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Sample records for attending outpatient treatment

  1. 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......+PDB were younger and had a longer history of alcohol abuse than A-PD and A+PDC. After treatment there was no significance between the patients with and without PD concerning alcohol outcome and psychosocial outcome. The significance of co-morbid PD for the prognosis of alcohol abusers may be overestimated...

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

    DEFF Research Database (Denmark)

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

    2009-01-01

    , were more often lowly educated, and had more physical and psychiatric problems. Traumatic childhood experience related to physical or sexual abuse was found as a major predictor for suicidal behaviour among alcohol-dependent patients. We found no significant difference in the effect of treatment in....... 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...... that suicidal patients in treatment for alcohol abuse are treated effectively within the present treatment settings....

  3. 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…

  4. 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.

  5. 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.

  6. 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...

  7. 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 the...

  8. 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

  9. 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.

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

    OpenAIRE

    Raquel Guimarães Nobre; Ana Vaneska Passos Meireles; Julyanne Torres Frota; Raphael Marques de Miranda Costa; Vanessa Fernandes Coutinho; Maria Miriam da Cunha Melo Garcia; Luciana Catunda Brito

    2014-01-01

    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, obst...

  11. 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

    INTRODUCTION: Non-attendance is a global health-care problem. The aim of the present study was 1) to investigate if a telephone reminder could reduce the non-attendance rate, 2) to study reasons for non-attendance and 3) to evaluate if a permanent implementation would be economically advantageous...... 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...

  12. A demographic study to profile non-attenders at a gynaecology outpatient clinic.

    Science.gov (United States)

    Pillai, R; Bhangu, N; Narayanan, M; Yoong, W

    2012-02-01

    Missed outpatient appointments result in the inefficient utilisation of resources and have secondary effects on the health of the non-attenders, as well as on other patients who have to wait longer for their appointments. The first part of the study involved retrospective analysis of trends of non-attendance based on a computerised database of all gynaecology appointments over 12 months. The second comprised a prospective case-control study in which women who missed their gynaecology outpatient appointments (index cases) over 2 months were compared with patients who attended the same clinics matched for indication for referral (control cases). The overall non-attendance rate over 12 months was 16.1%, of whom 42% were recurrent non-attenders. Data from 105 defaulters were compared with 105 non-defaulters who attended the same clinics. Defaulters were significantly younger, single or separated and were more likely to be 'follow-ups' rather than new cases (all p appointment letter and actual appointment date was significantly related to non-attendance (p = 0.01) and there was a trend to a greater degree of smoking and alcohol ingestion in the defaulter group (p = 0.059). Comparison of other variables such as severity of symptoms, parity, source of referral and fluency of English did not reach statistical significance (p > 0.05). This prospective study has demonstrated certain profiles which are common to defaulters and which can be used to develop strategies to minimise non-attendance. Examples include reducing the time interval between sending the appointment letter and actual appointment date and selectively over-booking younger, single women who smoke. PMID:22296428

  13. 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...

  14. 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: ...

  15. 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

  16. 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. ...

  17. Outpatient Treatment of Lumbar Disc Sciatica

    OpenAIRE

    Swezey, Robert L.; Crittenden, James O.; Swezey, Annette M.

    1986-01-01

    Of 47 patients with lumbar disc disease and sciatic radiculopathy (L-5 or S-1), 39 were successfully managed at home and as outpatients in an ambulatory care facility designed for the treatment of arthritis and back pain. When these patients were evaluated one to three years following discharge, they maintained their maximum level of activity and functional improvement noted at discharge. The average total cost per patient including physician's fees, x-rays, laboratory and therapy was approxi...

  18. 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...

  19. Involuntary outpatient treatment (IOT) in Spain.

    Science.gov (United States)

    Hernández-Viadel, M; Cañete-Nicolás, C; Bellido-Rodriguez, C; Asensio-Pascual, P; Lera-Calatayud, G; Calabuig-Crespo, R; Leal-Cercós, C

    2015-01-01

    In recent decades there have been significant legislative changes in Spain. Society develops faster than laws, however, and new challenges have emerged. In 2004, the Spanish Association of Relatives of the Mentally Ill (FEAFES) proposed amending the existing legislation to allow for the implementation of involuntary outpatient treatment (IOT) for patients with severe mental illness. Currently, and after having made several attempts at change, there is no specific legislation governing the application of this measure. Although IOT may be implemented in local programmes, we consider legal regulation to be needed in this matter. PMID:25896809

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  2. Clinical and demographic features of patients with dementia attended in a tertiary outpatient clinic

    Directory of Open Access Journals (Sweden)

    Vale Francisco A.C.

    2002-01-01

    Full Text Available We describe clinical and socio-demographic features of patients with dementia attended in a tertiary outpatient clinic during a three years period (56.9% of the total attendance. Most of them were men, white, from the local community, urban district. Nobody had a job at the moment, two thirds of them got social welfare benefit. They lived with their family, the caregiver being the spouse or a daughter. The education level was very low, a quarter of them being illiterate. They were referred mostly from the public health care service, by neurologists or psychiatrists due to cognitive disorders. Family history as well as individual history of previous neurological/psychiatric disorders were frequent, especially alcoholism, stroke, head trauma and dementia. The neurological exam showed abnormalities in two thirds of cases, chiefly extra-pyramidal and pyramidal signs. Alzheimer's disease was the most frequent cause, followed by cerebrovascular disorder; alcoholism and normal pressure hydrocephalus were also frequent causes. Most patients presented concomitant non-etiological neurological/psychiatric disorders, mainly alcoholism and depression, and non-neurological/psychiatric diseases, predominantly hypertension, cardiopathy and diabetes. Most patients had been referred under medication, frequently politherapy, including psychotropics.

  3. Evidence-Based Practices in Outpatient Treatment for Eating Disorders

    Science.gov (United States)

    Schaffner, Angela D.; Buchanan, Linda Paulk

    2010-01-01

    This study examined the current issues relevant to implementing evidence-based practices in the context of outpatient treatment for eating disorders. The study also examined the effectiveness of an outpatient treatment program for eating disorders among a group of 196 patients presenting with anorexia nervosa, bulimia nervosa, or eating disorder…

  4. Creative Art Therapy Groups: A Treatment Modality for Psychiatric Outpatients

    Science.gov (United States)

    Drapeau, Marie-Celine; Kronish, Neomi

    2007-01-01

    This brief report examines the benefits of a creative art therapy group program for outpatients suffering from psychiatric disorders. Included is a review of relevant treatment outcomes literature on the effectiveness of group art therapy. The authors describe the Creative Art Therapy Group Program offered to adult psychiatric outpatients that is…

  5. 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...

  6. Analysis of the problem of low adherence of patients to attendance at outpatient clinics and cardiorehabilitation programs according to the data from published studies

    OpenAIRE

    Yu. V. Semenova; N.P. Kutishenko; S.Yu. Martsevich

    2015-01-01

    The aim of this review was to study a problem of outpatient non-attendance by the analysis of relevant literature data. Pubmed and Cyberlenica articles and abstracts, published in 1966-2015, concerning the problem of non-attendance at outpatient clinics and cardiac rehabilitation programs, were used as data sources. The search included articles that reviewed the prevalence of outpatient non-attendance, reasons for it, it’s effect on disease outcomes and search for possible ways of its correct...

  7. A predictive model for survival in metastatic cancer patients attending an outpatient palliative radiotherapy clinic

    International Nuclear Information System (INIS)

    Purpose: To develop a predictive model for survival from the time of presentation in an outpatient palliative radiotherapy clinic. Methods and Materials: Sixteen factors were analyzed prospectively in 395 patients seen in a dedicated palliative radiotherapy clinic in a large tertiary cancer center using Cox's proportional hazards regression model. Results: Six prognostic factors had a statistically significant impact on survival, as follows: primary cancer site, site of metastases, Karnofsky performance score (KPS), and fatigue, appetite, and shortness of breath scores from the modified Edmonton Symptom Assessment Scale. Risk group stratification was performed (1) by assigning weights to the prognostic factors based on their levels of significance, and (2) by the number of risk factors present. The weighting method provided a Survival Prediction Score (SPS), ranging from 0 to 32. The survival probability at 3, 6, and 12 months was 83%, 70%, and 51%, respectively, for patients with SPS ≤13 (n=133); 67%, 41%, and 20% for patients with SPS 14-19 (n=129); and 36%, 18%, and 4% for patients with SPS ≥20 (n=133) (p<0.0001). Corresponding survival probabilities based on number of risk factors were as follows: 85%, 72%, and 52% (≤3 risk factors) (n=98); 68%, 47%, and 24% (4 risk factors) (n=117); and 46%, 24%, and 11% (≥5 factors) (n=180) (p<0.0001). Conclusion: Clinical prognostic factors can be used to predict prognosis among patients attending a palliative radiotherapy clinic. If validated in an independent series of patients, the model can be used to guide clinical decisions, plan supportive services, and allocate resource use

  8. Contingency Management for Attendance to Group Substance Abuse Treatment Administered by Clinicians in Community Clinics

    OpenAIRE

    Ledgerwood, David M.; Alessi, Sheila M.; Hanson, Tressa; Godley, Mark D.; Petry, Nancy M.

    2008-01-01

    Contingency management (CM) is effective in enhancing retention in therapy. After an 8-week baseline, four community-based substance abuse treatment clinics were exposed in random order to 16 weeks of standard care with CM followed by 16 weeks of standard care without CM or vice versa. In total, 75 outpatients participated. Patients who were enrolled in the clinics when the CM treatment phase was in effect attended a significantly greater percentage of therapy sessions than patients who were ...

  9. Minor burn injuries in children: inpatient versus outpatient treatment?

    Science.gov (United States)

    La Ferla, G. A.; Fyfe, A. H.; Drainer, I. K.

    1983-01-01

    Seventy-two children with minor superficial burns presented at our casualty department over a 5-month period. Half were treated as inpatients and the other half as outpatients. The colonisation rates were similar in the two groups. Colonised and sterile burns treated as inpatients showed no significant difference in healing rates. The healing time, however, was prolonged in colonised outpatient treated burns. Cosmetic results were satisfactory overall. In the absence of a definite benefit from inpatient treatment, outpatient care of a child with a minor burn should therefore be used if circumstances allow. PMID:6357035

  10. 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...

  11. Client incentives versus contracting and staff incentives: how care continuity interventions in substance abuse treatment can improve residential to outpatient transition.

    Science.gov (United States)

    Acquavita, Shauna P; Stershic, Sandra; Sharma, Rajni; Stitzer, Maxine

    2013-07-01

    Interventions for improving transition from short-term residential to outpatient treatment were examined. Usual care (UC; n=114) was referral to a preferred outpatient program with advance appointment optional. Client incentive (CI; n=97) offered up to $100 in gift cards for intake and attendance during the first 30days of treatment. Contracting with staff incentives (CSI; n=49) consisted of meeting with an outpatient counselor prior to residential discharge, signing an attendance contract, receiving an appointment and payment to staff if clients attended. CSI significantly improved rates of successful transition (84%) and admission (74%) compared to UC (64% contact; 49% admitted). CI did not result in significantly improved outcomes (74%; 60%). CSI was likely mediated by the reliability (92 versus 52% in UC) and immediacy (1.0 versus 3.9days) of appointment scheduling. This study supports use of CSI for improving rates of transition between residential and outpatient continuing care treatment. PMID:23375361

  12. Differential effectiveness of residential versus outpatient aftercare for parolees from prison-based therapeutic community treatment programs

    OpenAIRE

    Messina Nena P; Prendergast Michael L; Dang Jeff; Burdon William M; Farabee David

    2007-01-01

    Abstract Background Research has indicated that more intense treatment is associated with better outcomes among clients who are appropriately matched to treatment intensity level based on the severity of their drug/alcohol problem. This study examined the differential effectiveness of community-based residential and outpatient treatment attended by male and female drug-involved parolees from prison-based therapeutic community substance abuse treatment programs based on the severity of their d...

  13. 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.

  14. Outpatient treatment costs and their potential impact on cancer care

    International Nuclear Information System (INIS)

    Cancer creates a tremendous financial burden. Cancer-related costs are categorized into direct, indirect, and psychosocial costs. Although there have been many reports on medical care costs, which are direct, those on other costs are extremely scarce. We estimated travel time and costs required for cancer patients to receive outpatient treatment. We studied 521 cancer patients receiving anti-cancer treatment between February 2009 and December 2012 at the Outpatient Chemotherapy Center of Teikyo University Chiba Medical Center. Address data were extracted from Data Warehouse electronic medical records, and travel distance and time required for outpatient treatment were calculated via MapInfo and ACT Distance Calculator Package. Transportation costs were estimated on the basis of ¥274 (=$3.00) per kilometer. The study design was approved by an ethics review board of Teikyo University (12-851). Average round-trip travel distance, time, and cost for all patients were 26.7 km, 72.5 min, and ¥7,303 ($79.99), respectively. Cancer patients incurred a travel cost of ¥4000–¥9000 ($40.00 to $100.00) for each outpatient treatment. With population aging, seniors living alone and senior households are increasing, and outpatient visits are becoming a common burden

  15. Outpatient treatment costs and their potential impact on cancer care.

    Science.gov (United States)

    Isshiki, Takahiro

    2014-12-01

    Cancer creates a tremendous financial burden. Cancer-related costs are categorized into direct, indirect, and psychosocial costs. Although there have been many reports on medical care costs, which are direct, those on other costs are extremely scarce. We estimated travel time and costs required for cancer patients to receive outpatient treatment. We studied 521 cancer patients receiving anti-cancer treatment between February 2009 and December 2012 at the Outpatient Chemotherapy Center of Teikyo University Chiba Medical Center. Address data were extracted from Data Warehouse electronic medical records, and travel distance and time required for outpatient treatment were calculated via MapInfo and ACT Distance Calculator Package. Transportation costs were estimated on the basis of ¥274 (=$3.00) per kilometer. The study design was approved by an ethics review board of Teikyo University (12-851). Average round-trip travel distance, time, and cost for all patients were 26.7 km, 72.5 min, and ¥7,303 ($79.99), respectively. Cancer patients incurred a travel cost of ¥4000-¥9000 ($40.00 to $100.00) for each outpatient treatment. With population aging, seniors living alone and senior households are increasing, and outpatient visits are becoming a common burden. PMID:25060622

  16. Initiation and retention in couples outpatient treatment for parents with drug and alcohol use disorders.

    Science.gov (United States)

    Braitman, Abby L; Kelley, Michelle L

    2016-06-01

    The focus of the current study was to identity mental health, relationship factors, substance use related problems, and individual factors as predictors of couples-based substance abuse treatment initiation and attendance. Heterosexual couples with children that met study criteria were invited to attend 12 sessions of outpatient behavioral couples therapy. Men were more likely to initiate treatment if they had a higher income, had greater relationship satisfaction, were initiating treatment for alcohol use disorder only, were younger when they first suspected a problem, and had higher depression but lower hostility or phobic anxiety. Men attended more treatment sessions if they reported less intimate partner victimization, if they sought treatment for both alcohol and drug use disorder, if they were older when they first suspected a substance use problem, and if they were more obsessive-compulsive, more phobic anxious, less hostile, and experienced less somatization and less paranoid ideation. For women, treatment initiation was associated with less cohesion in their relationships, more somatization, and being older when they first suspected an alcohol or drug use problem. Trends were observed between women's treatment retention and being older, experiencing more somatization, and suspecting drug-related problems when they were younger; however, no predictors reached statistical significance for women. Results suggest that different factors may be associated with men and women's willingness to initiate and attend conjoint treatment for substance abuse. (PsycINFO Database Record PMID:27064819

  17. Efficacy, safety, and applicability of outpatient treatment for diverticulitis

    Directory of Open Access Journals (Sweden)

    Tursi A

    2014-03-01

    Full Text Available Antonio TursiGastroenterology Service, ASL BAT, Andria BT, ItalyAbstract: Acute diverticulitis of the colon represents a significant burden for national health systems, in terms of direct and indirect costs. Although current guidelines recommend use of antibiotics for the outpatient treatment of acute uncomplicated diverticulitis, evidence for this is still lacking. Hence, significant effort is now being made to identify the appropriate therapeutic approach to treat and prevent relapses of diverticulitis. Outpatient treatment has been identified as a safe and effective therapeutic approach in up to 90% of patients with uncomplicated diverticulitis. It allows important costs saving to health systems without a negative influence on quality of life for patients with uncomplicated diverticulitis, and reduces health care costs by more than 60%.Keywords: diverticulitis, 5-aminosalycilic acid, antibiotics, probiotics, outpatient treatment

  18. Groups as a part of integrated treatment plans : Inpatient psychotherapy for outpatients?

    NARCIS (Netherlands)

    Staats, H

    2005-01-01

    Group psychotherapy in Germany is well established as part of an integrative treatment plan in inpatient treatment. Outpatient group psychotherapy, however, is conceptualized as a separate treatment option in competition with individual therapy. German guidelines for outpatient psychotherapy exclude

  19. Outpatient Treatment of Primary Anorexia Nervosa in Adult Males.

    Science.gov (United States)

    Ziesat, Harold A., Jr.; Ferguson, James M.

    1984-01-01

    Describes three cases of adult-onset primary anorexia nervosa in males. For each case, the history and diagnostic patterns are considered, followed by a discussion of the course of outpatient treatment. The therapy was multimodal and included elements of behavioral contingency management, cognitive therapy, and dynamic psychotherapy. (JAC)

  20. Perceived Mental Illness Stigma among Youth in Psychiatric Outpatient Treatment

    Science.gov (United States)

    Elkington, Katherine S.; Hackler, Dusty; McKinnon, Karen; Borges, Cristiane; Wright, Eric R.; Wainberg, Milton L.

    2012-01-01

    This research explores the experiences of mental illness stigma in 24 youth (58.3% male, 13-24 years, 75% Latino) in psychiatric outpatient treatment. Using Link and Phelan's (2001) model of stigmatization, we conducted thematic analysis of the interview texts, examining experiences of stigma at individual and structural levels, in addition to the…

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

    Directory of Open Access Journals (Sweden)

    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.

  2. 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.

  3. Trends in comprehensive service availability in outpatient drug abuse treatment

    OpenAIRE

    Friedmann, Peter D; Lemon, Stephenie C.; Durkin, Elizabeth M.; D’Aunno, Thomas A.

    2003-01-01

    Comprehensive medical and psychosocial services are essential to quality addiction treatment, but their availability declined in the 1980s. To determine whether this downward trend in the availability of comprehensive services continued in the 1990s, we analyzed data from a national panel study of outpatient substance abuse treatment units in 1990, 1995, and 2000. Response rates were greater than 85%. Regarding the availability of comprehensive services, including physical examinations, routi...

  4. 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

  5. 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

  6. 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.

  7. 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

  8. Duodenal bacterial overgrowth during treatment in outpatients with omeprazole.

    OpenAIRE

    Fried, M; Siegrist, H.; Frei, R.; Froehlich, F.; Duroux, P; Thorens, J; Blum, A.; Bille, J; Gonvers, J J; Gyr, K

    1994-01-01

    The extent of duodenal bacterial overgrowth during the pronounced inhibition of acid secretion that occurs with omeprazole treatment is unknown. The bacterial content of duodenal juice of patients treated with omeprazole was therefore examined in a controlled prospective study. Duodenal juice was obtained under sterile conditions during diagnostic upper endoscopy. Aspirates were plated quantitatively for anaerobic and aerobic organisms. Twenty five outpatients with peptic ulcer disease were i...

  9. Awareness and Practices of Oral Hygiene and its Relation to Sociodemographic Factors among Patients attending the General Outpatient Department in a Tertiary Care Hospital of Kolkata, India

    OpenAIRE

    Paul, Bobby; Basu, Mausumi; Dutta, Sinjita; Chattopadhyay, Sita; Sinha, Debasis; Misra, Raghunath

    2014-01-01

    Background: Periodontal diseases, dental caries, malocclusion, and oral cancer are the most prevalent dental diseases affecting people in the Indian community. Objective: The study was conducted to assess the awareness and practices on oral hygiene and its association with the sociodemographic factors among patients attending the general Outpatient Department (OPD). Materials and Methods: A cross-sectional study was conducted among 224 patients attending the general OPD of the SSKM Hospital, ...

  10. Hepatic cystic echinococcosis:Percutaneous treatment as an outpatient procedure

    Institute of Scientific and Technical Information of China (English)

    Mert Krolu; Okan Akhan; Bekir Erol; Cemil Grses; Bar Trkbey; Cem Yunus Ba; Ahmetkr Alparslan; Banu Kale Krolu; clal Erdem Toslak; Blenteki

    2014-01-01

    Objective:To demonstrate utility and safety of the puncture aspiration injection and reaspiration (PAIR) technique for outpatients.Methods:Percutaneous treatment withUS guidance was applied to33 patients for44 cysts.Patients treated with thePAIR technique, were outpatients. PAIR and catheterization technique were evaluated for efficacy and safety of procedure and complication rates.Results:Thirty-five of44 cysts were treated with thePAIR and9 of44 were treated with the catheterization technique.The success rate of the cystsGharbi type1(CE1) and type2(CE3a) treated with thePAIR technique was100%.In the follow up of9 cysts treated with the catheterization technique,2 of them(22%) developed cyst infection and1(11%) developed a biliary fistula.Conclusions:ThePAIR technique was found to be an effective and safe approach in order to treatGharbi type1 and type2 cysts percutaneously for outpatients.It has a very low complication rate in comparison with the catheterization technique.So every effort should be made to finish the treatment withPAIR technique.

  11. Breast self-examination practices in Nigerian women attending a tertiary outpatient clinic

    Directory of Open Access Journals (Sweden)

    A M Ogunbode

    2015-01-01

    Full Text Available BACKGROUND: The morbidity and mortality caused by breast cancer can be decreased by early detection with breast self-examination (BSE. The objective of this study was to determine the prevalence and the factors determining the practice of BSE. MATERIALS AND METHODS: The study was conducted on 140 women aged above 18 years who presented consecutively in a General Outpatient's clinic in a tertiary hospital in Nigeria. This was the baseline study from an intervention study which looked at the effect of demonstration of BSE on improving Clinical Breast Examination (CBE among two groups of respondents. Structured questionnaires were validated and administered by an interviewer and the data were analyzed using Statistical Package for Social Sciences (SPSS version 12. RESULTS: The overall self-reported prevalence of BSE practice was 62.1% among the respondents. Older women (16, 76.2%, married women (63, 65.6% and women with tertiary education (51, 68.9% had the highest prevalence of BSE practice. Prevalence rate was highest for civil servant (25, 78.1%, P = 0.04. The practice of BSE was higher among women with a previous history of breast disease (15, 68.2% and in respondents with a family history of breast disease (7, 63.6%, Only 11 (12.6% performed BSE as per guidelines, which was once in a month. CONCLUSION: The prevalence of BSE was found to be high, especially in those with tertiary education and in those with a past personal or family history of breast disease. In resource-constrained countries, BSE is a screening tool that can be employed to help reduce the breast cancer burden because routine mammography screening is not yet feasible. Women need to be informed about the when and how to perform BSE.

  12. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  15. Factors Related to Attendance Rates in Obesity-Treatment-Groups.

    Science.gov (United States)

    Packer, Eugene R.; Popler, Kenneth

    1979-01-01

    Examines personal, psychological, physical, and social characteristics of persons seeking group treatment for obesity and correlates these variables with their subsequent attendance. The best candidates for continuing in treatment have completed more schooling, have been obese longer, and are less depressed, more self-sufficient, and less…

  16. Compliance to Cell Phone-Based EMA Among Latino Youth in Outpatient Treatment

    OpenAIRE

    Comulada, WS; Lightfoot, M; Swendeman, D; Grella, C; Wu, N.(Institute of High Energy Physics, Beijing, 100049, People's Republic of China)

    2015-01-01

    © 2015 Copyright © Taylor & Francis Group, LLC. Outpatient treatment practices for adolescent substance users utilize retrospective self-report to monitor drug use. Cell phone-based ecological momentary assessment (CEMA) overcomes retrospective self-report biases and can enhance outpatient treatment, particularly among Latino adolescents, who have been understudied with regard to CEMA. This study explores compliance to text message-based CEMA with youth (n = 28; 93% Latino) in outpatient trea...

  17. Patient-Treatment Matching Improves Compliance of Alcoholics in Outpatient Treatment

    DEFF Research Database (Denmark)

    Nielsen, Anette Søgaard; Nielsen, Bent; Wraae, Olaf

    1998-01-01

    curves. The consequence of compliance for long-term prognosis was described by means of the Addiction Severity Index. The form of treatment in itself had no importance for compliance. However, correct matching of a patient and a treatment structure resulted in a compliance rate of 63% as opposed to 38......In chronic medical disorders, patient compliance is very poor and often less than 50%. The purpose of this investigation was to determine whether the proper matching of patient, treatment, and therapist would improve patient compliance in the outpatient treatment of alcoholics. We randomly placed...... 119 alcoholics who had commenced protracted outpatient treatment for alcoholism in either low or high structured treatments. These 119 patients were offered 12 months of individual treatment. Interruption of this treatment was recorded as noncompliance. The treatment courses were expressed in survival...

  18. Residential Treatment Following Outpatient Treatment for Children with Mild to Borderline Intellectual Disabilities: A Study of Child and Family Characteristics

    Science.gov (United States)

    Embregts, Petri J. C. M.

    2009-01-01

    In this study, the question was explored whether children with a mild intellectual disability (MID) who were placed in residential treatment following outpatient treatment differ significantly on child and family characteristics from children with MID and not placed in residential treatment following outpatient treatment. The records of the…

  19. Differential effectiveness of residential versus outpatient aftercare for parolees from prison-based therapeutic community treatment programs

    Directory of Open Access Journals (Sweden)

    Messina Nena P

    2007-05-01

    Full Text Available Abstract Background Research has indicated that more intense treatment is associated with better outcomes among clients who are appropriately matched to treatment intensity level based on the severity of their drug/alcohol problem. This study examined the differential effectiveness of community-based residential and outpatient treatment attended by male and female drug-involved parolees from prison-based therapeutic community substance abuse treatment programs based on the severity of their drug/alcohol problem. Methods Subjects were 4,165 male and female parolees who received prison-based therapeutic community substance abuse treatment and who subsequently participated in only outpatient or only residential treatment following release from prison. The dependent variable of interest was return to prison within 12 months. The primary independent variables of interest were alcohol/drug problem severity (low, high and type of aftercare (residential, outpatient. Chi-square analyses were conducted to examine the differences in 12-month RTP rates between and within the two groups of parolees (residential and outpatient parolees based on alcohol/drug problem severity (low severity, high severity. Logistic regression analyses were performed to determine if aftercare modality (outpatient only vs. residential only was a significant predictor of 12-month RTP rates for subjects who were classified as low severity versus those who were classified as high severity. Results Subjects benefited equally from outpatient and residential aftercare, regardless of the severity of their drug/alcohol problem. Conclusion As states and the federal prison system further expand prison-based treatment services, the demand and supply of aftercare treatment services will also increase. As this occurs, systems and policies governing the transitioning of individuals from prison- to community-based treatment should include a systematic and validated assessment of post

  20. Early Working Alliance in Outpatient Substance Abuse Treatment: Predicting Substance Use Frequency and Client Satisfaction

    Science.gov (United States)

    Knuuttila, Vesa; Kuusisto, Katja; Saarnio, Pekka; Nummi, Tapio

    2012-01-01

    Background: The study examined the effect of the early working alliance on outcome in outpatient substance abuse treatment. Methods: A total of 327 clients and 33 therapists participated in the study. Data were collected in southern and western Finland in outpatient treatment units (N = 7). The dependent variables were percentage of days abstinent…

  1. Treatment Cost Analysis Tool (TCAT) for estimating costs of outpatient treatment services.

    Science.gov (United States)

    Flynn, Patrick M; Broome, Kirk M; Beaston-Blaakman, Aaron; Knight, Danica K; Horgan, Constance M; Shepard, Donald S

    2009-02-01

    A Microsoft Excel-based workbook designed for research analysts to use in a national study was retooled for treatment program directors and financial officers to allocate, analyze, and estimate outpatient treatment costs in the U.S. This instrument can also be used as a planning and management tool to optimize resources and forecast the impact of future changes in staffing, client flow, program design, and other resources. The Treatment Cost Analysis Tool (TCAT) automatically provides feedback and generates summaries and charts using comparative data from a national sample of non-methadone outpatient providers. TCAT is being used by program staff to capture and allocate both economic and accounting costs, and outpatient service costs are reported for a sample of 70 programs. Costs for an episode of treatment in regular, intensive, and mixed types of outpatient treatment were $882, $1310, and $1381 respectively (based on 20% trimmed means and 2006 dollars). An hour of counseling cost $64 in regular, $85 intensive, and $86 mixed. Group counseling hourly costs per client were $8, $11, and $10 respectively for regular, intensive, and mixed. Future directions include use of a web-based interview version, much like some of the commercially available tax preparation software tools, and extensions for use in other modalities of treatment. PMID:19004576

  2. 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.

  3. Risk profiles of treatment noncompletion for inpatients and outpatients undergoing alcohol disorder rehabilitation treatment

    Directory of Open Access Journals (Sweden)

    Preuss UW

    2012-05-01

    Full Text Available Ulrich W Preuss,1 Jörg Zimmermann,2,3 Gabriele Schultz,2 Anna Watzke,2 Peggy Schmidt,4 Bärbel Löhnert,5 Michael Soyka2,61Department of Psychiatry, Psychotherapy and Psychosomatics, University of Halle-Wittenberg, Halle, Germany; 2Ev Krankenhaus Bethanien GmbH, Fachklinik Gristower Wiek, Johanna-Odebrecht-Stiftung, Germany; 3Karl-Jaspers-Klinik, Fachkrankenhaus für Psychiatrie und Psychotherapie, Psychiatrieverbund Oldenburger Land, Germany; 4Department of Psychiatry, Ludwig-Maximilians-Universität Munich, Germany; 5Klientenzentrierte Problemberatung, Dachau/Munich, Germany; 6Privatklinik Meiringen, Meiringen, Switzerland Background: Rehabilitation treatment noncompletion is considered a risk factor for long term relapse in alcohol-dependent individuals. The aim of this analysis of in- and outpatients in alcohol dependence rehabilitation in Germany is to identify social, mental, and somatic risk profiles for treatment noncompletion.Methods: A total of 92 individuals from an outpatient program and 303 individuals from two inpatient rehabilitation treatment units in three different locations in Germany were recruited and assessed with a structured interview and several measures of psychopathology (personality disorders, anxiety, depression, and impulsivity at treatment admission, with termination at 12 months follow-up. Participants were subdivided into treatment completers and noncompleters for any reason.Results: A total of 10.2% of inpatients and 16.1% of outpatients did not complete treatment. Compared with treatment completers, noncompleters had a significantly lower rate of continuous abstinence at 1-year follow-up, more recent alcohol consumption before admission, and a higher rate of borderline personality disorders. Among inpatients, an elevated rate of lifetime mental disorders, depression, and suicide attempts was found among treatment noncompleters; among outpatients, treatment noncompleters were more often than completers to be

  4. Validation of the Treatment Motivation Scales for forensic outpatient treatment (TMS-F)

    OpenAIRE

    Drieschner, Klaus H.; Boomsma, Anne

    2008-01-01

    The validity of the Treatment Motivation Scales for outpatient offender treatment (TMS-F), a self-report questionnaire with scales for the motivation of patients to engage in the treatment and six cognitive and emotional determinants of this motivation, is evaluated in two studies. In Study 1 (N = 620), the construct validity of the TMS-F is investigated applying a multitrait-multimethod design with a therapist-rating instrument as the criterion method. All scales were found to have adequate ...

  5. Impact of drug awareness and treatment camps on attendance at a community outreach de-addiction clinic

    Directory of Open Access Journals (Sweden)

    Om Prakash Giri

    2015-01-01

    Full Text Available Background: Substance misuse is an increasing problem in urban and rural India. The utility of community-based interventions and preventive strategies are increasingly emphasized in this context. The drug de-addiction and treatment center, Department of Psychiatry, Postgraduate Institute of Medical Education and Research, has been running a drug de-addiction and treatment clinic at Kharar Civil Hospital, Kharar, District Mohali, Punjab, since 1998. As part of an effort to enhance this community outreach program, community-based drug awareness and treatment camps have been organized since March 2004 in villages in and around Tehsil Kharar of Mohali. Aim: To study the impact of the drug awareness and treatment camps on the attendance of patients at the community outreach drug de-addiction and treatment clinic at Kharar Civil Hospital. Methods: Sociodemographic and clinical variables, including treatment outcome-related variables, of patients attending the clinic at Kharar Civil Hospital, before and after the camps were compared. Discussion and Conclusion: The study showed a positive impact on drug awareness and treatment camps held in the community on outpatient attendance at a community outreach clinic, with attendance increasing more than 1.8 times.

  6. Treatment in a specialised out-patient mood disorder clinic v. standard out-patient treatment in the early course of bipolar disorder

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Hansen, Hanne Vibe; Hvenegaard, Anne; Christensen, Ellen Margrethe; Dam, Henrik; Gluud, Christian; Wetterslev, Jørn

    2013-01-01

    BACKGROUND: Little is known about whether treatment in a specialised out-patient mood disorder clinic improves long-term prognosis for patients discharged from initial psychiatric hospital admissions for bipolar disorder. AIMS: To assess the effect of treatment in a specialised out-patient mood...... randomised to treatment in a specialised out-patient mood disorder clinic or standard care (ClinicalTrials.gov: NCT00253071). The primary outcome measure was readmission to hospital, which was obtained from the Danish Psychiatric Central Register. RESULTS: A total of 158 patients with mania/bipolar disorder...... were included. The rate of readmission to hospital was significantly decreased for patients treated in the mood disorder clinic compared with standard treatment (unadjusted hazard ratio 0.60, 95% CI 0.37-0.97, P = 0.034). Patients treated in the mood disorder clinic more often used a mood stabiliser or...

