Conclusion: The study showed that 17% of HIV infected persons had tuberculosis co-infection. More strategic preventive measures that enhance body immunity among HIV patients are highly needed as early as possible before they develop active tuberculosis.

  12. An audit of first prescription of new patients attending a psychiatry walk-in-clinic in north India

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    Sandeep Grover

    2012-01-01

    Full Text Available Background: Although almost all psychotropic medications available worldwide are readily available in India, there is meager data in this country on the prescription patterns of psychiatrists. Aim: To study the first prescription handed over to patients attending the psychiatry outpatient clinic of a tertiary care hospital. Materials and Methods: Data of all patients (for the period of January 1, 2009 to November 30, 2010; diagnosed with an ICD-10 diagnosis of F2-F4 were extracted from the computer-based registry and analyzed. Results: Ten thousand two hundred and fourteen (10 214 patients were diagnosed to have a diagnosis of F2-F4 ICD-10 category. In all diagnostic groups, olanzapine was the most commonly prescribed antipsychotic followed by risperidone. Very few patients (8% received typical antipsychotic medication. In all diagnostic groups, escitalopram was the most commonly prescribed antidepressant; other frequently prescribed antidepressants were sertraline, paroxetine, and venlafaxine. Among the mood stabilizers, valproate was preferred over lithium. In all the groups, more than half of the patients were prescribed benzodiazepines, clonazepam being the most commonly prescribed agent, followed by lorazepam. The mean number of psychotropic medications was highest in the bipolar disorder group. Very few patients received the combination of same group of drugs. Conclusions: Olanzapine, escitalopram, and clonazepam are the most commonly prescribed antipsychotic, antidepressants, and benzodiazepines, respectively. Valproate was preferred over lithium as a mood stabilizer. In general, the prescription trends were in accordance to the recommendations of various treatment guidelines, except for the use of benzodiazepines, which was higher.

  13. Metabolic Syndrome Among Obese Patients Attending the Medical Clinics of Three Reaching Hospitals at Sana's City, Yemen

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    Soumeah M. AL-Ghazan

    2011-06-01

    Full Text Available Background: Yemen faces major challenges in improving the health status of its population as it is entering an epidemiological transition with rising noncommunicable diseases e.g. obesity, diabetes and cardiovascular diseases (CVDs. We designed this study to find out the prevalence of Metabolic Syndrome (MS and its components among obese Yemeni patients.Methods: All obese (waist circumference >102 cm in male and >88 cm in female attending the outpatients medical clinics at the three teaching hospitals in Sana'a city, were examined and their blood pressure (BP, fasting samples of plasma glucose, triglycerides, and HDL cholesterol were measured. The prevalence of MS obtained based on the Adult Treatment Panel III and presence of at least 3 of the following: systolic BP ≥130 mm Hg and/or diastolic BP ≥ 85 mm Hg or on treatment for high BP, fasting glucose ≥110 mg/dl or on diabetes treatment, triglycerides ≥150 mg/dl, and HDL cholesterol <40 mg/dl in men and <50 mg/dl in women.Results: 200 obese were identified during study period with an overall MS prevalence of 46%. The metabolic co-morbidities were raised BP (68%, high triglycerides (66%, reduced high density lipoprotein (64%, and raised fasting blood glucose (40%.Conclusion: Prevalence of MS is high among obese Yemeni patients and high BP was the commonest co-morbidity. These findings highlight an urgent need to develop strategies for prevention, detection, and treatment of MS that could contribute to decreasing the rising incidence of CVD and diabetes.

  14. Clinical features of diabetes mellitus in Japan as observed in a hospital outpatient clinic

    Energy Technology Data Exchange (ETDEWEB)

    Wada, Sunao; Toda, Shintaro; Omori, Yoshiaki; Yamakido, Michio; Blackard, W.G.

    1963-04-18

    A university diabetes clinic in Japan was characterized by age at examination, age at onset, sex ratio, microangiopathies, atherosclerotic complications, weight, heredity, and diet. The findings in this clinic, along with those from other diabetes clinics in Japan, were compared with studies on Western diabetics. The similarities between the 2 diabetic populations far outnumbered the dissimilarities. However, diabetes mellitus in Japan is distinguished by infrequent occurrence of juvenile diabetes and ketosis, relative lack of atherosclerotic complications, and reversal of the sex ratio. 39 references, 7 tables.

  15. A multidisciplinary stroke clinic for outpatient care of veterans with cerebrovascular disease

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    Moran E

    2011-04-01

    program evaluation was to assess the effectiveness of an outpatient Multidisciplinary Stroke Clinic model for the clinical management of veterans with cerebrovascular disease or cerebrovascular risk factors.Methods: The Multidisciplinary Stroke Clinic provided care to veterans with cerebrovascular disease during a one-half day clinic visit with interdisciplinary evaluations and feedback from nursing, health psychology, rehabilitation medicine, internal medicine, and neurology. We conducted a program evaluation of the clinic by assessing clinical care outcomes, patient satisfaction, provider satisfaction, and costs.Results: We evaluated the care and outcomes of the first consecutive 162 patients who were cared for in the clinic. Patients had as many as six clinic visits. Systolic and diastolic blood pressure decreased: 137.2 ± 22.0 mm Hg versus 128.6 ± 19.8 mm Hg, P = 0.007 and 77.9 ± 14.8 mm Hg versus 72.0 ± 10.2 mm Hg, P = 0.004, respectively as did low-density lipoprotein (LDL-cholesterol (101.9 ± 23.1 mg/dL versus 80.6 ± 25.0 mg/dL, P = 0.001. All patients had at least one major change recommended in their care management. Both patients and providers reported high satisfaction levels with the clinic. Veterans with stroke who were cared for in the clinic had similar or lower costs than veterans with stroke who were cared for elsewhere.Conclusion: A Multidisciplinary Stroke Clinic model provides incremental improvement in quality of care for complex patients with cerebrovascular disease at costs that are comparable to usual post-stroke care.Keywords: clinical management of stroke, cost, blood pressure management, clinical outcome

  16. The role of psychology in a pediatric outpatient cardiology setting: preliminary results from a new clinical program.

    Science.gov (United States)

    Brosig, Cheryl; Yang, Kai; Hoffmann, Raymond G; Dasgupta, Mahua; Mussatto, Kathleen

    2014-12-01

    The aim of this study was to provide a descriptive analysis of a new clinical program integrating psychology services within a pediatric outpatient cardiology clinic. Patients with congenital heart disease (CHD) (n = 79) were referred for psychological services by their pediatric cardiologist. Parents completed the child behavior checklist, and the pediatric quality of life inventory generic core scales (PedsQL parent report). Teachers completed the teacher report form. Reasons for referral included: emotional problems (29%); attention problems (25%); learning problems (22%); behavior problems (16%); and developmental delay (8%). Parents and teachers reported higher rates of behavior problems and lower quality of life scores than the general population. Psychological evaluation suggested that incorporating a psychologist within a pediatric cardiology clinic may be beneficial for children with CHD in order to optimize their psychosocial functioning. Practice implications for implementing psychology services within a pediatric outpatient cardiology program are discussed.

  17. Pattern of mental illness among women attending an infertility clinic in Southern Nigeria

    OpenAIRE

    J O Omoaregba; O Morakinyo; James, O B; A O Lawani

    2011-01-01

    Background: Female infertility is highly co-morbid with mental illness. In Nigeria, very few studies have been conducted to determine the pattern of mental illness among women with infertility. We aimed to determine the pattern of mental illness in a sample of women with female infertility as well as its associated correlates.Patients and Methods: A cross sectional two-stage survey of women (n=100) attending an infertility clinic was conducted in a teaching hospital in Nigeria. A 30-item GHQ ...

  18. The Prevalence and the Determinants of Musculoskeletal Diseases in Emiratis Attending Primary Health Care Clinics in Dubai

    OpenAIRE

    Jamal Al Saleh; Manal EL Sayed; Nahed Monsef; Ebtihal Darwish

    2016-01-01

    Objectives: To estimate the prevalence of rheumatic diseases in the Emiratis attending primary health care (PHC) clinics in Dubai. The secondary objective was to study the relationship between age, gender, and body mass index (BMI) and rheumatic diseases in the general population.  Methods: The Prevalence of Rheumatic Diseases and Osteoporosis (PRO) in Dubai study was a cross-sectional study, which randomly enrolled Emiratis’ aged between 18–85 years old who attended one of 13 PHC clinics...

  19. Study of the use of analgesics by patients with headache at a specialized outpatient clinic (ACEF

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    Olga Francis Pita Chagas

    2015-07-01

    Full Text Available Objective : To evaluate the use of analgesics in headache diagnosed in Outpatients Headache Clinic (ACEF, as well as his involvement in the activities of the patients. Method : 145 patients with headache seen at ACEF during the period August/July 2009/2010 underwent a questionnaire and interview with neurologist responsible for the final diagnosis according to ICHD-II. Results : Relationship Women:Men 7:1. 1 Prevalence: Migraine without aura (52.4%, migraine with aura (12.4%, chronic migraine (15.2% and medication overuse headache (MOH (20%. 2 Analgesic drugs used: Compounds with Dipyrone (37%, Dipyrone (23%, Paracetamol (16% compound with Paracetamol (6%, triptans (6% and non steroidal anti-inflammatory drugs (12%. There was a significant decrease in the duration of pain and less interference in the activities of the headache patients after the use of analgesics. Conclusion : Prevalence of MOH has been increasing in population level and specialized services. New studies emphasizing the MOH are needed to assist in the improvement of their diagnostic and therapeutic approach.

  20. [An outpatient clinic measure and control system for anticoagulation levels, CoaguChek XS].

    Science.gov (United States)

    Romero Guardeño, Araceli; Pérez Lucena, Dolores Amalia

    2009-03-01

    A significant increase during recent years in the number of patients who need Oral Anticoagulant Treatment has meant a greater role for nurses, especially in Primary Health Care Centers, since nurses, along with doctors, are the professionals responsible for treating those patients. This control is carried out by measuring the levels of anticoagulants in the blood, regulating the anticoagulant medicine doses, and providing patients with the essential health education so patients participate in the treatment of their illness. To a large degree, the preponderance of Primary Health Care Centers in the aforementioned control has developed hand-in-hand with the availability of portable, simple and low cost coagulation measuring systems which permit a direct reading of a patient's anticoagulation level with one drop of capillary blood. The objective of this article is introduce the reader to a measuring system appropriate for outpatient clinic control of anticoagulant levels in blood by mans of the CoaguChek XS System, which is described. The authors specify the sample extraction procedure, how to measure coagulant levels, and recommendations to keep in mind while carrying out this procedure. The authors sketch the importance of health education and finally, they describe some advantages and inconveniences this system has. PMID:19462604

  1. [An outpatient clinic measure and control system for anticoagulation levels, CoaguChek XS].

    Science.gov (United States)

    Romero Guardeño, Araceli; Pérez Lucena, Dolores Amalia

    2009-03-01

    A significant increase during recent years in the number of patients who need Oral Anticoagulant Treatment has meant a greater role for nurses, especially in Primary Health Care Centers, since nurses, along with doctors, are the professionals responsible for treating those patients. This control is carried out by measuring the levels of anticoagulants in the blood, regulating the anticoagulant medicine doses, and providing patients with the essential health education so patients participate in the treatment of their illness. To a large degree, the preponderance of Primary Health Care Centers in the aforementioned control has developed hand-in-hand with the availability of portable, simple and low cost coagulation measuring systems which permit a direct reading of a patient's anticoagulation level with one drop of capillary blood. The objective of this article is introduce the reader to a measuring system appropriate for outpatient clinic control of anticoagulant levels in blood by mans of the CoaguChek XS System, which is described. The authors specify the sample extraction procedure, how to measure coagulant levels, and recommendations to keep in mind while carrying out this procedure. The authors sketch the importance of health education and finally, they describe some advantages and inconveniences this system has.

  2. Implementation of a clinical pathway for emergency department out-patient management of deep vein thrombosis.

    LENUS (Irish Health Repository)

    Kidney, R

    2010-09-01

    There is good evidence demonstrating that outpatient management of deep venous thrombosis (DVT) is feasible and safe. However, few emergency departments in Ireland have implemented care pathways for outpatient management of DVT. The aim of this study was to examine the safety and efficacy of implementing an Emergency Department (ED)- care pathway for outpatient management of patients with DVT. A retrospective observational study of this care pathway introduced at our institution was performed. The primary outcome measure was the number of hospital admissions avoided by using the care pathway. Two hundred and eighty-four patients presenting to the ED with suspected lower limb DVT, were managed using the care pathway over a 6 month period. Forty-nine patients (17%) had a DVT diagnosed. Thirty-nine patients (81%) were suitable for outpatient DVT management. Ten patients (19%) were admitted to hospital. At 3 months there were no reported cases of the following complications: missed DVT, pulmonary embolism or death.

  3. Incidence of Osteoporosis in Patients Admitted to our Physical Medicine and Rehabilitation Outpatient Clinics

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    Berat Meryem Alkan

    2011-04-01

    Full Text Available Aim: Osteoporosis is a skeletal disease characterized with decreased bone mass and microarchtitectural deterioration of bone tissue which increases bone fragility and fracture risk. Osteoporosis and osteoporotic fractures constitute an important health problem in general population. This study aimed to determine the incidence of osteoporosis, chronic diseases accompanying osteoporosis and incidence of falls in male and female patients admitted to our out patient clinics retrospectively. Material and Methods: Patient records of the 11624 patients admitted to Ankara Atatürk Education and Research Hospital Physical Medicine and Rehabilitation Outpatient clinics between January 2010 and July 2010 were retrospectively reviewed and 644 patients diagnosed as osteoporosis according to femoral neck and/or lumbar dual energy x ray absoptiometry measurements were included in the study. Ages of the patients, sexes, chronic ilnesses, musculoskeletal sytem complaints and fall histories were also recorded. Results: The incidence of osteoporosis was found to be 7.61% in female patients and it was determined that incidence was 5-fold increased in women than in men. Besides, chronic ilnesses and fall history were accompanying in higher ratios in osteoporotic patients. Conclusion: Heart diseases, hypertension, diabetes, neurological diseases leading to impairment in balance and musculoskelatal system complaints were quite frequent in patients with osteoporosis and these diseases should be taken seriously since they increase the risk of falling. It is important to avoid using drugs which lead to balance impairment, to use walk aids like canes or walkers, to perform exercises including balance and coordination training and endurance exercises in order to prevent falls. (Turkish Journal of Osteoporosis 2011;17:10-3

  4. Body Mass Index in Clinic Attenders: Patient Self-Perception versus Actual Measurements

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    S. Pooransingh

    2014-01-01

    Full Text Available Objectives. The objectives of the study were to measure actual BMI in patients attending chronic disease clinics in health centres and to relate this to the patients’ own perceptions of their body image and the need to lose weight. Study Design. A cross sectional study. Methods. The actual BMIs in patients who attended chronic disease clinics in 14 health centres were measured. All participants were asked to state where they thought they were on a visual body image scale and were also asked if they thought they needed to lose weight. Results. All participants approached agreed to participate (RR 100%. 70% of patients were found to have a raised BMI. Approximately 73% of patients using the visual scale indicated that an overweight or obese BMI was ideal for them. Conclusions. Patients think they are thinner than they actually are, with obvious implications for health and health seeking behaviour. A whole of society approach is needed to change weight status perceptions and improve exercise and dietary behaviour.

  5. Health literacy screening of patients attending a student-led osteopathy clinic: A pilot investigation.

    Science.gov (United States)

    Vaughan, Brett; Mulcahy, Jane; Fitzgerald, Kylie

    2016-08-01

    Adequate levels of health literacy (HL) are required for patients to access appropriate health services and develop an understanding of the options for managing their healthcare needs. There is limited literature on HL of patients seeking care for a musculoskeletal complaint. The present study sought to screen the HL of patients presenting to an Australian osteopathy student-led clinic using a single screening question 'Are you confident completing medical forms?'. Less than 10% of patients attending the clinic were considered to have below adequate levels of HL using this question, consistent with other work in Australian populations. Logistic regression analysis identified that the most significant demographic variables associated with lower HL were patients who did not speak English at home, those with lower education levels, and those who were less satisfied with their life. Evaluation of a patients' HL may assist practitioners to improve patient education and management strategies. PMID:27502799

  6. Knowledge of Fecal Calprotectin and Infliximab Trough Levels Alters Clinical Decision-making for IBD Outpatients on Maintenance Infliximab Therapy

    OpenAIRE

    Huang, Vivian W; Prosser, Connie; Kroeker, Karen I.; Wang, Haili; Shalapay, Carol; Dhami, Neil; Fedorak, Darryl K; Halloran, Brendan; Dieleman, Levinus A.; Goodman, Karen J; Richard N Fedorak

    2015-01-01

    Background: Infliximab is an effective therapy for inflammatory bowel disease (IBD). However, more than 50% of patients lose response. Empiric dose intensification is not effective for all patients because not all patients have objective disease activity or subtherapeutic drug level. The aim was to determine how an objective marker of disease activity or therapeutic drug monitoring affects clinical decisions regarding maintenance infliximab therapy in outpatients with IBD. Methods: Consecutiv...

  7. A dance movement therapy group for depressed adult patients in a psychiatric outpatient clinic: effects of the treatment

    OpenAIRE

    Pylvänäinen, Päivi M.; Muotka, Joona S.; Lappalainen, Raimo

    2015-01-01

    We were interested in investigating the effects of dance movement therapy (DMT) in a psychiatric outpatient clinic with patients diagnosed with depression. DMT aims to engage the patients in physical and verbal exploration of their experiences generated in movement based interaction. The assumption was that DMT, which includes both physical engagement as well as emotional and social exploration, would alleviate the mood and psychiatric symptoms. All adult patients (n = 33) incl...

  8. Time-driven activity-based costing in an outpatient clinic environment: development, relevance and managerial impact.

    Science.gov (United States)

    Demeere, Nathalie; Stouthuysen, Kristof; Roodhooft, Filip

    2009-10-01

    Healthcare managers are continuously urged to provide better patient services at a lower cost. To cope with these cost pressures, healthcare management needs to improve its understanding of the relevant cost drivers. Through a case study, we show how to perform a time-driven activity-based costing of five outpatient clinic's departments and provide evidence of the benefits of such an analysis. PMID:19505741

  9. Sexual behaviour in adolescents and young people attending a sexually transmitted disease clinic, Ile Ife, Nigeria

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    Olasode Olayinka

    2007-01-01

    Full Text Available WHO estimates that 20% of persons living with HIV/AIDS are in their 20s and one out of twenty adolescents contract a sexually transmitted disease (STD each year. A total of 303 adolescents and youths (10-24 years of age attending an STD clinic were subjected to a questionnaire to assess sexual behavioural patterns that predisposed them to STD. Scope of the questions included age at initiation of sexual intercourse, partner at first exposure, number of sexual partners, use of condoms, exposure to commercial sex workers (CSWs, previous infection with STDs and role of alcohol. Their diagnosis was based on history, clinical findings and laboratory confirmation. Adolescents and youths accounted for 30% of the total number of patients attending the STD clinic during this period. The male to female ratio was 1:0.95. Ninety-six percent (290 were single while 4% (13 were married. Seventy-two percent (217 were students. Age at onset of sexual activity was 10-20 years in 80%, 85% practiced risky sexual behaviour, patronising casual partners was frequent especially after alcohol use, 10% had been exposed to CSWs, condom use was poor, number of sexual partners varied between 1 and 5 and previous infections were not professionally treated. Adolescents and young people are sexually active and practice risky sexual behavioural patterns. Adolescents and youths account for a high percentage of patients patronising the STD clinic. Sexual education and youth friendly reproductive health services are urgently needed to curb the spread of HIV/AIDS/STDs.

  10. Respiratory Virus Detection and Clinical Diagnosis in Children Attending Day Care

    Science.gov (United States)

    Moe, Nina; Pedersen, Bård; Nordbø, Svein Arne; Skanke, Lars Høsøien; Krokstad, Sidsel; Smyrnaios, Anastasios; Døllner, Henrik

    2016-01-01

    Background Respiratory viruses often have been studied in children with respiratory tract infection (RTI), but less knowledge exists about viruses in asymptomatic children. We have studied the occurrence of a broad panel of respiratory viruses in apparently healthy children attending day care, taking into account the influence of possible confounding factors, such as age, clinical signs of respiratory tract infection (RTI), location (day-care section) and season. Methods We have studied 161 children in two day-care centers, each with separate sections for younger and older children, during four autumn and winter visits over a two-year period. A total of 355 clinical examinations were performed, and 343 nasopharyngeal samples (NPS) were analyzed by semi-quantitative, real-time, polymerase chain reaction (PCR) tests for 19 respiratory pathogens. Result Forty-three percent of all NPS were PCR-positive for ≥ 1 of 13 virus species, with high species variation during visits. Rhinovirus 26% (88/343 NPS), enterovirus 12% (40/343) and parechovirus 9% (30/343) were detected in every visit, and the rates varied in relation to age, day-care section and season. Ten other viruses were detected in ≤ 3% of the NPS. Generally, viruses occurred together in the NPS. In 24% (79/331) of the clinical examinations with available NPS, the children had clear signs of RTI, while in 41% (135/331) they had mild signs, and in 35% (117/331) the children had no signs of RTI. Moreover, viruses were found in 70% (55/79) of children with clear signs of RTI, in 41% (55/135) with mild signs and in 30% (35/117) without any signs of RTI (p < 0.001). Conclusions Positive PCR tests for respiratory viruses, particularly picornaviruses, were frequently detected in apparently healthy children attending day care. Virus detection rates were related to age, presence of clinical signs of RTI, location in day care and season. PMID:27433803

  11. Doctor-Patient Communication In An Out-Patient Clinic Of A Teaching Hospital

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    Amir Ali

    1999-01-01

    Full Text Available Research question: What is the degree of satisfaction of patient with doctor-patient communication? Objective: To study the degree of satisfaction with doctor-patient communication. Study design: Cross-sectional Setting & participants: Patient attending department of Medicine, J.N.M.C. Hospital, A.M.U., Aligarh. Study period: April 1977 to March 1998. Sample size: 4460 urban male patients aged 18 years and above. Study variables: Age, no of clinic visits. Statistical analysis: Chi-Square test. Results: 38.34% patients received satisfactory answers to their questions. The proportion of dissatisfaction was (70.31% among elderly patients. The patients who visited clinic on more than 4 occasions were relatively more satisfied (43.83%. Majority of the patients received information on nature of investigation (30.71% and about treatment (26.63% but only 6.07% received information on prognosis and 18.92% about nature of the disease. Majority of the patients (82.62% preferred verbal information.

  12. PREVALENCE OF SKIN DISEASES IN A DERMATOLOGY OUTPATIENT CLINIC IN RIMS, KADAPA, A CROSS - SECTIONAL, RETROSPECTIVE STUDY

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    Sirisha

    2015-07-01

    Full Text Available BACKGROUND: Dermatological diseases vary widely as a result of geographic location climate socioeconomic status and personal habits and internal factors such as age gender and heredity. OBJECTIVE: The aim of the study was to determine the main causes for outpatient visits in dermatology outpatient clinic in RIMS Kadapa. MATERIALS AND METHOD S: The outpatient clinic records of the department of dermatology RIMS Kadapa, dated between 1 st March 2014 t o 1 st March 2015 were retrospectively assessed. Patients were grouped according to age, gender, and clinical diagnosis. RESULTS: A total of 8,545 new patients with 9,416 skin problems were included in the study. The study group was 52.3% female and 47.7% m ale. The age range was between 1 and 99 years. The most commonly encountered diseases were: contact dermatitis (11.7% of patients, scabies (8.9%, fungal infections (8.9%, urticaria (6.0%, acne (4.4% each. CONCLUSION: It appears that certain skin disea ses contact dermatitis, scabies, fungal infections, urticaria, and acne causes serious health problems. P ublic health policies should be implemented in order to manage these problems rationally.

  13. Identification of occupational risk factors by interviewing injured workers in an out-patient clinic

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    Johan Lund

    2010-06-01

    Full Text Available

    Background: To prevent injuries, identification of the involved risk factors is necessary. Two recent in-depth investigations were carried out in the health service of Oslo on workers seeking treatment of severe occupational injuries. The interviews were rather time-consuming, and hence rather costly. The aim of thepresent study was to find a less time-consuming method which nevertheless would identify preventable risk actors.

    Methods: In-depth investigations of 15 injuries with nail guns and 28 injuries related to scaffolding were onducted in an out-patient clinic in Trondheim, Norway. Patients were interviewed by health personnel just efore or after the treatment based on specifically designed questionnaires. A group of specialists analysed the information collected.

    Results: Some risk factors were identified: design weaknesses inherent in nail guns, presence of snow and ice at the injury location, foreign body in the eye and lack of control/inspection of scaffolding when erected. On average, about two man hours were used for each injury. The most relevant questions were those directly related to the narrative, in particular how the injury occurred, and if any special conditions were involved. Quite a few data elements require epidemiological representative studies in order to assess them as potential risk factors.

    Conclusions: This relatively low time-consuming method revealed some risk factors. However, it could be more effective if the interviews were conducted by telephone a few days after the treatment by a specialist in that particular injury type; such as an experienced labour inspector, in order to probe more deeply into the technical risk factors.

  14. Molecular characterization of methicillin-resistant Staphylococcus aureus recovered from outpatient clinics in Riyadh, Saudi Arabia

    International Nuclear Information System (INIS)

    To examine the recovered strains phenotypically, by conventional methods and genotypically by polymerase chain reaction (PCR), for direct detection of Staphylococcus aureus (S. aureus) 16S ribosomal Ribonucleic Acid (rRNA) gene (which serves as an internal control) and mecA gene. Secondly, introduce multiplex PCR targeting at the same time S. aureus 16S rRNA, Panton-Valentine Leucocidin (PVL), and staphylococcal cassette chromosome mec (SCCmec) type 4. Thirty-seven strains of S. aureus collected in 2007 from outpatient clinics in King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia, were tested in the College of Pharmacy phenotypically by conventional methods and genotypically by PCR for direct detection of S. aureus 16S rRNA and mecA genes. All the 37 strains, were tested also by multiplex PCR targeting at the same time S. aureus 16S rRNA, PVL, and (SCCmec) type 4. Polymerase chain reaction detected all the 37 bacteriologically positive S. aureus (100%) and the mecA gene in all strains phenotypically resistant to methicillin (100%), at the same time it detected the mecA gene in 2 strains phenotypically sensitive to methicillin. Only 3 strains (8.1%) recovered from skin and soft tissue infections were positive for PVL and SCCmec type 4. The PCR assay can be used for rapid detection of S. aureus and mecA gene. At the same time the multiplex PCR assay explained in this study is a rapid, sensitive, and reliable test for direct detection of community-acquired methicillin-resistant S. aureus. (author)

  15. Knowledge, attitude and practice towards child adoption amongst women attending infertility clinics in Lagos State, Nigeria

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    Adenike O. Omosun

    2011-02-01

    Full Text Available Background: Child adoption is a recommended alternative form of infertility management. Infertility is of public health importance in Nigeria and many other developing nations. This is a result of its high prevalence and especially because of its serious social implications as the African society places a passionate premium on procreation in any family setting. Objectives: The aim of this study was to determine the knowledge, attitude and practice of child adoption amongst women attending infertility clinics in teaching hospitals in Lagos State and to determine the factors that influence their attitude and practice towards it.Method: A cross-sectional descriptive design was used. Data were collected by using a structured questionnaire which was interviewer-administered. The study was conducted in the two teaching hospitals in Lagos State (LUTH [Lagos University Teaching Hospital] and LASUTH [Lagos State University Teaching Hospital] from amongst 350 women attending the gynaecological clinics. All the patients under management for infertility at the gynaecology clinics during the period of the study were interviewed.Results: Many respondents (85.7% had heard of child adoption and 59.3% of them knew the correct meaning of the term. More than half of the respondents (68.3% said that they could love an adopted child but less than half of them (33.7% were willing to consider adoption. Only 13.9% has ever adopted a child. The major reason given for their unwillingness to adopt was their desire to have their own biological child. Factors that were favourable towards child adoption were Igbo tribe identity, an age above 40 years, duration of infertility above 15 years, and knowing the correct meaning of child adoption.Conclusion: There is a poor attitude to adoption even amongst infertile couples. Interventions need to be implemented to educate the public on child adoption, to improve their attitude towards adoption and to make it more acceptable.

  16. Orofacial manifestations in HIV positive children attending Mildmay Clinic in Uganda.

    Science.gov (United States)

    Nabbanja, Juliet; Gitta, Sheba; Peterson, Stefan; Rwenyonyi, Charles Mugisha

    2013-01-01

    The aim of this study was to assess the orofacial manifestations and their influence on oral function in human immunodeficiency virus (HIV) positive children attending Mildmay Clinic in Uganda. This was a cross-sectional study based on clinical examination, medical records and a structured questionnaire of 368 children aged between 1.5 and 17 years. The clinical examination for dental caries was based on decayed, extracted and filled teeth (deft) and decayed, missing and filled teeth (DMFT) indices as defined by World Health Organisation. The soft tissue orofacial lesions were assessed using the classification and diagnostic criteria as described by the Collaborative Workgroup on the Oral Manifestations of Pediatric HIV Infections. Approximately 67.4% of the children were on highly active antiretroviral therapy (HAART). The majority (77.4%) of the children had at least one orofacial lesion associated with HIV, pseudomembranous candidiasis being the most prevalent. Overall, 61.7% of the children with orofacial lesions reported at least one form of discomfort in the mouth. Discomfort was particularly associated with swallowing. The prevalence of orofacial lesions was significantly higher in children with poor oral hygiene and lower in those on HAART than in their respective counterparts. The CD4+ cell count, age and gender of the children did not significantly influence the distribution of orofacial lesions. The mean deft and DMFT scores were 11.8 and 2.7, respectively. The d- and D-components contributed 54.7 and 42.1%, respectively. Consumption of sugary snacks was directly associated with dental caries. Despite these children attending an HIV care centre of excellence, they have a high prevalence of orofacial manifestations associated with HIV. The majority of the children experienced discomfort in the oral cavity, particularly during swallowing.

  17. Use of the internet by patients attending specialist clinics in Sri Lanka: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Kommalage Mahinda

    2009-02-01

    Full Text Available Abstract Background The internet is a relatively new medium of disseminating health information. Studies on Internet usage for health information are mainly done in developed countries and very few studies have been carried out in developing countries. Methods The Internet usage of patients who were attending specialist clinics in Teaching Hospital Karapitiya and Southern Hospital in Galle, Sri Lanka was investigated. The study was carried out on the following specialities; General Medicine, Pediatrics, General Surgery and Cardiothoracic surgery. Information was collected using an investigator-administered questionnaire while patients were waiting for a consultation. Results Three hundred and fifty five patients (or guardians in the Pediatric clinic participated in the study. One hundred seventy two (48.3% participants have heard about the Internet. There was a relationship between awareness of the Internet and age, educational level and the clinic attended. There was no difference of awareness depending on the gender or the hospital. Only three participants (0.97% have used the Internet to find information about their disease conditions. Close relatives searched the Internet about the conditions of two participants. Altogether, the Internet was used to search information on the disease condition of five participants (1.4%. Conclusion Very low usage of the Internet for health information retrieval in this study is probably due to low awareness of the Internet and low educational level. This low usage of Internet and the associated reasons shown in this study can be generalized to Sri Lanka and probably to other low-income countries that have lower educational level than Sri Lanka.

  18. Management of childhood febrile illness prior to clinic attendance in urban Nigeria.

    Science.gov (United States)

    Afolabi, B M; Brieger, W R; Salako, L A

    2004-03-01

    Parents and caregivers often try various treatment modalities for their sick children before bringing them to clinic. Many community-based studies have documented home and self-treatment practices, often with the aid of patent medicine vendors, but less is known about prior treatment behaviour of caregivers who actually reach a government clinic. This study, therefore, aimed at documenting the treatment provided by caregivers prior to their attendance at a public hospital. Beginning in April 1996, a year-long study was conducted among 1,943 sick children and their caregivers who attended the largest government-owned paediatric hospital in Lagos, Nigeria. The major complaints mentioned by the caregivers included fever, cough, and diarrhoea. Most (89%) caregivers had administered some form of medicine to the child prior to the clinic visit, and on average, 2.5 medications had been given. Associations were found between major complaint and type of medicine given: fevers were associated with antimalarial drugs and analgesics (antipyretics), cough was associated with cough syrup and analgesics, while diarrhoea was associated with antidiarrhoeal drugs. Although one-fifth of the children had received an antibiotic, provision of antibiotics was not associated with a particular complaint/illness. Since caregivers appeared to use perceived complaints/illnesses as a treatment guide, this can form the basis of safer and more appropriate recognition of illness and home management. In addition, the information obtained in this study can be used for training clinicians to inquire about home management and, thus, for making more informed decisions about their own treatment and prescribing practices. PMID:15190811

  19. Prevalence and Characteristics of Pregnant Syphilis among Women Attending Antenatal Clinics in Shenzhen (China) in 2003

    Institute of Scientific and Technical Information of China (English)

    Yang Fan(杨帆); Zhou Hua(周华); Hong Fuchang(洪福昌); Luo Bin(罗斌); Cai Yumao(蔡于茂); Wen Lizhang(文立章); Zhang Chunlai(张春来)

    2004-01-01

    Abstract Background: The Nnewly reported cases of congenital syphilis have been increaseding substantially over the past few years. To control the epidemic, a municipal program aimed at preventing mother-to-child transmission of syphilis was introduced in July, 2001,which was designed aimed to screen all pregnant women for syphilis at their first visit to antenatal clinics or at admission to hospitals in Shenzhen.Objectives: The aim of the study is tTo determine the prevalence of syphilis among women attending antenatal clinics and other medical institutions in Shenzhen and identifies its patterns of infection.Methods: Upon giving informed consent, w Women who attended antenatal care centers in Shenzhen from January to December 2003 were included in this study subject to obtaining informed consent. A blood sample was harvested for syphilis screened for syphilising by using rapid plasma reagent test (RPR) and confirmed by TPHA for those who were RPR positive. The women with pregnant syphilispositive serology were systematically interviewed to obtain. During the interview, their demographic detailsinformation, patterns of risk behaviors and other data. Data were collected andwere analyzed retrospectively.Results: Among Of 118,235 pregnant women surveyed,555 pregnant women were confirmed to have syphilis (prevalence of 4.69%), with a incidence of 4.69‰. 123women were excluded from the analysis because of incomplete medical records. Of 432 infected subjects with complete medical records, the average age was 26.8, with a range of 19 to 41. 7.41% (32/432) of them suffered from primary syphilis, 3.24% (14/432) were ofhad secondary syphilis, and 89.35%(386/432) had latent syphilis. Without any conspicuous clinical signs and symptoms. Conclusions: The prevalence of syphilis among the pregnant women in our series was high an most of them were asymptomatic. Screening for syphilis among pregnant women in Shenzhen is of importantce for the prevention of mother

  20. Self-care and adherence to medication: a survey in the hypertension outpatient clinic

    Directory of Open Access Journals (Sweden)

    Lip Gregory YH

    2008-02-01

    Full Text Available Abstract Background Self-care practices for patients with hypertension include adherence to medication, use of blood pressure self-monitoring and use of complementary and alternative therapies (CAM The prevalence of CAM use and blood pressure self-monitoring have not been described in a UK secondary care population of patients with hypertension and their impact on adherence to medication has not been described. Adherence to medication is important for blood pressure control, but poor adherence is common. The study aimed to determine the prevalence of self-care behaviours in patients attending a secondary care hypertension clinic. Methods Cross-sectional questionnaire survey. 196 patients attending a secondary care hypertension clinic in a teaching hospital serving a multiethnic population, Birmingham, UK. Main outcome measures: Prevalence of use of CAM, home monitors, adherence to anti-hypertensive medication. Results CAM use in previous 12 months was reported by 66 (43.1% respondents. CAM users did not differ statistically from non-CAM users by age, gender, marital status or education. Vitamins, prayer a dietary supplements were the most commonly used CAM. Nine (12.7% women reported using herbal CAM compared to one man (1.2%, (p = 0.006. Ten (6.7% respondents reported ever being asked by a doctor about CAM use. Perfect adherence to anti-hypertensive medication was reported by 26 (44.8% CAM-users and 46 (60.5% non-CAM users (p = 0.07. Being female and a CAM user was significantly associated with imperfect adherence to anti-hypertensive medication. Older and white British respondents were significantly more likely to report perfect adherence. Blood pressure monitors were used by 67 (43.8% respondents, which was not associated with gender, CAM use or adherence to medication. Conclusion Hypertensive patients use a variety of self-care methods, including CAM, home blood pressure monitors, and adherence to prescribed medication. This study found the

  1. Clinical presentation of genital warts among circumcised and uncircumcised heterosexual men attending an urban STD clinic.

    OpenAIRE

    Cook, L. S.; Koutsky, L A; Holmes, K. K.

    1993-01-01

    INTRODUCTION--A recent study comparing heterosexual men with and without confirmed sexually transmitted diseases (STDs) in an urban STD clinic showed that uncircumcised men were less likely than circumcised men to have genital warts detectable by clinical examination (adjusted odds ratio 0.7, 95% confidence interval 0.4, 0.9). Based on these initial findings we hypothesised that the appearance and anatomic distribution of genital warts, and possibly treatment response, may be different for ci...

  2. Seroprevalence of HIV in women attending antenatal clinic at KIMS hospital, Narketpally

    Directory of Open Access Journals (Sweden)

    Venna Guru Prasad

    2012-12-01

    Full Text Available Background: To assess seroprevalence of HIV among antenatal women and the extent of utilization of therapeutic interventions to minimize the risk of mother to child transmission. Methods: Pregnant women attending antenatal clinic of a medical college in a rural area of Nalgonda district of Andhra Pradesh, India from August 2006 to July 2009 were tested for HIV by Rapid Test which included pre and post test counseling. Antiretroviral prophylaxis with nevirapine was given to seropositive mother-baby pairs during delivery. Results: Of the 5809 new antenatal booking visits 4848 attended pretest counseling and 4698 accepted HIV testing. Fifty three women were found to be seropositive. Sero-prevalence rate of HIV infection was 1.12%. Ten had opted for pregnancy termination. Out of forty three deliveries four were intrauterine deaths. All the newborns received nevirapine prophylaxis. Conclusions: The seroprevalence of HIV infection among antenatal women is 1.12% which was high as the institute is located in Andhra Pradesh which is a known high prevalence state. Thirty one babies tested after 18 months of age were negative. Nine babies died before they reached 18 months of age. [Int J Reprod Contracept Obstet Gynecol 2012; 1(1.000: 17-21

  3. Changes in quality of life following group CBT for anxiety and depression in a psychiatric outpatient clinic.

    Science.gov (United States)

    Oei, Tian Po; McAlinden, Niamh May

    2014-12-30

    The present study examined the relationship between quality of life and symptom change following group CBT treatment for anxiety or depression in a psychiatric hospital outpatient setting. One hundred seventy seven outpatients undergoing eight sessions of group CBT for anxiety (n=124) or mood disorders (n=53) participated. The Beck Anxiety Inventory (BAI), Zung Self-Rating Depression Scale (Zung-SRDS), Quality of Life Inventory (QOLI), and Satisfaction with Life Scale (SWLS) were administered at baseline and post-treatment. Additionally, the QOLI and SWLS scores of those who achieved reliable improvement or clinically significant symptom change were compared to those who experienced no reliable symptom improvement. There were significant changes across the QOLI, SWLS, BAI and Zung-SRDS outcome measures between baseline and post-treatment, with moderate to very large effect sizes observed. Patients with reliable or clinically significant change in their symptoms experienced significant increases in QOLI and SWLS scores when compared to those whose symptoms did not change reliably. Overall, in a psychiatric hospital outpatient setting, group CBT appeared to be successful in increasing quality of life and satisfaction with life in addition to reducing anxiety and depression symptoms.

  4. Role of the Vision Van, a mobile ophthalmic outpatient clinic, in the Great East Japan Earthquake

    Directory of Open Access Journals (Sweden)

    Yuki K

    2014-04-01

    Full Text Available Kenya Yuki,1 Toru Nakazawa,2 Daijiro Kurosaka,3 Tsunehiko Yoshida,4–6 Eduardo C Alfonso,7 Richard K Lee,7 Shigeru Takano,8 Kazuo Tsubota1 1Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan; 2Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan; 3Department of Ophthalmology, Iwate Medical University, Iwate, Japan; 4The House of Representatives of Japan, Tokyo, Japan; 5Nagoya University Hospital, Aichi, Japan; 6Aichi Medical University Hospital, Aichi, Japan; 7Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA; 8Japan Ophthalmological Association, Tokyo, Japan Purpose: The Great East Japan Earthquake of March 11, 2011 triggered powerful tsunami waves off the northeastern Pacific coast of Japan that destroyed almost all of the built-up areas along the coast. The study reported here examined the role played by the Vision Van, a mobile outpatient ophthalmological clinic, in providing eye care to disaster evacuees. Methods: This was a retrospective case-series study of 2,070 victims (male: 732, female: 1,338 who visited the Vision Van. The subjects' medical records were examined retrospectively and analyzed in terms of age, sex, and date of visit to the Vision Van. Information regarding each patient's chief complaint, diagnosis, medication(s prescribed, and eyeglasses and contact lenses provided, was also examined. Results: The Vision Van was used to conduct medical examinations on 39 days between April 23 and June 29, 2011. The average number of subjects visiting the Vision Van each day was 53±31 (range: 7–135, with examinations carried out in Miyagi Prefecture and Iwate Prefecture. The most frequent complaint was a need for eye drops (871/2,070 [42.1%]. The second and third most frequent complaints, respectively, were the need for contact lenses (294/2,070 [14.2%] and eyeglasses (280/2,070 [13.5%]. The most frequent ocular disease diagnosis

  5. An audit on the knowledge, beliefs and attitudes about the uses and side-effects of antibiotics among outpatients attending 2 teaching hospitals in Jordan.

    Science.gov (United States)

    Alzoubi, K; Al-Azzam, S; Alhusban, A; Mukattash, T; Al-Zubaidy, S; Alomari, N; Khader, Y

    2013-05-01

    This study aimedto assess general knowledge, beliefs and attitudes of people towards the use of antibiotics. Individuals referring to the outpatient pharmacies of 2 major teaching hospitals in the north of Jordan completed a self-administered, validated questionnaire. A total of 1091 individuals (56.8% males) participated in the study. Of these, 20.1% of the participants stated that antibiotics were used for bacterial infections, while 18.3% thought they were used for viral infections and 43.6% for mixed bacterial/viral infections. The average knowledge score of the participants about antibiotic uses and side-effects was low. Middle-aged participants and those with an education beyond high school had significantly higher knowledge scores about antibiotics use. Almost 75% of the participants disagreed that antibiotics could be given without a prescription.

  6. Co-morbidity in a cystic fibrosis population attending a regional clinic.

    LENUS (Irish Health Repository)

    Healy, F

    2010-11-01

    Pulmonary disease remains the major cause of morbidity in patients with cystic fibrosis (CF). However, of 115 patients attending a regional CF clinic we noted 16 cases (14%) with co-morbid conditions. Of this group, 4 of 115 patients (3.5%) had renal problems including both structural and functional defects and 4 (3.5%) had neurological disorders, 3 of which were types of epilepsy. Notably, 3 of 115 patients (2.6%) had different forms of neoplasia, all of which required significant surgical and\\/or chemotherapeutic intervention. There is now increasing evidence of the association between digestive tract malignancy and CF, which further complicates management of these already complex cases.

  7. Implementation outcomes of evidence-based quality improvement for depression in VA community based outpatient clinics

    Directory of Open Access Journals (Sweden)

    Fortney John

    2012-04-01

    Full Text Available Abstract Background Collaborative-care management is an evidence-based practice for improving depression outcomes in primary care. The Department of Veterans Affairs (VA has mandated the implementation of collaborative-care management in its satellite clinics, known as Community Based Outpatient Clinics (CBOCs. However, the organizational characteristics of CBOCs present added challenges to implementation. The objective of this study was to evaluate the effectiveness of evidence-based quality improvement (EBQI as a strategy to facilitate the adoption of collaborative-care management in CBOCs. Methods This nonrandomized, small-scale, multisite evaluation of EBQI was conducted at three VA Medical Centers and 11 of their affiliated CBOCs. The Plan phase of the EBQI process involved the localized tailoring of the collaborative-care management program to each CBOC. Researchers ensured that the adaptations were evidence based. Clinical and administrative staff were responsible for adapting the collaborative-care management program for local needs, priorities, preferences and resources. Plan-Do-Study-Act cycles were used to refine the program over time. The evaluation was based on the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance Framework and used data from multiple sources: administrative records, web-based decision-support systems, surveys, and key-informant interviews. Results Adoption: 69.0% (58/84 of primary care providers referred patients to the program. Reach: 9.0% (298/3,296 of primary care patients diagnosed with depression who were not already receiving specialty care were enrolled in the program. Fidelity: During baseline care manager encounters, education/activation was provided to 100% (298/298 of patients, barriers were assessed and addressed for 100% (298/298 of patients, and depression severity was monitored for 100% (298/298 of patients. Less than half (42.5%, 681/1603 of follow-up encounters during the acute

  8. Prevalence of antibodies to HTLV in antenatal clinic attenders in south east London.

    Science.gov (United States)

    Hale, A; Leung, T; Sivasubramaniam, S; Kenny, J; Sutherland, S

    1997-07-01

    The prevalence of antibodies to HTLV in women attending a south east London antenatal clinic between October 1990 and July 1992 was determined using sera referred for routine rubella antibody testing. Samples were screened for HTLV antibody using a modified Fujirebio gel particle agglutination test and reactive sera confirmed by ELISA (Abbott Laboratories, North Chicago, IL) and two commercial Western blots (Cambridge Biotech Inc., Rockville, MD, and Diagnostic Biotechnology, Genelab Diagnostics, Louvaine, Belgium). This strategy confirmed the presence of HTLV-1 antibodies in 12 out of 6,289 sera (0.19%, 95% confidence limits 0.083% to 0.30%) and HTLV-2 antibodies in 2 (0.03%) sera. Specimens from 8 of 821 (0.97%, 95% confidence limits 0.42% to 1.9%) Afro-Caribbean women, three of 1,136 (0.26%, 95% confidence limits 0.055% to 0.78%) African women, and one of 3,049 (0.033%, 95% confidence limits 0.006% to 0.18%) Caucasian women were positive for HTLV-1 antibodies. Sera from Afro-Caribbean women born in the Caribbean were 7.6 times more likely to be HTLV-1 antibody positive than sera from Afro-Caribbean women born in the UK (P = 0.012). Selective testing of Afro-Caribbean and African antenatal clinic attenders, in this setting, would have identified 11 of the 12 HTLV-1 infections at an estimated cost of prevention of HTLV-1 associated disease of 100,000 pounds per case which is considerably less than the 1.3 million pounds which has been estimated to prevent a case by universal screening of UK blood donors.

  9. Clinical Features Of Acute Febrile Thrombocytopaenia Among Patients Attending Primary Care Clinics

    OpenAIRE

    Fah, Tong Seng; MMed, Noorazah Abdul Aziz; Liew, Chin Gek; Omar, Khairani

    2006-01-01

    Introduction: Identifying clinical features that differentiate acute febrile thrombocytopaenia from acute febrile illness without thrombocytopaenia can help primary care physician to decide whether to order a full blood count (FBC). This is important because thrombocytopaenia in viral fever may signify more serious underlying aetiology like dengue infection.

  10. The Etiology of Genital Ulcer Disease among Patients Attending Sexually Transmitted Disease Clinics in Guangzhou, China

    Institute of Scientific and Technical Information of China (English)

    GU Jin(谷进); ZENG Zhirong(曾志荣); CHEN Rongzhang(陈荣章); ZHU Huilan(朱慧兰); QIU Xiaoshan(邱晓珊)

    2002-01-01

    Objectives: To investigate the etiology of genital ulcerdisease (GUD) among patients attending sexuallytransmitted disease (STD) clinics in Guangzhou, China.Methods: Between September 8, 1998, and August 9,2001, 267 patients with a genital ulcer were clinicallyassessed. Clinical etiology of GUD was dependent onphysical appearance and microbiologic examination,including the following: dark field microscopy and serologyfor Treponema pallidum (TP), swabs of genital ulcer forHerpes simplex virus (HSV), processed quantitativefluorescent polymerase chain reaction (QF-PCR) forsimultaneous detection of HSV, TP, Haemophilus ducreyi(HD), Human papillomavirus (HPV), and serology for HIVinfection.Results: Two hundred thirty men and thirty-sevenwomen with a median age of 33.4 (range 16-74 years) wereanalyzed. The etiology of GUD was syphilis (26.59%)(71/267), genital herpes (17.60%) (47/267), condylomataacuminata (4.87%) (13/267), candidiasis (3.37%) (9/267),bacterial infection (3.75%) (10/267), and multiple infection(6.74%) (18/267). The seroprevalence of HIV was 0.75%(2/267). No etiology was identified in 50.56% (135/267).Conclusion: The etiology of GUD among STD patients inour area was multifactorial with a predominance of syphilisand genital herpes. Based on this limited data obtained atSTD clinics, HIV infection was not common.

  11. Scale-up, retention and HIV/STI prevalence trends among female sex workers attending VICITS clinics in Guatemala.

    Directory of Open Access Journals (Sweden)

    Sonia Morales-Miranda

    Full Text Available BACKGROUND: Since 2007, Guatemala integrated STI clinical service with an HIV prevention model into four existing public health clinics to prevent HIV infection, known as the VICITS strategy. We present the first assessment of VICITS scale-up, retention, HIV and STI prevalence trends, and risk factors associated with HIV infection among Female Sex Workers (FSW attending VICITS clinics in Guatemala. METHODS: Demographic, behavioral and clinical data were collected using a standardized form. Data was analyzed by year and health center. HIV and STI prevalence were estimated from routine visits. Retention was estimated as the percent of new users attending VICITS clinics who returned for at least one follow-up visit to any VICITS clinic within 12 months. Separate multivariate logistic regression models were conducted to investigate factors associated with HIV infection and program retention. RESULTS: During 2007-2011 5,682 FSW visited a VICITS clinic for the first-time. HIV prevalence varied from 0.4% to 5.8%, and chlamydia prevalence from 0% to 14.3%, across sites. Attending the Puerto Barrios clinic, having a current syphilis infection, working primarily on the street, and using the telephone or internet to contact clients were associated with HIV infection. The number of FSW accessing VICITS annually increased from 556 to 2,557 (361% during the period. In 2011 retention varied across locations from 7.7% to 42.7%. Factors negatively impacting retention included current HIV diagnosis, having practiced sex work in another country, being born in Honduras, and attending Marco Antonio Foundation or Quetzaltenango clinic sites. Systematic time trends did not emerge, however 2008 and 2010 were characterized by reduced retention. CONCLUSIONS: Our data show local differences in HIV prevalence and clinic attendance that can be used to prioritize prevention activities targeting FSW in Guatemala. VICITS achieved rapid scale-up; however, a better understanding

  12. The Use of a Token Economy to Improve Patient Responsibility in an Outpatient Methadone Maintenance Clinic.

    Science.gov (United States)

    Kelly, John S.; Gambatese, Richard J.

    Previous studies have shown that the use of behavior modification techniques, specifically the use of token reinforcement systems, can produce positive changes in the behavior of heroin addicts within a hospital setting. A token economy program was assessed to determine the effectiveness of such a program with patients in an outpatient methadone…

  13. Prevalence of Internet use amongst an elective spinal surgery outpatient population

    OpenAIRE

    Joseph F Baker; Devitt, Brian M; Kiely, Paul D.; Green, James; Mulhall, Kevin J.; Synnott, Keith A.; Poynton, Ashley R

    2010-01-01

    Nationally 62% of individuals in Ireland have internet access. Previous published work has suggested that internet use is higher among those with low back pain. We aimed to determine the levels of internet access and use amongst an elective spinal outpatient population and determine what characteristics influence these. We distributed a self-designed questionnaire to patients attending elective spinal outpatient clinics. Data including demographics, history of surgery, number of visits, level...

  14. Assessing Strategies for Heart Failure with Preserved Ejection Fraction at the Outpatient Clinic

    Directory of Open Access Journals (Sweden)

    Antonio José Lagoeiro Jorge

    2014-09-01

    Full Text Available Background: Heart failure with preserved ejection fraction (HFPEF is the most common form of heart failure (HF, its diagnosis being a challenge to the outpatient clinic practice. Objective: To describe and compare two strategies derived from algorithms of the European Society of Cardiology Diastology Guidelines for the diagnosis of HFPEF. Methods: Cross-sectional study with 166 consecutive ambulatory patients (67.9±11.7 years; 72% of women. The strategies to confirm HFPEF were established according to the European Society of Cardiology Diastology Guidelines criteria. In strategy 1 (S1, tissue Doppler echocardiography (TDE and electrocardiography (ECG were used; in strategy 2 (S2, B-type natriuretic peptide (BNP measurement was included. Results: In S1, patients were divided into groups based on the E/E'ratio as follows: GI, E/E'> 15 (n = 16; 9%; GII, E/E'8 to 15 (n = 79; 48%; and GIII, E/E' 122 for women and > 149 g/m2 for men] and ECG (atrial fibrillation parameters were assessed, confirming HFPEF in 33 more patients, adding up to 49 (29%. In S2, patients were divided into three groups based on BNP levels. GI (BNP > 200 pg/mL consisted of 12 patients, HFPEF being confirmed in all of them. GII (BNP ranging from 100 to 200 pg/mL consisted of 20 patients with LAVI > 29 mL/m2, or LVMI ≥ 96 g/m2 for women or ≥ 116 g/m2 for men, or E/E'≥ 8 or atrial fibrillation on ECG, and the diagnosis of HFPEF was confirmed in 15. GIII (BNP < 100 pg/mL consisted of 134 patients, 26 of whom had the diagnosis of HFPEF confirmed when GII parameters were used. Measuring BNP levels in S2 identified 4 more patients (8% with HFPEF as compared with those identified in S1. Conclusion: The association of BNP measurement and TDE data is better than the isolated use of those parameters. BNP can be useful in identifying patients whose diagnosis of HF had been previously excluded based only on TDE findings.