  7. Correlates of early substance use and crime among adolescents entering outpatient substance abuse treatment.

    Science.gov (United States)

    Gordon, Michael S; Kinlock, Timothy W; Battjes, Robert J

    2004-01-01

    Although many studies have examined the relationship between early deviant behavior and subsequent life problems among adolescents drawn from the general population, such relationships have not been examined for youth attending substance abuse treatment. Based on in-depth psychosocial assessments conducted with adolescents entering an outpatient substance abuse treatment program (N = 193), the current study examines individual characteristics, life circumstances, and other behavioral and psychological characteristics that are correlated with the age at which these youth initiated substance use and criminal activity. Early onset of substance use was associated with greater levels of family deviance and a variety of problems including school adjustment, drug use, criminal involvement, bullying and cruelty to people and animals, and involvement in risky sexual activities. In contrast, early onset of crime was related only to male gender, early onset of substance use, and cruelty to people. Findings suggest that treatment providers may need to consider the ages at which their adolescent clients initiated substance use given its association with illegal activity, other deviant behavior, and precocious and high-risk sexual behaviors. PMID:15083553

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

    Science.gov (United States)

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

    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 30.20% (95% CI: 24.52%–36.22%), respectively. Hypertension was associated with age (>35 years; odds ratio [OR] = 10.09, 95% CI: 5.46–18.66, P < 0.01) and female gender (OR = 1.81, 95% CI: 1.08–3.05, P = 0.02). Among total hypertensive patients, 54.9% were aware of their diagnosis, 28.43% were in treatment, and 7.84% had controlled blood pressure. Lack of awareness was significantly higher in younger (age ≤ 37 years; OR = 3.28, 95% CI: 1.13–9.49, P = 0.02). CONCLUSION This study revealed a high prevalence of hypertension, with low awareness, treatment, and control rates. Greater efforts are necessary to overcome these challenges. PMID:27398036

  9. Can outpatient non-attendance be predicted from the referral letter? An audit of default at neurology clinics.

    OpenAIRE

    Dickey, W; Morrow, J I

    1991-01-01

    Data obtained from new patient referral letters to regional and peripheral neurology clinics were studied prospectively over a 6-month period in an attempt to determine factors predicting non-attendance. Attendance at peripheral clinics was significantly better, confirming their value. At regional clinics, factors associated with non-attendance were male sex, patient age less than 50 years, urban home address, referral from Accident and Emergency Departments, symptom duration less than 12 mon...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  12. Psychopharmacological Treatment Status in Outpatients with Bipolar Disorder: A Clinical Survey in Germany

    OpenAIRE

    Quante, Arnim; Zeugmann, Sara; Regen, Francesca; Engelhardt, Annette; Anghelescu, Ion-George

    2010-01-01

    Objective The objective of this epidemiological study was to evaluate the current treatment status as well as the acceptance of medication and satisfaction with life in outpatients with bipolar disorder in Germany. Methods Data for this cross-sectional epidemiologic survey was collected between February 15th, 2006 and May 31st, 2006. Three hundreds six bipolar euthymic outpatients under routine treatment conditions were included in the study. Forty one practicing psychiatrists used a clinical...

  13. Process evaluation of the MOSAIC trial: treatment experience of two psychological therapies for out-patient treatment of Anorexia Nervosa

    OpenAIRE

    Zainal, K. A.; Renwick, B.; Keyes, A.; Lose, A.; Kenyon, M.; DeJong, H; Broadbent, H.; Serpell, L; Richards, L.; Johnson-Sabine, E.; Boughton, N.; Whitehead, L.; Treasure, J; Schmidt, U.; MOSAIC trial group

    2016-01-01

    BACKGROUND: This study is part of a series of process evaluations within the MOSAIC Trial (Maudsley Outpatient Study of Treatments for Anorexia Nervosa and Related Conditions). This randomised controlled trial (RCT) compared two psychological treatments, the Maudsley Model for Treatment of Adults with Anorexia Nervosa (MANTRA) and Specialist Supportive Clinical Management (SSCM) for adult outpatients with Anorexia Nervosa. The present process study integrates quantitative (treatment acceptabi...

  14. Changes in personal networks of women in residential and outpatient substance abuse treatment.

    Science.gov (United States)

    Min, Meeyoung O; Tracy, Elizabeth M; Kim, Hyunsoo; Park, Hyunyong; Jun, Minkyoung; Brown, Suzanne; McCarty, Christopher; Laudet, Alexandre

    2013-10-01

    Changes in personal network composition, support and structure over 12 months were examined in 377 women from residential (n=119) and intensive outpatient substance abuse treatment (n=258) through face-to-face interviews utilizing computer based data collection. Personal networks of women who entered residential treatment had more substance users, more people with whom they had used alcohol and/or drugs, and fewer people from treatment programs or self- help groups than personal networks of women who entered intensive outpatient treatment. By 12 months post treatment intake, network composition improved for women in residential treatment; however, concrete support was still lower and substance users are still more prevalent in their networks. Network composition of women in outpatient treatment remained largely the same over time. Both groups increased cohesiveness within the network over 12 months. Targeting interventions that support positive changes in personal networks may heighten positive long term outcomes for women entering treatment. PMID:23755971

  15. Alcohol Withdrawal Syndrome: Symptom-Triggered versus Fixed-Schedule Treatment in an Outpatient Setting

    DEFF Research Database (Denmark)

    Elholm, B.; Larsen, Klaus; Hornnes, N.;

    2011-01-01

    Aims: To investigate whether, in the treatment with chlordiazepoxide for outpatient alcohol withdrawal, there are advantages of symptom-triggered self-medication over a fixed-schedule regimen. Methods: A randomized controlled trial in outpatient clinics for people suffering from alcohol dependence...... (AD) and alcohol-related problems; 165 adult patients in an outpatient setting in a specialized alcohol treatment unit were randomized 1:1 to either a symptom-triggered self-medication or tapered dose, using chlordiazepoxide. Alcohol withdrawal symptoms, amount of medication, duration of symptoms...... the 1-year follow-up. Results: We found no differences in the quantity of medication consumed, time to relapse, well being or treatment satisfaction. Conclusion: Symptom-triggered self-medication was as safe as fixed-schedule medication in treating outpatients with AD and mild to moderate symptoms of...

  16. 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 ...

  17. Association of Human bocavirus with Respiratory Infections in Outpatients and in Patients Attended at a Reference Hospital

    OpenAIRE

    Pedrosa-Corral, Irene; Pérez-Ruiz, Mercedes; Navarro-Marí, José-María; Ruiz-Bravo, Alfonso

    2011-01-01

    The role of Human bocavirus (HBoV) in human infectious disease is unclear due to the frequent detection of this virus in association with other respiratory viruses with a recognized pathogenic role in acute respiratory infection. We have analyzed the impact of HBoV in outpatients and in patients requiring hospitalisation or emergency attention for acute respiratory infections. Respiratory viruses were investigated by real-time PCR, direct antigen detection and/or viral culture by shell-vial a...

  18. 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

  19. [Effectiveness of Portable Thoracic Drainage Kit for Outpatient Treatment of Spontaneous Pneumothorax].

    Science.gov (United States)

    Sato, Nobuyuki; Abe, Koutaro; Ishibashi, Naoya; Imai, Tadashi

    2016-06-01

    The demand for outpatient management of spontaneous pneumothorax (SP) has been increased, therefore we evaluated the effectiveness of Thoracic Egg(TE), a portable thoracic drainage kit for SP. We studied 43 SP patients who had received TE treatment between May 2008 and October 2010. Ages were ranged 12~73 years (mean:29.1), with 39 males, 4 females, 25 had primary, 18 had recurrent, pneumothorax. Of the 43 patients, 23 were treated outpatient therapy with TE only, 20 were required hospitalization for persistent air leakage, poor expansion or intent to surgery. Surgical intervention was undergone in 18 patients for persistent air leaks or recurrent pneumothorax. The average length of treatment was 8.4 days for outpatient therapy only cases. Of 25 patients who had primary SP, 18( 72%) were not required hospitalization. Outpatient therapy using TE was considered very useful for SP, especially for primary cases. PMID:27246123

  20. Outpatient management of febrile neutropenia: time to revise the present treatment strategy

    DEFF Research Database (Denmark)

    Carstensen, M.; Sørensen, Jens Benn

    2008-01-01

    We reviewed medical literature on the efficacy and safety of outpatient versus hospital-based therapy of low-risk febrile neutropenia in adult cancer patients. A PubMed search for all studies evaluating the outpatient treatment of adults diagnosed with solid tumors who suffered from low-risk febr......We reviewed medical literature on the efficacy and safety of outpatient versus hospital-based therapy of low-risk febrile neutropenia in adult cancer patients. A PubMed search for all studies evaluating the outpatient treatment of adults diagnosed with solid tumors who suffered from low......-risk febrile neutropenia was completed; reference lists from identified articles also were used. In all, 10 trials were included in the analysis, which showed no significant difference in clinical failure rates and mortality for ambulatory regimens and standard hospital-based therapy. Subgroup analysis...... treatment failure (P < 0.04). These findings need to be confirmed by further trials. Thus, outpatient management of adult cancer patients with low-risk febrile neutropenia is safe, effective, and comparable to standard hospital-based therapy. Patients at low risk are outpatients and are hemodynamically...

  1. Substance abuse and the workplace : a networking programme for employers and out-patient treatment centres / Gerbregda Smook

    OpenAIRE

    Smook, Gerbregda

    2014-01-01

    Both employers and out-patient treatment centres are key role players in addressing workplace related substance abuse. On the one hand, employers are directly and indirectly affected by the huge problem of substance abuse. On the other hand, out-patient treatment centres provide, as their core goal, for the treatment of substance abuse and dependency. Due to the extent of the problem of substance abuse, collaborative intervention measures between employers and out-patient treatment centres ar...

  2. Drug Treatment in Adult Probation: An Evaluation of an Outpatient and Acupuncture Program.

    Science.gov (United States)

    Moon, Melissa M.; Latessa, Edward J.

    1994-01-01

    The effectiveness of an innovative outpatient drug-free treatment facility serving felony drug offenders who are placed on probation is evaluated. Treatment included educational and group therapy as well as acupuncture. Background characteristics, levels of treatment, and selected outcomes are described. Principles of successful interventions are…

  3. Effectiveness of individualized, integrative outpatient treatment for females with anorexia nervosa and bulimia nervosa.

    Science.gov (United States)

    Freudenberg, Cara; Jones, Rebecca A; Livingston, Genvieve; Goetsch, Virginia; Schaffner, Angela; Buchanan, Linda

    2016-01-01

    The effectiveness of an individualized outpatient program was investigated in the treatment of bulimia nervosa (BN) and anorexia nervosa (AN). Participants included 151 females who received outpatient eating disorder treatment in the partial hospitalization program, the intensive outpatient program, or a combination of the two programs. Outcome measures included the Eating Disorder Inventory (EDI-2), Beck Depression Inventory (BDI-II), frequency of binge eating and purging, and mean body weight. Findings included significant increases in weight for the AN group, reductions in binge eating frequency for the BN group, and reductions in EDI-2 and BDI-II scores and purging frequency for both groups. This study provides preliminary support for the efficacy of a multimodal program for the treatment of both anorexia nervosa and bulimia nervosa. PMID:26467107

  4. [The concept "a case in outpatient treatment" in military policlinic activity].

    Science.gov (United States)

    Vinogradov, S N; Vorob'ev, E G; Shklovskiĭ, B L

    2014-04-01

    Substantiates the necessity of transition of military policlinics to the accounting system and evaluation of their activity on the finished cases of outpatient treatment. Only automating data-statistical processes can solve this problem. On the basis of analysis of the literature data, requirements of the guidance documents and observational results concludes that preliminarily should be done revisal (formalisation) of existing concepts of medical statistics from the position of information environment which in use - electronic databases. In this aspect specified the main features of outpatient treatment case as a unit of medical-statistical record, and formulated its definition. PMID:25051783

  5. The Comparative Effectiveness of Outpatient Treatment for Adolescent Substance Abuse: A Meta-Analysis

    OpenAIRE

    Tanner-Smith, Emily E; Wilson, Sandra Jo; Lipsey, Mark W.

    2012-01-01

    Meta-analysis was used to synthesize research on the effects of outpatient treatment on substance use outcomes for adolescents with substance use disorders. An extensive literature search located 45 eligible experimental or quasi-experimental studies reporting 73 treatment-comparison group pairs, with many of the comparison groups also receiving some treatment. The first analysis examined 250 effect sizes for the substance use outcomes of adolescents receiving different types of treatment rel...

  6. Facilitating outpatient treatment entry following detoxification for injection drug use: a multisite test of three interventions.

    Science.gov (United States)

    Campbell, Barbara K; Fuller, Bret E; Lee, Eun Sul; Tillotson, Carrie; Woelfel, Tiffany; Jenkins, Lindsay; Robinson, James; Booth, Robert E; McCarty, Dennis

    2009-06-01

    A multisite, randomized trial within the National Drug Abuse Treatment Clinical Trials Network (CTN) was conducted to test 3 interventions to enhance treatment initiation following detoxification: (a) a single session, therapeutic alliance intervention (TA) added to usual treatment; (b) a 2-session, counseling and education, HIV/HCV risk reduction intervention (C&E), added to usual treatment; and (c) treatment as usual (TAU) only. Injection drug users (n=632) enrolled in residential detoxification at 8 community treatment programs were randomized to 1 of the 3 study conditions. TA participants reported entering outpatient treatment sooner and in greater numbers than TAU participants. Reported treatment entry for C&E fell between TA and TAU with no significant differences between C&E and the other conditions. There were no differences among the interventions in retention, as measured by weeks of outpatient treatment for all participants who reported treatment entry. Alliance building interventions appear to be effective in facilitating transfer from detoxification to outpatient treatment, but additional treatment engagement interventions may be necessary to improve retention. PMID:19586142

  7. [Multidisciplinary outpatient clinics for back pain patients--a new treatment program].

    Science.gov (United States)

    Skouen, Jan Sture; Laerum, Even; Jensen, Thor Øivind

    2003-10-23

    Chronic low back pain (LBP) represents a major health problem, especially in Western Europe and North America. The aim of this study is to give an account of why a multidisciplinary treatment program in an outpatient spine clinic is the best treatment for many sub-acute and chronic LBP patients on long-term sick leave. We present an overview of documented treatment effects from multidisciplinary treatment programmes, an outline of the treatment in an outpatient spine clinic, and an account of why multidisciplinary programs are beneficial. The treatment of this patient group is also shown to be cost-effective when one differentiates between light and extensive multidisciplinary programmes. A future challenge rests in the fact that even after optimal treatment, approximately 20 % of patients still do not return to work. PMID:14600719

  8. 7-year trajectories of Alcoholics Anonymous attendance and associations with treatment

    OpenAIRE

    Kaskutas, Lee Ann; Bond, Jason; AVALOS, Lyndsay AMMON

    2009-01-01

    Although many members of Alcoholics Anonymous (AA) are introduced to AA during treatment, the relationship between treatment and AA attendance over time is unknown. This paper describes four latent classes of AA attendance among 586 dependent alcoholics interviewed by telephone 1, 3, 5 and 7 years after baseline, and models the relationship between treatment exposure and AA attendance in each class. There was a low AA group (averaging fewer than 5 meetings at most follow-ups), a medium AA gro...

  9. Association between Medication Adherence and Duration of Outpatient Treatment in Patients with Schizophrenia

    Science.gov (United States)

    Kikuyama, Hiroki; Ohta, Munehiro; Kanazawa, Tetsufumi; Okamura, Takehiko; Yoneda, Hiroshi

    2016-01-01

    Objective Medication adherence is important in the treatment of schizophrenia, and critical periods during treatment may be associated with relapse. However, the relationship between adherence and duration of outpatient treatment (DOT) remains unclear. The authors aimed to clarify the relationship between adherence and DOT at a psychiatric hospital in Japan. Methods For outpatients with schizophrenia who regularly visit Shin-Abuyama hospital, the authors conducted a single questionnaire survey (five questions covering gender, age, DOT, medication shortages, and residual medication) over one month period. Participants were divided into two groups whether DOT were from more than one year to within five years or not. Mantel-Haenszel analysis and logistic regression analysis were performed on the data regarding the medication adherence. Results Effective answers were received for 328 patients. The residual medication rate was significantly higher among those receiving outpatient treatment from more than one year to within five years than five years than those receiving outpatient treatment for more than five years or less than one year (p=0.016). Conclusion This survey suggests that there are critical periods during which patients are most prone to poor adherence. Because poor adherence increases the risk of relapse, specific measures must be taken to improve adherence during these periods.

  10. Predictors of motivation for abstinence at the end of outpatient substance abuse treatment

    OpenAIRE

    Laudet, Alexandre B.; Stanick, Virginia

    2010-01-01

    Commitment to abstinence, a motivational construct, is a strong predictor of reductions in drug and alcohol use. Level of commitment to abstinence at treatment end predicts sustained abstinence, a requirement for recovery. This study sought to identify predictors of commitment to abstinence at treatment end to guide clinical practice and to inform the conceptualization of motivational constructs. Polysubstance users (N = 250) recruited at the start of outpatient treatment were re-interviewed ...

  11. Changes in Personal Networks of Women in Residential and Outpatient Substance Abuse Treatment

    OpenAIRE

    Min, Meeyoung O.; Tracy, Elizabeth M.; Kim, Hyunsoo; Park, Hyunyong; Jun, MinKyong; Brown, Suzanne; McCarty, Christopher; Laudet, Alexandre

    2013-01-01

    Changes in personal network composition, support and structure over 12 months were examined in 377 women from residential (n=119) and intensive outpatient substance abuse treatment (n=258) through face-to-face interviews utilizing computer based data collection. Personal networks of women who entered residential treatment had more substance users, more people with whom they had used alcohol and/or drugs, and fewer people from treatment programs or self- help groups than personal networks of w...

  12. 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...

  13. Psychological Symptoms and Drug Use Severity among Israeli Adolescents Presenting for Outpatient Drug Abuse Treatment

    Science.gov (United States)

    Diamond, G.M.; Izzard, M.C.; Kedar, T.; Hutlzer, A.; Mell, H.

    2005-01-01

    The objective of this study was to assess the rates of externalizing and internalizing symptoms, and the relation between psychological symptoms and drug use severity, among 117 Israeli adolescents presenting for outpatient drug abuse treatment. Psychological symptoms were assessed via both adolescent self-report and parent report. Drug use was…

  14. Validation of a Predictive Model for Survival in Metastatic Cancer Patients Attending an Outpatient Palliative Radiotherapy Clinic

    International Nuclear Information System (INIS)

    Purpose: To validate a predictive model for survival of patients attending a palliative radiotherapy clinic. Methods and Materials: We described previously a model that had good predictive value for survival of patients referred during 1999 (1). The six prognostic factors (primary cancer site, site of metastases, Karnofsky performance score, and the fatigue, appetite and shortness-of-breath items from the Edmonton Symptom Assessment Scale) identified in this training set were extracted from the prospective database for the year 2000. We generated a partial score whereby each prognostic factor was assigned a value proportional to its prognostic weight. The sum of the partial scores for each patient was used to construct a survival prediction score (SPS). Patients were also grouped according to the number of these risk factors (NRF) that they possessed. The probability of survival at 3, 6, and 12 months was generated. The models were evaluated for their ability to predict survival in this validation set with appropriate statistical tests. Results: The median survival and survival probabilities of the training and validation sets were similar when separated into three groups using both SPS and NRF methods. There was no statistical difference in the performance of the SPS and NRF methods in survival prediction. Conclusion: Both the SPS and NRF models for predicting survival in patients referred for palliative radiotherapy have been validated. The NRF model is preferred because it is simpler and avoids the need to remember the weightings among the prognostic factors

  15. 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

  16. 76 FR 40452 - Agency Information Collection (Report of Treatment by Attending Physician) Activity Under OMB Review

    Science.gov (United States)

    2011-07-08

    ... AFFAIRS Agency Information Collection (Report of Treatment by Attending Physician) Activity Under OMB...: In compliance with the Paperwork Reduction Act (PRA) of 1995 (44 U.S.C. 3501-3521), this notice... INFORMATION: Title: Report of Treatment by Attending Physician, VA Form 29-551a. OMB Control Number:...

  17. 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.

  18. What could the program have done differently? A qualitative examination of reasons for leaving outpatient treatment

    OpenAIRE

    Laudet, Alexandre B.; Stanick, Virginia; Sands, Brian

    2009-01-01

    Attrition from treatment for substance abuse disorders (SUD) is a persistent challenge that severely limits the effectiveness of services. Though a large body of research has sought to identify predictors of retention, the perspective of clients of services is rarely examined. This exploratory qualitative study presents clients’ stated reasons for leaving outpatient treatment (N = 135, 54% of the sample of 250) and their views of what could have been done differently to keep them engaged in s...

  19. Effectiveness of outpatient, day hospital, and inpatient psychotherapeutic treatment for patients with cluster B personality disorders

    OpenAIRE

    Bartak, Anna; Andrea, Helene; Spreeuwenberg, Marieke; Ziegler, Uli; Dekker, Jack; Rossum, Bert; Hamers, Elisabeth; Scholte, Wubbo; Aerts, Janneke; Busschbach, Jan; Verheul, Roel; Stijnen, Theo; Emmelkamp, Paul

    2010-01-01

    textabstractAbstract Background: For patients with cluster B personality disor- ders there is no consensus regarding the optimal treatment setting. The aim of this study was to compare the effective- ness of different psychotherapeutic settings for patients with cluster B personality disorders, i.e. outpatient, day hos- pital, and inpatient treatment. Methods: The study was con- ducted between March 2003 and June 2008 in 6 mental health care centres in the Netherlands, with a sample of 207 pa...

  20. Erectile dysfunction among men attending surgical outpatients Department in a Tertiary Hospital in South-Western Nigeria

    Directory of Open Access Journals (Sweden)

    Augustine O Takure

    2016-01-01

    Full Text Available Background: Erectile dysfunction is becoming a public health issue with high incidences reported in community studies. Objective: To evaluate the characteristics and outcome of treatment in men with erectile dysfunction in a tertiary center in Ibadan southwestern Nigeria. Methods: Data of men with erectile dysfunction was retrieved between July 2004 and June 2014 and analyzed using SPSS version 16 statistical software. Results: Eighty-nine men with erectile dysfunction were managed which constituted 2% of all urological cases seen during the study period. Their median and mean ages were 39 years and 39.6 ± 1.2SD (range 19-76 years. The peak age incidence at 30-44 years was 41.6% and reduced with increasing age after 65 years to 4.5%. The etiologies were psychogenic in 55%, organic in 27%, idiopathic in 17% and 1% was familial. 67.5%, 31.5% and 3.4% were married, single and separated respectively. Seventy percent neither smoked cigarette nor drank alcohol, 21.3% drank alcohol and 9% took both alcohol and smoked cigarette. Seventy seven and half percent of men presented within 5 years of their symptom. The treatments offered were PDE type 5 inhibitors alone or in combination with psychotherapy or modification of medications. The outcome of these treatments ranged from 89% to 91% success rate. Conclusion: The number of men with erectile dysfunction managed in the tertiary hospital is very low though the outcome of treatment is within acceptable range. Increase public enlightenment may encourage increase hospital patronage and access to the available treatments for erectile dysfunction.

  1. Outpatient treatment of alcohol use disorders among subjects 60+ years

    DEFF Research Database (Denmark)

    Andersen, Kjeld; Bogenschutz, Michael P; Bühringer, Gerhard;

    2015-01-01

    BACKGROUND: The proportion of 60+ years with excessive alcohol intake varies in western countries between 6-16 % among men and 2-7 % among women. Specific events related to aging (e.g. loss of job, physical and mental capacity, or spouse) may contribute to onset or continuation of alcohol use...... six months after treatment initiation. Controlled use is defined as maximum blood alcohol content not exceeding 0.05 % during the last month. Total abstinence is a secondary outcome, together with quality of life andcompliance with treatment. DISCUSSION: The study will provide new knowledge about...... into the possible interaction of service system differences and related patient characteristics in predictionof treatment outcome. TRIAL REGISTRATION: Clinical Trials.gov NCT02084173 , March 7, 2014....

  2. Identification of patients with low-risk pulmonary embolism suitable for outpatient treatment using the pulmonary embolism severity index (PESI).

    LENUS (Irish Health Repository)

    McCabe, A

    2013-06-01

    There is increasing evidence that outpatient treatment of patients with low-risk stable pulmonary embolism (PE) is safe, effective and potentially reduces costs. It is not clear how many patients presenting to an Irish Emergency Department (ED) are potentially suitable for outpatient management.

  3. ASYMPTOMATIC BACTERIURIA AMONG PREGNANT WOMEN ATTENDING THE OUTPATIENT CLINIC OF CHITWAN MEDICAL COLLEGE TEACHING HOSPITAL, CHITWAN, NEPAL

    Directory of Open Access Journals (Sweden)

    Mamata Sharma Neupane

    2012-11-01

    Full Text Available Urinary Tract Infection (UTI refers to both microbial colonization of the urine and tissue invasion of any structure of the urinary tract. Pregnancy enhances the progression from asymptomatic to symptomatic bacteriuria which could lead to pyelonephritis and adverse obstetric outcomes such as prematurity, low-birth weight, and higher fetal mortality rates. This study was undertaken to determine the prevalence of asymptomatic bacteriuria in pregnancy; its causative agents and their antimicrobial susceptibility pattern, and also to determine the relationship between asymptomatic bacteriuria and pyuria. The total number of participants who finished the study was 392. The mean age of the participants was 29.76 ± 6.71(range, 21-37 years. Of the 392 urine specimens processed, 102 (26.0% showed significant bacteriuria. The commonest organism causing bacteriuria was Escherichia coli. The sensitivity pattern of the isolated organisms revealed that all were sensitive to ciprofloxacin and gentamicin at very high percentage. 200 (51.5% women had more than 5 pus cells in urine specimens from which 50 (12.75% had positive cultures. Women with higher number of pus cells in urine specimen had significantly higher asymptomatic bacteriuria (p < 0.0001.In conclusion, screening of bacteriuria in pregnancy and proper treatment must be considered as an essential part of antenatal care in Nepalese community. To prevent asymptomatic bacteriuria complications, all pregnant women should be screened at the first antenatal visit. A negative test for pyuria is not a reliable indicator of the absence of asymptomatic bacteriuria in pregnant women.

  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. Outpatient marijuana treatment for adolescents. Economic evaluation of a multisite field experiment.

    Science.gov (United States)

    French, Michael T; Roebuck, M Christopher; Dennis, Michael L; Godley, Susan H; Liddle, Howard A; Tims, Frank M

    2003-08-01

    An economic evaluation of five outpatient adolescent treatment approaches (12 total site-by-conditions) was conducted. The economic cost of each of the 12 site-specific treatment conditions was determined by the Drug Abuse Treatment Cost Analysis Program (DATCAP). Economic benefits of treatment were estimated by first monetizing a series of treatment outcomes and then analyzing the magnitude of these monetized outcomes from baseline through the 12-month follow-up. The average economic costs ranged from $90 to $313 per week and from $839 to $3,279 per episode. Relative to the quarter before intake, the average quarterly cost to society for the next 12 months (including treatment costs) significantly declined in 4 of the 12 site-by-treatment conditions, remained unchanged in 6 conditions, and increased in 2 treatment conditions (both in the same site). These results suggest that some types of substance-abuse intervention for adolescents can reduce social costs immediately after treatment. PMID:12959043

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  8. Quality of life of patients with schizophrenia treated in foster home care and in outpatient treatment

    Directory of Open Access Journals (Sweden)

    Mihanović M

    2015-03-01

    Full Text Available Mate Mihanović,1,2 Branka Restek-Petrović,1,2 Anamarija Bogović,1 Ena Ivezić,1 Davor Bodor,1 Ivan Požgain3 1Psychiatric Hospital “Sveti Ivan”, Zagreb, 2Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 3Department of Psychiatry, University Hospital Center Osijek, Osijek, Croatia Background: The Sveti Ivan Psychiatric Hospital in Zagreb, Croatia, offers foster home care treatment that includes pharmacotherapy, group psychodynamic psychotherapy, family therapy, and work and occupational therapy. The aim of this study is to compare the health-related quality of life of patients with schizophrenia treated in foster home care with that of patients in standard outpatient treatment. Methods: The sample consisted of 44 patients with schizophrenia who, upon discharge from the hospital, were included in foster home care treatment and a comparative group of 50 patients who returned to their families and continued receiving outpatient treatment. All patients completed the Short Form 36 Health Survey Questionnaire on the day they completed hospital treatment, 6 months later, and 1 year after they participated in the study. The research also included data on the number of hospitalizations for both groups of patients. Results: Though directly upon discharge from the hospital, patients who entered foster home care treatment assessed their health-related quality of life as poorer than patients who returned to their families, their assessments significantly improved over time. After 6 months of treatment, these patients even achieved better results in several dimensions than did patients in the outpatient program, and they also had fewer hospitalizations. These effects remained the same at the follow-up 1 year after the inclusion in the study. Conclusion: Notwithstanding the limitations of this study, it can be concluded that treatment in foster home care is associated with an improvement in the quality of life of patients

  9. Patterns in admission delays to outpatient methadone treatment in the United States.

    Science.gov (United States)

    Gryczynski, Jan; Schwartz, Robert P; Salkever, David S; Mitchell, Shannon Gwin; Jaffe, Jerome H

    2011-12-01

    Waiting lists for methadone treatment have existed in many U.S. communities, but little is known nationally about what patient and service system factors are related to admission delays that stem from program capacity shortfalls. Using a combination of national data sources, this study examined patterns in capacity-related admission delays to outpatient methadone treatment in 40 U.S. metropolitan areas (N = 28,920). Patient characteristics associated with admission delays included racial/ethnic minority status, lower education, criminal justice referral, prior treatment experience, secondary cocaine or alcohol use, and co-occurring psychiatric problems. Injection drug users experienced fewer delays, as did self-pay patients and referrals from health care and addiction treatment providers. Higher community-level utilization of methadone treatment was associated with delay, whereas delays were less common in communities with higher utilization of alternative modalities. These findings highlight potential disparities in timely admission to outpatient methadone treatment. Implications for improving treatment access and service system monitoring are discussed. PMID:21821378

  10. What Does It Take? Comparing Intensive Rehabilitation to Outpatient Treatment for Children With Significant Pain-Related Disability

    OpenAIRE

    Simons, Laura E.; Sieberg, Christine B.; Pielech, Melissa; Conroy, Caitlin; Logan, Deirdre E

    2012-01-01

    Objectives This study compared outcomes between day hospital pain rehabilitation patients and patients engaged in outpatient multidisciplinary pain treatment. Methods This study included 100 children who presented for an initial tertiary care pain clinic evaluation. 50 patients enrolled in intensive day hospital pain rehabilitation and 50 patients pursued outpatient multidisciplinary treatment. Across 2 time points, children completed measures of functional disability, pain-related fear, and ...

  11. Two Models of Integrating Buprenorphine Treatment and Medical Staff within Formerly "Drug-Free" Outpatient Programs.

    Science.gov (United States)

    Monico, Laura; Schwartz, Robert P; Gryczynski, Jan; O'Grady, Kevin E; Mitchell, Shannon Gwin

    2016-01-01

    "Drug-free" outpatient programs deliver treatment to the largest number of patients of all treatment modalities in the U.S., providing a significant opportunity to expand access to medication treatments for substance use disorders. This analysis examined staff perceptions of organizational dynamics associated with the delivery of buprenorphine maintenance within three formerly "drug-free" outpatient treatment programs. Semi-structured interviews (N = 15) were conducted with counseling and medical staff, and respondents were predominantly African American (n = 11) and female (n = 12). Themes and concepts related to medical staff integration emerged through an inductive and iterative coding process using Atlas.ti qualitative analysis software. Two treatment clinics incorporated buprenorphine maintenance into their programs using a co-located model of care. Their staff generally reported greater intra-organizational discord regarding the best ways to combine medication and counseling compared to the clinic using an integrated model of care. Co-located program staff reported less communication between medical and clinical staff, which contributed to some uncertainty about proper dosing and concerns about the potential for medication diversion. Clinics that shift from "drug-free" to incorporating buprenorphine maintenance should consider which model of care they wish to adapt and how to train staff and structure staff communication. PMID:26940870

  12. Cost-effectiveness of home visits in the outpatient treatment of patients with alcohol dependence.

    Science.gov (United States)

    Moraes, Edilaine; Campos, Geraldo M; Figlie, Neliana B; Laranjeira, Ronaldo; Ferraz, Marcos B

    2010-01-01

    The purpose of this study was to compare the cost-effectiveness of conventional outpatient treatment for alcoholic patients (CT) with this same conventional treatment plus home visits (HV), a new proposal for intervention within the Brazilian outpatient treatment system. A cost-effectiveness evaluation alongside a 12-week randomized clinical trial was performed. We identified the resources utilized by each intervention, as well as the cost according to National Health System (SUS), Brazilian Medical Association (AMB) tables of fees, and others based on 2005 data. The incremental cost-effectiveness ratio (ICER) was estimated as the main outcome measure - abstinent cases at the end of treatment. There were 51.8% abstinent cases for HV and 43.1% for CT, a clinically relevant finding. Other outcome measures, such as quality of life, also showed significant improvements that favored HV. The baseline scenario presented an ICER of USD 1,852. Sensitivity analysis showed an ICER of USD 689 (scenario favoring HV) and USD 2,334 (scenario favoring CT). The HV treatment was found to be cost-effective according to the WHO Commission on Macroeconomics and Health. PMID:20029212

  13. Laboratory testing improves diagnosis and treatment outcomes in primary health care facilities

    OpenAIRE

    Jane Y. Carter; Orgenes E. Lema; Magdaline W. Wangai; Charles G. Munafu; Philip H. Rees; Jackson A. Nyamongo

    2011-01-01

    Objective: To determine if use of basic laboratory tests improves diagnosis and treatment outcomes in outpatients attending rural primary health care facilities.Setting: Six rural health centres in Kenya.Design: Cross-sectional study to observe change in diagnosis and treatment made by clinical officers after laboratory testing in outpatients attending six rural health centres in Kenya.Subject: The diagnosis and treatment of 1134 patients attending outpatient services in six rural health cent...

  14. Effectiveness of reboxetine in treatment of outpatient children and adolescents with attention deficit-hyperactivity disorder with comorbid anxiety disorders.

    OpenAIRE

    Forough Riahi; Ashraf Tashakori; Sakineh Izadi-Mazidi; Mohammad Salehi-Veysi

    2013-01-01

    Objective Some previous studies have reported that ADHD is often comorbid with anxiety disorders. The aim of the present study was to evaluate the effectiveness of reboxetine in treating outpatient children and adolescents with ADHD and comorbid anxiety disorders. Method In this open-label study, 25 outpatient children and adolescents, aged 6-16 years were selected by convenient sampling and underwent treatment with 4mg reboxetine for four weeks. Data were collected at baseline, two weeks and...

  15. The effectiveness of individual interpersonal psychotherapy as a treatment for major depressive disorder in adult outpatients: a systematic review

    OpenAIRE

    van Hees Madelon L J M; Rotter Thomas; Ellermann Tim; Evers Silvia M A A

    2013-01-01

    Abstract Background This systematic review describes a comparison between several standard treatments for major depressive disorder (MDD) in adult outpatients, with a focus on interpersonal psychotherapy (IPT). Methods Systematic searches of PubMed and PsycINFO studies between January 1970 and August 2012 were performed to identify (C-)RCTs, in which MDD was a primary diagnosis in adult outpatients receiving individual IPT as a monotherapy compared to other forms of psychotherapy and/or pharm...

  16. Efficacy and Tolerability of Eight Antimicrobial Regimens in the Outpatient Treatment of Exacerbations of Chronic Obstructive Pulmonary Disease

    OpenAIRE

    Jordan Minov; Jovanka Karadzinska-Bislimovska; Tatjana Petrova; Kristin Vasilevska; Sasho Stoleski; Dragan Mijakoski; Snezhana Risteska-Kuc

    2014-01-01

    BACKGROUND: Bacterial infections are considered as the most important cause of exacerbations in patients with chronic obstructive pulmonary disease. AIM: To compare the efficacy and tolerability of eight antibiotics empirically administered for outpatient treatment of exacerbations of COPD. METHODS: We performed an observational study including 343 COPD patients with probable bacterial exacerbation (Group A and Group B COPD patients) managed in an outpatient setting. Eight antibiotic ...

  17. Variation in access to outpatient substance abuse treatment: organizational factors and conceptual issues.

    Science.gov (United States)

    McCaughrin, W C; Howard, D L

    1996-01-01

    Access is a multidimensional concept representing the ease with which health services are initiated and sustained. In this study, conceptual domains of access--affordability, acceptability, accommodation, availability, service diversity, and competitive stance--are hypothesized to predict the time clients wait to receive services. A large, recently surveyed, nationally representative sample of outpatient substance abuse treatment organizations provided the data. Multivariate regression analysis of 326 organizations was conducted with the conceptual domains sequentially predicting the time clients waited to receive service. Results show that increased waiting time was positively associated with treatment staff case overload and the average number of months clients spent in treatment and negatively associated with the percent of a treatment organization's client base on public assistance. Implications for policy makers and clinicians concerning client selection strategies by organizations and problems with the organizational capacity to treat clients are discussed. Areas for future research also are highlighted. PMID:9058353

  18. 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.

  19. Likelihood of Attending Treatment for Anxiety Among Veteran Primary Care Patients: Patient Preferences for Treatment Attributes.

    Science.gov (United States)

    Shepardson, Robyn L; Funderburk, Jennifer S

    2016-09-01

    Anxiety is common, but under-treated, in primary care. Behavioral health providers embedded in primary care can help address this treatment gap. Guidance on anxiety treatment preferences would help inform tailoring of clinical practice and new interventions to be more patient-centered and increase treatment engagement. We surveyed 144 non-treatment seeking Veteran primary care patients (82.6 % male, 85.4 % White, age M = 59.8 years, SD = 13.9) reporting current anxiety symptoms (M = 13.87, SD = 3.66, on the Generalized Anxiety Disorder-7 Questionnaire) on their likelihood of attending anxiety treatment featuring various levels of 11 attributes (modality, type, location, format, provider, visit frequency, visit length, treatment duration, type of psychotherapy, symptom focus, and topic/skill). Participants indicated clear preferences for individual, face-to-face treatment in primary care, occurring once a month for at least 30 min and lasting at least three sessions. They also tended to prefer a stress management approach focused on trouble sleeping or fatigue, but all topics/skills were rated equivalently. For most attributes, the highest rated options were consistent with characteristics of integrated care. Implications for research and practice are discussed. PMID:27465641

  20. Attending physician and patient in radiotherapeutic treatment: practical advices

    International Nuclear Information System (INIS)

    This brochure is devoted to external radiotherapy and provides some pieces of practical advices for each stage of the patient's treatment: before, during and after radiotherapy. The monitoring and management of short-, medium- and long-term side-effects represent a major stake. Such side-effects and their treatments are presented in tables for each affected part of the body or affected organ. (J.S.)

  1. What could the program have done differently? A qualitative examination of reasons for leaving outpatient treatment.

    Science.gov (United States)

    Laudet, Alexandre B; Stanick, Virginia; Sands, Brian

    2009-09-01

    Attrition from treatment for substance abuse disorders is a persistent challenge that severely limits the effectiveness of services. Although a large body of research has sought to identify predictors of retention, the perspective of clients of services is rarely examined. This exploratory qualitative study presents clients' stated reasons for leaving outpatient treatment (n = 135, 54% of the sample of 250) and their views of what could have been done differently to keep them engaged in services. Obstacles to retention fell into program- and individual-level factors. Program-level barriers include dissatisfaction with the program, especially counselors; unmet social services needs; and lack of flexibility in scheduling. Individual-level barriers to retention were low problem recognition and substance use. Study limitations are noted, and the implications of findings for research and practice are discussed, emphasizing the need to understand and address clients' needs and expectations starting at intake to maximize treatment retention and the likelihood of positive outcomes. PMID:19339133

  2. The Effect of Using Assessment Instruments on Substance-abuse Outpatients' Adherence to Treatment: a Multi-centre Randomised Controlled Trial

    Directory of Open Access Journals (Sweden)

    Broekaert Eric

    2011-05-01

    Full Text Available Abstract Background Drop-out is an important problem in the treatment of substance use disorder. The focus of this study was to investigate the effectiveness of within treatment assessment with feedback directly to patients with multiple substance use disorder on outpatient individual treatment adherence. Feedback consisted of personal resources' and readiness to change status and progress that facilitate or hinder change, thereby using graphical representation. Methods Informed consent was obtained from both the control and experimental groups to be involved in research and follow-up. Following Zelen's single consent design, baseline participants (n = 280 were randomised (sample-size-estimation: 80%power, p=.05, 2-sided and treatment consent was obtained from those allocated to the experiment (n = 142. In both groups, equal numbers of patients did not attend sessions after allocation. So, 227 persons were analyzed according to intention-to-treat analysis (ITT: experiment n = 116;control n = 111. Excluding refusals 211 participants remained for per-protocol analysis (PP: experiment n = 100; control n = 111, The study was conducted in five outpatient treatment-centres of a large network (De Sleutel in Belgium. Participants were people with multiple substance use disorder -abuse and dependence- who had asked for treatment and who had been advised to start individual treatment after a standardised admission assessment with the European Addiction Severity Index. The experimental condition consisted of informing the patient about the intervention and of subsequent assessments plus feedback following a protocol within the first seven sessions. Assessments were made with the Readiness to Change Questionnaire and the Personal Resources Diagnostic System. The control group received the usual treatment without within treatment assessment with feedback. The most important outcome measure in this analysis of the study was the level of adherence to treatment

  3. Urinary Tract Infections: Leading Initiatives in Selecting Empiric Outpatient Treatment (UTILISE)

    Science.gov (United States)

    Landry, Eric; Sulz, Linda; Bell, Ali; Rathgeber, Lane; Balogh, Heather

    2014-01-01

    Background Overuse of fluoroquinolone antibiotics is associated with outbreaks of methicillin-resistant Staphylococcus aureus and of Clostridium difficile–associated diarrhea and increasing resistance in gram-negative organisms. Over the past decade, resistance of Escherichia coli to ciprofloxacin has increased in the Regina Qu’Appelle Health Region. In August 2011, an exploratory audit of the Regina General Hospital (RGH) emergency department showed that 20% of new antibiotic orders were for fluoroquinolones, and 60% of these new fluoroquinolone orders were for ciprofloxacin. It was postulated that ciprofloxacin was predominantly prescribed for outpatients with urinary tract infection. Objective: To develop, implement, and evaluate a best-practice algorithm for the empiric treatment of uncomplicated urinary tract infection in the RGH emergency department, as part of an educational initiative for emergency physicians. Methods: A literature review was conducted and local antibiogram data were analyzed to establish a best-practice algorithm for treatment of uncomplicated urinary tract infection in outpatients seen in the emergency department. A chart review was conducted from January to March 2011 to establish a baseline of empiric antibiotic use. An educational strategy targeting emergency physicians described changes in antibiotic resistance patterns in the health region, principles of antimicrobial stewardship, drivers of resistance, and the results of a literature review of best practice for urinary tract infection in outpatients. A post-intervention audit was conducted from January to March 2012 to determine changes in practice. Results: Comparison of results from the post-intervention audit with baseline data showed that adherence to best practice increased significantly, from 41% (39/96) before the intervention to 66% (50/76) after the intervention (odds ratio [OR] 2.81, 95% confidence interval [CI] 1.51–5.25; p < 0.001). There was also a significant

  4. Men with Intellectual Disabilities Who Have Attended Sex Offender Treatment Groups: A Follow-up

    Science.gov (United States)

    Heaton, Kathryn M.; Murphy, Glynis H.

    2013-01-01

    Background: There have been a number of studies of treatment for men with intellectual disabilities and sexually abusive behaviour but few follow-up studies. Our aim was to follow up men with intellectual disabilities who had attended group cognitive behavioural treatment (CBT) for sexually abusive behaviour. Method Thirty-four men (from seven…

  5. [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

  6. Successfully reforming orthopaedic outpatients.

    Science.gov (United States)

    Schoch, Peter A; Adair, Lisa

    2012-05-01

    Since 2005, Barwon Health has successfully reformed its orthopaedic outpatient service to address the following issues: increasing number of referrals, inefficient referral management and triage, long waiting times for non-urgent appointments, high 'Did Not Attend' (DNA) rates and poor utilisation of conservative therapies before referral to surgeon. Numerous strategies have been implemented including: waiting list audits, triage guidelines, physiotherapy-led clinics, a DNA policy, an orthopaedic lead nurse role and a patient-focussed booking system. There has been a 66% reduction in the number of patients waiting for their first appointment; an 87% reduction in the waiting time from referral to first appointment; a 10% reduction in new patient DNAs; and more efficient referral management and communication processes. Patients are now seen in clinically appropriate time frames and offered earlier access to a wider range of conservative treatments. PMID:22624648

  7. Predictors of motivation for abstinence at the end of outpatient substance abuse treatment.

    Science.gov (United States)

    Laudet, Alexandre B; Stanick, Virginia

    2010-06-01

    Commitment to abstinence, a motivational construct, is a strong predictor of reductions in drug and alcohol use. Level of commitment to abstinence at treatment end predicts sustained abstinence, a requirement for recovery. This study sought to identify predictors of commitment to abstinence at treatment end to guide clinical practice and to inform the conceptualization of motivational constructs. Polysubstance users (N = 250) recruited at the start of outpatient treatment were reinterviewed at the end of services. Based on the extant literature, potential predictors were during treatment measures of substance use and related cognitions, psychological functioning, recovery supports, stress, quality of life satisfaction, and treatment experiences. In multivariate analyses, perceived harm of future drug use, abstinence self-efficacy, quality of life satisfaction, and number of network members in 12-step recovery contributed 26.6% of the variance explained in the dependent variable, a total of 49.6% when combined with the control variables (demographics and baseline level of the outcome). Gender subgroup analyses yielded largely similar results. Clinical implications of findings for maximizing commitment to abstinence when clients leave treatment are discussed as are future research directions. PMID:20185267

  8. Seasonality of antibiotic prescriptions for outpatients and resistance genes in sewers and wastewater treatment plant outflow.

    Science.gov (United States)

    Caucci, Serena; Karkman, Antti; Cacace, Damiano; Rybicki, Marcus; Timpel, Patrick; Voolaid, Veiko; Gurke, Robert; Virta, Marko; Berendonk, Thomas U

    2016-05-01

    To test the hypothesis of a seasonal relationship of antibiotic prescriptions for outpatients and the abundance of antibiotic resistance genes (ARGs) in the wastewater, we investigated the distribution of prescriptions and different ARGs in the Dresden sewer system and wastewater treatment plant during a two-year sampling campaign. Based on quantitative PCR (qPCR), our results show a clear seasonal pattern for relative ARGs abundances. The higher ARGs levels in autumn and winter coincide with the higher rates of overall antibiotic prescriptions. While no significant differences of relative abundances were observed before and after the wastewater treatment for most of the relative ARGs, the treatment clearly influenced the microbial community composition and abundance. This indicates that the ARGs are probably not part of the dominant bacterial taxa, which are mainly influenced by the wastewater treatment processes, or that plasmid carrying bacteria remain constant, while plasmid free bacteria decrease. An exception was vancomycin (vanA), showing higher relative abundance in treated wastewater. It is likely that a positive selection or community changes during wastewater treatment lead to an enrichment ofvanA. Our results demonstrate that in a medium-term study the combination of qPCR and next generation sequencing corroborated by drug-related health data is a suitable approach to characterize seasonal changes of ARGs in wastewater and treated wastewater. PMID:27073234

  9. Body attitudes in patients with eating disorders at presentation and completion of intensive outpatient day treatment.

    Science.gov (United States)

    Exterkate, Cecile C; Vriesendorp, Patricia F; de Jong, Cor A J

    2009-01-01

    Due to the importance of the distorted body experience in eating disorder diagnosis and treatment, we wanted to explore body attitudes of patients with eating disorders before and after 5 months of intensive specialized outpatient day treatment. We assessed 193 patients diagnosed with Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Eating Disorder Not Otherwise Specified (EDNOS) using the Body Attitude Test (BAT), Body Mass Index (BMI), Eating Disorder Evaluation Scale (EDES) and Symptom Checklist 90 (SCL-90). Eating disorder subtypes differed in BMI, total body attitudes and negative appreciation of body size at intake, but not at termination of treatment. Following treatment, all patient groups reported large improvements in eating disorder pathology and all but the AN-Restrictive (AN-R) group, reported large improvements in overall psychological functioning. The AN patients demonstrated significant improvement in BMI, however the Anorexia Nervosa purging (AN-P) and Anorexia Nervosa restrictive (AN-R) subtypes differed in their changes in body attitudes. AN-R patients indicated no significant improvement in body attitudes. AN-P patients improved in total body attitudes, except one subscale. Patients with Bulimia Nervosa non-purging (BN-NP) subtype, Bulimia Nervosa purging (BN-P) subtype and EDNOS demonstrated similar improvements in total body attitudes (BAT). Body attitudes provide important insights into differences between eating disorder diagnostic categories and their treatment responsiveness. PMID:19171312

  10. Outpatient Surgery

    Science.gov (United States)

    ... and Anesthesia Seniors and Anesthesia Surgery Risks Anesthesia Awareness Obesity and Anesthesia Sleep Apnea and Anesthesia Smoking and Anesthesia Outpatient Surgery Outpatient Surgery Surgery does ...

  11. Factors associated with antibiotic misuse in outpatient treatment for upper respiratory tract infections.

    Science.gov (United States)

    Schroeck, Jennifer L; Ruh, Christine A; Sellick, John A; Ott, Michael C; Mattappallil, Arun; Mergenhagen, Kari A

    2015-07-01

    The Centers for Disease Control and Prevention has promoted the appropriate use of antibiotics since 1995 when it initiated the National Campaign for Appropriate Antibiotic Use in the Community. This study examined upper respiratory tract infections included in the campaign to determine the degree to which antibiotics were appropriately prescribed and subsequent admission rates in a veteran population. This study was a retrospective chart review conducted among outpatients with a diagnosis of a respiratory tract infection, including bronchitis, pharyngitis, sinusitis, or nonspecific upper respiratory tract infection, between January 2009 and December 2011. The study found that 595 (35.8%) patients were treated appropriately, and 1,067 (64.2%) patients received therapy considered inappropriate based on the Get Smart Campaign criteria. Overall the subsequent readmission rate was 1.5%. The majority (77.5%) of patients were prescribed an antibiotic. The most common antibiotics prescribed were azithromycin (39.0%), amoxicillin-clavulanate (13.2%), and moxifloxacin (7.5%). A multivariate regression analysis demonstrated significant predictors of appropriate treatment, including the presence of tonsillar exudates (odds ratio [OR], 0.6; confidence interval [CI], 0.3 to 0.9), fever (OR, 0.6; CI, 0.4 to 0.9), and lymphadenopathy (OR, 0.4; CI, 0.3 to 0.6), while penicillin allergy (OR, 2.9; CI, 1.7 to 4.7) and cough (OR, 1.6; CI, 1.1 to 2.2) were significant predictors for inappropriate treatment. Poor compliance with the Get Smart Campaign was found in outpatients for respiratory infections. Results from this study demonstrate the overprescribing of antibiotics, while providing a focused view of improper prescribing. This article provides evidence that current efforts are insufficient for curtailing inappropriate antibiotic use. PMID:25870064

  12. The assessment of weight status in children and young people attending a spina bifida outpatient clinic: a retrospective medical record review

    OpenAIRE

    McPherson, Amy C.; Swift, Judy Anne; Yung, Emily; Lyons, Julia; Church, Paige

    2013-01-01

    PURPOSE: Children with disabilities are two to three times more likely to become overweight or obese than typically developing children. Children with spina bifida (SB) are at particular risk, yet obesity prevalence and weight management with this population are under-researched. This retrospective chart review explored how weight is assessed and discussed in a children's SB outpatient clinic. METHOD: Height/weight data were extracted from records of children aged 2-18 with a diagnos...

  13. Role of personality traits in cocaine craving throughout an outpatient psychosocial treatment program

    Directory of Open Access Journals (Sweden)

    Flávia Ismael

    2014-03-01

    Full Text Available Objective: Cocaine dependence is a major international public health concern. Its chronically relapsing nature is possibly related to craving intensity, which can be influenced by diverse biological and psychological aspects. This study aimed to evaluate the role of different personality traits in craving measured throughout a psychosocial treatment program. Method: The sample comprised 66 cocaine-dependent outpatients who were enrolled in an individual and manualized cognitive-behavioral therapy program. The influence of personality traits on craving intensity, frequency, and duration was analyzed using a generalized estimating equations model with an autoregressive correlation structure. Results: Craving varied during treatment. The personality traits of novelty seeking, reward dependence, and harm avoidance interacted with craving intensity, and the personality trait of persistence interacted with craving duration throughout the treatment period. Furthermore, there were significant interactions between drug use and craving intensity, and between different routes of administration and craving intensity. Participants who used cocaine/crack while in treatment and concurrent users of crack (i.e., freebase cocaine and powder cocaine also had a higher craving intensity. Conclusion: The extent of craving variation can depend on certain personality styles. This study shows that craving is influenced by personality traits, and this may presumably change clinical expression involved in disease.

  14. Treatment outcome and factors affecting time to recovery in children with severe acute malnutrition treated at outpatient therapeutic care program

    OpenAIRE

    Mengesha, Melkamu Merid; Deyessa, Negussie; Tegegne, Balewgizie Sileshi; Dessie, Yadeta

    2016-01-01

    Background: The outpatient therapeutic care program (OTP) of children with severe acute malnutrition (SAM) has been decentralized to health post level in Ethiopia since 2008–2009. However, there is a lack of evidence regarding treatment outcomes and factors related to the duration of stay on treatment after its decentralization to health post level.Objective: This study was aimed to assess treatment outcome and factors affecting time to recovery in children with SAM treated at OTP.Design: Hea...

  15. Prevalence of problem alcohol use among patients attending primary care for methadone treatment

    LENUS (Irish Health Repository)

    Ryder, Niamh

    2009-06-11

    Abstract Background Problem alcohol use is associated with adverse health outcomes among current or former heroin users and primary care is providing methadone treatment for increasing numbers of this population. This study aimed todetermine the prevalence of problem alcohol use among current or former heroin users attending primary care for methadone treatment and to describe the socio-demographic characteristics and health service utilisation characteristics associated with problem alcohol uses. Methods We conducted a cross sectional survey of patients sampled from a national database of patients attending general practice for methadone treatment. Participants were recruited by their general practitioner and data was collected using an interviewer-administered questionnaire, which included the Alcohol Use Disorders Identification Test (\\'AUDIT\\'), with a score of >7 considered abnormal (ie \\'AUDIT positive cases\\') and socio-demographic, medical and substance use characteristics. Results We interviewed 196 patients (71% of those invited, 31% of those sampled, 11% of the national database). The median age was 32 years, 55% were hepatitis C positive, 79% had used illicit drugs in the previous month and 68% were male. Sixty-eight \\'AUDIT positive\\' cases were identified (prevalence of 35%, 95% CI = 28–41%) and these were more likely to have attended a local Emergency Department in the previous year (p < 0.05) and less likely to have attended a hospital clinic in the previous year (p < 0.05). Twenty-seven (14%) scored 20 or higher indicating possible alcohol dependence. Conclusion Problem alcohol use has a high prevalence among current or former heroin users attending primary care for methadone treatment and interventions that address this issue should be explored as a priority. Interventions that address problem alcohol use in this population should be considered as a priority, although the complex medical and psychological needs of this population may make

  16. Prevalence of problem alcohol use among patients attending primary care for methadone treatment.

    LENUS (Irish Health Repository)

    Ryder, Niamh

    2012-02-01

    BACKGROUND: Problem alcohol use is associated with adverse health outcomes among current or former heroin users and primary care is providing methadone treatment for increasing numbers of this population. This study aimed to determine the prevalence of problem alcohol use among current or former heroin users attending primary care for methadone treatment and to describe the socio-demographic characteristics and health service utilisation characteristics associated with problem alcohol uses. METHODS: We conducted a cross sectional survey of patients sampled from a national database of patients attending general practice for methadone treatment. Participants were recruited by their general practitioner and data was collected using an interviewer-administered questionnaire, which included the Alcohol Use Disorders Identification Test (\\'AUDIT\\'), with a score of >7 considered abnormal (ie \\'AUDIT positive cases\\') and socio-demographic, medical and substance use characteristics. RESULTS: We interviewed 196 patients (71% of those invited, 31% of those sampled, 11% of the national database). The median age was 32 years, 55% were hepatitis C positive, 79% had used illicit drugs in the previous month and 68% were male. Sixty-eight \\'AUDIT positive\\' cases were identified (prevalence of 35%, 95% CI = 28-41%) and these were more likely to have attended a local Emergency Department in the previous year (p < 0.05) and less likely to have attended a hospital clinic in the previous year (p < 0.05). Twenty-seven (14%) scored 20 or higher indicating possible alcohol dependence. CONCLUSION: Problem alcohol use has a high prevalence among current or former heroin users attending primary care for methadone treatment and interventions that address this issue should be explored as a priority. Interventions that address problem alcohol use in this population should be considered as a priority, although the complex medical and psychological needs of this population may make this

  17. The Impact of Cancer Treatment on the Diets and Food Preferences of Patients Receiving Outpatient Treatment

    OpenAIRE

    Coa, Kisha I.; Epstein, Joel B; Ettinger, David; Jatoi, Aminah; McManus, Kathy; Platek, Mary E.; Price, Wendy; Stewart, Meghan; Teknos, Theodoros N.; Moskowitz, Bruce

    2015-01-01

    Patients undergoing cancer treatment experience a multitude of symptoms that can influence their ability to complete treatment as well as their quality of life during and after treatment. This cross-sectional study sought to describe the dietary changes experienced by cancer patients and to identify associations between these changes and common treatment symptoms. A convenience sample of 1199 cancer patients aged 18 yr and older undergoing active treatment were recruited from 7 cancer centers...

  18. Evaluation of radiation safety in (177)Lu-PSMA therapy and development of outpatient treatment protocol.

    Science.gov (United States)

    Demir, Mustafa; Abuqbeitah, Mohammad; Uslu-Beşli, Lebriz; Yıldırım, Özlem; Yeyin, Nami; Çavdar, İffet; Vatankulu, Betül; Gündüz, Hüseyin; Kabasakal, Levent

    2016-06-01

    The aim of this study is to investigate the outpatient treatment protocol and radiation safety of a new-emerging lutetium-177 ((177)Lu) prostate specific membrane antigen (PSMA) therapy. This work analyzed the dose rate of 23 patients treated with 7400 MBq (177)Lu-PSMA at different distances (0, 0.25, 0.50, 1.0 and 2.0 m) and variable time marks (0, 1, 2, 4, 18, 24, 48 and 120 h) after the termination of infusion. Blood samples were withdrawn from 17 patients within the same group at 3, 10, 20, 40, 60 and 90 min and 2, 3, 24 h after termination of infusion. Seven different patients were asked to collect urine for 24 h and a gamma well counter was used for counting samples. Family members were invited to wear an optically stimulated luminescence dosimeter whenever they were in the proximity of the patients up to 4-5 d. The total dose of the medical team including the radiopharmacist, physicist, physician, nurse, and nuclear medicine technologist was estimated by an electronic personnel dosimeter. The finger dose was determined using a ring thermoluminescent dosimeter for the radiopharmacist and nurse. The mean dose rate at 1 m after 4 h and 6 h was 23  ±  6 μSv h(-1) and 15  ±  4 μSv h(-1) respectively. The mean total dose to 23 caregivers was 202.3  ±  42.7 μSv (range: 120-265 μSv). The radiation dose of the nurse and radiopharmacist was 6 and 4 μSv per patient, respectively, whereas the dose of the physicist and physician was 2 μSv. The effective half life of blood distribution and early elimination was 0.4  ±  0.1 h and 5  ±  1 h, respectively. Seven patients excreted a mean of 45% (range: 32%-65%) from the initial activity in 6 h. Our findings demonstrate that (177)Lu-PSMA is a safe treatment modality to be applied as an outpatient protocol, since the dose rate decreases below the determined threshold of  <30 μSv h(-1) after approximately 5 h and degrades to 20 μSv h(-1) after 6

  19. How Attendance and Quality of Participation Affect Treatment Response to Parent Management Training

    OpenAIRE

    Nix, Robert L.; Bierman, Karen L.; McMahon, Robert J.

    2009-01-01

    This study examined whether attendance and quality of participation in parent management training predicted treatment response. Data were from 445 parents (55% minority, 62% single; almost all of low socioeconomic status) who had 1st-grade children with severe conduct problems. Quality of participation in weekly parent groups was based on group leader ratings. Parent outcomes were based on interviewer ratings, behavioral observations, parent reports, and teacher ratings. Results of hierarchic...

  20. Risk Factors for Problematic Behaviors among Forensic Outpatients under the Medical Treatment and Supervision Act in Japan.

    Science.gov (United States)

    Ando, Kumiko; Soshi, Takahiro; Nakazawa, Kanako; Noda, Takamasa; Okada, Takayuki

    2016-01-01

    The Medical Treatment and Supervision Act (MTSA) was enacted in 2005 in Japan to promote the reintegration of clinical offenders with mental disorders into society. Under the MTSA, individuals who committed serious crimes in a state of insanity or diminished responsibility are diverted from the criminal justice system to the mental health system. Based on court decisions about MTSA-based treatment, clinical offenders have an obligation to engage in rehabilitation within their local community under the guidance of mental health professionals. However, patients under MTSA-based clinical treatments have faced various problems in the course of treatment, because of psychiatric as well as other static or dynamic factors, and sometimes have committed problematic behaviors, such as violence and medical non-compliance. Hence, this study aimed to clarify factors related to patients' inclusion in MTSA-based outpatient treatment and additionally, their commitment of problematic behaviors, based on confidential data acquired during a four-year government survey period (National Center of Neurology and Psychiatry) from MTSA enactment (July 15, 2005) to December 31, 2009. In total, we recruited 441 clinical offenders receiving MTSA-based outpatient treatment from 158 nationwide facilities. To evaluate related factors, we collected demographic, psychiatric, forensic, clinical treatment, and social service information. Statistical analyses demonstrated that predominant profiles of patients included male gender, younger age, low school history, psychiatric diagnoses (F1, F2, and F3), and no correctional or outpatient history before MTSA-based treatment. F1 or substance use diagnosis, in particular, was increasingly correlated with other factors, such as male gender, older age, and correctional history before MTSA treatment. Among the 441 patients, 189 (43%) committed problematic behaviors in the course of the MTSA-based outpatient treatment. Risk factors for patients' commitment of

  1. Risk Factors for Problematic Behaviors among Forensic Outpatients under the Medical Treatment and Supervision Act in Japan

    Science.gov (United States)

    Ando, Kumiko; Soshi, Takahiro; Nakazawa, Kanako; Noda, Takamasa; Okada, Takayuki

    2016-01-01

    The Medical Treatment and Supervision Act (MTSA) was enacted in 2005 in Japan to promote the reintegration of clinical offenders with mental disorders into society. Under the MTSA, individuals who committed serious crimes in a state of insanity or diminished responsibility are diverted from the criminal justice system to the mental health system. Based on court decisions about MTSA-based treatment, clinical offenders have an obligation to engage in rehabilitation within their local community under the guidance of mental health professionals. However, patients under MTSA-based clinical treatments have faced various problems in the course of treatment, because of psychiatric as well as other static or dynamic factors, and sometimes have committed problematic behaviors, such as violence and medical non-compliance. Hence, this study aimed to clarify factors related to patients’ inclusion in MTSA-based outpatient treatment and additionally, their commitment of problematic behaviors, based on confidential data acquired during a four-year government survey period (National Center of Neurology and Psychiatry) from MTSA enactment (July 15, 2005) to December 31, 2009. In total, we recruited 441 clinical offenders receiving MTSA-based outpatient treatment from 158 nationwide facilities. To evaluate related factors, we collected demographic, psychiatric, forensic, clinical treatment, and social service information. Statistical analyses demonstrated that predominant profiles of patients included male gender, younger age, low school history, psychiatric diagnoses (F1, F2, and F3), and no correctional or outpatient history before MTSA-based treatment. F1 or substance use diagnosis, in particular, was increasingly correlated with other factors, such as male gender, older age, and correctional history before MTSA treatment. Among the 441 patients, 189 (43%) committed problematic behaviors in the course of the MTSA-based outpatient treatment. Risk factors for patients

  2. 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...

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

    OpenAIRE

    Somen Bhattacharjee; Yogendra Jamra; Shiv Shankar Sharma; Arti Parmar

    2016-01-01

    Background: The study was conducted with an objective to study the spectrum of thyroid dysfunction and to correlate clinical symptoms with abnormal thyroid function. Methods: A total no. of 1010 women, attending the Gynecology and Medicine OPD of M.Y. Hospital, Indore, MP were subjected to screening with TSH levels estimation. The women with abnormal TSH values were then evaluated for various clinical symptoms. Results: Out of total 1010 women, 120 had abnormal TSH. The prevalence was ...

  4. Preventing Medical Noncompliance in the Outpatient Treatment of Bipolar Affective Disorders.

    Science.gov (United States)

    Cochran, Susan D.

    1984-01-01

    Evaluated the efficacy of a preventive compliance intervention based on cognitive therapy principles with newly admitted lithium outpatients (N=28). Results indicated that the intervention significantly enhanced compliance at both postintervention and 6-month follow-up assessment. (LLL)

  5. DIAGNOSIS AND TREATMENT OF PATIENTS WITH SEVERE HYPERCHOLESTEROLEMIA IN REAL OUTPATIENT PRACTICE (ACCORDING TO THE RECVASA REGISTRY

    Directory of Open Access Journals (Sweden)

    A. I. Ershova

    2015-09-01

    Full Text Available Hypercholesterolemia is a proven risk factor for atherosclerotic cardiovascular diseases and for their complications.Aim. To assess the quality of diagnosis and treatment of patients with severe hypercholesterolemia (total cholesterol >6.2 mmol/L in the real outpatient practice.Material and methods. All patients with a diagnosis of arterial hypertension, ischemic heart disease, chronic heart failure, atrial fibrillation applied to primary care physicians or cardiologists in one of the randomly selected out-patient clinic of Ryazan in March-May 2012 and included into the RECVASA registry were enrolled into the study group (n=1642.Results. The group of patients with severe hypercholesterolemia consisted of 561 (44% patients at the age of 67 (59-75 years [Me (25% -75%]. At that, diagnosis of hyperlipidemia was indicated only in 9% of outpatient cards. Data of one or more blood chemistries including low density cholesterol (LDC levels were presented only in 7% of outpatient cards. 83.7% of patients with severe hypercholesterolemia were classified as patients at high or very high cardiovascular risk, but statins were recommended only to 17.8% of them. Statins were mainly recommended in moderate doses; only one patient took atorvastatin 40 mg per day. Blood LDC levels were examined only in 5% of patients during statins therapy; nobody of them reached target LDC levels.Conclusion. The study data revealed the presence of a high prevalence of severe hypercholesterolemia in patients with cardiovascular diseases and poor quality of diagnosis and treatment in these patients in the real outpatient practice.

  6. Personality Disorders in Addiction Outpatients: Prevalence and Effects on Psychosocial Functioning

    OpenAIRE

    Paola Casadio; Deanna Olivoni; Barbara Ferrari; Cecilia Pintori; Elvira Speranza; Monica Bosi; Valentina Belli; Lucia Baruzzi; Paola Pantieri; Grazia Ragazzini; Filippo Rivola; Anna Rita Atti

    2014-01-01

    AIM To evaluate the prevalence of personality disorders (PDs) in the outpatients attending an addiction service, with particular attention to the effects of PDs on social and occupational functioning and on the intensity of treatment required. DESIGN A cross-sectional epidemiological study with the assessment of 320 outpatients, through SCID-II (Structured Clinical Interview for DSM-IV Axis II PDs), SOGS (South Oaks Gambling Screen), and questionnaire extracted from EuropASI. RESULTS The perc...

  7. 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

  8. Factors influencing caries status and treatment needs among pregnant women attending a maternity hospital in Udaipur city, India

    OpenAIRE

    Kumar, Santhosh; Tadakamadla, Jyothi; Tibdewal, Harish; Duraiswamy, Prabu; Kulkarni, Suhas

    2013-01-01

    Objectives: To estimate the prevalence and severity of dental caries along with the treatment needs; to determine the factors that influence dental caries status among pregnant women attending a district maternity hospital in Udaipur, India. Study design: Study sample comprised of 206 pregnant women attending a district maternity hospital in Udaipur, India. Clinical data were collected on dental caries by DMFT and treatment needs as described in World Health Organization Dentition status and ...