  15. Validation of the PHQ-9 as a screening instrument for depression in diabetes patients in specialized outpatient clinics

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    van Steenbergen-Weijenburg Kirsten M

    2010-08-01

    Full Text Available Abstract Background For the treatment of depression in diabetes patients, it is important that depression is recognized at an early stage. A screening method for depression is the patient health questionnaire (PHQ-9. The aim of this study is to validate the 9-item Patient Health Questionnaire (PHQ-9 as a screening instrument for depression in diabetes patients in outpatient clinics. Methods 197 diabetes patients from outpatient clinics in the Netherlands filled in the PHQ-9. Within 2 weeks they were approached for an interview with the Mini Neuropsychiatric Interview. DSM-IV diagnoses of Major Depressive Disorder (MDD were the criterion for which the sensitivity, specificity, positive- and negative predictive values and Receiver Operator Curves (ROC for the PHQ-9 were calculated. Results The cut-off point of a summed score of 12 on the PHQ-9 resulted in a sensitivity of 75.7% and a specificity of 80.0%. Predictive values for negative and positive test results were respectively 93.4% and 46.7%. The ROC showed an area under the curve of 0.77. Conclusions The PHQ-9 proved to be an efficient and well-received screening instrument for MDD in this sample of diabetes patients in a specialized outpatient clinic. The higher cut-off point of 12 that was needed and somewhat lower sensitivity than had been reported elsewhere may be due to the fact that the patients from a specialized diabetes clinic have more severe pathology and more complications, which could be recognized by the PHQ-9 as depression symptoms, while instead being diabetes symptoms.

  16. Cefditoren: Comparative efficacy with other antimicrobials and risk factors for resistance in clinical isolates causing UTIs in outpatients

    Directory of Open Access Journals (Sweden)

    Hatzaki Despina

    2012-09-01

    Full Text Available Abstract Background To investigate a possible role of Cefditoren, a recently marketed in Greece third-generation oral cephalosporin in urinary infections of outpatients. Methods During a multicenter survey of Enterobacteriaceae causing UTIs in outpatients during 2005–2007, Cefditoren MICs were determined by agar dilution method in a randomly selected sample of uropathogens. Susceptibility against 18 other oral/parenteral antimicrobials was determined according to Clinical and Laboratory Standards Institute methodology. Results A total of 563 isolates (330 Escherichia coli, 142 Proteus mirabilis and 91 Klebsiella spp was studied; MIC50/MIC90 of Cefditoren was 0.25/0.5 mg/L respectively, with 97.1% of the isolates being inhibited at 1 mg/L. All 12 strains producing ESBLs or AmpC enzymes were resistant to cefditoren. Susceptibility rates (% for amoxicillin/clavulanic acid, cefuroxime axetil, cefotaxime, ciprofloxacin, trimethoprim/sulfamethoxazole and fosfomycin were 93.1- 94.1- 96.8-93.1-71.9 and 92.8% respectively. Cefditoren MIC was significantly higher in nalidixic/ciprofloxacin non-susceptible strains; resistance to cefditoren was not associated with resistance to mecillinam, fosfomycin nitrofurantoin and aminoglycosides. Multivariate analysis demonstrated history of urinary infection in the last two weeks or three months as risk factors for cefditoren resistance. Conclusions Cefditoren exhibited enhanced in vitro activity against the most common uropathogens in the outpatient setting, representing an alternative oral treatment option in patients with risk factors for resistance to first-line antibiotics.

  17. Assessing Readiness to Lose Weight among Obese Women Attending the Nutrition Clinic

    Directory of Open Access Journals (Sweden)

    Fatemeh Ghannadiasl

    2014-07-01

    Full Text Available Background: Assessing individual’s readiness to change and targeting the intervention to the level of readiness may improve successful weight loss rates. This study aimed to assess readiness for weight loss in obese women using the trans theoretical model. Methods: A cross-sectional study was conducted on 90 volunteer apparently healthy obese women, in Ardabil, Iran. Participants completed the translated and validated University of Rhode Island Change Assessment questionnaire in their first visit. Subjects were categorized into one of the stages of change based on the highest of four z-transformed scale scores. The readiness to change score was calculated. Results: More than half of the participants were in early stages of weight loss and 24.5% were in the action stage. The readiness score in the precontemplation stage was significantly lower than the other stages, but no significant difference was observed among the contemplation, action and maintenance stages. The significant correlation was observed between the stages of change and waist-to-hip ratio (r=0.33, P<0.05. Conclusion: Obese women attending the nutrition clinic are in different stages to change for weight loss. Understanding person specific stages of change orientates the dietitian to use the most appropriate counseling strategies. Hence the stages and readiness to change should be considered before implementing any intervention in clinical settings for optimal outcomes.

  18. ASSESSMENT OF UTI IN POSTMENOPAUSAL WOMEN ATTENDING OPD CLINIC OF CHITWAN MEDICAL COLLEGE, BHARATPUR, CHITWAN, NEPAL

    Directory of Open Access Journals (Sweden)

    Mamata Sharma Neupane

    2013-06-01

    Full Text Available Urinary tract infection (UTI is the most common bacterial infection in young and elderly women. Despite the higher incidence of bacteriuria in elderly women, most UTI research has been conducted in young women. Hence, the present paper investigates the assessment of UTI in postmenopausal women attending OPD Clinic of Chitwan Medical College, Bharatpur, Chitwan, Nepal. A cross-sectional study was conducted in OPD clinic of Chitwan Medical College Teaching Hospital from December, 2012 to April, 2013. Total 400 patients suspected with UTI were reviewed, out of which 173 (43.3 % of the suspected samples showed presence of potential pathogens causing UTI in postmenopausal women. Escherichia coli (E. coli was the predominant (65.1% bacterial pathogen. Amikacin was found to be most sensitive antimicrobial followed by Nitrofurantoin and Gentamcin. Ampicillin showed the higher percentage of resistant, compared to other antimicrobials. In conclusion, drug resistance among bacterial pathogens is an evolving process, regular surveillance and monitoring is necessary to provide effective treatment of UTIs.

  19. Frequency of vaginal candidiasis in pregnant women attending routine antenatal clinic

    International Nuclear Information System (INIS)

    To determine the frequency of vaginal candidiasis in clinically symptomatic and asymptomatic cases of pregnant women attending routine antenatal clinic. A total of 110 pregnant women were nonrandomly recruited by convenient sampling. The studied variables included the demographic data information on parity, trimester of pregnancy, presence of vaginal discharge and the presence or absence of diabetes. Vulva and vagina were inspected for signs of inflammation and discharge with sterile speculum and vaginal specimens were collected with sterile cotton tipped swabs. Swabs were subjected to Gram staining and examined microscopically for the diagnosis of candidiasis. The frequency of vaginal candidiasis during pregnancy was found to be 38%, in which 27% were symptomatic and 11% were asymptomatic group. Increased ratio of infection was observed in multigravida and diabetic women. There was no marked differences in results with respect to age and trimester of pregnancy. Although there is generally a high frequency of vaginal candidiasis, an increased ratio of vaginal candidiasis in multigravida and diabetic pregnant women requires these women to be routinely screened for vaginal candidiasis regardless of symptomatic status. (author)

  20. Effects on cognitive and clinical insight with the use of Guided Self-Determination in outpatients with schizophrenia

    DEFF Research Database (Denmark)

    Jørgensen, Rikke; Licht, R W; Lysaker, P H;

    2015-01-01

    with schizophrenia. The design was an open randomized trial. The primary hypothesis was cognitive insight would improve in those patients who received GSD-SZ+TAU as assessed by the BCIS. We additionally explored whether the intervention led to changes in clinical insight, self-perceived recovery, self-esteem, social...... their illness management, Guided Self-Determination (GSD), has been adapted for use in patients with schizophrenia (GSD-SZ). The purpose of this study was to investigate the effect on insight of GSD-SZ as a supplement to treatment as usual (TAU) as compared to TAU alone in outpatients diagnosed...

  1. Brief experimental analysis of stimulus prompts for accurate responding on academic tasks in an outpatient clinic.

    OpenAIRE

    McComas, J J; Wacker, D P; Cooper, L J; Asmus, J M; Richman, D; Stoner, B

    1996-01-01

    Brief multielement designs were used to examine the effects of specific instructional strategies on accuracy of academic performance during outpatient evaluations of 4 children with learning disorders. Instructional strategies that improved accuracy on academic tasks were identified for all participants. These results suggest that the application of experimental analysis methodologies to instructional variables may facilitate the identification of stimulus prompts that are associated with enh...

  2. Dyslipidemia and cardiovascular disease risk profiles of patients attending an HIV treatment clinic in Harare, Zimbabwe

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    Zhou DT

    2015-05-01

    Full Text Available Danai Tavonga Zhou,1,2 Vitaris Kodogo,1 Kudzai Fortunate Vongai Chokuona,1 Exnevia Gomo,1 Olav Oektedalen,3 Babill Stray-Pedersen21Department of Medical Laboratory Sciences, College of Health Sciences, University of Zimbabwe, Avondale, Zimbabwe; 2Institute of Clinical Medicine, University in Oslo, Oslo University Hospital, Oslo, Norway; 3Department of Infectious Diseases, Oslo University Hospital, Oslo, NorwayAbstract: The chronic inflammation induced by human immunodeficiency virus (HIV contributes to increased risk of coronary heart disease (CHD in HIV-infected individuals. HIV-infected patients generally benefit from being treated with antiretroviral drugs, but some antiretroviral agents have side effects, such as dyslipidemia and hyperglycemia. There is general consensus that antiretroviral drugs induce a long-term risk of CHD, although the levels of that risk are somewhat controversial. The intention of this cross-sectional study was to describe the lipid profile and the long-term risk of CHD among HIV-positive outpatients at an HIV treatment clinic in Harare, Zimbabwe. Two hundred and fifteen patients were investigated (females n=165, mean age 39.8 years; males n=50; mean age 42.0 years. Thirty of the individuals were antiretroviral-naïve and 185 had been on antiretroviral therapy (ART for a mean 3.9±3.4 years. All participants had average lipid and glucose values within normal ranges, but there was a small difference between the ART and ART- for total cholesterol (TC and high-density lipoprotein (HDL.Those on a combination of D4T or ZDV/NVP/3TC and PI-based ART were on average oldest and had the highest TC levels. Framingham risk showed 1.4% prevalence of high CHD risk within the next ten years. After univariate analysis age, sex, TC/HDL ratio, HDL, economic earnings and systolic BP were associated with medium to high risk of CHD. After multivariate regression analysis and adjusting for age or sex only age, sex and economic earnings

  3. Perfil dos usuários de crack que buscam atendimento em Centros de Atenção Psicossocial Crack cocaine users who attend outpatient services

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    Rogério Lessa Horta

    2011-11-01

    Full Text Available O artigo descreve o perfil de 95 usuários de crack acolhidos em três Centros de Atenção Psicossocial (CAPS da Região Metropolitana de Porto Alegre, no Sul do Brasil, entre agosto de 2009 e março de 2010. Todos os usuários de crack que buscaram atendimento no período foram entrevistados. Utilizou-se questionários desenvolvidos pela equipe, mais o Self-Reporting Questionnaire (SRQ-20 e inventários de critérios de dependência e abuso (SAMHSA. Houve predomínio de pacientes homens, adultos jovens, com escolaridade fundamental, sem ocupação regular, mas com renda individual informada, em uso frequente e pesado há mais de um ano, e a maioria preenchia critérios para dependência e abuso do crack e tinha escores elevados de SRQ-20. Os resultados evidenciam que os CAPS são buscados por usuários de crack em sofrimento, que deve ser valorizado, mas também a existência de algum tipo de seleção na oferta destes serviços, caracterizada pelas especificidades de renda, escolaridade e grupo primário de apoio aos entrevistados.This paper describes the profile of 95 crack cocaine users attending three community mental health services (CAPS in Greater Metropolitan Porto Alegre, Rio Grande do Sul State, Brazil, from August 2009 to March 2010. The instruments employed were questionnaires developed by the team, the Self-Reporting Questionnaire (SRQ-20, and inventories of criteria for dependence and abuse (SAMHSA. The data depict a group of users consisting predominantly of young males with elementary schooling, without regular employment but reporting individual income, none of whom living on the streets. They were currently addicted, with heavy daily use of crack for more than two years, and with high SRQ-20 score. This group's characteristics showed that the community mental health services are attended by crack users that suffer losses resulting from their addiction, but also some possible selection process in the supply of these health

  4. The incidence and clinical burden of respiratory syncytial virus disease identified through hospital outpatient presentations in Kenyan children.

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    Emelda A Okiro

    Full Text Available BACKGROUND: There is little information that describe the burden of respiratory syncytial virus (RSV associated disease in the tropical African outpatient setting. METHODS: We studied a systematic sample of children aged <5 years presenting to a rural district hospital in Kenya with acute respiratory infection (ARI between May 2002 and April 2004. We collected clinical data and screened nasal wash samples for RSV antigen by immunofluorescence. We used a linked demographic surveillance system to estimate disease incidence. RESULTS: Among 2143 children tested, 166 (8% were RSV positive (6% among children with upper respiratory tract infection and 12% among children with lower respiratory tract infection (LRTI. RSV was more likely in LRTI than URTI (p<0.001. 51% of RSV cases were aged 1 year or over. RSV cases represented 3.4% of hospital outpatient presentations. Relative to RSV negative cases, RSV positive cases were more likely to have crackles (RR = 1.63; 95% CI 1.34-1.97, nasal flaring (RR = 2.66; 95% CI 1.40-5.04, in-drawing (RR = 2.24; 95% CI 1.47-3.40, fast breathing for age (RR = 1.34; 95% CI 1.03-1.75 and fever (RR = 1.54; 95% CI 1.33-1.80. The estimated incidence of RSV-ARI and RSV-LRTI, per 100,000 child years, among those aged <5 years was 767 and 283, respectively. CONCLUSION: The burden of childhood RSV-associated URTI and LRTI presenting to outpatients in this setting is considerable. The clinical features of cases associated with an RSV infection were more severe than cases without an RSV diagnosis.

  5. Ten years' trend of HIV seroprevalence among Indian pregnant women attending antenatal clinic at tertiary hospital in Dhule, Maharashtra, India

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    Vaishali Milind Patil

    2016-05-01

    Conclusions: Declining HIV seroprevalence rate is noted among pregnant women attending the antenatal clinics from 2004 to 2013. The effective implementation of prevention of parent to child transmission of HIV/AIDS (PPTCT programmed is helping in control of the spread of HIV. [Int J Reprod Contracept Obstet Gynecol 2016; 5(5.000: 1514-1519

  6. Predictors of consistent condom use among Portuguese women attending family planning clinics.

    Science.gov (United States)

    Costa, Eleonora C V; Oliveira, Rosa; Ferreira, Domingos; Pereira, M Graça

    2016-01-01

    Women account for 30% of all AIDS cases reported to the Health Ministry in Portugal and most infections are acquired through unprotected heterosexual sex with infected partners. This study analyzed socio-demographic and psychosocial predictors of consistent condom use and the role of education as a moderator variable among Portuguese women attending family planning clinics. A cross-sectional study using interviewer-administered fully structured questionnaires was conducted among 767 sexually active women (ages 18-65). Logistic regression analyses were used to explore the association between consistent condom use and the predictor variables. Overall, 78.7% of the women were inconsistent condom users. The results showed that consistent condom use was predicted by marital status (being not married), having greater perceptions of condom negotiation self-efficacy, having preparatory safer sexual behaviors, and not using condoms only when practicing abstinence. Living with a partner and having lack of risk perception significantly predicted inconsistent condom use. Less educated women were less likely to use condoms even when they perceive being at risk. The full model explained 53% of the variance in consistent condom use. This study emphasizes the need for implementing effective prevention interventions in this population showing the importance of taking education into consideration. PMID:26277905

  7. Attitudes toward consequences of pregnancy in young women attending a family planning clinic.

    Science.gov (United States)

    Paikoff, R L

    1990-10-01

    This study examines the relationship between young women's knowledge and attitude concerning pregnancy and their sexual behavior. The study involved 78 young women (14-20 years of age) who had attended a midwestern family planning clinic. Primarily from a larger socioeconomic status, 70% of the participants said that they had never been pregnant. Adapting the testing methods of previous investigations, the study presented the participants with various exams intended to measure the following: 1) knowledge concerning "how babies are made"; 2) knowledge regarding intercourse and pregnancy; 3) anticipation of future consequences of adolescent childbirth; 4) anticipation of immediate consequences or fears of adolescent pregnancy. The study also examined the participants' contraceptive behavior and pregnancy history. The findings indicate that knowledge concerning understanding "how babies are made" does not influence sexual behavior, with no significant difference found between contraceptive users and non-contraceptive users. Also, the participants generally had accurate knowledge concerning intercourse and pregnancy. But the study did reveal significant differences in the evaluation of the consequences of pregnancy and childbirth. Those women who had previously been pregnant -- including those who had terminated their pregnancies -- showed a less negative attitude towards the consequences of pregnancy and childbirth than those who had never been pregnant. Furthermore, as the age of the women increased, the attitude became more positive. However, the study found that the attitude towards the consequences of pregnancy and childbirth had no impact on contraceptive behavior. PMID:12283995

  8. Heterosexual practices of women and men living with HIV attending hospital outpatient services (ANRS-VESPA2 survey): a French comparative study with the general population (CSF survey).

    Science.gov (United States)

    Boyer, V; Vilotitch, A; Panjo, H; Sagaon-Teyssier, L; Marcellin, F; Dray-Spira, R; Spire, B; Bajos, N

    2016-11-01

    HAART has improved the well-being of many people living with HIV (PLWH). This study aimed at (i) comparing heterosexual practices between PLWH and the general population by gender, and (ii) identifying factors associated with sexual practices and at-risk behaviors in the two populations. Self-reported data were collected among PLWH attending hospitals (VESPA2 survey; n = 3022) and the general population (CSF survey; n = 10,280). Significant differences between the two samples were corrected for by implementing propensity score matching on both socio-demographic characteristics and sexual behavior in terms of number of partners. Men not reporting heterosexual intercourse were excluded. After matching, 61% of women (out of 707) and 68% of men (out of 709) were sexually active in both populations. PLWH practiced oral sex less than the general population and used condoms more consistently over the previous 12-month period, irrespective of having multiple sexual partners or not. For women living with HIV: those with several sexual partners and those consuming drugs over the previous 12 months were more likely to practice oral sex; those living in a couple for at least 6 years and migrants were less likely to practice anal intercourse. For men living with HIV: those reporting bisexual relationships and those with multiple sexual partners over the previous 12 months were more likely to practice anal heterosexual intercourse; migrants reported less oral sex, irrespective of HIV status. Error term correlations showed that anal intercourse was not linked to condom use for women or men from either population. Our results show that PLWH had a lower rate of heterosexual practices compared with the general population, and used condoms more often, irrespective of the number of sexual partners and strong cultural background (e.g., for Sub-Saharan African women). Further preventive information needs to be disseminated on the risk of infection transmission through

  9. Antibiotic Prescribing Patterns in Outpatient Emergency Clinics at Queen Rania Al Abdullah II Children's Hospital, Jordan, 2013

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    Sahar I. Al-Niemat

    2014-07-01

    Full Text Available Objective: To investigate antibiotics prescribing patterns in the outpatient pediatric emergency clinic at Queen Rania Al Abdullah II Children’s Hospital at Royal Medical Services in Amman, Jordan. Methods: The data was collected from the emergency pharmacy over the period of a -five consecutive months. The methodology recommended by the World Health Organization for investigating drug use in a health facility was followed. The study measures the percentage of encounter with a prescribed antibiotic and the percentage share of each antibiotic category. The distribution of diagnostic categories that accounted for all antibiotics being prescribed and the distribution of each antibiotic being prescribed for upper respiratory tract infections (URTIs were also measured. Results: Antibiotic prescribing was frequent during pediatric visits to the outpatient pediatric emergency clinic resulting in a high percentage of encounters (85% when compared to appropriate. Emergency physicians continue to frequently prescribe broad spectrum antibiotics which accounted for approximately (60% of the total prescribed antibiotics and (83% of prescribed antibiotics for upper respiratory tract infections and macrolides (primarily azithromycin were the leading class among them. Conclusion: Our results showed high consumption of antibiotics by emergency department pediatricians which highlight the importance for interventions to promote rational and judicious prescribing. An insight into factors influencing antibiotics prescribing patterns by military prescribers is required.

  10. PSYCHOMETRIC PROPERTIES AND VALIDATION OF THE POSITIVE AND NEGATIVE SUICIDE IDEATION (PANSI INVENTORY IN AN OUTPATIENT CLINICAL POPULATION IN MALAYSIA

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    Aishvarya eSinniah

    2015-12-01

    Full Text Available The PANSI is a measure designed to assess the risk and protective factors related to suicidal behaviors. The present study evaluated the psychometric properties and factor structure of the Positive and Negative Suicide Ideation (PANSI Inventory in a sample of clinical outpatients at a major hospital in Malaysia. In this study, 283 psychiatric patients and 200 medical (non- psychiatric patients participated. All the patients completed the PANSI and seven other self-report instruments. Confirmative factor analysis supported the 2-factor oblique model. The internal consistency of the two subscales of PANSI-Negative and the PANSI-Positive were 0.93 and 0.84, respectively. In testing construct validity, PANSI showed sizable correlation with the other seven scales. Criterion validity was supported by scores on PANSI which differentiated psychiatric patients from medical patients. Logistic regression analyses showed PANSI can be used to classify the patients into suicidal or non-suicidal. The PANSI is a reliable and valid instrument to measure the severity of suicidal ideation among clinical outpatients in Malaysia.

  11. Subjective and objective quality of life, levels of life skills, and their clinical determinants in outpatients with schizophrenia.

    Science.gov (United States)

    Aki, Hirofumi; Tomotake, Masahito; Kaneda, Yasuhiro; Iga, Jun-Ichi; Kinouchi, Sawako; Shibuya-Tayoshi, Sumiko; Tayoshi, Shin-Ya; Motoki, Ikuyo; Moriguchi, Kazuhiko; Sumitani, Satsuki; Yamauchi, Ken; Taniguchi, Takahide; Ishimoto, Yasuhito; Ueno, Shu-Ichi; Ohmori, Tetsuro

    2008-02-28

    The purpose of the present study is to investigate the relationships among subjective and objective quality of life (QOL), and levels of life skills, and their clinical determinants in outpatients with schizophrenia by using schizophrenia disease-specific QOL measures. Data collected from 64 outpatients were analyzed. Subjective QOL was measured with the Schizophrenia Quality of Life Scale (SQLS) and objective QOL with the Quality of Life Scale (QLS). Patients' family members completed the Life Skills Profile (LSP). Clinical symptoms were also assessed with several scales including the Brief Psychiatric Rating Scale (BPRS) and the Calgary Depression Scale for Schizophrenia (CDSS). Only the motivation/energy scale, but not the other scales of the SQLS, correlated with the QLS. The LSP rated by the family showed significant correlations with both the SQLS and the QLS. The CDSS score predicted each scale of the SQLS, and the BPRS negative symptoms score predicted the QLS. The LSP was predicted by the BPRS negative symptoms score and the CDSS score independently. These results indicate that the patient's QOL could be predicted by the life skills measured by a family member and suggest that active treatment for depressive and negative symptoms might be recommended to improve the patient's QOL and life skills.

  12. Condom-use errors and problems among teens attending clinics: better or worse than young adults?

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    Shrier LA

    2012-03-01

    Full Text Available Richard Crosby1–3, Richard J Charnigo1, Lydia A Shrier41College of Public Health, University of Kentucky, Lexington, KY, USA; 2Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN, USA; 3The Kinsey Institute for Research in Sex, Gender, and Reproduction, Bloomington, IN, USA; 4Children's Hospital Boston, Boston, MA, USAObjectives: To compare the frequency of condom-use errors and problems between teens (15–19 years of age and young adults (20–24 years of age attending clinics. Also, to assess whether the odds of experiencing condom failure were influenced by age group, gender, and motives for condom use.Methods: As part of a larger study of condom effectiveness, youth (15–24 years of age from five clinics, in three US cities, were recruited (N = 263. Data were prospectively collected using daily electronic diaries. For each episode of condom use with penile–vaginal sex, youths were asked to respond to questions assessing seven errors and five problems in condom use. Data analyses entailed statistical modeling with generalized estimating equations.Results: Teens did not significantly differ from their older counterparts on any of the seven condom-use errors or any of the five condom-use problems. Of all condom-use events, teens reported that 20% did not involve condom use from start-to-finish of sex, 14.7% involved a condom that had dried out, 8.1% involved rushed application, 6.7% did not involve adequate lubrication, and other errors and problems occurred less often. Further, condom failure was not predicted by age group, gender, or motive for using condoms. Significant interaction effects were not observed.Conclusions: Several forms of condom-use errors/problems occurred with similar frequency when comparing teens and young adults, suggesting a need to intervene to improve condom-use behavior regardless of age.Keywords: condoms, teens, sexually transmitted diseases, sexual behavior

  13. Study of potential drug interactions between prescribed drugs in geriatric patients attending outpatient department in a government tertiary care hospital in Maharashtra

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    Tushar Bhimrao Nishandar

    2016-08-01

    Conclusions: In the present study, PDIs were studied in geriatric population. Knowledge of the prevalence and predictors of clinically important PDIs will help physicians and pharmacists identify patients at higher risk of adverse drug interactions requiring more cautious pharmacotherapy. [Int J Basic Clin Pharmacol 2016; 5(4.000: 1569-1573

  14. Prevalence of Chlamydia trachomatis in women attending sexually transmitted disease clinics in the Colombo district, Sri Lanka

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    Gunasekera Henadira Appuhamilage Kamani Mangalika

    2014-01-01

    Full Text Available Background: In Sri Lanka little is known about the prevalence of Chlamydia trachomatis (CT infection. Objective was to determine the prevalence of CT in female patients attending sexually transmitted disease (STD clinics in the Colombo district. Materials and Methods: A descriptive cross-sectional study was carried out for the prevalence of CT in all female patients (n = 168 more than 18 years of age, attending two STD clinics in the Colombo district from January to May 2012. Endocervical swabs were collected and tested for CT using the Amplicor CT/NG polymerase chain reaction assay. Results: Prevalence of CT in females attending the STD clinics in the Colombo district was 8.3%. Mean age of those infected with CT was 32.9 years (SD ± 8.2. Majority of females with CT infections were Sinhalese and married. There was no significant association with age, ethnicity or being married or not. Females who did not attend school, or had their education only up to Grade 5 were significantly found to have six times the risk of having CT infection (95% CI = 1.8-22.6. A significant association was found with number of sexual partners but not with commercial sex work or past history of STD. Conclusions: Prevalence of CT was moderately high in this population.

  15. Residency training in advance care planning: can it be done in the outpatient clinic?

    Science.gov (United States)

    Alderman, Jeffrey S; Nair, Baishali; Fox, Mark D

    2008-01-01

    Resident physicians are expected to assist their outpatients to understand and complete advance directives, but their efficacy in doing so remains uncertain. After receiving educational training, internal medicine residents identified at-risk patients and solicited them about advance directives. Residents completed pretest and posttest questionnaires that assessed their knowledge, skills, attitude, and comfort with advance directives. Patients were also surveyed about their attitudes regarding advance directives. Ten internal medicine residents and 88 patients participated. Residents' self-assessed knowledge rose from 6.0 to 9.2 on a 10-point Likert scale. Skills using advance directives increased from 4.0 to 7.9, attitudes improved from 6.0 to 8.4, and comfort rose from 5.4 to 8.9. Eighty-four percent of patients expressed interest in completing advance directives, and 16% actually completed documents. An educational intervention improved knowledge, skills, attitudes, and comfort with advance directives among internal medicine residents practicing in the outpatient setting. Meanwhile, patients demonstrated a strong interest in completing advance directives.

  16. Use of Outpatient Endometrial Biopsy in a Population with Intellectual Disability

    Science.gov (United States)

    Jaffe, Joshua S.

    2008-01-01

    Background: To demonstrate the feasibility of outpatient endometrial sampling to evaluate abnormal uterine bleeding in a population of women with intellectual disability. Method: Retrospective chart review was completed of all endometrial biopsies performed on women attending a dedicated gynaecology clinic for women with intellectual disability…

  17. A pilot evaluation of group-based programming offered at a Canadian outpatient adult eating disorders clinic.

    Science.gov (United States)

    Mac Neil, Brad A; Leung, Pauline; Nadkarni, Pallavi; Stubbs, Laura; Singh, Manya

    2016-10-01

    Eating disorder clinics across Canada place heavy reliance on group-based programming. However, little work has examined whether this modality of treatment is well-received by patients and results in clinical improvements. The purpose of this pilot study was to evaluate patient satisfaction and outcomes for group-based programming offered through an adult eating disorders clinic. Participants were 81 adults who met DSM-5 criteria for an eating disorder and participated in the study as part of the clinic's program evaluation. Participants received medical monitoring, psychiatric follow-up, adjunct nutrition and pre-psychological treatment, and participated in the clinic's core cognitive behavioural therapy (CBT) group. Demographic information and weight were collected at intake. Participants also completed pre- and post-group programming measures of life satisfaction, depressive and anxiety symptoms, psychological symptoms of the eating disorder, and satisfaction with the programming. Participants' experienced a significant increase in satisfaction with life, and decreases in depressive symptoms and psychological symptoms of the eating disorder post-group. Adults endorsed feeling fairly satisfied with the group-based services provided. Results draw attention to the importance of program evaluation as an integral component of an adult outpatient eating disorder clinic by providing a voice for patients' views of the services received and program outcomes. PMID:27288960

  18. A pilot evaluation of group-based programming offered at a Canadian outpatient adult eating disorders clinic.

    Science.gov (United States)

    Mac Neil, Brad A; Leung, Pauline; Nadkarni, Pallavi; Stubbs, Laura; Singh, Manya

    2016-10-01

    Eating disorder clinics across Canada place heavy reliance on group-based programming. However, little work has examined whether this modality of treatment is well-received by patients and results in clinical improvements. The purpose of this pilot study was to evaluate patient satisfaction and outcomes for group-based programming offered through an adult eating disorders clinic. Participants were 81 adults who met DSM-5 criteria for an eating disorder and participated in the study as part of the clinic's program evaluation. Participants received medical monitoring, psychiatric follow-up, adjunct nutrition and pre-psychological treatment, and participated in the clinic's core cognitive behavioural therapy (CBT) group. Demographic information and weight were collected at intake. Participants also completed pre- and post-group programming measures of life satisfaction, depressive and anxiety symptoms, psychological symptoms of the eating disorder, and satisfaction with the programming. Participants' experienced a significant increase in satisfaction with life, and decreases in depressive symptoms and psychological symptoms of the eating disorder post-group. Adults endorsed feeling fairly satisfied with the group-based services provided. Results draw attention to the importance of program evaluation as an integral component of an adult outpatient eating disorder clinic by providing a voice for patients' views of the services received and program outcomes.

  19. Types of thalassemia among patients attending a large university clinic in Kuala Lumpur, Malaysia.

    Science.gov (United States)

    George, E; Li, H J; Fei, Y J; Reese, A L; Baysal, E; Cepreganova, B; Wilson, J B; Gu, L H; Nechtman, J F; Stoming, T A

    1992-01-01

    We have identified the beta-thalassemia mutations in 59 patients with thalassemia major and 47 patients with Hb E-beta-thalassemia, and the deletional and nondeletional alpha-thalassemia determinants in 23 out of 24 patients with Hb H disease. All persons were attending the Haematology Clinic at the National University of Malaysia in Kuala Lumpur (Malaysia). Most patients (76) were of Malay descent, while 52 patients were Chinese, and two came from elsewhere. The most frequently occurring beta-thalassemia alleles among the Malay patients were IVS-I-5 (G----C) and G----A at codon 26 (Hb E), while a few others were present at lower frequencies. The Chinese patients carried the mutation characteristic for Chinese [mainly codons 41/42 (-TTCT) and IVS-II-654 (C----T)]; Malay mutations were not observed among Chinese and Chinese mutations were virtually absent in the Malay patients. The large group of patients with Hb E-beta-thalassemia and different beta-thalassemia alleles offered the opportunity of comparing hematological data; information obtained for patients with Hb E-beta-thalassemia living in other countries was included in this comparison. Twenty-three patients with Hb H disease carried the Southeast Asian (SEA) alpha-thalassemia-1 deletion; 13 had the alpha CS alpha (Constant Spring) nondeletional alpha-thalassemia-2 determinant, while the deletional alpha-thalassemia-2 (-3.7 or -4.2 kb) was present in 10 subjects. The --/alpha CS alpha condition appeared to be the most severe with higher Hb H values. Both deletional and nondeletional types of alpha-thalassemia-2 were seen among Malay and Chinese patients.

  20. Behavioral and clinical characteristics of people receiving medical care for HIV infection in an outpatient facility in Sicily, Italy

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    Di Carlo P

    2016-05-01

    Full Text Available Paola Di Carlo,1 Giuliana Guadagnino,1 Palmira Immordino,1 Giovanni Mazzola,2 Pietro Colletti,2 Ilenia Alongi,1 Lucia Adamoli,1 Francesco Vitale,1 Alessandra Casuccio1 1Department of Sciences for Health Promotion and Mother-Child Care “G D’Alessandro”, University of Palermo, 2Department of Medicinal Clinics and Emerging Diseases, “Paolo Giaccone” Polyclinic University Hospital, Palermo, Italy Aim: The authors examined a cohort of HIV-positive outpatients at the AIDS Center of Palermo University in Italy in order to identify factors related to the frequency of their visits to the outpatient facility for health care services.Methods: Two hundred and twenty-four HIV-infected subjects were enrolled in the study. Demographic and HIV disease characteristics were recorded and assessed with the number of days accessed to our outpatients unit in univariate and multivariate analyses. The potential relationship with immunological status was also analyzed stratifying the patients into groups according to their CD4+ T-cell counts (≥500 vs <500/mm3, and ≥200 vs <200/mm3.Results: Both univariate and multivariate analyses showed that duration of antiretroviral therapy <5 years and hypertension were significantly associated with a CD4+ T-cell count of <500/mm3, whereas geographic origin (Africa was associated with a CD4+ T-cell count of <200/mm3. Mean number of days the patients sought access to day-care services for laboratory tests was negatively associated with CD4+ T-cell count.Conclusion: Patients with low CD4+ T-cell counts showed higher use of health care services, demonstrating how early HIV diagnosis can help to reduce health care costs. The CD4+ T-cell cut-off of 200 cells emphasizes the importance of identifying and managing HIV infection among hard-to-reach groups like vulnerable migrants. In our sample, the illegal status of immigrants does not influence the management of their HIV/AIDS condition, but the lack of European health card

  1. [Health of immigrant population of consultants at the Baudelaire outpatient clinic in Saint-Antoine hospital in Paris, France].

    Science.gov (United States)

    Kaoutar, B; Mathieu-Zahzam, L; Lebas, J; Chauvin, P

    2012-05-01

    Social and health data on the immigrant population remain scarce in France, especially concerning those in irregular situation. The Baudelaire outpatient clinic in Saint- Antoine hospital in Paris (PASS, i.e. specific free medicosocial care for the poor, the uninsured or the undocumented patients) treats a majority of immigrants, a lot of them being in an irregular residence status. The objectives of this study were to describe the social and health status of the immigrant consultants, to compare regular and undocumented migrants and to describe their main reasons for migration. A cross-sectional, descriptive, survey among the immigrant consultants has been performed among this outpatient clinic in April and May 2009. In total, 536 patients were included. Their age mean was 45 years, 62% are male, 49% are in an irregular situation and they have been in France for 12 years in average (19 years for the regular immigrants and 5 years for the undocumented). More than 20% had no health insurance. A majority (55%) of patients were suffering from a chronic disease. The more frequent ones were hypertension (20%), type 2 diabetes (11.6%), chronic infectious diseases - HIV, HBV, HCV - (7%). Reasons for immigration were mostly economical (39%), family (19%) and political (17%). Health reasons were at the 4th rank and concerned 9% of the patients. The main chronic diseases observed among this population are similar to those of the general population of consultants in primary health care, except for the chronic infectious diseases, which are more frequent. Immigration for health reasons represents only a small proportion of all immigration reasons. For this population, free clinics like the one investigated here constitute unique, irreplaceable, access points in the French healthcare system.

  2. 我院门诊喹诺酮类药物临床应用调查%Investigation on Clinical Use of Quinolones in Outpatient Clinic

    Institute of Scientific and Technical Information of China (English)

    田雪莉; 周霞

    2011-01-01

    Objective To understand the use status of quinolone- related drugs in the outpatient clinic for standardizing rational drug use in clinic. Methods The prescriptions involving quinolone- related drugs in the outpatient clinic were extracted and statistically analyzed in aspects of disease category, age, drug variety and rationality of drug use. Results Quinolone medication accounted for 21.50% of all antibiotic uses in the outpatient clinic. 43.06% of quinolones were used for respiratory diseases. Among them, levofloxacin had the highest use frequency(48.79% ). Unreasonable prescriptions included the use of quinolones for the patients yomger than 18 years old and without clear diagnosis of infectious diseases. Conclusion Quinolones are commonly used in anti- infection treatment in the outpatient clinic. The use indicators are rationally grasped as a whole. But using quinolones in children still exists, which should be needed to pay attention. The dosage in different ages has no apparent difference. The medieation dose in elderly patients should be adjusted.%目的 了解医院门诊喹诺酮类药物的使用情况,规范临床合理用药.方法 抽取喹诺酮类药物的处方,从痛种、患者年龄、用药品种、用药合理性等方面进行统计分析.结果 喹诺酮类药物的使用占全部抗茵药物的21.50%,43.06%用于呼吸系统疾病,其中左氧氟沙星使用频率最高(占喹诺酮类的48.79%).不合理用药包括18岁以下儿童用药、无感染性疾病诊断用药等.结论 喹诺酮类药物在医院门诊抗感染治疗中比较常见,应用指征掌握基本合理,但仍存在儿童用药,应予以重视.不同年龄用量差异不明显,对老年患者用药应进行剂量调整.

  3. A study of thyroid disorders in females attending obstetrics and gynecology outpatient department of a tertiary care institute of central India

    Directory of Open Access Journals (Sweden)

    Somen Bhattacharjee

    2016-05-01

    Results: Out of total 1010 women, 120 had abnormal TSH. The prevalence was high (11.88%. Hypothyroidism (71.66% was more common than hyperthyroidism (28.33%. The incidence of thyroid disorders was higher with advancing age. Abnormal TSH levels had a linear correlation with increasing BMI. Majority of the patients presented with vague symptoms commonest being weight changes (24.15%. Abnormal uterine bleeding (5.8% and infertility (5.8% were the chief gynecological complaints. Hypertension was strongly associated with thyroid dysfunction. Conclusions: Thyroid dysfunction is a highly prevalent problem in female population. Estimation of TSH level is a good screening tool; however complete thyroid profile is required before initiating treatment. The incidence increases with advancing age, hypothyroidism being the more common variant. Classical symptoms may not be present in majority of patients who have a vague clinical picture. This study recommends universal screening of women for thyroid dysfunction in view of high prevalence, vague and varied presentation. [Int J Res Med Sci 2016; 4(5.000: 1320-1324

  4. Pacemaker patients’ perspective and experiences in a pacemaker outpatient clinic in relation to test intervals of the pacemaker

    DEFF Research Database (Denmark)

    Lauberg, Astrid; Hansen, Tina; Pedersen, Trine Pernille Dahl

    an evident decline in quality of life regarding psychological and social aspects 6 month after the implantation in terms of cognitive function, work ability, and sexual activity. Mlynarski et al (2009) have found correlations between pacemaker implantation and anxiety and depression. Aim The aim...... the patients expect the nurses to check the technicalities of the pacemaker and talk about precautions. Long test intervals led to worry that the pacemaker was still working. The patients did not expect specialists to pay attention to psychological reactions as they did not find a correlation between...... the pacemaker and psychological reactions. Patients with pacemakers older than 3 months lacked communication with fellowmen. Conclusion The patients express receiving competent and professional treatment when visiting the outpatient clinic, there seems to be a discrepancy between the long test intervals...

  5. Demyelinizing neurological disease after treatment with tumor necrosis factor alpha-inhibiting agents in a rheumatological outpatient clinic

    DEFF Research Database (Denmark)

    Theibich, Ali; Dreyer, Lene; Magyari, Melinda;

    2014-01-01

    multiple sclerosis (MS) have been described as a rare AE. During about 10-year use of anti TNF-alpha, the Danish Medicines Agency has recorded eight cases of MS like AEs. The objective of this study was to estimate the incidence of demyelinizing AEs both in the central and peripheral nervous system after......Biological treatment with inhibitors of the pro-inflammatory cytokine TNF-alpha has dramatically improved the disease course of several chronic rheumatologic conditions. Adverse events (AEs) are primarily infections and hypersensitivity reactions. Demyelinizing neurological symptoms resembling...... treatment with anti TNF-alpha in a cohort of patients from a large rheumatologic outpatient clinic in Copenhagen. In a 4-year period from January 2008 to December 2011, approximately 550 patients annually were undergoing treatment with anti TNF-alpha inhibitors in our department. We collected data on all...

  6. Psychosocial Characteristics and Obstetric Health of Women Attending a Specialist Substance Use Antenatal Clinic in a Large Metropolitan Hospital

    OpenAIRE

    Lucy Burns; Elizabeth Conroy; Moore, Elizabeth A.; Delyse Hutchinson; Haber, Paul S

    2011-01-01

    Objective. This paper reports the findings comparing the obstetrical health, antenatal care, and psychosocial characteristics of pregnant women with a known history of substance dependence (n = 41) and a comparison group of pregnant women attending a general antenatal clinic (n = 47). Method. Face-to-face interviews were used to assess obstetrical health, antenatal care, physical and mental functioning, substance use, and exposure to violence. Results. The substance-dependent group had more d...

  7. Sensitization to common food and inhalant allergens in children attending Allergy and Asthma Pediatric Clinic in Doha, Qatar

    OpenAIRE

    Kerkadi, Abdelhamid; Al-Thani, Asma; Al-Boainain, Amina; al Janahi, Ibrahim; Singh, Rajiv

    2009-01-01

    The prevalence of allergic diseases such as asthma, allergic rhinitis and atopic dermatitis have risen at an alarming rate throughout the world in the past 50 years. Sensitization to food (FA) and inhalant allergens (IA) have been associated with an increase of allergic diseases. The objective of this study was to estimate the prevalence of sensitization to FA and IA among children attending Allergy and Asthma Pediatric Clinic in Doha, Qatar. A total of 134 children with age between 1 mont...

  8. A survey of the use of prostitutes (commercial sex workers) by new male attenders at a genito urinary medicine clinic.

    OpenAIRE

    C. C. Lim; Armstrong, D.K.; Dinsmore, W W; Maw, R. D.

    1995-01-01

    This study documents the use of prostitutes (commercial sex workers) by new male patients attending a genito urinary medicine clinic. 541 consecutive male patients completed an anonymous self-administered questionnaire. 48 (8.9%) gave a history of previous purchase of sexual services in Northern Ireland and/or elsewhere; 69% of these encounters occurred outside Northern Ireland. The largest group were single men aged 20-29 years. 87% of those who purchased services in Northern Ireland were as...

  9. Examining Longitudinal Stimulant Use and Treatment Attendance as Parallel Outcomes in Two Contingency Management Randomized Clinical Trials.

    Science.gov (United States)

    McPherson, Sterling; Brooks, Olivia; Barbosa-Leiker, Celestina; Lederhos, Crystal; Lamp, Amanda; Murphy, Sean; Layton, Matthew; Roll, John

    2016-02-01

    The primary aim of this study was to examine stimulant use and longitudinal treatment attendance in one 'parallel outcomes' model in order to determine how these two outcomes are related to one another during treatment, and to quantify how the intervention impacts these two on- and off-target outcomes differently. Data came from two multi-site randomized clinical trials (RCTs) of contingency management (CM) that targeted stimulant use. We used parallel multilevel modeling to examine the impact of multiple pre-specified covariates, including selected Addiction Severity Index (ASI) scores, age and sex, in addition to CM on concurrent attendance and stimulant use in two separate analyses, i.e., one per trial. In one trial, CM was positively associated with attending treatment throughout the trial (β=0.060, pnegative urinalysis ((-)UA) over the 12-week treatment period (β=0.069, preinforcement' between two clinically meaningful on-target (directly reinforced behavior) and off-target (indirectly reinforced behavior) outcomes is in need of further examination in order to fully exploit the potential clinical benefits that could be realized in substance use disorder treatment trials. PMID:26456717

  10. Examining Longitudinal Stimulant Use and Treatment Attendance as Parallel Outcomes in Two Contingency Management Randomized Clinical Trials.

    Science.gov (United States)

    McPherson, Sterling; Brooks, Olivia; Barbosa-Leiker, Celestina; Lederhos, Crystal; Lamp, Amanda; Murphy, Sean; Layton, Matthew; Roll, John

    2016-02-01

    The primary aim of this study was to examine stimulant use and longitudinal treatment attendance in one 'parallel outcomes' model in order to determine how these two outcomes are related to one another during treatment, and to quantify how the intervention impacts these two on- and off-target outcomes differently. Data came from two multi-site randomized clinical trials (RCTs) of contingency management (CM) that targeted stimulant use. We used parallel multilevel modeling to examine the impact of multiple pre-specified covariates, including selected Addiction Severity Index (ASI) scores, age and sex, in addition to CM on concurrent attendance and stimulant use in two separate analyses, i.e., one per trial. In one trial, CM was positively associated with attending treatment throughout the trial (β=0.060, preinforcement' between two clinically meaningful on-target (directly reinforced behavior) and off-target (indirectly reinforced behavior) outcomes is in need of further examination in order to fully exploit the potential clinical benefits that could be realized in substance use disorder treatment trials.

  11. An audit of influenza and pneumococcal vaccination in rheumatology outpatients

    Directory of Open Access Journals (Sweden)

    Mitchell William S

    2007-07-01

    Full Text Available Abstract Background Influenza and pneumococcal vaccination are recommended for a number of clinical risk groups including patients treated with major immunosuppressant disease modifying anti-rheumatic drugs. Such immunisation is not only safe but immunogenic in patients with rheumatic diseases. We sought to establish dual vaccination rates and significant influencing factors amongst our hospital rheumatology outpatients. Method We audited a sample of 101 patients attending hospital rheumatology outpatient clinics on any form of disease modifying treatment by clinical questionnaire and medical record perusal. Further data were collected from the local immunisation coordinating agency and analysed by logistic regression modelling. Results Although there was a high rate of awareness with regard to immunisation, fewer patients on major immunosuppressants were vaccinated than patients with additional clinical risk factors against influenza (53% vs 93%, p Conclusion Influenza and pneumococcal immunisation is suboptimal amongst patients on current immunosuppressant treatments attending rheumatology outpatient clinics. Raising awareness amongst patients may not be sufficient to improve vaccination rates and alternative strategies such as obligatory pneumococcal vaccination prior to treatment initiation and primary care provider education need to be explored.

  12. Epidemiological and clinical characteristics, spirometric parameters and response to budesonide/formoterol in patients attending an asthma clinic: an experience in a developing country

    OpenAIRE

    Imad, Hassan; Yasir, Ged

    2015-01-01

    Introduction This study aims at describing the epidemiological and clinical characteristics, severity, reversibility testing and response to treatment using simple spirometry in asthmatic patients attending a model specialized Asthma Care Center. Methods Eligible subjects must have a suggestive clinical picture and confirmed by spirometry to have a 12% plus 200ml absolute increase in FEV1 either by reversibility testing or after a therapeutic trial with inhaled and/or oral steroid therapy. Bu...

  13. The Relationship between Childhood Sexual Abuse, Complex Post-Traumatic Stress Disorder and Alexithymia in Two Outpatient Samples: Examination of Women Treated in Community and Institutional Clinics

    Science.gov (United States)

    McLean, Linda M.; Toner, Brenda; Jackson, Jennifer; Desrocher, Mary; Stuckless, Noreen

    2006-01-01

    Relationships between trauma variables, complex post-traumatic stress disorder (complex PTSD), affect dysregulation, dissociation, somatization, and alexithymia were studied in 70 women with early-onset sexual abuse treated in community-based private (n = 25) or clinic outpatient settings (n = 45). Measures were the Toronto Alexithymia Scale-20…

  14. Prediction of the need for an MRI after surgical treatment of symptomatic lumbar herniated disc at discharge: evaluation of the necessity for regular visits at the outpatient clinic.

    NARCIS (Netherlands)

    Bartels, R.H.M.A.; Beems, T.; Verbeek, A.L.M.

    2010-01-01

    BACKGROUND: Surgical treatment of symptomatic lumbar disc herniations has been well established. The need for regular postoperative visits at the outpatient clinic has never been evaluated. In this study, factors predicting the need for magnetic resonance imaging, denoting an unfavorable outcome nee

  15. Clinical-anthropometric characteristics of COPD outpatients belonging to the different groups and having different severity of airway obstruction

    Directory of Open Access Journals (Sweden)

    Gashynova K.Y.

    2015-06-01

    Full Text Available The aim of the study was to compare the clinical and anthropometric characteristics of patients with COPD, which differ in the degree of airways obstruction and belong to groups A, B, C, D in accordance with GOLD, 2011 classification. A total of 112 ambulatory COPD patients in remission made the study sample. Anthropometric data, body mass index, medical history, dyspnea by mMRC scale, and spirometry was performed for all patients. There was confirmed that outpatients with COPD is a heterogeneous group, in which the majority are those with moderate (48.22 % and severe (30.36 %, airway obstruction. Despite the vast majority of men among outpatients, the percentage of women among patients with mild to moderate obstruction (22.58±5.31 % was significantly higher (p=0.002 as compared with those with severe or very severe limitation of airflow (6.00±3.36 %. Patients with severe and very severe obstruction were of significantly older age (p = 0.024. At the same time, the distribution of patients according to the GOLD, 2011 classification, demonstrate that all groups did not differ on any of the anthropometric indicators, including gender and age (p > 0.050. Distribution of patients by groups with different risk for future exacerbations is not a mirror image of gradation in accordance with the degree of airway obstruction. Every second (50.00±4.43 % of cases patient is included in group C and every tenth (10.20±4.32 % belongs to the group D not due to degree of bronchial obstruction, but due to the number of exa­cerbations in the past year. Therefore, in future studies it is advisable to use both principles of patients’ classification.

  16. Lower urinary tract symptoms associated with neurological conditions: Observations on a clinical sample of outpatients neurorehabilitation service

    Directory of Open Access Journals (Sweden)

    Fabrizio Torelli

    2015-07-01

    Full Text Available Objectives: The overall aims of this study were to investigate the lower urinary tract symptoms (LUTS associated with neurological conditions and their prevalence and impact on a clinical sample of outpatients of a neurorehabilitation service. Materials and methods: We reviewed the files of 132 patients treated in our neurorehabilitation service from December 2012 to December 2013. Patients were divided into several subgroups based on the neurological diagnosis: Multiple Sclerosis (MS, other demyelinating diseases, Peripheral Neuropathy, neurovascular disorders (ND, neoplastic disease, traumatic brain injury (TBI, Parkinson and Parkinsonism, spinal cord injuries (SCI. Urinary status was based on medical evaluations of history of LUTS, type, degree, onset and duration of symptoms. We tried to analyze prevalence, kind of disorder, timing of presentation (if before or after the neurological onset and eventual persistence of urological disorders (in the main group and in all subgroups. Results: At the time of admission to our rehabilitation service, LUTS were observed in 14 out of 132 cases (11%. A high proportion of these outpatients (64.2% presented bothersome urinary symptoms such as incontinence, frequency and urgency (storage LUTS. The most frequent symptom was urinary urge incontinence (42.8%. This symptom was found to be prevalent in the multiple sclerosis and neurovascular disorders. In 93% the urinary symptoms arose as a result of neurologic conditions and 78.5% did not present a complete recovery of urological symptoms in spite of improved selfreported functional activity limitations. None of these patients performed urological rehabilitation. Conclusions: Neurological disorders are a significant issue in rehabilitation services and it can lead to lower tract dysfunction, which causes LUTS. Storage symptoms are more common, especially urge incontinence. Current literature reports that a further optimization of the rehabilitation potential

  17. 42 CFR 440.20 - Outpatient hospital services and rural health clinic services.

    Science.gov (United States)

    2010-10-01

    ... profession under State law, if the physician performs the services in the clinic or the services are... residence” does not include a hospital or a skilled nursing facility. (c) Other ambulatory...

  18. [Critical evaluation and predictive value of clinical presentation in out-patients with acute community-acquired pneumonia].