  9. Oral health status and treatment needs of hearing impaired children attending a special school in Bhimavaram, India

    OpenAIRE

    V Sandeep; Manikya Kumar; Vinay, C; R Chandrasekhar; P Jyostna

    2016-01-01

    Background: Children with hearing impairment (CHI) have special accessibility issues to meet their health care needs. Their oral health status is deprived and has wide ranging treatment needs to attend. Aim: The aim of this study was to evaluate the oral health status and treatment needs of CHI attending a special school in Bhimavaram Town, India. Study Design: The study design was a descriptive cross-sectional study. Materials and Methods: This study was conducted in November 2012...

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

    Directory of Open Access Journals (Sweden)

    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

  11. Relationship of reasons and fears of treatment with outcome in substance using population attending a de-addiction centre

    OpenAIRE

    Siddharth Sarkar; Naresh Nebhinani; Jasveen Kaur; Kamalpreet Kaur; Sandhya Ghai; Debasish Basu

    2013-01-01

    Background: Substance users approach a treatment facility for a variety of reasons as well as avoid or delay in help seeking due to perceived fears with treatment facilities. Sometimes these factors might be associated with treatment outcomes. Objectives: We studied the relationship of reasons and fears of treatment seeking with treatment outcome in substance users. Materials and Methods: One hundred subjects, attending the Drug Deaddiction and Treatment Centre, PGIMER, were prospectively rec...

  12. Frequent attenders in general practice: problem solving treatment provided by nurses [ISRCTN51021015

    Directory of Open Access Journals (Sweden)

    van Oppen P

    2005-10-01

    Full Text Available Abstract Background There is a need for assistance from primary care mental health workers in general practice in the Netherlands. General practitioners (GPs experience an overload of frequent attenders suffering from psychological problems. Problem Solving Treatment (PST is a brief psychological treatment tailored for use in a primary care setting. PST is provided by nurses, and earlier research has shown that it is a treatment at least as effective as usual care. However, research outcomes are not totally satisfying. This protocol describes a randomized clinical trial on the effectiveness of PST provided by nurses for patients in general practice. The results of this study, which currently being carried out, will be presented as soon as they are available. Methods/design This study protocol describes the design of a randomized controlled trial to investigate the effectiveness and cost-effectiveness of PST and usual care compared to usual care only. Patients, 18 years and older, who present psychological problems and are frequent attenders in general practice are recruited by the research assistant. The participants receive questionnaires at baseline, after the intervention, and again after 3 months and 9 months. Primary outcome is the reduction of symptoms, and other outcomes measured are improvement in problem solving skills, psychological and physical well being, daily functioning, social support, coping styles, problem evaluation and health care utilization. Discussion Our results may either confirm that PST in primary care is an effective way of dealing with emotional disorders and a promising addition to the primary care in the UK and USA, or may question this assumption. This trial will allow an evaluation of the effects of PST in practical circumstances and in a rather heterogeneous group of primary care patients. This study delivers scientific support for this use and therefore indications for optimal treatment and referral.

  13. 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

  14. Psychosocial interventions for pregnant women in outpatient illicit drug treatment programs compared to other interventions

    Science.gov (United States)

    Terplan, Mishka; Ramanadhan, Shaalini; Locke, Abigail; Longinaker, Nyaradzo; Lui, Steve

    2016-01-01

    Background Illicit drug use in pregnancy is a complex social and public health problem. The consequences of drug use in pregnancy are high for both the woman and her child. Therefore, it is important to develop and evaluate effective treatments. There is evidence for the effectiveness of psychosocial interventions in drug treatment but it is unclear whether they are effective in pregnant women. This is an update of a Cochrane review originally published in 2007. Objectives To evaluate the effectiveness of psychosocial interventions in pregnant women enrolled in illicit drug treatment programmes on birth and neonatal outcomes, on attendance and retention in treatment, as well as on maternal and neonatal drug abstinence. In short, do psychosocial interventions translate into less illicit drug use, greater abstinence, better birth outcomes, or greater clinic attendance? Search methods We conducted the original literature search in May 2006 and performed the search update up to January 2015. For both review stages (original and update), we searched the Cochrane Drugs and Alcohol Group Trial's register (May 2006 and January 2015); the Cochrane Central Register of Trials (CENTRAL; the Cochrane Library 2015, Issue 1); PubMed (1996 to January 2015); EMBASE (1996 to January 2015); and CINAHL (1982 to January 2015). Selection criteria We included randomized controlled trials comparing any psychosocial intervention vs. a control intervention that could include pharmacological treatment, such as methadone maintenance, a different psychosocial intervention, counselling, prenatal care, STD counselling and testing, transportation, or childcare. Data collection and analysis We used standard methodological procedures expected by the Cochrane Collaboration. We performed analyses based on three comparisons: any psychosocial intervention vs. control, contingency management (CM) interventions vs. control, and motivational interviewing based (MIB) interventions vs. control. Main results

  15. Factors Associated with Antibiotic Misuse in Outpatient Treatment for Upper Respiratory Tract Infections

    OpenAIRE

    Schroeck, Jennifer L.; Ruh, Christine A.; Sellick, John A.; Ott, Michael C.; Mattappallil, Arun; Mergenhagen, Kari A.

    2015-01-01

    The Centers for Disease Control and Prevention has promoted the appropriate use of antibiotics since 1995 when it initiated the National Campaign for Appropriate Antibiotic Use in the Community. This study examined upper respiratory tract infections included in the campaign to determine the degree to which antibiotics were appropriately prescribed and subsequent admission rates in a veteran population. This study was a retrospective chart review conducted among outpatients with a diagnosis of...

  16. National Trends in Outpatient Surgical Treatment of Degenerative Cervical Spine Disease

    OpenAIRE

    Baird, Evan O.; Egorova, Natalia N.; McAnany, Steven J.; Qureshi, Sheeraz A.; Hecht, Andrew C.; Cho, Samuel K.

    2014-01-01

    Study Design Retrospective population-based observational study. Objective To assess the growth of cervical spine surgery performed in an outpatient setting. Methods A retrospective study was conducted using the United States Healthcare Cost and Utilization Project's State Inpatient and Ambulatory Surgery Databases for California, New York, Florida, and Maryland from 2005 to 2009. Current Procedural Terminology, fourth revision (CPT-4) and International Classification of Diseases, ninth revis...

  17. Opioid treatment and hypoalbuminemia are associated with increased hospitalisation rates in chronic pancreatitis outpatients

    DEFF Research Database (Denmark)

    Olesen, Søren S; Poulsen, Jakob Lykke; Broberg, Marie Christine Hede;

    2016-01-01

    BACKGROUND/OBJECTIVES: Chronic pancreatitis (CP) is a complex and debilitating disease with high resource utilisation. Prospective data on hospital admission rates and associated risk factors are scarce. We investigated hospitalisation rates, causes of hospitalisations and associated risk factors...... in CP outpatients. METHODS: This was a prospective cohort study comprising 170 patients with CP. The primary outcome was time to first pancreatitis related hospitalisation and secondary outcomes were the annual hospitalisation frequency (hospitalisation burden) and causes of hospitalisations. A...

  18. The effect of co-morbid depression and anxiety on the course and outcome of alcohol outpatient treatment

    DEFF Research Database (Denmark)

    Mellentin, Angelina Isabella; Nielsen, Bent; Stenager, Elsebeth;

    2015-01-01

    Background: Studies examining the effect of alcohol treatment among patients with alcohol use disorders (AUD) and co-morbid depression and/or anxiety are few and show inconsistent, but mainly negative drinking outcomes. Aims: To describe the prevalence of anxiety and depression among Danish....... No difference was found between patients with and without co-morbidity. Conclusion: In contrast to the majority of prior studies, this study provides evidence that depression and anxiety do not have an effect on alcohol treatment. However, because of the naturalistic setting, a number of limitations should...... patients seeking treatment for an AUD, and to investigate the infl uence of psychiatric co-morbidity on the course and effect of treatment. Method: A consecutive sample of 363 outpatients with an AUD diagnosis according to the ICD-10 Diagnostic Criteria for Research was assessed by the means...

  19. 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

  20. Outpatient treatment of low-risk venous thromboembolism with monotherapy oral anticoagulation: patient quality of life outcomes and clinician acceptance

    Science.gov (United States)

    Kline, Jeffrey A; Kahler, Zachary P; Beam, Daren M

    2016-01-01

    Background Oral monotherapy anticoagulation has facilitated home treatment of venous thromboembolism (VTE) in outpatients. Objectives The aim of this study was to measure efficacy, safety, as well as patient and physician perceptions produced by a protocol that selected VTE patients as low-risk patients by the Hestia criteria, and initiated home anticoagulation with an oral factor Xa antagonist. Methods Patients were administered the Venous Insufficiency Epidemiological and Economic Study Quality of life/Symptoms questionnaire [VEINEs QoL/Sym] and the physical component summary [PCS] from the Rand 36-Item Short Form Health Survey [SF36]). The primary outcomes were VTE recurrence and hemorrhage at 30 days. Secondary outcomes compared psychometric test scores between patients with deep vein thrombosis (DVT) to those with pulmonary embolism (PE). Patient perceptions were abstracted from written comments and physician perceptions specific to PE outpatient treatment obtained from structured survey. Results From April 2013 to September 2015, 253 patients were treated, including 67 with PE. Within 30 days, 2/253 patients had recurrent DVT and 2/253 had major hemorrhage; all four had DVT at enrollment. The initial PCS scores did not differ between DVT and PE patients (37.2±13.9 and 38.0±12.1, respectively) and both DVT and PE patients had similar improvement over the treatment period (42.2±12.9 and 43.4±12.7, respectively), consistent with prior literature. The most common adverse event was menorrhagia, present in 15% of women. Themes from patient-written responses reflected satisfaction with increased autonomy. Physicians’ (N=116) before-to-after protocol comfort level with home treatment of PE increased 48% on visual analog scale. Conclusion Hestia-negative VTE patients treated with oral monotherapy at home had low rates of VTE recurrence and bleeding, as well as quality of life measurements similar to prior reports.

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

    Directory of Open Access Journals (Sweden)

    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

  2. An Exploration of the Effect of On-Site 12-Step Meetings on Post-Treatment Outcomes among Polysubstance-Dependent Outpatient Clients

    Science.gov (United States)

    Laudet, Alexandre; Stanick, Virginia; Sands, Brian

    2007-01-01

    Rates of return to active substance use after addiction treatment tend to be high; participation in 12-step fellowships (e.g., Alcoholics Anonymous) reduces relapse rates but many clients do not attend or attend for a short period only. This quasi-experimental study uses repeated measurement to explore the role of presence/absence of on-site…

  3. 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.

  4. The Feasibility of Cognitive Adaption Training for Outpatients with Schizophrenia in Integrated Treatment

    DEFF Research Database (Denmark)

    Hounsgaard, Lise; Hansen, J. P.; Østergaard, B.;

    2012-01-01

    Cognitive adaptation training (CAT) has been tested as a psychosocial treatment, showing promising results. To date there are no reported tests of CAT treatment outside the United States. Thus, we decided to adjust CAT treatment and apply it to an Integrated Treatment setting in Denmark. In this ......Cognitive adaptation training (CAT) has been tested as a psychosocial treatment, showing promising results. To date there are no reported tests of CAT treatment outside the United States. Thus, we decided to adjust CAT treatment and apply it to an Integrated Treatment setting in Denmark...

  5. The Feasibility of Cognitive Adaptation Training for Outpatients with Schizophrenia in Integrated Treatment

    DEFF Research Database (Denmark)

    Hansen, Jens Peter; Ostergaard, Birte; Nordentoft, Merete;

    2012-01-01

    Cognitive adaptation training (CAT) has been tested as a psychosocial treatment, showing promising results. To date there are no reported tests of CAT treatment outside the United States. Thus, we decided to adjust CAT treatment and apply it to an Integrated Treatment setting in Denmark. In this ......Cognitive adaptation training (CAT) has been tested as a psychosocial treatment, showing promising results. To date there are no reported tests of CAT treatment outside the United States. Thus, we decided to adjust CAT treatment and apply it to an Integrated Treatment setting in Denmark...

  6. Influence of pretreatment coping strategies on the outcome of outpatient treatment of Danish alcohol abusers

    DEFF Research Database (Denmark)

    Bussey Rask, Marie; Jørgensen, Tina; Pinnerup Jensen, Jeanette;

    2006-01-01

    An important issue regarding treatment for alcohol abuse is the high rate of relapse following treatment. In the research on treatment of alcohol abuse, the concept of coping has been proposed as a relevant factor in the relationship between relapse crises and treatment outcome. The present study...

  7. Effectiveness of reboxetine in treatment of outpatient children and adolescents with attention deficit-hyperactivity disorder with comorbid anxiety disorders.

    Directory of Open Access Journals (Sweden)

    Forough Riahi

    2013-12-01

    Full Text Available Some previous studies have reported that ADHD is often comorbid with anxiety disorders. The aim of the present study was to evaluate the effectiveness of reboxetine in treating outpatient children and adolescents with ADHD and comorbid anxiety disorders.In this open-label study, 25 outpatient children and adolescents, aged 6-16 years were selected by convenient sampling and underwent treatment with 4mg reboxetine for four weeks. Data were collected at baseline, two weeks and four weeks after the start of the medication using Conners' Parent Questionnaire, Hamilton's Rating Scale for Anxiety, Clinical Global Assessment Scale, Clinical Global Impression-Severity Scale and Side Effects Form. Data were analyzed using repeated measure, analyses of variance (ANOVA, Tukey post hoc test and paired t-test.There were significant reduction in the total score of ADHD (F = 31.441; P <0.001 at the end of the treatment compared to baseline (Table 1. The differences between T0 and T2 in the subscales of attention deficit, hyperactivity and confrontation (F = 20.691; P <0.001, F = 28.810; P < 0.001, and F = 17.463; P <0.001, respectively were also significant. Findings also indicated significant differences between T0 and T1 (P<0.01 and T1 and T2 (P<0.01 in all of the subscales except for confrontation. A significant improvement was observed in the severity of ADHD and anxiety disorders during different courses of the treatment (p<0.001. No significant changes were observed in systolic and diastolic blood pressure and pulse and weight of the patients during the study. The most common complications were headache and anorexia.The short-term treatment with reboxetine was effective in improving ADHD with comorbid anxiety disorders. Therefore, reboxetine could be used as a treatment option for ADHD in those children who experience comorbid anxiety disorders or in those who are non-responsive or intolerant to methylphenidate.

  8. The relationship of psychological reactance, health locus of control and sense of self-efficacy with adherence to treatment in psychiatric outpatients with depression

    OpenAIRE

    De las Cuevas, Carlos; Peñate, Wenceslao; Emilio J. Sanz

    2014-01-01

    Background Although non-adherence to antidepressant medications is a significant barrier to the successful treatment of depression in clinical practice, few potentially modifiable predictors of poor adherence to antidepressant treatment are known. The aim of this study was to examine the relationship of psychological reactance, health locus of control and the sense of self-efficacy on adherence to treatment regimen among psychiatric outpatients with depression. Methods One hundred and forty-f...

  9. 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

  10. The functional status of patients with AIDS attending antiretroviral treatment center

    Directory of Open Access Journals (Sweden)

    T J Thejus

    2009-01-01

    Full Text Available Aims: To assess the functional status of patients with Acquired immunodeficiency syndrome (AIDS registered in the Anti-Retroviral Treatment (ART center. Materials and Methods: Design: Descriptive study. Study setting: ART center in Calicut Medical College, Kerala, India. Subjects: Cohorts of AIDS patients attending the ART center during the year 2007. Data collection: Done prospectively from the secondary data available from the center. Outcome measures: The demographic, morbidity, functional status and laboratory parameters were collected. Data processing was done using Excel datasheet and analysis were done using Epi info 2003. Results: One hundred and ninety-five patients received care during this period; 69% were males. The mean age was 38±9 years; 80% of them were married and in 50% of their spouses also tested positive for HIV. The mean CD4 count was 127 cells/microliter. The majority (90% were categorized as WHO Stage 3 or 4 of HIV. Only 52% of them were able to perform their usual work in or outside their house; the rest were not able to lead an economically productive life. Thirty-six per cent were only able to perform activities of daily living; 12% were bedridden.The functional status of the patients positively correlated with WHO disease stage ( P = < 0-0001, and CD4 count and hemoglobin levels negatively correlated with staging ( P = < 0.001. 62% are having any of the opportunistic infections. Conclusion: Fifty per cent of the AIDS patients are disabled and need support and care. As AIDS is a growing problem, community-based palliative care for AIDS patients should be strengthened in India.

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

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

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    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

  13. Outpatient treatment of low-risk venous thromboembolism with monotherapy oral anticoagulation: patient quality of life outcomes and clinician acceptance

    Directory of Open Access Journals (Sweden)

    Kline JA

    2016-04-01

    Full Text Available Jeffrey A Kline,1,2 Zachary P Kahler,1,3 Daren M Beam1,2 1Department of Emergency Medicine, 2Department of Cellular and Integrative Physiology, Indiana University School of Medicine, Indianapolis, IN, 3Department of Emergency Medicine, University of South Carolina Greenville School of Medicine, Greenville, SC, USA Background: Oral monotherapy anticoagulation has facilitated home treatment of venous thromboembolism (VTE in outpatients. Objectives: The aim of this study was to measure efficacy, safety, as well as patient and physician perceptions produced by a protocol that selected VTE patients as low-risk patients by the Hestia criteria, and initiated home anticoagulation with an oral factor Xa antagonist. Methods: Patients were administered the Venous Insufficiency Epidemiological and Economic Study Quality of life/Symptoms ques­tionnaire [VEINEs QoL/Sym] and the physical component summary [PCS] from the Rand 36-Item Short Form Health Survey [SF36]. The primary outcomes were VTE recurrence and hemorrhage at 30 days. Secondary outcomes compared psychometric test scores between patients with deep vein thrombosis (DVT to those with pulmonary embolism (PE. Patient perceptions were abstracted from written comments and physician perceptions specific to PE outpatient treatment obtained from structured survey. Results: From April 2013 to September 2015, 253 patients were treated, including 67 with PE. Within 30 days, 2/ 253 patients had recurrent DVT and 2/253 had major hemor­rhage; all four had DVT at enrollment. The initial PCS scores did not differ between DVT and PE patients (37.2±13.9 and 38.0±12.1, respectively and both DVT and PE patients had similar improvement over the treatment period (42.2±12.9 and 43.4±12.7, respectively, consistent with prior literature. The most common adverse event was menorrhagia, present in 15% of women. Themes from patient-written responses reflected satisfaction with increased autonomy. Physicians’ (N=116

  14. Out-patient drug treatment of pneumonia among children under two years of age in Fortaleza, Brazil

    Directory of Open Access Journals (Sweden)

    Misago Chizuru

    1997-01-01

    Full Text Available Results are reported from a study on drug use in treatment of children with pneumonia in a pediatric hospital in the city of Fortaleza, Northeastern Brazil. There were 171 out-patients; prescription details were obtained for 149. The most commonly prescribed antimicrobial drug was procaine penicillin, accounting for 33% of antimicrobial prescriptions, followed by benzathine penicillin (31%, ampicillin or amoxicillin (12%, and cotrimoxazole (8%. Benzathine penicillin was frequently given with other drugs, but was the sole antimicrobial agent for 31 children. Compliance with antimicrobial treatment was 52% overall and was higher for the injectables. Prescription patterns varied from child to child, and children were often prescribed more than one antimicrobial in the same or repeat prescriptions; combining this information with compliance, 81 (54% of the children were estimated to have received 5 or more days of appropriate antimicrobial treatment for pneumonia. This percentage is not high, and five days were often reached after using more than one antimicrobial and after repeat visits. The authors concluded that the need remains for simple antimicrobial regimes, attractive to comply with, that can be expected to be consistently used. Other drugs were chiefly analgesics and bronchodilators.

  15. Psychometric properties of the Drug Use Disorders Identification Test (DUDIT) with substance abusers in outpatient and residential treatment.

    Science.gov (United States)

    Voluse, Andrew C; Gioia, Christopher J; Sobell, Linda Carter; Dum, Mariam; Sobell, Mark B; Simco, Edward R

    2012-01-01

    The psychometric properties of the Drug Use Disorders Identification Test (DUDIT), an 11-item self-report questionnaire developed to screen individuals for drug problems, are evaluated. The measure, developed in Sweden and evaluated there with individuals with severe drug problems, has not been evaluated with less severe substance abusers or with clinical populations in the United States. Participants included 35 drug abusers in an outpatient substance abuse treatment program, 79 drug abusers in a residential substance abuse treatment program, and 39 alcohol abusers from both treatment settings who did not report a drug abuse problem. The DUDIT was found to be a psychometrically sound drug abuse screening measure with high convergent validity (r=.85) when compared with the Drug Abuse Screening Test (DAST-10), and to have a Cronbach's alpha of .94. In addition, a single component accounted for 64.91% of total variance, and the DUDIT had sensitivity and specificity scores of .90 and .85, respectively, when using the optimal cut-off score of 8. Additionally, the DUDIT showed good discriminant validity as it significantly differentiated drug from alcohol abusers. These findings support the DUDIT as a reliable and valid drug abuse screening instrument that measures a unidimensional construct. Further research is warranted with additional clinical populations. PMID:21937169

  16. Medical outpatient strategy

    OpenAIRE

    Midlands Medicine

    1989-01-01

    Outpatient clinics have two main functions: to provide family doctors with rapid access to specialist expertise and high tech facilities which are centred on the District General Hospital; and to provide hospital doctors with a well organised department for investigation and treatment of patients who do not need a hospital bed but do need specialist supervision.

  17. Custo real do tratamento do glaucoma para o paciente The real cost of glaucoma treatment for an outpatient

    Directory of Open Access Journals (Sweden)

    Larissa Pedroso

    1999-12-01

    Full Text Available Objetivo: Avaliar o custo do tratamento do glaucoma para o paciente, numa instituição de ensino médico. Casuística e Métodos: Foram aplicados, aleatoriamente, questionários, na forma de entrevista ativa, a 94 pacientes do ambulatório do Setor de Glaucoma do Departamento de Oftalmologia da Universidade Federal de São Paulo, analisando gastos pessoais e com medicamentos antiglaucomatosos. Os dados foram agrupados, tabulados e foi realizada separação da amostra em dois grupos: pacientes cirúrgicos e não-cirúrgicos. Resultados: A mediana do gasto total anual estimado com glaucoma foi de R$ 480,15, o equivalente a 13% da renda anual mediana dos pacientes. Separadamente, o grupo dos pacientes cirúrgicos obteve uma mediana dos gastos totais estimados de R$ 677,94, o que corresponde a 19% da renda mediana anual. Já o grupo dos pacientes não-cirúrgicos, apresentou mediana de R$ 393,54, representando 11% da renda mediana anual. Foi encontrada diferença estatisticamente significante entre os grupos cirúrgico e não-cirúrgico para o gasto total anual (p = 0,012. Conclusão: Observou-se que o custo do tratamento na renda familiar de pessoas portadoras de glaucoma é considerável, mesmo em uma instituição públicaPurpose: To evaluate the cost of glaucoma treatment for an outpatient in a public university hospital. Patients and Methods: Ninety-four outpatients were ran-domly Glaucoma Clinic of the Ophthalmology Department of the Universidade Federal de São Paulo, submitted to questionnaires at the regarding personal and antiglaucoma medicine expenses. Data collected, tabulated and the sample was divided into two were groups: surgical and nonsurgical. Results: The median estimated total spent annually on glaucoma treatment was R$ 480.15, equivalent to 13% of the median annual family income of the patients. When the sample was divided into two groups, the figures were quite different. The surgical group had a median annual estimated total

  18. How Outpatient Substance Abuse Treatment Unit Director Activities May Affect Provision of Community Outreach Services

    Science.gov (United States)

    Chuang, Emmeline; Wells, Rebecca; Alexander, Jeffrey; Green, Sherri

    2013-01-01

    Aims: Community outreach services play an important role in infectious disease prevention and engaging drug users not currently in treatment. However, fewer than half of US substance abuse treatment units provide these services and many have little financial incentive to do so. Unit directors generally have latitude about scope of services,…

  19. Treatment outcome and factors affecting time to recovery in children with severe acute malnutrition treated at outpatient therapeutic care program

    Directory of Open Access Journals (Sweden)

    Melkamu Merid Mengesha

    2016-07-01

    Full Text Available Background: The outpatient therapeutic care program (OTP of children with severe acute malnutrition (SAM has been decentralized to health post level in Ethiopia since 2008–2009. However, there is a lack of evidence regarding treatment outcomes and factors related to the duration of stay on treatment after its decentralization to health post level. Objective: This study was aimed to assess treatment outcome and factors affecting time to recovery in children with SAM treated at OTP. Design: Health facility–based retrospective cohort study was conducted using data from 348 patient cards. The outcome variable was time to recovery. Descriptive analysis was done using percentages for categorical data and mean/median for continuous variables. A robust method of analyzing time to event data, the Cox proportional-hazard regression, was used. All statistical tests in this study are declared significant at p<0.05. Result: 89.1% of children with kwashiorkor and 69.4% of children with marasmus were recovered. Of the total children studied, 22% were readmitted cases. The median time of recovery was 35 days for children with kwashiorkor and 49 days for children with marasmus. Children older than 3 years were 33% less likely to achieve nutritional recovery [adjusted hazard ratio, AHR=0.67, 95% confidence interval, CI (0.46, 0.97]. Similarly, marasmic children stayed longer on treatment [AHR=0.42, 95% CI (0.32, 0.56]. However, children who gained Mid-Upper Arm Circumference (MUAC ≥ 0.24 mm/day were 59% more likely to recover faster [AHR=1.59, 95% CI (1.23, 2.06]. Conclusions: Close monitoring of weight and MUAC gain to assess nutritional improvement with due emphasis given to children with lower admission weight, children of age 3 years and above and marasmic children will have a positive effect on treatment duration and outcome.

  20. The relationship between treatment attendance, adherence, and outcome in a caregiver-mediated intervention for low-resourced families of young children with autism spectrum disorder.

    Science.gov (United States)

    Carr, Themba; Shih, Wendy; Lawton, Kathy; Lord, Catherine; King, Bryan; Kasari, Connie

    2016-08-01

    Rates of participation in intervention research have not been extensively studied within autism spectrum disorder. Such research is important given the benefit of early intervention on long-term prognosis for children with autism spectrum disorder. The goals of this study were to examine how family demographic factors predicted treatment attendance and adherence in a caregiver-mediated randomized controlled trial targeting core deficits of autism spectrum disorder, and whether treatment attendance and adherence predicted outcome. In all, 147 caregiver-child dyads from a low-resourced population were randomized to in-home caregiver-mediated module or group-based caregiver education module treatment. Treatment attendance, adherence, and outcome (time spent in joint engagement) were the primary outcome variables. The majority of families who entered treatment (N = 87) maintained good attendance. Attendance was significantly predicted by socioeconomic status, site, and treatment condition. Families in caregiver-mediated module reported lower levels of treatment adherence, which was significantly predicted by site, condition, caregiver stress, and child nonverbal intelligence quotient. Dyads in caregiver-mediated module had significantly longer interactions of joint engagement, which was significantly predicted by an interaction between treatment attendance and condition. Overall, the results from this study stress the importance of considering demographic variables in research design when considering barriers to treatment attendance and adherence. PMID:26290524

  1. The pattern of mucocutaneous disorders in HIV – infected children attending care and treatment centres in Dar es Salaam, Tanzania

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    Massawe Augustine W

    2009-07-01

    Full Text Available Abstract Background HIV/AIDS is associated with a wide range of mucocutaneous disorders some of which are useful in the clinical staging and prognosis of the syndrome. There is paucity of information regarding the prevalence and pattern of mucocutaneous disorders among HIV infected children attending paediatric Care and Treatment Centres (CTC in Dar es Salaam. Objective To determine the prevalence and pattern of mucocutaneous disorders among HIV infected children attending public paediatric 'Care and Treatment Centres' in Dar es Salaam. Methods This was a cross sectional descriptive study involving public paediatric 'Care and Treatment Centres' in Dar es Salaam. Clinical information was obtained using a questionnaire. Dermatological examination was carried out in daylight. Investigations were taken as appropriate. Data was analysed using the Statistical Package for Social Sciences (SPSS program version 10.0. Chi-squared and Fisher's exact tests were utilized. A p-value of less than 0.05 was considered statistically significant. Results Three hundred and forty seven HIV infected children (52% males attending CTCs were recruited into the study. Mucocutaneous disorders were encountered in 85% of them. There was no gender difference in the prevalence of the infective mucocutaneous disorders but males had a higher prevalence of non-infective/inflammatory dermatoses (58% than females (42% (p = 0.02. Overall, mucocutaneous disorders (infective + non infective were more prevalent in advanced stages of HIV disease. Children with advanced HIV disease had a significantly increased frequency of fungal and viral infections (43% and 25% respectively than those with less advanced disease; 24% and 13% respectively (p = 0.01. Seventy four percent of the HIV-infected children with mucocutaneous disorders were already on ART. Conclusion Mucocutaneous disorders among HIV infected children attending Care and Treatment Centres are common and highly variable

  2. Consequences of Misspecifying the Number of Latent Treatment Attendance Classes in Modeling Group Membership Turnover within Ecologically-Valid Behavioral Treatment Trials

    OpenAIRE

    Morgan-Lopez, Antonio A.; Fals-Stewart, William

    2008-01-01

    Historically, difficulties in analyzing treatment outcome data from open enrollment groups have led to their avoidance in use in federally-funded treatment trials, despite the fact that 79% of treatment programs use open enrollment groups. Recently, latent class pattern mixture models (LCPMM) have shown promise as a defensible approach for making overall (and attendance class-specific) inferences from open enrollment groups with membership turnover. We present a statistical simulation study c...

  3. Nonpharmacological Alternatives to Benzodiazepine Drugs for the Treatment of Anxiety in Outpatient Populations: A Literature Review.

    Science.gov (United States)

    Platt, Lois M; Whitburn, Amy Irene; Platt-Koch, Alexander G; Koch, Ronald L

    2016-08-01

    Overuse of benzodiazepine drugs to treat anxiety, mood, and sleep disorders is a growing problem in clinical practice. GABAergic medications (benzodiazepine drugs in particular) have side effects, drug interactions, and the potential to create tolerance and dependence in users. GABA-enhancing dietary supplements have similar and unique risks. Natural, non-chemical, anxiolytic treatments exist and can be safely recommended to patients. Three such treatments have been the focus of study in the past 20 years: mindfulness, meditation, and yoga. Growing evidence exists that these treatments can be safely recommended to patients with anxiety. [Journal of Psychosocial Nursing and Mental Health Services, 54(8), 35-42.]. PMID:27479478

  4. The Impulsive Lifestyle Counseling Program for Antisocial Behavior in Outpatient Substance Abuse Treatment.

    Science.gov (United States)

    Thylstrup, Birgitte; Hesse, Morten

    2016-06-01

    Antisocial behavior is associated with low quality of life for the patient and with adverse effects on society and those close to the antisocial patient. However, most patients with antisocial behavior are not seen in treatment settings that focus on their personality but rather in criminal justice settings, substance-abuse treatment, and social welfare settings. This article describes the adaptation and implementation of a highly structured manualized treatment, Impulsive Lifestyle Counseling (ILC), based on the Lifestyle Issues program, a 10-week psychoeducation program studied in prison settings. ILC consists of four sessions over 4 weeks and a booster session 8 weeks later. The goal of treatment is described to patients as "to help people identify their impulsive thoughts and lifestyle leading to problems with drug use, other people, and the police." Two clinical examples and reflections on our experiences with the training and implementation of the ILC program are presented. PMID:21862528

  5. Mothers' Differential Treatment of Adolescent Siblings: Predicting College Attendance of Sisters versus Brothers

    Science.gov (United States)

    Bissell-Havran, Joanna M.; Loken, Eric; McHale, Susan M.

    2012-01-01

    Current estimates suggest that by 2015, 60% of college students will be women, a change since 1970 when 59% were men. We investigated family dynamics that might explain the growing gender gap in college attendance, focusing on an ethnically diverse sample of 522 mixed sex sibling dyads from the National Longitudinal Study of Adolescent Health. We…

  6. Increases in Parent Attendance to Behavioral Parent Training Due to Concurrent Child Treatment Groups

    Science.gov (United States)

    Jensen, Scott A.; Grimes, Lisa K.

    2010-01-01

    Though behavioral parent training has been demonstrated to be an effective intervention for child behavior problems, it continues to suffer from high attrition rates. Few variables have been found to predict or decrease high attrition rates from parent training classes. The present study found 43-52% increases in attendance rates for parents whose…

  7. Musculoskeletal ultrasound : for diagnostics and treatment guidance in the orthopaedic outpatient care

    OpenAIRE

    Sunding, Kerstin

    2016-01-01

    Ultrasound (US) has shown to be of great value in diagnostics and treatment of injuries and chronic pain disorders of the musculoskeletal system. Today, it is considered to be a suitable method when investigating superficially located tendons. Another exciting field of application is the use of US for guidance of different invasive treatments. Traditionally, most diagnostic imaging have been performed at the radiologic departments but the interest for the technique at different care units, in...

  8. Treatment of anorexia nervosa with long-term risperidone in an outpatient setting: case study

    OpenAIRE

    Kracke, Elsa J; Tosh, Aneesh K.

    2014-01-01

    Introduction There are currently few studies focusing on the efficacy of long-term atypical antipsychotics to treat anorexia nervosa in the pediatric population. Case description This case report follows the treatment of a 17 year-old female with anorexia nervosa over her four-year undergraduate career. After two years of multidisciplinary treatment, low-dose risperidone was initiated due to persistence of her disease. She expressed decreased rigidity around meal times, her weight improved an...