    Science.gov (United States)

    Mayaud, C; Fartoukh, M; Prigent, H; Parrot, A; Cadranel, J

    2006-01-01

    Diagnostic probability of community-acquired pneumonia (CAP) depends on data related to age and clinical and radiological findings. The critical evaluation of data in the literature leads to the following conclusions: 1) the prevalence of CAP in a given population with acute respiratory disease is 5% in outpatients and 10% in an emergency care unit. This could be as low as 2% in young people and even higher than 40% in hospitalized elderly patients; 2) the collection of clinical data is linked to the way the patient is examined and to the expertise of the clinician. The absolute lack of "vital signs" has a good negative predictive value in CAP; presence of unilateral crackles has a good positive predictive value; 3) there is a wide range of X-ray abnormalities: localized alveolar opacities; interstitial opacities, limited of diffused. The greatest radiological difficulties are encountered in old people with disorders including chronic respiratory or cardiac opacities and as a consequence of the high prevalence of bronchopneumonia episodes at this age; 4) among patients with lower respiratory tract (LRT) infections, the blood levels of leukocytes, CRP and procalcitonine are higher in CAP patients, mainly when their disease has a bacterial origin. Since you have not a threshold value reliably demonstrated in large populations with LRT infections or acute respiratory disease, presence or absence of these parameters could only be taken as a slight hint for a CAP diagnosis. PMID:17084571

  19. The Relationship of Osteoporosis Risk Factors with Bone Mineral Density in Patients Admitted Our Outpatient Clinic in Trabzon

    Directory of Open Access Journals (Sweden)

    Münevver Serdaroğlu Beyazal

    2016-04-01

    Full Text Available Objective: Our aim was to identify the relationship of osteoporosis (OP risk factors with bone mineral density (BMD in patients admitted our outpatient clinic in Trabzon. Materials and Methods: Two hundred one patients with OP or osteopenia were included in this study. Sociodemographic characteristics of the patients were recorded and a standardized interview was employed by the researcher physician. BMD values were measured by dual energy X-ray absorptiometry at lumbar spine and femoral neck. Results: The mean age of the patients was 61.47±10.57 years (182 females/19 males. One hundred fifteen patients (57.2% were osteoporotic and 86 (42.8% were osteopenic. A significant negative correlation was found between age and femoral neck T scores. The number of pregnancies showed a significant negative correlation with lumbar T scores. Body mass index and daily tea consumption showed a negligible positive correlation with femoral neck T scores. No association was found between age at menarche, age at menopause, total lactation duration, daily calcium intake and T scores of lumbar spine and femoral neck. Conclusions: Identification of regional OP risk factors may be useful for the OP risk management of patients in clinical practice.

  20. One-Year Retrospective Analysis of Forensic Cases Referred to Child and Adolescent Psychiatry Outpatient Clinic in the Province of Adiyaman

    OpenAIRE

    Funda Gumustas; Yasemin Yulaf; Sebla Gokce; Sema Saglam; Emel Koyuncu Kutuk

    2014-01-01

    Purpose: This study’s aim is to investigate child and adolescent cases referred for forensic examination to our child and adolescent psychiatry outpatient clinic. Material and Methods: File informations of 121 cases who referred to Adiyaman University Training and Research Hospital, child psychiatry clinic between 01 June 2012 and 31 May 2013 were reviewed retrospectively. Socio-demographic characteristics of the children and reasons for referral determined. The study was focused on ...

  1. Sluggish Cognitive Tempo in a Child and Adolescent Clinical Outpatient Setting.

    Science.gov (United States)

    Camprodon-Rosanas, Ester; Batlle, Santiago; Estrada-Prat, Xavier; Aceña-Díaz, Marta; Petrizan-Aleman, Araitz; Pujals, Elena; Martin-López, Luis M; Pérez-Solá, Víctor; Ribas-Fitó, Núria

    2016-09-01

    Sluggish cognitive tempo (SCT) symptoms have largely emerged from investigations of attention-deficit/hyperactivity disorder (ADHD). Recent research has demonstrated the relevance of SCT symptoms in the field of clinical child and adolescent psychiatry. The goal of this research was to study the symptoms of SCT in a clinical child and adolescent sample and to define its features and comorbid conditions. We reviewed 834 clinical records of patients referred to Child and Adolescent Mental Health Services and examined SCT symptoms and their relation with sociodemographic data, clinical diagnosis, comorbid conditions, Child Behavior Checklist dimensions, and intelligence quotient. Of the 515 patients (age range, 4 to 17 y, 62.5% male) for whom a fully completed Child Behavior Checklist for Children and Adolescents was available, 20.8% showed high levels of SCT symptoms. SCT symptoms were strongly associated with age, internalizing symptoms, learning disabilities, and ADHD inattentive subtype (ADHD-I). No significant correlations with intelligence quotient were found. We concluded that SCT symptoms are highly prevalent in a clinical sample, and that these symptoms might be related to the difficulties that some individuals have in responding to demands in their environments, such as academic or social demands, as they increase over time. PMID:27648500

  2. The cost of antiretroviral treatment service for patients with HIV/AIDS in a central outpatient clinic in Vietnam

    Directory of Open Access Journals (Sweden)

    Nguyen LT

    2014-02-01

    Full Text Available Long Thanh Nguyen,1 Bach Xuan Tran,2 Cuong Tuan Tran,1 Huong Thi Le,1 Son Van Tran1 1Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam; 2Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam Introduction: Antiretroviral treatment (ART services are estimated to account for 30% of the total resources needed for human immunodeficiency virus (HIV/acquired immunodeficiency syndrome (AIDS control and prevention in Vietnam during the 2011–2020 timeframe. With international funding decreasing, determining the total cost of HIV/AIDS treatment is necessary in order to develop a master plan for the transition of ART services delivery and management. We analyzed the costs of HIV/AIDS treatment paid by both HIV programs and patients in a central outpatient clinic, and we explored factors associated with the capacity of patients to pay for this service. Methods: Patients (n=315 receiving ART in the Department of Infectious Diseases at Bach Mai Hospital, Hanoi, Vietnam, were interviewed. Patient records and expenses were reviewed. Results: The total cost of ART per patient was US$611 (75% from health care providers, 25% from patients or their families. The cost of a second-line regimen was found to be 2.7 times higher than the first-line regimen cost. Most outpatients (73.3% were able to completely pay for all of their ART expenses. Capacity to pay for ART was influenced by five factors, including marital status, distance from house to clinic, patient's monthly income, household economic condition, and health insurance status. Most of the patients (84.8% would have been willing to pay for health insurance if a copayment scheme for ART were to be introduced. Conclusion: This study provides evidence on payment capacity of HIV/AIDS patients in Vietnam and supplies information on ART costs from both provider and patient perspectives. In particular, results from this study suggest that earlier access to ART

  3. The Prevalence and the Determinants of Musculoskeletal Diseases in Emiratis Attending Primary Health Care Clinics in Dubai

    Directory of Open Access Journals (Sweden)

    Jamal Al Saleh

    2016-03-01

    Full Text Available Objectives: To estimate the prevalence of rheumatic diseases in the Emiratis attending primary health care (PHC clinics in Dubai. The secondary objective was to study the relationship between age, gender, and body mass index (BMI and rheumatic diseases in the general population.  Methods: The Prevalence of Rheumatic Diseases and Osteoporosis (PRO in Dubai study was a cross-sectional study, which randomly enrolled Emiratis’ aged between 18–85 years old who attended one of 13 PHC clinics between 2 January 2009 and 31 December 2009. Demographic and health data for all participants was obtained via a questionnaire. Participants that indicated positive answers had their responses validated by a rheumatologist and underwent a thorough locomotor examination.  Results: The study included 3,985 participants with a mean age of 42.1±15.8 years. The majority (77.4% were female. Lower back pain was the most prevalent problem in our study population (32.9%. Knee osteoarthritis (OA was the most common form of arthritis seen in our cohort (25.8%. Overall, the prevalence of inflammatory arthritis was 3.1%. Age and BMI were associated with increased risk of knee OA and lower back pain.  Conclusions: Rheumatic diseases are quite common in Emirati patients attending PHC clinics. Lower back pain and knee OA were the most common musculoskeletal diseases seen in our cohort. There is a need for more population-based studies in the Middle East to have a better understanding of the epidemiology of rheumatic diseases in this region.

  4. The relationship between visual orienting responses and clinical characteristics in children attending special education for the visually impaired.

    Science.gov (United States)

    Kooiker, Marlou J G; Pel, Johan J M; van der Steen, Johannes

    2015-05-01

    We recently introduced a method based on quantification of orienting responses toward visual stimuli to assess the quality of visual information processing in children. In the present study, we examined the relationship between orienting responses and factors that are associated with visual processing impairments in current clinical practice. Response time and fixation quality to visual features such as form, contrast, motion, and color stimuli were assessed in 104 children from 1 to 12 years attending special education for the visually impaired. Using regression analysis, we investigated whether these parameters were affected by clinical characteristics of children. Response times significantly depended on stimulus type. Responses to high-contrast cartoons were significantly slower in children with a clinical diagnosis of cerebral visual impairment. Fixation quality was significantly affected by visual acuity and nystagmus. The results suggest that the quantitative measurement of orienting responses is strongly related to cerebral visual impairment in children.

  5. The Strategy of Combining Antidepressants in the Treatment of Major Depression: Clinical Experience in Spanish Outpatients

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    Luis M. Martín-López

    2011-01-01

    The most frequent combinations are SSRIs and tricyclic antidepressants. The active principle most widely combined is fluoxetine. Conclusions. The prevalence of use of antidepressant combination therapy is 2.2% of the global sample and 8.3% of treated patients. Other than duration of the depressive episode, no clinical characteristics exclusive to patients who received combination rather than monotherapy were found. Our study found that the most frequent combination is SSRIs + TCAs, also being the most studied.

  6. Incidence rate and pattern of clinically relevant potential drug-drug interactions in a large outpatient population of a developing country.

    Science.gov (United States)

    Nabovati, Ehsan; Vakili-Arki, Hasan; Taherzadeh, Zhila; Saberi, Mohammad Reza; Abu-Hanna, Ameen; Eslami, Saeid

    2016-01-01

    The objective of this study was to determine incidence rate, type, and pattern of clinically relevant potential drug-drug interactions (pDDIs) in a large outpatient population of a developing country. A retrospective, descriptive cross-sectional study was conducted on outpatients' prescriptions in Khorasan Razavi province, Iran, over 12 months. A list of 25 clinically relevant DDIs, which are likely to occur in the outpatient setting, was used as the reference. Most frequent clinically relevant pDDIs, most common drugs contributing to the pDDIs, and the pattern of pDDIs for each medical specialty were determined. Descriptive statistics were used to report the results. In total, out of 8,169,142 prescriptions, 6,096 clinically relevant pDDIs were identified. The most common identified pDDIs were theophyllines-quinolones, warfarin-nonsteroidal anti-inflammatory drugs, benzodiazepines-azole antifungal agents, and anticoagulants-thyroid hormones. The most common drugs contributing to the identified pDDIs were ciprofloxacin, theophylline, warfarin, aminophylline, alprazolam, levothyroxine, and selegiline. While the incidence rate of clinically relevant pDDIs in prescriptions of general practitioners, internists, and cardiologists was the highest, the average pDDI incidence per 10,000 prescriptions of pulmonologists, infectious disease specialists, and cardiologists was highest. Although a small proportion of the analyzed prescriptions contained drug pairs with potential for clinically relevant DDIs, a significant number of outpatients have been exposed to the adverse effects associated with these interactions. It is recommended that in addition to training physicians and pharmacists, other effective interventions such as computerized alerting systems and electronic prescribing systems be designed and implemented. PMID:27499793

  7. A study of the anemia statues of the chronic kidney disease patient attending the kidney outpatient service.%肾病门诊慢性肾脏疾病患者贫血情况调查

    Institute of Scientific and Technical Information of China (English)

    刘旭; 尹道馨; 徐睿; 张东亮; 刘文虎

    2011-01-01

    目的 了解慢性肾脏疾病(CKD)患者的贫血状况,对贫血相关因素进行分析,为采取相应对策改善患者贫血状况提供依据.方法 采用筛查的方法,对北京友谊医院就诊的129例慢性肾脏病患者进行问卷调查,抽取血样标本化验相应指标,应用统计软件进行分析.结果 对129例调查对象进行慢性肾脏病分期,Ⅳ期患者血红蛋白平均值显著低于Ⅱ期患者(P<0.001),Ⅳ期患者贫血发生率、促红细胞生成素治疗率和铁剂治疗率显著高于Ⅱ期患者(P<0.05).单因素分析显示,女性与CKD患者贫血发生相关(χ2=8.293,P=0.004).多因素分析显示,女性(OR= 3.679; 95% CI:1.383~9.783;P= 0.009)、体质指数(BMI)≥24(OR= 5.155;95% CI:1.380-19.254; P=0.015)为CKD患者发生贫血的独立危险因素.结论 女性患者和肥胖患者是CKD患者中贫血的高发人群,更应引起重视.慢性肾脏病患者补充促红细胞生成素和铁剂的治疗还需进一步完善.%Objective To investigate the factors that might be related to the anemia status of the chronic kidney disease patient attending the Beijing Friendship Hospital, in order to improve the treatment of patients with anemia. Methods One hundred and twenty nine patients with chronic attending the kidney outpatient service of Beijing Friendship Hospital took blood tests and were surveyed with questionnaire. Statistical analysis was made by SPSS version 16.0. Results 129 patients with chronic kidney disease were classified in 5 stages. Hemoglobin value in patients with stage Ⅳ was significantly lower than that in patients with stage Ⅱ ( P < 0. 001 ). Patients with stage Ⅳ had a higher incidence of anemia and higher treatment rate with erythropoietin therapy, respectively, than patients with stage Ⅱ ( P < 0.05 ). Female showed consistent association with anemia by univariate analysis ( x2 = 8.293, P=0. 004 ). Multivariate analysis demonstrated Female and body mass index ( BMI ) ≥ 24

  8. Brief intervention for alcohol misuse in people attending sexual health clinics: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Sanatinia Rahil

    2012-08-01

    Full Text Available Abstract Background Over the last 30 years the number of people who drink alcohol at harmful levels has increased in many countries. There have also been large increases in rates of sexually transmitted infections. Available evidence suggests that excessive alcohol consumption and poor sexual health may be linked. The prevalence of harmful alcohol use is higher among people attending sexual health clinics than in the general population, and a third of those attending clinics state that alcohol use affects whether they have unprotected sex. Previous research has demonstrated that brief intervention for alcohol misuse in other medical settings can lead to behavioral change, but the clinical- and cost-effectiveness of this intervention on sexual behavior have not been examined. Methods We will conduct a two parallel-arm, randomized trial. A consecutive sample of people attending three sexual health clinics in London and willing to participate in the study will be screened for excessive alcohol consumption. Participants identified as drinking excessively will then be allocated to either active treatment (Brief Advice and referral for Brief Intervention or control treatment (a leaflet on healthy living. Randomization will be via an independent and remote telephone randomization service and will be stratified by study clinic. Brief Advice will comprise feedback on the possible health consequences of excessive alcohol consumption, written information about alcohol and the offer of an appointment for further assessment and Brief Intervention. Follow-up data on alcohol use, sexual behavior, health related quality of life and service use will be collected by a researcher masked to allocation status six months later. The primary outcome for the study is mean weekly alcohol consumption during the previous three months, and the main secondary outcome is the proportion of participants who report unprotected sex during this period. Discussion Opportunistic

  9. [Characteristics of patients with chronic kidney disease referred to a nephrology outpatient clinic: results of Nefrodata study].

    Science.gov (United States)

    Cupisti, Adamasco; Bottai, Anna; Bellizzi, Vincenzo; Brunori, Giuliano; Cianciaruso, Bruno; De Nicola, Luca; Oldrizzi, Lamberto; Quintaliani, Giuseppe; Santoro, Domenico; Di Iorio, Biagio Raffaele

    2015-01-01

    Chronic kidney disease is acknowledged as one of the most relevant disease for public health. Knowledge of epidemiology of CKD may allow public health interventions both for prevention and treatment in order to limit burden and management costs. Nefrodata is a multicentric, prospective, and observational study conducted in Italy, including patients with CKD followed in a specialist setting. The study uses a web-based data setting; it includes 1263 subjects with an estimate glomerular filtration rate (eGFR) less than 60 ml/min *1,73 sqm, followed in outpatient clinics in Italy. Patients' characteristics analysis evidences that old subjects (mean age of 70.3 13.4 years, 55% of them older than 70 years), with cardiovascular morbidity (50,6%) and diabetics (37%) have a high prevalence. With the reduction of residual renal function, prevalence of hyperphospatemia, metabolic acidosis, use of erythropoiesis-stimulating agents, Vitamin D, and diuretics increases. Also allopurinol and gastric-protective drugs are widely used. Fifty-four and eight % of patients with CKD stage 4 and 65.9% of patients with CKD stage 5 received indication on nutritional therapy. PMID:26005945

  10. Investigation of Trichomonas Vaginalis by Parasitological and Cytological Methods in Patients Admitted to Gynecology Outpatient Clinics in a University Hospital

    Directory of Open Access Journals (Sweden)

    Özlem Aycan-Kaya

    2015-11-01

    Full Text Available Aim: In this study, it was aimed to compare parasitological and cytological diagnostic methods to detect T. Vaginalis in samples taken from posterior fornix of vagina. Methods: In this cross-sectional study, study population (n=104 were selected from women applying to gynecology outpatient clinic of Mustafa Kemal University Hospital with different complaints between March- August 2013. The presence of T. vaginalis was investigated by parasitological and cytological diagnostic methods. While direct microscopy, giemsa staining and culture in Cysteine-Peptone-Liver-Maltose medium (CPLM were performed for parasitological diagnosis of T. vaginalis in samples taken from posterior fornix of vagina, cervical smear stained by Papanicolaou (PAPS was used for cytological diagnosis. Results: T. vaginalis was detected in 12 (11.5%, 12 (11.5%, 14 (%13.4 of materials by direct microscopy, giemsa staining and culture, respectively. T. vaginalis was detected only 5 (4.8% of materials by cytology. This difference was statistically significant (p<0.05. Conclusion: Our study results showed that parasitological methods are more sensitive than cytological methods in diagnosis of T. vaginalis. Therefore, T. vaginalis should be screened in women with non-specific symptoms in under developed countries where lack of periodic examination and polygamy were seen.

  11. The association between maltreatment in childhood and pre-pregnancy obesity in women attending an antenatal clinic in Australia.

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    Katharine Hollingsworth

    Full Text Available INTRODUCTION: Obesity in pregnancy is associated with increased risk of complications and adverse outcomes in mother and child. Childhood adverse experiences are known to have numerous negative physical and emotional sequelae. We aimed to examine if exposure to abuse and/or neglect in childhood increased the likelihood of pre-pregnancy obesity. METHODS: Demographic and clinical data including weight, height, mental health as measured by the General Health Questionnaire and exposure to childhood trauma as measured by the childhood trauma questionnaire was collected from 239 women attending antenatal care at an Australian tertiary hospital. RESULTS: More than one quarter of women were obese prior to pregnancy and approximately 20% of women self reported experiencing moderate to severe physical, sexual or emotional abuse. Almost 60% of women scored in the clinical range on the GHQ. Pre-pregnancy obesity in women attending antenatal care was associated with a self-reported history of emotional or physical abuse with those exposed to moderate or severe emotional or physical abuse having increased odds of being obese prior to pregnancy (O.R. and 95% CI: 2.40; 1.19-4.84 and 2.38; 1.18-4.79 respectively. There was no significant association between other forms of childhood maltreatment, demographic or current mental health status and pre-pregnancy obesity. CONCLUSIONS: The high rates of obesity, mental health problems and self reported childhood maltreatment in the Australian antenatal population are serious public health concerns due to the extra health risks conferred on mother and offspring. Exposure to physical or emotional abuse during childhood increases the likelihood of obesity in women attending antenatal care. Further research is required to determine reasons for this association.

  12. Prevalence of Trichomonas vaginalis, Mycoplasma genitalium and Ureaplasma urealyticum in men with urethritis attending an urban sexual health clinic.

    Science.gov (United States)

    Khatib, N; Bradbury, C; Chalker, V; Koh, G C K W; Smit, E; Wilson, S; Watson, J

    2015-05-01

    We conducted a study to determine the prevalence of Trichomonas vaginalis (TV), Mycoplasma genitalium (MG) and Ureaplasma urealyticum (UU) in men with urethritis, attending an urban sexual health clinic, in order to inform screening and treatment policies. Men attending an urban sexual health clinic between June 2011 and January 2012 were evaluated. Urine samples were collected from men with urethritis and tested for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (GC) and TV using transcription-mediated amplification and for MG and UU using polymerase chain reaction. Eighty-three samples were analysed. The prevalence of CT was 33.7% (28/83), GC was 16.8% (14/83), TV was 3.6% (3/83), MG was 12.0% (10/83) and UU was 4.8% (4/83). Fifteen men had recurrent urethritis. Of these, three were found to have had TV, five to have had MG and none to have had UU, at initial presentation. Given the prevalence of MG in this study, there is an urgent need for further larger studies looking at optimal treatment regimens and screening strategies in urethritis.

  13. Epidemiological Investigation of Human Papillomavirus Infection in Men Attending a Sexually Transmitted Disease Clinic in Hangzhou Area

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    To investigate the epidemiological characteristics of human papillomavirus (HPV) infection in men attending a sexually transmitted diseases (STD) clinic in Hangzhou area. Methods Male subjects (n=375) aged 18-70 years,attending the STD clinic were recruited. Urethral swabs were assessed for HPV DNA using polymerase chain reaction (PCR)with the consensus primers MY09/11. HPV genotypes of positive PCR products were determined by restriction fragment length polymorphisms and direct sequence analysis. Results Of the 375 swabs collected, 305 (81.3%) yielded sufficient DNA for the subsequent HPV analysis. Among the 305 subjects, the prevalence of HPV was 13.8%. Nononcogenic HPV types were found in 8.5% (26/305) of subjects, oncogenic types in 4.3% (13/305), and multiple types in 1.0% (3/305). The prevalence of HPV infection was higher in subjects from urban area than in those from rural area (P<0.05). The prevalence was also higher in those who received fewer years of education (P<0.05) and those who had more sex partners (P<0.05). Conclusions HPV infection among men at high risk is not uncommon. The detection rate of HPV DNA is significantly related to some sociodemographic factors, such as residence, educational level and the number of sex partners.

  14. Evaluation of trend in semen analysis for 11 years in subjects attending a fertility clinic in India

    Institute of Scientific and Technical Information of China (English)

    P.Marimuthu; M.C.Kapilashrami; M.M.Misro; G.Singh

    2003-01-01

    Aim: The data on semen analysis of subjects attending the Fertility Clinic at NIHFW (National Institute of Health and Family Welfare) Munirka, New Delhi for the last 11 years were analyzed to verify the claims and speculations on declining sperm counts in men. Methods: Approximately 10 % of the records every year starting from 1990 to 2000 (numbering 1176 in total) were randomly selected for analysis. Subjects with azoospermia or severe oligozoospermia were excluded from analysis. Results: The average age of the men attending the infertility clinic was 31.2 years. The average semen volume and sperm count were found to be (2.6 ± 0.1) mL and (60.6 ±0.9)× 106/ml., respectively. No significant decline in sperm counts was observed in anyyear during the entire studyperiod. Only 1.8 % of the total number of sperm counts in the random sampling were less then 20×106/mL. On the basis of WHO criteria on motility, the total percentage of non-progressive and non-motile sperm in the ejaculate was higher (63 %) as compared to the combined categories of slow and rapid linear progressive. Conclusion: The present study has confmned similar findings from other different countries that declining sperm counts in humans is not a global phenomenon. ( Asian J Androl 2003 Sep; 5: 221-225)

  15. Determinants of Tuberculosis Infection among Adult HIV Positives Attending Clinical Care in Western Ethiopia: A Case-Control Study

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    Hatoluf Melkamu

    2013-01-01

    Full Text Available There has been a drastic rise of tuberculosis (TB infection across the world associated with the pandemic occurrence of HIV/AIDS. There are various determinants factors that increase the chance of TB infection among HIV positives (TB/HIV confection that varies contextually. This study aimed to assess the determinants of TB/HIV coinfection among adult HIV positives attending clinical care at two public health facilities in Nekemte, western Ethiopia. Unmatched case-control study was conducted from December 26, 2011, to February 29, 2012. Cases were 123 TB infected HIV positives, and controls were 246 non-TB infected HIV positives. Being divorced/widowed , 95% CI (1.70, 7.88, not attending formal education , 95% CI (2.20, 14.15, being underweight ( kg/m2 , 95% CI (2.18, 6.87, having history of diabetic mellitus , 95% CI (1.33, 9.94, and being in advanced WHO HIV/AIDS clinical staging , 95% CI (1.32, 3.98, were determinant factors associated with TB/HIV co-infection. Having a separate kitchen , 95% CI (0.28, 0.81 showed protective role. For most of these determinants interventions can be made at individual and institutional levels, whereas, factors like education and nutrition need societal level integrations.

  16. Touch screens as a tool in patient care in the IBD outpatient clinic

    DEFF Research Database (Denmark)

    Larsen, Lone; Drewes, Asbjørn Mohr; Fallingborg, Jan;

    2016-01-01

    OBJECTIVE: We have introduced online touch screens in the waiting room for patients with ulcerative colitis (UC) or Crohn's disease (CD) for recording of symptoms before their consultation. This has made disease activity scores readily available to the physician in our newly established database......, 'Gastrobio'. We wanted to validate the use of touch screens compared to paper questionnaires. MATERIAL AND METHODS: A total of 54 patients with UC and 74 patients with CD were included in the study. The UC patients filled out the Short Health Scale (SHS) and Simple Clinical Colitis Activity Index (SSCAI......). The CD patients filled out the SHS and Harvey-Bradshaw Index (HBI). Paper questionnaires and touch screen versions were used in random order and comparison between the two modalities was made by Spearman correlation test, Bland-Altman plots, and Kappa-statistics. RESULTS: Among the 128 patients, the...

  17. Foot care and footwear practices among patients attending a specialist diabetes clinic in Jamaica

    OpenAIRE

    Gayle, Krystal A.T.; Tulloch-Reid, Marshall K.; Younger, Novie O; Francis, Damian K.; Shelly R. McFarlane; Wright-Pascoe, Rosemarie A.; Boyne, Michael S.; Wilks, Rainford J; Ferguson, Trevor S

    2012-01-01

    This study aimed to estimate the proportion of patients at the University Hospital of the West Indies (UHWI) Diabetes Clinic who engage in recommended foot care and footwear practices. Seventy-two participants from the UHWI Diabetes Clinic completed an interviewer-administered questionnaire on foot care practices and types of footwear worn. Participants were a subset of a sex-stratified random sample of clinic attendees and were interviewed in 2010. Data analysis included frequency estimates ...

  18. Perception and utilization of traditional birth attendants by pregnant women attending primary health care clinics in a rural Local Government Area in Ogun State, Nigeria

    OpenAIRE

    Ebuehi OM; Akintujoye IA

    2012-01-01

    Olufunke M Ebuehi, IA AkintujoyeReproductive and International Health Unit, Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, NigeriaBackground: In developing countries, most childbirth occurs at home and is not assisted by skilled attendants. This situation increases the risk of death for both mother and child and has severe maternal and neonatal health complications. The purpose of this study was to explore pregnant women’s perceptio...

  19. Depression prevalence and primary care among vulnerable patients at a free outpatient clinic in Paris, France, in 2010: results of a cross-sectional survey.

    OpenAIRE

    Rondet, Claire; Cornet, Philippe; Kaoutar, Bacha; Lebas, Jacques; Chauvin, Pierre

    2013-01-01

    BACKGROUND: Data on the prevalence of depression and on how a depressive episode prompts the sufferer to seek primary care are not scarce, but the available evidence on the prevalence of depression among immigrants and poor people who frequent general practice facilities is scarce. The Baudelaire Outpatient Clinic at the Saint-Antoine Hospital in Paris provides free medical and social assistance to the poor and/or uninsured. The goal of our study was to estimate the prevalence of depression a...

  20. The Assessment of Children’s Socio-Demographic Features at the Adolescent Outpatient Clinic

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    Y. Kenan Haspolat

    2016-03-01

    Full Text Available Objective: In this study, we investigated socio-demo­graphic characteristics of adolescents living in our region. Methods: Were analyzed, retrospectively, patients admit­ted Dicle University Faculty of Medicine’ adolescent out­patient clinic. Demographic data, body mass index (BMI, medical history and family background, school status, academic achievement, habits, trauma and psychosocial status were recorded. Results: Of the 244 adolescents, 124/% were females. The average age of cases was 12.99 ± 1.89 years (10-18 years. 48.3% of adolescents were low BMI. The smoking rate of 32.4% (n=79 and was higher in men. In smok­ers, school performance was lower (p = 0.002, and the rate of suicidal idea was higher (p < 0.001. In those with family history of suicide, the rate of suicidal thoughts or attempted suicide was higher (p = 0.005, p = 0.022, re­spectively. Similarly, in cases exposed to physical vio­lence, the rates of attempted suicide or suicidal thoughts were higher (p=0.011, p=0.001, respectively. In addition, in cases exposed to psychological violence the rates of attempted suicide or suicidal thoughts were higher (p<0.001, p<0.001, respectively. Conclusion: Adolescents, for they can complete this period in a healthy way, health-care services, education units, especially their parents, should be made aware of the adolescence period-specific problems. Additionally, special centers customized adolescents, should be cre­ated and supported by state and private institutions.

  1. Vitamin D Levels in Children Admitted to the Endocrine Outpatient Clinic

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    Meliha Demiral

    2016-08-01

    Full Text Available Introduction: Vitamin D regulates calcium and phosphorus metabolism. Vitamin D deficiency results in rickets and it has been reported that vitamin D plays role in the development of autoimmune diseases, inflammatory bowel disease, rheumatoid arthritis, multiple sclerosis, diabetes, many kinds of cancer and heart diseases. Herein, we aimed to investigate the prevalence of vitamin D deficiency and associated factors by evaluating the records of the patients whose vitamin D levels [25-hydroxyvitamin D (25-OH D] were determined in our endocrine clinic. Materials and Methods: During winter between January and April, the hospital records of children and adolescents whose age ranged from 3 to 18 years among 171 patients were investigated. Vitamin D levels higher than the 20 ng/mL were defined as normal, <12 ng/mL were defined as deficient, 12-20 ng/mL as insufficient. Results: The mean age of the patients was 11.78±4 (3-18 years. Hundred and thirty patients were in pubertal period and 41 patients were in prepubertal period. Diagnoses were type 1 diabetes in 40 patients, obesity in 47 patients and other endocrine diseases in 84 patients. Twenty three patients (13.4% had normal vitamin D levels. In 148 patients (86.6%, 25-OH D levels were <20 ng/mL. Eighty eight (51.5% of these patients had vitamin D deficiency and 60 (35.1% patients were found to have vitamin D insufficiency. 25-OH D levels were lower in girls than in boys and lower in pubertal children than in prepubertal children (p<0.01; p<0.05, respectively. Vitamin D levels in diabetics and in the obese were lower than the other disease groups (in both p<0.01. Conclusions: Children and adolescents with endocrine diseases have a relatively high frequency of vitamin D deficiency during winter. These findings suggest that vitamin D prophylaxis programs should be applied not only to the previously identified risk groups but also to all children and adolescents with chronic diseases.

  2. Nutrition related knowledge and practices of hypertensive adults attending hypertensive clinics at day hospitals in the Cape Metropole

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    H. Becker

    2004-09-01

    Full Text Available The aim of this study was to determine nutrition knowledge and dietary practices of hypertensive adults attending hypertensive clinics at Day Hospitals in the Cape Metropole. Ten Day Hospitals were randomly selected from a total of 31 Day Hospitals and the first participants attending the hypertension clinics per day were recruited. A total of 85 participants were evaluated. The weight, height, waist and hip circumference of each participant was measured, as well as their blood pressure. Knowledge of dietary intake was obtained by completing a questionnaire, during an interview with the patient. Knowledge regarding salt usage indicated that a large percentage (34.1 % of participants believed that flavour enhancers like Aromat or Fondor could safely be used instead of table salt. Furthermore, 23.5% reported that tinned and smoked meat or fish have a low sodium (salt content. Fruit and vegetables were perceived as having a positive effect on hypertension by 74.1 % of participants. However, only 15% of the group knew that the recommendation for their usage was five or more servings per day. Only 12.9% of participants in this study had a normal weight (body mass index (BMI < 25, 25.9% were overweight (BMI 25 - 29.9 and 61.2% were obese (BMI ≥ 30; 84.7% recognized the association between obesity and hypertension. A large waist circumference (> 88cm in women; 102cm in men was found in 61.2% of participants, however, only 18.2% of black men had such a measurement. Uncontrolled blood pressure readings (> 140/90mm Hg were found in 61.2% of these patients at the hypertension clinics.

  3. Prevalence of hepatitis B virus infection in out-patient alcoholics

    DEFF Research Database (Denmark)

    Gluud, C; Gluud, B; Aldershvile, J;

    1984-01-01

    Sera from 192 out-patient alcoholics attending a clinic for the treatment of alcoholism were tested for hepatitis B surface antigen (HBsAg) and for antibodies to HBsAg and to hepatitis B core antigen (HBcAg). Three sera (1.5%) were positive for HBsAg. Of the remaining 189 alcoholics, 29 (15%) were...... positive for one or both antibodies. This prevalence is not significantly different from that found in 137 hospitalized HBsAg-negative patients with alcoholic liver disease (35/137 [26%] were positive for one or both antibodies). However, the prevalence of hepatitis B antibodies in out-patient alcoholics...

  4. Association between air pollution and general outpatient clinic consultations for upper respiratory tract infections in Hong Kong.

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    Wilson W S Tam

    Full Text Available BACKGROUND AND OBJECTIVES: Many studies have shown the adverse effects of air pollution on respiratory health, but few have examined the effects of air pollution on service utilisation in the primary care setting. The aim of this study was to examine the association between air pollution and the daily number of consultations due to upper respiratory tract infections (URTIs in general outpatient clinics (GOPCs in Hong Kong. METHODS: Daily data on the numbers of consultations due to URTIs in GOPCs, the concentrations of major air pollutants, and the mean values of metrological variables were retrospectively collected over a 3-year period (2008-2010, inclusive. Generalised additive models were constructed to examine the association between air pollution and the daily number of consultations, and to derive the relative risks and 95% confidence intervals (95% CI of GOPC consultations for a unit increase in the concentrations of air pollutants. RESULTS: The mean daily consultations due to URTIs in GOPCs ranged from 68.4 to 253.0 over the study period. The summary relative risks (and 95% CI of daily consultations in all GOPCs for the air pollutants PM10, NO2, O3, and SO2 were 1.005 (1.002, 1.009, 1.010 (1.006, 1.013, 1.009 (1.006, 1.012, and 1.004 (1.000, 1.008 respectively, per 10 µg/m(3 increase in the concentration of each pollutant. CONCLUSION: Significant associations were found between the daily number of consultations due to URTIs in GOPCs and the concentrations of air pollutants, implying that air pollution incurs a substantial morbidity and increases the burden of primary health care services.

  5. Misuse of antibiotics reserved for hospital settings in outpatients: a prospective clinical audit in a university hospital in Southern France.

    Science.gov (United States)

    Roche, Manon; Bornet, Charléric; Monges, Philippe; Stein, Andreas; Gensollen, Sophie; Seng, Piseth

    2016-07-01

    Some antibiotics are reserved essentially for hospital settings owing to cost effectiveness and in order to fight the emerging antibiotic resistance crisis. In some cases, antibiotics reserved exclusively for use in hospitals may be prescribed in outpatients for serious infections or in the absence of a therapeutic alternative. A 30-day prospective audit of outpatient prescriptions of antibiotics reserved exclusively for use in hospitals was performed. The objective of this study was to evaluate the relevance of outpatient antibiotic prescriptions by measuring appropriateness according to guidelines. During the study period, 53 prescriptions were included, only 40% of which were appropriate. Among the 32 inappropriate prescriptions, 4 cases lacked microbial arguments, 1 case was not adequate for the infection type, 1 case involved an incorrect antibiotic dosage, 1 case involved an incorrect interval of dose administration, 3 cases had a therapeutic alternative and 22 cases were not recommended. Of the 53 prescriptions, 66% were started in hospital and 34% in outpatients. Only 25% of cases were prescribed with infectious diseases specialist (IDS) advice, 64% were based on microbiological documentation and 13% had a negative bacterial culture. Inappropriate prescriptions were usually observed in antibiotic lock therapy, skin infections, Clostridium difficile colitis, intra-abdominal infections and intravascular catheter-related infections. Outpatient prescriptions of antimicrobial drugs reserved exclusively for use in hospitals are frequently inappropriate. We recommend a real-time analysis algorithm with the involvement of an IDS for monitoring prescriptions to improve the quality of these prescriptions and possibly to prevent antibiotic resistance. PMID:27234677

  6. Prevalence of sexually transmitted infections among women attending antenatal clinics in Tanga, north eastern Tanzania

    DEFF Research Database (Denmark)

    Chiduo, M; Theilgaard, Z P; Bakari, V;

    2012-01-01

    This study aimed to determine the prevalence of sexually transmitted infections (STIs) among HIV-infected and uninfected pregnant women in Tanga, Tanzania. Retrospective data on syphilis and HIV status during 2008-2010 were collected from antenatal clinic (ANC) records. Prospective data were coll...

  7. What Comes before Report Writing? Attending to Clinical Reasoning and Thinking Errors in School Psychology

    Science.gov (United States)

    Wilcox, Gabrielle; Schroeder, Meadow

    2015-01-01

    Psychoeducational assessment involves collecting, organizing, and interpreting a large amount of data from various sources. Drawing upon psychological and medical literature, we review two main approaches to clinical reasoning (deductive and inductive) and how they synergistically guide diagnostic decision-making. In addition, we discuss how the…

  8. Psychosocial characteristics and obstetric health of women attending a specialist substance use antenatal clinic in a large metropolitan hospital.

    Science.gov (United States)

    Burns, Lucy; Conroy, Elizabeth; Moore, Elizabeth A; Hutchinson, Delyse; Haber, Paul S

    2011-01-01

    Objective. This paper reports the findings comparing the obstetrical health, antenatal care, and psychosocial characteristics of pregnant women with a known history of substance dependence (n = 41) and a comparison group of pregnant women attending a general antenatal clinic (n = 47). Method. Face-to-face interviews were used to assess obstetrical health, antenatal care, physical and mental functioning, substance use, and exposure to violence. Results. The substance-dependent group had more difficulty accessing antenatal care and reported more obstetrical health complications during pregnancy. Women in the substance-dependent group were more likely to report not wanting to become pregnant and were less likely to report using birth control at the time of conception. Conclusions. The profile of pregnant women (in specialised antenatal care for substance dependence) is one of severe disadvantage and poor health. The challenge is to develop and resource innovative and effective multisectoral systems to educate women and provide effective care for both women and infants. PMID:21760814

  9. Changes in Saturday outpatient volume and billings after introducing the Saturday incentive programme to clinics in South Korea: a longitudinal cohort study using claims data from 2012 to 2014

    OpenAIRE

    Ha, Hyun Ji; Han, Kyu-Tae; Kim, Sun Jung; Sohn, Tae Yong; Jeon, Byungyool; Park, Eun-Cheol

    2016-01-01

    Objective In October 2013, the South Korean government introduced an incentive programme to increase the availability of Saturday treatment at clinics, hoping to increase the role of primary care providers as gatekeepers to medical care. To the best of our knowledge, no one has yet investigated this programme's effect on overall outpatient care. Our study aims to analyse the change in Saturday outpatient volume and billings in clinics that adopted the Saturday incentive programme. Setting Our...

  10. Evaluation of risk factors in patients attending STI clinic in a tertiary care hospital in North India

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    Charu Nayyar

    2015-01-01

    Full Text Available Background: In the past few years, the interest in STDs and their management has increased tremendously because of their proven role in facilitation of HIV infection, which, in turn, also increases the risk of acquiring STIs. Sexually transmitted diseases (STDs are a major health problem affecting mostly young people, not only in developing, but also in developed countries Male circumcision is being considered as strategy to reduce the burden of HIV/AIDS. Aims: (i To screen the new patients attending the STI clinic for bacterial causes of STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum and Gardnerella vaginalis and (ii to evaluate the role of various risk factors in the prevalence of STIs. Materials and Methods: The present study was conducted on 200 patients attending the STI clinic. They were evaluated for the prevalence of HIV and bacterial STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum and Gardnerella vaginalis along with the role of risk factors particularly circumcision. Results: The prevalence of HIV was 7% and prevalence of other STI was 20%. The causative agents were Chlamydia 8%, Gonorrhea 7.5%, Bacterial Vaginosis 2.7% and Syphilis 2%. Conclusion: The factors found to be significantly associated with the prevalence of STI were circumcision, positive HIV status, education, religion, multiple sexual partners, contact with Commercial sex workers (CSW, non use of contraception, profession involving long stay away from home, and past history of STI. The present study suggests that circumcision is a protective factor for acquisition of STIs but other factors like sexual behavior, use of barrier contraceptives, drug abuse etc., also play a role.

  11. The Prevalence of Trichomoniasis in High-Risk Behavior Women Attending the Clinics of Tehran Province Penitentiaries

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    Zarrintaj Valadkhani

    2010-09-01

    Full Text Available Background: Trichomoniasis is a worldwide sexually transmitteddisease (STD, and is associated with important publichealth problems, including enhancement of HIV transmission.The prevalence of the parasite, Trichomonas vaginalis, dependson host factors such as age, sexual activity, number ofsexual partners and sexual behavior. The aim of the study wasto evaluate the prevalence of trichomoniasis in high-risk behaviorwomen, such as drug addicts and those who had multiplesexual partners, attending Gynecology Clinics in penitentiariesof Tehran province to help gynecologists with the diagnosisand treatment of the disease.Methods: Samples of posterior vaginal fornix discharges andurines of 450 women attending Gynecology Clinics of three prisonsin Tehran province were collected. All samples were examinedby direct smear and cultured in TYI-S-33 culture media.Results: 10.2% of subjects were positive for trichomoniasis.82.7% of infected patients were symptomatic individuals whocomplained of vaginal discharge and itching and/or burningsensation. Most of the infected women in the high risk behaviorgroup were drug users (54.3%. Physical examinationshowed that 50% of T. vaginalis positive subjects had a normalappearance of vagina and cervix. The peak prevalence (32.8%of the disease occurred in the age range of 31-40 years.Conclusion: T. vaginalis infection is commonly associatedwith other STDs, and is a marker of high-risk sexual behavior.Due to the side effects of the drugs used to treat the infection,it is suggested that the treatment be performed after definitediagnosis using a diagnostic method with a higher sensitivity.

  12. Clinical and epidemiological profile of leprosy patients attended at Ceará, 2007-2011*

    Science.gov (United States)

    Queirós, Maria Iranilda; Ramos Júnior, Alberto Novaes; Alencar, Carlos Henrique Morais; Monteiro, Lorena Dias; Sena, Amanda Lima; Barbosa, Jaqueline Caracas

    2016-01-01

    Background Leprosy is an infectious chronic condition associated with potentially serious physical, social and psychological impacts. Objectives To characterize the clinical and epidemiological profile of leprosy patients treated from 2007 to 2011 in the University Hospital of Ceará, Northeastern Brazil. Methods This is a retrospective and descriptive study. The study population consisted of residents in the state of Ceará treated in a dermatology clinic between 2007-2011. Clinical and epidemiological data analyzed were obtained from medical records and from the database of national Information System for Notifiable Diseases. Results 475 cases were analyzed, mostly women (51.8%), aged 45-59 years (35.0%) - mean of 45.2 years at diagnosis - with 6.3% of children under 15 , with low education (73.7%), white color (68.8%), residency in the city of Fortaleza (82.3%), and no defined work occupation (59.6%). At diagnosis, most patients were multibacillary (MB) (65.5%), had borderline clinical form (48.0%), and 22.7% had physical disability (8.0% with grade 2), predominantly in MB cases (p <0.001). We observe worsening of disability in 5.1% of cases post-MDT. The proportion of cases with reactional episodes was 42.7%, mainly during MDT (51.2%). Conclusion This is the first study conducted in this hospital context, revealing late diagnosis, high burden of disease, hidden endemicity, and high social vulnerability in the state of Ceará. This study reinforces the need to strengthen health care network for timely diagnosis and treatment, aiming at longitudinality of assistance. PMID:27438198

  13. Foot care and footwear practices among patients attending a specialist diabetes clinic in Jamaica.

    Science.gov (United States)

    Gayle, Krystal A T; Tulloch Reid, Marshall K; Younger, Novie O; Francis, Damian K; McFarlane, Shelly R; Wright-Pascoe, Rosemarie A; Boyne, Michael S; Wilks, Rainford J; Ferguson, Trevor S

    2012-10-12

    This study aimed to estimate the proportion of patients at the University Hospital of the West Indies (UHWI) Diabetes Clinic who engage in recommended foot care and footwear practices. Seventy-two participants from the UHWI Diabetes Clinic completed an interviewer-administered questionnaire on foot care practices and types of footwear worn. Participants were a subset of a sex-stratified random sample of clinic attendees and were interviewed in 2010. Data analysis included frequency estimates of the various foot care practices and types of footwear worn. Participants had a mean age of 57.0±14.3 years and mean duration of diabetes of 17.0±10.3 years. Fifty-three percent of participants reported being taught how to care for their feet, while daily foot inspection was performed by approximately 60% of participants. Most participants (90%) reported daily use of moisturizing lotion on the feet but almost 50% used lotion between the toes. Approximately 85% of participants reported wearing shoes or slippers both indoors and outdoors but over 40% reported walking barefoot at some time. Thirteen percent wore special shoes for diabetes while over 80% wore shoes without socks at some time. Although much larger proportions reported wearing broad round toe shoes (82%) or leather shoes (64%), fairly high proportions reported wearing pointed toe shoes (39%), and 43% of women wore high heel shoes. In conclusion, approximately 60% of patients at the UHWI diabetic clinic engage in daily foot inspection and other recommended practices, but fairly high proportions reported foot care or footwear choices that should be avoided. PMID:24765484

  14. Foot care and footwear practices among patients attending a specialist diabetes clinic in Jamaica

    Directory of Open Access Journals (Sweden)

    Krystal A.T. Gayle

    2012-10-01

    Full Text Available This study aimed to estimate the proportion of patients at the University Hospital of the West Indies (UHWI Diabetes Clinic who engage in recommended foot care and footwear practices. Seventy-two participants from the UHWI Diabetes Clinic completed an interviewer-administered questionnaire on foot care practices and types of footwear worn. Participants were a subset of a sex-stratified random sample of clinic attendees and were interviewed in 2010. Data analysis included frequency estimates of the various foot care practices and types of footwear worn. Participants had a mean age of 57.0±14.3 years and mean duration of diabetes of 17.0±10.3 years. Fifty-three percent of participants reported being taught how to care for their feet, while daily foot inspection was performed by approximately 60% of participants. Most participants (90% reported daily use of moisturizing lotion on the feet but almost 50% used lotion between the toes. In conclusion, approximately 85% of participants reported wearing shoes or slippers both indoors and outdoors but over 40% reported walking barefoot at some time. Thirteen percent wore special shoes for diabetes while over 80% wore shoes without socks at some time. Although much larger proportions reported wearing broad round toe shoes (82% or leather shoes (64%, fairly high proportions reported wearing pointed toe shoes (39%, and 43% of women wore high heel shoes. Approximately 60% of patients at the UHWI diabetic clinic engage in daily foot inspection and other recommended practices, but fairly high proportions reported foot care or footwear choices that should be avoided.

  15. Augmentation and reduction mammaplasty: demographic and obstetric differences in women attending a National Health Service clinic.

    OpenAIRE

    Birtchnell, S.; Lacey, J H

    1988-01-01

    Women presenting for breast augmentation and breast reduction to a National Health Service plastic surgery/psychiatry liaison clinic appear to differ beyond the anatomical. Those requesting breast reduction tend to be younger, unmarried and not to have been pregnant and may be uncomfortable with adult sexuality. Those requesting breast augmentation are presenting for surgery in their mid-thirties although many have always had small breasts. This is at a time of fading attractiveness, marital ...

  16. Sociodemographic and Clinical Characteristics of Patients attending Psychotherapy in a Tertiary Care Hospital in Oman

    Directory of Open Access Journals (Sweden)

    Zena Al-Sharbati

    2012-02-01

    Full Text Available Objectives: There is significant evidence that psychotherapy is a pivotal treatment for persons diagnosed with Axis I clinical psychiatric conditions; however, a psychotherapy service has only recently been established in the Omani health care system. This study aimed to investigate the sociodemographic and clinical characteristics of attendees at a psychotherapy clinic at a tertiary care hospital. Methods: An analysis was carried out of 133 new referrals to the Psychotherapy Service at Sultan Qaboos University Hospital, a tertiary care hospital. Results: The majority of referrals were females (59%, aged 18–34 years, employed (38%, had ≤12 years of formal education (51%, and were single (54%. A total of 43% were treated for anxiety disorders (including obsessive compulsive disorder, while 22% were treated for depression. A total of 65% were prescribed psychotropic medications. The utilisation of the Psychotherapy Service and its user characteristics are discussed within the context of a culturally diverse Omani community which has unique personal belief systems such as in supernatural powers (Jinn, contemptuous envy (Hassad, evil eye (Ain and sorcery (Sihr which are often used to explain the aetiology of mental illness and influence personal decisions on utilising medical and psychological treatments. Conclusion: Despite the low number of referrals to the Psychotherapy Service, there is reason to believe that psychotherapy would be an essential tool to come to grips with the increasing number of mental disorders in Oman.

  17. Cervical Cancer Screening Knowledge and Behavior among Women Attending an Urban HIV Clinic in Western Kenya.

    Science.gov (United States)

    Rosser, Joelle I; Njoroge, Betty; Huchko, Megan J

    2015-09-01

    Cervical cancer is a highly preventable disease that disproportionately affects women in developing countries and women with HIV. As integrated HIV and cervical cancer screening programs in Sub-Saharan Africa mature, we have an opportunity to measure the impact of outreach and education efforts and identify areas for future improvement. We conducted a cross-sectional survey of 106 women enrolled in care at an integrated HIV clinic in the Nyanza Province of Kenya 5 years after the start of a cervical cancer screening program. Female clinic attendees who met clinic criteria for cervical cancer screening were asked to complete an oral questionnaire assessing their cervical cancer knowledge, attitudes, and screening history. Ninety-nine percent of women had heard of screening, 70 % felt at risk, and 84 % had been screened. Increased duration of HIV diagnosis was associated with feeling at risk and with a screening history. Nearly half (48 %) of women said they would not get screened if they had to pay for it.

  18. Prevalence of Trichomonas vaginalis by PCR in men attending a primary care urology clinic in South Korea.

    Science.gov (United States)

    Seo, Jun-Hyeok; Yang, Hye-Won; Joo, So-Young; Song, Su-Min; Lee, Yu-Ran; Ryu, Jae-Sook; Yoo, Eun Sang; Lee, Won Kee; Kong, Hyun-Hee; Lee, Sang-Eun; Lee, Won-Ja; Goo, Youn-Kyoung; Chung, Dong-Il; Hong, Yeonchul

    2014-10-01

    Trichomonas vaginalis, a causative agent of trichomoniasis, may trigger symptomatic or asymptomatic nongonococcal urethritis and chronic prostatitis in men. Despite the availability of highly sensitive diagnostic tests, such as nucleic acid amplification tests, including PCR, few prospective studies present data on male T. vaginalis infection in South Korea. In the present study, the prevalence of T. vaginalis and associated clinical conditions were evaluated in 201 male patients from a primary care urology clinic in South Korea. The prevalence of T. vaginalis infection in our cohort was 4% (8/201) by PCR. T. vaginalis infection was common in men older than 40 years (median age, 52 years). Among the 8 Trichomonas-positive patients, 87.5% (7/8) had prostatic diseases, such as prostatitis and benign prostatic hyperplasia, and 25.0% (2/8) and 12.5% (1/8) were coinfected with Chlamydia trachomatis and Mycoplasma genitalium, respectively. Our results suggest that T. vaginalis infection is not rare in men attending primary care urology clinics in South Korea, especially in those older than 40 years, in whom it may explain the presence of prostatic disease. The possibility of T. vaginalis infection should be routinely considered in older male patients with prostatic diseases in South Korea.

  19. IBD patients in remission strongly prefer annual telephone calls by IBD nurse - compared to outpatient visits

    DEFF Research Database (Denmark)

    Bager, Palle; Hentze, Runa; Markussen, Toto

    Aim: To investigate the willingness among IBD patients in remission to change regularly outpatient visits to annual telephone calls by an IBD nurse. To illuminate potential barriers for introducing Self Management (SM) in the handling of IBD patients. Background: Incidence of IBD is increasing...... in the western world. It seems obvious to transfer health care resources from IBD patients in remission to IBD patients with disease activity. One way of doing so is by introducing SM. Elements of SM includes replacement of routine appointments in the outpatient clinic with annual blood samples followed...... by a telephone call by an IBD nurse. Furthermore an extended acute access to the hospital is needed if flare occurs. Patients and Methods: 150 consecutive IBD patients attending to the outpatient clinic at Aarhus University Hospital were presented to the SM approach. On a Likert scale they were asked to what...

  20. Subtypes of chronic urticaria in patients attending allergy clinics in Venezuela.

    Science.gov (United States)

    Sánchez-Borges, M; Caballero-Fonseca, F; Capriles-Hulett, A

    2014-11-01

    Chronic urticaria (CU) is one of the most puzzling clinical entities confronted by the medical profession. It is a common motive for consultation, and in a sizable proportion of patients no identifiable cause is evident. Since there are relatively few publications regarding CU in developing countries, we performed a prospective 3-year study on the demographic and clinical features of patients with CU. Four hundred and twenty-three subjects were studied, 52 children and 371 adults, 295 females (69.7%), with a mean age of 38.4 ± 17.8 years. More often, wheals and angioedema (AE) were present on the head, upper and lower limbs and the trunk. AE was present in 162 patients (38.4%). The most frequent subtypes were chronic spontaneous urticaria, aspirin-exacerbated cutaneous disease, dermographic urticaria, and combinations of various subtypes. A better understanding of the characteristics of patients suffering CU is helpful for clinicians dealing with this ailment, and provides guidance for new investigations on its pathogenesis, which will hopefully result in a better management of this vexing condition.