  9. A pilot study on community-based outpatient treatment for patients with chronic psychotic disorders in Somalia: Change in symptoms, functioning and co-morbid khat use

    Directory of Open Access Journals (Sweden)

    Odenwald Michael

    2012-07-01

    Full Text Available Abstract Background In Low and Middle Income Countries, mental health services are often poorly developed due to the lack of resources and trained personnel. In order to overcome these challenges, new ways of care have been suggested such as a focus on community-based services. In Somalia, the consumption of the natural stimulant khat is highly prevalent, aggravating mental illness. At the same time, mental health care is largely unavailable to the vast majority of the population. In a pilot project, we tested possibilities for effective measures in community-based out-patient mental health care. Methods Thirty-five male patients with chronic psychotic disorders and their carers were involved in a 10-months follow-up study. All of them abused khat. Seventeen outpatients experiencing acute psychotic episodes were recruited from the community and received an intensive six week home-based treatment package. Additionally eighteen patients with chronic psychotic disorders in remission were recruited either following hospital discharge or from the community. In a second phase of the study, both groups received community-based relapse prevention that differed in the degree of the family’s responsibility for the treatment. The treatment package was comprised of psycho-education, low-dose neuroleptic treatment, monthly home visits and counseling. The Brief Psychiatric Rating Scale (BPRS was applied three times. Additionally, we assessed functioning, khat use and other outcomes. Results Of the 35 patients enrolled in the study, 33 participated in the 10-month follow-up. Outpatients improved significantly in the first six weeks of treatment and did not differ from remitted patients at the start of the second treatment phase. In the preventive treatment phase, we find heterogeneous outcomes that diverge between symptom and functioning domains. With the exception of depressive symptoms, symptoms in all patients tended to worsen. The outpatient group had

  10. A meta-analytic review on treatment dropout in child and adolescent outpatient mental health care

    NARCIS (Netherlands)

    A.M. de Haan; A.E. Boon; J.T.V.M. de Jong; M. Hoeve; R.R.J.M. Vermeiren

    2013-01-01

    A large proportion (28% up to 75%) of the treatments in youth mental health care results in premature termination (dropout). It is important to gain knowledge of the determinants of dropout because it can have very severe consequences. The aim of our meta-analytic review was to provide an overview o

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

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    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

  12. Effectiveness and cost-effectiveness of web-based treatment for phobic outpatients on a waiting list for psychotherapy: protocol of a randomised controlled trial

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    Kok Robin N

    2012-08-01

    Full Text Available Abstract Background Phobic disorders are highly prevalent and constitute a considerable burden for patients and society. As patients wait for face-to-face psychotherapy for phobic disorders in outpatient clinics, this time can be used for guided self-help interventions. The aim of this study is to investigate a five week internet-based guided self-help programme of exposure therapy in terms of clinical effectiveness and impact on speed of recovery in psychiatric outpatients, as well as the cost-effectiveness of this pre-treatment waiting list intervention. Methods/design A randomised controlled trial will be conducted among 244 Dutch adult patients recruited from waiting lists of outpatient clinics for face-to-face psychotherapy for phobic disorders. Patients suffering from at least one DSM-IV classified phobic disorder (social phobia, agoraphobia or specific phobia are randomly allocated (at a 1:1 ratio to either a five-week internet-based guided self-help program followed by face-to-face psychotherapy, or a control group followed by face-to-face psychotherapy. Waiting list status and duration are unchanged and actual need for further treatment is evaluated prior to face-to-face psychotherapy. Clinical and economic self-assessment measurements take place at baseline, post-test (five weeks after baseline and at 3, 6, 9 and 12 months after baseline. Discussion Offering pre-treatment internet-based guided self-help efficiently uses time otherwise lost on a waiting list and may increase patient satisfaction. Patients are expected to need fewer face-to-face sessions, reducing total treatment cost and increasing speed of recovery. Internet-delivered treatment for phobias may be a valuable addition to psychotherapy as demand for outpatient treatment increases while budgets decrease. Trial registration Netherlands Trial Register NTR2233

  13. Anorexia nervosa in adults: The urgent need for novel outpatient treatments that work.

    Science.gov (United States)

    Le Grange, Daniel

    2016-06-01

    Anorexia nervosa (AN) is a serious psychiatric disorder that often follows a protracted course, and continues to confound those who attempt treatment once the patient has reached adulthood. Several randomized clinical trials for adults with AN have tested well-known therapies such as cognitive behavior therapy, supportive psychotherapies, or focal psychodynamic therapy, all of which have delivered frustratingly few helpful treatment strategies. Perhaps a different path could be pursued where we do not aim to cure all patients with 1 or 2 of these well-trodden therapies. Instead, a more targeted alternative, testing several novel approaches, could collectively reach a larger cohort of patients suffering from AN, the most lethal of all psychiatric disorders. (PsycINFO Database Record PMID:27267511

  14. An exploration of the effect of onsite 12‐step meetings on post‐treatment outcomes among polysubstance‐dependent outpatient clients

    OpenAIRE

    Laudet, Alexandre; Stanick, Virginia; Sands, Brian

    2007-01-01

    Rates of return to active substance use after addiction treatment tend to be high; participation in 12‐step fellowships (e.g., Alcoholics Anonymous) reduces relapse rates but many clients do not attend or attend for a short period only. This quasi‐experimental study uses repeated measurement to explore the role of presence/absence of onsite 12‐step meetings during treatment on post‐treatment outcomes. Polysubstance‐dependent clients (N = 219) recruited at a program with and one without 12‐ste...

  15. Posttraumatic stress disorder symptoms in Korean conflict and World War II combat veterans seeking outpatient treatment.

    Science.gov (United States)

    McCranie, E W; Hyer, L A

    2000-07-01

    Given important differences in the Korean conflict and World War II, samples of treatment-seeking combat veterans from these wars (30 Korea, 83 World War II) were compared on the prevalence and severity of posttraumatic stress disorder (PTSD). With age, ethnicity, and combat exposure taken into account, the Korean veterans reported significantly more severe symptoms on both interview and self-report PTSD measures. Group differences in the prevalence of current PTSD were in a similar direction but not significant. These results are generally consistent with other studies that have found Korean combat veterans to exhibit higher rates of psychosocial maladjustment than World War II combat veterans. Based on related research with Vietnam veterans, one direction for future investigation is to examine what role stressful postmilitary homecoming experiences may have played in influencing the development and course of combat-related PTSD in the aging cohort of "forgotten" Korean conflict veterans. PMID:10948483

  16. ‘Responsible, but Still not a Real Treatment Partner’: A Qualitative Study of the Experiences of Relatives of Patients on Outpatient Commitment Orders

    OpenAIRE

    Stensrud, Bjørn; Høyer, Georg; Granerud, Arild; Landheim, Anne Signe

    2015-01-01

    The aim of this study was to explore relatives’ experiences when their family member is under an outpatient commitment order. A descriptive and exploratory approach was used based on qualitative interviews with 11 relatives. The relatives felt they had responsibility for the patient, but experienced a lack of recognition for their contribution to the treatment. Relatives paid little attention to coercion, but were more concerned about whether the follow-up care improved the patient's social f...

  17. A hospitalização por asma e a carência de acompanhamento ambulatorial Asthma-related hospitalizations and lack of outpatient follow-up treatment

    Directory of Open Access Journals (Sweden)

    Emanuel Sarinho

    2007-08-01

    Full Text Available OBJETIVO: Verificar se as crianças e os adolescentes internados por crise aguda de asma em duas unidades de saúde da cidade do Recife faziam acompanhamento ambulatorial preventivo para controle da asma. MÉTODOS: Estudo prospectivo de uma série de casos de pacientes internados por asma aos quais foi aplicado um questionário no momento da internação para verificar a freqüência de acompanhamento ambulatorial para tratamento profilático. Foi considerado asmático aquele paciente que apresentou duas ou mais crises de broncoespasmo com boa resposta aos broncodilatadores. RESULTADOS: Do total de 169 pacientes internados por asma, 67% (112/167 - dados referentes a 2 pacientes não foram fornecidos foram atendidos exclusivamente em serviços de urgência no período intercrise. Apesar de haver encaminhamento médico para atendimento ambulatorial em 53,3% (89/167 - dados referentes a 2 pacientes não foram fornecidos dos casos, apenas 16% (27/169 dos pacientes efetivamente freqüentavam um ambulatório específico de asma para tratamento preventivo e somente 13% (22/169 usavam medicação profilática. CONCLUSÃO: A maioria das crianças e dos adolescentes internados por asma não fazia acompanhamento ambulatorial preventivo. Uma série de problemas, tais como a não referência para acompanhamento ambulatorial após a alta hospitalar, a dificuldade de acesso ao ambulatório e a impossibilidade de se obter a medicação profilática gratuitamente, entre outros fatores relacionados ao sistema de saúde, podem ter contribuído para esta baixa taxa de procura por atendimento ambulatorial. Recomenda-se a implementação de uma política de saúde que possibilite o efetivo funcionamento do programa de controle da asma.OBJECTIVE: To determine whether the children and adolescents with acute asthma attacks admitted to two public hospitals in the city of Recife, Brazil underwent outpatient follow-up treatment for the prevention and control of asthma

  18. Behavioural profile of drug users attending public drug-treatment centres in Sicily: the role of social context

    Directory of Open Access Journals (Sweden)

    Francesco Vitale

    2007-12-01

    Full Text Available

    Objective: Investigations of injecting drug users (IDUs have suggested that the social context may influence high-risk behaviours in this population. The aim of this study was to describe knowledge, attitudes and behaviours of IDUs attending public drug-treatment centres in our area.

    Study design and methods: A cross-sectional survey was conducted between July 2002 and February 2004, enrolling 607 drug users attending four public drug-treatment centres in the Palermo area. Two of them were located inside the urban area, whereas the other two were in rural districts near the city. All participants answered an anonymous questionnaire concerning social and demographic characteristic and potential high-risk behaviours.

    Results: IDUs living in urban context have a higher educational level, higher number of sexual partners, as well as a lower prevalence of exchanging sex for drugs. Conversely, IDUs living in suburban/rural context are less likely to share syringes and more likely to have used light drugs in the past. Suburban/rural IDUs drink more alcohol but smoke less cigarettes/day, although both groups are strong smokers.

    Conclusions: The results suggest that public drug-treatment centres should take in consideration the adoption of specific programs targeting specific groups, in line with the profile and needs of the subjects in each context in order to promote approaches leading to risk reduction.

  19. Treatment Goals of Depressed Outpatients: A Qualitative Investigation of Goals Identified by Participants in a Depression Treatment Trial

    OpenAIRE

    Battle, Cynthia L.; Uebelacker, Lisa; Friedman, Michael A.; Cardemil, Esteban V.; Beevers, Christopher G.; Miller, Ivan W.

    2010-01-01

    Treatment goals and preferences of depressed patients are important, but they are rarely empirically studied. Although clinicians are likely to discuss goals with individual patients, research that clarifies overall patterns in the treatment goals of depressed patients could be useful in informing new interventions for depression. Such research could also potentially help address problems such as poor adherence and psychotherapy drop-out. In this preliminary qualitative investigation, we exam...

  20. Relationship of reasons and fears of treatment with outcome in substance using population attending a de-addiction centre

    Directory of Open Access Journals (Sweden)

    Siddharth Sarkar

    2013-01-01

    Full Text Available Background: Substance users approach a treatment facility for a variety of reasons as well as avoid or delay in help seeking due to perceived fears with treatment facilities. Sometimes these factors might be associated with treatment outcomes. Objectives: We studied the relationship of reasons and fears of treatment seeking with treatment outcome in substance users. Materials and Methods: One hundred subjects, attending the Drug Deaddiction and Treatment Centre, PGIMER, were prospectively recruited by purposive sampling. A semistructured proforma was used to gather sociodemographic and clinical data. Reasons of help-seeking and fear questionnaire, social support scale, and PGI locus of control scale were then applied. Followup data were available for 69 patients, which were classified into good or poor outcome based on relapse status. Results: At 6 months followup, 22 patients had relapsed, while 47 patients did not relapse. A higher degree of dysfunction due to substance at baseline was associated with relapsed status at followup. Parents or guardians coming to know about resuming substance and being unemployed for a long time were the reasons associated with relapsed status, while needing to consult a doctor immediately was significantly related to abstinent status at followup. Fear of not being able to meet substance using friends was associated with a poorer outcome in the form of relapse. Conclusions: Reasons for treatment seeking as well as fears related to treatment have significant implications on the clinical outcome of substance abusing patients. Addressing these could help in better patient outcomes.

  1. Perceived stigma among attendees of psychiatric and nonpsychiatric outpatients department in an industrial township: A comparative study

    OpenAIRE

    Abhishek Mahajan; Amitav Banerjee

    2015-01-01

    Introduction and Context: Stigma associated with psychiatric disorders and few somatic disorders such as sexually transmitted diseases (STDs), tuberculosis and leprosy, adversely effects treatment seeking behavior, leads to concealment, and poor compliance with treatment. In busy outpatient departments (OPDs), the issue of stigma is likely to be overlooked. Materials and Methods: We carried out a cross-sectional study collecting data on an 8-item stigma scale from patients attending psychiatr...

  2. 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...

  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...... is significantly (p less than 0.01) higher when compared with the prevalence in healthy volunteer blood donors (5/114 [4%] were positive for one or both antibodies). A comparison of out-patient alcoholics positive for one or both antibodies (n = 29) with patients negative for both antibodies (n = 160...

  4. 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...

  5. Consent to treatment by minors attending accident and emergency departments: guidelines.

    OpenAIRE

    Williams, L; Harris, A.; Thompson, M.; Brayshaw, A

    1997-01-01

    The absolute right to refuse medical treatment, even if the reasons are irrational, is confined to competent adults. Children under 16 years can give legal consent to treatment in the absence of consent from those with parental responsibility. Children under 18 years do not, however, have an absolute right to consent, or refuse to consent, to treatment. The views of children assume increasing importance with age and maturity. Accident and emergency medical and nursing staff may face difficult...

  6. Quality of life changes following inpatient and outpatient treatment in obsessive-compulsive disorder: a study with 12 months follow-up

    Directory of Open Access Journals (Sweden)

    Hertenstein Elisabeth

    2013-02-01

    Full Text Available Abstract Background Quality of life (QoL is increasingly recognized as a critical outcome parameter in mental health studies. The aim of this study was to investigate different domains of the QoL in persons with obsessive-compulsive disorder (OCD before and after a multimodal, disorder-specific in- and outpatient treatment. Methods Data of 73 persons with OCD treated in an inpatient setting followed by outpatient treatment were analyzed. The World Health Organization Quality of Life abbreviated (a multidimensional measure of the QoL and the Beck Depression Inventory were administered prior to (baseline and 12 months after the inpatient treatment (follow-up. Results At baseline, participants reported a significantly diminished psychological, social, physical, and global QoL compared to the German general population. Environmental QoL was not impaired in the present sample. The QoL was significantly improved at follow-up, except for social QoL, but remained below norm values. The QoL improvement was predicted by improvements of depressive symptoms. Conclusions The results indicate that persons with OCD suffer from a very low QoL. The QoL was significantly improved after 12 months of intensive state-of-the-art treatment. However, the QoL indices remained considerably lower than population norm values, indicating the need for additional research into novel treatment options for persons with OCD.

  7. Psychosocial and medical factors affecting treatment compliance in patients attending psychiatric hospital: a study from Kashmir

    OpenAIRE

    Sheikh Shoib; Raheel Mushtaq; Mohammad Maqbool Dar; Javid Ahmad Mir; Tabindah Shah; Rameshwar Singh; Javid Ahmad; Syed Kyser

    2014-01-01

    Background: Compliance with medication is decisive for treatment of the psychiatric disorders and is necessary for determining the outcome and prognoses of psychiatric patients. While the causes of poor compliance are multifactorial, the psychiatrist should be aware of such factors and may be able to implement interventions to address those factors. The objective of study was to find out the various medical and social reasons affecting treatment Compliance among patients suffering from psychi...

  8. Recent outbreak of cutaneous anthrax in Bangladesh: clinico-demographic profile and treatment outcome of cases attended at Rajshahi Medical College Hospital

    Directory of Open Access Journals (Sweden)

    Siddiqui Muhammad

    2012-08-01

    Full Text Available Abstract Background Human cutaneous anthrax results from skin exposure to B. anthracis, primarily due to occupational exposure. Bangladesh has experienced a number of outbreaks of cutaneous anthrax in recent years. The last episode occurred from April to August, 2011 and created mass havoc due to its dreadful clinical outcome and socio-cultural consequences. We report here the clinico-demographic profile and treatment outcome of 15 cutaneous anthrax cases attended at the Dermatology Outpatient Department of Rajshahi Medical College Hospital, Bangladesh between April and August, 2011 with an aim to create awareness for early case detection and management. Findings Anthrax was suspected primarily based on cutaneous manifestations of typical non-tender ulcer with black eschar, with or without oedema, and a history of butchering, or dressing/washing of cattle/goat or their meat. Diagnosis was established by demonstration of large gram-positive rods, typically resembling B. anthracis under light microscope where possible and also by ascertaining therapeutic success. The mean age of cases was 21.4 years (ranging from 3 to 46 years, 7 (46.7% being males and 8 (53.3% females. The majority of cases were from lower middle socioeconomic status. Types of exposures included butchering (20%, contact with raw meat (46.7%, and live animals (33.3%. Malignant pustule was present in upper extremity, both extremities, face, and trunk at frequencies of 11 (73.3%, 2 (13.3%, 1 (6.7% and 1 (6.7% respectively. Eight (53.3% patients presented with fever, 7 (46.7% had localized oedema and 5 (33.3% had regional lymphadenopathy. Anthrax was confirmed in 13 (86.7% cases by demonstration of gram-positive rods. All cases were cured with 2 months oral ciprofloxacin combined with flucoxacillin for 2 weeks. Conclusions We present the findings from this series of cases to reinforce the criteria for clinical diagnosis and to urge prompt therapeutic measures to treat

  9. 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...

  10. Characteristics and treatment response of self-identified problematic Internet users in a behavioral addiction outpatient clinic

    OpenAIRE

    Thorens, Gabriel; Achab, Sophia; Billieux, Joël; Khazaal, Yasser; Khan, Riaz; Pivin, Edward; Gupta, Vishal; Zullino, Daniel

    2014-01-01

    Aims: Controversies remain about the validity of the diagnosis of problematic Internet use. This might be due in part to the lack of longitudinal naturalistic studies that have followed a cohort of patients who self-identify as having Internet-related problems. Methods: This retrospective study included 57 patients who consulted the Geneva Addiction Outpatient Clinic from January 1, 2007, to January 1, 2010. Patients underwent an initial clinical psychiatric evaluation that included collectio...

  11. Identification of Individuals With Undiagnosed Diabetes and Pre-Diabetes in a Danish Cohort Attending Dental Treatment

    DEFF Research Database (Denmark)

    Holm, Niels-Christian Reimers; Belstrøm, Daniel; Østergaard, Jakob Appel; Schou, Søren; Holmstrup, Palle; Bay Grauballe, Morten Christian

    reduce diabetes-related complications including periodontitis. The objective of the study was to identify individuals with undiagnosed diabetes or pre-diabetes among individuals attending a dental setting for diagnosis and treatment. METHODS: 291 adults with no history of diabetes were included in the......BACKGROUND AND OBJECTIVE: It is estimated that 3.6% and 13.6% of the Danish population suffer from undiagnosed type 2 diabetes and pre-diabetes, respectively. Periodontitis is an established complication to diabetes. Identification of individuals with diabetes and pre-diabetes is important to...... study (periodontitis patients n=245, non-periodontitis control individuals n=46). Participants answered questionnaires concerning general health, including family history of diabetes. BMI, waist circumference, fat percentage, and glycated hemoglobin level (HbA1c) were recorded chair-side. Periodontal...

  12. A comparative analysis of outpatient costs in HIV treatment programs Análise comparativa dos custos ambulatoriais em programas de tratamento de pacientes HIV

    Directory of Open Access Journals (Sweden)

    Flavia Mori Sarti

    2012-10-01

    Full Text Available OBJECTIVE: To analyze the costs of human immunodeficiency virus (HIV outpatient treatment for individuals with different CD4 cell counts in the Brazilian public health system, and to compare to costs in other national health systems. METHODS: A retrospective survey was conducted in five public outpatient clinics of the Brazilian national HIV program in the city of São Paulo. Data on healthcare services provided for a period of one year of HIV outpatient treatment were gathered from randomly selected medical records. Prices of inputs used were obtained through market research and public sector databases. Information on costs of HIV outpatient treatment in other national health systems were gathered from the literature. Annual costs of HIV outpatient treatment from each country were converted into 2010 U.S. dollars. RESULTS: Annual cost of HIV outpatient treatment for the Brazilian national public program was US$ 2,572.92 in 2006 in São Paulo, ranging from US$ 1,726.19 for patients with CD4 cell count > 500 to US$ 3,693.28 for patients with 51 OBJETIVO: Analisar custos de tratamento ambulatorial de pacientes portadores do vírus da imunodeficiência humana (HIV com diferentes níveis de CD4 no sistema público de saúde brasileiro e comparar aos custos de outros sistemas de saúde. MÉTODOS: Foi conduzida pesquisa retrospectiva em cinco ambulatórios especializados do programa DST/AIDS no município de São Paulo. Dados referentes à assistência ambulatorial para tratamento de pacientes HIV durante um ano foram obtidos em prontuários médicos selecionados aleatoriamente. Preços dos recursos utilizados foram obtidos via pesquisa de mercado e bancos de dados do setor público. Informações sobre custos do tratamento ambulatorial de pacientes HIV em outros sistemas de saúde foram obtidos na literatura. Os custos anuais de tratamento ambulatorial de pacientes HIV em cada país foram convertidos em dólares norte-americanos no ano base 2010

  13. Prevalence and correlates of serostatus disclosure in HIV-infected adults attending the follow up and treatment clinic in Barbados.

    Directory of Open Access Journals (Sweden)

    Sheila Forde

    2007-04-01

    Full Text Available Objective: To determine the extent of disclosure and factors associated with disclosure of HIV status to sexual partners, we interviewed HIV infected adults attending the centralized HIV clinics seeking medical care for HIV. Methods: The subjects were patients who attended the LRU for primary care and treatment of their HIV infection during the three months period of this study enrolment. Patients were asked to participate in this study after initial clinical care was performed, in a 30-minute standardized interview concerning behavioral, medical, and social history. Results: The study patients had the following characteristics: female, 42.7%; male, 57.3%; singles, 84.5%; married, 11.8%. The median age of respondents was 35 years, and 66.4% were employed. Seventy nine percent were sexually active, and of these 72% had a steady sex partner and 61% had one or more casual partners. Over all 64 (58.2% of those interviewed, had disclosed their HIV status to significant others. Of the sixty three persons who had a steady partner 71.4% had self disclosed their HIV status to one or more steady partners. Of the fifty three persons who had one or more casual partners, 26.4% had self-disclosed their status to one or more casual partners. The most common reasons listed for nondisclosure to spouse or significant other were stigma/discrimination, fear of spread of information, rejection. Conclusion: Our findings suggest that both the knowing and unknowing sexual partners of HIV-infected persons continue to be at risk for HIV transmission.

  14. The ANTOP study: focal psychodynamic psychotherapy, cognitive-behavioural therapy, and treatment-as-usual in outpatients with anorexia nervosa - a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Schauenburg Henning

    2009-04-01

    Full Text Available Abstract Background Anorexia nervosa is a serious eating disorder leading to high morbidity and mortality as a result of both malnutrition and suicide. The seriousness of the disorder requires extensive knowledge of effective treatment options. However, evidence for treatment efficacy in this area is remarkably weak. A recent Cochrane review states that there is an urgent need for large, well-designed treatment studies for patients with anorexia nervosa. The aim of this particular multi-centre study is to evaluate the efficacy of two standardized outpatient treatments for patients with anorexia nervosa: focal psychodynamic (FPT and cognitive behavioural therapy (CBT. Each therapeutic approach is compared to a "treatment-as-usual" control group. Methods/Design 237 patients meeting eligibility criteria are randomly and evenly assigned to the three groups – two intervention groups (CBT and FPT and one control group. The treatment period for each intervention group is 10 months, consisting of 40 sessions respectively. Body weight, eating disorder related symptoms, and variables of therapeutic alliance are measured during the course of treatment. Psychotherapy sessions are audiotaped for adherence monitoring. The treatment in the control group, both the dosage and type of therapy, is not regulated in the study protocol, but rather reflects the current practice of established outpatient care. The primary outcome measure is the body mass index (BMI at the end of the treatment (10 months after randomization. Discussion The study design surmounts the disadvantages of previous studies in that it provides a randomized controlled design, a large sample size, adequate inclusion criteria, an adequate treatment protocol, and a clear separation of the treatment conditions in order to avoid contamination. Nevertheless, the study has to deal with difficulties specific to the psychopathology of anorexia nervosa. The treatment protocol allows for dealing with the

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

    Directory of Open Access Journals (Sweden)

    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

  16. 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.

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

    Directory of Open Access Journals (Sweden)

    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. Utility of Accelerometers to Measure Physical Activity in Children Attending an Obesity Treatment Intervention

    Directory of Open Access Journals (Sweden)

    Wendy Robertson

    2011-01-01

    Full Text Available Objectives. To investigate the use of accelerometers to monitor change in physical activity in a childhood obesity treatment intervention. Methods. 28 children aged 7–13 taking part in “Families for Health” were asked to wear an accelerometer (Actigraph for 7-days, and complete an accompanying activity diary, at baseline, 3-months and 9-months. Interviews with 12 parents asked about research measurements. Results. Over 90% of children provided 4 days of accelerometer data, and around half of children provided 7 days. Adequately completed diaries were collected from 60% of children. Children partake in a wide range of physical activity which uniaxial monitors may undermonitor (cycling, nonmotorised scootering or overmonitor (trampolining. Two different cutoffs (4 METS or 3200 counts⋅min-1 for minutes spent in moderate and vigorous physical activity (MVPA yielded very different results, although reached the same conclusion regarding a lack of change in MVPA after the intervention. Some children were unwilling to wear accelerometers at school and during sport because they felt they put them at risk of stigma and bullying. Conclusion. Accelerometers are acceptable to a majority of children, although their use at school is problematic for some, but they may underestimate children's physical activity.

  19. Psychosocial and medical factors affecting treatment compliance in patients attending psychiatric hospital: a study from Kashmir

    Directory of Open Access Journals (Sweden)

    Sheikh Shoib

    2014-02-01

    Results: Out of 200 respondents studied in the study 41.5 % were males and 58.5% were females. Maximum number of patients (31.5% studied were in the age group below the 30 years. 3.5% of respondents were in the age group above 70 years. Out of total 200 respondents in the study 74 % of the respondents are in compliance with recommended medicine whereas non-compliance was found in the 26% of studied population. Complications (13.46% ascending out by usage of psychiatric medicine can be attributed as one of the major case of treatment non-compliance in psychiatric patients, among the psychiatric patients. Accessibility of psychiatric medicine and Financial constrain was also one of the reasons behind the medicine non-compliance (7.69%. Patients with no insight to psychiatric disease also include a good percentage of (5.76 % of medicine non- compliance. Conclusions: Non-compliance is a dominant factor which causes possibly causes readmission in psychiatric wards. Compliance in psychiatric patients in general could be enhanced and improved by adequate intervention via patient counselling and patient medicinal care and education. [Int J Basic Clin Pharmacol 2014; 3(1.000: 220-224

  20. Effect of guided self-determination youth intervention integrated into outpatient visits versus treatment as usual on glycemic control and life skills

    DEFF Research Database (Denmark)

    Husted, Gitte R; Thorsteinsson, Birger; Esbensen, Bente Appel;

    2014-01-01

    , their parents, and interdisciplinary healthcare providers (HCP) to create GSD-Youth (GSD-Y). We evaluated the impact of GSD-Y after it was integrated into pediatric outpatient visits versus treatment-as-usual, focusing on glycemic control and the development of life skills in adolescents with type 1 diabetes...... the amotivation for diabetes self-management after adjusting for the baseline value (P = 0.001). Compared with the control group, the trial completion was prolonged in the GSD-Y group (P parents participated in fewer...... of the adolescents' visits (P = 0.05) compared with control parents. CONCLUSIONS: Compared with treatment-as-usual, GSD-Y did not improve HbA1c levels, but it did decrease adolescents' amotivation for diabetes self-management.Trial registration: ISRCTN 54243636, registered on 10 January 2010. Life skills...

  1. Community-based distribution of sulfadoxine-pyrimethamine for intermittent preventive treatment of malaria during pregnancy improved coverage but reduced antenatal attendance in southern Malawi

    NARCIS (Netherlands)

    K.P. Msyamboza; E.J. Savage; P.N. Kazembe; S. Gies; G. Kalanda; U. D'Alessandro; B.J. Brabin

    2009-01-01

    To evaluate the impact of a 2-year programme for community-based delivery of sulfadoxine-pyremethamine (SP) on intermittent preventive treatment during pregnancy coverage, antenatal clinic attendance and pregnancy outcome. Fourteen intervention and 12 control villages in the catchment areas of Chikw

  2. Comprehensive out-patient pulmonary rehabilitation: Treatment outcomes in early and late stages of chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Ergün Pinar

    2011-01-01

    Full Text Available Background : The aim was to evaluate the outcomes of a comprehensive pulmonary rehabilitation (PR in chronic obstructive pulmonary disease (COPD and to establish whether in early disease stage PR is as effective as in late stages of disease. Methods : A total of 55 stable COPD patients, 28 with early and 27 with late disease stages, were assessed. Patients underwent a comprehensive out-patient PR program for 8 weeks. To eluciate the effects of PR and compare the level of improvement; lung function, dyspnea sensation [Medical Research Council (MRC], body composition [body mass index (BMI, fat free mass (FFM, fat free mass index (FFMI], exercise capacity [incremental shuttle walking test, endurance shuttle walking test], health related quality of life (HRQoL with St. George Respiratory Disease Questionnaire, psycohological status (Hospital anxiety-depression (HAD scale were evaluated before and after PR. Results : At the end of PR in the early disease stage group, the improvement in forced vital capacity (FVC reached a statistically significant level (P < 0.05. In both disease stages, there were no significant differences in BMI, FFM, and FFMI. The decrease in exertional dyspnea for the two groups evaluated with the modified BORG scale were not found statistically significant, though the dyspnea scores evaluated with MRC showed significant improvements (P < 0.001. HRQoL and exercise capacity were significantly improved for the two groups (P < 0.001. Psychological status evaluated with the HAD scale improved after PR (P < 0.001 both in early and late stages. Gainings in the study parameters did not differ in the early and the late disease stages. Conclusions : These results showed that patients with COPD had benefited from a comprehensive PR program in an out-patient setting regardless of disease severity. Even patients with earlier stage of disease should be referred and encouraged to participate in a PR program.

  3. Outpatient angioplasty and stenting facilitated by percutaneous arterial suture closure devices

    International Nuclear Information System (INIS)

    Aim: To review our practice of outpatient percutaneous vascular interventions facilitated by an arterial suture device. Materials and methods: A retrospective review of all patients attending this tertiary centre for iliac or femoral intervention was undertaken between February 2001 and December 2004. All patients who underwent angioplasty or stenting had their puncture sites closed using a Perclose suture. Patients were kept flat for 15 min and allowed to fully mobilize at 60 min. Puncture sites were scored for visible bruising, haematoma and pain at discharge and on outpatient follow-up. Patient preference for future outpatient treatment was assessed. Results: Fifty-seven outpatients underwent 81 punctures. Forty-eight (84%) patients underwent iliac angioplasty; of those 42% underwent stent placement. Six patients (10%) required inpatient admission, five secondary to failed suture deployment. One patient had a non-closer-related puncture site intimal flap occlusion successfully repaired at surgery. Fifty-one (90%) patients discharged with a mean time of 157 min (60-280 min). Forty-six (92%) patients had no visible bruising or palpable haematoma on discharge. No patient had a haematoma greater than 2.5 cm. No discharged patient required readmission. Thirty percent reported a moderate to severe groin pain score (2-5/5) at discharge, increasing to 40% at follow-up. Forty-seven (98%) of the 48 patients, who expressed a preference, would be happy to undergo outpatient treatment again. Conclusion: Outpatient treatment is feasible, well tolerated and preferable to patients, but 10% will require inpatient admission. A planned post-procedure analgesia regimen or advice should be considered

  4. Low Non-structured Antiretroviral Therapy Interruptions in HIV-Infected Persons Who Inject Drugs Receiving Multidisciplinary Comprehensive HIV Care at an Outpatient Drug Abuse Treatment Center.

    Science.gov (United States)

    Vallecillo, Gabriel; Mojal, Sergio; Roquer, Albert; Samos, Pilar; Luque, Sonia; Martinez, Diana; Martires, Paula Karen; Torrens, Marta

    2016-05-01

    Continuous HIV treatment is necessary to ensure successful combined antiretroviral therapy (cART). The aim of this study was to evaluate the incidence of patient-initiated non-structured treatment interruptions in HIV-infected persons who inject drugs and who received a multidisciplinary comprehensive program, including medical HIV care, drug-dependence treatment and psychosocial support, at a drug outpatient addiction center. Non-structured treatment interruptions were defined as ≥30 consecutive days off cART without medical indication. During a median follow-up of 53.8 months, 37/132 (28 %) patients experienced the first non-structured treatment interruptions. The cumulative probability of cART interruption at 5 years was 31.2 % (95 % CI 22.4-40.0). Current drug use injection ≥1/day (HR 14.77; 95 % CI 5.90-36.96) and cART naive patients (HR 0.35, 95 % CI 0.14-0.93) were predictive factors for non-structured treatment interruptions. HIV care provided at a drug addiction center is a useful strategy to sustain continuous cART, however, drug abstinence is essential for the long-term maintenance of cART. PMID:26427376

  5. Depression in patients with chronic pain attending a specialised pain treatment centre: prevalence and impact on health care costs.

    Science.gov (United States)

    Rayner, Lauren; Hotopf, Matthew; Petkova, Hristina; Matcham, Faith; Simpson, Anna; McCracken, Lance M

    2016-07-01

    This cross-sectional study aimed to determine the prevalence and impact of depression on health care costs in patients with complex chronic pain. The sample included 1204 patients attending a tertiary pain management service for people with chronic disabling pain, unresponsive to medical treatment. As part of routine care, patients completed a web-based questionnaire assessing mental and physical health, functioning, and service use in the preceding 3 months. Depression was assessed using the 9-item Patient Health Questionnaire. Self-report health care utilisation was measured across 4 domains: general practitioner contacts, contacts with secondary/tertiary care doctors, accident and emergency department visits, and days hospitalised. The participation rate was 89%. Seven hundred and thirty-two patients (60.8%; 95% CI 58.0-63.6) met criteria for probable depression, and 407 (33.8%) met the threshold for severe depression. Patients with depression were more likely to be unable to work because of ill health and reported greater work absence, greater pain-related interference with functioning, lower pain acceptance, and more generalised pain. Mean total health care costs per 3-month period were £731 (95% CI £646-£817) for patients with depression, compared with £448 (95% CI £366-£530) for patients without depression. A positive association between severe depression and total health care costs persisted after controlling for key demographic, functional, and clinical covariates using multiple linear regression models. These findings reveal the extent, severity, and impact of depression in patients with chronic pain and make evident a need for action. Effective treatment of depression may improve patient health and functioning and reduce the burden of chronic pain on health care services. PMID:26963849

  6. Long-term outcomes of anthroposophic treatment for chronic disease: a four-year follow-up analysis of 1510 patients from a prospective observational study in routine outpatient settings

    OpenAIRE

    Hamre, Harald Johan; Kiene, Helmut; Glockmann, Anja; Ziegler, Renatus; Kienle, Gunver Sophia

    2013-01-01

    Background Anthroposophic treatment includes special artistic and physical therapies and special medications. We here report an update to a previously published study of anthroposophic treatment for chronic diseases, including more patients and a longer follow up. The Anthroposophic Medicine Outcomes Study (AMOS) was a prospective observational cohort study of anthroposophic treatment for chronic indications in routine outpatient settings in Germany. Anthroposophic treatment was associated wi...