  1. Prevalence and risk factors for female sexual dysfunction in women attending a medical clinic in south India

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    Singh J

    2009-01-01

    Full Text Available Background: Reports from India on the prevalence and determinants of female sexual dysfunction (FSD are scant. Aims: To determine the prevalence and risk factors for FSD. Settings and Design: A cross-sectional survey in a medical outpatient clinic of a tertiary care hospital. Materials and Methods: We administered a Tamil version of the Female Sexual Function Index (FSFI to 149 married women. We evaluated putative risk factors for FSD. We elicited participant′s attributions for their sexual difficulties. Statistical Analysis: We estimated the prevalence of possible FSD and sexual difficulties from published FSFI total and domain cut-off scores. We used logistic regression to identify risk factors for possible FSD. Results: FSFI total scores suggested FSD in two-thirds of the 149 women (73.2%; 95% confidence intervals [CI] 65.5% to 79.6%. FSFI domain scores suggested difficulties with desire in 77.2%; arousal in 91.3%; lubrication in 96.6%; orgasm in 86.6%, satisfaction in 81.2%, and pain in 64.4%. Age above 40 years (odds ratios [OR] 11.7; 95% CI 3.4 to 40.1 and fewer years of education (OR 1.2; 95% CI 1.0 to 1.3 were identified by logistic regression as contributory. Women attributed FSD to physical illness in participant or partner, relationship problems, and cultural taboos but none had sought professional help. Conclusions: Sexual problems suggestive of dysfunction, as suggested by FSFI total and domain scores, are highly prevalent in the clinic setting, particularly among women above 40 and those less educated, but confirmation using locally validated cut-off scores of the FSFI is needed.

  2. Adding serial N-terminal pro brain natriuretic peptide measurements to optimal clinical management in outpatients with systolic heart failure

    DEFF Research Database (Denmark)

    Schou, Morten; Gustafsson, Finn; Videbaek, Lars;

    2013-01-01

    AIMS: This study was designed to evaluate a new NT-proBNP monitoring concept in outpatients with systolic heart failure (HF). METHODS AND RESULTS: This was a multicentre, prospective randomized open-label blinded endpoint study. A total of 407 systolic HF patients were allocated to either clinica...

  3. Effects of an outpatient physical exercise program on hematopeoetic stem-cell transplantation recipients: a randomized clinical trial

    NARCIS (Netherlands)

    R.H. Knols; E.D. de Bruin; D. Uebelhart; G. Aufdemkampe; U. Schanz; F. Stenner-Liewen; F. Hitz; C. Taverna; N.K. Aaronson

    2011-01-01

    Patients who undergo hematopoietic SCT (HSCT) often experience physical and psychological problems, even long after treatment has been completed. This study was performed to evaluate the effects of a 12-week outpatient physical exercise (PE) program, incorporating aerobic and strength exercises, as

  4. Assessment of menopausal symptoms among women attending various outreach clinics in South Canara District of India

    Science.gov (United States)

    Joseph, Nitin; Nagaraj, Kondagunta; Saralaya, Vittal; Nelliyanil, Maria; Rao, PP Jagadish

    2014-01-01

    Introduction: Menopausal symptoms experienced by women are known to affect their quality-of-life. The symptoms experienced at menopause are quite variable and their etiology is found to be multifactorial. This study was hence done to assess the pattern and severity of menopausal symptoms and to find out the factors associated with these symptoms. Materials and Methods: This cross-sectional study was conducted in various outreach clinics of Kasturba Medical College, Mangalore. Women in the age group of 40-65 years were included in the study by convenient sampling method. Data regarding menopausal symptom was obtained by interviewing each participant using the menopause rating scale questionnaire. Results: Mean age of the participants were 54.2 ± 7.2 years and mean age of attainment of menopause was 48.4 ± 4.5 years. Mean duration of menopause was found to be 7.5 ± 5.3 years. Commonest symptom reported was joint and muscular discomfort and physical and mental exhaustion seen in 94 (85.4%) participants. The mean number of symptoms reported by participants was 7.6 ± 2.8. Educated women reported significantly more symptoms (F = 2.218, P = 0.047). Somatic and urogenital symptoms were more among perimenopausal women and somatic symptoms were more among postmenopausal women. Fifty-eight (52.7%) participants had one or more severe symptoms. Severe symptoms were most among premenopausal women. Conclusion: The high proportion and severity of menopausal symptoms observed in this study group proves that menopausal symptoms are common and cannot be ignored. More of menopausal clinics are needed for awareness generation, early recognition and treatment of related morbidities. PMID:24970987

  5. Reproductive tract disorders among Afghan refugee women attending health clinics in Haripur, Pakistan.

    Science.gov (United States)

    Balsara, Z P; Wu, I; Marsh, D R; Ihsan, A T; Nazir, R; Owoso, E; Robinson, C; Darmstadt, G L

    2010-10-01

    Afghans comprise one of the largest groups of refugees in the world, with the majority living in Pakistan. The objective of this study was to identify commonly-occurring reproductive tract infections (RTIs), describe knowledge of women about RTIs, and assess physical and behavioural factors contributing to the development of RTIs. Afghan women presenting at Basic Health Units in refugee camps in Haripur, Pakistan, with reproductive health-related complaints, were included in the study (n=634). Data collection included implementation of an interviewer-administered questionnaire, along with a physical examination and laboratory tests. A descriptive analysis was conducted first. Qualitative data were coded and analyzed using predetermined themes. Chi-square test was used for determining the possible relationships between a binary outcome and categorical risk factors. Over three-fourths (76.7%) of those who reported to the health clinics with reproductive complaints had an RTI. Nearly half (49.5%) of these women were diagnosed with some form of vaginitis, and 14.7% were diagnosed with clinical suspicion of pelvic inflammatory disease (PID). Women with cervical prolapse (p = 0.033) or who cleansed after intercourse (p = 0.002) were more likely to have vaginitis. There was a significant difference (p = 0.017) in the prevalence of suspected PID among women who used mud only (11.1%), any water (18.8%), and an old cloth or toilet paper (9.8%) for cleansing after defaecation. Specific physical and behavioural contributors to the high prevalence of RTIs in this population were identified, and recommendations to ameliorate these factors are offered. PMID:20941902

  6. Hypertension among Outpatients at a General Hospital in South Angola: Prevalence, Awareness, Treatment, and Control

    OpenAIRE

    Feliciano C. Paquissi; Arminda B.P. Cuvinje; Almeida B. Cuvinje; Arlindo M. Paquissi

    2016-01-01

    OBJECTIVE This study aimed to assess the prevalence, awareness, treatment, and control of hypertension in patients attending an outpatient clinic at a general hospital in Huambo, South Angola. METHODS A total of 265 subjects aged 18 years and older were included. Evaluation included complete interview and blood pressure measurement using a validated automatic device. RESULTS The prevalence rates of hypertension and prehypertension were 38.5% (95% confidence interval [CI]: 32.83%–44.90%) and 3...

  7. Improving physician's adherence to completing vaccination schedules for patients with type 2 diabetes attending non-communicable diseases clinics in West Bay Health Center, Qatar.

    Science.gov (United States)

    Tawfik, Hassan; Bashwar, Zelaikha; Al-Ali, Amal; Salem, Mohamed; Abdelbagi, Isameldin

    2015-01-01

    Incomplete vaccination for patients with type 2 diabetes attending non-communicable diseases (NCD) clinics is an issue that could affect patient's health and wellness negatively and puts patients at high risk of serious diseases. We aimed to improve physicians adherence to complete vaccination schedule for patients with type 2 diabetes attending NCD clinics in west bay health center according to American Diabetes Association (ADA) recommendation by 25% by January 2015. In the pre-intervention phase: the quality improvement team designed a checklist to collect the percentage of physician's adherence of prescription of the recommended vaccination for patients with type 2 diabetes. The percentage of complete vaccination in patients with diabetes attending NCD clinic in West Bay Health Center was 20% . In the intervention phase the intervention was in the form of: the creation a vaccination form and attached to the (NCD) progress note; to distribute and remind the physicians about the ADA guidelines vaccination recommendations; a summary of the vaccination schedule developed and attached to (NCD) form; development of vaccination reminder posters and posters in the waiting area, nurse station, and physician clinics and education and orientation sessions for NCD clinic staff. In the post-intervention phase the average percentage of complete vaccination in patients with diabetes attending NCD clinic in West Bay Health Center increased to 69%.

  8. Questionnaire survey on the clinical characteristics of 2 408 outpatients with tinnitus%门诊耳鸣患者2408例问卷调查

    Institute of Scientific and Technical Information of China (English)

    韩朝; 田亮; 丛宁; 黄一波; 杨娟梅

    2013-01-01

    Objective To explore the clinical characteristics of tinnitus in otolaryngological outpatients. Methods Tinnitus questionnaire survey was performed in 2 408 otolaryngological outpatients treated from Dec. 2009 to Jul. 2010. The data obtained were analyzed by statistical software. Results All outpatients were aged from 6 to 95 years, averagely (47.02 ± 17. 05) years. There were 996 cases with tinnitus(41. 36% ) , including 388(38. 96% ) male cases and 608(61. 04% )female cases. The difference of tinnitus incidence between male and female was significant(P = 0.001 9). Except for 4 cases aged less than 12 years, the remaining 992 tinnitus patients were divided into four groups according to the effect of tinnitus on life: no affection(149 cases, 15. 02%) , mild affection(480 cases, 48. 39%) , moderate affection(329 cases,33.16% ) ,severe affection(34 cases,3.43% ). The relationship between the degree of the different affection to life and doctors' office visiting was significantly correlated(P 2个月者,有效8例、无效6例.结论 耳鸣的发生率在耳鼻喉科门诊患者中所占比例极高,其中尤以女性多见.双侧耳鸣持续时间更长.随着治疗时间的延长,有效率有增加趋势.

  9. Perceptions of natural health products among patients attending a memory clinic.

    Science.gov (United States)

    Sharma, Papita; Herrmann, Nathan; Rochon, Paula A; Lee, Monica; Croxford, Ruth; Rothenburg, Lana; Black, Sandra E; Lanctôt, Krista L

    2006-01-01

    This study compared patient and caregiver perceptions of natural health products (NHPs) and conventional medications in a memory clinic population. A total of 620 mildly cognitively impaired patients and their caregivers participated in interviews enquiring about their perceptions of NHPs in 4 areas: (1) disclosure of NHP usage information to health care professionals, (2) safety and benefits of NHPs, (3) safety and benefits of conventional medications, and (4) physician knowledge about NHPs. Differences in responses between NHP users and nonusers and between patients and caregivers were examined. A total of 51.8% of subjects were current NHP users, with vitamin E, ginkgo biloba, and glucosamine being the most commonly used products. Multivariate analysis of variance showed that NHP use significantly influenced participant interview responses (Pillai's trace, F[4, 613] = 3.488, P = .008), while interviewee (patient or caregiver; Pillai's trace, F[8, 1228] = 1.499, P = .153) and gender (Pillai's trace, F[4, 615] = 0.528, P = .715) did not. Subsequent univariate tests showed that NHP users were significantly more likely to endorse the effectiveness and safety of NHPs compared with nonusers (F[1, 616] = 7.826, P = .005). Careful questioning during visits with health care providers and better counseling may be necessary to reduce the potential for adverse events and NHP-drug interactions.

  10. Prevalence of Depression among Elderly Diabetes Mellitus Patients Attending Diabetes Clinic at Bangalore Medical College and Research Institute

    Directory of Open Access Journals (Sweden)

    Shivaraj B Mallappa

    2016-03-01

    Full Text Available "Introduction: Depression is the most common psychiatric disorder among the elderly. Diabetes will add additional burden on occurrence of depression. The study was conducted to study the prevalence of the depression among elderly diabetics who are seeking care at a tertiary care centre. Methods: A cross sectional study held at a diabetes clinic of a tertiary care institute with the purposive sample of 100 subjects during the month of March 2013. The diabetic patients who were above the age of 60 years are surveyed.. WHO Geriatric Depression Scale (GDS short form was used to collect the data. Results: Prevalence of Depression among studied population 41%. Mean age of the study population 67.8 (+6.2 years with females constituting 72%. 39 % of the study population was illiterate and 33 % of them did primary schooling. There were significant association of depression with female gender, widows, illiterates, financially dependent and persons with multiple co-morbid conditions. Conclusion: This study has shown that geriatric depression is highly prevalent. The results of this study emphasize the need of intervention studies which can promote the physical, mental and social health of the patient attending the diabetes clinic." [Natl J Community Med 2016; 7(3.000: 198-200

  11. Health-related quality of life among osteoarthritis patients attending primary care clinics of Mangalore city

    Directory of Open Access Journals (Sweden)

    HN Harsha Kumar

    2015-01-01

    Full Text Available Introduction: Osteoarthritis (OA of the knee is the most common type of arthritis of the elderly among Asians. Reports suggest that it affects the quality of life. Hence, this study was undertaken with the objective to know the impact of OA of the knee on 8 domains of health related quality of life (HRQoL which include: (1 Physical functioning (PF, (2 role limitation due to physical health (RP. (3 Emotional well-being/mental health (MH, (4 role limitation due to emotional problems (RE, (5 energy/vitality, (6 social well-being (short form [SF], (7 body pain, (8 general health. Materials and Methods: This cross-sectional study was conducted in primary care rural clinics situated on peripheral areas of Mangalore city. Total sample size was calculated to be 77. Patients who met the criteria of modified American Rheumatologic Association Classification for OA of knee were administered a SF-36 questionnaire to measure the HRQoL in the local language version. Mean scores (with its standard deviation across each domain was calculated. Results: Of 80 patients, 38 were males. OA affected HRQoL. Four out 8 factors had more impact on HRQoL (they are PF, RP, MH, RE. Duration of OA is an important determinant on HRQoL. Patients with newer onset of OA (4 years of OA (Domain, Mean, the emotional impact (MH, 44.67; RE, 45.67 reduced but the physical impact (PF, 47.83; RP, 19.75 persisted/got worse. Conclusion: Osteoarthritis had impact on HRQoL. Duration of OA determines the kind of impact. With the onset of OA emotional/mental support would be needed in addition to the medical treatment. As the disease progresses, they tend to cope with emotional/mental problems even as the physical problems persist/increase.

  12. Perceived Maternal Role Competence among the Mothers Attending Immunization Clinics of Dharan, Nepal

    Directory of Open Access Journals (Sweden)

    Shah Shrooti

    2016-04-01

    Full Text Available Background: Being a mother is considered by many women as their most important role in life. Women’s perceptions of their abilities to manage the demands of parenting and the parenting skills they posses are reflected by perceived maternal role competence. The present study was carried out to assess the perceived maternal role competence and its associated factors among mothers. Methods: A descriptive cross-sectional research study was carried out on 290 mothers of infant in four immunization clinics of Dharan, Nepal. Data were collected using a standardized predesigned, pretested questionnaire (Parent sense of competence scale, Rosenberg’s self esteem scale, Maternity social support scale. The data were analyzed using descriptive and inferential statistics and multiple regression analysis at 0.05 level of significance. Results: The mean score of the perceived maternal role competence obtained by mothers was 64.34±7.90 and those of knowledge/skill and valuing/comfort subscale were 31±6.01 and 33±3.75, respectively. There was a significant association between perceived maternal role competence and factors as the age of the mother (P<0.001, educational status (P=0.015, occupation (P=0.001 and readiness for pregnancy (P=0.022. The study findings revealed a positive correlation between perceived maternal role competence and age at marriage (r=0.132, P=0.024, per capita income (r=0.118, P=0.045, self esteem (r=0.379, P<0.001, social support (r=0.272, P<0.001, and number of support persons (r=0.119, P=0.043. The results of the step wise multiple regression analysis revealed that the major predictor of perceived maternal role competence was self esteem. Conclusion: The factors associated with perceived maternal role competence were age, education, occupation, per capita income, self esteem, social support, and the number of support persons.

  13. Evaluation of Retention in Methadone Treatment in Patients Attending Baharan Hospital Clinic in Zahedan City

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    M.D. Mohebi

    2015-04-01

    Full Text Available Introduction & Objectives: Substance abuse and opioid dependency refers to hazardous use of psychoactive substance .Prevention and treatment of opiate dependence has not been success-ful. Most effective drug in agonist treatment of opiates is methadone maintenance therapy (MMT.But the lack of cooperation of addicts in methadone maintenance therapy has always been a big problem to continue. The purpose of this study is to investigate the retention in the MMT. Materials & Methods: This historical cohort study analyzed the medical records of patients of Baharan hospital in Zahedan. All 912 cases of methadone maintenance clinic of Baharan hos-pital in Zahedan 2011-2012 were studied and the data were analyzed using SPSS. Tables and indexes were analyzed by the Chi-square test and survival curves were plotted using Kaplan–Meier method and analyzed by Log-Rank test. Results: This study reviewed records from 912 patients with a mean age of 34.67% and stan-dard deviation of 10.88 and the range of 15-86 years. 735 were male and 177 ware female. 1-moth retention rate was 71%, 3 months was 59%, 6 months was 47%, 1 year was 30% and 2 years was 17%. Kaplan-Meier median survival time of 8 months was estimated by relation-ship. Doses higher than 60 mg/d of methadone was associated with increased survival on MMT. Conclusion: Age increase, increase of employment time, increasing of the duration of drug abuse, increasing the daily dose of methadone, oral substance abuse increased retention rate and heroin abuse and smoking were associated with decrease retention rate of methadone maintenance therapy. So, with an emphasis on each of these factors effective steps can be taken to improve the cooperation of patients in MMT. (Sci J Hamadan Univ Med Sci 2015; 22 (1:30-36

  14. Impact on Patient Safety and Satisfaction of Implementation of an Outpatient Clinic in Interventional Radiology (IPSIPOLI-Study): A Quasi-Experimental Prospective Study

    Energy Technology Data Exchange (ETDEWEB)

    Lutjeboer, Jacob, E-mail: j.lutjeboer@lumc.nl; Burgmans, Mark Christiaan, E-mail: m.c.burgmans@lumc.nl, E-mail: mburgmans@hotmail.com; Chung, Kaman, E-mail: kaman.chung10@gmail.com; Erkel, Arian Robert van, E-mail: a.r.van-erkel@lumc.nl [Leiden University Medical Center, Department of Radiology (Netherlands)

    2015-06-15

    PurposeInterventional radiology (IR) procedures are associated with high rates of preparation and planning errors. In many centers, pre-procedural consultation and screening of patients is performed by referring physicians. Interventional radiologists have better knowledge about procedure details and risks, but often only get acquainted with the patient in the procedure room. We hypothesized that patient safety (PS) and patient satisfaction (PSAT) in elective IR procedures would improve by implementation of a pre-procedural visit to an outpatient IR clinic.Material and MethodsIRB approval was obtained and informed consent was waived. PS and PSAT were measured in patients undergoing elective IR procedures before (control group; n = 110) and after (experimental group; n = 110) implementation of an outpatient IR clinic. PS was measured as the number of process deviations. PSAT was assessed using a questionnaire measuring Likert scores of three dimensions: interpersonal care aspects, information/communication, and patient participation. Differences in PS and PSAT between the two groups were compared using an independent t test.ResultsThe average number of process deviations per patient was 0.39 in the control group compared to 0.06 in the experimental group (p < 0.001). In 9.1 % patients in the control group, no legal informed consent was obtained compared to 0 % in the experimental group. The mean overall Likert score was significantly higher in the experimental group compared to the control group: 2.68 (SD 0.314) versus 2.48 (SD 0.381) (p < 0.001).ConclusionPS and PSAT improve significantly if patients receive consultation and screening in an IR outpatient clinic prior to elective IR procedures.

  15. CLINICO EPIDEMIOLOGICAL PROFILE OF WILD ANIMAL BITE VICTIMS ATTENDING ANTI RABIES CLINIC AT GOVERNMENT TERTIARY CARE CENTRE IN MANDYA

    Directory of Open Access Journals (Sweden)

    Jahnavi

    2014-11-01

    Full Text Available : INTRODUCTION: Rabies is an acute viral disease that causes fatal encephalitis in virtually all the warm blooded animals including man. In India it is estimated that annually 17.4 million animal bite cases occur and 20, 000 deaths occur due to human rabies. Dogs are responsible for about 97%of the human rabies, followed by cats (2%, jackals, mongoose and others (1%. There is scarcity of literature regarding human rabies due to wild animals. OBJECTIVES: To describe the socio- demographic characteristics of wild animal bite victims attending Anti Rabies Clinic (ARC, Mandya Institute of Medical Sciences (MIMS, Mandya and to describe the circumstances, characteristics of bite and post exposure prophylactic measures taken to prevent rabies. METHODOLOGY: This hospital based case record analysis was done for a period of 3 years from January 2011 to December 2013 at Anti Rabies Clinic (ARC, Mandya Institute of Medical Sciences, Mandya. The details regarding the socio demographic characteristics of bite victims, characteristics of the bite wound and post exposure prophylactic measures taken to prevent rabies were collected using case records of wild animal bite victims. RESULTS: A total of 12, 798 animal bite victims had attended ARC during the study period, of which 67 (0.52% cases were exposed to wild animals. Of these 67 cases, 45 (67.2% of the victims were exposed to monkey and 13 (19.4% were exposed to wild boar. 45 (67.2% of the wild animal bite victims were in the age group of 15 to 60 years, 49 (73.1% were males and 22 (32.8% belonging to class IV socio economic status. Many of the monkey bites happened when the monkey was trying to snatch food from the victims and while other wild animal bites happened when the farmers were guarding their field. 40 (59.7% had bites on upper limb. 51 (76.1% had washed the wound with soap and water before coming to ARC. RIG was advised to all victims but was taken by 49 (73.1% of the bite victims. All four doses

  16. Clinico-epidemiological profile of tobacco users attending a tobacco cessation clinic in a teaching hospital in Bangalore city

    Directory of Open Access Journals (Sweden)

    George D′Souza

    2012-01-01

    Full Text Available Background: Tobacco-attributable mortality in India is estimated to be at least 10%. Tobacco cessation is more likely to avert millions of deaths before 2050 than prevention of tobacco use initiation. Objective: To describe the clinico-epidemiological profile of attendees of a tobacco cessation clinic in a teaching hospital in Bangalore city. Materials and Methods: A descriptive study of 189 attendees seen over 2 years in the Tobacco Cessation Clinic of a tertiary-care teaching hospital in Bangalore, with information on socio demographic characteristics, tobacco-use details, nicotine dependence, family/medical history, past quit attempts, baseline stage-of-change, and treatment initiated. Results: Only 5% were ′walk-in′ patients; 98% of attendees were smokers; 97% were males. The mean (±SD age of attendees was 48.0 (±14.0 years. Most participants were married (88%, and predominantly urban (69%. About 62% had completed at least 8 years of schooling. Two-thirds of smokers reported high levels of nicotine dependence (Fagerström score >5/10. About 43% of patients had attempted quitting earlier. Four-fifths (79% of tobacco-users reported a family member using tobacco. Commonly documented comorbidities included: Chronic respiratory disease (44%, hypertension (23%, diabetes (12%, tuberculosis (9%, myocardial infarction (2%, stroke (1%, sexual dysfunction (1% and cancer (0.5%. About 52% reported concomitant alcohol use. At baseline, patients′ motivational stage was: Precontemplation (14%, contemplation (48%, preparation/action (37% and maintenance (1%. Treatment modalities started were: Counseling alone (41%, nicotine replacement therapy alone (NRT (34%, medication alone (13%, and NRT+medication (12%. Conclusions: This is the first study of the baseline profile of patients attending a tobacco cessation clinic located within a chest medicine department in India. Important determinants of outcome have been captured for follow-up and prospective

  17. The effect of fines on nonattendance in public hospital outpatient clinics: study protocol for a randomized controlled trial

    DEFF Research Database (Denmark)

    Blæhr, Emely; Kristensen, Thomas; Væggemose, Ulla;

    2016-01-01

    Background Nonattendance at scheduled appointments in public hospitals presents a challenge for efficient resource use and may ultimately affect health outcomes due to longer waiting times. Seven percent of all scheduled outpatient appointments in the United Kingdom are estimated to be nonattended...... nonattendance without prior notice. Appointments assigned to the control arm follow usual practice (same system but no letter attachment). The primary outcome is the proportion of nonattendance. Secondary outcomes are proportions of cancellations, sociodemographics, and health-problem characteristics...

  18. Behavioral and clinical characteristics of people receiving medical care for HIV infection in an outpatient facility in Sicily, Italy

    Science.gov (United States)

    Di Carlo, Paola; Guadagnino, Giuliana; Immordino, Palmira; Mazzola, Giovanni; Colletti, Pietro; Alongi, Ilenia; Adamoli, Lucia; Vitale, Francesco; Casuccio, Alessandra

    2016-01-01

    Aim The authors examined a cohort of HIV-positive outpatients at the AIDS Center of Palermo University in Italy in order to identify factors related to the frequency of their visits to the outpatient facility for health care services. Methods Two hundred and twenty-four HIV-infected subjects were enrolled in the study. Demographic and HIV disease characteristics were recorded and assessed with the number of days accessed to our outpatients unit in univariate and multivariate analyses. The potential relationship with immunological status was also analyzed stratifying the patients into groups according to their CD4+ T-cell counts (≥500 vs illegal status of immigrants does not influence the management of their HIV/AIDS condition, but the lack of European health card that documents the current antiretroviral status, could interfere with the efforts to eradicate AIDS. A better understanding of the major determinants of HIV treatment costs has led to appropriate large-scale actions, which in turn has increased resources and expanded intervention programs. Further guidance should be offered to hard-to-reach groups in order to improve early AIDS diagnosis, and procedures for identifying and managing these vulnerable subjects should be made available to care commissioners and service providers. PMID:27307712

  19. Acoustic Noise Levels of Dental Equipments and Its Association with Fear and Annoyance Levels among Patients Attending Different Dental Clinic Setups in Jaipur, India

    Science.gov (United States)

    Ganta, Shravani; Nagaraj, Anup; Pareek, Sonia; Atri, Mansi; Singh, Kushpal; Sidiq, Mohsin

    2014-01-01

    Background: Noise is a source of pervasive occupational hazard for practicing dentists and the patients. The sources of dental sounds by various dental equipments can pose as a potential hazard to hearing system and add to the annoyance levels of the patients. The aim of the study was to analyze the noise levels from various equipments and evaluate the effect of acoustic noise stimulus on dental fear and annoyance levels among patients attending different dental clinic setups in Jaipur, India. Methodology: The sampling frame comprised of 180 patients, which included 90 patients attending 10 different private clinics and 90 patients attending a Dental College in Jaipur. The levels of Acoustic Noise Stimulus originating from different equipments were determined using a precision sound level meter/decibulometer. Dental fear among patients was measured using Dental Fear Scale (DFS). Results: Statistical analysis was performed using chi square test and unpaired t-test. The mean background noise levels were found to be maximum in the pre-clinical setup/ laboratory areas (69.23+2.20). Females and the patients attending dental college setup encountered more fear on seeing the drill as compared to the patients attending private clinics (p<0.001). Conclusion: The sources of dental sounds can pose as a potential hazard to hearing system. It was analyzed that the environment in the clinics can directly have an effect on the fear and annoyance levels of patients. Hence it is necessary control the noise from various dental equipments to reduce the fear of patients from visiting a dental clinic. PMID:24959512

  20. Plasmodium falciparum malaria in pregnancy: Prevalence of peripheral parasitaemia, anaemia and malaria care-seeking behaviour among pregnant women attending two antenatal clinics in Edo State, Nigeria

    NARCIS (Netherlands)

    E.F.O. Enato; P.F. Mens; A.O. Okhamafe; E.E. Okpere; E. Pogoson; H.D.F.H. Schallig

    2009-01-01

    This study evaluated malaria care-seeking behaviour, as well as the prevalence of parasitaemia and anaemia among pregnant women attending antenatal clinics of two tertiary healthcare facilities in Edo State, Nigeria. Malaria was highly prevalent in the study group (20%) by microscopy and estimated 2

  1. [Professional dysphonia and its risk factors in the material of the outpatient clinic of the Department of Otolaryngology, Medical Academy of Białystok].

    Science.gov (United States)

    Kosztyła-Hojna, Bozena; Rogowski, Marek; Ruczaj, Jan; Pepiński, Witold

    2004-01-01

    Occurrence of professional dysphonia was analysed in a group of 309 patients treated in the Phoniatric Outpatient Clinic, Department of Otolaryngology, Medical Academy in Białystok through the period of 1999-2001. In a group of professional voice users female teachers of primary schools and lower secondary schools predominated. Obtained results were compared with those from a group of 65 persons of other occupations. In the both groups other harmful factors affecting the voice organ were excluded. The clinical assessment included subjective and objective laryngological examination using videolaryngostroboscopy. The clinical material was evaluated in a view of functional and organic disorders of the voice organ. Early occurrence and aggravation of functional changes in the larynx was recorded in non professional voice users in the course of their seniority. In professional patients organic changes were more common and occurred earlier than functional disorders. Severity of dysphonia was related to the larynx pathology, especially of a functional character.

  2. Trichomonas vaginalis infection in a low-risk women attended in Obstetrics and Gynaecology Clinic, Universiti Kebangsaan Malaysia Medical Centre

    Institute of Scientific and Technical Information of China (English)

    Norhayati Moktar; Nor Liyana Ismail; Phoy Cheng Chun; Mohamad Asyrab Sapie; Nor Farahin Abdul Kahar; Yusof Suboh; Noraina Abdul Rahim; Nor Azlin Mohamed Ismail; Tengku Shahrul Anuar

    2016-01-01

    Objective: To investigate the presence of trichomoniasis among women attending the Obstetrics and Gynaecology Clinic, Universiti Kebangsaan Malaysia Medical Centre. Methods: A total of 139 high vaginal swabs were taken from the subjects and sent to the laboratory in Amies gel transport media. The specimens were examined for the presence of Trichomonas vaginalis using wet mount, Giemsa staining and cultured in Diamond's medium. Sociodemographic characteristics and gynaecological complaints were obtained in private using structured questionnaire applied by one investigator. Results: The median age was 32 years, with an interquartile interval of 9.96. Most of the subjects were Malays (76.9%) and the remaining were Chinese (15.1%), Indians (2.2%) and other ethnic groups (5.8%). One hundred and thirty eight (99.3%) of the women were married and 98.6%had less than 6 children. More than half (75.5%) of the women's last child birth was less than 6 years ago. Forty seven percent of them were involved in supporting administrative work and 64.7% of the women gave a history of previous or current vaginal discharge. Conclusions: The present study reported zero incidence rate of trichomoniasis. The low incidence rate was postulated due to all women who participated in this study were categorized into a low-risk group.

  3. Prevalence of erectile dysfunction and its correlates among men attending primary care clinics in three countries: Pakistan, Egypt, and Nigeria.

    Science.gov (United States)

    Shaeer, K Z M; Osegbe, D N; Siddiqui, S H; Razzaque, A; Glasser, D B; Jaguste, V

    2003-04-01

    The prevalence and correlates of erectile dysfunction (ED) in developing countries are largely unknown. Our objectives were to determine the prevalence and associated factors of ED in three countries (Pakistan, Egypt, Nigeria) that represent very different cultures. Men 35-70y of age seeking primary medical care answered a structured questionnaire adapted to reflect local cultures. Degree of ED was categorized as 'none,' 'mild,' 'moderate,' or 'complete.' The age-adjusted prevalence rates of ED among men attending primary care clinics was 57.4% in Nigeria, 63.6% in Egypt, and 80.8% in Pakistan. Older age, diabetes, peptic ulcers, prostate disease, depression-related symptoms, and caffeine consumption were independently associated with increased prevalence of ED, whereas being moderately active to very active at work (hard physical labor) and during leisure time (strenuous exercise) was associated with half the prevalence of moderate-to-complete ED. Our multicultural study demonstrates that in every country studied, high proportions of men older than age 35 have some degree of ED (57-81%). Both severity and prevalence increase consistently with age. Factors associated with ED are similar, but their distribution differs across countries. PMID:12825103

  4. Depression during pregnancy: prevalence and risk factors among women attending a public health clinic in Rio de Janeiro, Brazil.

    Science.gov (United States)

    Pereira, Priscila Krauss; Lovisi, Giovanni Marcos; Pilowsky, Daniel L; Lima, Lúcia Abelha; Legay, Leticia Fortes

    2009-12-01

    Depression is the most prevalent psychiatric disorder during pregnancy and is associated with psychosocial and clinical obstetric factors. Despite being an important public health issue, there are few studies about this issue in Brazil. A cross-sectional study was carried out, involving 331 pregnant women attending a public primary health service over a one-year period in Rio de Janeiro city, Brazil. Participants were interviewed about their socio-demographic status, obstetric/medical conditions, life events and violence during pregnancy. Depression was assessed using the Composite International Development Interview. The prevalence of depression during pregnancy was 14.2% (95%CI: 10.7-18.5) and associated factors included: previous history of depression and any psychiatric treatment, unplanned pregnancy, serious physical illness and casual jobs. These data emphasize the need for screening for depression and its risk factors during pregnancy in settings where care is available. Psychosocial interventions and social policies need to be devised for this population. PMID:20191163

  5. Psychosocial Characteristics and Obstetric Health of Women Attending a Specialist Substance Use Antenatal Clinic in a Large Metropolitan Hospital

    Directory of Open Access Journals (Sweden)

    Lucy Burns

    2011-01-01

    Full Text Available Objective. This paper reports the findings comparing the obstetrical health, antenatal care, and psychosocial characteristics of pregnant women with a known history of substance dependence (n=41 and a comparison group of pregnant women attending a general antenatal clinic (n=47. Method. Face-to-face interviews were used to assess obstetrical health, antenatal care, physical and mental functioning, substance use, and exposure to violence. Results. The substance-dependent group had more difficulty accessing antenatal care and reported more obstetrical health complications during pregnancy. Women in the substance-dependent group were more likely to report not wanting to become pregnant and were less likely to report using birth control at the time of conception. Conclusions. The profile of pregnant women (in specialised antenatal care for substance dependence is one of severe disadvantage and poor health. The challenge is to develop and resource innovative and effective multisectoral systems to educate women and provide effective care for both women and infants.

  6. Prevalence of lymphoedema and quality of life among patients attending a hospital-based wound management and vascular clinic.

    LENUS (Irish Health Repository)

    Gethin, Georgina

    2012-04-01

    Lymphoedema is a chronic, incurable, debilitating condition, usually affecting a limb and causes discomfort, pain, heaviness, limited motion, unsatisfactory appearance and impacts on quality of life. However, there is a paucity of prevalence data on this condition. This study aimed to determine the prevalence of lymphoedema among persons attending wound management and vascular clinics in an acute tertiary referral hospital. Four hundred and eighteen patients meeting the inclusion criteria were assessed. A prevalence rate of 2.63% (n = 11) was recorded. Thirty-six percent (n = 4) had history of cellulitis and broken skin, 64% (n = 7) had history of broken skin and 36% (n = 4) had undergone treatment for venous leg ulcers. The most common co-morbidities were hypertension 55% (n = 6), deep vein thrombosis (DVT) 27% (n = 3), hypercholesterolemia 36% (n = 4) and type 2 diabetes 27% (n = 3). Quality of life scores identified that physical functioning was the domain most affected among this group. This study has identified the need to raise awareness of this condition among clinicians working in the area of wound management.

  7. Substance-dependent women attending a de-addiction center in North India: Sociodemographic and clinical profile

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    Grover S

    2005-07-01

    Full Text Available Background: Treatment-seeking is limited in women substance abusers. Studying the sociodemographic and clinical profile of treatment-seeking substance-dependent women can help us to understand the problem better and respond appropriately in terms of primary and secondary prevention strategies. Aim: To study the sociodemographic and clinical profile of women attending a de-addiction centre in North India. Design and Methodology: Retrospective structured chart review of 35 women substance abusers. Results: The results indicated that a typical subject was urban (86%, married (63%, nuclear family (60%, based housewife (57%, educated up to school completion (54%, and having poor social support (57%. The common substances were opioids (60%, followed by alcohol (17%, and tobacco and benzodiazepines (11.5% each. The mean age at onset of substance use was 30.5 years, the mean duration of use was 9 years and mean duration to develop dependence was 5.5 years. The common reasons for initiating use were medical (63% and curiosity (34%. Comorbidity profile was: physical illness (34%, psychiatric illness (23% and dependence on another substance (14%. Only 20% had a family history of substance dependence. The social impairment ranged from 77% for social to 40% for financial and none for legal aspects. A typical subject had followed up 4.2 times in 8.4 months, while 54% were abstaining, 40% were continuing their substance dependence at the last follow up. Conclusions: The results suggest that the development of substance dependence in women is a combination of genetic, personal, and social vulnerability factors, including the drug culture of the social milieu and the poor social support. Comorbidity and impairment are common features.

  8. Vitamin D status among immigrant mothers from Pakistan, Turkey and Somalia and their infants attending child health clinics in Norway.

    Science.gov (United States)

    Madar, Ahmed A; Stene, Lars C; Meyer, Haakon E

    2009-04-01

    High prevalences of vitamin D deficiency have been reported in non-Western immigrants moving to Western countries, including Norway, but there is limited information on vitamin D status in infants born to immigrant mothers. We aimed to describe the vitamin D status and potentially correlated factors among infants aged 6 weeks and their mothers with Pakistani, Turkish or Somali background attending child health clinics in Norway. Eighty-six healthy infants and their mothers with immigrant background were recruited at the routine 6-week check-up at nine centres between 2004 and 2006. Venous or capillary blood was collected at the clinics from the mother and infant, and serum separated for analysis of 25-hydroxyvitamin D (s-25(OH)D) and intact parathyroid hormone (s-iPTH). The mean maternal s-25(OH)D was 25.8 nmol/l, with 57 % below 25 nmol/l and 15 % below 12.5 nmol/l. Of the mothers, 26 % had s-iPTH>5.7 pmol/l. For infants, mean s-25(OH)D was 41.7 nmol/l, with 47 % below 25 nmol/l and 34 % below 12.5 nmol/l. s-25(OH)D was considerably lower in the thirty-one exclusively breast-fed infants (mean 11.1 nmol/l; P < 0.0001). Use of vitamin D supplements and education showed a positive association with maternal s-25(OH)D. There was no significant association between mother's and child's s-25(OH)D, and no significant ethnic or seasonal variation in s-25(OH)D for mothers or infants. In conclusion, there is widespread vitamin D deficiency in immigrant mothers and their infants living in Norway. Exclusively breast-fed infants who did not receive vitamin D supplements had particularly severe vitamin D deficiency.

  9. Patients' experiences of receiving chemotherapy in outpatient clinic and/or onboard a unique nurse-led mobile chemotherapy unit: a qualitative study.

    Science.gov (United States)

    Mitchell, T

    2013-07-01

    There is a drive in the UK to revise chemotherapy provision for people living in rural communities. Using a different model of treatment delivery might impact positively upon the experience of receiving chemotherapy. In 2007 the first nurse-led mobile chemotherapy unit (MCU) in the UK was launched in the South West of England with the intention of providing treatment closer to home. The aim of the research was to explore experiences of people with cancer who received chemotherapy treatment in outpatient clinic and/or onboard the MCU using an interpretive phenomenological approach. Interviews were conducted with 20 people and data were interpreted using thematic analysis. The cancer and chemotherapy journey was described as being undertaken by the participant and their significant other. Available car parking and travelling impacted upon quality of life, as did the environment and accessibility of nurses to discuss issues with participants. The most important, distinguishing feature between receiving chemotherapy in outpatient clinic and the MCU was the amount of time spent waiting. Having treatment on the MCU was perceived to be less formal and therefore less stressful. Participants reported significant savings in time spent travelling, waiting and having treatment, expenditure on fuel and companion costs.

  10. Clinical Application of Multiplex PCR Assay for the Diagnosis of the Etiology of Genital Ulcer Disease Among Patients Attending STD Clinics in Guangzhou, China

    Institute of Scientific and Technical Information of China (English)

    朱慧兰; 苏向阳; 林路洋; 叶兴东

    2002-01-01

    Objectives: To develop a method of simultaneous PCRdetection of Haemophilus ducreyi, Treponema pallidum, andHerpes Simplex Virus Types 1 and 2 from genital ulcersamong patients attending STD clinics in Guangzhou, China;and evaluate the clinical application of multiplex PCR (M-PCR) assay for diagnosing the etiology of genital ulcerdiseases (GUD). Methods: 244 patients with a genital ulcer were evaluated.Clinical etiology of GUD was based on physical appearanceand microbiologic evaluations that included dark fieldmicroscopy examination (D-F) and serology test for syphilis(STS). Swabs of each genital ulcer were tested for HSVantigen by enzyme immunoassay (EIA) and processed in anM-PCR assay for simultaneous detection of T. pallidum, HSVand H. ducreyi. Results: The standard strains of T. pallidum, HSV and H.ducreyi were amplified by M-PCR, producing amplifiedproducts of 260bp,432bp,170bp, respectively. The sensitivityof M-PCR is 102pg DNA. M-PCR assay for T. pallidum, HSVand H. ducreyi showed good agreement when compared withD-F detection for T. pallidum, STS, H. ducreyi culture and EIAfor HSV antigen (Kappa scores are 0.774,0.704,0.793,0.756,respectively). Conclusions: The M-PCR is a convenient, accurate andreliable assay for the detection of T. pallidum, HSV and H.ducreyi from genital ulcers, and can be used as a method of diagnosing the etiology of GUD.

  11. Knowledge, attitudes and practices among people with chronic hepatitis B attending a hepatology clinic in Malaysia: A cross sectional study

    Directory of Open Access Journals (Sweden)

    Mohamed Rosmawati

    2012-08-01

    Full Text Available Abstract Background Hepatitis B (HBV is the leading cause of cirrhosis and hepatocellular carcinoma worldwide. This study assessed the knowledge, attitudes and practices of people with chronic HBV and the associated factors. Methods This cross-sectional study was conducted at an outpatient adult hepatology clinic at a tertiary hospital in Kuala Lumpur. A self-administered questionnaire was administered on a one-to-one basis to assess knowledge, attitudes, and lifestyle practices of people with chronic HBV. Results The response rate was 89% (n = 483/543. Participants had a mean age of 46.3 (±14.7 years and the mean duration of HBV from time of diagnosis was 12.2 (±8.8 years. The mean knowledge score was 12.57/20 (standard deviation: ±4.4, range: 0–19. Participants aged 30–39 years, with higher educational attainment, employed in professional jobs, longer duration of diagnosis and those without cirrhosis had significantly higher knowledge scores. Age, education level and duration of diagnosis were significant predictors of the knowledge score on standard multiple regression analysis. More than half of the participants were worried of spreading HBV infection to family and friends and worried since the diagnosis. A third of the participants (33.5% were embarrassed to reveal their diagnosis to the public but most of them (93.6% would inform their family. Those who reported feeling worried since their diagnosis were more likely to be middle-aged, of Malay ethnicity, have shorter duration of diagnosis of less than 10 years and have received therapy. About half of the participants (50.6% did not share dining utensils and the majority (93.2% believed that HBV can be transmitted by sharing of eating and drinking utensils. Older patients were significantly less likely to share utensils. Those who felt worried since diagnosis had significant higher knowledge of HBV. Conclusion The findings highlight the stigma and misconceptions that still

  12. Quality of life of People living with HIV and AIDS attending the Antiretroviral Clinic, University College Hospital, Nigeria

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    Oluyemisi F. Folasire

    2012-02-01

    Full Text Available Background: Quality of life (QOL is an important component in the evaluation of the well-being of people living with HIV and AIDS (PLWHA, especially with the appreciable rise in longevity of PLWHA. Moreover, limited studies have been conducted in Nigeria on how PLWHA perceive their life with the World Health Organisation Quality of Life Brief Scale (WHOQOL-Bref instrument. Objective: This study assessed the QOL of PLWHA attending the antiretroviral (ARV clinics, UCH Ibadan, Nigeria.Method: A cross-sectional study was conducted from June to September 2008 that involved 150 randomly selected HIV-positive patients who were regular attendees at the antiretroviral clinic, UCH Ibadan. An interviewer administered questionnaire was used to collect information on sociodemographic data, satisfaction with perceived social support, medical records, and QOL was assessed with WHOQOL-Bref.Results: The mean age of the respondents was 38.1 ± 9.0 years and the male : female ratio was 1:2. The mean CD4 count was higher in female patients than in male patients, 407 cells/mm3 : 329 cells/mm3 (p = 0.005. The mean QOL scores on the scale of (0–100 in three domains were similar: psychological health, 71.60 ± 18.40; physical health, 71.60 ± 13.90; and the environmental domain, 70.10 ± 12.00; with the lowest score in the social domain, 68.89 ± 16.70. Asymptomatic HIV-positive patients had significantly better mean QOL scores than symptomatic patients in the physical (74.04 ± 16.85 versus 64.47 ± 20.94, p = 0.005 and psychological domains (76.09 ± 12.93 versus 69.74 ± 15.79, p = 0.015. There was no significant difference in the mean QOL scores of men compared to those of women, in all domains assessed.Conclusion: High QOL scores in the physical, psychological and environmental domains may be reflective of the effectiveness of some of the interventions PLWHA are exposed to at the ARV clinic, UCH Ibadan (on-going psychotherapy, free antiretroviral drugs

  13. Age-appropriate feeding practices and nutritional status of infants attending child welfare clinic at a Teaching Hospital in Nigeria

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    Umar M Lawan

    2014-01-01

    Full Text Available Background: Appropriate infant feeding is the key to optimum infant and child development and survival. This study investigates age-appropriate infant feeding practices and nutritional status of infants attending the immunization and child welfare clinic at Aminu Kano Teaching Hospital. Materials and Methods: Using a cross-sectional descriptive design, a sample of 300 sets of infants (age ≤12 months and caregivers was systematically selected and studied. The data were analyzed using the MINITAB ® 12.21 (USA statistical software. Results: All the infants studied were still on breast milk. Most of the mothers demonstrated correct body positioning (89.9 and attachment (78.7% during breastfeeding, and effective suckling was demonstrated in 77.0%. Interestingly, none of the infants was either exclusively breastfed for 6 months or currently on exclusive breastfeeding. Furthermore, only 64 (58.2% of the 110 infants that were more than 6 months of age had appropriately been started on complementary feeding from 6 months of age. Overall, most caregivers (88.7% had "fair" to "good" infant feeding practices. The practices were significantly associated with their level of education, and their relationship with the infants. Up to 40.0% and 73.7% of the infants had varying degrees of wasting and stunting respectively. Infant feeding practices and the age of the infants emerged as the only factors significantly associated with stunting, while both the caregivers′ practices and age of the infants emerged as significant predictors of wasting in the infants. Conclusion and Recommendations: Barely 3 years to the 2015 target of the millennium development goals (MDGs, infant feeding and nutritional status still poses a serious threat to the dream of realizing the MDG-4. The Ministry of Health and relevant developing partners in this region should as a matter of urgency, formulate and implement a strong community-based public health intervention program to

  14. An assessment of serum prolactin levels among infertile women with galactorrhea attending a gynecological clinic North-West Nigeria

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    Emmanuel Ajuluchukwu Ugwa

    2016-01-01

    Full Text Available Background: Galactorrhea is a common manifestation of hyperprolactinemia but may not always be present in women with hyperprolactinemia. This study was, therefore, undertaken to assess the serum prolactin levels of infertile women presenting with galactorrhea and to determine the prevalence of hyperprolactinemia among them. Materials and Methods: This was a retrospective study of serum prolactin levels of 63 female partners of infertile couples attending the gynecological clinic of Federal Medical Centre, Birnin Kudu, Jigawa State, Nigeria, who were found to have galactorrhea from January 1, 2012, to December 31, 2013. Ethical clearance was obtained. Solid phase enzyme-linked immunosorbent assay was used to measure serum prolactin. Sociodemographic characteristics were determined. The data obtained were analyzed using SPSS version 17.0 statistical software. Absolute numbers and simple percentages were used to describe categorical variables. Similarly, quantitative variables were described using measures of central tendency (mean, median and measures of dispersion (range, standard deviation as appropriate. Results: The average age of the women was 27.9 ± 5.6 years. In half of the cases (50%, galactorrhea was associated with menstrual disturbances, mainly amenorrhea (23.3%. Although most (63.3% of the clients had normal serum prolactin level despite being galactorrheic, averagely there was a marked elevation in serum prolactin of as high as 40.3 ± 52.3 ng/mL. Conclusion: We conclude, therefore, that the prevalence of hyperprolactinemia in this study was low when compared with other studies and that galactorrhea does not always indicate raised serum prolactin levels.

  15. An assessment of serum prolactin levels among infertile women with galactorrhea attending a gynecological clinic North-West Nigeria

    Science.gov (United States)

    Ugwa, Emmanuel Ajuluchukwu; Ashimi, Adewale Olufemi; Abubakar, Mohammed Yusuf; Takai, Idris Usman; Lukman, Okunade Taiwo; Lawal, Hamzah Abdurrahman; Also, Muhammed Abubakar; Gift, Amadi Ngozi; Kiri, Halimat Muhammed

    2016-01-01

    Background: Galactorrhea is a common manifestation of hyperprolactinemia but may not always be present in women with hyperprolactinemia. This study was, therefore, undertaken to assess the serum prolactin levels of infertile women presenting with galactorrhea and to determine the prevalence of hyperprolactinemia among them. Materials and Methods: This was a retrospective study of serum prolactin levels of 63 female partners of infertile couples attending the gynecological clinic of Federal Medical Centre, Birnin Kudu, Jigawa State, Nigeria, who were found to have galactorrhea from January 1, 2012, to December 31, 2013. Ethical clearance was obtained. Solid phase enzyme-linked immunosorbent assay was used to measure serum prolactin. Sociodemographic characteristics were determined. The data obtained were analyzed using SPSS version 17.0 statistical software. Absolute numbers and simple percentages were used to describe categorical variables. Similarly, quantitative variables were described using measures of central tendency (mean, median) and measures of dispersion (range, standard deviation) as appropriate. Results: The average age of the women was 27.9 ± 5.6 years. In half of the cases (50%), galactorrhea was associated with menstrual disturbances, mainly amenorrhea (23.3%). Although most (63.3%) of the clients had normal serum prolactin level despite being galactorrheic, averagely there was a marked elevation in serum prolactin of as high as 40.3 ± 52.3 ng/mL. Conclusion: We conclude, therefore, that the prevalence of hyperprolactinemia in this study was low when compared with other studies and that galactorrhea does not always indicate raised serum prolactin levels.

  16. Effectiveness of mobile-phone short message service (SMS reminders for ophthalmology outpatient appointments: Observational study

    Directory of Open Access Journals (Sweden)

    Car Josip

    2008-05-01

    Full Text Available Abstract Background Non-attendance for hospital outpatient appointments is a significant problem in many countries. It causes suboptimal use of clinical and administrative staff and financial losses, as well as longer waiting times. The use of Short Message Service (SMS appointment reminders potentially offers a cost-effective and time-efficient strategy to decrease non-attendance and so improve the efficiency of outpatient healthcare delivery. Methods An SMS text message was sent to patients with scheduled appointments between April and September 2006 in a hospital ophthalmology department in London, reminding them of their appointments. This group acted as the intervention group. Controls were patients with scheduled ophthalmology appointments who did not receive an SMS or any alternative reminder. Results During the period of the study, 11.2% (50/447 of patients who received an SMS appointment reminder were non-attenders, compared to 18.1% (1720/9512 who did not receive an SMS reminder. Non-attendance rates were 38% lower in patients who received an SMS reminder than in patients who did not receive a reminder (RR of non-attendance = 0.62; 95% CI = 0.48 – 0.80. Conclusion The use of SMS reminders for ophthalmology outpatient appointments was associated with a reduction of 38% in the likelihood of patients not attending their appointments, compared to no appointment reminder. The use of SMS reminders may also be more cost-effective than traditional appointment reminders and require less labour. These findings should be confirmed with a more rigorous study design before a wider roll-out.

  17. Improving glycaemic control and life skills in adolescents with type 1 diabetes: A randomised, controlled intervention study using the Guided Self-Determination-Young method in triads of adolescents, parents and health care providers integrated into routine paediatric outpatient clinics

    DEFF Research Database (Denmark)

    Thorsteinsson, Birger; Esbensen, Bente Appel; Hommel, Eva;

    2011-01-01

    are lacking. The Guided Self-Determination method is proven effective in adult care and has been adapted to adolescents and parents (Guided Self-Determination-Young (GSD-Y)) for use in paediatric diabetes outpatient clinics. Our objective is to test whether GSD-Y used in routine paediatric outpatient clinic......ABSTRACT: BACKGROUND: Adolescents with type 1 diabetes face demanding challenges due to conflicting priorities between psychosocial needs and diabetes management. This conflict often results in poor glycaemic control and discord between adolescents and parents. Adolescent-parent conflicts are thus...... a barrier for health care providers (HCPs) to overcome in their attempts to involve both adolescents and parents in improvement of glycaemic control. Evidence-based interventions that involve all three parties (i.e., adolescents, parents and HCPs) and are integrated into routine outpatient clinic visits...

  18. Neuropsychological screening of children of substance-abusing women attending a Special Child Welfare Clinic in Norway

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    Skogmo Idar

    2010-07-01

    Full Text Available Abstract Background Exposure to alcohol and illicit substances during pregnancy can have an impact on the child for the rest of his/her life. A Special Child Welfare Clinic (SCWC in Norway provides care for pregnant women with substance abuse problems. Treatment and support are provided without replacement therapy. Methods We performed a neuropsychological screening of 40 children aged four to 11 years whose mothers had attended the SCWC during pregnancy, and of a comparison group of 80 children of women without substance abuse problems. The children were presented with tests chosen from Wechsler Intelligence Scale for Children, third version (WISC-III, Nepsy, Halstead-Reitan and Raven's Progressive Matrices, Coloured Version. The tests were grouped into five main domains; (1 learning and memory, (2 visual scanning, planning and attention, (3 executive function, (4 visuo-motor speed and dexterity and (5 general intellectual ability Results No children in the study had test results in the clinical range in any domain. Bivariate analyses revealed that children of short-term substance-abusing mothers (who stopped substance abuse within the first trimester had significantly lower test scores than the comparison group in three out of five domains (domain 2,3,4. Children of long-term substance abusers (who maintained moderate substance abuse throughout pregnancy had significantly lower test results than the comparison group in one domain of the test results (domain 1. All but one child in the long-term group were or had been in foster homes. Most children in the short-term group stayed with their mothers. Multivariate regression analyses revealed that foster care minimum 50% of life time was associated with better scores on domains (1 learning and memory, (2 visual scanning, planning and attention, and (3 executive functions, while no significant associations with test scores was found for substance abuse and birth before 38 weeks of gestation

  19. Contraception matters: indicators of poor usage of contraception in sexually active women attending family planning clinics in Victoria, Australia

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    Ong Jason

    2012-12-01

    Full Text Available Abstract Background Unintended pregnancy (mistimed or unwanted remains an important health issue for women. The purpose of this study was to determine the prevalence of and factors associated with risk of unintended pregnancy in a sample of Victorian women attending family planning clinics. Methods This cross-sectional survey of three Family Planning Victoria Clinics from April to July 2011 recruited women aged 16-50 years with a male sexual partner in the last 3 months, and not intending to conceive. The questionnaire asked about contraceptive behaviours and important factors that influence contraception use (identified from a systematic literature review. Univariate analysis was calculated for the variables of interest for associations with contraceptive use. An overall multivariate model for being at risk for unintended pregnancy (due to inconsistent or ineffective contraceptive use or non-use was calculated through backward elimination with statistical significance set at Results 1006 surveys were analyzed with 96% of women reporting contraception use in the last 3 months. 37% of women were at risk for unintended pregnancy due to imperfect use (61% inconsistent users; 31% ineffective methods or never using contraception (8%. On multivariate analysis, women at risk for unintended pregnancy compared with women not at risk were 1 partner in the last 3 months (OR 3.2, 95% CI 2.3-4.6. These women were dissatisfied with current contraception (OR 2.5, 95% 1.8-3.5; felt “vulnerable” to pregnancy (OR 2.1, 95% CI 1.6-3.0; were not confident in contraceptive knowledge (OR 2.6, 95% CI 1.5-4.8; were unable to stop to use contraception when aroused (OR 2.1, 95% CI 1.5-2.9 but were comfortable in speaking to a doctor about contraception (OR 2.3, 95% CI 1.1-4.1. Conclusion Despite reported high contraceptive usage, nearly 40% of women were at risk for unintended pregnancy primarily due to inconsistent contraceptive use and use of ineffective

  20. Characteristics of chronic non-specific musculoskeletal pain in children and adolescents attending a rheumatology outpatients clinic: a cross-sectional study

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    Murray Kevin

    2011-01-01

    Full Text Available Abstract Background Chronic non-specific musculoskeletal pain (CNSMSP may develop in childhood and adolescence, leading to disability and reduced quality of life that continues into adulthood. The purpose of the study was to build a biopsychosocial profile of children and adolescents with CNSMSP. Methods CNSMSP subjects (n = 30, 18 females, age 7-18 were compared with age matched pain free controls across a number of biopsychosocial domains. Results In the psychosocial domain CNSMSP subjects had increased levels of anxiety and depression, and had more somatic pain complaints. In the lifestyle domain CNSMSP subjects had lower physical activity levels, but no difference in television or computer use compared to pain free subjects. Physically, CNSMSP subjects tended to sit with a more slumped spinal posture, had reduced back muscle endurance, increased presence of joint hypermobility and poorer gross motor skills. Conclusion These findings support the notion that CNSMSP is a multidimensional biopsychosocial disorder. Further research is needed to increase understanding of how the psychosocial, lifestyle and physical factors develop and interact in CNSMSP.

  1. Determinants of acceptance of an illness in the case of patients suffering from psoriasis treated in the hospital and outpatient clinic settings

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    Marta Adamska

    2015-09-01

    Full Text Available Background Psoriasis is one of the most commonly occurring cutaneous conditions. In connection with its chronic character, and with the presence of defacing pathological changes on the skin, this medical condition reduces the quality of life in the physical, mental and social aspects. It is also an illness whose course is substantially influenced by psychological factors. The level of acceptance of an illness in the case of psoriasis patients may exert a significant influence on their level of adjustment to their medical condition and psycho-social functioning. The objective of this research was to estimate the level of acceptance of the illness, and to determine the correlations between acceptance of the illness and the way in which it is perceived, the exacerbation of symptoms, and the health locus of control in groups of patients with psoriasis treated in the hospital and outpatient clinic settings. Participants and procedure The research included a group of 61 patients suffering from psoriasis. The following research tools were applied: the Acceptance of Illness Scale (AIS, the Multidimensional Health Locus of Control Scale (MHLC, the Disease Rating Scale (DRS, the Self-Administered Psoriasis Area Severity Index (SAPASI, and the Visual Analogue Scale (VAS. Results The studied patients accepted their illness to an average degree. No significant differences were found for that variable between the studied individuals treated in the hospital setting and those treated in the outpatient clinic setting. In the group of hospitalized patients, the perception of the illness in the categories of a threat, harm, life balance disturbance and an obstacle/a loss was negatively correlated with the acceptance of it. In the group of patients treated in the outpatient clinic setting, the assessment of the illness in the categories of a threat and harm, and the subjective assessment of exacerbation of symptoms of the illness, measured using the VAS, were

  2. Prescribing Practices of Topical Corticosteroids in the Outpatient Dermatology Department of a Rural Tertiary Care Teaching Hospital

    OpenAIRE

    Suvarna S. Rathod; Vijay M. Motghare; Vinod S. Deshmukh; Rushikesh P Deshpande; Chetanraj G. Bhamare; Patil, Jyoti R

    2013-01-01

    Background: Inappropriate or excessive use of topical corticosteroids can lead to cutaneous and systemic adverse effects which occur more commonly with the use of very potent steroids. Monitoring and analysis of the prescription practices of topical steroids can help to achieve rational prescription of these drugs. Aim: The present study was carried out to study and analyze the pattern of prescribing topical corticosteroids among outpatients attending the dermatology clinic in a rural tertiar...

  3. Practice and outcomes of lean management at outpatient clinic process optimization%应用精益管理优化门诊流程的实践与效果

    Institute of Scientific and Technical Information of China (English)

    陈书人; 王跃建; 杨智才; 梁玉颜; 蒋慧明; 陈木莲

    2013-01-01

    Targeting such setbacks as "difficulty to register"and "difficulty to see doctors" at outpatient clinic services,the hospital adopted the lean management since August 2010.For example,diversified reengineering of the outpatient service process in place,which has improved outpatient traffic at the registration section by means of innovated appointment mode and outpatients total reservation;workload balance by means of through-counters for registration and fee payment as well as the timeinterval outpatient visits to doctors; reduced human costs and outpatient back-forth movement by means of integrated service and resources integration.Lean management plays a positive role in hospital management,as proven by much shortened outpatient waiting time,much higher outpatient satisfaction,for a win-win of both patients and the hospital.%我院针对门诊流程存在的缺陷,“挂号难”、“看病烦”等问题,于2010年8月开始采用精益思维管理,实施多元化门诊流程优化措施,通过创新预约诊疗方式及门诊全预约诊疗改善门诊患者挂号环节的流动;通过挂号收费通窗、分时段就诊使工作量均衡;通过集中式服务整合资源的方法降低人力成本,减少患者跑动次数.精益管理在医院门诊管理中起着积极作用,患者等候时间明显缩短,满意度显著提高,实现患者和医院双赢.

  4. Health-related quality of life in patients with knee osteoarthritis attending two primary care clinics in Malaysia: a cross-sectional study

    OpenAIRE

    Zakaria Zainal F; Bakar Azman A; Hasmoni Hadzri M; Rani Fauzi A; Kadir Samiah A

    2009-01-01

    Abstract Background Measurement of health-related quality of life (HRQOL) among patients with osteoarthritis (OA) helps the health care provider to understand the impact of the disease in the patients' own perspective and make health services more patient-centered. The main aim of this study was to measure the quality of life among patients with symptomatic knee OA attending primary care clinic. We also aimed to ascertain the association between socio-demographic and medical status of patient...

  5. Demographic determinants of survival of people living with HIV attending an outpatient reference unit in the city of Três Lagoas, state of Mato Grosso do Sul, Brazil, in the period 1984-2009

    Directory of Open Access Journals (Sweden)

    Maria Angelina da Silva Zuque

    2013-01-01

    Full Text Available INTRODUCTION: While the incidence of HIV infection and AIDS is increasing in small Brazilian cities, epidemiological studies are often conducted in large urban centers. METHODS: Our group conducted a retrospective analysis of survival determinants among 358 patients who attended a reference unit in a small city. RESULTS: Death risk was lower among men that had sex with men, patients with an HIV-seropositive partner, and those admitted after highly active antiretroviral therapy (HAART was available. CONCLUSIONS: The study documents the striking beneficial effect of HAART. The finding of other groups with improved survival may aid in the development of programmatic strategies.

  6. Maintenance of improved lipid levels following attendance at a cardiovascular risk reduction clinic: a 10-year experience

    Directory of Open Access Journals (Sweden)

    Glen J Pearson

    2008-08-01

    Full Text Available Glen J Pearson1,5, Kari L Olson6, Nicole E Panich1, Sumit R Majumdar2,5, Ross T Tsuyuki1,4, Dawna M Gilchrist2,5, Ali Damani4, Gordon A Francis3,5The MILLARR Study (Maintenance of Improved Lipid Levels Following Attendance at a Cardiovascular Risk Reduction Clinic 1Department of Medicine, Divisions of Cardiology; 2General Internal Medicine; 3Endocrinology and Metabolism; Faculty of Pharmacy and Pharmaceutical Sciences; 4University of Alberta, Edmonton, Alberta, Canada; 5Cardiovascular Risk Reduction Clinic (CRRC, University of Alberta Hospital, Edmonton, Alberta, Canada; 6University of Colorado Health Sciences Center, Denver, Colorado, USA; 7Family Medicine (Private Practice, Calgary, Alberta, CanadaBackground: Specialty cardiovascular risk reduction clinics (CRRC increase the proportion of patients attaining recommended lipid targets; however, it is not known if the benefits are sustained after discharge. We evaluated the impact of a CRRC on lipid levels and assessed the long-term effect of a CRRC in maintaining improved lipid levels following discharge.Methods: The medical records of consecutive dyslipidemic patients discharged >6 months from a tertiary hospital CRRC from January 1991 to January 2001 were retrospectively reviewed. The primary outcome was the change in patients’ lipid levels between the final CRRC visit and the most recent primary care follow-up. A worst-case analysis was conducted to evaluate the potential impact of the patients in whom the follow-up lipid profiles post-discharge from the CRRC were not obtained.Results: Within the CRRC (median follow-up = 1.28 years in 1064 patients, we observed statistically significant improvements in all lipid parameters. In the 411 patients for whom post-discharge lipid profiles were available (median follow-up = 2.41 years, there were no significant differences observed in low-density lipoprotein-cholesterol, total cholesterol (TC, or triglycerides since CRRC discharge; however, there

  7. Validation and results of a questionnaire for functional bowel disease in out-patients

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    Skordilis Panagiotis

    2002-05-01

    Full Text Available Abstract Background The aim was to evaluate and validate a bowel disease questionnaire in patients attending an out-patient gastroenterology clinic in Greece. Methods This was a prospective study. Diagnosis was based on detailed clinical and laboratory evaluation. The questionnaire was tested on a pilot group of patients. Interviewer-administration technique was used. One-hundred-and-forty consecutive patients attending the out-patient clinic for the first time and fifty healthy controls selected randomly participated in the study. Reliability (kappa statistics and validity of the questionnaire were tested. We used logistic regression models and binary recursive partitioning for assessing distinguishing ability among irritable bowel syndrome (IBS, functional dyspepsia and organic disease patients. Results Mean time for questionnaire completion was 18 min. In test-retest procedure a good agreement was obtained (kappa statistics 0.82. There were 55 patients diagnosed as having IBS, 18 with functional dyspepsia (Rome I criteria, 38 with organic disease. Location of pain was a significant distinguishing factor, patients with functional dyspepsia having no lower abdominal pain (p Conclusions This questionnaire for functional bowel disease is a valid and reliable instrument that can distinguish satisfactorily between organic and functional disease in an out-patient setting.

  8. Clinical and economic value of performing dialysis vascular access procedures in a freestanding office-based center as compared with the hospital outpatient department among Medicare ESRD beneficiaries.

    Science.gov (United States)

    Dobson, Al; El-Gamil, Audrey M; Shimer, Matthew T; DaVanzo, Joan E; Urbanes, Aris Q; Beathard, Gerald A; Litchfield, Terry Foust

    2013-01-01

    Dialysis vascular access (DVA) care is being increasingly provided in freestanding office-based centers (FOC). Small-scale studies have suggested that DVA care in a FOC results in favorable patient outcomes and lower costs. To further evaluate this issue, data were drawn from incident and prevalent ESRD patients within a 4-year sample (2006-2009) of Medicare claims (USRDS) on cases who receive at least 80% of their DVA care in a FOC or a hospital outpatient department (HOPD). Using propensity score matching techniques, cases with a similar clinical and demographic profile from these two sites of service were matched. Medicare utilization, payments, and patient outcomes were compared across the matched cohorts (n = 27,613). Patients treated in the FOC had significantly better outcomes (p advantages over that provided in a HOPD.

  9. The Personalized Triage Service and Triage Skills in Dental Outpatient Clinic%口腔门诊人性化分诊服务与分诊技巧

    Institute of Scientific and Technical Information of China (English)

    赵丽萍; 朱琳虹

    2011-01-01

    门诊口腔科的分诊工作与其他科室相比,既有共性又有其特殊性.从人性化服务的角度出发,根据门诊口腔科的分诊特点,探讨人性化分诊服务与分诊技巧.主要有:候诊环境的人性化布局;分诊人员的人性化配备和服务,如挂号人员要有一定的口腔专业知识,分诊护士应提前到岗、做好分诊前的各项准备工作;要具备人性化分诊技巧,如诊前三分钟的医护交流、护患交流,诊后三分钟的随诊;逐步建立科学的预约管理体制.%The triage work in dental outpatient clinic, compared with other sub - sections, has some common points but also its unique features. From the perspective of people - oriented service, this paper explored the personalized triage service and triage skills according to the characteristics of outpatient dental clinic. Main contents include the user -friendly layout of the waiting environment, triage personnels equipment and personalized services( registering staff should be equipped with basic dental professional knowledge, and triage nurses should get ready for task in advance for better preparation) and personalized triage skills (such as the 3 - minute pre - therapy communication between dentists & nurses, and nurses & patients, and the 3 - minute post - therapy follow up) , and the stepwise establishment of the scientific appointments management system.

  10. EFFECT OF THERAPEUTIC TRAINING AND ACTIVE OUTPATIENT MANAGEMENT ON CLINICAL STATE AND CARDIOVASCULAR COMPLICATIONS IN PATIENTS WITH CHRONIC HEART FAILURE (THREE YEAR FOLLOW-UP

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    A. P. Rebrov

    2011-01-01

    Full Text Available Aim.  To  evaluate  effect  of  therapeutic  training  and  active  outpatient management  on  clinical  state  and  cardiovascular  complications  (CVC  in  patients with  chronic  heart  failure  (CHF  during  three year follow-up. Material and methods. A total of 211 patients with CHF experienced Q-wave myocardial infarction were enrolled in the study. At admission to the hospital all patients were randomized into two groups. Patients of the first group (group 1; n=106 were managed actively after discharge from the hospital, patients of the second group (group 2; n=105 - managed conventionally after discharge from the hospital. In the hospital patients of the both groups were therapeutically trained and treated according to contemporary guidelines. Patients were observed for three years.  Results. Over three year follow-up actively managed patients demonstrated significant (p<0.05 decrease in systolic and diastolic blood pressure, heart rate, blood serum levels of total cholesterol and N-terminal prohormone of brain natriuretic peptide (NT-proBNP, augmentation of 6-minute walk-test distance, deceleration of heart remodeling and left ventricle ejection fraction reduction as compared to those who were conventionally managed. Kaplan-Meier curves revealed that risk of CHF decompensation (р=0.001, mortality (р=0.04, and total number of CVC (р=0.04 was significantly lower in the first group than this in the second one. Conclusion. Therapeutic training and active outpatient management in patients with CHF improves patient compliance to pharmacotherapy , their clinical state and outcomes.

  11. Disability and health-related quality of life in outpatients with generalised anxiety disorder treated in psychiatric clinics: is there still room for improvement?

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    Vilardaga Inma

    2011-03-01

    Full Text Available Abstract Objective We assessed the impact of generalised anxiety disorder (GAD on disability and health-related quality of life in outpatients treated in psychiatric clinics via a secondary analysis conducted in 799 patients from a cross-sectional study of prevalence of GAD in psychiatric clinics. Methods Patients were allocated into two groups: follow-up (15.7% and newly diagnosed patients (84.3%, and were administered the Hamilton Anxiety Scale (HAM-A, Clinical Global Impressions Scale (CGI, Sheehan Disability Scale (SDS, and 36-item short form structured quality of life questionnaire (SF-36 scales. Results The newly diagnosed group showed higher significant intensity of anxiety (56.9% vs 43.0% (HAM-A >24, psychiatrist's CGI Severity (CGI-S scores (4.2 vs 3.7, and perceived stress according to SDS (5.7 vs 5.2. They also showed lower scores in mental health-related quality of life: 25.4 vs 30.8. Statistical differences by gender were not observed. GAD was shown to have a significant impact on patient quality of life and disability, with a substantial portion having persistent, out of control symptoms despite treatment. Conclusions These results suggest that there is still room for improvement in the medical management of patients with GAD treated in psychiatric clinics.

  12. Dental anxiety reduction and dental attendance after treatment in a dental fear clinic: A follow-up study.

    NARCIS (Netherlands)

    I.H.A. Aartman; A. de Jongh; P.C. Makkes; J. Hoogstraten

    2000-01-01

    The aim of the present study was to assess treatment outcome in terms of dental anxiety reduction at a post-treatment assessment and dental anxiety reduction and dental attendance one year later. Furthermore, it was determined to what extent psychopathological characteristics were related to treatme

  13. Prevalence of potentially reversible dementias in a dementia outpatient clinic of a tertiary university-affiliated hospital in Brazil

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    Takada Leonel Tadao

    2003-01-01

    Full Text Available The importance of investigating the etiology for dementia lies in the possibility of treating potentially reversible dementias. The aims of this retrospective study are to determine the prevalence of potentially reversible dementias among 454 outpatients seen at the Cognitive and Behavioral Neurology Unit, Hospital das Clínicas, São Paulo University School of Medicine - Brazil, between the years of 1991 and 2001, and observe their evolution in follow-up. Among the initial 454 patients, 275 fulfilled the DSM-IV criteria for dementia. Alzheimer's disease was the most frequent diagnosis (164 cases; 59.6%. Twenty-two cases (8.0% of potentially reversible dementia were observed, the most frequent diagnoses being neurosyphilis (nine cases and hydrocephalus (six cases. Full recovery was observed in two patients and partial recovery in 10 patients. Two cases were not treated and eight cases were lost on follow-up. The prevalence found in the present study falls within the range reported in previous studies (0-30%.

  14. IQ as a moderator of outcome in severity of children’s mental health status after treatment in outpatient clinics

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    Mathiassen Børge

    2012-06-01

    Full Text Available Abstract Background Psychotherapy is an effective treatment for mental health disorders, but even with the most efficacious treatment, many patients do not experience improvement. Moderator analysis can identify the conditions under which treatment is effective or whether there are factors that can attenuate the effects of treatment. Methods In this study, linear mixed model analysis was used to examine whether the Full Scale IQ (FSIQ, Performance IQ (PIQ and Verbal IQ (VIQ on the Wechsler Intelligence Scale for Children – Third Edition, moderated outcomes in general functioning and symptom load. A total of 132 patients treated at three outpatient child and adolescent mental health services (CAMHS were assessed at three different time points. The Children’s Global Assessment Scale (CGAS and the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA were used to measure the severity of impairments in general functioning and symptom load. IQ was assessed at the start of treatment. Results Moderator analysis revealed that the FSIQ × time interaction predicted changes in CGAS scores (p p  Conclusions FISQ and PIQ moderated change in general functioning and symptom load, respectively. This implies that patients with higher IQ scores had a steeper improvement slope than those with lower scores. The patients with the highest initial symptom loads showed the greatest improvement, this pattern was not found in the improvement of general functioning.

  15. Elderly alcoholics in outpatient treatment

    DEFF Research Database (Denmark)

    Nielsen, Bent; Nielsen, Anette Søgaard; Lolk, Anette;

    2010-01-01

    In Denmark, the treatment of alcoholics is provided by public outpatient alcohol clinics. The purpose of this study was to investigate whether elderly patients differ from younger patients with regards to sociodemographic data, drinking pattern and psychiatric comorbidity which may affect...

  16. Prevalence of Antenatal Depression and Associated Risk Factors among Pregnant Women Attending Antenatal Clinics in Abeokuta North Local Government Area, Nigeria.

    Science.gov (United States)

    Thompson, Okechukwu; Ajayi, IkeOluwapo

    2016-01-01

    Objective. The prevalence of antenatal depression (AD) and associated risk factors among pregnant women attending antenatal clinics in Abeokuta North Local Government Area, Nigeria, was determined. Methods. A descriptive cross-sectional survey was conducted, interviewing 314 pregnant women selected by multistage sampling technique from among those attending antenatal clinics. Information was collected using structured questionnaire and a screening tool, Edinburgh Postnatal Depression Scale (EPDS), to assess probable depression. Results. The prevalence of antenatal depression was 24.5%. There were significant associations between antenatal depression and attending public health facility (P = 0.000), young maternal age (P = 0.012), single marital status (P = 0.010), not having formal education (P = 0.022), large family size (P = 0.029), planned pregnancy (P = 0.014), coexisting medical conditions (P = 0.034), history of previous caesarian section (P = 0.032), drinking alcohol during pregnancy (P = 0.004), and gender based abuse (P = 0.001). On health seeking behaviour for antenatal depression among depressed pregnant women, most, 68.9%, consulted their husbands about their symptoms; 57.3% took the decision to get treatment from doctors, and 52% sought prayer in the church. Conclusion. Antenatal depression is prevalent in this study population. Interventions to address its risk factors should be carried out and physicians should suspect depression in pregnant women reporting alcohol use and gender abuse. PMID:27635258

  17. Prevalence of Antenatal Depression and Associated Risk Factors among Pregnant Women Attending Antenatal Clinics in Abeokuta North Local Government Area, Nigeria.

    Science.gov (United States)

    Thompson, Okechukwu; Ajayi, IkeOluwapo

    2016-01-01

    Objective. The prevalence of antenatal depression (AD) and associated risk factors among pregnant women attending antenatal clinics in Abeokuta North Local Government Area, Nigeria, was determined. Methods. A descriptive cross-sectional survey was conducted, interviewing 314 pregnant women selected by multistage sampling technique from among those attending antenatal clinics. Information was collected using structured questionnaire and a screening tool, Edinburgh Postnatal Depression Scale (EPDS), to assess probable depression. Results. The prevalence of antenatal depression was 24.5%. There were significant associations between antenatal depression and attending public health facility (P = 0.000), young maternal age (P = 0.012), single marital status (P = 0.010), not having formal education (P = 0.022), large family size (P = 0.029), planned pregnancy (P = 0.014), coexisting medical conditions (P = 0.034), history of previous caesarian section (P = 0.032), drinking alcohol during pregnancy (P = 0.004), and gender based abuse (P = 0.001). On health seeking behaviour for antenatal depression among depressed pregnant women, most, 68.9%, consulted their husbands about their symptoms; 57.3% took the decision to get treatment from doctors, and 52% sought prayer in the church. Conclusion. Antenatal depression is prevalent in this study population. Interventions to address its risk factors should be carried out and physicians should suspect depression in pregnant women reporting alcohol use and gender abuse.

  18. Differences in Characteristics and Treatment Received among Depressed Adolescent Psychiatric Outpatients with and without Co-Occuring Alcohol Misuse: A 1-Year Follow-Up Study

    Directory of Open Access Journals (Sweden)

    Tiia Pirkola

    2011-01-01

    Full Text Available Objectives. We aimed at examining the differences between depressed psychiatric adolescent outpatients with and without cooccurring alcohol misuse in psychosocial background, clinical characteristics, and treatment received during one-year followup. Furthermore, we investigated factors related to nonattendance at treatment. Materials and Methods. Consecutive 156 adolescent (13–19 years psychiatric outpatients with a unipolar depressive disorder at baseline were interviewed using structured measures at baseline and at 12 months. Alcohol misuse was defined as having an AUDIT score of 8 or more points. The outpatients received “treatment as usual” of clinically defined duration. Results. Among depressive outpatients, poor parental support, parental alcohol use and decreased attendance at treatment associated with alcohol misuse. The severity of alcohol use as measured by AUDIT-score was the strongest factor independently predicting nonattendance at treatment in multivariate analysis. Conclusions. Alcohol misuse indicates family problems, has a deleterious effect on treatment attendance, and should be taken into account when managing treatment for depressive adolescent outpatients.

  19. Nutritional status in children with chronic renal failure in outpatient pediatric nephrology clinic at the Hospital Universitario del Valle, Cali

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    Adela Isabel Herrera

    2009-12-01

    Full Text Available Introduction: Chronic renal disease (CRD can compromise nutritional status in children. Nutritional assessment should be performed in early stages of CRD in order to maintain growth, as well as to prevent malnutrition and to diminish progression of renal diseases and metabolic consequences of uremia. Objective: Evaluation of nutritional status of children with moderate CRD stages 2- 4 by means of anthropometry, biochemical profile and dietary survey by records of last three days. Methods: A descriptive observational study was performed to a total of 17 patients that attended to pediatric nephrology service at the Hospital Universitario del Valle, from December 2007 to March 2008. Results: Of the children 65% were males, mean age was 6.2 for males and 10.3 for females. Causes of CRD were reflux nephropathy in 41%. Malnutrition under-2 Standard Deviation for height and weight for the age was found in 30% of patients. The measurement of triceps fold, showed moderate undernourishment in 75% of the children. According to the biochemical data 5 patients (29% had serum albumin Conclusions: These results support that an early nutritional intervention, is essential in children with of CRD in early stages; nutritional deficiencies were found in early stages of disease. It is essential to consume 100% of calories and other nutrients to avoid growth deficit and other important alterations.

  20. Improvement in the clinical cure rate of outpatient management of pelvic inflammatory disease following a change in therapy

    OpenAIRE

    Piyadigamage, A; Wilson, J.

    2005-01-01

    Objective: In the United Kingdom many genitourinary medicine clinics use oral doxycycline and metronidazole to treat pelvic inflammatory disease (PID). A retrospective case note review of PID treatment at our department in 2000 showed that the clinical cure rate (CCR) was only 55% with oral doxycycline and metronidazole for 2 weeks. We therefore added ceftriaxone 250 mg intramuscularly to the doxycycline and metronidazole for treating PID. We have repeated the review and compared the results ...

  1. [Hi-tech center of outpatient care (To the 40th anniversary of the Branch N 6 of the Vishnevsky Central military clinical hospital N 3)].

    Science.gov (United States)

    Popov, A P

    2015-10-01

    The authors present the history of the branch N 6 of the Federal States Organization "the Vishnevsky Central Military Clinical Hospital N 3" of the Ministry of Defense of the Russian Federation, which dates back to November 1, 1974. Over the past years, organizational and staff structure; and the name of the clinic (45th central polyclinic, 45th central consultative-diagnostic polyclinic, 52nd Advisory Diagnostic Center of Defense) has repeatedly changed, but the core the work stays unchangeable--to continually improve patient care technology, to be the leader in the outpatient care for soldiers, reserve officers (retired), members of their families. The. branch consists of 58 medical and 19 specialized diagnostic departments, including 4 hospital departments, 1845 employee work at the branch. Among them 4 doctors of medical science and 43 candidates of medical sciences, 20 honoured physicians and 10 honoured health workers of republic. 70% of doctors and 93% of nurses have the highest qualification category. To health care in the Branch are more than 110 thousand people. PMID:26827510

  2. Intensive Behavioral Treatment of Urinary Incontinence of Children with Autism Spectrum Disorders: An Archival Analysis of Procedures and Outcomes from an Outpatient Clinic

    Science.gov (United States)

    Hanney, Nicole M.; Jostad, Candice M.; LeBlanc, Linda A.; Carr, James E.; Castile, Allison J.

    2013-01-01

    LeBlanc, Crossett, Bennett, Detweiler, and Carr (2005) described an outpatient model for conducting intensive toilet training with young children with autism using a modified Azrin and Foxx, protocol. In this article, we summarize the use of the protocol in an outpatient setting and the outcomes achieved with a large sample of children with autism…

  3. The Maudsley Outpatient Study of Treatments for Anorexia Nervosa and Related Conditions (MOSAIC):Comparison of the Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA) With Specialist Supportive Clinical Management (SSCM) in Outpatients With Broadly Defined Anorexia Nervosa: A Randomized Controlled Trial

    OpenAIRE

    Schmidt, Ulrike; Magill, Nicholas; Renwick, Bethany; Keyes, Alexandra; Kenyon, Martha; DeJong, Hannah; Lose, Anna; Broadbent, Hannah; Loomes, Rachel; Yasin, Huma; Watson, Charlotte; Ghelani, Shreena; Bonin, Eva-Maria; Serpell, Lucy; Richards, Lorna

    2015-01-01

    OBJECTIVE: Anorexia nervosa (AN) in adults has poor outcomes, and treatment evidence is limited. This study evaluated the efficacy and acceptability of a novel, targeted psychological therapy for AN (Maudsley Model of Anorexia Nervosa Treatment for Adults; MANTRA) compared with Specialist Supportive Clinical Management (SSCM).METHOD: One hundred forty-two outpatients with broadly defined AN (body mass index [BMI] ≤ 18.5 kg/m2) were randomly allocated to receive 20 to 30 weekly sessions (depen...

  4. Children's Views Matter Too! A Pilot Project Assessing Children's and Adolescents' Experiences of Clinical Psychology Services

    Science.gov (United States)

    Gordon, Michael; Russo, Kate

    2009-01-01

    This pilot study explored the experiences and understanding of clinical psychology practices and services of children and adolescents attending clinical psychology outpatient appointments. Fifteen young participants took part in the study. A content analysis indicated that young children and adolescents have an appropriate understanding of the…

  5. Specialist Nurse-Led Intervention in Outpatients with Congestive Heart Failure: Impact on Clinical and Economic Outcomes

    OpenAIRE

    Palmer, Nicholas D.; Barbara Appleton; Erwin A. Rodrigues

    2003-01-01

    Congestive heart failure (CHF) encompasses a spectrum of clinical syndromes and presentations. It affects 1-2% of the population in the UK and is associated with significant mortality which is comparable to most cancers. It accounts for more than 5% of adult medical admissions in the UK, with significant annual re-admission rates. Improved understanding of the pathophysiology of CHF has resulted in significant advancements in CHF management. Current pharmacologic agents, such as ACE inhibitor...

  6. Evaluation of pathologic and clinical findings of 366 outpatients and inpatients of Razi Hospital for 8.5 tears

    Directory of Open Access Journals (Sweden)

    Naraghie ZS

    1997-04-01

    Full Text Available Mycosis fungoides is virtually a kind of cutaneous T cell lymphoma. The wide spectrum of clinical, and histopathologial features of MF accessitated performing an exact study on it. During a retrospective survey, clinical findings of 115 in-patients and histopathological finding of 366 ontpatients and inpatients of MF in an 8½ years period were studies with special attention to the pathological Aspects: Males were affected more than females. Their ages ranges from 11-88 years. The most common symptom and sign were pruritus and scaling, respectively. The first involved areas in male were the limbs and females was the trunk. The role of environmental and occupational factors in pathogenesis deserves greater contemplation. There were four distinct histopathological pattern in the epidermis: 1 without significant changes, 2 hyperplasia, 3 poikilodermatosus and 4 pagetoid patten. Epidrmotropism with or without associated pauntrier's microabscesses and halo cells was noted in the majority of cases (233 patients. The inflammatory infiltrate with predominence of atypical lymphocytes and also fibrosis, edema and occasional grenz-zone were the prominent finding of papillary dermis. The major finding of hypodermis was septal panniculitis. In conclusion integrated correlation between clinical and wide spectrum pathologic features of M.F could be a gnide to early diagnosis and appropriate mangement.

  7. Pulmonary tuberculosis among women with cough attending clinics for family planning and maternal and child health in Dar Es Salaam, Tanzania

    Directory of Open Access Journals (Sweden)

    Wandwalo Eliud R

    2009-08-01

    Full Text Available Abstract Background Tuberculosis (TB case detection in women has remained low in developing world. This study was conducted to determine the proportion of smear positive TB among women with cough regardless of the duration attending family Planning (FP and Maternal and child health (MCH clinics in Dar es Salaam. Methods We conducted a cross sectional study in all three municipal hospitals of Dar es Salaam, between October 2007 and June 2008. All women with cough attending FP and MCH clinics were screened for TB by smear microscopy. Pearson chi-square was used to compare group difference for categorical variables. Risk factors for smear positive were estimated by logistics regression with 95% confidence intervals (CI given for odds ratios indicating statistically significant relationship if the CI did not include one. Results We enrolled a total of 749 TB suspects. Five hundred and twenty nine patients (70.6% were from MCH clinics. Mean (SD age was 27.6 (5.2 years. A total of 616 (82.2% patients were coughing for less than two weeks as compared to 133 (17.8%, who coughed for two or more weeks. Among 616 TB suspects, 14 (2.3% were smear positive TB patients, and of the 133 who had coughed for two or more weeks, 13 (9.8% were smear positive TB patients. Risk factors associated with smear positive results were having attended more than one visit to any facility prior to diagnosis (OR = 6.8; 95%CI 2.57–18.0 and having HIV/AIDS (OR = 4.4; 95%CI 1.65–11.96. Long duration of cough was not a risk factor for being smear positive (OR = 1.6; 95%CI 0.59–4.49. Conclusion The proportion of smear positive TB patients among women with cough attending MCH and FP was 3.8%. Visits to any health facility prior to Diagnosis and HIV infection were risk for having a smear positive TB.

  8. Indicators of adherence to physiotherapy attendance among Saudi female patients with mechanical low back pain: a clinical audit

    Directory of Open Access Journals (Sweden)

    Al-Eisa Einas

    2010-06-01

    Full Text Available Abstract Background Among current musculoskeletal interventions used to treat low back pain (LBP, physiotherapy exercise has the highest evidence of effectiveness in avoiding recurrence and chronic disability. However, effectiveness of physiotherapy is thought to be directly related to the patients' adherence to physiotherapy. Since adherence is reported to be directly influenced by socio-cultural factors, this study was conducted to investigate factors related to patients' adherence in a group of Saudi female patients with LBP. Methods A retrospective chart review was conducted on female LBP patients referred to the department of physiotherapy at a local tertiary hospital over a 12 month period. A total of 98 charts were reviewed. Two physiotherapists specialized in musculoskeletal rehabilitation collected information from the medical files. Data were classified in three categories: patients' personal demographics, patients' medical condition and history, and type of physiotherapy administered. Contingency tables and chi-square test were computed to test for differences in proportions. Spearman rank correlation coefficient was calculated to examine relationships among variables. Results Subjects who attended their scheduled appointments were classified as adherent (40%, and those who failed to attend 2 consecutive scheduled appointments and got discharged were classified as non-adherent (60%. Factors that significantly correlated with adherence included: age (r = 0.7, p Conclusion This study reveals an alarming level of non-adherence to physiotherapy among patients with LBP. It remains unclear as to what level of adherence is required to achieve beneficial effect of treatment. It is quite evident however, that early withdrawal from treatment would not allow the therapeutic benefits of the treatment to be realized. Future research should be directed toward developing strategies to improve adherence.

  9. Variables associated with health-related quality of life in a Brazilian sample of patients from a tertiary outpatient clinic for depression and anxiety disorders

    Directory of Open Access Journals (Sweden)

    Bianca Schwab

    2015-12-01

    Full Text Available Introduction: Health-related quality of life (HRQOL assessment tools have been broadly used in the medical context. These tools are used to measure the subjective impact of the disease on patients. The objective of this study was to evaluate the variables associated with HRQOL in a Brazilian sample of patients followed up in a tertiary outpatient clinic for depression and anxiety disorders. Method: Cross-sectional study. Independent variables were those included in a sociodemographic questionnaire and the Hospital Anxiety and Depression Scale (HADS scores. Dependent variables were those included in the short version of the World Health Organization Quality of Life (WHOQOL-BREF and the scores for its subdomains (overall quality of life and general health, physical health, psychological health, social relationships, and environment. A multiple linear regression analysis was used to find the variables independently associated with each outcome. Results: Seventy-five adult patients were evaluated. After multiple linear regression analysis, the HADS scores were associated with all outcomes, except social relationships (p = 0.08. Female gender was associated with poor total scores, as well as psychological health and environment. Unemployment was associated with poor physical health. Conclusion: Identifying the factors associated with HRQOL and recognizing that depression and anxiety are major factors are essential to improve the care of patients.

  10. Human toxocariasis: frequency of anti-Toxocara antibodies in children and adolescents from an outpatient clinic for lymphatic filariasis in Recife, Northeast Brazil

    Directory of Open Access Journals (Sweden)

    Aguiar-Santos Ana Maria

    2004-01-01

    Full Text Available In a transversal study on a sample of 386 children and adolescents from an outpatient clinic for filariasis in Recife, Northeast Brazil, the frequency of anti-Toxocara antibodies and its relation to age, gender, number of peripheral eosinophils, Wuchereria bancrofti microfilariae and intestinal helminths was determined. The total anti-Toxocara IgG antibody frequency was 39.4%, by ELISA technique. The difference in frequency between males (40.1% and females (37.6% was not statistically significant. The 6 to 10-year-old subset presented the highest frequency of anti-Toxocara antibodies (60%, and within this age group there was a statistically significant male bias. There was also a significant association between the number of eosinophils and the presence of anti-Toxocara antibodies. Intestinal parasite frequency was 52.1%, but no association was found between this data and the presence of anti-Toxocara antibodies. In the present sample, 42.2% of the patients were Wuchereria bancrofti carriers, however, again this was not associated with the presence of anti-Toxocara antibodies. In conclusion, anti-Toxocara antibodies were highly prevalent in this sample. The present data show that there is no cross correlation between anti-Toxocara IgG antibody and the presence of intestinal helminths and filariasis.

  11. Power is only skin deep: an institutional ethnography of nurse-driven outpatient psoriasis treatment in the era of clinic web sites.

    Science.gov (United States)

    Winkelman, Warren J; Halifax, Nancy V Davis

    2007-04-01

    We present an institutional ethnography of hospital-based psoriasis day treatment in the context of evaluating readiness to supplement services and support with a new web site. Through observation, interviews and a critical consideration of documents, forms and other textually-mediated discourses in the day-to-day work of nurses and physicians, we come to understand how the historical gender-determined power structure of nurses and physicians impacts nurses' work. On the one hand, nurses' work can have certain social benefits that would usually be considered untenable in traditional healthcare: nurses as primary decision-makers, nurses as experts in the treatment of disease, physicians as secondary consultants, and patients as co-facilitators in care delivery processes. However, benefits seem to have come at the nurses' expense, as they are required to maintain a cloak of invisibility for themselves and for their workplace, so that the Centre appears like all other outpatient clinics, and the nurses do not enjoy appropriate economic recognition. Implications for this negotiated invisibility on the implementation of new information systems in healthcare are discussed.

  12. Kinship and Leprosy in the Contacts of Leprosy Patients: Cohort at the Souza Araújo Outpatient Clinic, Rio de Janeiro, RJ, 1987–2010

    Directory of Open Access Journals (Sweden)

    Daiane Santos dos Santos

    2013-01-01

    Full Text Available A broad variety of factors have been associated with leprosy among contacts, including socioeconomic, epidemiological, and genetic characteristics. Data from 7,174 contacts of leprosy patients from a leprosy outpatient clinic in Rio de Janeiro, Brazil, 1987–2010, were analyzed to investigate the effects of kinship, individual, and contextual factors on leprosy. Multivariate analyses were performed using a robust estimation method. In the prevalence analysis, close kinship (sibling OR = 2.75, offspring OR = 2.00, and other relatives OR = 1.70, socioeconomic factors, and the duration of exposure to the bacillus were associated to leprosy. In the incidence analysis, significant risks were found for all categories of kinship (parents RR = 10.93, spouse, boyfriend/girlfriend, and bride/groom RR = 7.53, sibling RR = 7.03, offspring RR = 5.34, and other relatives RR = 3.71. Once the treatment of the index case was initiated, other factors lost their significance, and the index case bacteriological index and BCG (Bacillus Calmette-Guérin vaccine protection had a greater impact. Our findings suggested that both genetic susceptibility and physical exposure play an important role in the epidemiology of leprosy, but it was not possible establishing the role of genetic factor. Analyses of other factors related to the genotype of individuals, such as genetic polymorphisms, are needed.

  13. Nurses in the provision of outpatient care for women with malignant fungating wounds in the breasts

    Directory of Open Access Journals (Sweden)

    Flávia Firmino

    2014-06-01

    Full Text Available This study aimed to analyze accounts of nurses who undertake the dressing of fungating wounds of women with breast cancer, and to outline contributions to the nursing care. This is qualitative research, carried out in November 2010 with interviews and thematic analysis involving five nurses from the outpatient department of a public hospital in the city of Rio de Janeiro, specializing in the treatment of breast cancer. Categories were elaborated corresponding to the practice of outpatient nursing; the cancer wound; and, indications for the nursing care. It is concluded that there is a need for specific knowledge in the area of oncology nursing, professional involvement, technical skill and autonomy, the forming of a therapeutic group, clinical attendance interfacing with the palliative approach, and collaborative work as a team.

  14. Developing public health clinical decision support systems (CDSS for the outpatient community in New York City: our experience

    Directory of Open Access Journals (Sweden)

    Singer Jesse

    2011-09-01

    Full Text Available Abstract Background Developing a clinically relevant set of quality measures that can be effectively used by an electronic health record (EHR is difficult. Whether it is achieving internal consensus on relevant priority quality measures, communicating to EHR vendors' whose programmers generally lack clinical contextual knowledge, or encouraging implementation of EHR that meaningfully impacts health outcomes, the path is challenging. However, greater transparency of population health, better accountability, and ultimately improved health outcomes is the goal and EHRs afford us a realistic chance of reaching it in a scalable way. Method In this article, we summarize our experience as a public health government agency with developing measures for a public health oriented EHR in New York City in partnership with a commercial EHR vendor. Results From our experience, there are six key lessons that we share in this article that we believe will dramatically increase the chance of success. First, define the scope and build consensus. Second, get support from executive leadership. Third, find an enthusiastic and competent software partner. Fourth, implement a transparent operational strategy. Fifth, create and test the EHR system with real life scenarios. Last, seek help when you need it. Conclusions Despite the challenges, we encourage public health agencies looking to build a similarly focused public health EHR to create one both for improved individual patient as well as the larger population health.

  15. Longer Weekly Sleep Duration Predicts Greater 3-Month BMI Reduction among Obese Adolescents Attending a Clinical Multidisciplinary Weight Management Program

    Directory of Open Access Journals (Sweden)

    Bethany J. Sallinen

    2013-05-01

    Full Text Available Aims: To determine whether baseline levels of self-reported sleep and sleep problems among obese adolescents referred to an outpatient multidisciplinary family-based weight management program predict reduction in BMI 3 months later. Methods: A retrospective medical chart review was conducted for 83 obese adolescents. The following baseline variables were extracted: self-reported sleep duration (weekdays and weekends, and presence of snoring, daytime fatigue, suspected sleep apnea, and physician-diagnosed sleep apnea. Anthropometric data at baseline and 3 months were also collected. Results: On average, adolescents reported significantly less sleeping on weeknights (7.7 ± 1.3 h compared to weekend nights (10.0 ± 1.8 h, t(82 = 10.5, p = 0.0001. Reduction in BMI after 3 months of treatment was predicted by more weekly sleep at baseline (R2 = 0.113, F(1, 80 = 10.2, p = 0.002. Adolescents who reduced their BMI by ≥1 kg/m2 reported greater weekly sleep at baseline compared to adolescents who experienced 2 reduction (60.7 ± 7.5 h vs. 56.4 ± 8.6 h; F(1, 80 = 5.7, p = 0.02. Conclusion: Findings from this study, though correlational, raise the possibility that increased duration of sleep may be associated with weight loss among obese adolescents enrolled in a weight management program. Evidence-based behavioral techniques to improve sleep hygiene and increase sleep duration should be explored in pediatric weight management settings.

  16. Health-related quality of life in patients with knee osteoarthritis attending two primary care clinics in Malaysia: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Zakaria Zainal F

    2009-12-01

    Full Text Available Abstract Background Measurement of health-related quality of life (HRQOL among patients with osteoarthritis (OA helps the health care provider to understand the impact of the disease in the patients' own perspective and make health services more patient-centered. The main aim of this study was to measure the quality of life among patients with symptomatic knee OA attending primary care clinic. We also aimed to ascertain the association between socio-demographic and medical status of patients with knee OA and their quality of life. Methods A clinic based, cross sectional study using the Short Form-36 (SF-36 questionnaire was conducted in two primary care health clinics in Hulu Langat, Selangor, Malaysia over a period of 8 months. The nurses and medical assistants were involved in recruiting the patients while the family physicians conducted the interview. Results A total 151 respondents were recruited. The mean age was 65.6 ± 10.8 years with females constituted 119 (78.8% of the patients. The mean duration of knee pain was 4.07 ± 2.96 years. Half of the patients were overweight and majority, 138 (91.4%, had at least one co-morbidity, the commonest being hypertension. The physical health status showed lower score as compared to mental health component. The domain concerning mental health components showed positive correlation with age. There was a significant negative correlation between age and physical functioning (p Conclusions This study has shown that patients with knee OA attending primary care clinics have relatively poor quality of life pertaining to the physical health components but less impact was seen on the patients' mental health.

  17. Effects on cognitive and clinical insight with the use of Guided Self-Determination in outpatients with schizophrenia: A randomized open trial.

    Science.gov (United States)

    Jørgensen, R; Licht, R W; Lysaker, P H; Munk-Jørgensen, P; Buck, K D; Jensen, S O W; Hansson, L; Zoffmann, V

    2015-07-01

    Poor insight has a negative impact on the outcome in schizophrenia; consequently, poor insight is a logical target for treatment. However, neither medication nor psychosocial interventions have been demonstrated to improve poor insight. A method originally designed for diabetes patients to improve their illness management, Guided Self-Determination (GSD), has been adapted for use in patients with schizophrenia (GSD-SZ). The purpose of this study was to investigate the effect on insight of GSD-SZ as a supplement to treatment as usual (TAU) as compared to TAU alone in outpatients diagnosed with schizophrenia. The design was an open randomized trial. The primary hypothesis was cognitive insight would improve in those patients who received GSD-SZ+TAU as assessed by the BCIS. We additionally explored whether the intervention led to changes in clinical insight, self-perceived recovery, self-esteem, social functioning and symptom severity. Assessments were conducted at baseline, and at 3-, 6- and 12-month follow-up. Analysis was based on the principles of intention to treat and potential confounders were taken into account through applying a multivariate approach. A total of 101 participants were randomized to GSD-SZ+TAU (n=50) or to TAU alone (n=51). No statistically significant differences were found on the cognitive insight. However, at 12-month follow-up, clinical insight (measured by G12 from the Positive and Negative Syndrome Scale), symptom severity, and social functioning had statistically significantly improved in the intervention group as compared to the control group. "Improving insight in patients diagnosed with schizophrenia", NCT01282307, http://clinicaltrials.gov/. PMID:25601635

  18. EFFICACY AND SAFETY OF SINUS RHYTHM RESTORATION WITH AMIODARONE AND PROPAFENONE IN OUTPATIENTS, ECONOMIC ASPECTS (BASED ON DATA OF N.A. SEMASHKO NORTHERN MEDICAL CLINICAL CENTER

    Directory of Open Access Journals (Sweden)

    T. A. Istomina

    2016-01-01

    Full Text Available Aim. To study efficacy and safey of sinus rhythm restoration with amiodarone and propafenone in outpatients with recurrent atrial fibrillation (AF, and to estimate pharmacoeconomic efficiency of such cardioversion in comparison with hospital treatment.Material and methods. Patients (n=199; aged 59.2±1.36 with paroxysmal (73.9% or persistent (26.1% AF were included into the multicenter prospective study. Follow-up period was 13.14 months (min 1 month, max 36 months. Patients with arrhythmia relapse <48 h received outpatient cardioversion with amiodarone or propafenone orally. Daily outpatient examination, including ECG and blood pressure monitoring every 30-60 min, was carried out to evaluate efficacy of cardioversion and hemodynamics. Phone contact with patients was available. Patients with unstable hemodynamics received cardioversion in hospital. Patients received propafenone in cumulative dose of 600 mg (150-300 mg every hour, and amiodarone 600-800 mg daily. The cost/effectiveness ratio (CER was estimated. This ratio shows the cost of one unit of effect.Results. Outpatient cardioversion with amiodarone was started 24 h earlier (p=0.029 and with propafenone — 4.5 h earlier (p=0.002 than that in hospital. The average dose of amiodarone in ambulatory cardioversion was 1.3 times less (713.7±84,62 mg, p=0.345 than that in hospital cardioversion. Outpatient treatment with amiodarone restored sinus rhythm 8.7 h earlier, and with propafenone - 3.5 h earlier than the same treatments in hospital. Efficiency of hospital cardioversion with amiodarone was 70%, with propafenone - 80%, and efficiency of outpatient cardioversion — 96,1% and 98,4%, respectively. Outpatient treatment did not cause any severe side effects. Expenses for outpatient cardioversion made up 143 724.25 rubles, and for hospital cardioversion — 92 870.47 rubles. Average treatment costs for one patient in hospital was 6 times greater than for an outpatient. Outpatient

  19. Impact of outpatient clinic ultrasound imaging in the diagnosis and treatment for shoulder impingement: a randomized prospective study.

    LENUS (Irish Health Repository)

    Saeed, Aamir

    2013-11-05

    The use of musculoskeletal ultrasonography (MSUS) in guiding subdeltoid injection has been shown to improve outcome up to 6 weeks in a few small studies. A recent meta-analysis identified the need for further studies with longer-term outcome and larger sample size. This randomized prospective study assessed whether clinic-based MSUS can significantly improve diagnostic accuracy in shoulder pain and whether MSUS-guided shoulder injection results in improved long-term outcomes. One hundred consecutive patients with 125 painful shoulders were recruited. Patients were randomized to receive either sonographic assessment with consequent palpation-guided injection (Group 1, n = 66) or sonographic assessment with a MSUS-guided injection of 40 mg of methylprednisolone acetate (Group 2, n = 59). A blinded rheumatologist (ADF) performed clinical assessments at baseline, 6 and 12 weeks including shoulder function tests (SFTs) (Hawkins-Kennedy test, supraspinatus tendon tenderness), physician global assessment (PGA) and patient visual analogue scores (VAS) for pain (0-10). Eighty patients with 90 symptomatic shoulders completed 12-week follow-up. Twenty patients, 11 (20 shoulders) from the palpation-guided group and 9 (15 shoulders) from the MSUS-guided group, were excluded at 6 weeks either due to requirement for repeat injection or due to surgical referral. Mean age for patients was 57.7 years, and 65 % patients were female; mean shoulder pain duration was 18 weeks (range 14-22 weeks). SFTs, patient VAS and PGA scores for pain improved significantly from baseline in both groups with significantly greater improvements in the MSUS-guided group (44 shoulders) compared to the palpation-guided group (46 shoulders) in all parameters at 6 (p < 0.01) and 12 weeks (p < 0.05). The use of MSUS in guiding subdeltoid injection has been shown to improve outcome up to 6 weeks in a few small studies. A recent meta-analysis identified the need for further studies with longer

  20. Retention in Early Care at an HIV Outpatient Clinic in Rio de Janeiro, Brazil, 2000-2013.

    Science.gov (United States)

    Silva, Daniel S; De Boni, Raquel B; Lake, Jordan E; Cardoso, Sandra W; Ribeiro, Sayonara; Moreira, Ronaldo I; Clark, Jesse L; Veloso, Valdilea G; Grinsztejn, Beatriz; Luz, Paula M

    2016-05-01

    Retention in early HIV care has been associated with virologic suppression and improved survival, but remains understudied in Brazil. We estimated retention in early HIV care for the period 2000-2013, and identified socio-demographic and clinical factors associated with good retention in an urban cohort from Rio de Janeiro, Brazil. Antiretroviral therapy-naïve, HIV-infected persons ≥18 years old linked to care between 2000 and 2011 were included. Retention in the first 2 years post-linkage (i.e. early care) was defined by the proportion of 6-month intervals with ≥1 HIV laboratory result. "Good" retention was defined as ≥1 HIV laboratory result recorded in at least three intervals. Overall, 80 % of participants met criteria for good retention and retention significantly improved over the study period. Older age, higher education level and early antiretroviral therapy initiation were associated with good retention. Efforts to improve retention in early care in this population should target younger and less-educated HIV-infected persons.

  1. Sero-prevalence of Toxoplasma gondii infection among pregnant women attending antenatal clinics in Khartoum and Omdurman Maternity Hospitals, Sudan

    Institute of Scientific and Technical Information of China (English)

    Musa Abdel-Raouff; Mohamed Mobarak Elbasheir

    2014-01-01

    Objective:To determine the sero-prevalence of Toxoplasma gondii (T. gondii) infection among pregnant Sudanese women. Methods:One hundred and sixty three pregnant women attending antenatal care in Omdurman Maternity Hospitals, Khartoum, Sudan during June to August in 2013 were enrolled and screened for immunoglobulin G (IgG) and IgM antitoxoplasma antibodies using enzyme linked immunosorbent assay technique. Results:Among 163 pregnant women, 33 (20.2%) were positive for (IgG) antitoxoplasma antibodies, while 130 (79.8%) were seronegative. None of the examined women had IgM antitoxoplasma antibodies. The highest rate of infection (26.7%) was detected among women aged 21-29 years. No statistically significant relation was observed between T. gondii sero-prevalence and the other variable of risk factors studied. Conclusions: Over 79% Sudanese women screened for antitoxoplasma IgG antibodies were seronegative and they were at risk of seroconversion during pregnancy. Moreover, the study showed that screening of T. gondii infections during antenatal care should be considered in Khartoum state as the main strategy to minimize congenital toxoplasmosis.