  7. Drop-out and treatment outcome of outpatient cognitive-behavioral therapy for anorexia nervosa and bulimia nervosa.

    Science.gov (United States)

    Schnicker, Katja; Hiller, Wolfgang; Legenbauer, Tanja

    2013-10-01

    In the present study, drop-out-analyses were carried out for a manual-based cognitive-behavioral therapy for 104 females with anorexia nervosa (AN) and bulimia nervosa (BN), in the service setting of a university outpatient clinic (naturalistic setting). A total of 22.9% of patients with AN terminated therapy prematurely (drop-outs), compared to 40.6% of patients with BN. Group differences between drop-outs and completers show that the group of drop-outs with BN had higher values in the depression score at the start of therapy and was almost two times more likely to have a comorbid disorder (odds ratio 1.69), whereas drop-outs with AN had higher values in the outcome-scale drive for thinness and the odds ratio for being employed or living in a partnership was slightly lower. Completers and drop-outs did not differ significantly within groups in regard to age, body mass index at the start and end of therapy, or the number of comorbid disorders. On the whole, the therapy effect in the group of drop-outs was relatively moderate. For patients with AN, even higher therapy effects were observed among the drop-outs than among the completers. These data suggest that moderate therapy effects and responses can be achieved even among the drop-outs. PMID:23587528

  8. 门诊森田疗法治疗失眠症的对照研究%Outpatient Morita Therapy in the Treatment of Insomnia

    Institute of Scientific and Technical Information of China (English)

    李艳青

    2014-01-01

    Objective To explore the short-term and long-term efficacy of outpatient Morita therapy in the treatment of insomnia . Methods 60 outpatients with insomnia were randomly assigned to study groups and control groups ,30 cases each.The study group re-ceived drug treatment and Morita therapy ,while the control group received drug treatment only for 4 weeks,then follow up 3 months.Be-fore and after 4-week treatment and follow -up 3-month,two groups were assessed with Pittsburgh Sleep Quality Index (PSQI).Re-sults After 4-week treatment ,6 factor scores of PSQI in the study group were significantly lower than those in the control group ( t=1.98~2.76,P<0.05 );Follow-up 3 months,6 factor scores of PSQI in the study group were significantly lower than those in the con-trol group(t=2.35~4.09,or P<0.05).Conclusion The short-term and the long -term efficacy of outpatient Morita therapy are better than those of mono -drug in the treatment of insomnia .%目的:探讨门诊森田疗法辅助药物治疗失眠症的近期疗效和远期疗效。方法将60例失眠症患者随机分为研究组和对照组各30例,两组患者均口服佐匹克隆治疗,研究组辅以门诊森田疗法,于治疗前、治疗4周后及随访3个月时,分别用匹兹堡睡眠质量指数( PSQI)评定近期和远期临床效果。结果治疗4周后,研究组PSQI中6个因子分低于对照组,差异有统计学意义(t=1.98~2.76,P<0.05);随访3个月时,PSQI中6个因子分低于对照组,差异有统计学意义(t=2.35~4.09,P<0.05)。结论门诊森田疗法辅助药物治疗失眠症的近期效果和远期效果均优于单纯药物治疗。

  9. Anorexia Nervosa: A Synthesis of Poetic and Narrative Therapies in the Outpatient Treatment of Young Adult Women

    Science.gov (United States)

    Robbins, Joy M.; Pehrsson, Dale-Elizabeth

    2009-01-01

    Current trends for treatment of women with anorexia nervosa often focus on weight gain as the primary therapeutic goal without concurrently addressing psychological concerns. As a result of this singular focus, many women drop out of treatment before recovering. This article offers an alternate treatment model. A synthesized narrative and poetry…

  10. 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…

  11. Prevalence of Hepatitis B co-infection amongst HIV infected children attending a care and treatment centre in Owerri, South-eastern Nigeria

    OpenAIRE

    Nwolisa, Emeka; Mbanefo, Francis; Ezeogu, Joseph; Amadi, Paul

    2013-01-01

    Introduction Hepatitis B infection impacts negatively on disease progression in HIV infected children thereby increasing morbidity and mortality. In spite of the foregoing, there is paucity of data on Hepatitis B co-infection in children living with HIV in Owerri, South Eastern Nigeria.This study set out to determine the prevalence of Hepatitis B Co- infection in HIV infected children attending the Paediatric HIV Care and Treatment clinic of the Federal Medical Centre Owerri. Methods The stud...

  12. 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.

  13. Does Pretreatment Severity Moderate the Efficacy of Psychological Treatment of Adult Outpatient Depression? A Meta-Analysis

    Science.gov (United States)

    Driessen, Ellen; Cuijpers, Pim; Hollon, Steven D.; Dekker, Jack J. M.

    2010-01-01

    Objective: It is widely believed that psychological treatment has little effect on more severely depressed patients. This study assessed whether pretreatment severity moderates psychological treatment outcome relative to controls by means of meta-analyses. Method: We included 132 studies (10,134 participants) from a database of studies…

  14. 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

    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 TNF inhibitors are aware of this potentially serious AE and report these events to the proper medical authorities....

  15. Osteoarthrosis in outpatient practice

    Directory of Open Access Journals (Sweden)

    Elena Andreyevna Galushko

    2012-12-01

    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.

  16. Factors Associated with No Dental Treatment in Preschoolers with Toothache: A Cross-Sectional Study in Outpatient Public Emergency Services

    Directory of Open Access Journals (Sweden)

    Geovanna C. M. Machado

    2014-08-01

    Full Text Available Many parents rely on emergency services to deal with their children’s dental problems, mostly pain and infection associated with dental caries. This cross-sectional study analyzed the factors associated with not doing an oral procedure in preschoolers with toothache attending public dental emergency services. Data were obtained from the clinical files of preschoolers treated at all nine dental emergency centers in Goiania, Brazil, in 2011. Data were children’s age and sex, involved teeth, oral procedures, radiography request, medications prescribed and referrals. A total of 531 files of children under 6 years old with toothache out of 1,108 examined were selected. Children’s mean age was 4.1 (SD 1.0 years (range 1–5 years and 51.6% were girls. No oral procedures were performed in 49.2% of cases; in the other 50.8%, most of the oral procedures reported were endodontic intervention and temporary restorations. Primary molars were involved in 48.4% of cases. With the exception of “sex”, the independent variables tested in the regression analysis significantly associated with non-performance of oral procedures: age (OR 0.7; 95% CI 0.5–0.8, radiography request (OR 3.8; 95% CI 1.7–8.2, medication prescribed (OR 7.5; 95% CI 4.9–11.5 and patient referred to another service (OR 5.7; 3.0–10.9. Many children with toothache received no oral procedure for pain relief.

  17. Neonatal Abstinence Syndrome: Influence of a Combined Inpatient/Outpatient Methadone Treatment Regimen on the Average Length of Stay of a Medicaid NICU Population

    Science.gov (United States)

    Hulman, Sonia; Musci, Michael; Stang, Ellen

    2015-01-01

    Abstract Prescription opioid and heroin abuse have been increasing steadily year after year, and continue to be a serious national problem. A sequela of the increase in opioid abuse has been an increase in the number of infants born with opioid dependence. These infants often require costly, prolonged stays in the neonatal intensive care unit (NICU) for drug withdrawal treatment. The authors studied a population of infants from a large Medicaid health plan who were born with neonatal abstinence syndrome (NAS) secondary to in utero opioid exposure to assess the average length of stay in the NICU, and to determine the variables that may account for differences in interinstitutional lengths of stay. The overall average length of stay for NAS was 21.1 days for the 139 infants included in the study. Analysis of the medication used for treatment revealed that infants who were treated with a combined inpatient/outpatient regimen with methadone had an average length of stay of 11.4 days versus 25.1 days for infants who were treated entirely as inpatients (PPopulation Health Management 2015;18:392–397) PMID:25803316

  18. 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. PMID:17489506

  19. A Meta-Analysis of Long-Term Outpatient Treatment Effects for Children and Adolescents with Conduct Problems

    OpenAIRE

    Fossum, Sturla; Handegård, Bjørn Helge; Adolfsen, Frode; Vis, Svein Arild; Wynn, Rolf

    2015-01-01

    Accepted manuscript version. The final publication is available at Springer via http://dx.doi.org/10.1007/s10826-015-0221-8. The present meta-analytic review explored long-term treatment effects in children and adolescents, age ranging from 2 to 17 years, treated because of conduct problems. The presumed mediators were examined. Various treatments, in all 56 studies including 2589 participants, were included. 32 studies involved an untreated control condition, whereas 24 studies did no...

  20. Tratamiento ambulatorio de la trombosis venosa profunda: comparación con tratamiento en hospitalización de pacientes de un registro histórico Outpatient treatment of deep vein thrombosis: comparative study with historical inpatients

    Directory of Open Access Journals (Sweden)

    J. L. Alonso

    2009-04-01

    Full Text Available Antecedentes. El tratamiento ambulatorio de la trombosis venosa profunda (TVP se ha propuesto como un método seguro y coste efectivo, bien completamente ambulatorio o como un patrón mixto de hospitalización corta seguido de tratamiento ambulatorio. El objetivo es comparar la seguridad del tratamiento ambulatorio de la TVP y calcular las estancias medias ahorradas en el hospital. Material y métodos. Análisis descriptivo de cohortes sobre nuestra experiencia de tratamiento completamente ambulatorio de pacientes con TVP (184 pacientes durante el periodo 2003 y 2004 -recogiendo las proporciones de hemorragia mayor, complicaciones (definidas como nuevo embolismo pulmonar, re-extensión de la TVP o necesidad de ingreso hospitalario relacionado con TVP y muerte por todas las causas-, comparadas con una cohorte de 109 pacientes históricos de tratamiento en hospitalización correspondientes al año 2002. Resultados. De los 184 pacientes tratados ambulatoriamente, presentaron hemorragia mayor 3% [IC 95% 1-6,57, riesgo relativo (RR 0,38], complicaciones 5% (IC 95% 2,41-9,37; RR 1,25, de los pacientes y la tasa de mortalidad fue de 4% (IC 95% 1,68-7,99; RR 0,36. Se evitaron 844 estancias hospitalarias. Los 109 pacientes históricos presentaron hemorragia en 8% (IC 95% 4-15, complicación 4% (IC 95% 1,18-9,68 y muerte 11% (IC 95% 6-18,8. Conclusiones. El tratamiento completamente ambulatorio de la TVP puede ser tan seguro como el realizado en hospitalización evitándose estancias hospitalarias innecesarias.Background. Outpatient treatment of deep venous thrombosis (DVT has been proposed as a safe and cost-saving process, either as a mixed pattern: as an inpatient for 1 to 3 days followed by outpatient treatment; or rarely as completely outpatient. Patients and methods. We evaluated two cohorts of consecutive patients diagnosed with DVT. Patients who received entirely outpatient treatment in the years 2003 and 2004, compared with historical patients

  1. [SEIP-AEPAP-SEPEAP consensus document on the aetiology, diagnosis and treatment of bacterial skin infections in out-patients].

    Science.gov (United States)

    Conejo-Fernández, A J; Martínez-Chamorro, M J; Couceiro, J A; Moraga-Llop, F A; Baquero-Artigao, F; Alvez, F; Vera Casaño, A; Piñeiro-Pérez, R; Alfayate, S; Cilleruelo, M J; Calvo, C

    2016-02-01

    Skin infections are a common cause for dermatological consultations in the paediatric setting. A review is presented of the clinical manifestations, diagnosis and treatment of the main bacterial skin infections, as well as the diagnosis and treatment of super-infected puncture and bite wounds. The most prevalent bacteria in skin infections are Staphylococcus aureus and Streptococcus pyogenes. Treatment is usually empirical, since microbiological studies are only recommended under certain circumstances or lack of improvement with common therapies. Superficial skin infections can be treated with local antiseptics or antibiotics (mupirocin or fusidic acid). Systemic treatment is usually reserved for patients with extensive or severe disease or with other risk factors. Systemic treatment depends on the suspected infecting bacteria, with penicillin, amoxicillin, amoxicillin-clavulanic acid and first or second generation cephalosporin being the most frequently used drugs. Due to the low incidence of community-acquired methicillin-resistant infection by S. aureus in Spain, the use of clindamycin or co-trimoxazole is only recommended after severe disease, relapses or a clear epidemiological background. PMID:25735876

  2. Successful treatment on an out-patient basis of a patient with Down's syndrome and disseminated testicular seminoma

    NARCIS (Netherlands)

    Sleijfer, S; vanderGraaf, WTA; Schraffordt Koops, H.

    1996-01-01

    Due to a high incidence of undescended testicles, patients with Down's syndrome have an increased risk of testicular cancer. The treatment of these patients with the successful cisplatin-containing regimens, which are however toxic and require hospitalization, can cause several problems. We present

  3. Reasons for and Attitudes toward Follow-Up Research Participation among Adolescents Enrolled in an Outpatient Substance Abuse Treatment Program

    Science.gov (United States)

    Garner, Bryan R.; Passetti, Lora L.; Orndoff, Matt G.; Godley, Susan H.

    2007-01-01

    Maintaining study cohorts over time is crucial to the success of treatment outcome research studies. This paper examines reasons why adolescents with substance use problems continued to participate in follow-up interviews. The sample consisted of 145 adolescents between the ages of 12 and 18, who completed an outcome study following out-patient…

  4. 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...

  5. Tratamiento ambulatorio involuntario de carácter civil: Una revisión Involuntary outpatient treatment in civil law: A review

    Directory of Open Access Journals (Sweden)

    G. Portero

    2010-06-01

    Full Text Available En este artículo se analiza el tratamiento ambulatorio involuntario (TAI en España. También hacemos un breve repaso de él en el derecho internacional. En España no hay una legislación explícita del TAI, pero en el año 2004 el grupo parlamentario CIU (Convergencia i Unió propuso una modificación del articulo 763 de la Ley de Enjuiciamiento Civil para autorizar el TAI. Surgió así uno de los temas más controvertidos sobre la salud mental de los últimos años estando aún sin resolver. Hay tres posiciones sobre el TAI: aquellos que argumentan a favor, los que argumentan en contra y los que consideran que no es necesaria una nueva legislación. Muchos profesionales esperan que el Tratamiento Asertivo Comunitario (TAC minimice el denominado "síndrome de puerta giratoria". En España, el Sistema Nacional de Salud recomendó en el año 2006 este tratamiento.In this article, the Involuntary Outpatient Treatment (IOT in Spain is analized. Also we briefly summarize the international law about it. In Spain there is not explicit legislation about OIT, but in 2004 the Parliamentary Group of CIU (Convergencia i Unió proposed a modification of the article 763 of the Law of Civil Judgement to explicitly authorising the OIT. This arose one of the most controversial issues in mental health in the last years and nowadays it is not yet solved. There are three positions about de OIT: Those who argument for OIT, those who argument against, and those others who consider unnecessary new legislation. Many professionals hope that Assertive Community Treatment minimize the so-called "revolving door syndrome". This treatment was recommended in 2006 by The National Health System in Spain.

  6. Effectiveness, toxicity, and economic evaluation of ipilimumab for the treatment of patients with metastatic melanoma in the Spanish outpatient setting.

    Science.gov (United States)

    Guglieri-López, Beatriz; Pérez-Pitarch, Alejandro; Porta Oltra, Begoña; Ferriols-Lisart, Francisco; Royo-Peiró, Ángeles; Climente-Martí, Mónica

    2016-08-01

    To evaluate the effectiveness and toxicity profile of ipilimumab treatment and to examine the cost-effectiveness relation in a real-world sample of patients with metastasic melanoma. This was a multicenter, observational, retrospective cohorts study. To assess the effectiveness and safety of ipilimumab treatment progression-free survival (PFS), overall survival (OS) and adverse events were registered. An economic evaluation was performed and cost-effectiveness ratios (CERs) were calculated. Eleven patients were included, mean age 59 (SD=11) years. The median PFS was 3.83 months (95% confidence interval 0.98-9.80) and the median OS was 5.15 months (95% confidence interval 1.70-8.48). None of the patients included in the study achieved an objective response. A stable disease was achieved in four (36%) patients. The most commonly reported analytical adverse event was anemia, with all patients developing anemia in any grade. The most severe adverse event was neutropenia (n=6; 55%), with three patients developing grade 4 neutropenia (3/11; 27%). The total cost of ipilimumab treatment was &OV0556;483 397, with a median of 43 033 (interquartile range=9555) euros per patient. The median-based CER was 136 675 (28 539-474 865) euros per progression-free year gained and the median-based CER was 100 112 (23 107-374 893) euros per life-year gained. PFS observed in real-world patients was higher than that reported in clinical trials and OS was lower. The incidence of adverse events was higher. The additional cost per progression-free year gained was ∼&OV0556;136 675. The data from this study fill an important need for information on the relative value of this treatment in terms of cost-effectiveness. PMID:27058705

  7. Integrating HIV treatment with primary care outpatient services: opportunities and challenges from a scaled-up model in Zambia

    OpenAIRE

    Topp, Stephanie M.; Chipukuma, Julien M.; Chiko, Matimba M; Matongo, Evelyn; Bolton-Moore, Carolyn; Reid, Stewart E.

    2012-01-01

    Background Integration of HIV treatment with other primary care services has been argued to potentially improve effectiveness, efficiency and equity. However, outside the field of reproductive health, there is limited empirical evidence regarding the scope or depth of integrated HIV programmes or their relative benefits. Moreover, the body of work describing operational models of integrated service-delivery in context remains thin. Between 2008 and 2011, the Lusaka District Health Management ...

  8. Self-Determination Theory and Outpatient Follow-Up After Psychiatric Hospitalization.

    Science.gov (United States)

    Sripada, Rebecca K; Bowersox, Nicholas W; Ganoczy, Dara; Valenstein, Marcia; Pfeiffer, Paul N

    2016-08-01

    The objective of this study was to assess whether the constructs of self-determination theory-autonomy, competence, and relatedness-are associated with adherence to outpatient follow-up appointments after psychiatric hospitalization. 242 individuals discharged from inpatient psychiatric treatment within the Veterans Health Administration completed surveys assessing self-determination theory constructs as well as measures of depression and barriers to treatment. Medical records were used to count the number of mental health visits and no-shows in the 14 weeks following discharge. Logistic regression models assessed the association between survey items assessing theory constructs and attendance at mental healthcare visits. In multivariate models, none of the self-determination theory factors predicted outpatient follow-up attendance. The constructs of self-determination theory as measured by a single self-report survey may not reliably predict adherence to post-hospital care. Need factors such as depression may be more strongly predictive of treatment adherence. PMID:26319610

  9. Factors associated with having a medical marijuana card among Veterans with recent substance use in VA outpatient treatment.

    Science.gov (United States)

    Davis, Alan K; Bonar, Erin E; Ilgen, Mark A; Walton, Maureen A; Perron, Brian E; Chermack, Stephen T

    2016-12-01

    Psychiatric symptoms, somatic problems, and co-occurring substance use have been associated with medical marijuana consumption among civilian patients with substance use disorders. It is possible that these factors may impact Veterans' ability to engage in or adhere to mental health and substance use disorder treatment. Therefore, we examined whether psychiatric functioning, substance use, and somatic problems were associated with medical marijuana use among Veterans receiving substance use disorder and/or mental health treatment. Participants (n=841) completed screening measures for a randomized controlled trial and 67 (8%) reported that they had a current medical marijuana card. Most of these participants (78%) reported using marijuana to treat severe/chronic pain. Significant bivariate differences revealed that, compared to participants without a medical marijuana card, those with a card were more likely to be in a middle income bracket, unemployed, and they had a significantly higher number of recent days of marijuana use, synthetic marijuana use, and using sedatives prescribed to them. Additionally, a significantly higher proportion of participants with a medical marijuana card scored above the clinical cutoff for posttraumatic stress disorder (PTSD) symptoms, had significantly higher severity of sleep-related problems, and reported a higher level of pain. These findings highlight the co-occurrence of substance use, PTSD symptoms, sleep-related problems, and chronic pain among Veterans who use medical marijuana. Future research should investigate the inter-relationships among medical marijuana use and other clinical issues (e.g., PTSD symptoms, sleep, pain) over time, and potential implications of medical marijuana use on treatment engagement and response. PMID:27475408

  10. 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...

  11. 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...

  12. 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...

  13. 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...

  14. Have splenectomy rate and main outcomes of ITP changed after the introduction of new treatments? A monocentric study in the outpatient setting during 35 years.

    Science.gov (United States)

    Palandri, Francesca; Polverelli, Nicola; Sollazzo, Daria; Romano, Marco; Catani, Lucia; Cavo, Michele; Vianelli, Nicola

    2016-06-01

    In the last years, rituximab (RTX) and agonists of the thrombopoietin receptor (TPO-R) eltrombopag and romiplostim have provided new treatment options in persistent and chronic immune thrombocytopenia (ITP). Here, we analyzed the changes in therapeutic choices over time and their impact on clinical outcomes in a cohort of 557 ITP outpatients followed at the "L. and A. Seràgnoli" Institute of Hematology, Bologna, Italy, from 1980 to 2015. Overall 397 patients (71%) required front-line corticosteroids, mainly prednisone. Over the decades, splenectomy was delayed from second to third-line, but was steadily used in around 15-25% of patients refractory or relapsing after first-line treatment. Consensually, RTX and TPO-R agonists emerged as second and third-line therapy of choice, respectively. Splenectomy was associated with the best response rates and the lower incidences of relapse, while the relapse rate after RTX was comparable to that observed with corticosteroids and other immunosuppressive agents. The introduction of TPO-R agonists gave an alternative to the administration of immunosuppressive drugs and probably contributed to moderate the incidence of infectious complications that remained stable over the decades, despite an increasing use of RTX from the 2000s onwards. Overall responses were similar over time, with over 97% achieving a response in all time-periods. However, the cumulative risk of bleeding significantly decreased [14.3% (1980-89) vs. 7% (1990-99) vs. 5.6% (2000-09) vs. 0.2% (2010-15)] (P < 0.001), mainly thanks to the optimization of front-line corticosteroids therapy and to the wider availability of second and third-line therapies. Am. J. Hematol. 91:E267-E272, 2016. © 2016 Wiley Periodicals, Inc. PMID:26799593

  15. Psychiatric disorders and associated factors in cancer: results of an interview study with patients in inpatient, rehabilitation and outpatient treatment.

    Science.gov (United States)

    Härter, M; Reuter, K; Aschenbrenner, A; Schretzmann, B; Marschner, N; Hasenburg, A; Weis, J

    2001-07-01

    An association between mental disorders, especially affective and anxiety disorders, and cancer has been reported in many studies. The present study investigated current (4-weeks-, 12-months-, and lifetime-prevalence rates of comorbid mental disorders in cancer patients. Through a cross-sectional design, 517 patients (75% female patients) from two acute inpatient care clinics, two rehabilitation clinics and nine specialised practices for oncology were examined with standardised scales for psychological burden and quality of life. Somatic parameters were assessed through standardised medical records. In the second-stage-examination, a sample of 200 patients was interviewed with standardised clinical interview (CIDI) in order to obtain DSM-IV diagnoses of mental disorders. Differences in the type of mental disorders were examined for gender, treatment setting, severity of cancer and physical impairment. Prevalence rates of mental disorders were 23.5% for the 4-weeks, 40% for the 12-months, and 56.5% for the lifetime periods. The current and 12-months rates of affective and anxiety disorders were approximately 25-33% higher than prevalence rates found in recent epidemiological studies of the general population. These higher rates were, however, mainly due to the preponderance of female patients with a higher risk for mental disorders compared with males. The most prevalent current disorders were affective (9.5%), and anxiety disorders (13%). Female gender was associated with an approximately 2-fold risk of mental disorders during the patient's lifespan. Current diagnosis of affective disorders in women was highly related to the cancer. Physical impairment was also associated with the frequency of current psychiatric disorders, especially affective and anxiety disorders. The frequency of mental disorders in cancer patients does not differ from results of recent international epidemiological studies of the normal population. The slightly higher rates of anxiety

  16. 儿童单纯肥胖症门诊治疗效果观察%Outpatient Treatment Program for Obese Children

    Institute of Scientific and Technical Information of China (English)

    蒋竞雄; 吴光驰; 郭素怡; 夏秀兰; 闫桂凤; 谈藏文; 王力; 宋小芳

    2001-01-01

    【 Objective】 To design an outpatient treatment program for obese children and to investigate the feasibility and ef fect. 【Methods】 258 obese children(112 boys and 146 girls,average age:(10.5+1.8)y,range 6~16y,average body mass in dex:26.7kg/m2,range(22.3~32.4). were involved in our outpatient treatment program including change eating and lifestyle,resis tance exercise(HR 145~155 beat per minute)reducing sedentary behavior and nutrition education. Anthropometrical dates were ob tained at the fu-st visit and every week visit. The use of weight maintenance versus weight loss to achieve weight goals depends on each obese child's age,obese degree,and presence of medical complications. 【Results】 98 obese children were treated less than 4 weeks and 160 obese children were treated 4 weeks or more. Among the 160 obese children, 127 loss their weight, average 3.5kg, range 0.5~7.5kg. 158 had a decrease of body mass index(BMI), average 1.8, range 0.2~5.6. Significantly better outcome were obtained when 9 weeks or more of treatment occurred for the 160 obese children. 【conclusions】 The outpatient treatment program that including reductions in high- fat and high calorie foods,changing the child's eating habits,moderate exercise and nutrition edu cation was feasibility and effective for obese children.%【目的】 观察门诊治疗肥胖儿童的可行性及治疗效果。【方法】以WHO身高标准体重值为肥胖 判断标准。自1997年12月~1999年8月共治疗单纯性肥胖儿童158例,治疗方法为控制饮食、改变饮食行为、中等程 度(心率145~155次/分)有氧运动、减少静坐时间、健康教育等,首诊制订一周治疗方案,每周复诊1次,根据患儿对 治疗方案的执行情况制订下1周治疗计划。采用个案分析方法,对不同年龄、不同肥胖度及是否有合并症等设定不同 的治疗目标。【结果】治疗时间少于4周者98例,治疗时间在4

  17. Metabolic syndrome and associated factors among outpatients of Jimma University Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Abda E

    2016-03-01

    Full Text Available Edris Abda,1 Leja Hamza,2 Fasil Tessema,3 Waqtola Cheneke4 1Department of Medicine, College of Medicine and Health Sciences, Madda Walabu University, Bale Robe, 2Department of Internal Medicine, 3Department of Epidemiology, 4Department of Medical Laboratory Sciences and Pathology, College of Health Sciences, Jimma University, Jimma, Ethiopia Background: Developing countries are now experiencing the epidemiologic transition, whereby the burden of chronic diseases, like metabolic syndrome, is increasing. However, no study had previously been conducted to show the status of metabolic syndrome among outpatients of Jimma University Teaching Hospital. Therefore, this study was designed to determine the prevalence of metabolic syndrome and associated factors among adult (≥20 years patients. Methods: A cross-sectional hospital-based study was conducted in July 2014 among adult (≥20 years patients attending Jimma University Teaching Hospital, outpatient department. All patients attending the outpatient department and were willing to participate in the study were included. Anthropometric and biochemical measurements were undertaken for all the study subjects to know the status of metabolic syndrome. Metabolic syndrome was identified using the National Cholesterol Education Program’s Adult Treatment Panel III criteria. Results: A total of 225 participants were included in the study, of whom 106 (47.1% were males and 119 (52.9% were females. A total of 59 (26% adults were found to have metabolic syndrome, which was seen more than twice as much in females, 42 (35%, as compared with males, 17 (16%, (P<0.01. The most frequent metabolic syndrome parameters were hypertension (45%, hyperglycemia (39%, decreased high-density lipoprotein (HDL (31%, central obesity (26%, and elevated triglycerides (18%. Elevated blood pressure is more common in females (44.5% than in males (34.9%. Decreased HDL-cholesterol was observed among 37% of females versus 24% males (P

  18. Validação, no Brasil, do Índice de Barthel em idosos atendidos em ambulatórios Validación, en Brasil, del índice de Barthel en pacientes ancianos atendidos en ambulatorios clínicos Validation of the Barthel Index in elderly patients attended in outpatient clinics, in Brazil

    Directory of Open Access Journals (Sweden)

    Jéssica Sponton Moura Minosso

    2010-04-01

    Full Text Available OBJETIVO: Validar o Índice de Barthel para idosos atendidos em ambulatórios, no Brasil, por meio de análises de confiabilidade e validade. MÉTODOS: Para comprovação da confiabilidade, utilizou-se a consistência interna e, para a verificação da validade, a análise fatorial e as validades de critério convergente e discriminante. RESULTADOS: A confiabilidade, estimada pelo alfa de Cronbach, apresentou o valor de 0,90 para a escala total. A análise da validade de critério convergente, utilizando a Medida de Independência Funcional, identificou correlação satisfatória para a maioria dos domínios. Na análise fatorial, que manteve apenas um domínio e os 10 itens da escala original, a variância explicada foi de 63,8%. CONCLUSÃO: Os resultados permitem recomendar sua utilização para avaliar a capacidade funcional de idosos em atendimento ambulatorial no Brasil.OBJETIVO: Validar el índice de Barthel para personas ancianas atendidos en ambulatorios clínicos, en Brasil, a través del análisis de fiabilidad y validez. MÉTODOS: Para probar la fiabilidad, se utilizó la consistencia interna y para verificar su validez el análisis factorial y los criterios de validez convergente y discriminante. RESULTADOS: La fiabilidad estimada por el alfa de Cronbach, mostró el valor de 0,90 para la escala total. El análisis de la validez de criterio convergente, por medio de la Medida de Independencia Funcional, identificó una correlación satisfactoria para la mayoría de las áreas. En el análisis factorial, que sólo conservó un dominio y los 10 ítems de la escala original, la varianza explicada fue de 63,8%. CONCLUSIÓN: Los resultados permiten recomendar su utilización para evaluar la capacidad funcional de los pacientes de edad avanzada en la atención ambulatoria en Brasil.OBJECTIVE: To validate the Barthel Index for elderly patients being attended in outpatient clinics in Brazil through analysis of reliability and validity

  19. Parental socioeconomic status and change in physical activity among children attending a family-based obesity treatment program

    OpenAIRE

    Tautra, Cathrine VIk

    2013-01-01

    Background: Physical activity is associated with health and a normal weight status and is therefore recommended in childhood obesity treatment. To produce more effective treatment for obese children, there is a need to investigate how social factors affect the outcome of these treatments. Children with low parental socioeconomic status (SES) are particularly at high risk for being obese and having a sedentary lifestyle. The impact of socioeconomic status in the treatment o...

  20. Impact of Music on Pediatric Oncology Outpatients

    OpenAIRE

    Kemper, Kathi J; Hamilton, Craig A; McLean, Thomas W.; LOVATO, JAMES

    2008-01-01

    Music is widely used to enhance well-being. We wished to assess music’s effect on pediatric oncology outpatients. Patients who had leukemia and were in maintenance or consolidation outpatient treatment served as their own control at two visits. At visit 1, children rested for 20 min; at visit 2, for 20 min they listened to music designed to increase vitality and improve heart rate variability (HRV). At both visits, parents completed before and after treatment visual analog scales (VAS) of the...

  1. Standardisation of the Waist Circumference (WC for each range of Body Mass Index (BMI in adult outpatients attended to in Endocrinology and Nutrition Departments Estandarización de la circunferencia de cintura (WC, para cada rango de índice de masa corporal (BMI en pacientes adultos atendidos en un servicio de endocrinología y nutrición

    Directory of Open Access Journals (Sweden)

    M. López de la Torre

    2010-04-01

    Full Text Available By this study we seek the expectable range of waist circumference (WC for every degree of body mass index (BMI, which will serve to studies targeting ascertaining the health risk. We studied 2,932 patients (39.6% men and 60.4% women, between 18 and 96 years of the same ethnic group who consecutively attended outpatient departments of our clinics between 2000 and 2004.. BMI correlated linearly with the WC (cc: 0.85; p = 102 cm and women > = 88 cm in 94.3% of the obese, in 32.3% of overweight patients, in 3.8% of patients with BMI En este estudio hemos buscado el rango de circunferencia de cintura (WC para cada grado de índice de masa corporal (BMI, que sirva para estudios que determinen riesgos de salud. Estudiamos 2.932 pacientes (39,6% varones y 60,4% mujeres, entre 18 y 96 años del mismo grupo étnico que consecutivamente asistieron a consultas externas de nuestras clínicas entre 2000 and 2004. El BMI correlacionó linealmente con la WC (cc: 0,85; p = 102 cm y mujeres > = 88 cm la presentaban el 94,3% de los obesos, el 32,3% de los pacientes con sobrepeso y el 3,8% de pacientes con BMI < 25, el 84,3% de diabéticos y el 72,6% de pacientes sin diabetes. Elaboramos una estandarización gráfica de WC en relación con BMI y calculamos los precentiles 10, 25, 50, 75 y 90, agrupados en rangos de 2 kg/m² de BMI. Como el número de diabeticos es menor, los agrupamos en rangos de 4 kg/m². En conclusión presentamos una estandarización de la WC de pacientes atendidos en nuestra consulta de endocrinología y nutrición distribuidos en percentiles como herramienta utilizable clínicamente para definir rangos de WC para cada valor de BMI.