  2. Effects of structured written feedback by cards on medical students’ performance at mini clinical evaluation exercise (Mini-CEX) in an outpatient clinic

    OpenAIRE

    FARIBA HAGHANI; MOHAMMAD HATEF KHORAMI; MOHAMMAD FAKHARI

    2016-01-01

    Introduction: Feedback cards are recommended as a feasible tool for structured written feedback delivery in clinical education while effectiveness of this tool on the medical students’ performance is still questionable. The purpose of this study was to compare the effects of structured written feedback by cards as well as verbal feedback versus verbal feedback alone on the clinical performance of medical students at the Mini Clinical Evaluation Exercise (Mini-CEX) test in...

  3. The causal representation of outpatients with Crohn's disease: is there a link between psychological distress and clinical disease activity?

    Science.gov (United States)

    Banovic, Ingrid; Gilibert, Daniel; Andronikof, Anne; Jebrane, Ahmed; Ajdukovic, Ivan; Cosnes, Jaques

    2013-01-01

    Zielsetzung: Aufgrund des fluktuierenden Charakters des Morbus Crohn (Crohn’s disease, (CD)) müssen Patienten mit der Veränderlichkeit ihres Gesundheitszustandes zurechtkommen. Die wahrgenommene, persönliche Kontrollierbarkeit ist ein wichtiges Element der Anpassungsfähigkeit an die Herausforderungen des Krankheitsbildes. In dieser Arbeit wird untersucht, ob wahrgenommene Kontrolle als Prädiktor klinischer Aktivität der Krankheit und psychologischer Belastung (Depression, Angst) angesehen werden kann.Methode: Der HADS (Hospital Anxiety Depression Scale), die Kausale Dimensonsskala und der CGI (Clinical Global Impression, Einschätzung der wahrgenommenen Schwere) wurden an 160 CD-Patienten erhoben. Entzündungsindikatoren (CRP), Krankheitsdauer und klinische Aktivität der Krankheit wurden ebenfalls erhoben.Ergebnisse: Insgesamt scheinen die Patienten ihre Krankheit weder als persönlich ausgeprägt kontrollierbar noch unkontrollierbar zu empfinden. Während die psychologische Belastung bei klinisch aktivem Symptombild höher ist, erweist sich die Beziehung zwischen den Variablen als komplex. Das Gefühl persönlicher Kontrolle weist einen Zusammenhang zu der klinischen Aktivität der Krankkheit auf (p=0,0001), wie auch die Wahrnehmung der Stabilität der CD (p<0,0001) und die Globalität des Einflusses der Krankheit auf das Leben (p=0,001). Ungeachtet dessen zeigte sich die wahrgenommene persönliche Kontrolle nicht als prädiktiv für den Aktivitätsstatus der Krankheit. Schließlich zeigte sich ein Zusammenhang psychologischer Belastung mit der Wahrnehmung der Kontrollierbarkeit der Krankheit durch das medizinische Team (p=0,00001) und der Globalität der Krankheitsfolgen für das Leben (p<0,005)Schlussfolgerung: Psychologische Behandlungen sollten diese Dimensionen berücksichtigen, um das Wohlbefinden und die Gesundheit der Patienten zu verbessern.

  4. Loss to follow-up in anti-HCV-positive patients in a Brazilian regional outpatient clinic

    Science.gov (United States)

    Mendes, L.C.; Ralla, S.M.; Vigani, A.G.

    2016-01-01

    Loss to follow-up (LF), which refers to patients who started care but voluntary stopped it, is a problem for patients with chronic disease. We aimed to estimate the rate of LF among patients seropositive for hepatitis C virus (HCV) and identify possible demographic and lifestyle risk factors associated with LF. From January 2009 through December 2012, 1010 anti-HCV-positive patients were included in the study. Among participants, 223 (22.1%) met the case definition for LF (more than 1-year elapsed since the last clinical appointment). Among 787 patients who remained in follow-up, 372 (47.2%) were discharged after undetectable HCV RNA, 88 (11.1%) were transferred (and remained on regular follow-up at the destination), and 25 (3.1%) died. According to univariate analysis, male gender, absence of a life partner, black race, psychiatric illness, previous alcohol abuse, previous or current recreational drug use, and previous or current smoking were significantly associated with LF. In multivariate analysis, absence of a life partner (adjusted odds ratio (AOR)=1.44; 95% confidence interval (95%CI)=1.03–2.02), black race (AOR=1.81, 95%CI=1.12–2.89), psychiatric illness (AOR=1.77, 95%CI=1.14–2.73), and the presence of at least one lifestyle risk factor (pertaining to substance abuse) (AOR=1.95, 95%CI=1.29–2.94) were independently associated with LF. Our study provides an estimate of the incidence of LF among anti-HCV-positive patients and identifies risk factors associated with this outcome. In addition, these results can help clinicians recognize patients at risk for LF, who require additional support for the continuity of care. PMID:27580006

  5. ART treatment costs and retention in care in Kenya: a cohort study in three rural outpatient clinics

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    Bruce A Larson

    2013-01-01

    Full Text Available Introduction: After almost 10 years of PEPFAR funding for antiretroviral therapy (ART treatment programmes in Kenya, little is known about the cost of care provided to HIV-positive patients receiving ART. With some 430,000 ART patients, understanding and managing costs is essential to treatment programme sustainability. Methods: Using patient-level data from medical records (n=120/site, we estimated the cost of providing ART at three treatment sites in the Rift Valley Province of Kenya (a clinic at a government hospital, a hospital run by a large agricultural company and a mission hospital. Costs included ARV and non-ARV drugs, laboratory tests, salaries to personnel providing patient care, and infrastructure and other fixed costs. We report the average cost per patient during the first 12 months after ART initiation, stratified by site, and the average cost per patient achieving the primary outcome, retention in care 12 months after treatment initiation. Results: The cost per patient initiated on ART was $206, $252 and $213 at Sites 1, 2 and 3, respectively. The proportion of patients remaining in care at 12 months was similar across all sites (0.82, 0.80 and 0.84. Average costs for the subset of patients who remained in care at 12 months was also similar (Site 1, $229; Site 2, $287; Site 3, $237. Patients not retained in care cost substantially less (Site 1, $104; Site 2, $113; Site 3, $88. For the subset of patients who remained in care at 12 months, ART medications accounted for 51%, 44% and 50% of the costs, with the remaining costs split between non-ART medications (15%, 11%, 10%, laboratory tests (14%, 15%, 15%, salaries to personnel providing patient care (9%, 11%, 12% and fixed costs (11%, 18%, 13%. Conclusions: At all three sites, 12-month retention in care compared favourably to retention rates reported in the literature from other low-income African countries. The cost of providing treatment was very low, averaging $224 in the first

  6. Multisource feedback analysis of pediatric outpatient teaching

    OpenAIRE

    Tiao, Mao-Meng; Huang, Li-Tung; Huang, Ying-Hsien; Tang, Kuo-Shu; Chen, Chih-Jen

    2013-01-01

    Background This study aims to evaluate the outpatient communication skills of medical students via multisource feedback, which may be useful to map future directions in improving physician-patient communication. Methods Family respondents of patients, a nurse, a clinical teacher, and a research assistant evaluated video-recorded medical students’ interactions with outpatients by using multisource feedback questionnaires; students also assessed their own skills. The questionnaire was answered ...

  7. Healthcare in the New Vietnam: comparing patients' satisfaction with outpatient care in a traditional neighborhood clinic and a new, western-style clinic in Ho Chi Minh City.

    Science.gov (United States)

    Tat, Sonny; Barr, Donald

    2006-03-01

    As Vietnam opens its economy to privatization, its system of healthcare will face a series of crucial tests. Vietnam's system of private healthcare--once comprised only of individual physicians holding clinic hours in their homes--has come to also include larger customer-oriented clinics based on an American business model. As the two models compete in the expanding private market, it becomes increasingly important to understand patients' perceptions of the alternative models of care. This study reports on interviews with 194 patients in two different types of private-sector clinics in Vietnam: a western-style clinic and a traditional style, after-hours clinic. In bivariate and multivariate analyses, we found that patients at the western style clinic reported both higher expectations of the facility and higher satisfaction with many aspects of care than patients at the after-hours clinic. These different perceptions appear to be based on the interpersonal manner of the physician seen and the clinic's delivery methods rather than perceptions of the physician's technical skill and method of treatment. These findings were unaffected by the ethnicity of physician seen. These findings suggest that patients in Vietnam recognize and prefer more customer-oriented care and amenities, regardless of physician ethnicity and perceive no significant differences in technical skill between the private delivery models. PMID:16162387

  8. Can the Theory of Planned Behavior predict dietary intention and future dieting in an ethnically diverse sample of overweight and obese veterans attending medical clinics?

    Science.gov (United States)

    Lash, Denise N; Smith, Jane Ellen; Rinehart, Jenny K

    2016-04-01

    Obesity has become a world-wide epidemic; in the United States (U.S.) approximately two-thirds of adults are classified as overweight or obese. Military veterans' numbers are even higher, with 77% of retired or discharged U.S. veterans falling in these weight categories. One of the most common methods of changing one's weight is through dieting, yet little is known regarding the factors that facilitate successful dieting behavior. The current investigation tested the Theory of Planned Behavior's (TPB) ability to predict dietary intention and future dieting in a sample of 84 overweight and obese patients attending medical clinics at a Veterans Affairs Hospital in the southwestern part of the U.S. Participants primarily were male (92%) and ethnic/racial minorities (58%). Perceived need and anticipated regret were added to the standard TPB model. While the TPB predicted dietary intention, it did not significantly account for improved dietary behaviors. Anticipated regret significantly enhanced the basic TPB's ability to predict intention to diet, while perceived need did not. These findings highlight the difficulty in predicting sustained change in a complex behavior such as dieting to lose weight. The need for more work with older, overweight/obese medical patients attending veterans' facilities is stressed, as is the need for such work with male patients and ethnic minorities in particular. PMID:26792774

  9. Assessment of Response to Providing Health-related Information in a Community Psychiatry Outpatient Setting.

    Science.gov (United States)

    Pawar, Deepa; Mojtabai, Ramin; Goldman, Aviva; Batkis, Donna; Malloy, Kathleen; Cullen, Bernadette

    2016-07-01

    The objective of this study was to assess the subjective responses of patient and staff to the provision of health-related information in an outpatient psychiatric clinic. Simple educational information on healthy eating, exercising, and smoking cessation was provided in the waiting area of a clinic over the course of a year. This information took the form of educational handouts, educational DVDs, and monthly "special events" such as a poster competition for smoking cessation. In addition, patients were given an opportunity to attend free nutritional counseling sessions. Also, when needed, staff assisted patients in making appointments with primary care physicians. At the end of the year, a survey was distributed to patients and staff to assess the perceived benefits of the initiative. The majority of the 79 patients who completed the survey (n=60, 76%) had used the information provided, 95% of whom (n=57) had made some behavioral change, with 13% of the total survey respondents indicating that they had quit smoking. Ninety percent of the surveyed providers (18/20) felt that the initiative had had a positive impact on their patients. These results suggest that simple, low cost health and wellness initiatives in conjunction with an enthusiastic expenditure of a relatively small amount of staff time have the potential to have a positive impact on individuals attending an outpatient psychiatric clinic. PMID:27427848

  10. Perfil de sujeitos de pesquisa clínica em um centro ambulatorial independente Profile of clinical research subjects in an independent outpatient center

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    Paulo Gustavo Sampaio Lacativa

    2008-06-01

    Full Text Available Este artigo tem como objetivos avaliar a qualidade de atendimento de um centro de pesquisa clínica e o entendimento do termo de consentimento informado (TCLE; determinar os motivos da participação e detalhar níveis socioeconômicos. Foi feito um estudo transversal em centro de pesquisa ambulatorial, através de questionário auto-explicativo. Dos cem questionários avaliados, todos os sujeitos de pesquisa consideraram o centro como ótimo (86% ou bom (9%. A quase totalidade foi bem informada do conteúdo do TCLE e o conhecimento do direito "confidencialidade", comum a todos os TCLEs, foi seis vezes maior que " acesso aos dados", que não faz parte. Os principais motivos para participarem foram para "saber mais sobre a sua saúde" (59% e para "beneficiar outras pessoas no futuro" (47%. A principal faixa de renda salarial dos participantes foi entre dois e cinco salários mínimos (48% e a maioria (66% concluiu pelo menos até a 4º série do ensino fundamental. A população possui o mesmo perfil econômico do Rio de Janeiro, nível de escolaridade suficiente para assinar e compreender o que está assinando, conhecendo não só a existência do TCLE, mas demonstrando conhecer seu conteúdo. O motivo principal para participação é para autobenefício e por atitude altruísta.This paper assesses the quality of assistance in a clinical trial outpatient center as well as the patients´understanding of the informed consent (IC; determine the reasons why they participate and detail socio-economic levels. A cross-sectional study was adopted in a clinical trial outpatient center using a self-explanatory questionnaire. All 100 respondents considered the assistance at the center excellent (86% or good (9%. Almost all of them were well informed about the content of the IC. Their knowledge about the right to "confidentiality", present in all ICs, was 6 times higher than their knowledge about their right to "access the results", generally not included

  11. Modeling the longitudinal latent effect of pregabalin on self-reported changes in sleep disturbances in outpatients with generalized anxiety disorder managed in routine clinical practice

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    Ruiz MA

    2015-08-01

    Full Text Available Miguel A Ruiz,1 Enrique Álvarez,2 Jose L Carrasco,3 José M Olivares,4 María Pérez,5 Javier Rejas6 1Department of Methodology, School of Psychology, Universidad Autónoma de Madrid, Madrid, 2Department of Psychiatry, Hospital de la Santa Creu i San Pau, Barcelona, 3Department of Psychiatry, Hospital Clínico San Carlos, Madrid, 4Department of Psychiatry, Hospital Meixoeiro, Complejo Hospitalario Universitario, Vigo, 5Medical Department, Pfizer, S.L.U., Alcobendas, Madrid, 6Health Economics and Outcomes Research Department, Pfizer, S.L.U., Alcobendas, Madrid, Spain Background: Anxiety disorders are among the most common psychiatric illnesses, with generalized anxiety disorder (GAD being one of the most common. Sleep disturbances are highly prevalent in GAD patients. While treatment with pregabalin has been found to be associated with significant improvement in GAD-related sleep disturbance across many controlled clinical trials, mediational analysis has suggested that a substantial portion of this effect could be the result of a direct effect of pregabalin. Thus, the objective of this study was to model the longitudinal latent effect of pregabalin or usual care (UC therapies on changes in sleep in outpatients with GAD under routine clinical practice. Methods: Male and female GAD outpatients, aged 18 years or above, from a 6-month prospective noninterventional trial were analyzed. Direct and indirect effects of either pregabalin or UC changes in anxiety symptoms (assessed with Hamilton Anxiety Scale and sleep disturbances (assessed with Medical Outcomes Study-Sleep Scale [MOS-S] were estimated by a conditional latent curve model applying structural equation modeling. Results: A total of 1,546 pregabalin-naïve patients were analyzed, 984 receiving pregabalin and 562 UC. Both symptoms of anxiety and sleep disturbances were significantly improved in both groups, with higher mean (95% confidence interval score reductions in subjects receiving

  12. Qualidade de vida de pacientes hipertensos em tratamento ambulatorial Quality of life of hypertensive patients treated at an outpatient clinic

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    Margaret Assad Cavalcante

    2007-10-01

    treatment is effective however it is not well known how affects the quality of life (QOL in patients afterwards. OBJECTIVE: To comparatively assess the QOL in patients submitted to an antihypertensive treatment. METHODS: One-hundred patients with AH were studied of which 46 had complied with a standard treatment regimen (group A and 54 (group B control were about to start the same regimen. We collected clinical and sociodemographic data and questions focusing sexuality, self-perception of QOL, number and types of medication taken and their influence on sex life. The questionnaire SF-36 was also administered. The data were analyzed using the tests chi-square, Student’s t, Pearson correlation and Tukey. RESULTS: No differences were detected between group A and B in any of the SF-36 domains. There was an association between the question on self-perception of QOL and the SF-36 domains, emotional aspects excepted. As regards sexuality, there was difference in the quality of sex life between the groups, which was less satisfactory for group A. CONCLUSION: When the SF-36 was administered no changes in QOL were detected between the groups because it is an asymptomatic chronic disease. The SF-36 did not properly assess emotional aspects in our case series of hypertensive patients that had high behavior variability. Group A showed lower quality sex life; however, this was not related to the number and type of medication used.

  13. The Inlfuence of Midwives Specialist Nurse Outpatient Clinic on Birth Outcomes%助产士专科护士门诊对分娩结局的影响

    Institute of Scientific and Technical Information of China (English)

    徐玲娣

    2015-01-01

    Objective To explore the midwife specialist nurse clinics in childbirth pregnant women late in pregnancy outcomes. Methods Selected 200 cases with obstetric clinic from January 2013 to August in zhenjiang normal primipara maternity and children's health care centers as the research object. Divided into control group and intervention group randomly, each group had 100 cases. The control group in the maternity clinic routine inspection, the intervention group than a routine inspection of also attend the midwife specialist nurse clinic intervention, that pregnant women can recognize the natural childbirth. Compare two groups of prenatal anxiety. Results The intervention group prenatal SAS (anxiety self-assessment scale) score SAS scores were lower than the control group, prenatal outpatient satisfaction and perinatal experience satisfaction was 100%was higher than control group in the satisfaction of 91%, P<0.05, the difference statistically signiifcance. Conclusion Correct understanding of natural childbirth, ease the tension, irritability and prenatal anxiety, improve natural births, perinatal maternal satisfaction, decrease the rate of cesarean section, strengthen maternal in perinatal debugging and response capacity, improve the quality of among their worth, midwives health nurses.%目的:探讨助产士专科护士门诊对孕晚期孕妇分娩结局影响。方法选择2013年1月~2013年8月在镇江市妇幼保健院产科门诊的200例正常初产妇作为研究对象。将其随机分为对照组和干预组,各100例。对照组于产科门诊常规检查,干预组除接受常规检查还参加助产士专科护士门诊干预,使孕妇能正确认识自然分娩。比较两组产前焦虑情况。结果干预组产前SAS(焦虑自评量表)评分低于对照组的SAS评分,干预组产前门诊满意度和围产期经历满意度为100%高于对照组的满意度91%,P<0.05,差异具有统计学意义。结论正确认识自然分娩

  14. Trends in and determinants of loss to follow up and early mortality in a rapid expansion of the antiretroviral treatment program in Vietnam: findings from 13 outpatient clinics.

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    Dam Anh Tran

    Full Text Available BACKGROUND: This study aims to describe the trends in and determinants of six month mortality and loss to follow up (LTFU during 2005-2009 in 13 outpatient clinics in Vietnam. METHOD: Data were obtained from clinical records of 3,449 Vietnamese HIV/AIDS patients aged 18 years or older who initiated ART between 1 January 2005 and 31 December 2009. Mantel-Haenszel chi-square test, log rank test were conducted to examine the trends of baseline characteristics, six month mortality and LTFU. Cox proportional hazards regression models were performed to compute hazard ratio (HR and 95% Confidence Interval (CI. RESULTS: Though there was a declining trend, the incidence of six month mortality and LTFU remained as high as 6% and 15%, respectively. Characteristics associated with six month mortality were gender (HR females versus males 0.54, 95%CI: 0.34-0.85, years of initiation (HR 2009 versus 2005 0.54, 95%CI: 0.41-0.80, low baseline CD4 (HR 350-500 cells/mm(3 versus <50 cells/mm(3 0.26, 95%CI: 0.18-0.52, low baseline BMI (one unit increase: HR 0.96, 95%CI: 0.94-0.97, co-infection with TB (HR 1.61, 95%CI: 1.46-1.95, history of injecting drugs (HR 1.58, 95%CI: 1.31-1.78. Characteristics associated with LTFU were younger age (one year younger: HR 0.97, 95%CI: 0.95-0.98, males (HR females versus males 0.82, 95%CI: 0.63-0.95, and poor adherence (HR 0.55, 95%CI: 0.13-0.87. CONCLUSIONS: To reduce early mortality, special attention is required to ensure timely access to ART services, particularly for patients at higher risk. Patients at risk for LTFU after ART initiation should be targeted through enhancing treatment counselling and improving patient tracing system at ART clinics.

  15. Hidden female urinary incontinence in urology and obstetrics and gynecology outpatient clinics in Turkey: what are the determinants of bothersome urinary incontinence and help-seeking behavior?

    Science.gov (United States)

    Cetinel, Bulent; Demirkesen, Oktay; Tarcan, Tufan; Yalcin, Onay; Kocak, Taner; Senocak, Mustafa; Itil, Ismail

    2007-06-01

    The purpose of this study was to assess the prevalence of female urinary incontinence (UI) and risk factors of bothersomeness and help-seeking behavior of hidden female UI in urology and obstetrics and gynecology outpatient clinics. This multicentric and cross-sectional study was conducted as a part of the Turkish Overactive Bladder Study. Female patients (n = 5,565) who were referred with complaints other than UI and overactive bladder symptoms were surveyed using the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) with supplementation of five more questions. The crude prevalence of UI was found to be 35.7%. The prevalence of frequent and severe incontinence was 8.2 and 6.8%, respectively. The mean age of incontinent patients was significantly higher (p < 0.001). The prevalence of stress, urge, and mixed UI was 39.8, 24.8, and 28.9%, respectively. More than half (53%) of incontinent patients were not bothered by UI, and only 12% of incontinent patients had previously sought medical help for their problem. Frequency, severity, and type of UI were independent factors for predicting bothersome UI, while only bothersomeness increased help-seeking behavior. The ICIQ-SF score of 8 has been found to be the best cutoff value to delineate the bothersome UI. Although the crude prevalence of female UI was found to be high, bothersome UI was not so common. The majority of incontinent female patients did not seek medical help. Frequency, severity, and mixed type of UI were found to be the determinants of bothersome UI for which the ICIQ-SF cutoff score of 8 was obtained. PMID:17164988

  16. Evaluation of the likelihood of reflux developing in patients with recurrent upper respiratory infections, recurrent sinusitis or recurrent otitis seen in ear-nose-throat outpatient clinics.

    Science.gov (United States)

    Önal, Zerrin; Çullu-Çokuğraş, Fügen; Işıldak, Hüseyin; Kaytaz, Asım; Kutlu, Tufan; Erkan, Tülay; Doğusoy, Gülen

    2015-01-01

    Gastroesophageal reflux is considered a risk factor for recurrent or persistent upper and lower respiratory tract conditions including asthma, chronic cough, sinusitis, laryngitis, serous otitis and paroxysmal laryngospasm. Fifty-one subjects with recurrent (more than three) episodes of upper respiratory tract infection (URTI), serous otitis or sinusitis who had been admitted to an earnose- throat (ENT) outpatient clinic during the previous year were enrolled in the present study to evaluate the presence of laryngeal and/or esophageal reflux. The participants, who were randomly selected, were questioned about symptoms of reflux, including vomiting, abdominal pain, failure to thrive, halitosis, bitter taste in the mouth, chronic cough, heartburn, constipation and hoarseness. All subjects had an endoscopic examination, an otoscopic examination, a tympanogram and upper GI system endoscopy. Esophagitis was diagnosed endoscopically and histologically. The likelihood of occurrence of esophagitis was found to be higher only among subjects with postglottic edema/erythema as determined by pathological laryngeal examination. The reflux complaints reported did not predict the development of esophagitis, but the odds of esophagitis occurring were ninefold greater among subjects with recurrent otitis. Of the subjects, 45.1% were Helicobacter pylori-positive. However, no association was found between esophagitis and Helicobacter pylori positivity. The likelihood of the occurrence of esophagitis was found to be increased in the presence of recurrent otitis media and/or postglottic edema, irrespective of the presence of reflux symptoms. We concluded that, in contrast to the situation where adults are concerned, the boundaries for discriminating laryngopharyngeal reflux from gastroesophageal reflux are somewhat blurred in pediatric patients. PMID:26701945

  17. Hidden female urinary incontinence in urology and obstetrics and gynecology outpatient clinics in Turkey: what are the determinants of bothersome urinary incontinence and help-seeking behavior?

    Science.gov (United States)

    Cetinel, Bulent; Demirkesen, Oktay; Tarcan, Tufan; Yalcin, Onay; Kocak, Taner; Senocak, Mustafa; Itil, Ismail

    2007-06-01

    The purpose of this study was to assess the prevalence of female urinary incontinence (UI) and risk factors of bothersomeness and help-seeking behavior of hidden female UI in urology and obstetrics and gynecology outpatient clinics. This multicentric and cross-sectional study was conducted as a part of the Turkish Overactive Bladder Study. Female patients (n = 5,565) who were referred with complaints other than UI and overactive bladder symptoms were surveyed using the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) with supplementation of five more questions. The crude prevalence of UI was found to be 35.7%. The prevalence of frequent and severe incontinence was 8.2 and 6.8%, respectively. The mean age of incontinent patients was significantly higher (p < 0.001). The prevalence of stress, urge, and mixed UI was 39.8, 24.8, and 28.9%, respectively. More than half (53%) of incontinent patients were not bothered by UI, and only 12% of incontinent patients had previously sought medical help for their problem. Frequency, severity, and type of UI were independent factors for predicting bothersome UI, while only bothersomeness increased help-seeking behavior. The ICIQ-SF score of 8 has been found to be the best cutoff value to delineate the bothersome UI. Although the crude prevalence of female UI was found to be high, bothersome UI was not so common. The majority of incontinent female patients did not seek medical help. Frequency, severity, and mixed type of UI were found to be the determinants of bothersome UI for which the ICIQ-SF cutoff score of 8 was obtained.

  18. Comparison of the bedside head impulse test with the video head impulse test in a clinical practice setting: a prospective study of 500 outpatients.

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    Chun Wai eYip

    2016-04-01

    Full Text Available Objectives: The primary aim was to determine the sensitivity, specificity, positive predictive value (PPV, and negative predictive value (NPV of the bedside head impulse test (bHIT using the video HIT (vHIT as the gold standard for quantifying the function of the vestibulo-ocular reflex (VOR. Secondary aims were to determine the bHIT inter-rater reliability, and sensitivity in detecting unilateral and bilateral vestibulopathy.Methods: In this prospective study, 500 consecutive outpatients presenting to a tertiary neuro-otology clinic with vertigo or dizziness of various vestibular etiologies who did not have any of the pre-defined exclusion criteria were recruited. Bedside HITs were done by three experienced neuro-otology clinicians masked to the diagnosis, and the results were compared with the vHIT. The patients were likewise blinded to the bHIT and vHIT findings. Patients with VOR deficits were identified on the vHIT by referencing to the pre-selected pathological gain of 40%, the bHIT sensitivity = 51.7% and 83%, respectively. For bilateral vestibulopathy, overall bHIT sensitivity = 66.3%, reaching 86.84% for severely reduced bidirectional gains.Conclusions: For the primary outcome, the bHIT had moderate sensitivity and low PPV. While the study did not elucidate the best choice for vHIT reference, it demonstrated how the bHIT test properties varied with vHIT thresholds: selecting a lower threshold improved the sensitivity but diminished the PPV, while a higher threshold had the opposite effect. The VOR was most likely normal if the bHIT was negative due to its high NPV. The bHIT was moderately sensitive for detecting unilateral and bilateral vestibulopathy overall, but better for certain subgroups.

  19. Evaluation of Diagnostic Algorithms and Risk Assessment Among Women Attending STD Clinics with Vaginal Discharge in China

    Institute of Scientific and Technical Information of China (English)

    王千秋; 杨凭; 钟铭英; 王广聚

    2001-01-01

    Objectives: To determine the aetiologies of vaginal discharge syndromes, to calculate the performance of different management algorithms, and validate these algorithms in STD clinics in China. These algorithms were adopted from those proposed by the World Health Organization. Methods: A total of 315 consecutive patients with vaginal discharge were enrolled at three STD clinics. Cervical infection was defined as presence of Neisseria gonorrhoeae on culture and/or Chlamydia trachomatis by polymerase chain reaction.Other laboratory tests included wet mount microscopy and pH testing of vaginal fluid. Sensitivity, specificity, and positive predictive value of different algorithms were determined using standard methods. Results: Cervical infection was identified in 37.8% of patients (20.6% gonorrhea, 12.7% chlamydial infection, 4.4%gonorrhea in combination with chlamydial infection). The sensitivity, specificity, and positive predictive value of algorithms A and B for the identification of Neisseria gonorrhoeae and/or Chlamydia trachomatis were respectively 71.4% and90.8%, 65.3% and 46.9%, 55.6% and 50.9%. Conclusions: The vaginal discharge algorithms could be applied for clinical management. Their sensitivities are acceptable. However, there is a need to further improve their specificity and positive predictive value. The two algorithms could be used in clinical settings with different facilities. These algorithms should also be validated in populations with lower disease prevalence.

  20. A STUDY ON THE PATTERN OF BLOOD PRESSURE AND ITS CO-RELATES AMONG THE PATIENTS ATTENDING THE GERIATRIC CLINIC OF GAUHATI MEDICAL COLLEGE AND HOSPITAL, GUWAHATI

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    Shashanka Shekhar

    2016-06-01

    Full Text Available BACKGROUND All over the world, the geriatric population is growing continuously and it is projected that by the year 2025 majority of the elderly population will be residing in the developing countries, especially India. Cardiovascular Diseases (CVD are the major cause of death among the elderly population in which High Blood Pressure plays an important role. AIM To study the pattern of Blood Pressure and its co-relates among the elderly patients attending the Geriatric Clinic. Setting: Hospital-based Cross-sectional study. MATERIALS AND METHODS All the patients those who attended the Geriatric Clinic during the study period were taken. Predesigned, pretested interview schedule was used to collect the information from the patients and also to note down the physical examination findings. STATISTICAL ANALYSIS Chi-squared test, t-test were done. Odds ratio with 95% CI was calculated wherever applicable. RESULTS Among all the patients, 16.04% were found to be hypertensive. Prevalence is found to be highest among those in the age group of 75 years or more. Hypertension was found to be 17.81% among the male patients compared to 12.89% among the females. Hypertension was found to be significantly associated with increasing age, family type and socio-economic status (p<0.05. Hypertension was also found to be significantly associated with co-relates like age, non-vegetarian diet, history of alcohol intake, history of smoking, history of use of chewable tobacco (p=0.0031, p=0.0017, p<0.0001, p=0.0121. There was significant difference in mean BP between the normotensive and hypertensive patients across all the age groups in both males and females. There was significant association between BMI and hypertension in both males and females. CONCLUSION The blood pressure pattern among the geriatric population tends to increase with increasing age and other behavioural risk factors.

  1. Infant feeding practice and associated factors of HIV positive mothers attending prevention of mother to child transmission and antiretroviral therapy clinics in Gondar Town health institutions, Northwest Ethiopia

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    Muluye Dagnachew

    2012-03-01

    Full Text Available Abstract Background It has been estimated that 430,000 children under 15 years of age were newly infected with HIV in 2008, and more than 71% are living in sub-Saharan Africa. In the absence of intervention to prevent mother-to-child transmission, 30-45% of infants born to HIV-positive mothers in developing countries become infected during pregnancy, delivery and breastfeeding. The aim of this study was to assess infant feeding practice and associated factors of HIV positive mothers attending prevention of mother to child transmission and antiretroviral therapy clinics of Northwest Ethiopia. Methods Institution based cross sectional study was conducted from January to May 2011 among all HIV positive mothers with less than two years old child attending prevention of mother to child transmission and antiretroviral therapy clinics in Gondar Town health institutions. A structured pre-tested questionnaire using interview technique was used for data collection. The data was entered and analyzed using SPSS version 16 statistical package. Results A total of 209 HIV positive mothers were included in the study. Of these, 187 (89.5% had followed the recommended way of infant feeding practice while significant percentage (10.5% had practiced mixed breast feeding. In multivariate analysis, disclosure of HIV status with their spouse, insufficient breast milk and occupational status were found to be independently associated (p-value of Conclusions Higher proportion of respondents used the recommended way of infant feeding practice by WHO as well as by Ethiopian Ministry of Health. However, mixed feeding in the first 6 months of age, an undesirable practice in infant feeding, were reported in this study. Infant feeding education that is aligned to national policy should be strengthened in primary health care, particularly in situations where prevention of mother to child transmission of HIV is prioritized.

  2. The cause analysis of low rate for dementia diagnosis in outpatient clinic%门诊痴呆患者诊断率低的原因分析

    Institute of Scientific and Technical Information of China (English)

    山媛; 屈秋民; 郭峰; 乔晋

    2011-01-01

    Objective To investigate the cause of low rate for dementia diagnosiss in out-patient clinic.Methods All outpatients between September 15,2009 and December 25,2009 were screened by IQCODE,MMSE and neuropsychological examination.Diagnosis of dementia and its subtype were confirmed according to DSM-IV-TR,NINCDS-ADRDA,and NINDS-AIREN criteria.The caregivers of dementia patients were interviewed with questionnaire.Results There were 8,042 outpatients in the period and 1716 patients completed IQCODE,317 completed MMSE,72 completed a set of neuropsychological test.41 patients were diagnosed as dementia which composed of 23 cases of AD (56.1%),12 cases of vascular dementia(29.3%),2 cases of mixed dementia(4.9%),4 cases of other types of dementia(9.7%),and the prevalence of dementia at age of over 55 years was 1.8% in out-patient clinics.Among the patients,18 cases were mild dementia (43.9%),19 moderate dementia (46.3 % ) and 4 severe dementia (9.8 %).Four patients(9.8 % ) were diagnosed as dementia by case history,15 patients(36.5%) were diagnosed as dementia by clinic doctors,while 22 patients (53.7%) were diagnosed as dementia in the survey.35 caregivers finished questionaire,and 10 caregivers(28.6%) had no knowledge about dementia,22(62.8%) caregivers had a few knowledge and 3(8.6%) caregivers had lots of knowledge.19 (46.3%) dementia patients went to see a doctor with cognitive impairment and 22 (53.7 %) with other symptoms.The reasons for delay in seeing a doctor included that caregivers considered the impairment of cognition as a result of normal aging (54.3%),patients rejected to see a doctor(14.3%),caregivers considered no treatment for dementia (5.7 %),and there was economic reason ( 2.9%),inconvenient (8.5 %) and others ( 14.3 %).Conclusions The visiting rate of dementia patients in china is very low and many demented patients do not receive early diagnosis and treatment.Patients' delay may contribute to the lack of

  3. The prevalence of Chlamydia trachomatis infection among Saudi women attending the infertility clinic in Central Saudi Arabia

    OpenAIRE

    Alfarraj, Dunia A.; Ali M. Somily; Alssum, Rasheed M.; Abotalib, Zeinab M.; El-Sayed, Amal A.; Al-Mandeel, Hazim H.

    2015-01-01

    Objectives: To determine the prevalence of Chlamydia trachomatis (C. trachomatis) infection among Saudi women, its clinical presentation, and its association to infertility. Methods: This study was conducted between October 2012 and July 2013 at King Khalid University Hospital and King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia. Female patients aged between 19 and 46 years old with infertility problems seen at both hospitals were recruited to join the study. A separate gro...

  4. Clinical Characteristics and Pharmacological Treatment of Psychotic Patients Attending the Mental Health Services of the Pediatric Hospital of Cienfuegos

    Directory of Open Access Journals (Sweden)

    Beatriz Sabina Roméu

    2016-06-01

    Full Text Available Background: the mental health services of the Pediatric Hospital of Cienfuegos receive all patients in the province that need to be hospitalized. Among them, children and adolescents functioning at the psychotic level are of great clinical and social importance. Objective: to describe the clinical characteristics and pharmacological treatment of psychotic patients treated in the mental health services. Methods: a case series study of 35 psychotic patients admitted to the mental health unit of the Pediatric Hospital of Cienfuegos was conducted between 2008 and 2012. Demographic variables, in addition to variables related to clinical data and pharmacotherapeutic aspects were analyzed. Results: sixty five point seven percent of patients were adolescents and 77.1% were of urban origin. The most common diagnoses were acute and transient psychotic disorder and schizophrenia. Sixty three percent had a family history of psychiatric disorder. Forty percent were treated with trifluoperazine and an equal percent took haloperidol. Psychotic symptoms were controlled in 58% of patients during the first weeks. Conclusion: white adolescent patients from urban areas with a family history of psychiatric illness predominated. They received regular psychiatric attention and experienced the symptoms for a short time before being treated. The most frequently prescribed medications were typical antipsychotic drugs, which caused adverse reactions in a third of the patients. In the first few weeks, psychotic symptoms were controlled in most patients, although half of them experienced a recurrence of symptoms, which evolved into conditions with worse prognosis.

  5. Clinical-epidemiological profile of children with schistosomal myeloradiculopathy attended at the Instituto Materno-Infantil de Pernambuco.

    Science.gov (United States)

    Araújo, Karina Conceição G M; Rosa e Silva, Cristiana da; Barbosa, Constança Simões; Ferrari, Teresa C A

    2006-09-01

    The most critical phase of exposure to schistosomal infection is the infancy, because of the more frequent contact with contaminated water and the immaturity of the immune system. One of the most severe presentations of this parasitosis is the involvement of the spinal cord, which prognosis is largely dependent on early diagnosis and treatment. Reports on this clinical form of schistosomiasis in children are rare in the literature. We present here the clinical-epidemiological profile of schistosomal myeloradiculopathy (SMR) from ten children who were admitted at the Instituto Materno-Infantil de Pernambuco over a five-year period. They were evaluated according to an investigation protocol. Most of these patients presented an acute neurological picture which included as the main clinical manifestations: sphincteral disorders, low back and lower limbs pain, paresthesia, lower limbs muscle weakness and absence of deep tendon reflex, and impairment of the gait. The diagnosis was presumptive in the majority of the cases. This study emphasizes the importance of considering the diagnosis of SMR in pediatric patients coming from endemic areas who present a low cord syndrome, in order to start the appropriate therapy and avoid future complications.

  6. Irrational Prescribing of Antibiotics in Pediatric Outpatients: A Need for Change

    Directory of Open Access Journals (Sweden)

    Edita Alili-Idrizi

    2015-12-01

    Full Text Available Background and Aims: Antibiotics play a major role in the treatment of infectious diseases and are among the drugs most commonly prescribed for children. Respiratory tract infections in pediatric patients are a common cause of antibiotic prescribing which increases morbidity, mortality, patient cost and the likelihood for emergence of antibiotics-resistant microorganisms. This study was undertaken to determine the proportion of common respiratory tract infections and to generate data on the extent of rational/irrational prescribing of antibiotics in patients attending the pediatric out-patient department. Material and Methods: retrospective study carried out during one year (January to December, 2013 in the pediatric out-patient department of the Clinical Center in Tetovo. Patients of either sex at age group between 1 week and 14 years who attended the pediatric out-patient department and were prescribed antibiotics for respiratory tract infections were included in the study. The data was compared against national guideline-based medicine, major antibiotic guidelines recommended by World Health Organization (WHO and American Academy of Pediatrics (AAP, and cross-referenced against Cochrane studies. Results: Children aged >1 - ≤3 years received 49.6% of antibiotics. The most common prescribed antibiotics were penicillins (62.2%, followed by cephalosporins (32.5%. Sore throat (61.5% was identified as the most common diagnosis. There was a significant relationship (r=0.234, p< 0.05 between diagnosis and antibiotic prescribing. Ninety two percent of pediatric patients with common cold, laryngitis, viral sore throat, acute otitis media and bronchitis were prescribed antibiotics irrationally, that represents a major deviation from the recommendations from the guidelines. High levels (90% of antibiotic irrational prescribing were revealed in pediatric outpatients diagnosed with pneumonia. Conclusion: This study reinforces the need to implement

  7. The study of 101 cases of onychomycosis and associate factors in patients referred to Boali Sina Hospital and Toba dermatology outpatient clinics in Sari

    Directory of Open Access Journals (Sweden)

    Tahereh Shokohi

    2009-01-01

    Full Text Available (Received 20 May, 2009 ; Accepted 10 August, 2009AbstractBackground and purpose: Onychomycosis is a nail fungal infection caused by various species of dermatophytes, yeasts and non-dermatophytic molds and represents about 30% of cutaneous mycotic infections. The goal of this study was to investigate the frequency of onychomycosis and its associated factors in patients referred to Boali Sina Hospital and Toba dermatology outpatient clinics, Sari.Materials and methods: In this cross-sectional study, nail specimens were collected from 101 patients suspected of onychomycosis during a 14 month period. Nail specimens were examined by direct microscopy, using potassium hydroxide (KOH 20%, KOH + CFW, KONCPA (KOH treated nail clipping+PAS and also culturing on sabouraud’s dextrose agar, containing chloramphenicol (SC, and sabouraud’s dextrose agar containing cyclohexamide and chloramphenicol (SCC mediums.Results: In this study, 79 (78% of patients were female and 22 (22% were male. Yeasts were isolated in 30% cases of onychomycosis, mainly from fingernails. Candida albicans, and C.krusei was the most prevalent species. Non-dermatophytic filamentous fungi were yielded at 24%, especially from toenails, with Aspergillus terreus being the most prevalent species. Dermatophytes were found in 7% of the samples, especially from toenails. Trichophyton mentagrophytes was the predominant species. Unknown filamentous fungi were identified in 19% of samples, while mixed infections were identified in 20% of samples. The highest prevalence rate of onychomycosis was identified in the patients within the 30 to 49 years of age group. Distal and lateral subfungual onychomycosis (DLSO was the most prevalent clinical types with (88%, followed by WSO (5%, PSO (5%, TDO (1% and DLSO + PSO (1%.Conclusion: The results of our study showed that onychomycosis is one of the most prevalent infections in patients who are suffering from nail disorders. Yeast and yeast like organisms

  8. The Clinical Significance of Establishing Wound Treatment Center and Developing Outpatient Nursing%建立创面治疗中心及开展护理门诊的临床意义

    Institute of Scientific and Technical Information of China (English)

    任素琴; 孟凡慧; 王玉英

    2016-01-01

    随着临床业务拓展的迫切需求,开展专科护理门诊是护理学科发展的必然趋势.某院在借鉴国内外多家医院开设护理门诊经验基础上,经过充分的专家论证,在新门诊大楼内增设了创面治疗中心,并开设了伤口护理门诊、造口/失禁护理门诊、经外周中心静脉置管(PICC)护理门诊等专科护理门诊.其合理的布局设置,科学的功能分区,规范的工作流程,通过一支专业化护理队伍的全方位建设,使其诊疗范畴不断扩增.设立的伤口护理与造口/失禁护理门诊不但提高了患者伤口愈合速度,缩短了伤口愈合时间,而且通过承担出院患者的延续护理服务,降低了平均住院日,加快了病房床位周转,同时提升了护理人员的社会价值感,获得了较好的经济效益和社会效益.%As the urgent needs of clinical business development, the carrying out of outpatient nursing is the inevitable trend of the disciplinary development. On the basis of development of outpatient nursing experience from home and abroad, as well as full demonstration of experts, we added wound therapy center in the new outpatient building and opened a wound care clinic, ostomy/incontinence care clinic, peripherally inserted central venous catheter(PICC) nursing specialist care in outpatient clinics. The reasonable layout, the scientific function, standardized work process through a full range of professional nursing team construction, its diagnosis and treatment scope was continuously expanding. The establishment of wound nursing and ostomy/incontinence outpatients nursing not only improved the speed of wound healing, shortened the healing time, and reduced the average length of stay, speeded up the ward beds turnover and enhanced the social value of the nursing staff, and received good economic and social benefits at the same time.

  9. Prevalence and clinical characteristics of insulin-treated, anti-GAD-positive, type 2 diabetic subjects in an outpatient clinical department of a Dutch teaching hospital.

    NARCIS (Netherlands)

    Romkens, T.E.H.; Kusters, G.C.M.; Netea, M.G.; Netten, P.M.

    2006-01-01

    BACKGROUND: In clinical practice, type 1 and type 2 diabetic patients are sometimes difficult to distinguish. Type 1 diabetes has an immune-mediated pathogenesis, resulting in a loss of insulin-secreting beta-cells. Type 2 diabetes mellitus is characterised by a relative insulin insufficiency, witho

  10. Health literacy, health information seeking behaviors and internet use among patients attending a private and public clinic in the same geographic area.

    Science.gov (United States)

    Gutierrez, Natalia; Kindratt, Tiffany B; Pagels, Patti; Foster, Barbara; Gimpel, Nora E

    2014-02-01

    Despite the growing body of health information available online, patients with limited health literacy may lack either internet access or skills necessary to utilize this information. Nonetheless, patients at all health literacy levels may prefer other primary sources to obtain health information. We conducted a cross-sectional study to measure health literacy of patients attending two clinics in Dallas, TX and determine associations between health literacy, health information access and internet usage before and after controlling for confounders. Patients from both clinics (county N = 265; private N = 233) completed a brief survey which included sociodemographics, internet patterns, confidence in filling out medical forms and a self-administered Newest Vital Sign to measure health literacy. In the county clinic, most patients (61.5 %) were Hispanic, had low income (literacy (68.5 %). In the private clinic, participants were mostly black (40.4 %) or white (38.6 %), had higher incomes (≥$46,000), higher education (technical college or college) and adequate health literacy (75.1 %). The primary source of obtaining health information in both clinics was their health care professional (50.6 % county; 40.1 % private). In multivariate analyses to determine differences by health literacy level, there were no statistically significant differences between patients with limited and adequate health literacy and their primary information source. Regardless of health literacy, patients rely on their health care providers to obtain health information. These results showcase the importance of providers' effective communication with patients to make shared decisions about their health regardless of other factors.

  11. The management of isolated positive syphilis enzyme immunoassay results in HIV-negative patients attending a sexual health clinic.

    Science.gov (United States)

    Thorley, Nicola; Adebayo, Michael; Smit, Erasmus; Radcliffe, Keith

    2016-08-01

    An unconfirmed positive treponemal enzyme immunoassay (enzyme immunoassay positive, Treponema pallidum particle agglutination negative and rapid plasma reagin negative) presents a clinical challenge to distinguish early syphilis infection from false-positive results. These cases are referred for syphilis line assay (INNO-LIA) and recalled for repeat syphilis serology. We performed a retrospective audit to establish the proportion of HIV-negative cases with unconfirmed positive enzyme immunoassay results, the proportion of these cases that received an INNO-LIA test and repeat syphilis serology testing and reviewed the clinical outcomes; 0.35% (80/22687) cases had an unconfirmed positive treponemal enzyme immunoassay result. Repeat syphilis serology was performed in 80% (64/80) cases, but no additional cases of syphilis were identified. Eighty-eight per cent (70/80) received an INNO-LIA test; 14% (5/37) unconfirmed enzyme immunoassay-positive cases with no prior history of syphilis were confirmed on INNO-LIA assay, supporting a diagnosis of latent syphilis. As a confirmatory treponemal test, the INNO-LIA assay may be more useful than repeat syphilis serological testing. PMID:26637236

  12. HIV/Tuberculosis Co-Infection among Patients Attending a Referral Chest Clinic in Nasarawa State, Nigeria

    Science.gov (United States)

    Umeh, E. U.; Ishaleku, D.; Iheukwumere, C. C.

    Human immunodeficiency virus (HIV) and Mycobacterium tuberculosis (TB) coinfection rate was investigated among patients referred to a chest clinic in Nasarawa State, Nigeria. Out of the 344 patients who presented with respiratory problems at the clinic, 44.8% had M. tuberculosis infection, 24.7% HIV infection and 12.8% HIV/tubercle bacilli co-infection. Coinfection rate in HIV infected persons (HIV+) was 51.8 and 28.6% in those with M. tuberculosis infection. The relative risk of HIV positive persons being coinfected was 1.075, while it was 0.401 for TB infected persons. The estimated Odds Ratio (OR) shows that the risk of co-infection was 2.68 times higher among HIV+ persons than among those with tuberculosis. The attributable risk was 45% and shows the extent to which co-infection could be attributed to HIV infection. A key socio-economic variable, eating in groups, was significantly correlated with coinfection (r = 0.107; p< 0.05). The results of this study may provide a useful policy guide in the formulation of HIV and tuberculosis control measures in Nigeria.

  13. Filariasis in sub-Saharan immigrants attended in a health area of southern Spain: clinical and epidemiological findings.

    Science.gov (United States)

    Cobo, Fernando; Cabezas-Fernández, Ma Teresa; Salas-Coronas, Joaquín; Cabeza-Barrera, Ma Isabel; Vázquez-Villegas, José; Soriano-Pérez, Manuel J

    2015-02-01

    Filariasis is still an endemic disease in several countries worldwide. Patients with mansonellosis result in only relatively mild symptoms, but these infections could produce many visits to health care providers. In Spain, this infection is imported due to the increase of immigrant population reaching our country during last years. The health area of the Hospital of Poniente has a rate of immigrants around to 20%, with a high percentage coming from sub-Saharan countries, being Mansonella perstans the main filarial infection in the majority of cases. In the protocol for the immigrants, it has been included the diagnosis of filarial infections in order to treat them. This manuscript describes epidemiological and clinical aspects of patients with this kind of infection. PMID:23881533

  14. Clinical results obtained with a combination of an anti-inflammatory steroid, an antibacterial agent and an antifungal in dermatological outpatient practice.

    Science.gov (United States)

    Pazzaglia, A

    1985-07-01

    Forty outpatients with skin diseases were treated with an extempore combination of three creams, the respective bases of which were beclomethasone dipropionate, sodium fusidate and ketoconazole. Positive results were obtained in 97.5% of the cases with good relief of symptoms and excellent local tolerance in all cases treated.

  15. Effect of intermittent preventive treatment of malaria on the outcome of pregnancy among women attending antenatal clinic of a new Nigerian teaching hospital, Ado-Ekiti

    Directory of Open Access Journals (Sweden)

    Aduloju Olusola Peter

    2013-01-01

    Full Text Available Background: Malaria is a public health problem globally especially in the Sub-Saharan Africa and among the under five children and pregnant women and is associated with a lot of maternal and foetal complications. Objective: The study was on the effect of intermittent preventive treatment of malaria in pregnancy on the prevalence of malaria in pregnancy and the outcome of pregnancy. Materials and Methods: In a descriptive cross-sectional study, a semi-structured questionnaire was administered to women admitted in Ekiti State University Teaching Hospital labour ward, Ado-Ekiti. About 4,200 women participated in the study and the inclusion criteria were women who were booked in the hospital, attended at least four antenatal clinic visits, and consented to the study while the exclusion criteria were those who didn′t book in the hospital and failed to give their consent. Results: The study revealed that about 75% of the pregnant women studied had access to intermittent preventive treatment of malaria. Among the women attending the antenatal clinic that received sulphadoxine-pyrimethamine (SP, about 78% of them took two doses of SP. The prevalence of clinical malaria was statistically higher in women who did not receive intermittent preventive treatment with SP during pregnancy (44.7% vs. 31.3%, P = 0.0001 and among women who had one dose of the drug instead of two doses (40.0% vs. 28.7%, P = 0.0001. There was no statistical significant difference in the mean age in years (31.53 ± 5.238 vs. 31.07 ± 4.751, P = 0.09 and the gestational age at delivery (38.76 ± 1.784 vs. 38.85 ± 1.459, P = 0.122 between the women who did not receive SP and those who had it. There was a statistical significant difference in the outcome of pregnancy among women who had Intermittent Preventive Treatment in pregnancy (IPTp and those who did not viz.-a-viz. in the duration of labor (8.6 ± 1.491 vs. 8.7 ± 1.634, P = 0.011 and the birth weight of the babies (3.138 ± 0

  16. MAGNITUDE AND CAUSES OF VISUAL IMPAIRMENT AND BLINDNESS AMONG CHILDREN ATTENDING PAEDIATRIC EYE CLINIC AT SANTHIRAM MEDICAL COLLEGE

    Directory of Open Access Journals (Sweden)

    Sanjeeva Kumar

    2016-02-01

    Full Text Available BACKGROUND The number of blind years resulting from blindness in children is alarmingly high. Blindness in children can have a significant impact on their performance at school as well as their social interaction and future employment as visually impaired children have a long lifetime of blindness ahead of them. The consequences of visual impairment and blindness in children are an important public health issues with greater impact in developing countries, where 80% of the blindness in children occurs. The control of blindness in children is considered a high priority area within the World Health Organization’s VISION 2020 initiative. However many developing countries do not have the accurate information about the magnitude and causes of visual impairment and blindness in children, from which the scope and priorities for prevention and treatment can be identified. To date the established Pediatric Eye Clinic, which works as a Tertiary Eye Centre does not have baseline data on the magnitude and causes of visual impairment and blindness in children.

  17. A novel program for clinical pathology training for residents emphasizing high-impact and attending-level learning opportunities.

    Science.gov (United States)

    Ranheim, Erik A

    2014-02-01

    Clinical pathology (CP) rotations in our residency program consistently received lower evaluations and lower scores on the Resident In-Service Exam (RISE) in comparison to anatomic pathology rotations. In 2010 to 2011, we instituted a new model for CP training, wherein the separate rotations for chemistry, transfusion medicine, molecular diagnostics, microbiology, and coagulation/immunology were combined into a 3-month "Superblock" in an effort to maximize and repeat high-impact learning opportunities in a team-based model. Resident and faculty satisfaction with the new curriculum and RISE scores were assessed in the 3 years before and after implementation of the curriculum. Large majorities of residents and faculty expressed increased satisfaction with the curriculum. Average RISE scores increased 8.3% in CP in the 3 years following introduction of the curriculum compared to the 3 years prior to introduction, while anatomic pathology average scores decreased by 1.5%. The CP Superblock provides a model of CP education which may address some of the difficulties in teaching CP topics and recruiting residents to CP specialization. The pros and cons of its implementation are discussed.

  18. Development of a clinical decision support system using genetic algorithms and Bayesian classification for improving the personalised management of women attending a colposcopy room.

    Science.gov (United States)

    Bountris, Panagiotis; Topaka, Elena; Pouliakis, Abraham; Haritou, Maria; Karakitsos, Petros; Koutsouris, Dimitrios

    2016-06-01

    Cervical cancer (CxCa) is often the result of underestimated abnormalities in the test Papanicolaou (Pap test). The recent advances in the study of the human papillomavirus (HPV) infection (the necessary cause for CxCa development) have guided clinical practice to add HPV related tests alongside the Pap test. In this way, today, HPV DNA testing is well accepted as an ancillary test and it is used for the triage of women with abnormal findings in cytology. However, these tests are either highly sensitive or highly specific, and therefore none of them provides an optimal solution. In this Letter, a clinical decision support system based on a hybrid genetic algorithm - Bayesian classification framework is presented, which combines the results of the Pap test with those of the HPV DNA test in order to exploit the benefits of each method and produce more accurate outcomes. Compared with the medical tests and their combinations (co-testing), the proposed system produced the best receiver operating characteristic curve and the most balanced combination among sensitivity and specificity in detecting high-grade cervical intraepithelial neoplasia and CxCa (CIN2+). This system may support decision-making for the improved management of women who attend a colposcopy room following a positive test result. PMID:27382484

  19. A CLINICAL AND RADIOLOGICAL PROFILE OF PATIENTS OF INTERSTITIAL LUNG DISEASES, ATTENDING THE CHEST HOSPITAL OF MEDICAL COLLEGE FROM NORTH INDIA

    Directory of Open Access Journals (Sweden)

    Anand

    2016-05-01

    Full Text Available OBJECTIVE To know the clinical and radiological profile of patients of Interstitial Lung Diseases attending the Chest Hospital of Medical College from North India from February 2014 to December 2015. MATERIAL AND METHODS The study was conducted in Department of Tuberculosis and Respiratory Diseases, G.S.V.M. Medical College, Kanpur (India. The patients were subjected to complete clinical history (Including work environment and occupational history, physical examination, various haematological investigations, spirometry and high resolution computerized tomography thorax. RESULTS In present study a total of 80 patients with interstitial lung disease were analysed. There were 36 males and 44 females (mean age was 54.4±1.8 years. Of 80 patients of interstitial lung diseases examined, Idiopathic Pulmonary Fibrosis (IPF pattern was present in maximum number (38.8% followed by sarcoidosis (17.5%, Hypersensitivity pneumonitis (15% Non-specific interstitial pneumonias (10%, Connective Tissue Disorder (C.T.D. associated ILD (7.5% and Cryptogenic Organizing Pneumonias (C.O.P. in 5% of cases. CONCLUSION IPF was the most common subgroup among ILDs.

  20. Self-Disorders and Clinical High Risk for Psychosis: An Empirical Study in Help-Seeking Youth Attending Community Mental Health Facilities.

    Science.gov (United States)

    Raballo, Andrea; Pappagallo, Elena; Dell' Erba, Alice; Lo Cascio, Nella; Patane', Martina; Gebhardt, Eva; Boldrini, Tommaso; Terzariol, Laura; Angelone, Massimiliano; Trisolini, Alberto; Girardi, Paolo; Fiori Nastro, Paolo

    2016-07-01

    Anomalous subjective experiences involving an alteration of the basic sense of self (ie, Self-disorder [SD]) are emerging as a core marker of schizophrenia spectrum disorders with potential impact on current early detection strategies as well. In this study, we wished to field-test the prevalence of SD in a clinical sample of adolescent/young adult help-seekers at putative risk for psychosis attending standard community mental health facilities in Italy. Participants (n = 47), aged between 14 and 25, underwent extensive psychopathological evaluations with current semi-structured tools to assess Clinical High Risk (CHR) state (ie, Structured Interview for Prodromal Syndromes/Scale of Prodromal Symptoms [SIPS/SOPS], Schizophrenia Proneness Instrument-Adult/Child and Youth [SPI-A/CY]). SD aggregated in CHR subjects as compared to the non-CHR and revealed substantial association with sub-psychotic symptoms (SIPS), subjective experience of cognitive and cognitive-perceptual vulnerability (basic symptoms) and functional level (Global Assessment of functioning). Moreover, a combination of the 2 approaches (ie, CHR plus SD) enabled further "closing-in" on a subgroup of CHR with lower global functioning. The results confirm SD's relevance for the early profiling of youths at potential high risk for psychosis. PMID:26757754

  1. Outpatient Imaging Efficiency - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — Use of medical imaging - national data. These measures give you information about hospitals' use of medical imaging tests for outpatients. Examples of medical...

  2. Outpatient Imaging Efficiency - State

    Data.gov (United States)

    U.S. Department of Health & Human Services — Use of medical imaging - state data. These measures give you information about hospitals' use of medical imaging tests for outpatients. Examples of medical imaging...

  3. Outpatient Imaging Efficiency - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — Use of medical imaging - provider data. These measures give you information about hospitals' use of medical imaging tests for outpatients. Examples of medical...

  4. Anxiety at outpatient hysteroscopy

    OpenAIRE

    Gambadauro, Pietro; Navaratnarajah, Ramesan; Carli, Vladimir

    2015-01-01

    This review summarises current understanding and research on the association between anxiety and outpatient hysteroscopy. Women undergoing hysteroscopy suffer from significant levels of anxiety, with repercussions on pain perception, success rates and satisfaction. Using validated tools such as the Spielberger State-Trait Anxiety Index (STAI) or the Hospital Anxiety and Depression Scale (HADS) in the outpatient hysteroscopy setting, average state anxiety scores similar or greater than those m...

  5. AWARENESS ABOUT EMERGENCY CONTRACEPTIVE PILLS VERSUS CONVENTIONAL CONTRACEPTIVE METHODS AMONG MOTHERS ATTENDING MATERNAL AND CHILD HEALTH (MCH CLINIC, BAPUJI HOSPITAL, DAVANGERE, KARNATAKA

    Directory of Open Access Journals (Sweden)

    Vandana

    2015-02-01

    Full Text Available BACKGROUND: Unwanted pregnancies are a major public health problem for both developing and developed nations, which generally results from ineffective use of contraceptives and end up in induced abortions. Emergency contraception sometimes called “morning after”, “postcoital” or “second chance pills” can be used to prevent pregnancy after an unprotected sex. Attention has been focused on the potential for emergency contraception to reduce the number of unwanted pregnancies and thus abortion rate. OBJECTIVES: 1 . To compare the awareness about emergency contraceptive pills and conventional contraceptive methods among mothers attending MCH clinic, Bapuji Hospital, Davangere. 2. To study the socio - demographic profile of the above group. METHODS: A pre - tested, semi - structured questionnaire was used to know the awareness about emergency contraceptive pills versus conventional contraceptive methods among mothers attending MCH clinic, Bapuji hospital, Davangere from 1 st October 2011 to 31 st December 2011. Data was entered into Excel sheet and was analysed using SPSS software version 17. Data was described as proportions, categorical data using chi square test. RESULTS: A total of 500 mothers were included in the study for duration of 3months. Approximately 80% of the respondents were in the age group of 21 - 30yrs, 72.8% from urban background, 83.4% were Hindus, 55% were from joint family. Approximately 49% belonged to socioeconomic class II and III, 97.2% were literate and 86.6% were housewives. 31.8% had knowledge about emergency contraception which is very less when compared to 84.2% of conventional methods. 6.2% have practiced emergency contraception which is very poor when compared to 47.5% of conventional methods. 77.8% were aware of female sterilization. The most common known temporary method of contrac eption was Cu - T (71% followed by OCP (60.6%. Most common method used by couples was condom (21.8% followed by Cu - T (19

  6. Analysis of related factors of panic disturbance consulted in out-patient clinic%惊恐障碍患者门诊咨询相关因素分析

    Institute of Scientific and Technical Information of China (English)

    杨晓玉; 盛宝英; 乔香兰; 杨晏清; 丛桂红

    2003-01-01

    @@ INTRODUCTION With increasing of social mentality stress factors, anxiety has becomean important mental health problem that people face. It was reportedthat patients with anxiety neurosis consists 2% - 5% of people. Butin mental counseling out-patient clinic of multiple hospital, only13.7% are diagnosed as anxiety neurosis, among which were manypatients with panic disturbance. Patients search for medical servicefor chest pain, palpitation and dying feeling in department of neu-rology or emergeny department. No evidence identifying ischemicheart disease is found after repeated examination and correspondingtreatment can' t effectively alleviate symptoms. The effective rate byantianxiety treatment might be 80. 65%.

  7. Opportunistic and other intestinal parasites among HIV/AIDS patients attending Gambi higher clinic in Bahir Dar city, North West Ethiopia

    Institute of Scientific and Technical Information of China (English)

    Abebe Alemu; Yitayal Shiferaw; Gebeyaw Getnet; Aregaw Yalew; Zelalem Addis

    2011-01-01

    Objective:To determine the magnitude of opportunistic and non-opportunistic intestinal parasitic infections amongHIV/AIDS patients in Bahir Dar.Methods: Cross-sectional study was conducted amongHIV/ AIDS patients attending Gambi higher clinic from April1- May30, 2009. Convenient sampling technique was employed to identify the study subjects and hence a total of248subjects were included. A pre-tested structured questionnaire was used to collect socio-demographic data of patients. Stool samples were examined by direct saline, iodine wet mount, formol-ether sedimentation concentration and modified Ziehl-Neelsen staining technique. Results: Out of248 enrolled in the study,171(69.0%) (90 males and81 females) were infected with one or more intestinal parasites. The highest rate of intestinal parasites were observed amongHIV/AIDS patients (80.3%, 151/188), and the infection rate of HIV negative individuals was 33.3% (20/60). Cryptosporidum parvum(43.6%),Isospora belli (15.5%) andBlastocystis hominis (10.5%)were opportunistic parasites that were found only inHIV/AIDS patients.Conclusions:Opportunistic parasite infections are common health problem among HIV/ AIDS patients in the study area. Therefore, early detection and treatment of these parasites are important to improve the quality of life ofHIV/AIDS patients.

  8. Frequency of HCV infection and its genotypes among patients attending a liver clinic and voluntary blood donors in a rural area of Pakistan

    International Nuclear Information System (INIS)

    Objectives: To determine the frequency of Hepatitis C virus (HCV) infection and its genotypic distribution in a rural area of Sindh, Pakistan. Methodology: Retrospective study of patients attending the Free Liver Clinic (FLC), and investigated for detectable HCV antibodies (n=1638), and those screened for HCV infection prior to voluntary blood donation (n=804) at a teaching hospital, located in rural Sindh. All patients had HCV antibodies tested by ELISA. A total of 1022 patients, who tested 'reactive' to HCV antibodies, and who could financially afford to have HCV RNA tested by PCR, had their results analysed. A total of 200 patients also had their HCV genotyped and analysed. Results: Patients at FLC had a higher chance of being reactive for HCV antibodies, compared to voluntary blood donors (20% VS 14% - p = 0.004). HCV RNA was detectable in 904/1022 (88%) patients. Among type able genotypes, 125/166 (75%) had a single genotype, and 7 patients (4%) were infected with genotype 1, either alone (n=4) or in combination with 3a. Conclusions: One out of every five people tested in our FLC, and 14% of 'healthy' voluntary blood donors were seropositive for HCV antibodies. Genotype 1 is very rare in our region. (author)

  9. Accuracy of serological testing for the diagnosis of prevalent neurocysticercosis in outpatients with epilepsy, Eastern Cape Province, South Africa.

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    Humberto Foyaca-Sibat

    Full Text Available BACKGROUND: Few studies have estimated prevalence of neurocysticercosis (NCC among persons with epilepsy in sub-Saharan Africa. While the limitations of serological testing in identification of NCC are well known, the characteristics of persons who are misdiagnosed based on serology have not been explored. The first objective of this pilot study was to estimate the prevalence of NCC in epilepsy outpatients from an area of South Africa endemic for cysticercosis. The second objective was to estimate the accuracy of serological testing in detecting NCC in these outpatients and characterize sources of disagreement between serology and neuroimaging. METHODOLOGY/PRINCIPAL FINDINGS: All out-patients aged 5 or older attending the epilepsy clinic of St. Elizabeth's Hospital in Lusikisiki, Eastern Cape Province, between July 2004 and April 2005 were invited to participate. Epidemiological data were collected by local study staff using a standardized questionnaire. Blood samples were tested by ELISA for antibody and antigen for Taenia solium. Four randomly chosen, consenting participants were transported each week to Mthatha for brain CT scan. The proportion of persons with epilepsy attending St. Elizabeth clinic with CT-confirmed NCC was 37% (95% CI: 27%-48%. Using CT as the gold standard, the sensitivity and specificity of antibody testing for identifying NCC were 54.5% (36.4%-71.9% and 69.2% (52.4%-83.0%, respectively. Sensitivity improved to 78.6% (49.2%-95.3% for those with active lesions. Sensitivity and specificity of antigen testing were considerably poorer. Compared to false negatives, true positives more often had active lesions. False positives were more likely to keep pigs and to have seizure onset within the past year than were true negatives. CONCLUSIONS/SIGNIFICANCE: The prevalence of NCC in South African outpatients with epilepsy is similar to that observed in other countries where cysticercosis is prevalent. Errors in classification of NCC

  10. Prevalence and associated factors of polypharmacy among adult Saudi medical outpatients at a tertiary care center

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    Salih Bin Salih

    2013-01-01

    Full Text Available Objective: The objective of this study was to assess the prevalence of polypharmacy (PP and the associated factors in medical outpatients. Materials and Methods: A cross-sectional, observational, descriptive study was carried out in adult medical outpatients attending internal medicine clinics at King Abdulaziz Medical City, Riyadh, Saudi Arabia from 1 March 2009 to 31 December 2009. PP was defined as the concomitant use of ≥5 medications daily. The number of medications being currently taken by patient was recorded. Effect of patients′ age, gender, educational level, number of prescribers, disease load and disease type on PP was assessed by multivariate analysis using Statistical Package for Social Sciences Incorporated (SPSS Inc Version 18. Results: Out of 766 patients included in the study, 683 (89% had PP. The mean number of prescribed medications, oral pills and doses was 8.8, 9.6 and 12.1, respectively. Factors significantly associated with PP included age (≥61 years, disease load and the number of prescribers. Gender had no impact on PP while education beyond primary education significantly decreased PP. Hypertension, diabetes mellitus and dyslipidemia alone and as a cluster increased PP. Conclusion: We found an extremely high level of PP in medical outpatients at our tertiary care center. The impact of PP on medication compliance and control of underlying diseases in Saudi Arabia is unknown and needs to be studied at different levels of care.

  11. Prevalence of Internet use amongst an elective spinal surgery outpatient population.

    LENUS (Irish Health Repository)

    Baker, Joseph F

    2010-10-01

    Nationally 62% of individuals in Ireland have internet access. Previous published work has suggested that internet use is higher among those with low back pain. We aimed to determine the levels of internet access and use amongst an elective spinal outpatient population and determine what characteristics influence these. We distributed a self-designed questionnaire to patients attending elective spinal outpatient clinics. Data including demographics, history of surgery, number of visits, level of satisfaction with previous consultations, access to the internet, possession of health insurance, and details regarding use of the internet to research one\\'s spinal complaint were collected. 213 patients completed the questionnaire. 159 (75%) had access to the internet. Of this group 48 (23%) used the internet to research their spinal condition. Increasing age, higher education level, and possession of health insurance were all significantly associated with access to the internet (p < 0.05). A higher education level predicted greater internet use while possession of insurance weakly predicted non-use (p < 0.05). In our practice, internet access is consistent with national statistics and use is comparable to previous reports. Approximately, one quarter of outpatients will use the internet to research their spinal condition. Should we use this medium to disseminate information we need to be aware some groups may not have access.

  12. Knowledge, attitude, perception of malaria and evaluation of malaria parasitaemia among pregnant women attending antenatal care clinic in metropolitan Lagos, Nigeria

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    N.C. Iriemenam, A.O. Dosunmu, W.A. Oyibo & A.F. Fagbenro-Beyioku

    2011-03-01

    Full Text Available Background & objectives: Little information exists on the compliance of pregnant women to malaria managementin malaria endemic countries. This study was designed to access knowledge, attitude, perception and homemanagement of malaria among consenting pregnant women attending antenatal care (ANC clinic.Methods: In total, 350 pregnant women were randomly recruited during their ANC Clinic in Lagos. Structuredquestionnaires were administered in a two-stages research design; first during their early months of ANC visitand the second approximately 1–2 months before delivery. Information on occupation, parity, symptoms used torecognise malaria, treatment sources, control measures, knowledge factors, anti-vector measures, health-seekingpractices, malaria parasitaemia and packed cell volume (PCV were recorded.Results: The results revealed that 78.9% of the pregnant women identified infected mosquitoes as the cause ofmalaria while 86% of the pregnant women identified stagnant water as its breeding sites. Knowledge of thebenefit of insecticide-treated mosquito bednets was less prominent as most of the selected subjects decried itshigh market price. Our data also showed that educational programme targeted on potential mothers is beneficial.Overall, 27.4% (96/350 of the pregnant women had peripheral malaria infection with 88.5% (85/96 of theparasite positive women infected with Plasmodium falciparum and 11.5% (11/96 with P. malariae. PCV rangedfrom 20–40% (median 33.9% with 25.7% (90/350 of the pregnant women being anaemic with PCV <33%. Wefound an association between malaria infection and occupation, and this association was not influenced byparity.Interpretation & conclusion: Our findings revealed that improvement in knowledge and education of women ofchild-bearing age has an influential impact on malaria control

  13. Medication adherence and blood pressure control amongst adults with primary hypertension attending a tertiary hospital primary care clinic in Eastern Nigeria

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    Gabriel UP. Iloh

    2013-02-01

    Full Text Available Background: As the case detection rates of hypertension increase in adult Nigerians, achieving target blood pressure (BP control has become an important management challenge.Objectives: To describe medication adherence and BP control amongst adult Nigerians with primary hypertension attending a primary care clinic of a tertiary hospital in a resource-poor environment in Eastern Nigeria.Methods: A cross-sectional study was carried out in 140 adult patients with primary hypertension who have been on treatment for at least 6 months at the primary care clinic of Federal Medical Centre, Umuahia. A patient was said to have achieved goal BP control if the BP was < 140 per 90 mmHg. Adherence was assessed in the previous 30 days using a pretested researcher-administered questionnaire on 30 days of self-reported therapy. Adherence was graded using an ordinal scoring system of 0–4; an adherent patient was one who scored 4 points in the previous 30 days. Reasons for non-adherence were documented.Results: Adherence to medication and BP control rates were 42.9% and 35.0% respectively. BP control was significantly associated with medication adherence (p = 0.03, antihypertensive medication duration ≥3 years (p = 0.042, and taking ≥ one form of antihypertensive medication (p = 0.04. BP at the recruitment visit was significantly higher than at the end of the study (p = 0.036. The most common reason for non-adherence was forgetfulness (p = 0.046. Conclusion: The rate of BP control amongst the study population was low, which may be connected with low medication adherence. This study urges consideration of factors relating to adherence alongside other factors driving goal BP control.

  14. Awareness and knowledge of Human Papillomavirus (HPV infection among high-risk men of Hispanic origin attending a Sexually Transmitted Infection (STI clinic

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    Colón-López Vivian

    2012-12-01

    Full Text Available Abstract Background Genital Human papilloma virus (HPV is one of the most commonly diagnosed Sexually Transmitted Infection (STIs in men and women. Knowledge about HPV infection among men is limited. This study aims to determine correlates of adequate knowledge of HPV infection among men who attend an STI clinic in Puerto Rico. Methods A cross-sectional study of 206 men was conducted at an STI clinic in San Juan, PR. Adequate knowledge was defined as a score of at least 70% of correct responses among those men who reported having ever heard of HPV. Variables that achieved statistical significance in the bivariate analysis (p Results Although 52.5% of men reported having heard of HPV infection before the survey, only 29.3% of this sub-group had an adequate knowledge of HPV. Most men did not know that HPV is a risk factor for anal (38.7%, penile (50.0% and oral (72.6% cancer. Factors associated with adequate knowledge of HPV in age-adjusted models were being men who have sex with men (MSM (OR=2.6;95%CI=1.1-6.1, self-report of genital warts (OR=3.2;95%CI=1.3-7.9 and herpes (OR=7.4;95% CI=2.2-25.1. MSM was marginally associated with adequate knowledge (OR=2.3;95% CI=0.9-5.9 and self-report of herpes remained significantly associated (OR=5.0;95%CI=1.3-18.4 in multivariate logistic regression analysis. Conclusions Awareness and knowledge of HPV was very low in this group of men. Interventions to increase knowledge and awareness in this group are necessary to promote preventive practices for HPV-related cancers in high-risk groups.

  15. Screening of pregnant women attending the antenatal care clinic of a tertiary hospital in eastern Saudi Arabia for Chlamydia trachomatis and Neisseria gonorrhoeae infections

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    Alzahrani Alhusain

    2010-01-01

    Full Text Available Inroduction: Of the "top ten" sexually transmitted infections, Chlamydia trachomatis and Neisseria gonorrhoeae are ranked second and fifth, respectively, worldwide. Aim: The aim of this study was to screen the pregnant women for C. trachomatis and N. gonorrhoeae infections and to detect antimicrobial resistance pattern of N. gonorrhoeae. Materials and Methods: This study was a prospective, hospital-based analysis of a random sample of pregnant women visiting the antenatal clinic of a tertiary hospital in eastern Saudi Arabia. Endocervical and high vaginal swabs were collected both from pregnant women and female patients attending gynecology clinic with lower genital tract infection (control group. C. trachomatis antigen was detected using enzyme-linked immunosorbent assay (ELISA. N. gonorrhoeae was detected by culture and identification of isolates, and antimicrobial susceptibility testing was performed. Statistical Package for Social Sciences (SPSS version 13.0 and Chi-square test were used for statistical analysis. Results: C. trachomatis antigen was detected in 10.5% (10/95 and 34.4% (35/102 of pregnant women and control group, respectively (P < 0.001. The isolation rate of N. gonorrhoeae among pregnant women was 0.0% compared to 7.8% (8/102 among the control group (P < 0.01. N. gonorrhoeae were resistant to penicillin (62.5%, tetracycline (50%, ampicillin (25%, amoxycillin-clavulinic acid (25% and ciprofloxacin (37.5%, while they were susceptible to cefepime, ceftriaxone, ceftazidime, spectinomycin, and cefuroxime. Conclusion: Screening of pregnant women for C. trachomatis infection should be included in the antenatal care in this area. The detection rate of both organisms among the control group highlights the importance of preventive strategies. Certain antibiotics previously used in treating gonorrhea are no longer effective.

  16. Student Satisfaction with Attending Systems.

    Science.gov (United States)

    McConnell, Thomas A.; And Others

    1993-01-01

    A survey of 252 dental students in three schools measured student satisfaction with (1) the patient care system in the dental school clinic; and (2) the responsibilities of the attending faculty, who manage 10-student teams. Results indicated general satisfaction but point to some problems in individual situations. (MSE)

  17. Epidemiological study of clinical characteristics of patients with PCOS attending infertility clinic and awareness of PCOS in a rural set up

    OpenAIRE

    Shubhada Jajoo; Riju Angik

    2013-01-01

    Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age group. It is a common diagnosis in women presenting with infertility. All the dimensions of PCOS have not been completely explored. In this study we studied the clinical features of PCOS and comparing with non-PCOS infertility patients and simultaneously studied the prevalence of PCOS in infertility patients and its awareness in a rural set up. Methods: It is a prospect...

  18. Smoker's face: an underrated clinical sign?

    OpenAIRE

    Model, D

    1985-01-01

    In a prospective survey of patients attending a general medical outpatient clinic roughly half the current cigarette smokers who had smoked for 10 years or more were identified, using defined criteria, by their facial features alone. These facial features, designated "smoker's face," were present in three (8%) of those who had smoked cigarettes for 10 years or more in the past and in none of the non-smokers. The association of smoker's face with current smoking that had continued for 10 years...

  19. The implementation of the clinic nursing students training plan and effect Zhangye district people's hospital outpatient%门诊护生培训计划的实施与效果

    Institute of Scientific and Technical Information of China (English)

    马慧珍

    2015-01-01

    目的:提高门诊护生实习效果。方法:对全年门诊科室100名大专护生在门诊实习一个月内全部发放培训计划手册,执行一对一带教,实习年度结束后统计数据对比。结果:通过2012年和2013年数据比较,护生实习效果明显提高。结论:门诊护生发放培训计划手册,执行一对一带教,在短期实习时间内获得了非常好的学习效果。%objective:to improve the effect of clinic practice of nursing students.Methods:the outpatient department for the whole year 100 college nursing students in clinic practice handbook,all paid within one month of training program to perform a teaching,internship after the annual statistical data contrast.Re-sults:through comparing data in 2012 and 2012,the nursing students internship effect is improved obviously.Conclusion:the outpatient service nursing students training plan manual,perform a pair of teaching,in a short -term internship time obtained the very good learning effect.

  20. Optimizing pain care delivery in outpatient facilities: experience in NCI, Cairo, Egypt.

    Science.gov (United States)

    Hameed, Khaled Abdel

    2011-04-01

    As a result of increasing waiting lists of patients attending National Cancer Institute of Cairo, we are faced to provide high-quality pain care service through our outpatient pain clinic. The program description presented here shows the capacity of a 24 hours/7 days outpatient cancer pain management service to provide rapidly accessible, high-quality care to patients with complex pain and palliative care symptom burdens. In addition, this model avoids inpatient hospital admissions. Pain clinics of cancer are committed to helping patients and families identify and implement the treatments necessary to achieve optimum functional ability and the best possible quality of life. These clinics also help to communicate and work with the family physician, surgeon, and other physicians associated with patient treatment. Cancer pain is complex in its causes, and affects all parts of the body. It involves the tissues, body systems , and the mind. Being multidimensional, it is never adequately addressed with unidimensional treatment. Pain management must extend beyond physical approaches to include the psychological, social, and even spiritual aspects of the patient. Effective integrated treatment fosters self awareness and teaches appropriate and effective self care. With time, complex issues are managed, pain is reduced, and the patient moves toward peak physical and psychological functioning. These goals can be achieved by providing the highest quality pain management services. Patients attending the clinic get treated medically for their physical ailments. Their emotional and psychological problems also need to be attended with an atmosphere of love and care. The mission of the highest quality service is to obtain customer satisfaction with reduction of cost in a multidisciplinary (or better interdisciplinary) approach. This can be reached by proper identification of the customers either internal or external, assessing their needs, and implementing plans for their

  1. Optimizing pain care delivery in outpatient facilities: experience in NCI, Cairo, Egypt.

    Science.gov (United States)

    Hameed, Khaled Abdel

    2011-04-01

    As a result of increasing waiting lists of patients attending National Cancer Institute of Cairo, we are faced to provide high-quality pain care service through our outpatient pain clinic. The program description presented here shows the capacity of a 24 hours/7 days outpatient cancer pain management service to provide rapidly accessible, high-quality care to patients with complex pain and palliative care symptom burdens. In addition, this model avoids inpatient hospital admissions. Pain clinics of cancer are committed to helping patients and families identify and implement the treatments necessary to achieve optimum functional ability and the best possible quality of life. These clinics also help to communicate and work with the family physician, surgeon, and other physicians associated with patient treatment. Cancer pain is complex in its causes, and affects all parts of the body. It involves the tissues, body systems , and the mind. Being multidimensional, it is never adequately addressed with unidimensional treatment. Pain management must extend beyond physical approaches to include the psychological, social, and even spiritual aspects of the patient. Effective integrated treatment fosters self awareness and teaches appropriate and effective self care. With time, complex issues are managed, pain is reduced, and the patient moves toward peak physical and psychological functioning. These goals can be achieved by providing the highest quality pain management services. Patients attending the clinic get treated medically for their physical ailments. Their emotional and psychological problems also need to be attended with an atmosphere of love and care. The mission of the highest quality service is to obtain customer satisfaction with reduction of cost in a multidisciplinary (or better interdisciplinary) approach. This can be reached by proper identification of the customers either internal or external, assessing their needs, and implementing plans for their

  2. Demographic study of port wine stain patients attending a laser clinic: family history, prevalence of naevus anaemicus and results of prior treatment.

    Science.gov (United States)

    Mills, C M; Lanigan, S W; Hughes, J; Anstey, A V

    1997-07-01

    All patients with port wine stains (PWS) attending a tunable dye laser clinic were examined by one author (SWL), forming a large group which has allowed study of the demographic data of such patients. Two hundred and eighty-three patients, 217 females (median age 24 years, range 0.5-73) and 66 males (median age 20 years, range 0.75-72), were examined. The PWS were on the face in 226, neck in 69, trunk in 36, upper limb in 35 and lower limb in 29. The commonest lesional colour was purple (63 patients), while 39 naevi were pink/red, 35 pink/ purple and 35 pink. The naevus was flat in 255 patients, cobblestoned in 28, associated with hypertrophy in 31 and with scarring in 22. Seventy-two patients (25.4%) had a positive family history of birthmarks, 20 strawberry haemangiomas and 22 PWS, the family history of PWS being higher than expected for the prevalence of this naevus in the population. One hundred and forty-six patients were also examined for naevus anaemicus which was noted in 12 (8.2%), confirming an association between these two naevi. Ninety-four patients had received previous treatment, most commonly with the argon laser (56 patients), of whom only five reported a good result, and 17 of 22 patients with treatment-related scarring had been treated with this laser. Cosmetic camouflage was used in 109 (38.5%) of patients, who usually had PWS on the face (94%), of whom only 46 (16%) had received advice of its use. PMID:9499604

  3. Multiplex immunoassay of lower genital tract mucosal fluid from women attending an urban STD clinic shows broadly increased IL1ß and lactoferrin.

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    Gregory T Spear

    Full Text Available BACKGROUND: More than one million new cases of sexually transmitted diseases (STDs occur each day. The immune responses and inflammation induced by STDs and other frequent non-STD microbial colonizations (i.e. Candida and bacterial vaginosis can have serious pathologic consequences in women including adverse pregnancy outcomes, infertility and increased susceptibility to infection by other pathogens. Understanding the types of immune mediators that are elicited in the lower genital tract by these infections/colonizations can give important insights into the innate and adaptive immune pathways that are activated and lead to strategies for preventing pathologic effects. METHODOLOGY/PRINCIPAL FINDINGS: 32 immune mediators were measured by multiplexed immunoassays to assess the immune environment of the lower genital tract mucosa in 84 women attending an urban STD clinic. IL-3, IL-1ß, VEGF, angiogenin, IL-8, ß2Defensin and ß3Defensin were detected in all subjects, Interferon-α was detected in none, while the remaining mediators were detected in 40% to 93% of subjects. Angiogenin, VEGF, FGF, IL-9, IL-7, lymphotoxin-α and IL-3 had not been previously reported in genital mucosal fluid from women. Strong correlations were observed between levels of TNF-α, IL-1ß and IL-6, between chemokines IP-10 and MIG and between myeloperoxidase, IL-8 and G-CSF. Samples from women with any STD/colonization had significantly higher levels of IL-8, IL-3, IL-7, IL-1ß, lactoferrin and myeloperoxidase. IL-1ß and lactoferrin were significantly increased in gonorrhea, Chlamydia, cervicitis, bacterial vaginosis and trichomoniasis. CONCLUSIONS/SIGNIFICANCE: These studies show that mucosal fluid in general appears to be an environment that is rich in immune mediators. Importantly, IL-1ß and lactoferrin are biomarkers for STDs/colonizations providing insights into immune responses and pathogenesis at this mucosal site.

  4. Inpatient and outpatient cardiac rehabilitation programmes improve cardiometabolic risk in revascularized coronary patients with type 2 diabetes

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    Claudiu Avram

    2010-12-01

    Full Text Available The purpose of this paper is to evaluate cardiometabolic risk reduction of diabetic patients following coronary revascularizationprocedures after participation in outpatients or inpatients cardiac rehabilitation programmes. Materials and methods: weperformed a retrospective analytical study which included a group of 103 revascularized coronary patients with diabetesmellitus. Depending on participation in a cardiac rehabilitation program we have defined the following subgroups of patients:Group O (N=37 - attended the outpatient cardiac rehabilitation program; Group H (N=37 - attended the inpatient cardiacrehabilitation program; Group C (N=34 - did not participate in any cardiac rehabilitation program. Between those two momentsof assessment: T0 - revascularization / early post-revascularization and T1 - time of the interview (16±2.3 months afterrevascularization, patients in groups A and S participated in outpatient cardiac rehabilitation program (12 weeks, 3sessions/week of exercise training, with clinical and paraclinical evaluation scheduled at 1, 6, 12 months afterrevascularization, or inpatient cardiac rehabilitation program (3 weeks, intensive sessions, scheduled at 1, 3, 6 and 12months after revascularization. Results: at the end of the study, we found significant differences among the three groups forthe following parameters: body mass index (p=0.01, systolic blood pressure (p=0.002, total cholesterol (p<0.001, LDLcholesterol(p<0.001 and non-HDL cholesterol (p=0.004 in favor of groups A and S, that have participated in comprehensivecardiac rehabilitation programs. Conclusions: comprehensive cardiac rehabilitation programmes, performed outpatient orinpatient, are effective methods of reducing the high cardiometabolic risk, specific in revascularized coronary patients withdiabetes.

  5. Knowledge of and attitude to foot care amongst Type 2 diabetes patients attending a university-based primary care clinic in Nigeria

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    Rabi I. Ekore

    2010-03-01

    Full Text Available Background: Individuals living with diabetes mellitus are at an increased risk of developing foot ulcers and cardiovascular complications or a neuropathy that may result in amputations. These complications have been shown to be already present in about 10% of diabetic patients at the time of diagnosis.Objectives: This study was carried out to determine the level of awareness and attitude to foot care among adult diabetic patients attending a university health centre (i.e. a primary care centre and to emphasise the ever-present need for health education and promotion and early complication detection (especially of foot problems among diabetic patients.Method: A descriptive cross-sectional, clinic-based study was carried out at the University of Ibadan Health Centre (Jaja Clinic. The study population consisted of consenting adult diabetic patients. Data were collected by the self-administration of structured questionnaires to eligible subjects and were analysed using the SPSS v.15software. Appropriate statistics were employed to analyse the collected data.Results: A total of 137 patients participated in the study and ranged in age from 37 to 75 years, with the mean ± SD age being 58.2 ± 9.2 years. Of the participants, 98 (71.5% were men and 39 (28.5%were women; all of the participants were married. The duration of illness ranged from 1 year to 20 years, with the median duration of illness being 3 ± 1.7 years. One hundred and twenty-six (92%patients had never received any education on foot care from their healthcare providers, while 11(8% had received some form of foot care education. Among those who had never received any foot care education, 92 (73% had been diabetic for 1–5 years, while the remaining 34 (27% had been diabetic for 6 – 20 years. Of the foot care measures that were known, 35 (25.5% patients knew to wash their feet daily and dry in between the toes thoroughly, 31 (22.6% knew not to go outdoors barefooted, 27 (19.7% checked

  6. Prevalence of gingivitis and perception of gingival colour among pregnant women attending the antenatal clinic of Lagos University Teaching Hospital, Idi-Araba

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    Modupeoluwa Omotunde Soroye

    2016-01-01

    Full Text Available Objective: To determine the prevalence of gingivitis and perception of gingival colour among pregnant women attending the antenatal clinic of a tertiary health institution in Lagos State, Nigeria. Materials and Methods: A single-point assessment was conducted using a self-reported questionnaire completed by participants. Information such as patients′ age, gestational age, educational status, occupation, and perception of gingival colours was obtained. Furthermore, the participants were examined by trained dentists to determine their gingival colours and the presence and severity of gingival inflammation. The data obtained were processed, and descriptive and comparative analyses were done using Epi info version 3.5.1 (2008. Statistical significance was established at P values <0.05. Results: Four hundred and forty-five pregnant women aged between 18 years and 43 years [mean age: 30.3 (±4.61 years] participated in the study. Gestational age was between 4 weeks and 41 weeks with a mean of 23.49 (±9.53 weeks. The prevalence of gingivitis was 85.2%. Two hundred and thirty (51.7% participants described their gingival colour as pink, 127 (28.5% as red, 51 (11.5% as black, 3 (0.7% as white, 2 (0.4% as brown, and 32 (7.2% could not determine the colour of their gingivae. Two hundred and ten (47.2% participants knew that pink was the normal colour of a healthy gingiva. From objective clinical examinations by dentists, 344 (77.3% patients had pink gingivae, 85 (19.1% had pigmented gingivae, and only 16 (3.6% had red gingivae. Conclusion: The higher prevalence of gingivitis during pregnancy is well-established and that observation is corroborated by this study. Since a change in gingival colour may be an early indication of gingival inflammation, early detection and prompt treatment could prevent further periodontal deterioration. Hence, there is the need to incorporate and intensify oral health education during antenatal care so that pregnant women are

  7. Clinical features and sociodemographic factors affecting Trichomonas vaginalis infection in women attending a central sexually transmitted diseases clinic in Sri Lanka

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    Sumadhya D Fernando

    2012-01-01

    Full Text Available Introduction: Trichomoniasis is a relatively neglected area of research in Sri Lanka. Given the number of infections observed, an analysis of sociodemographic characteristics of patients would be valuable in prevention. Materials and Methods: Data were collected from 359 newly registered women at a tertiary level sexually transmitted diseases clinic over a period of 18 months. Trichomoniasis was diagnosed by culture of vaginal swabs collected from the posterior fornix. Results: The prevalence of trichomoniasis in the sample was 7.2%. Of those who tested positive for trichomoniasis, 76% were in the age group of 21-45 years, 68% were married and living with a spouse and 60% were unemployed. A diagnosis of Trichomoniasis was associated with being married (OR, 1.6; CI, 0.56-4.41, age over 33 years (OR=1.3, CI, 0.55-2.9, being employed (OR, 1.3; CI, 0.56 - 2.94, having an education of less than ten years at school (OR, 3.0; CI 1.28-7.26 and not using condoms during the last sexual act (OR 2.0, CI 0.84-4.86. The risk was less among commercial sex workers (OR, 0.3, CI: 0.14-0.85, those with multiple sexual partners (OR, 0.2; CI; 0.073-0.408 and women reporting extramarital sexual relationships (OR, 0.3; CI, 0.128-0.733. Conclusions: Education on safe sex and recognition of symptoms is currently targeted at high risk groups such as commercial sex workers. Extending these programmes to the rest of the community will further reduce the risk of transmission of trichomonas.

  8. VA Outpatient Visits by Administrative Parent, FY2010-2014

    Data.gov (United States)

    Department of Veterans Affairs — Outpatient visits by Administrative Parent. A visit is counted as a visit to one or more clinics or units within 1 calendar day at the site of care level. A patient...

  9. Patterns of complementary and alternative medicine use amongst outpatients in Tokyo, Japan

    Directory of Open Access Journals (Sweden)

    Vasconcelos Joana C

    2008-04-01

    Full Text Available Abstract Background The use of complementary and alternative medicine (CAM has been increasing rapidly throughout the world during the past decade. The use of CAM in the general Japanese population has been previously reported to be as high as 76%. This study aims to investigate the patterns of CAM use, perceived effectiveness and disclosure of CAM use to orthodox medical practitioners amongst patients attending typical primary and secondary care clinics in a busy district general hospital in Tokyo, Japan. Methods The authors analysed data collected during March 2002 on patients attending general outpatient clinics held at Shiseikai Daini Hospital in Tokyo, Japan. Data was collected by use of self-completed questionnaires distributed to patients in the outpatient clinics waiting area. Statistical analysis was performed using chi-square tests of independence. Results 515 adults were approached to participate in this study and the overall response rate was 96% (n = 496. 50% of the patients were using or have used at least 1 CAM therapy within the last 12 months. The 5 most commonly used therapies were massage (n = 106, 43%, vitamins (n = 85, 35%, health foods including dietary supplements (n = 56, 23%, acupressure (n = 51, 21% and kampo (n = 46, 19%. The majority of CAM users (75%, n = 145 found their CAM treatment to be effective (95% CI = 68–81%. Patients who were more likely to use CAM were females (p = 0.003 and those with a high number of medical conditions (p = Conclusion Patterns of CAM usage in the sample surveyed was high (50%. Despite this high prevalence rate and presumed acceptance of CAM in Japan, the reporting of CAM use by patients to their physicians was low (42%. It is therefore important that physicians are aware of the possibility that their patients may be using CAM and also increase their knowledge and understanding of these treatments.

  10. Skype clinics after intestinal transplantation - follow-up beyond post codes.

    Science.gov (United States)

    Gerlach, Undine A; Vrakas, Georgios; Holdaway, Lydia; O'Connor, Marion; Macedo, Rubens; Reddy, Srikanth; Friend, Peter J; Giele, Henk; Vaidya, Anil

    2016-07-01

    The follow-up after intestinal transplantation (ITX) is complex and limited to specialized centers. ITX recipients often travel all over the country to be seen in the outpatient clinic of specialized centers which is costly and time-consuming. Videoconferences through Skype have been implemented to eliminate travel time, costs, and to improve patient compliance without jeopardizing safety. Eighteen of 19 patients followed up after ITX or modified multivisceral transplantation (MMVTX) in conventional outpatient clinics in Oxford agreed to attend additional Skype clinics. All patients who were followed up through Skype clinics after ITX/MMVTX received a questionnaire to measure their satisfaction with methods and technical aspects of videoconferencing as well as time/mode of traveling, travel expenses/costs, waiting time in outpatient clinic and patients' satisfaction. Mean travel distance to Oxford was 236 ± 168 miles, mean travel time was 277 ± 175 min, and mean travel cost was 200 ± 56 Great Britain Pounds. A total of 56% had to take time off work and/or find child/family care for the time spent in travel. These patients reported a satisfaction score of 4.38 ± 0.77 of 5 points as opposed to 2.88 ± 0.90 for attending the conventional outpatient clinic. Skype clinics have been proven successful and feasible in highly specialized fields like ITX in eligible patients.

  11. Skype clinics after intestinal transplantation - follow-up beyond post codes.

    Science.gov (United States)

    Gerlach, Undine A; Vrakas, Georgios; Holdaway, Lydia; O'Connor, Marion; Macedo, Rubens; Reddy, Srikanth; Friend, Peter J; Giele, Henk; Vaidya, Anil

    2016-07-01

    The follow-up after intestinal transplantation (ITX) is complex and limited to specialized centers. ITX recipients often travel all over the country to be seen in the outpatient clinic of specialized centers which is costly and time-consuming. Videoconferences through Skype have been implemented to eliminate travel time, costs, and to improve patient compliance without jeopardizing safety. Eighteen of 19 patients followed up after ITX or modified multivisceral transplantation (MMVTX) in conventional outpatient clinics in Oxford agreed to attend additional Skype clinics. All patients who were followed up through Skype clinics after ITX/MMVTX received a questionnaire to measure their satisfaction with methods and technical aspects of videoconferencing as well as time/mode of traveling, travel expenses/costs, waiting time in outpatient clinic and patients' satisfaction. Mean travel distance to Oxford was 236 ± 168 miles, mean travel time was 277 ± 175 min, and mean travel cost was 200 ± 56 Great Britain Pounds. A total of 56% had to take time off work and/or find child/family care for the time spent in travel. These patients reported a satisfaction score of 4.38 ± 0.77 of 5 points as opposed to 2.88 ± 0.90 for attending the conventional outpatient clinic. Skype clinics have been proven successful and feasible in highly specialized fields like ITX in eligible patients. PMID:27140671

  12. Patient adherence to evidence-based pharmacotherapy in systolic heart failure and the transition of follow-up from specialized heart failure outpatient clinics to primary care

    DEFF Research Database (Denmark)

    Gjesing, Anne; Schou, Morten; Torp-Pedersen, Christian Tobias;

    2013-01-01

    of evidence-based pharmacotherapy during and after participation in specialized HFCs. METHODS AND RESULTS: Initiation, dosages, and adherence were studied in patients with systolic HF attending HFCs in Denmark from 2002 to 2009. Information was obtained from an electronic patient file and research database...... initiated renin-angiotensin system (RAS) inhibitors and beta-blockers. Adherence after 1 year was 93% for RAS inhibitors, 92% for beta-blockers, and 86% for spironolactone. After 3 years, it was 90% for RAS inhibitors, 88% for beta-blockers, and 74% for spironolactone. For patients referred back...

  13. Comorbid Illness, Bowel Preparation, and Logistical Constraints Are Key Reasons for Outpatient Colonoscopy Nonattendance

    Directory of Open Access Journals (Sweden)

    Deepti Chopra

    2016-01-01

    Full Text Available Background. Colonoscopy nonattendance is a challenge for outpatient clinics globally. Absenteeism results in a potential delay in disease diagnosis and loss of hospital resources. This study aims to determine reasons for colonoscopy nonattendance from a Canadian perspective. Design. Demographic data, reasons for nonattendance, and patient suggestions for improving compliance were elicited from 49 out of 144 eligible study participants via telephone questionnaire. The 49 nonattenders were compared to age and sex matched controls for several potential contributing factors. Results. Nonattendance rates were significantly higher in winter months; the OR of nonattendance was 5.2 (95% CI, 1.6 to 17.0, p<0.001 in winter versus other months. Being married was positively associated with attendance. There was no significant association between nonattendance and any of the other variables examined. The top 3 reasons for nonattendance were being too unwell to attend the procedure, being unable to complete bowel preparation, or experiencing logistical challenges. Conclusions. Colonoscopy attendance rates appear to vary significantly by season and it may be beneficial to book more colonoscopies in the summer or overbook in the winter. Targets for intervention include more tailored teaching sessions, reminders, taxi chits, and developing a hospital specific colonoscopy video regarding procedure and bowel preparation requirements.

  14. Determination of {sup 131}Iodine Incorporation of the attending personnel at a nuclear medical clinic; Bestimmung von {sup 131}Jod-Inkorporationen beim Pflegepersonal einer nuklearmedizinischen Klinik

    Energy Technology Data Exchange (ETDEWEB)

    Petzold, J.; Lincke, T.; Petzold, L.; Sabri, O.; Seese, A. [Universitaetsklinikum Leipzig (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Alborzi, H.; Keller, A.; Meyer, K.

    2007-07-01

    During a radioiodine therapy, the patients discharge {sup 131}I also via the breathing air. At the attending personnel of a therapy station, contaminations and incorporations up to 400 Bq could be found by means of whole body counting. The height of the measured values depends only on the duration of stay of the personnel in the patients room. (orig.)

  15. 78 FR 43533 - Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical...

    Science.gov (United States)

    2013-07-19

    ..., Ninth Revision, Clinical Modification ICD Implantable cardioverter defibrillator ICU Intensive care unit...: Cardiac Rehabilitation Measure: Patient Referral From an Outpatient Setting D. Quality Measures...

  16. Correlates and depression among married women outpatients with Type II diabetes: an exploratory study

    Directory of Open Access Journals (Sweden)

    Meral Kelleci

    2016-06-01

    Full Text Available Objektive: The purpose of this study was to examine correlates and depression among married women with Type II diabetes attended the diabetes outpatient clinic. We studied depression in women with Type II diabetes in relation to their demographic, medical and biochemical characteristics. Method:The study sample included 351 women with Type II diabetes who presented to the diabetes outpatient clinic, were married, had no psychiatric diagnosis, and agreed to participate in the study. Their depression status was assessed with the General Health Questionnaire-28 (GHQ-28. The data on biochemical test results (fasting blood glucose, HbA1c, total triglycerides, total cholesterol, LDL, HDL, socio-demographic and disease characteristics were obtained from the patients’ medical records or through interviews held with the patients. Results: Of the participants 42.7% were found to be at a greater risk for depression. The logistic regression analysis revealed that the participants having three or more children were at risk of depression 1.848 times more than were those having two or fewer children (95% CI: 1135-3009, p 0.05. Conclusions: This study revealed that nearly half of the participants with Type II diabetes were at risk of depression, and that factors such as education level, the number of the children, duration of the disease, presence of hypertension, the treatment type and some of the biochemical indicators played an important part in diabetes-related health care.

  17. Trends in antibiotic use among outpatients in New Delhi, India

    Directory of Open Access Journals (Sweden)

    Holloway Kathleen

    2011-04-01

    Full Text Available Abstract Background The overall volume of antibiotic consumption in the community is one of the foremost causes of antimicrobial resistance. There is much ad-hoc information about the inappropriate consumption of antibiotics, over-the-counter availability, and inadequate dosage but there is very little actual evidence of community practices. Methods This study surveyed antibiotic use in the community (December 2007-November 2008 using the established methodology of patient exit interviews at three types of facilities: 20 private retail pharmacies, 10 public sector facilities, and 20 private clinics to obtain a complete picture of community antibiotic use over a year. The Anatomical Therapeutic Chemical (ATC classification and the Defined Daily Dose (DDD measurement units were assigned to the data. Antibiotic use was measured as DDD/1000 patients visiting the facility and also as percent of patients receiving an antibiotic. Results During the data collection period, 17995, 9205, and 5922 patients visiting private retail pharmacies, public facilities and private clinics, respectively, were included in our study. 39% of the patients attending private retail pharmacies and public facilities and 43% of patients visiting private clinics were prescribed at least one antibiotic. Consumption patterns of antibiotics were similar at private retail pharmacies and private clinics where fluoroquinolones, cephalosporins, and extended spectrum penicillins were the three most commonly prescribed groups of antibiotics. At public facilities, there was a more even use of all the major antibiotic groups including penicillins, fluoroquinolones, macrolides, cephalosporins, tetracyclines, and cotrimoxazole. Newer members from each class of antibiotics were prescribed. Not much seasonal variation was seen although slightly higher consumption of some antibiotics in winter and slightly higher consumption of fluoroquinolones during the rainy season were observed

  18. Sex education and rehabilitation with schizophrenic male outpatients.

    Science.gov (United States)

    Lukoff, D; Gioia-Hasick, D; Sullivan, G; Golden, J S; Nuechterlein, K H

    1986-01-01

    Research indicates that schizophrenic patients lack intimate relationships and show a high rate of sexual dysfunction. Despite increasing awareness of the rights of handicapped persons to sexual expression, the treatment of schizophrenic patients rarely addresses their sexuality. A sex education program for recent-onset male schizophrenic patients attending an outpatient clinic was developed in response to several incidents involving patients' inappropriate sexual behaviors. To enhance our understanding of the current sexual functioning and needs of these patients, sex histories were taken. Almost all of the 16 patients interviewed were sexually active, with autoerotic activity predominating. Sixty-three percent of the patients reported orgasmic and/or erectile dysfunctions. Other studies have linked sexual dysfunction to the side effects of antipsychotic medications. The objectives of the sex education program were: to provide information; to clarify values; to overcome sexual dysfunction; and to enhance intimacy skills. The authors used role playing, modeling, group exercises, and explicit sex therapy audiovisual material to improve patients' intimacy skills. Patients participated actively and used the group to explore sexual issues. No exacerbations of symptoms were observed among patients participating in the program. PMID:3027886

  19. Insufficient depression treatment in outpatient settings

    OpenAIRE

    Berger, Mathias; Gaebel, Wolfgang; Hegerl, Ulrich; Mulert, Christoph; Menke, Ralph; Bermejo, Isaac; Kratz, Sandra; Schneider, Frank; Härter, Martin

    2004-01-01

    Background: The present status of outpatient treatment of depression in Germany was evaluated with respect to the adherence of general practitioners (GPs) and specialists of psychiatry to clinical practice guidelines. Methods: In total, 488 depressed patients' psychopathology, diagnostic assessment, therapeutic measures and referral frequency were documented at inclusion into study by 43 general practitioners and 23 specialists of psychiatry in three regions of Germany. The investigation of c...

  20. The correlation between emotional distress and aging males’ symptoms at a psychiatric outpatient clinic: sexual dysfunction as a distinguishing characteristic between andropause and anxiety/depression in aging men

    Directory of Open Access Journals (Sweden)

    Chen CY

    2013-06-01

    Full Text Available Ching-Yen Chen,1,4,5 Chin-Pang Lee,1,4 Yu Chen,2,4,5 Jun-Ran Jiang,3,4,5 Chun-Lin Chu,1,4,5 Chun-Liang Chen3,4,5 1Department of Psychiatry, 2Department of Urology, 3Department of Traditional Chinese Medicine, 4Men’s Health Center, Chang Gung Memorial Hospital at Linkou, Taiwan; 5School of Medicine, Chang Gung University, Taoyuan, Taiwan Background: Andropause and psychiatric disorders are associated with various symptoms in aging males and are part of the differential diagnosis of depression and anxiety. This study was designed to investigate the relationship between symptoms of aging, anxiety, and depression, and to determine if sexual dysfunction could be a differentiating characteristic in the psychiatric outpatient clinic. Methods: One hundred seventy-six male psychiatric outpatients participated in the study and completed self-reported measures assessing symptoms of aging, depression, and anxiety. Symptoms of aging were assessed by the Aging Males’ Symptoms scale. Anxiety and depression were measured by the Hospital Anxiety and Depression Scale. Erectile dysfunction was considered if a response to item 15 on the Aging Males’ Symptoms scale (impaired sexual potency was rated with 4 or 5 points. Affective disturbance was assessed by the total scores of the Hospital Anxiety and Depression Scale. Results: Age was correlated with less anxiety and more sexual symptoms. Anxiety and depression were associated with more severe symptoms of aging, and depression was associated with more sexual symptoms than was anxiety. Impaired sexual potency was the only sexual symptom not significantly associated with depression and anxiety. Depression was associated with an interspousal age gap of ≥6 years. The point prevalence of erectile dysfunction was 28.4%, and age and affective disturbance were associated with the risk of erectile dysfunction. Conclusion: Impaired sexual potency should raise the suspicion of androgen deficiency rather than depression

  1. Screening for major depressive disorder with the Patient Health Questionnaire (PHQ-9 and PHQ-2 in an outpatient clinic staffed by primary care physicians in Japan: a case control study.