  2. Avaliação dos Tipos 1 e 2 de alcoolismo de Cloninger em homens participantes de um programa de tratamento ambulatorial Evaluation of Cloninger's Type I and Type II alcoholism in male alcoholics in an outpatient treatment program

    Directory of Open Access Journals (Sweden)

    Mário Sérgio Ribeiro

    2008-01-01

    Full Text Available CONTEXTO: A classificação Tipo 1/Tipo 2 de Cloninger é uma das mais estudadas tipologias de alcoolismo. OBJETIVOS: Testar a aplicabilidade dessa tipologia, caracterizar os subtipos identificados e avaliar seu comportamento ante um programa terapêutico. MÉTODOS: Partindo das variáveis descritas por Cloninger et al., 16 características de 308 homens alcoolistas tratados ambulatorialmente foram submetidas à análise de cluster para identificação de dois subgrupos (clusters. Posteriormente, efetivaram-se cruzamentos de dados para testar possível associação dos clusters identificados com variáveis demográficas e clínicas. RESULTADOS: Pacientes do cluster 1 foram caracterizados por início mais tardio dos problemas relacionados ao álcool, menos problemas sociais e maior sentimento de culpa em relação a seu consumo. O cluster 2 incluiu pacientes com história familiar de alcoolismo mais evidente, características anti-sociais mais presentes, mais uso disfuncional de outras substâncias psicoativas e piores níveis de adesão ao tratamento. CONCLUSÕES: Os resultados evidenciaram a diferenciada associação dos clusters a variáveis de tratamento e prognóstico; em sua maior parte foram coerentes com a classificação Tipo 1/Tipo 2 e reforçam a tese de que o simples diagnóstico de dependência ao álcool não é suficiente para atender às necessidades terapêuticas de subgrupos específicos de pacientes.BACKGROUND: Cloninger's Type 1/Type 2 classification is one of the most frequently studied alcoholism typologies. OBJECTIVES: To test the applicability of this typology, to characterize the identified subtypes and to evaluate their behavior in a therapeutic program. METHODS: Starting from variables described by Cloninger et al., 16 characteristics of 308 alcoholic men attending an outpatient treatment program were submitted to Cluster analysis for identification of two subgroups (clusters. Cross-tabulations were then performed to

  3. Day hospital Mentalization-based treatment versus intensive outpatient Mentalization-based treatment for patients with severe borderline personality disorder: protocol of a multicentre randomized clinical trial

    OpenAIRE

    Laurenssen, E.; Smits, M.L.; Bales, D.L.; Feenstra, D. J.; Eeren, H.V. (Hester V.); Noom, M.J.; Koster, M.A.; Lucas, Z.; Timman, R.; Dekker, J.; Luyten, Patrick; Busschbach, J.; Verheul, R.

    2014-01-01

    Background Borderline personality disorder (BPD) is associated with a high socioeconomic burden. Although a number of evidence-based treatments for BPD are currently available, they are not widely disseminated; furthermore, there is a need for more research concerning their efficacy and cost-effectiveness. Such knowledge promises to lead to more efficient use of resources, which will facilitate the effective dissemination of these costly treatments. This study focuses on the efficacy and cost...

  4. 成人神经性厌食的门诊个别心理治疗%Individual Psychotherapy in the Outpatient Treatment of Adults with Anorexia Nervosa

    Institute of Scientific and Technical Information of China (English)

    Hay P; Bacaltchuk J; Claudino A; Yong PY; Ben-Tovim D

    2004-01-01

    Objective Anorexia nervosa is a disorder of high morbidity and significant mortality. The aim of the present review was to evaluate the evidence from randomized controlled trials for the efficacy of outpatient psychotherapies used in the treatment of older adolescents ( aged > 16 years) and adults with anorexia nervosa. Methods The search strat egy comprised database searches of Medline, EXTRAMED, EMBASE, PSYCLIT, Current Contents, Cochrane Con trolled Trials Register and the Depression and Anxiety Neurosis Cochrane Group ( CCDAN), the search date was Novem ber 2002. A hand-search of The International Journal of Eating Disorders from its first issue up to March 2003, and the ref erence lists of all papers selected. Personal letters were sent to identified leading researchers published in the area, requesting information on trials that are unpublished. All randomized controlled trials of adult individual outpatient therapy for anorexia nervosa, as defined by the DSM-IV or similar international criterion, were included. Quality ratings were made according to the CCDAN criteria. A range of outcome variables were selected, including physical state, severity of eating disorder attitudes and behefs, interpersonal function, and general psychiatric symptom severity. Continuous outcome data comparisons were planned with the standardized mean difference statistic, and binary outcome comparisons planned with the relative risk statistic. Results Six small trials only, two of which included children or adolescents, were identified from the search and aggregation of data was not possible. Bias was possible due to lack of blinding of outcome assessments. The results in two trials suggested that "treatment as usual" or similar may be less efficacious than a specific psychotherapy. No specific treatment was consistently superior to any other specific approach. Dietary advice as a control arm had a 100% non-completion rate in one trial. Conclusions No specific approach can be

  5. Outpatients in Neurological Rehabilitation.

    Science.gov (United States)

    Barnes, M. P.; Skeil, D. A.

    1996-01-01

    This paper describes the multidisciplinary approach used at a neurological rehabilitation clinic in England. Analysis of questionnaire responses from outpatients indicated general support for the multidisciplinary approach, though a significant minority felt intimidated by the large number of professionals seen simultaneously. Patients also…

  6. Outcome of treatment seeking rural gamblers attending a nurse-led cognitive-behaviour therapy service: A pilot study

    Directory of Open Access Journals (Sweden)

    Barry Tolchard

    2016-03-01

    Conclusion: This study suggests that rural problem gamblers experience different levels of co-morbid anxiety and depression from their urban counterparts, but once in treatment appear to respond quicker. ACBT approach was found to be effective in treating rural gamblers and outcomes were maintained. Ensuring better availability and access to such treatment in rural areas is important. Nurses are in a position as the majority health professional in rural areas to provide such help.

  7. Infecções agudas das vias aéreas superiores: diagnóstico e tratamento ambulatorial Acute upper respiratory tract infections: outpatient diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Paulo M.C. Pitrez

    2003-06-01

    Full Text Available OBJETIVO: apresentar uma revisão atualizada sobre as infecções das vias aéreas superiores (IVAS mais comuns na prática diária de consultório do pediatra, visando a uma adequada orientação de condutas diagnósticas e terapêuticas. FONTES DOS DADOS: foram revisadas referências obtidas na base de dados Medline. Foram selecionados os artigos mais relevantes sobre o tema. SÍNTESE DOS DADOS: rinofaringite aguda, sinusite aguda, faringoamigdalite aguda estreptocócica e laringite viral aguda são apresentadas de forma crítica e sucinta. As dificuldades observadas na prática clínica, em relação ao diagnóstico diferencial de determinadas IVAS, limitações na busca do agente etiológico e o uso, muitas vezes abusivo, de antimicrobianos são analisados e discutidos. CONCLUSÕES: as IVAS são um dos motivos mais comuns de visita ao consultório do pediatra. Por isso, conceitos e informações atualizados são essenciais para que o manejo dessa doença seja otimizado, reduzindo a indicação de exames diagnósticos dispensáveis, ou a implementação de tratamentos desnecessários ou prejudiciais ao paciente.OBJECTIVE: to present an updated review of the most common upper respiratory infections (URI in children seen by the pediatrician in outpatient clinics, for better diagnostic and therapeutic decisions. SOURCES OF DATA: references from Medline database were reviewed. The most relevant articles were selected. SUMMARY OF THE FINDINGS: acute rhinopharyngitis, sinusitis, streptococcal tonsillitis and viral croup are presented in a concise and critical view. Differential and etiological diagnosis limitations and the abusive use of antimicrobials in these illnesses are also discussed. CONCLUSIONS: URI are the most common cause of visits to pediatrician clinics. Therefore, update and critical concepts, as well as references are essential for a proper management of these illnesses, decreasing the indication of unnecessary diagnostic tests and

  8. 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.

  9. 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

  10. The impact of HIV status and antiretroviral treatment on TB treatment outcomes of new tuberculosis patients attending co-located TB and ART services in South Africa: a retrospective cohort study

    OpenAIRE

    Nglazi, Mweete D; Bekker, Linda-Gail; Wood, Robin; Kaplan, Richard

    2015-01-01

    Background The implementation of collaborative TB-HIV services is challenging. We, therefore, assessed TB treatment outcomes in relation to HIV infection and antiretroviral therapy (ART) among TB patients attending a primary care service with co-located ART and TB clinics in Cape Town, South Africa. Methods In this retrospective cohort study, all new TB patients aged ≥ 15 years who registered and initiated TB treatment between 1 October 2009 and 30 June 2011 were identified from an electronic...

  11. Psychosocial and clinical predictors of retention in outpatient alcoholism treatment Preditores psicossociais e clínicos de retenção ao tratamento para alcoolismo

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    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

  12. Radioiodine therapy of differentiated thyroid cancer: radiologic impact of out-patient treatment with 100 to 150 mCi Iodine-131 activities

    International Nuclear Information System (INIS)

    Purpose: To evaluate exposure and dosimetry to family members and environment due to outpatient radioiodine therapy of differentiated thyroid carcinoma. Methods: Twenty patients were treated with 100-150 mCi of iodine-131 on an out-patient basis. Family members dosimetry (n = 27) and potential doses inside the house were measured with thermoluminescent dosimeters. Surface contamination and radioactive wastes were also monitored. Results: Less than 1.0 mSv doses were found in 26 co-habitants and 2.8 mSv in a single case (inferior to the acceptable value of 5.0 mSv/procedure). Potential doses in the houses were inferior to 0.25 mSv, excluding the patients bedroom (mean value = 0.69 mSv). Surface contamination (mean = 4.2 Bq.cm-2) were below clearance levels. Radioactive wastes generated had a volume of 2.5 liters and a total activity estimated in 90 μCi, with a calculated exposure close to the background radiation levels. Conclusions: No radiological impact was detected after iodine therapy with 100-150 mCi on an out-patient basis followed by experienced professionals. (author)

  13. Oral health status and treatment needs of hearing impaired children attending a special school in Bhimavaram, India

    Directory of Open Access Journals (Sweden)

    V Sandeep

    2016-01-01

    Study Design: The study design was a descriptive cross-sectional study. Materials and Methods: This study was conducted in November 2012 at SVS special school for deaf, Bhimavaram, India. This study involved 180 CHI of both genders, aged 6-16 years, divided into Group-I (6-8 years, Group-II (9-12 years, and Group-III (13-16 years. Oral health status and treatment needs were recorded using methods and standards recommended by the WHO for Oral Health Surveys, 1997. Dental caries prevalence (decayed, missing, and filled teeth [DMFT/dmft], gingivitis levels (Lφe, Silness Gingival Index, plaque levels (Silness, Lφe Plaque index, and treatment needs were the parameters recorded and analyzed. Statistical Analysis: Z-test for proportion, one-way analysis of variance, and Chi-square test were used to analyze the data. Results: Prevalence of dental caries in the sample was found to be 65% with a mean level of caries prevalence (DMFT of 1.6 ± 1.3 in Group-I, 1.9 ± 1.2 in Group-II, and 2.2 ± 1.2 in Group-III. About 91.7% of the total children examined needs treatment. The mean plaque and gingivitis scores of the sample were 1.70 ± 0.61 and 1.59 ± 0.58, respectively. Conclusion: These findings imply the overwhelming situation of CHI in oral health perspective. Hence, prevention-based educational and motivational programs should be targeted to this vital group to achieve adequate oral hygiene levels.

  14. Outpatient anorectal surgery.

    Science.gov (United States)

    Medwell, S J; Friend, W G

    1979-10-01

    Over a period of 16 months, three-fourths of the proctologic surgery performed by our clinic was done on an outpatient basis. By doing so, 1,200 patient visits and approximately 300 histories, physicals, and discharge summaries are eliminated, while obviously benefiting patients and reducing health care costs. Thus, we can conclude that hospitalization is not necessary for the majority of proctologic surgery patients. PMID:527434

  15. Parent-focused treatment for adolescent anorexia nervosa: a study protocol of a randomised controlled trial

    OpenAIRE

    Hughes, Elizabeth K; Le Grange, Daniel; Court, Andrew; Yeo, Michele SM; Campbell, Stephanie; Allan, Erica; Crosby, Ross D.; Loeb, Katharine L.; Sawyer, Susan M

    2014-01-01

    Background Family-based treatment is an efficacious outpatient intervention for medically stable adolescents with anorexia nervosa. Previous research suggests family-based treatment may be more effective for some families when parents and adolescents attend separate therapy sessions compared to conjoint sessions. Our service developed a novel separated model of family-based treatment, parent-focused treatment, and is undertaking a randomised controlled trial to compare parent-focused treatmen...

  16. Outpatient emergency treatment by ESWL for ureteral calculi with renal colic%门诊急诊ESWL治疗输尿管结石伴肾绞痛疗效分析

    Institute of Scientific and Technical Information of China (English)

    吕金东; 汤元杰; 张丽; 李书铃; 陶淑芬

    2013-01-01

    目的 探讨门诊急诊ESWL治疗输尿管结石伴肾绞痛的治疗效果.方法 回顾性分析2010年1月~2012年4月门诊急诊ESWL治疗输尿管结石伴肾绞痛的体外冲击波治疗的效果.结果 经1次碎石后肾绞痛缓解者715例(89.4%),经1次治疗后结石排净者660例(82.5%),经2~5次治疗后结石排净者126例(15.8%),结石总排净率为98.3%.失败14例,失败者均转入外科行肾镜输尿管镜或手术治疗.结论 门诊急诊ESWL治疗输尿管结石伴肾绞痛效果满意,是治疗输尿管结石伴肾绞痛的首选治疗手段.%OBJECTIVE To investigate outpatient emergency treatment by extracorporeal shock wave lithotripsy (ESWL) for ureteral calculi with renal colic. METHODS A retrospective analysis was made on the effect of outpatient emergency treatment by ESWL for ureteral calculi with renal colic from January, 2010 to April, 2012. RESULTS After one time of ESWL, the o-dynolysis rate and lithecbole rate were 89.4% and 82.5% respectively. The lithecbole rate after 2-5 times of ESWL was 15.8%, and the total lithecbole rate was 98.3%. 14 cases were failed, and were transferred to urinary surgery to do examins by nephro-scope or ureteroscope surgical treatment or surgical operation. CONCLUSION Outpatient emergency treatment by ESWL for ureteral calculi with renal colic is very effective, and can be the first choice for the treatment of ureteral calculi with renal colic.

  17. Implementation of cardiovascular risk factor recording in a rheumatology outpatient clinic

    OpenAIRE

    2013-01-01

    Background: The high cardiovascular (CV) risk in patients with rheumatoid arthritis (RA) is under-recognized and under-assessed in both primary and secondary health care. Our aim was to evaluate the quality of CV risk recording in rheumatology outpatient clinics and to evaluate strategies for optimizing CV risk factor screening in RA patients. Methods: RA patients (n=1142) who visited the rheumatology outpatient clinic at the Hospital of Southern Norway in 2012, either attended the regul...

  18. 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...

  19. 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

  20. Physical and Mental Factors Associated with Obesity in Individuals with Mental Disorders Attending Psychiatric Day-Care Facilities

    OpenAIRE

    Saiga, Michiko; Watanabe, Takashi; Yoshioka, Shin-ichi

    2013-01-01

    Background Individuals with mental disorders have increased rates of obesity and metabolic syndrome. Here we evaluated factors influencing obesity in individuals with mental disorders who were attending psychiatric day-care facilities on an outpatient basis. Methods The subjects (n = 108) were outpatients attending hospital-based rehabilitation programs. We assessed body fat, weight, height, waist circumference, body mass index (BMI), blood pressure, Geriatric Depression Scale-15 (GDS) scores...

  1. Oral health status and treatment needs of children and young adults attending a day centre for individuals with special health care needs

    Directory of Open Access Journals (Sweden)

    Akindayomi Yinka

    2008-10-01

    Full Text Available Abstract Background The oral health condition of individuals with special health care needs have been reported in literature to be influenced by various sociodemographic factors, including living conditions and severity of impairment. This study was carried out to determine the oral health status and treatment needs of children and young adults attending a day institution for those with special needs. Methods This study was carried out as part of an oral health screening program organized by the institution and consent was obtained from parents and guardians before the screening. All information was supplied by the parents during the screening using a questionnaire completed by the dentist. Oral examination was carried out on all consenting subjects in attendance on the days of screening in the school clinic with parents and teachers in attendance, using standard World Health Organisation oral health indices to assess dental caries, oral hygiene status, malocclusion and other oral health parameters. Results Fifty-four subjects aged 3–26 years (mean 12.28 ± 6.82 years and comprising 72.2% males and 27.8% females participated in the study. Over 90% were from parents of high and middle level educational background. Thirty-six (66.7% were caries free, with a mean dmft score of 0.7 ± 1.77 and mean DMFT score of 0.4 ± 1.44 with no significant difference across gender (p = 0.5 and parents' educational status (p = 0.43. The mean OHI-S of the total population in this study was 1.36 ± 0.16. Females had a mean score of 0.88 ± 1.10 while males had a mean score of 1.55 ± 1.24 with no significant difference (p = 0.6. Twenty-five (46.3% had good oral hygiene, 17 (31.5% had fair oral hygiene and 12 (22.2% had poor oral hygiene, with no significant difference across gender (p = 1.11 and age groups (p = 0.07. Fifteen (27.8% had gingivitis with no significant difference across age groups (p = 0.17. Forty-five (83.3% had Angle's class I malocclusion, 6

  2. Screening for mental disorders in cardiology outpatients

    DEFF Research Database (Denmark)

    Birket-Smith, M.; Rasmussen, A.

    2008-01-01

    The objective of the study was to compare the frequency of mental disorders in cardiology outpatients to the number of patients with psychological problems identified by cardiologists. In a cardiology outpatient service, 103 consecutive patients were asked to participate in the study. Of these 86...... were included and screened for mental disorder with the Primary Care Evaluation of Mental Disorders (PRIME-MD), Structured Clinical Interview for DSM-IV (SCID) psychosis screening, the Clock Drawing Test, and the WHO-5 Well-being Index. The cardiologists were asked to rate the severity of somatic and...... mental problems in each patient on visual analogue scales (VAS-som and VAS-men). The current treatments, including psychiatric and psychological treatments, were noted, and the survival was followed for 3 years. Of the 86 patients included, 34 (40%) had a diagnosis of mental disorder. Eleven (12.8%) had...

  3. Factors associated with methadone maintenance treatment retention among outpatients with drug abuse%美沙酮维持治疗门诊患者依从性影响因素分析

    Institute of Scientific and Technical Information of China (English)

    覃莎莎; 贺健梅; 丁林; 易再明; 郑军; 陈曦

    2011-01-01

    Objective To examine the factors associated with methadone maintenance treatment (MMT) retention among outpatients with drug abuse. Methods An informed consent questionnaire survey was performed among the registered outpatients of MMT clinics for collecting the basic information, including treatment status, clinical service and treatment, economic condition, social relationship,employment status and living situation. Results A total of 769 outpatients (321 cases in maintenance therapy group and 448 cases in dropout group) were interviewed for the study. Of these patients, 80.4 %are males. The mean age was 33. 98±6. 19 years and 63.7% of the outpatients had an education level of junior high school or below. The average age of initial drug-use was 24. 23±5.77 years old and the average daily dosage of methadone was 50. 65 ± 27.70 mg. There were no significant differences in gender,age, marital status, education levels, employment, age of initial drug-use, the daily dosage of heroin,the daily dosage of methadone and multiple drug abuse before treatment between the two groups. However, there were significant differences in life skill training, life satisfaction, the sources of income and family support between the two groups. The results indicated that the MMT retention was associated with age, family support, multiple drug and heroin abuse after treatment. Conclusion Family support and medical counseling are important in improving methadone maintenance treatment compliance.%目的 了解美沙酮维持治疗门诊患者依从性的影响因素.方法 以美沙酮维持治疗门诊中登记治疗的患者为调查对象,采用调查问卷的方法,收集基本情况、治疗情况、对门诊服务及维持治疗的评价、经济相关情况、社会关系、就业及生活状况6个方面的资料.结果 769名患者接受了调查,其中维持组321人,脱失组448人;男性占80.4%,年龄(33.98±6.19)岁,初中及以下程度者占63.7%;首次吸毒年龄(24

  4. Adaptation of the Patient Feedback Survey at a Community Treatment Setting

    OpenAIRE

    Kolodziej, Monika E.; Muchowski, Patrice M.; Hamdi, Nayla R.; Morrissette, Paula; Psy.D.,; McGowan, Alicen J.; Weiss, Roger D.

    2011-01-01

    The Patient Feedback Survey is a performance improvement measure designed to assess the quality of outpatient substance abuse treatment. We modified and administered this measure to 500 individuals at a multi-site treatment provider. Although the feedback scores were high in general, analyses of variance showed score variability in relation to type and length of treatment. Moreover, respondents who reported any use of marijuana, cravings for substances, or mutual-support group attendance (i.e...

  5. 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.

  6. 预控管理在治疗性门诊患者医疗安全与质量管理中的应用%Pre-control management in treatment of outpatient health care safety and quality management

    Institute of Scientific and Technical Information of China (English)

    赵淑珍; 何晓俐; 戴燕

    2012-01-01

    The Ministry of Health regarded "safety" as the primary indicators of the evaluation of hospital management in 2008. In order to adapt to the new health care reform, and to meet the needs of patients, our hospital established the first out-patient treatment center in March 2010. There were 62,710 cases of patients with treatment to the end of June 2011. There are more health care safety and quality risks because of the specificity and complexity of outpatient treatment. Our department applied modern quality management philosophy of prevention and control of management of the patient's health care safety and quality management. To date, no patient complaints, no medical accidents, we protected the patient' s medical safety and quality.%2008年卫生部将“安全”作为评价医院管理的首要指标.为了适应新的医疗体制改革,满足患者需求,我院于2010年3月在全国率先成立了门诊治疗中心.截止2011年6月底,已为62710例次患者进行诊疗.由于治疗性门诊患者的特殊性及诊疗项目的复杂性,诊疗过程存在较多的影响医疗安全与质量隐患.为此,我科应用了现代质量管理中的预控管理理念对患者的医疗安全与质量进行管理,迄今为止无一例患者投诉,无一例医疗安全事故发生,保障了患者的医疗安全与质量.

  7. 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.

  8. Inpatient or outpatient rehabilitation after herniated disc surgery? - Setting-specific preferences, participation and outcome of rehabilitation.

    Directory of Open Access Journals (Sweden)

    Margrit Löbner

    Full Text Available OBJECTIVE: To examine rehabilitation preferences, participation and determinants for the choice of a certain rehabilitation setting (inpatient vs. outpatient and setting-specific rehabilitation outcomes. METHODS: The longitudinal observational study referred to 534 consecutive disc surgery patients (18-55 years. Face-to-face baseline interviews took place about 3.6 days after disc surgery during acute hospital stay. 486 patients also participated in a follow-up interview via telephone three months later (dropout-rate: 9%. The following instruments were used: depression and anxiety (Hospital Anxiety and Depression Scale, pain intensity (numeric analog scale, health-related quality of life (Short Form 36 Health Survey, subjective prognosis of gainful employment (SPE-scale as well as questions on rehabilitation attendance, return to work, and amount of sick leave days. RESULTS: The vast majority of patients undergoing surgery for a herniated disc attended a post-hospital rehabilitation treatment program (93%. Thereby two-thirds of these patients took part in an inpatient rehabilitation program (67.9%. Physical, psychological, vocational and health-related quality of life characteristics differed widely before as well as after rehabilitation depending on the setting. Inpatient rehabilitees were significantly older, reported more pain, worse physical quality of life, more anxiety and depression and a worse subjective prognosis of gainful employment before rehabilitation. Pre-rehabilitation differences remained significant after rehabilitation. More than half of the outpatient rehabilitees (56% compared to only one third of the inpatient rehabilitees (33% returned to work three months after disc surgery (p<.001. CONCLUSION: The results suggest a "pre-selection" of patients with better health status in outpatient rehabilitation. Gaining better knowledge about setting-specific selection processes may help optimizing rehabilitation allocation procedures

  9. Structured skills training for adults with ADHD in an outpatient psychiatric context: an open feasibility trial.

    Science.gov (United States)

    Morgensterns, E; Alfredsson, J; Hirvikoski, T

    2016-06-01

    The aim of the current study was to evaluate the feasibility, acceptability, and effectiveness of Dialectical Behavioral Therapy-based skills training groups for adults with ADHD in an outpatient psychiatric context. Furthermore, the purpose was to analyze the impact of clinical characteristics on the effect and attrition. Ninety-eight adults (out of 102) with ADHD were allocated to the treatment. Self-rating scales were administered as baseline before the first session (T1), post-treatment (T2), and at 3-month follow-up (T3). Approximately 80 % (74 individuals) attended at least two-thirds of the sessions. Treatment satisfaction was good. ADHD symptoms and ADHD-related functional impairment in every-day life were reduced. Well-being, ability to be mindful, acceptance of emotions and quality of life were increased. The results were stable at 3-month follow-up. None of the predictors, i.e., age, comorbidity, ADHD medication status, IQ-level, treatment credibility, or functional impairment at the beginning of treatment, significantly predicted treatment outcome (change in ADHD symptoms from T1 to T2). Likewise, none of the predictors, i.e., irritability/aggression, comorbidity, and functional impairment, were significantly associated with attrition. Due to the difficulties in predicting treatment outcome, as well as attrition, based on clinical characteristics, broad inclusion criteria should be applied. PMID:26410823

  10. Perceived stigma among attendees of psychiatric and nonpsychiatric outpatients department in an industrial township: A comparative study

    Directory of Open Access Journals (Sweden)

    Abhishek Mahajan

    2015-01-01

    Full Text Available Introduction and Context: Stigma associated with psychiatric disorders and few somatic disorders such as sexually transmitted diseases (STDs, tuberculosis and leprosy, adversely effects treatment seeking behavior, leads to concealment, and poor compliance with treatment. In busy outpatient departments (OPDs, the issue of stigma is likely to be overlooked. Materials and Methods: We carried out a cross-sectional study collecting data on an 8-item stigma scale from patients attending psychiatry and other OPDs of a Tertiary Care Teaching Hospital in an industrial township. Information was collected by face to face interview from 400 patients attending psychiatry OPD and 401 patients attending other OPDs. Validations of the scale were done by face, content, and construct validity. Reliability was appraised by Cronbach′s alpha and Guttmann split-half coefficients. Significant differences in answers to the 8-item questionnaire were explored by Chi-square test for individual responses and Kruskal-Wallis test for difference in total stigma score. Results: Patients attending psychiatry OPD consistently gave responses indicating a greater degree of perceived stigma than those attending OPD for somatic disorders. This difference was almost 3-4 times more on most of the items (P < 0.001. Among somatic disorders, stigma was highest (even higher than psychiatric disorders among STDs, tuberculosis and leprosy patients among these and psychiatric disorders the score was almost 3 times more compared to other somatic disorders (P < 0.001. The scale demonstrated good face, content, and construct validity. Reliability was also very high with Cronbach′s alpha coefficient and Guttmann split-half reliability coefficient 0.932 and 0.901 indicating very good internal consistency of the 8-item scale. Conclusion: Stigma was higher among STD patients, tuberculosis, leprosy, and psychiatry patients as compared to patients suffering from somatic disorders. Assessment of

  11. 76 FR 72003 - Calendar Year 2011 Cost of Outpatient Medical, Dental, and Cosmetic Surgery Services Furnished by...

    Science.gov (United States)

    2011-11-21

    ... BUDGET Calendar Year 2011 Cost of Outpatient Medical, Dental, and Cosmetic Surgery Services Furnished by... the cost of outpatient medical, dental, and cosmetic surgery services furnished by military treatment... outpatient medical, dental, and cosmetic surgery services rates referenced are effective upon publication...

  12. 78 FR 62709 - Calendar Year 2013 Cost of Outpatient Medical, Dental, and Cosmetic Surgery Services Furnished by...

    Science.gov (United States)

    2013-10-22

    ... BUDGET Calendar Year 2013 Cost of Outpatient Medical, Dental, and Cosmetic Surgery Services Furnished by... the cost of outpatient medical, dental and cosmetic surgery services furnished by military treatment... Outpatient Medical, Dental, and Cosmetic Surgery rates referenced are effective upon publication of...

  13. Intensive Outpatient Cognitive Behaviour Therapy for Eating Disorder

    Directory of Open Access Journals (Sweden)

    Riccardo Dalle Grave

    2008-12-01

    Full Text Available The aim of this paper is to describe a novel model of intensive outpatient cognitive-behaviour therapy (CBT indicated for eating disorder patients who are having difficulty modifying their eating habits in response to conventional outpatient CBT. Intensive outpatient CBT is a manual based treatment derived by the CBT-Enhanced (CBT-E for eating disorders. The treatment has four features that distinguish it from the conventional outpatient CBT-E: (1 it is designed to be suitable for both adult and adolescent patients, (2 it is delivered by a multidisciplinary non-eclectic team trained in CBT, (3 there is assistance with eating, (4 there is a family therapy module for patients under the age of 18 years. Preliminary outcome of intensive outpatient CBT-E are encouraging. The treatment has been applied to 20 consecutive underweight eating disorder patients (age 18.2 ± 6.5 years; BMI 14.6 ± 1.5 kg/m2. Thirteen patients (65% concluded the treatment, five (25% were admitted at an eating disorder inpatient unit, and two (10% prematurely interrupted the treatment. Completers obtained significant weight regain and improvement of eating disorder and general psychopathology. Most of the improvements were maintained at six-month follow-up.

  14. ADHERENCIA AL TRATAMIENTO DE PACIENTES HIPERTENSOS ATENDIDOS EN ASSBASALUD ESE, MANIZALES (COLOMBIA 2011 Treatment adherence of hypertensive patients' being attended by Assbasalud ESE, Manizales (Colombia 2011

    Directory of Open Access Journals (Sweden)

    José Jaime Castaño-Castrillón

    2012-09-01

    hypertensive disease. Objective. Studying adherence to treatment concerning hypertensive patients being attended in Manizales, Colombia, by the state-run Assbasalud programme in 2011. Materials and Methods. This was a cross-sectional study involving a population of 200 hypertensive people (73.5% were female, average age was 63.76 years being attended by the state-run Assbasalud ESE, Manizales, during the second half of 2011. The Martín-Bayarre-Grau (MBG and Morisky-Green (MG questionnaires were used for evaluating the social support network, as well as the Medical Outcomes Study (MOS questionnaire. Results.45% of patients were totally adherent according to MG and 51% totally adherent according to MBG. Regarding the MOS questionnaire, 12.29 people on average were in a patient's social support network, 74.83% received emotional support, 80.45% material aid, 78.61% were involved in leisure and entertainment-related activities, 83.28% were receiving affective support and enalapril was the drug most used in treatment (17.9%, followed by verapamil (10.1%. According to the MBG questionnaire, adherence significantly depended on variables such as education (p=0.000, knowledge about the disease (p=0.032 and MOS social support questionnaire results (p=0.000. The MG questionnaire revealed very few significant relationships for treatment adherence. Conclusion. The study revealed low adherence levels associated with having a low educational level, poor knowledge regarding the disease and poor social support, thereby making it necessary that Assbasalud ESE take more effective action, especially through its healthcare personnel. The MBG questionnaire had greater consistency regarding a description of adherence than the MG questionnaire.

  15. Effect of nursing intervention on the treatment of children with acute bronchitis in the outpatient department%护理干预对门诊急性支气管炎患儿治疗效果的影响

    Institute of Scientific and Technical Information of China (English)

    尤丽亚; 朱雪凤; 朱彩勤

    2012-01-01

    目的 探讨护理干预对门诊急性支气管炎患儿临床疗效的影响.方法 将120例急性支气管炎的门诊患儿随机分为综合护理干预组60例和对照组60例.两组均进行常规治疗与护理,干预组在此基础上进行治疗、预防、保健、认知等综合护理干预.对两组临床表现、治疗效果进行评价.结果 用药后治疗效果干预组显效率达51.67%,高于对照组33.33%;总有效率干预组为81.67%,高于对照组71.67%,差异有统计学意义(x2=4.19,P<0.05).临床表现患儿的咳嗽消失、痰鸣音消失、湿啰音消失及体温降至正常的天数干预组均少于对照组,差异有统计学意义(P<0.05).结论 护理干预对门诊急性支气管炎患儿的治疗能够增强疗效,尽快缓解患儿症状,缩短病程,提高治愈率,值得在临床推广.%Objective To investigate the effects of nursing intervention on the treatment of children with acute bronchitis in the outpatient department.Methods 120 cases of children diagnosed with acute bronchitis in the outpatient department were randomly selected and divided into intervention group and control group. Both groups received routine therapy and nursing. Intervention group was treated with nursing intervention including treatment,prevention,health care,and cognition.Clinical manifestations and treatment effects were evaluated for two groups.Results Treatment effects for the intervention group was 51.67% and significantly higher than the control group (33.33% ); The total efficacy for the intervention group is significantly higher than that for the control group (81.67% vs 71.67% respectively; x2 =4.19,P <0.05).In terms of clinical manifestations,significant more patients had disappeared coughing,Wheezy phlegm,wet rales,less days for body temperature return to normal in the intervention group than in the control group (P<0.05).Conclusions Nursing intervention for acute bronchitis pediatric outpatients

  16. 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.

  17. 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…

  18. The ANTOP study: focal psychodynamic psychotherapy, cognitive-behavioural therapy, and treatment-as-usual in outpatients with anorexia nervosa - a randomized controlled trial

    OpenAIRE

    Schauenburg Henning; de Zwaan Martina; Giel Katrin E; Herzog Wolfgang; Teufel Martin; Gross Gaby; Friederich Hans-Christoph; Wild Beate; Schade-Brittinger Carmen; Schäfer Helmut; Zipfel Stephan

    2009-01-01

    Abstract Background Anorexia nervosa is a serious eating disorder leading to high morbidity and mortality as a result of both malnutrition and suicide. The seriousness of the disorder requires extensive knowledge of effective treatment options. However, evidence for treatment efficacy in this area is remarkably weak. A recent Cochrane review states that there is an urgent need for large, well-designed treatment studies for patients with anorexia nervosa. The aim of this particular multi-centr...

  19. Interpersonal Community Psychiatric Treatment for non-psychotic chronic patients and nurses in outpatient mental health care: A controlled pilot study on feasibility and effects

    NARCIS (Netherlands)

    Koekkoek, B.; Meijel, B. van; Schene, A.; Smit, A.; Kaasenbrood, A.; Hutschemaekers, G.