    Directory of Open Access Journals (Sweden)

    Keiko Suzuki

    Full Text Available The Patient Health Questionnaire (PHQ-9 is a self-report questionnaire commonly used to screen for depression, with ≥8-11 generally recommended as the cut-off. In Japan, studies of the validity of the PHQ-9 and PHQ-2 have been limited. In this study, we examined the utility of the PHQ-9 and PHQ-2 at an outpatient clinic in a Medical University Hospital in Japan.New consecutive outpatients were included in the study. We administered the PHQ-9 to 574 patients, and acquired complete PHQ-9 and PHQ-2 data for 521 patients. Major depressive disorders were diagnosed according to the DSM-IV-TR.Forty-two patients were diagnosed with major depressive disorders. The mean PHQ-9 (15.7 and PHQ-2 (3.8 scores of the patients with major depressive disorders were significantly higher than the scores of the patients without depression (6.0 (PHQ-9 and 1.8 (PHQ-2. The best cut-off points for the PHQ-9 and PHQ-2 summary scores were ≥11 (sensitivity 0.76, specificity 0.81 and ≥3 (sensitivity 0.76, specificity 0.82, respectively. No relationship was observed between the age and PHQ-9 scores.The PHQ-9 and PHQ-2 were useful instruments for screening for major depressive disorders. The best cut-off point for the PHQ-9 summary score should be ≥11 to detect depression in the primary care setting in Japan.

  2. A randomized trial assessing the impact of written information on outpatients' knowledge about and attitude toward randomized clinical trials. The Info Trial Group

    DEFF Research Database (Denmark)

    Kruse, A Y; Kjaergard, L L; Krogsgaard, K;

    2000-01-01

    To improve the patient education process in clinical research, three information materials describing general aspects of design and conduct of randomized clinical trials were developed. The materials varied in length, reading ability level, and reader appeal. Their influence on knowledge about an...

  3. Clinical Profile, Co-Morbidities and Health Related Quality of Life in Pediatric Patients with Allergic Rhinitis and Asthma

    OpenAIRE

    Keya R. Lahiri, Milind S. Tullu* and Rachna Kalra

    2010-01-01

    Background: Co-existence of allergic rhinitis (AR) and bronchial asthma (BA) is well known. We planned to study the clinical profile of patients with AR & BA, the associated co-morbidities and the effect of AR &/ or BA on health related quality of life (HRQOL) in Pediatric patients. Methods: Patients attending the Pediatric out-patients department and Pediatric Chest Clinic of tertiary care center were enrolled. The sample size included 100 subjects with BA & AR (Group 1) with control groups ...

  4. The frequency of atheromas in panoramic radiographs of patients with periodontal disease, 40 year and older attending the University Dental Clinic

    International Nuclear Information System (INIS)

    The aim of the present study was to determine the frequency of atheromas in panoramic radiographic in patients 40 years and older with periodontal diseases attending the Dental School 'Roberto Beltran Neira' in the Universidad Peruana Cayetano Heredia, during the period 2000 and 2004. The sample consisted of 217 random panoramic radiographic with no systematically selected subjects. Variables were analyzed using frequency tables and the chi-square test. Results showed the frequency of atheromas was of 17.1% and the highest number of atheromas appeared between the ages of 40 and 59 years, mostly of feminine sex. (author)

  5. Monitoring Student Attendance Using Dashboard

    OpenAIRE

    Hasniza Yahya; Rina Md. Anwar

    2013-01-01

    Research has shown that student attendance has positive relationship with academic achievement. However, the manual process of taking attendance using paper does not allow the teacher to easily view and monitor individual attendance. The purpose of this paper is to discuss the use of dashboard in managing and monitoring student attendance. By using the attendance dashboard, teacher can easily track the attendance of a student and take necessary actions when needed.

  6. Perfil dos atendimentos ambulatoriais realizados em uma clínica de cirurgia plástica no sul do Brasil Outpatient service profile in a plastic surgery clinic in Southern Brazil

    Directory of Open Access Journals (Sweden)

    Everton Fernando Alves

    2010-07-01

    Full Text Available Objetivo: Descrever o perfil dos atendimentos ambulatoriais realizados em uma clínica de cirurgia plástica no sul do Brasil. Materiais e Métodos: Foi realizado um estudo descritivo, exploratório e de caráter quantitativo com o intuito de analisar a totalidade de atendimentos ambulatoriais (consultas e cirurgias realizadas em uma clínica privada de cirurgia plástica no período de 01 de janeiro a 31 de dezembro de 2010. Resultados: Observou-se que, das 671 (60,5% consultas novas, apenas 205 (18,5% cirurgias foram realizadas. Março foi o mês com mais consultas (10% e cirurgias (11,7%. Do total de consultas novas, as reparadoras foram predominantes em 55,6% dos casos seguidos das estéticas com 33,7%. A média etária foi de 37 anos e com predomínio de mulheres. A idade variou de 8 meses a 89 anos. Os pacientes casados representaram a maioria das cirurgias (49,8%; houve predomínio de pacientes na fase adulta (31 a 59 anos com 316 pacientes (47,1%. A Unimed foi o convênio mais atendido (49,3% nas consultas; os procedimentos cirúrgicos mais frequentes foram as exéreses e/ou raspagem de afecções de pele e anexos 70 (33,1%, seguido das mastoplastias (mastoplastia de aumento, mamopexia, ginecomastia. Conclusão: Apesar da maioria dos atendimentos cirúrgicos terem sido exéreses de deformidades congênitas e/ou adquiridas, o resultado não se distancia da realidade encontrada no restante do Brasil, com predomínio de mulheres e grande número de implantes mamários. A clínica em estudo é uma instituição que apresenta condições para a viabilização de atendimentos ambulatoriais, considerando-se as inúmeras vantagens proporcionadas por este método.Objective: To describe the outpatient service profile in a plastic surgery clinic in southern Brazil. Materials and Methods: It was conducted a descriptive, exploratory and quantitative study in order to analyze the total outpatient service (consultations and surgeries performed in a

  7. Association of short-term exposure to ground-level ozone and respiratory outpatient clinic visits in a rural location – Sublette County, Wyoming, 2008–2011

    Energy Technology Data Exchange (ETDEWEB)

    Pride, Kerry R., E-mail: hgp3@cdc.gov [Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA (United States); Wyoming Department of Health, 6101 Yellowstone Road, Suite 510, Cheyenne, WY 82002 (United States); Peel, Jennifer L. [Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523 (United States); Robinson, Byron F. [Scientific Education and Professional Development Program Office, Office of Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, E-92, Atlanta, GA 30333 (United States); Busacker, Ashley [Field Support Branch, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Wyoming Department of Health, 6101 Yellowstone Road, Suite 510, Cheyenne, WY 82002 (United States); Grandpre, Joseph [Chronic Disease Epidemiologist, Wyoming Department of Health, 6101 Yellowstone Road, Suite 510, Cheyenne, WY 82002 (United States); Bisgard, Kristine M. [Scientific Education and Professional Development Program Office, Office of Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, 600 Clifton Road, NE, E-92, Atlanta, GA 30333 (United States); Yip, Fuyuen Y. [Air Pollution and Respiratory Disease Branch, Centers for Disease Control and Prevention, 600 Clifton Rd, NE, E-92, Atlanta, GA 30333 (United States); Murphy, Tracy D. [Wyoming Department of Health, 101 Yellowstone Road, Suite 510, Cheyenne, WY 82002 (United States)

    2015-02-15

    Objective: Short-term exposure to ground-level ozone has been linked to adverse respiratory and other health effects; previous studies typically have focused on summer ground-level ozone in urban areas. During 2008–2011, Sublette County, Wyoming (population: ~10,000 persons), experienced periods of elevated ground-level ozone concentrations during the winter. This study sought to evaluate the association of daily ground-level ozone concentrations and health clinic visits for respiratory disease in this rural county. Methods: Clinic visits for respiratory disease were ascertained from electronic billing records of the two clinics in Sublette County for January 1, 2008–December 31, 2011. A time-stratified case-crossover design, adjusted for temperature and humidity, was used to investigate associations between ground-level ozone concentrations measured at one station and clinic visits for a respiratory health concern by using an unconstrained distributed lag of 0–3 days and single-day lags of 0 day, 1 day, 2 days, and 3 days. Results: The data set included 12,742 case-days and 43,285 selected control-days. The mean ground-level ozone observed was 47±8 ppb. The unconstrained distributed lag of 0–3 days was consistent with a null association (adjusted odds ratio [aOR]: 1.001; 95% confidence interval [CI]: 0.990–1.012); results for lags 0, 2, and 3 days were consistent with the null. However, the results for lag 1 were indicative of a positive association; for every 10-ppb increase in the 8-h maximum average ground-level ozone, a 3.0% increase in respiratory clinic visits the following day was observed (aOR: 1.031; 95% CI: 0.994–1.069). Season modified the adverse respiratory effects: ground-level ozone was significantly associated with respiratory clinic visits during the winter months. The patterns of results from all sensitivity analyzes were consistent with the a priori model. Conclusions: The results demonstrate an association of increasing ground

  8. Association of short-term exposure to ground-level ozone and respiratory outpatient clinic visits in a rural location – Sublette County, Wyoming, 2008–2011

    International Nuclear Information System (INIS)

    Objective: Short-term exposure to ground-level ozone has been linked to adverse respiratory and other health effects; previous studies typically have focused on summer ground-level ozone in urban areas. During 2008–2011, Sublette County, Wyoming (population: ~10,000 persons), experienced periods of elevated ground-level ozone concentrations during the winter. This study sought to evaluate the association of daily ground-level ozone concentrations and health clinic visits for respiratory disease in this rural county. Methods: Clinic visits for respiratory disease were ascertained from electronic billing records of the two clinics in Sublette County for January 1, 2008–December 31, 2011. A time-stratified case-crossover design, adjusted for temperature and humidity, was used to investigate associations between ground-level ozone concentrations measured at one station and clinic visits for a respiratory health concern by using an unconstrained distributed lag of 0–3 days and single-day lags of 0 day, 1 day, 2 days, and 3 days. Results: The data set included 12,742 case-days and 43,285 selected control-days. The mean ground-level ozone observed was 47±8 ppb. The unconstrained distributed lag of 0–3 days was consistent with a null association (adjusted odds ratio [aOR]: 1.001; 95% confidence interval [CI]: 0.990–1.012); results for lags 0, 2, and 3 days were consistent with the null. However, the results for lag 1 were indicative of a positive association; for every 10-ppb increase in the 8-h maximum average ground-level ozone, a 3.0% increase in respiratory clinic visits the following day was observed (aOR: 1.031; 95% CI: 0.994–1.069). Season modified the adverse respiratory effects: ground-level ozone was significantly associated with respiratory clinic visits during the winter months. The patterns of results from all sensitivity analyzes were consistent with the a priori model. Conclusions: The results demonstrate an association of increasing ground

  9. 社会支持对门诊化疗肿瘤患者焦虑抑郁情绪的影响%Effect of social support on anxiety and depression among outpatient in chemothera-py clinic

    Institute of Scientific and Technical Information of China (English)

    杨红; 郑世利

    2015-01-01

    Objective To investigate the effect of social support on anxiety and depression among outpatient in chemotherapy clinic.Methods Totally 100 chemotherapy outpatients from a top three hospital were investigated with Self-Rating Anxiety Scale ( SAS ) , self-rating depression scale ( SDS ) and Social Science Research Solutions ( SSRS) .Results Social support overall, anxiety and depression were higher than those of the domestic norm ( P<0.001) .There was a significantly negative correlated between social support and anxiety (P<0.05), also between so-cial support and depression ( P<0.01 ) .Conclusions Medical personnel should be fully assess the chemotherapy pa-tient in clinic with social support network system, to individual care measure, to improve their emotional status and the quality of life effectively.%目的:探讨门诊化疗的癌症患者社会支持度对其焦虑、抑郁情绪的影响,为进一步实施相应措施提供数据支持。方法对100例门诊化疗的患者,用一般情况调查表、社会支持量表( SSRS)、焦虑自评量表( SAS)及抑郁自评量表( SDS)进行调查,分析社会支持度现状及其对患者焦虑、抑郁的影响。结果本组患者SSRS评分高于国内常模(P<0.001),SAS评分与SSRS主观支持维度呈负相关(P<0.05),SDS评分与SSRS总分及客观支持维度呈负相关( P<0.01)。结论应合理评估门诊化疗癌症患者社会支持网络系统,制定合适的护理措施,对其进行有效干预,改善患者焦虑、抑郁情绪,促进身心健康。

  10. Medical Mishap and Negligence: It happens in the Outpatients too

    LENUS (Irish Health Repository)

    Murphy, JFA

    2011-06-01

    When we consider medical negligence and clinical error we think of busy hospitals late at night and at week-ends. We think of crowded emergency medicine departments, complex surgery and the critically ill ICU patient. We think of prescribing errors in the administration of potent intravenous therapy. We think of high risk specialties such as obstetrics, anaesthesia and surgery. We are less likely to think of outpatients\\/ ambulatory care or a non-interventionist specialty as an important source of litigation. This is remiss on our part. Risks in this setting have gone relatively unnoticed. There 30 times more outpatients than inpatients annually. In the US there are 900 million outpatient visits compared with 30 million inpatients. It is not surprising that this quantum of patient-doctor interaction should also be a source of litigation claims. Furthermore it is likely to continue rising with the increased numbers of procedures now being undertaken at outpatients.

  11. Impact of Attendance Policies on Course Attendance among College Students

    Science.gov (United States)

    Chenneville, Tiffany; Jordan, Cary

    2008-01-01

    The purpose of this study was twofold: (a) to investigate whether having a graded attendance policy would have an effect on course attendance among college students, and (b) to examine beliefs about education and attendance policies among college students. Results support the utility of graded attendance policies for increasing class attendance…

  12. 腹膜透析患者门诊随访频率与生存率关系的研究%Relationship between follow-up frequency at the outpatient clinic and their survival in peritoneal dialysis patients

    Institute of Scientific and Technical Information of China (English)

    杨桂鲜; 韩庆烽; 周晓玲; 孙庆华; 聂建东; 孙玲华; 史均宝; 何培丽

    2012-01-01

    Objective To investigate the relationship between follow-up frequency at the outpatient clinic and their survival in peritoneal dialysis (PD) patients. Method We recruited 202 incident patients who started PD between September 2006 and September 2008. They were divided into two groups according to the follow-up frequency: once a month in a group (one month group), and once more than a month in another group (more than one month group). Their general information and clinical data including laboratory examinations, nutrition status, complications and outcome after PD for 3 months and at the endpoint of the study were analyzed. Results At the beginning of PD, there were no significant differences in these parameters between the two groups, except that patients from rural area were different in the two groups (X2 = 10.629, P=0.005). At the end-point of the study, patients in the more than one month group had higher rate of hypertension (X2=15.561, P=0.000), lower serum albumin (t=2.219, P=0.028), higher serum phosphorus (t=-3366, P=0.001), and higher rate of malnutrition evaluated by SGA (X2=3.859, P=0.046), as compared with those in the one month group. Kaplan-Meier survival analysis demonstrated that survival rate and technical survival rate were significantly higher in the one month group than in the more than one month group (P=0.001 and P-0.002, respectively). Cox regression analysis showed that age, serum albumin, Kt/V and CCI were the independent factors affecting survival in PD patients, and that the follow-up frequency at the outpatient clinic was not included in the independent factors for survival (X2 = 40.673, P= 0.000). Conclusion The follow-up frequency at the outpatient clinic was unrelated to survival of PD patients. However, lower follow-up frequency at outpatient clinics may associate with malnutrition and more complications leading to poorer prognosis. We recommend the follow-up frequency of once a month for PD patients.%目的 探讨腹膜透析患

  13. Design and methodology of the NorthStar Study: NT-proBNP stratified follow-up in outpatient heart failure clinics -- a randomized Danish multicenter study

    DEFF Research Database (Denmark)

    Schou, Morten; Gustafsson, Finn; Videbaek, Lars;

    2008-01-01

    stable, educated, and medical optimized patients with CHF with N-terminal pro-brain natriuretic peptide (NT-proBNP) levels > or = 1,000 pg/mL benefit from long-term follow-up in an HFC and to assess the efficacy of NT-proBNP monitoring. METHODS: A total of 1,250 clinically stable, medically optimized......, and educated patients with CHF will be enrolled from 18 HFCs in Denmark. The patients will be randomized to treatment in general practice, to a standard follow-up program in the HFC, or to NT-proBNP monitoring in the HFC. The patients will be followed for 30 months (median). RESULTS: Data will be collected...... patients who may benefit from long-term follow-up. Our results may also indicate whether patients with CHF will benefit from adding serial NT-proBNP measurements to usual clinical monitoring....

  14. Treatment and outcomes of an Australian cohort of outpatients with bipolar I or schizoaffective disorder over twenty-four months: implications for clinical practice

    Directory of Open Access Journals (Sweden)

    Kulkarni Jayashri

    2012-12-01

    Full Text Available Abstract Background The Bipolar Comprehensive Outcomes Study (BCOS is a 2-year, prospective, non-interventional, observational study designed to explore the clinical and functional outcomes associated with ‘real-world’ treatment of participants with bipolar I or schizoaffective disorder. All participants received treatment as usual. There was no study medication. Methods Participants prescribed either conventional mood stabilizers (CMS; n = 155 alone, or olanzapine with, or without, CMS (olanzapine ± CMS; n = 84 were assessed every 3 months using several measures, including the Young Mania Rating Scale, 21-item Hamilton Depression Rating Scale, Clinical Global Impressions Scale – Bipolar Version, and the EuroQol Instrument. This paper reports 24-month longitudinal clinical, pharmacological, functional, and socioeconomic data. Results On average, participants were 42 (range 18 to 79 years of age, 58%; were female, and 73%; had a diagnosis of bipolar I. Polypharmacy was the usual approach to pharmacological treatment; participants took a median of 5 different psychotropic medications over the course of the study, and spent a median proportion of time of 100%; of the study on mood stabilizers, 90%; on antipsychotics, 9%; on antidepressants, and 5%; on benzodiazepines/hypnotics. By 24 months, the majority of participants had achieved both symptomatic and syndromal remission of both mania and depression. Symptomatic relapse rates were similar for both the CMS alone (65%; and the olanzapine ± CMS (61%; cohorts. Conclusions Participants with bipolar I or schizoaffective disorder in this study were receiving complex medication treatments that were often discordant with recommendations made in contemporary major treatment guidelines. The majority of study participants demonstrated some clinical and functional improvements, but not all achieved remission of symptoms or syndrome.

  15. Usefulness of the Spanish version of the mood disorder questionnaire for screening bipolar disorder in routine clinical practice in outpatients with major depression

    Directory of Open Access Journals (Sweden)

    Montes José

    2008-05-01

    Full Text Available Abstract Background According to some studies, almost 40% of depressive patients – half of them previously undetected – are diagnosed of bipolar II disorder when systematically assessed for hypomania. Thus, instruments for bipolar disorder screening are needed. The Mood Disorder Questionnaire (MDQ is a self-reported questionnaire validated in Spanish in stable patients with a previously known diagnosis. The purpose of this study is to evaluate in the daily clinical practice the usefulness of the Spanish version of the MDQ in depressive patients. Methods Patients (n = 87 meeting DSM-IV-TR criteria for a major depressive episode, not previously known as bipolar were included. The affective module of the Structured Clinical Interview (SCID was used as gold standard. Results MDQ screened 24.1% of depressive patients as bipolar, vs. 12.6% according to SCID. For a cut-off point score of 7 positive answers, sensitivity was 72.7% (95% CI = 63.3 – 82.1 and specificity 82.9% (95% CI = 74.9–90.9. Likelihood ratio of positive and negative tests were 4,252 y 0,329 respectively. Limitations The small sample size reduced the power of the study to 62%. Conclusion Sensitivity and specificity of the MDQ were high for screening bipolar disorder in patients with major depression, and similar to the figures obtained in stable patients. This study confirms that MDQ is a useful instrument in the daily clinical assessment of depressive patients.

  16. Psychosocial and clinical predictors of retention in outpatient alcoholism treatment Preditores psicossociais e clínicos de retenção ao tratamento para alcoolismo

    Directory of Open Access Journals (Sweden)

    João Maria Corrêa Filho

    2012-12-01

    Full Text Available OBJECTIVE: One of the factors associated with low rates of compliance in the treatment for alcoholism seems to be the intensity of craving for alcohol. This study aimed to evaluate the associations between alcohol craving and biopsychosocial addiction model-related variables and to verify whether these variables could predict treatment retention. METHODS: The sample consisted of 257 male alcoholics who were enrolled in two different pharmacological trials conducted at the Universidade de São Paulo in Brazil. Based on four factors measured at baseline - biological (age, race, and family alcoholism, psychiatric (depression symptoms, social (financial and marital status, and addiction (craving intensity, severity of alcohol dependence, smoking status, drinking history, preferential beverage, daily intake of alcohol before treatment - direct logistic regression was performed to analyze these factors' influence on treatment retention after controlling for medication groups and AA attendance. RESULTS: Increasing age, participation in Alcoholics Anonymous groups, and beer preference among drinkers were independently associated with higher treatment retention. Conversely, higher scores for depression increased dropout rates. CONCLUSION: Health services should identify the treatment practices and therapists that improve retention. Information about patients' characteristics linked to dropouts should be studied to render treatment programs more responsive and attractive, combining pharmacological agents with more intensive and diversified psychosocial interventions.OBJETIVO: Um dos fatores associados com baixas taxas de adesão ao tratamento para alcoolismo parece ser a intensidade da fissura pelo álcool. Este estudo objetiva avaliar a associação entre a fissura pelo álcool e variáveis relacionadas ao modelo biopsicossocial de dependência, bem como verificar se estas variáveis prevêem retenção ao tratamento. MÉTODO: A amostra foi composta por

  17. Clinical analysis of gout outpatient from a database of Peking Union Medical College Hospital%北京协和医院痛风门诊患者数据库的资料分析

    Institute of Scientific and Technical Information of China (English)

    马亚; 朱卫国; 王玉; 沙悦; 黄程锦; 黄晓明; 方卫纲; 曾学军

    2012-01-01

    Objective To analyze the clinical characteristics of gout outpatients from Peking Union Medical College Hospital. Methods Questionnaire survey and clinical analysis were conducted to collect 324 gout outpatients' clinical data and clinical features. Results The average duration of the 324 patients was (100±77) months and their mean serum uric acid level was (601.5±11.2) μmol/L. The proportion of males and females was 97.5% and 2.5% respectively. Although young patients had a long course of disease (P<0.05) and a greater frequency of concurrent diseases (P<0.05) than the aged group, the number of affected joins in the young patients group did not show significant difference with the aged group. In addition, young patients group showed a high level of serum uric acid (P<0.05) than the aged group. Conclusion People may have an earlier age of gout onset. Clinical presentations are also different and complicate. More attention should be paid to young patients with gout.%目的 对就诊于北京协和医院痛风门诊的青年痛风患者的临床特点进行分析.方法 对2008年1月至2012年2月就诊于协和医院普通内科痛风门诊的324例痛风患者进行问卷调查和临床资料收集,并将资料录入痛风门诊患者数据库管理系统并分析,以了解该人群的临床特点,初步探讨青年患者的人群特征.结果 本组324例中,男316例(97.5%),女8例(2.5%),平均病程( 100±77)个月,血清尿酸平均值(585.0±123.2) μmol/L,多关节受累多见,占79%;青年组较中老年组病程更短(P<0.05).基础疾病合并率更低(P<0.05),但尿酸水平[(601.5±11.2)μmol/L]较中老年组[(569.7±11.1) μmol/L]更高(P<0.05),累及关节数与中老年组差异无统计学意义.结论 痛风患者人群更加年轻化,临床特征更具复杂性.青年患者所为一个独特人群需要给予足够的重视.

  18. "Silver medical"Medical Service in Outpatient Clinic Process Reengineering of the Implementation and Experience%“银医”医疗服务在门诊就诊流程再造中的实施与体会

    Institute of Scientific and Technical Information of China (English)

    王亮; 谈永奇; 李长利

    2014-01-01

    该文通过介绍“银医”医疗服务平台,阐述“银医”医疗服务在门诊就诊流程再造中的优势与实施体会。指出“银医”医疗服务为一种新兴的就诊服务模式,具有自助发卡,银行卡自助绑定、自助缴费充值、自助预约挂号、报告单自助打印等功能,能够优化患者门诊就诊流程,提高医院工作效率。%This paper, through the introduction of the"silver medical"medical service platform. This"silver medical"medical ser-vice in outpatient clinic process reengineering of the advantages and implementation experience. Pointed out that"silver medical"medical service as a new medical service mode, through its self-service card, bank card self-help binding, self-help pay cost re-chargeable, self-help make an appointment, report self-help printing function. Optimizing the patient to the hospital process, im-prove the work efficiency of the hospital.

  19. Attitudes of Patients in Developing Countries Toward Participating in Clinical Trials: A Survey of Saudi Patients Attending Primary Health Care Services

    Directory of Open Access Journals (Sweden)

    Lateefa O. Al-Dakhil

    2016-07-01

    Full Text Available Objectives: Clinical trials are experimental projects that include patients as subjects. A number of benefits are directly associated with clinical trials. Healthcare processes and outcomes can be improved with the help of clinical trials. This study aimed to assess the attitudes and beliefs of patients about their contribution to and enrolment in clinical trials. Methods: A cross-sectional study design was used for data collection and analysis. A questionnaire was developed with six categories to derive effective outcomes. Results: Of the 2000 participants approached to take part in the study, 1081 agreed. The majority of the study population was female, well educated, and unaware of clinical trials. Only 324 subjects (30.0% had previously agreed to participate in a clinical trial. The majority (87.1% were motivated to participate in clinical trials due to religious aspects. However, fear of any risk was the principal reason (79.8% that reduced their motivation to participate. Conclusions: The results of this study revealed that patients in Saudi Arabia have a low awareness and are less willing to participate in clinical trials. Different motivational factors and awareness programs can be used to increase patient participation in the future.

  20. 音乐干预改善门诊痔疮手术患者心理状态临床研究%Clinical Research of Improving Mental State of Outpatients with Haemorrhoid on Operation by Music Intervention

    Institute of Scientific and Technical Information of China (English)

    吕孟华; 才桂兰; 陈宏; 于文红; 刘言滨

    2012-01-01

    Objective: To explore the clinical effect of nursing care on patients of haemorrhoid at outpatient operating room by music intervention. Methods: 72 cases of haemorrhoid were randomly divided into control and experimental groups,36 cases in each group. Control group received routine nursing care, experimental group was added the use of music intervention. We observed changes of physiological indexes and pain degree on operation in each group of patients, and assessed the anxiety of patients by self-rating anxiety scale (SAS). Results: The indexes of BP, HR and the concentrations of plasma cortisol were lower than another after intervention (P0.05); the scores of SAS were lower after the intervention in the experimental group than those in the controlgroup(P<0.01); the incidence of pain of the patients was lower in the experimental group than that in the control group (P<0.01). Conclusion: Outpatients with haemorrhoid using music intervention helps to eliminate the patient's tension,decrease the occurance of complications and make the operation safety.%目的:探讨门诊手术室应用音乐干预护理痔疮手术患者的临床效果.方法:选取痔疮手术患者72例,随机分为试验组和对照组,各36例.对照组给予常规护理,试验组在对照组基础上进行音乐干预,观察2组患者生理指标的变化及疼痛的发生情况,并采用焦虑自评量表(SAS)评估两组患者焦虑情况.结果:试验组实施干预后,心率、血压、血浆皮质醇浓度低于对照组(P<0.05),术中疼痛程度低于对照组(P<0.01);试验组SAS评分明显低于干预前(P<0.01),对照组治疗前后SAS评分比较无显著差异(P>0.05),试验组干预后gAS评分低于对照组(P<0.01).结论:门诊痔疮手术患者采用音乐干预,能缓解患者的紧张心理,减少术中并发症,有利于手术的顺利进行.

  1. Combination use of anti-inflammatory drugs and myorelaxants in the treatment of patients with ankylosing spondylitis in outpatient settings

    Directory of Open Access Journals (Sweden)

    Inna Zurabievna Gaidukova

    2015-01-01

    Full Text Available Objective: to assess different treatment regimens for ankylosing spondylitis (AS. The specific features of using topical and oral nonsteroidal anti-inflammatory drugs (NSAIDs and myorelaxants in outpatient settings were retrospectively analyzed.Subjects and methods. The investigation enrolled 96 AS patients admitted to the Department of Rheumatology, Saratov Regional Clinical Hospital, in 2010 to 2012, who took nimesulide during the last year (at least three 14-day cycles. The patients' mean age was 42.6±10.9 years; disease duration was 11.9±8.2 years; 83.33% were male. The diagnosis of AS was based on the 1984 modified New York criteria. Physical examination (clinical blood analysis, clinical urinalysis, C-reactive protein, total protein, albumins, urea, creatinine, glucose, bilirubin, serum aspartate aminotransferase and alanine aminotransferase was made. AS activity was determined using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI. Axial skeleton mobility and cervical spine rotation were evaluated. Therapy received by the patients at the moment of hospitalization and the attending physicians' recommendations for discharging patients from the hospital were analyzed. Saratov outpatient physicians were interviewed using a questionnaire to specify the aims and procedures of using anti-inflammatory drugs.Results. The outpatient physicians (n=100 were shown to use three-, two-, and one-component therapy in 53.12, 45, and 2% of the AS patients, respectively. Higher lumbar spine mobility and comparably reduced pain were established in the patients receiving threecomponent therapy (a combination of nimesulide 200 mg/day, tizanidine 4–8 mg/day, and topical NSAIDs than those who had NSAIDs only.

  2. Osteoarthrosis in outpatient practice

    Directory of Open Access Journals (Sweden)

    Elena Andreyevna Galushko

    2012-01-01

    Full Text Available Objective: to elucidate the awareness of osteoarthrosis - OA (the most common location and treatment methods among primary care physicians. Subjects and methods. The questionnaire developed at the Research Institute of Rheumatology, Russian Academy of Medical Sciences, was used to interview 1912 specialists (therapists, rheumatologists, neurologists, and surgeons who made a primary outpatient reception in the local polyclinics of 25 Russian Federation’s cities with a population of more than 500,000. Results. In the opinion of the physicians of all specialties, knee joints turned out to be the most location of OA. In practice, the rheumatologists encountered knee, hip, and hand joint lesions in OA in 92, 42, and 38%, respectively. Analysis of therapeutic preferences has shown that virtually all the physicians prescribe nonsteroidal anti-inflammatory drugs and only two thirds do structure-modifying drugs (chondroprotectors for OA patients. When treating OA, only the rheumatologists use slow-acting drugs in practically 100% of cases, by preferring chondroitin sulfate. The physicians of all specialties use topical glucocorticoid therapy extensively. The rheumatologists use this therapy most probably due to the fact that patients with severe polyarticular OA come to see them. Notwithstanding the fact that new guidelines for the treatment of OA were published in 2008, most physicians are oriented to the 1995 guidelines, frequently giving rise to therapeutic errors and wrong treatment.

  3. Attending IBM & SAM

    Institute of Scientific and Technical Information of China (English)

    马洁

    2007-01-01

    The delegation of China Acrobats Association, twelve people with Lin Jian, Vice President of China Acrobats Association as a director, went to America to attend the 79th Annual Convention of International Brotherhood of Magic (IBM) and the Magic Convention of Society of American Magicians 2007 from June 26th, 2007 to July 8th, 2007.

  4. Assessment of Effects of Air Pollution on Daily Outpatient Visits using the Air Quality Index

    OpenAIRE

    Mu, Haosheng; Otani, Shinji; Okamoto,Mikizo; Yokoyama, Yae; Tokushima, Yasuko; Onishi, Kazunari; Hosoda, Takenobu; KUROZAWA, Youichi

    2014-01-01

    Background The air quality index (AQI) is widely used to characterize the quality of ambient air. Chinese cities officially report the AQI on a daily basis. To assess the possible effects of air pollution on daily outpatient visits, we examined the association between AQI and the daily outpatient count. Methods Daily data on outpatient visits to each clinical department were collected from the Z county hospital of Datong City, China. The collection period was between 5 April and 30 June, 2012...

  5. 门诊支气管哮喘患者就诊情况分析%Investigation on the visit clinic of outpatients with bronchial asthma in respiratory department

    Institute of Scientific and Technical Information of China (English)

    左震华; 管希周

    2014-01-01

    [ABSTRACT]Objective: To investigate regularity of medical visit and medication of the outpatients with bronchial asthma, in order to provide reference for improving work quality in clinic.Methods: A total of 132 outpatients with bronchial asthma collected from our hospital during January 25, 2013 and May 31, 2013 were investigated. According to the history inquiry and outpatient medical records review, the patients were divided into two groups, regular visit group and intermittent visit group. The education background, frequencies of medical visit, treatment, asthma knowledge education, and pulmonary function test of the patients with bronchial asthma were investigated.Results:There were 76 patients in intermittent visit group, and 56 patients in regular visit group. The main visit reason for irregular visit group was asthma exacerbation. Only 24.2% of the patients regularly received pulmonary function test. The number of patients receiving the asthma education accounted for 42.0%, the numbers of patients with bachelor degree or above in intermittent visit group and regular visit group accounted for 38.1%, 73.2%, respectively. Conclusion: Delayed diagnosis, irregular treatment, and under application of pulmonary function test are common defects in management of asthma. It is important to strengthen the education of asthma for patients and doctor-patient communication to better control the disease.%目的:了解门诊支气管哮喘患者的就诊规律及用药情况等,以期为临床工作质量提高提供参考。方法:对我院呼吸科军人门诊2013年1月25日–5月31日期间就诊的132例支气管哮喘患者进行调查,采用询问病史和复习门诊病历的方法,将调查病例分为两组,一组为规律就诊组,另一组为非规律就诊组。调查内容包括:教育背景、就诊规律、治疗情况、哮喘知识教育、肺功能定期复查情况等。结果:76例患者不规律就诊,56例患者为规律就诊

  6. 某综合医院门诊患者满意度的调查研究%Investigation on the patient satisfaction on the outpatient clinic of a general hospital basis

    Institute of Scientific and Technical Information of China (English)

    国实; 胡鸿; 汪彬

    2014-01-01

    目的:了解某三甲医院门诊患者满意度的情况,探讨通过门诊患者满意度提高医疗服务质量和医院综合实力的方法和途径。方法:采用分层抽样的方法对门诊患者进行现场问卷调查和统计分析,获有效问卷239份。结果:患者对医院服务的总体满意度(得分3.73)较高;满意度较高的项目主要体现在医师医疗技术水平、医疗环境设施,满意度较低的项目主要集中在看病前等候时间和医疗收费等方面。在总满意度上,首次就诊的门诊患者明显高于多次就诊的患者,差异有统计学意义(F=10.084,P<0.01);不同年龄与医疗过程(F=6.814,P<0.01)、服务结果(F=3.262,P<0.01),不同文化程度与医疗过程(F=3.477,P<0.01),不同费用支付方式与环境设施(F=9.473,P<0.01),不同就诊次数与环境设施(F=9.218,P<0.01)、等候时间(F=12.419,P<0.01)、服务态度(F=5.115,P<0.01)和服务结果(F=7.643,P<0.01)比较均存在差异,且差异具有统计学意义。结论:该综合医院门诊患者满意度较好,年龄、文化程度、费用支付方式、就诊次数是满意度的影响因素。建议通过满足不同层次患者需求;进一步优化门诊流程;完善医院收费管理制度;进一步加大宣传力度,提高患者的忠诚度,提高服务满意度。%Objective:To investigate the patient satisfaction extent based on the outpatient clinic in a general hospital(Third-level-Grade-A hospital) for assessment of the measures to improve the quality of medical services and provision of modern facilities.Methods:By stratified sampling,we conducted a survey on the outpatients with field questionnaire .Final retrieval of valid questionnaire included 239 respondents,and the data were analyzed.Results:The interviewees showed better satisfaction with the

  7. Managing patients' wait time in specialist out-patient clinic using real-time data from existing queue management and ADT systems.

    Science.gov (United States)

    Ju, John Chen; Gan, Soon Ann; Tan Siew Wee, Justine; Huang Yuchi, Peter; Mei Mei, Chan; Wong Mei Mei, Sharon; Fong, Kam Weng

    2013-01-01

    In major cancer centers, heavy patients load and multiple registration stations could cause significant wait time, and can be result in patient complains. Real-time patient journey data and visual display are useful tools in hospital patient queue management. This paper demonstrates how we capture patient queue data without deploying any tracing devices; and how to convert data into useful patient journey information to understand where interventions are likely to be most effective. During our system development, remarkable effort has been spent on resolving data discrepancy and balancing between accuracy and system performances. A web-based dashboard to display real-time information and a framework for data analysis were also developed to facilitate our clinics' operation. Result shows our system could eliminate more than 95% of data capturing errors and has improved patient wait time data accuracy since it was deployed.

  8. Determinants of misconceptions about diabetes among Saudi diabetic patients attending diabetes clinic at a tertiary care hospital in Eastern Saudi Arabia

    OpenAIRE

    Alsunni, Ahmed A.; Waleed I Albaker; Ahmed Badar

    2014-01-01

    Objective: To identify the determinants of misconceptions about diabetes in patients registered with a diabetes clinic at a tertiary care hospital in Eastern Saudi Arabia. Materials and Methods: This cross-sectional survey was carried out at a diabetes clinic of a tertiary care hospital in Eastern Saudi Arabia, from January to December 2012. A total of 200 diabetic patients were interviewed using a questionnaire comprising 36 popular misconceptions. The total misconception score was calculate...

  9. Assessment of Effects of Air Pollution on Daily Outpatient Visits using the Air Quality Index

    Science.gov (United States)

    Mu, Haosheng; Otani, Shinji; Okamoto, Mikizo; Yokoyama, Yae; Tokushima, Yasuko; Onishi, Kazunari; Hosoda, Takenobu; Kurozawa, Youichi

    2014-01-01

    Background The air quality index (AQI) is widely used to characterize the quality of ambient air. Chinese cities officially report the AQI on a daily basis. To assess the possible effects of air pollution on daily outpatient visits, we examined the association between AQI and the daily outpatient count. Methods Daily data on outpatient visits to each clinical department were collected from the Z county hospital of Datong City, China. The collection period was between 5 April and 30 June, 2012. Daily AQI data and meteorological information were simultaneously recorded. We compared outpatient counts between the index days and comparison days, and calculated Pearson’s product moment correlation coefficient between outpatient counts and AQI levels. Results The average AQI level for index days was significantly higher than that for comparison days. No significant difference was observed in temperature or relative humidity between index days and comparison days. The outpatient counts for pediatrics were significantly higher on index days than on comparison days, and no significant difference was noted in other clinical departments. The outpatient counts for pediatrics positively correlated with the AQI level, and no correlation was noted in other clinical departments. Conclusion The present study assessed the association between daily outpatient visits and air pollution using AQI. The results obtained suggest that air pollution could increase the outpatient count for pediatrics. PMID:25901100

  10. Comparação dos perfis dos pacientes hipertensos atendidos em Pronto-Socorro e em tratamento ambulatorial Perfil de los pacientes hipertensos atendidos en un servicio de emergencia: comparación con hipertensos en tratamiento ambulatorio Comparison of the profile of hypertensive patients seen in emergency unit with those receiving outpatient clinic treatment

    Directory of Open Access Journals (Sweden)

    Cristiane Garcia Sanchez

    2004-03-01

    Full Text Available O estudo comparou 100 hipertensos atendidos no Pronto-socorro com 100 pacientes do Ambulatório. Os hipertensos do Pronto-Socorro foram diferentes (p Este estudio comparó 100 hipertensos atendidos en un servicio de emergencia, con 100 pacientes de consulta externa. Los hipertensos de emergencia fueron diferentes (pThis study compares 100 hypertensive patients in emergency units with those who were seen in outpatient clinics. Hypertensive patients seen at the emergency unit showed to be different (p < 0.05 from those seen at the outpatient clinic regarding: higher blood pressure; lower income; not belonging to the hospital community; greater alcohol intake; became aware of their hypertension because felt bad; measured blood pressure less often; did not take the medicine more often. In conclusion, unfavorable characteristics can contribute to hypertensive patients who do not follow anti-hypertension treatment adequately, leading to care in emergency units.

  11. Designing and Developing a Mobile Smartphone Application for Women with Gestational Diabetes Mellitus Followed-Up at Diabetes Outpatient Clinics in Norway

    Directory of Open Access Journals (Sweden)

    Lisa Maria Garnweidner-Holme

    2015-05-01

    Full Text Available The prevalence of Gestational Diabetes Mellitus (GDM is increasing worldwide. Controlling blood sugar levels is fundamental to the management of GDM. Current practice in Norway includes patients registering blood sugar levels in a booklet and receiving verbal and/or written health information. A smartphone application may provide patients individually targeted and easily available advice to control blood sugar levels. The aim of this paper is to document the process of designing and developing a smartphone application (the Pregnant+ app that automatically transfers blood sugar levels from the glucometer and has information about healthy eating and physical activity. This formative research included expert-group discussions among health professionals, researchers and experts in data privacy and security. User-involvement studies were conducted to discuss prototypes of the app. Results indicated that the content of the application should be easy to understand given the varying degree of patients’ literacy and in line with the information they receive at clinics. The final version of the app incorporated behavior change techniques such as self-monitoring and cues to action. Results from the first round of interactions show the importance of involving expert groups and patients when developing a mobile health-care device.

  12. Persistent frequent attenders in primary care: costs, reasons for attendance, organisation of care and potential for cognitive behavioural therapeutic intervention

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    Morriss Richard

    2012-07-01

    Full Text Available Abstract Background The top 3% of frequent attendance in primary care is associated with 15% of all appointments in primary care, a fivefold increase in hospital expenditure, and more mental disorder and functional somatic symptoms compared to normal attendance. Although often temporary if these rates of attendance last more than two years, they may become persistent (persistent frequent or regular attendance. However, there is no long-term study of the economic impact or clinical characteristics of regular attendance in primary care. Cognitive behaviour formulation and treatment (CBT for regular attendance as a motivated behaviour may offer an understanding of the development, maintenance and treatment of regular attendance in the context of their health problems, cognitive processes and social context. Methods/design A case control design will compare the clinical characteristics, patterns of health care use and economic costs over the last 10 years of 100 regular attenders (≥30 appointments with general practitioner [GP] over 2 years with 100 normal attenders (6–22 appointments with GP over 2 years, from purposefully selected primary care practices with differing organisation of care and patient demographics. Qualitative interviews with regular attending patients and practice staff will explore patient barriers, drivers and experiences of consultation, and organisation of care by practices with its challenges. Cognitive behaviour formulation analysed thematically will explore the development, maintenance and therapeutic opportunities for management in regular attenders. The feasibility, acceptability and utility of CBT for regular attendance will be examined. Discussion The health care costs, clinical needs, patient motivation for consultation and organisation of care for persistent frequent or regular attendance in primary care will be explored to develop training and policies for service providers. CBT for regular attendance will

  13. Risk factors for type 2 diabetes mellitus among patients attending a rural Kenyan hospital

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    Masemiano P. Chege

    2010-03-01

    Full Text Available Background: The Diabetes Management and Information Center in Nairobi has conducted population surveys among rural and urban Kenyans during the last decade. They have reported a rise in the prevalence of diabetes among rural Kenyans from 3% in 2003 to 7% in 2007. Our study was undertaken to investigate rural factors for type 2 diabetes and determine those that could be responsible for this rise in prevalence.Objectives: To describe the risk factors for type 2 diabetes mellitus among patients attending the outpatient clinics in a rural mission hospital in Kenya.Method: Forty-five diabetics and forty-five non-diabetics, resident in this rural hospital’s catchment area for at least 10 years, were randomly selected from patients attending outpatient clinics. Diabetics in a stable condition (not requiring hospitalisation, whose fasting blood sugars were below 6.1 mmol/L, were matched for age and gender with the non-diabetics who came to the hospital for outpatient services. A pilot-tested questionnaire on demography, current and past dietary habits, social habits, and family history was used to collect data. Waist circumference, height and weight were measured and BMI calculated. Data was analysed using SPSS for Windows. The Kruskal–Wallis test was used to compare the medians for the continuous variables, while the chi-squared test was used for the categorical variables. The z-test was used to calculate the relative risk.Results: Ninety participants (26 males, 64 females. The mean age was 61.8 for diabetics and 61.4 for non-diabetics. Childhood starvation (relative risk 2.08, p = 0.0090 and use of cassava for sustenance during childhood starvation (relative risk 3.12, p = 0.0090 were identified as risk factors. Diabetes in close relatives, another risk factor for this population (relative risk 2.2, p = 0.0131. Abdominal obesity was a risk factor for this population (in females relative risk 2.0, p = 0.0010.Conclusion: The risk factors for type 2

  14. 抑郁症门诊患者中未识别出的双相障碍者的临床特征%Clinical features of unrecognized bipolar disorder in outpatients with major depressive disorder

    Institute of Scientific and Technical Information of China (English)

    陈发展; 陆峥; 郭珍; 张旭; 杨程青

    2011-01-01

    Background:Bipolar disorders are often unrecognized or misdiagnosed as unipolar depression.Determining the clinical features associated with unrecognized or misdiagnosed bipolar disorder should help decrease the rates of misclassification.Objective:Estimate the prevalence of unrecognized bipolar disorders among outpatients with major depressive disorder and analyze the clinical characteristics of patients with unrecognized bipolar disorder.Method:100 outpatients with a current diagnosis of major depressive disorder were administered the Hypomania Checklist-32(HCL-32),the Mood Disorder Questionnaire(MDQ)and the Mini International Neuropsychiatric Interview(MINI).The characteristics of patients who were re-diagnosed as bipolar disorder were compared to those whose diagnosis did not change.Results:Twenty nine(29%) of the outpatients were diagnosed with bipolar disorder;6 as Bipolar 1 and 23 as Bipolar Ⅱ.Compared to those whose diagnosis did not change,those re-diagnosed as bipolar were younger,had an earlier age of onset,had more episodes,had a higher level of education and were more likely to have concurrent psychotic symptoms.Multivariate logistic regression analysis showed that age(OR=0.55,95% CI=0.34-0.89)and concurrent psychotic symptoms(OR=9.12,CI=1.56-53.26)were independent risk factors of bipolar disorder.Conclusion:A substantial proportion of outpatients diagnosed with major depressive disorder have unrecognized bipolar disorders,particularly bipolar Ⅱ disorder.Compared to patients with unipolar depression,patients with a diagnosis of depression who have unrecognized bipolar disorders are younger and are more likely to have experienced psychotic symptoms.%背景 双相障碍常未被识别或被误诊为单相抑郁.明确未被识别或被误诊的双相障碍者的临床特征有助于减少错误分类.目的 调查门诊抑郁症患者中未被识别的双相障碍者的比例,并分析未被识别的双相障碍者的临床特征.方法 使用32

  15. Visão do paciente quanto à participação do residente no exame proctológico em ambulatório Patient view about the proctological exam assisted by the resident in outpatient clinics

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    Isabela Pessoa Elias

    2006-12-01

    patientes and their participation in the examination is essential for the learning of colorectal surgery specialty. Patients may be reluctant to have residents present in outpatient colorectal clinics. This study evalueted patients' attitudes towards resident' s involvement in an outpatient colorectal clinic of a private institution. METHODS: One hundred consecutive patients answered voluntarily and anonymously a questionnaire after the physical examination with the involmement of residents. The examination consisted of anal inspection, palpation, anoscopy, rigid proctosigmoidoscopy and abdominal examination. Age, gender, race, marital, educational and social status were evaluated, as well as the patients' attitudes towards resident's involvement in the outpatient setting. The reasons for acceptance or refusal of resident' involvement werw also evaluated. For statistical analysis the [chi]² os Fisher test and t Student test were used. RESULTS: The acceptance rate of residents during the rectal examination was 87 per cent and the refusal rate was 1 per cent. Eleven per cent reported tha resident's involvement was indifferent for them and 1 patient did not answer this question. There was no significant difference among the studied variables regarding resident's involvement, except for the marital status, since married patients accepted the resident better than single patients. The main reason for acceptance was cooperatin for medical training, while for refusal was loss of privacy. CONCLUSION: Patients accept resident's involvement during rectal examination in outpatient setting. Knowledge of the reasons for their acceptance and refusal by patients may emphasize positive attiyudes in order to improve this acceptance and minimize the refusal.

  16. Perfil de 300 trabalhadores expostos à sílica atendidos ambulatorialmente em Belo Horizonte Profile of 300 workers exposed to silica seen in an university outpatient clinic

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    ANA PAULA SCALIA CARNEIRO

    2002-11-01

    Full Text Available Introdução: A silicose é a pneumoconiose de maior prevalência no Brasil, sendo a maioria dos casos proveniente do Estado de Minas Gerais. Apesar de ser uma doença evitável, continuam ocorrendo epidemias localizadas. Objetivo: Descrever o perfil dos trabalhadores atendidos no Ambulatório de Doenças Profissionais do Hospital das Clínicas da Universidade Federal de Minas Gerais. Material e métodos: Foram estudados 300 prontuários de trabalhadores expostos à sílica em diversas atividades profissionais, atendidos no período de 1989 a 2000, sendo analisados dados clínico-ocupacionais, espirométricos e radiológicos. Realizaram-se análises univariadas, utilizando o teste do qui-quadrado e teste t. Resultados e conclusão: A média de idade dos pacientes expostos foi de 51 anos, com tempo médio de exposição de 15,6 anos. Diagnosticaram-se radiologicamente 126 (42% casos de silicose, constatando-se que, quanto mais avançada a categoria radiológica da doença, piores foram os resultados à espirometria e mais freqüentes as associações com tuberculose e com limitação crônica ao fluxo aéreo. O mercado de trabalho formal representou o principal vínculo empregatício, sendo a mineração a principal atividade exercida, responsável pela exposição de 197 indivíduos (66%. Os trabalhadores do mercado informal foram aqueles que apresentaram achados radiológicos indicativos de formas mais avançadas da doença, sugerindo piores condições de exposição à sílica, neste grupo de trabalhadores.Introduction: Silicosis is the most prevalent pneumoconiosis in Brazil, with most of the registered cases occurring in the State of Minas Gerais. Although it is a preventable disease, silicosis is still epidemic in some areas. Objective: To describe the profile of workers seen at the Clinics Hospital of the Federal University of Minas Gerais. Patients and methods: 300 medical records of silica-exposed workers in different occupations, seen

  17. Are self-stigma, quality of life, and clinical data interrelated in schizophrenia spectrum patients? A cross-sectional outpatient study

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    Holubova M

    2016-03-01

    Full Text Available Michaela Holubova, Jan Prasko, Klara Latalova, Marie Ociskova, Aleš Grambal, Dana Kamaradova, Kristyna Vrbova, Radovan Hruby Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic Background: Current research attention has been moving toward the needs of patients and their consequences for the quality of life (QoL. Self-stigma is a maladaptive psychosocial phenomenon disturbing the QoL in a substantial number of psychiatric patients. In our study, we examined the relationship between demographic data, the severity of symptoms, self-stigma, and QoL in patients with schizophrenia spectrum disorder.Methods: Probands who met International Classification of Diseases-10 criteria for schizophrenia spectrum disorder (schizophrenia, schizoaffective disorder, or delusional disorder were recruited in the study. We studied the correlations between the QoL measured by the QoL Satisfaction and Enjoyment Questionnaire, self-stigma assessed by the Internalized Stigma of Mental Illness, and severity of the disorder measured by the objective and subjective Clinical Global Impression severity scales in this cross-sectional study.Results: A total of 109 psychotic patients and 91 healthy controls participated in the study. Compared with the control group, there was a lower QoL and a higher score of self-stigmatization in psychotic patients. We found the correlation between an overall rating of self-stigmatization, duration of disorder, and QoL. The level of self-stigmatization correlated positively with total symptom severity score and negatively with the QoL. Multiple regression analysis revealed that the overall rating of objective symptom severity and the score of self-stigma were significantly associated with the QoL.Conclusion: Our study suggests a negative impact of self-stigma level on the QoL in patients suffering from schizophrenia spectrum disorders. Keywords: quality

  18. The Investigation on Clinical Attendance on Children Patients With Cough Variant Asthma%小儿咳嗽变异性哮喘的临床护理探析

    Institute of Scientific and Technical Information of China (English)

    金丽华

    2015-01-01

    目的:探讨小儿咳嗽变异性哮喘的临床护理探析。方法选取2013年10月~2014年10月我院接诊的38例咳嗽变异性哮喘患儿,按照入院的先后顺序分为两组,实验组和对照组,实验组采用综合护理,对照组采用常规护理,观察两组患儿的护理效果。结果实验组患儿的家长满意度高于对照组,差异有统计学意义(P<0.05);实验组患儿在护理缺陷的发生率、护理投诉率低于对照组,差异有统计学意义(P<0.05)。结论小儿咳嗽变异性哮喘采用综合护理模式的效果显著,有效提高家长的满意度,降低护理缺陷的发生率和投诉率。%Objective Clinical attendance on children patients with cough variant asthma is to be discussed. Methods Chose 38 children patients with cough variant asthma who were treated in our hospital from October 2013 to October 2014 and separate them into study group and control group according to hospitalization sequence. Patients in study group were given comprehensive attendance,while patients in control group were given conventional treatment,and then observe and compare the treatment efficacy of these two groups. Results Patients’satisfaction with treatment in study group was much higher than that in control group,there was a treatment differential between the two groups,and such a differential had statistic value(P<0.05). Conclusion Comprehensive attendance is of efficacy in treatment of children patients with cough variant asthma,and it appeals their parents with much more satisfaction,such a treatment approach is quite conducive to reducing probability of attendance defect and complaint.