    2011-01-01

    In psychiatric care professionals perceive some patients as 'difficult', especially patients with long-term non-psychotic disorders. For these patients few evidence-based treatments exist. An intervention program, Interpersonal Community Psychiatric Treatment (ICPT), was developed by the authors. It

  20. Physical exercise as a supplement to outpatient treatment of alcohol use disorders – design and preliminary results of a randomized controlled trial

    DEFF Research Database (Denmark)

    Sari, Sengül; Bilberg, Randi Marie; Roessler, Kirsten Kaya

    Background and aim Alcohol use disorder is a widespread problem in Denmark and has severe impacts on health and quality of life of each individual. The clinical treatment of alcohol use disorder involves evidence-based knowledge on medical treatment, physical training, and psychological management....... The aim of this study is to investigate the effect of physical exercise on alcohol intake, cardio-respiratory fitness and socio-psychological outcomes. Methods and design The study is a randomized controlled trial with three arms: (A) Standard treatment alone, (B) Standard treatment and physical...... exercise in groups, or (C) Standard treatment and physical exercise on an individual basis. The patients will fill a questionnaire and they will be tested at baseline, and after 6 and 12 months. Results At the end of March 2014 we expect to analyse the first baseline data and follow up data. Here, we will...

  1. 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…

  2. Brinquedo terapêutico no preparo da criança para punção venosa ambulatorial: percepção dos pais e acompanhantes El juego terapéutico en la preparación del niño para una punción venosa en ambulatorio: percepción de los padres y acompañantes Therapeutic play when preparing the child for venipuncture outpatient: perception from the parents and attendants

    Directory of Open Access Journals (Sweden)

    Caroline Monteiro Conceição

    2011-06-01

    ambulatorios y en unidades básicas de salud.This qualitative descriptive study aimed to understand the perception from the parents and attendants about the use of Therapeutic Play when preparing their children for venipuncture, followed by blood collection. This study was performed in an outpatient clinic in the city of Sao Paulo. Data were collected using semi-structured interviews, conducted with eight parents of children who had been prepared with the play for the blood collection. These data were subsequently submitted to qualitative content analysis. Results showed that parents approved this preparation strategy and considered it to promote knowledge about the procedure, reduce the fear, have a soothing effect, and increase parents' and child's sense of security, in addition to this, it contributes to a humanized nursing care for the child and family. Finally, the importance of implementing the Therapeutic Play in child care provided in outpatient clinics and basic health units should be emphasized.

  3. 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...

  4. 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...

  5. Outpatient treatment of alcohol use disorders among subjects 60+ years: design of a randomized clinical trial conducted in three countries (Elderly Study)

    OpenAIRE

    Andersen, Kjeld; Bogenschutz, Michael P.; Bühringer, Gerhard; Behrendt, Silke; Bilberg, Randi; BRAUN, BARBARA; Ekstrøm, Claus Thorn; Forcehimes, Alyssa; Lizarraga, Christine; Moyers, Theresa B.; Nielsen, Anette Søgaard

    2015-01-01

    Background The proportion of 60+ years with excessive alcohol intake varies in western countries between 6–16 % among men and 2–7 % among women. Specific events related to aging (e.g. loss of job, physical and mental capacity, or spouse) may contribute to onset or continuation of alcohol use disorders (AUD). We present the rationale and design of a multisite, multinational AUD treatment study for subjects aged 60+ years. Methods/Design 1,000 subjects seeking treatment for AUD according to DSM...

  6. Student Attendance Accounting Manual.

    Science.gov (United States)

    Freitas, Joseph M.

    In response to state legislation authorizing procedures for changes in academic calendars and measurement of student workload in California community colleges, this manual from the Chancellor's Office provides guidelines for student attendance accounting. Chapter 1 explains general items such as the academic calendar, admissions policies, student…

  7. 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.

  8. Description of an outpatient psychiatric population in a youthful offender's prison.

    Science.gov (United States)

    Kemph, J P; Braley, R O; Ciotola, P V

    1997-01-01

    Prisons are receiving increased numbers of inmates with mental and emotional problems. This study describes some of the characteristics and treatment of such an outpatient population. It was determined that a typical patient is a white male, 19 years old, of average intelligence, with a sporadic work record and poor academic performance, who quits high school in his freshman year. He has a history of substance abuse and is likely to have a multidrug habit. He is likely to have had a traumatic childhood and had psychiatric treatment as a child or young adolescent, as well as having attended special classes in school and counseling for drug abuse. The great majority of patients were diagnosed as having either mood, adjustment, or psychotic disorders. All were treated with a psychotropic medication and case management and also with some type of accepted individual and/or group counseling. In this population, there is a high incidence of expression of aggression requiring medication and counseling with the patient's permission. Patients responded well to treatment, but usually requested to discontinue treatment when symptoms diminished. However, approximately half of them returned for medication when symptoms recurred. PMID:9213287

  9. Gamma-glutamyltransferase, aspartate aminotransferase and alkaline phosphatase as markers of alcohol consumption in out-patient alcoholics

    DEFF Research Database (Denmark)

    Gluud, C; Andersen, I; Dietrichson, O;

    1981-01-01

    Serum activity of gamma-glutamyltransferase, aspartate aminotransferase and alkaline phosphatase were determined in 316 patients attending an out-patients clinic for treatment of alcoholism. The activity of gamma-glutamyltransferase was raised in 34% and that of aspartate aminotransferase and...... alkaline phosphatase in 18% and 7%. Neither the activity of gamma-glutamyltransferase, aspartate aminotransferase nor alkaline phosphatase showed any significant (P greater than 0.05) correlation with the history of alcohol consumption. The activities of gamma-glutamyltransferase and aspartate...... aminotransferase were raised significantly more often in patients with recent alcohol consumption than in patients who had abstained for more than 9 days. The concentration of alkaline phosphatase was not significantly (P greater than 0.05) different in these groups. The predictive value of raised and normal...

  10. Aumento da procura de tratamento por usuários de crack em dois ambulatórios na cidade de São Paulo: nos anos de 1990 a 1993 Increase in crack users attending treatment services in São Paulo: 1990-1993

    Directory of Open Access Journals (Sweden)

    C.P. Ferri

    1997-03-01

    Full Text Available Nos últimos anos tem sido observado aumento do uso de crack (uma forma de cocaína fumada em pesquisas epidemiológicas e em apreensões policiais. Até o presente, não havia dados brasileiros relacionando a procura de tratamento para a dependência de cocaína com as vias habituais de administração OBJETIVO. Analisar as modificações das vias de administração da cocaína em uma população de 245 pacientes atendidos em dois serviços ambulatoriais especializados (PROAD e UDED, na cidade de São Paulo, entre os anos de 1990 e 1993. MÉTODOS. Dados de entrevistas padronizadas realizadas na admissão dos pacientes aos serviços foram estudados e determinada a prevalência de uso das diferentes vias de administração de cocaína. RESULTADOS. A percentagem de pacientes que relataram uso de cocaína fumada (crack aumentou de 17%, em 1990, para 64%, em 1993 (pAn increase in crack use has been detected in epidemiological research and police data. Currently, in Brazil, no data are available linking the route of administration and attendance to treatment for cocaine dependence OBJECTIVE - The purpose of this paper was to analyze the changes in cocaine routes of administration in a cocaine dependent population treated in two outpatient public services (PROAD and UDED. METHOD - Standardized interview data, collected at admission to treatment were compared from 1990 to 1993. The prevalence rates of smoked ("crack", injected and snorted cocaine were compared. RESULTS - The percentage of patients who reported "crack" cocaine use increased from 17% in 1990 to 64% in 1993 (p<0.01 The prevalence of snorted cocaine remained stable in the period of time analyzed, being the most frequent route reported. The intravenous route tended to decrease from 40% in 1990 to 28% in 1993. CONCLUSION - The implications of the increase of "crack" cocaine users who sought treatment are discussed. These data are important in planning prevention and treatment strategies

  11. 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.

  12. Outpatient pulmonary rehabilitation – rehabilitation models and shortcomings in outpatient aftercare

    Directory of Open Access Journals (Sweden)

    Dietl, Markus

    2010-01-01

    Full Text Available Background: The chronic obstructive pulmonary disease (COPD and the bronchial asthma are widespread diseases. They need long-lasting and sustainable rehabilitation. Objectives: The goal of this HTA is to describe the present supply and the economic relevance of out-patient pulmonary rehabilitation in conjunction with its social aspects. A further target is to derivate options for actions in the health-care system and possible research necessities. Methods: Relevant publications are identified by means of a structured search in 37 database accessed through the German Institute of Medical Documentation and Information (DIMDI. In addition a manual search of identified reference lists has been done. The present report includes German and English literature published from 2004 to 2009. The methodological quality was assessed by two independent researchers according to pre-defined quality criteria of evidence based medicine. Results: Among 860 publications 31 medical studies, four economic studies and 13 ethical studies meet the inclusion criteria. The studies cover rehabilitation programmes in 19 countries. The majority of them has a high level of evidence (1A to 2C. The pulmonary rehabilitation programmes differ by the setting (in-patient, out-patient, in-home, community-based, by the length of intervention (from two weeks to 36 months, by the way and the frequency of intervention and by the duration of the follow-up treatment. Overall out-patient rehabilitation programmes achieve the same positive effects for COPD patients as in-patient programmes do. This is especially true for physical performance and health related quality of life. There are only a few studies dealing with asthma. Therefore, valid statements cannot be given. The results for cost-effectiveness are not distinct enough. Discussion: Goals of pulmonary rehabilitation like prevention and adequate treatment of acute exacerbations, the minimisation of hospitalisation and the reduction

  13. The evolution of arsenic in the treatment of acute promyelocytic leukemia and other myeloid neoplasms: Moving toward an effective oral, outpatient therapy.

    Science.gov (United States)

    Falchi, Lorenzo; Verstovsek, Srdan; Ravandi-Kashani, Farhad; Kantarjian, Hagop M

    2016-04-15

    The therapeutic potential of arsenic derivatives has long been recognized and was recently rediscovered in modern literature. Early studies demonstrated impressive activity of this compound in patients with relapsed acute promyelocytic leukemia (APL). Over the last 2 decades, intravenous arsenic trioxide has been used successfully, both alone and in combination with other agents, for the treatment of APL and, with some success, of other myeloid neoplasms. Arsenic trioxide is currently part the standard of care for patients with APL. More recently, oral formulations of this compound have been developed and are entering clinical practice. In this review, the authors discuss the evolution of arsenic in the treatment of APL and other myeloid neoplasms. Cancer 2016;122:1160-8. © 2015 American Cancer Society. PMID:26716387

  14. A chance for change : building an outcome monitoring feedback system for outpatient mental health care

    NARCIS (Netherlands)

    Jong, Kim de

    2012-01-01

    The principal aim of this thesis was to develop an outcome monitoring feedback model for Dutch outpatient mental health care in the Netherlands and to test whether providing feedback to therapists and patients can improve treatment outcomes. Data on patient progress collected in outpatient centers i

  15. PENANGANAN BALITA GIZI BURUK SECARA RAWAT JALAN DI PUSKESMAS DENGAN PEMBERIAN MAKANAN TERAPI : FORMULA-100 DAN READY TO USE THERAPEUTIC FOOD (OUT-PATIENT TREATMENT OF SEVERE MALNOURISHED CHILDREN AT HEALTH CENTER WITH THERAPEUTIC FOOD : FORMULA-100 AND RE

    Directory of Open Access Journals (Sweden)

    Astuti Lamid

    2012-12-01

    Full Text Available ABSTRACT The study of outpatient treatment of severe malnourished children with therapeutic food: Formula-100 (F-100 and Ready To Use Therapeutic Food (RUTF had been conducted. The purpose was to optimize the growth of severe malnourished children. Formula-100, milk-based, has been used in health centers. While RUTF, lipid based, has been widely used to improve the nutritional status of severe malnourished children in African countries. The design of this study was quasi experiment and located in ten health centers in Bogor and Subang Regency. Samples were severe malnutrition children, aged 10-54 months with Weight (W / Height (H indicator <-3,0 Z-scores or W/H <-2,0 Z-scores with clinical signs of severe malnutrition. There were two treatment groups: F-100 and RUTF which were given to 39 children in each group for 6 weeks. Data collected were anthropometric, consumption of nutrients, diseases and socio-economics aspects, then data were analyzed using t test. Result showed that before treatment the mean of W/H both groups were <-3,0 Z-scores which catagorized as severe wasted, while after treatment the mean became >-3,0 Z-scores which was catagorized wasted. The improvement of nutritional status (W/H between the RUTF and F-100 group were not significantly different (p>0,05. Almost all of nutrients consumption in both groups fulfilled the recommended dietary allowances, and the nutrient adequancy in both groups were not significantly different after treatment (p>0,05. Therefore RUTF can be used as alternative of F-100. The advantages of RUTF were lower price and containedmore vitamines and minerals compared to F-100. Keywords: malnutrition, wasted, outpatient, Ready to Use Therapeutic Food ABSTRAK Penelitian penanganan balita gizi buruk secara rawat jalan di Puskesmas dengan pemberian makanan terapi Formula-100 (F-100 dan Ready to Use Therapeutic Food (RUTF telah dilakukan. Tujuannya adalah untuk mengoptimalkan pertumbuhan balita gizi buruk

  16. Basic Stand Alone Medicare Outpatient Procedures PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — This release contains the Basic Stand Alone (BSA) Outpatient Procedures Public Use Files (PUF) with information from Medicare outpatient claims. The CMS BSA...

  17. Hospital Outpatient Prospective Payment System (OPPS) Lim...

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Outpatient Prospective Payment System (OPPS) Limited Data Set This file contains select claim level data and is derived from 2010 hospital outpatient PPS...

  18. Clostridium difficile Infection in Outpatients

    Centers for Disease Control (CDC) Podcasts

    2011-11-07

    Dr. Jon Mark Hirshon, Associate Professor of Emergency Medicine at the University of Maryland School of Medicine, discusses Clostridium difficile infection in outpatients.  Created: 11/7/2011 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 11/21/2011.

  19. Is outpatient robotic pyeloplasty feasible?

    Science.gov (United States)

    Finkelstein, Julia B; Van Batavia, Jason P; Casale, Pasquale

    2016-09-01

    With increased experience, many laparoscopic procedures have evolved from mandatory same-day admission to the outpatient setting. Given the shorter operative time and length of stay, the potential to perform robotic surgery as an outpatient procedure exists. We sought to describe our initial experience with performing robotic-assisted laparoscopic pyeloplasty (RP) on children in an outpatient setting. We retrospectively reviewed a prospectively collected database of all patients undergoing RP from July 2012 to May 2014 by a single surgeon. All patients discharged home within 12 h of completion of surgery were included in the analysis. Prior to discharge the Wong-Baker Pain Scale 1-10 was reviewed and given to all patients. All patients were prescribed oxybutynin and phenazopyridine for bladder spasms and stent discomfort. Post-operative follow-up telephone calls were made inquiring about oral intake, pain control, constitutional symptoms, and voiding issues. Readmission rates and post-operative outcomes were reviewed. During the study period, 62 children underwent RP and 13 patients (21 %) were selected for outpatient management. These 7 boys and 6 girls had a mean age of 8.1 years old. Of the 13 patients, 11 patients had left-sided procedures and 2 had right; all had primary UPJO. Mean pain score was 2.7 in the first 12 h at home. Within 24 h, the pain score decreased to a mean of 2.2. No patient required opioid analgesics and no child required admission after surgery. At 3-month follow-up, 7 patients had resolved hydronephrosis, 5 had improved hydronephrosis and 1 was unchanged. MAG3 renal scan in the latter patient showed no sign of obstruction. Outpatient RP is feasible and appears to be safe. Great care must be taken when selecting which patients can be fast tracked. PMID:27026272

  20. EXPECTATION SCHOOL ATTENDANCE

    OpenAIRE

    BURGSTALLEROVÁ, Kateřina

    2011-01-01

    In a theoretical part of this work I will map on the basis of work with qoalifications literature the problem of inauguaration school attendance. Describ pre-school child from the porspective of development psychology, will mention posibility of adaptions problems.I will also try to quylify the diference between primary and preprimary education, and conception in document of education program. In practical part I will with aid of quality interview to find out, how is the expectation of future...

  1. 42 CFR 419.21 - Hospital outpatient services subject to the outpatient prospective payment system.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Hospital outpatient services subject to the... FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES Categories of Hospitals and Services Subject to and Excluded From the Hospital Outpatient Prospective Payment System § 419.21 Hospital outpatient...

  2. Children stomatology outpatient treatment requirements analysis and countermeasures%儿童口腔科门诊治疗需求特征分析及对策

    Institute of Scientific and Technical Information of China (English)

    夏斌; 秦满; 韩烨; 张笋

    2013-01-01

    To assess dental treatment needs and oral health status among children under 18-year-old in Beijing and to examine how these are affected by age, gender. Methods: In the retrospective study, 3 148 children aged 0. 8 -18. 0 years were selected from patients who first visit the Department of Paediatric Dentistry, Peking University School and Hospital of Stomatology, from May 2010 to January 2011. The treatment needs were evaluated and analysed. Results: Mean age of the group was 6. 23 ± 3.46, median was 5.0, and 52.4% (1 649/3 148) were boys. The percentages of treatment need for caries, pulptis and periapical periodontitis, teeth developmental abnormality, dental injury space management, periodontal disease, non carious disease and others were 35. 1% (1 105/3 148), 32. 2% (1013/3 148), 11.5% (363/3 148) and 6. 7% (212/3 148), 2.0% (62/3 148), 1. 3% (41/ 3 148), 0.1% (2/3 148) and 2. 2% (69/3 148) respectively. 3.6% (112/3 148) children suffered toothache and need an emergency dental treatment. In 1 602 children under 6-year-old, 55. 2% (884/ 1 602) were diagnosed as severe early childhood caries. Only 8.9% (281/3 148) children were found to need no treatment, who just asked a regular dental examine. Conclusion: Systematic implementation of preventive oral care and community-oriented health programmers for children, especially preschool-aged children, are urgently needed in China.%目的:回顾性分析到北京大学口腔医院儿童口腔科就诊的初诊患者的主诉和治疗需求,发现其特点并提出相应对策.方法:选择在2010年5月到2011年1月到北京大学口腔医院儿童口腔科就诊的3 148名患者作为研究对象,记录患者的年龄、性别、主诉、主要疾病诊断等信息.结果:患者的年龄为0.8 ~18.0岁,中位数为5.0岁,平均(6.23±3.46)岁,其中男1 649例(52.4%,1 649/3 148),女1 499例(47.6%,1 499/3148).按主要疾病诊断分类为:龋病1 105例(35.1%,1 105/3 148),牙髓根尖周病1 013例(32.2

  3. 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.

  4. Craving decrease with topiramate in outpatient treatment for cocaine dependence: an open label trial Diminuição da fissura com topiramato no tratamento ambulatorial para dependência de cocaína: um ensaio clínico aberto

    OpenAIRE

    Alessandra Diehl Reis; Luiz André Castro; Roberta Faria; Ronaldo Laranjeira

    2008-01-01

    OBJECTIVE: To evaluate anticraving action and tolerability of topiramate in cocaine user treatment. METHOD: Male users of inhaled cocaine which met criteria for cocaine dependence (Diagnostic and Statistical Manual of Mental Disorders, fourth edition) were selected for outpatient 12-week, open label trial with topiramate; individual dosage ranged between 25-300 mg/day. Main clinical variables were abstinence rate, craving intensity, frequency and duration, adherence, dropouts, side effects an...

  5. Lab Attendance and Academic Performance

    OpenAIRE

    Kirk Adair; Swinton, Omari H

    2012-01-01

    The benefits from attendance of lectures have been established in the literature. This paper focuses on attendance not of the lecture, but of smaller labs. These labs are 50 minutes one-day-a-week sessions to emphasis material covered during lecture. Using a 200-student Principles of Economics class that covers microeconomics with six different labs, we investigate the effect of lab attendance on exam performance by taking into account individual characteristics. We find that lab attendance b...

  6. Does class attendance still matter?

    OpenAIRE

    Abel Nyamapfene

    2010-01-01

    This paper presents a study on the impact of class attendance on academic performance in a second year Electronics Engineering course module with online notes and no mandatory class attendance policy. The study shows that class attendance is highly correlated to academic performance, despite the availability of online class notes. In addition, there is significant correlation between class attendance and non-class contact with the lecturer and between student performance in the first year of ...

  7. Cohesion to the Group and Its Association with Attendance and Early Treatment Response in an Adult Day-Hospital Program for Eating Disorders: A Preliminary Clinical Investigation

    Science.gov (United States)

    Crino, Natalie; Djokvucic, Ivana

    2010-01-01

    Treatment outcome studies demonstrate that day-hospital programs are effective in the treatment of eating disorders. Few descriptions are available on the specifics of treatment, particularly the process of therapy. The group therapy modality is thought to provide important therapeutic benefits. The present study aimed to examine the association…

  8. 智慧服务理念在门诊破伤风抗毒素治疗流程中的应用%Wisdom services concept in the outpatient treatment process of TAT

    Institute of Scientific and Technical Information of China (English)

    闻亚军; 王娟; 梅云霞; 王哓凤

    2011-01-01

    目的 探讨智慧服务理念对提高门诊患者TAT治疗的依从性, 减少患者因超过观察皮试结果时间而需重新皮试引起的痛苦及人为地延长注射时间.方法 选择门诊TAT治疗患者50例作为研究对象, 随机分为观察组和对照组各25例.观察组引用智慧服务理念向患者讲述TAT的相关知识,让患者详细了解TAT治疗的流程、用药须知、局部反应、脱敏疗法等注意事项;对照组按照护理常规护理.结果 观察组患者在观察区内休息的依从性明显增加;因没有及时观察皮试结果而需要重新皮试的现象明显减少.结论 智慧服务能调动患者的积极性,主动参与配合,提高护士的工作效率和患者的满意度,对预防医疗纠纷和事故的发生, 保障患者的医疗安全具有显著的意义.%Objective To know the effects of wisdom services on improving patient compliance with TAT treatment and avoiding skin test once more due to missed observation in time.Methods 50 outpatients with TAT treatment were recruited in this study. They were randomly divided into the observation group and the control group, 25 patients respectively. We quoted the wisdom service idea to the patients in the observation group, let the patients know about TAT in medication notices, treatment procedure, local response, desensitization therapy. As for the patients in control group, we did according to conventional nursing. Results The compliance of patients in observation group increased obviously. The number of patients in observation group who needed to receive skin test again was obviously fewer than that in the control group. Conclusion Wisdom services can mobilize the patients who could participate in the treatment with enthusiasm, improve the efficiency of nursing work and patient satisfaction, avoid medical disputes and protect the patients.

  9. RATIONAL THERAPY OF OSTEOARTHRITIS IN OUTPATIENT CONDITIONS

    Directory of Open Access Journals (Sweden)

    E. E. Savelova

    2012-01-01

    Full Text Available Aim. To evaluate in the comparative aspect of the symptomatic effectiveness of therapy chondroitin sulfate and it’s combination with glucosamine hydrochloride in patients with osteoarthritis in outpatient conditions and determine the most rational scheme of the treatment.Materials and methods. 65 patients with osteoarthritis of the knee and hip joints, of which 35 were chondroitin sulfate and 30 – chondroitin sulfate in combination with glucosamine hydrochloride according to the scheme in the course of 3 months. Additionally carried out x-ray and ultrasound study of the affected joints.Results. The use of these drugs has led to the reduction of pain, the improvement of function of joints and quality of life of patients, whichallowed to reduce the need for receiving nonsteroidal anti-inflammatory drugs.Conclusion. In the outpatient setting can be applied widely chondroitin sulfate in combination with glucosamine hydrochloride, in connection with higher efficiency and lower cost.

  10. RATIONAL THERAPY OF OSTEOARTHRITIS IN OUTPATIENT CONDITIONS

    Directory of Open Access Journals (Sweden)

    E. E. Savelova

    2014-07-01

    Full Text Available Aim. To evaluate in the comparative aspect of the symptomatic effectiveness of therapy chondroitin sulfate and it’s combination with glucosamine hydrochloride in patients with osteoarthritis in outpatient conditions and determine the most rational scheme of the treatment.Materials and methods. 65 patients with osteoarthritis of the knee and hip joints, of which 35 were chondroitin sulfate and 30 – chondroitin sulfate in combination with glucosamine hydrochloride according to the scheme in the course of 3 months. Additionally carried out x-ray and ultrasound study of the affected joints.Results. The use of these drugs has led to the reduction of pain, the improvement of function of joints and quality of life of patients, whichallowed to reduce the need for receiving nonsteroidal anti-inflammatory drugs.Conclusion. In the outpatient setting can be applied widely chondroitin sulfate in combination with glucosamine hydrochloride, in connection with higher efficiency and lower cost.

  11. [Controlling in outpatient radiology].

    Science.gov (United States)

    Baum, T

    2015-12-01

    Radiology is among the medical disciplines which require the highest investment costs in the healthcare system. The need to design efficient workflows to ensure maximum utilization of the equipment has long been known. In order to be able to establish a sound financial plan prior to a project or equipment purchase, the costs of an examination have to be broken down by modality and compared with the reimbursement rates. Obviously, the same holds true for operative decisions when scarce human resources have to be allocated. It is the task of controlling to review the economic viability of the different modalities and ideally, the results are incorporated into the management decision-making processes. The main section of this article looks at the recognition and allocation of direct and indirect costs in a medical center (Medizinisches Versorgungszentrum - MVZ) in the German North Rhine region. The profit contribution of each examination is determined by deducting the costs from the income generated by the treatment of patients with either private or statutory health insurance. PMID:26538134

  12. Blood cultures in ambulatory outpatients

    Directory of Open Access Journals (Sweden)

    Laupland Kevin B

    2005-05-01

    Full Text Available Abstract Background Blood cultures are a gold standard specific test for diagnosing many infections. However, the low yield may limit their usefulness, particularly in low-risk populations. This study was conducted to assess the utility of blood cultures drawn from ambulatory outpatients. Methods Blood cultures drawn at community-based collection sites in the Calgary Health Region (population 1 million in 2001 and 2002 were included in this study. These patients were analyzed by linkages to acute care health care databases for utilization of acute care facilities within 2 weeks of blood culture draw. Results 3102 sets of cultures were drawn from 1732 ambulatory outpatients (annual rate = 89.4 per 100,000 population. Significant isolates were identified from 73 (2.4% sets of cultures from 51 patients, including Escherichia coli in 18 (35% and seven (14% each of Staphylococcus aureus and Streptococcus pneumoniae. Compared to patients with negative cultures, those with positive cultures were older (mean 49.6 vs. 40.1 years, p Conclusion Blood cultures drawn in outpatient settings are uncommonly positive, but may define patients for increased intensity of therapy. Strategies to reduce utilization without excluding patients with positive cultures need to be developed for this patient population.

  13. Patterns of Attendance of Children Under 12 Years at School Dental Service in Western Australia

    OpenAIRE

    Lam, SPL; Baros, H; O’Grady, MJ; Kendall, GE; Messer, LB; Slack-Smith, LM

    2012-01-01

    The aim of this study was to investigate the patterns of attendance at School Dental Service (SDS) and reasons for attendance (treatment or prevention) for children in the Perth Metropolitan Area, in particular investigating the first year of SDS attendance and attendance until the year the child turned 12. The first 150 SDS records located for children from the Western Australian Pregnancy Cohort (Raine) Study were used for this study. Patterns of attendance of children at SDS were described...

  14. 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.

  15. PHARMACOECONOMIC ANALYSIS OF OUTPATIENT COMBINED THERAPY OF ARTERIAL HYPERTENSION AND HYPERCHOLESTEROLEMIA

    OpenAIRE

    Egorova, E.; Okonenko, L.; Bondarenko, O.

    2011-01-01

    Pharmacoeconomic analysis of outpatient therapy for patients with diagnosis of arterial hypertension (AH) and hypercholesterolemia has been carried out. Result of treatment is estimated by reducing risk of cardiovascular death.

  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. 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

  18. A chance for change: building an outcome monitoring feedback system for outpatient mental health care

    OpenAIRE

    de Jong, Kim

    2012-01-01

    The principal aim of this thesis was to develop an outcome monitoring feedback model for Dutch outpatient mental health care in the Netherlands and to test whether providing feedback to therapists and patients can improve treatment outcomes. Data on patient progress collected in outpatient centers in the Netherlands were used to predict the functioning of patients at the end of treatment and the rate of change. In addition, two feedback studies were conducted. In the first study the effect of...

  19. Successful outpatient management of pelvic actinomycosis by ceftriaxone: a report of three cases

    Directory of Open Access Journals (Sweden)

    Eda Demir Onal

    2009-10-01

    Full Text Available Pelvic actinomycosis is a chronic granulomatous suppurative disease caused by actinomyces israeli. Intravenous penicillin is the preferred antimicrobial but it requires hospitalization up to one month. An outpatient treatment strategy would be cost effective and a good choice for patients. Here we present three cases in which intramuscular ceftriaxone was successfully used in the outpatient settings following surgery and IV penicillin treatment in the hospital.

  20. Outpatient cervical and lumbar spine surgery is feasible and safe: A consecutive single center series of 1449 patients

    OpenAIRE

    Helseth, Øystein; Lied, Bjarne Lidvar; Halvorsen, Charlotte Marie; Ekseth, Kåre; Helseth, Eirik

    2015-01-01

    BACKGROUND: There is an increasing demand for surgery of degenerative spinal disease. Limited healthcare resources draw attention to the need for cost-effective treatments. Outpatient surgery, when safe and feasible, is more cost effective than inpatient surgery. OBJECTIVE: To study types and rates of complications after outpatient lumbar and cervical spine decompressions. METHODS: Complications were recorded prospectively in 1449 (1073 lumbar, 376 cervical) outpatients undergoing micro...

  1. Problems of the oncology outpatient: role of the liaison health visitor.

    OpenAIRE

    Trotter, J M; Scott, R.; MacBeth, F. R.; McVie, J.G.; Calman, K. C.

    1981-01-01

    A survey by a liaison health visitor of outpatients attending an oncology department has identified and enumerated the principal problems with which she is confronted, and defined her role. The main medical symptoms of concern to the patient at home and needing attention by the liaison health visitor were anorexia, nausea, vomiting, and constipation: inadequate pain control due to poor drug compliance was also common. Other functions of the liaison health visitor include providing nursing aid...

  2. [Respiratory tract infections in children treated on an outpatient basis for a year].

    Science.gov (United States)

    Karkowski, M K

    1993-09-01

    On the basis of doctor's work record an analysis was done of respiratory tract diseases in children treated in the Paediatric Division of the Regional outpatient Clinic of the Railway Health Service in Elblag in 1991. Respiratory tract infections accounted for 24.17% attendance (255.42% in July and 53.62% in March). Despite periodicity, high morbidity persisted over the whole year. PMID:7975596

  3. PSYCHOLOGY OF FLIGHT ATTENDANT'S PROFESSION

    OpenAIRE

    Tatyana V. Filipieva

    2012-01-01

    The profession of a flight attendant appeared in aviation in the 1920s. Professional community of flight attendants is constantly growing with the growth of complexity of aviation technology, professional standards of passenger service and safety. The psychological scientific research was carried out by a psychologist who worked as a flight attendant. The study revealed the psychological content, demands, peculiarities in cabin crews' labor. A job description was accomplished. Temporal and sp...

  4. Attendance Policies, Student Attendance, and Instructor Verbal Aggressiveness

    Science.gov (United States)

    Snyder, Jason; Forbus, Robert; Cistulli, Mark

    2012-01-01

    The authors utilized an experimental design across six sections of a managerial communications course (N = 173) to test the impact of instructor verbal aggressiveness and class attendance policies on student class attendance. The experimental group received a policy based on the principle of social proof (R. B. Cialdini, 2001), which indicated…

  5. [Efficacy of Levofloxacin Hydrate in Febrile Neutropenia for Outpatient Chemotherapy].

    Science.gov (United States)

    Inagaki, Manato; Sato, Junya; Nihei, Satoru; Kashiwaba, Masahiro; Kudo, Kenzo

    2016-05-01

    Management of febrile neutropenia (FN) is important for the safety of patients undergoing outpatient chemotherapy. Oral antimicrobials are usually prescribed as the initial treatment for FN, and outpatients are instructed to begin medication prior to chemotherapy. However, the effectiveness and safety of the use of these oral antibiotics have not yet been established. In this study, we investigated the effectiveness and safety of levofloxacin hydrate (LVFX) for breast cancer patients with FN, and the factors associated with the onset of FN in 134 breast cancer patients who underwent chemotherapy including the anticancer drug anthracycline (total, 513 courses), in an outpatient chemotherapy department. The effectiveness and safety of LVFX were defined respectively as defervescence within 5 days, and the appearance of side effects such as diarrhea and rashes. Fever was observed in 89 (66%) of the 134 patients, and during 164 (32%) of 513 courses. Defervescence was observed with the LVFX medication in 149 (93%) of 160 courses. The primary side effect was the development of rashes, and only 2 (1%) of the 160 courses were discontinued. Onset of stomatitis during chemotherapy was observed as a factor of FN (odds ratio: 1.36, p<0.05). Our results suggest that the use of LVFX according to the patients' discretion might be an effective and safe option for the management of FN during outpatient chemotherapy. PMID:27210089

  6. Patient Satisfaction in Malaysia’s Busiest Outpatient Medical Care

    Directory of Open Access Journals (Sweden)

    Kurubaran Ganasegeran

    2015-01-01

    Full Text Available This study aimed to explore factors associated with patient satisfaction of outpatient medical care in Malaysia. A cross-sectional exit survey was conducted among 340 outpatients aged between 13 and 80 years after successful clinical consultations and treatment acquirements using convenience sampling at the outpatient medical care of Tengku Ampuan Rahimah Hospital (HTAR, Malaysia, being the country’s busiest medical outpatient facility. A survey that consisted of sociodemography, socioeconomic, and health characteristics and the validated Short-Form Patient Satisfaction Questionnaire (PSQ-18 scale were used. Patient satisfaction was the highest in terms of service factors or tangible priorities, particularly “technical quality” and “accessibility and convenience,” but satisfaction was low in terms of service orientation of doctors, particularly the “time spent with doctor,” “interpersonal manners,” and “communication” during consultations. Gender, income level, and purpose of visit to the clinic were important correlates of patient satisfaction. Effort to improve service orientation among doctors through periodical professional development programs at hospital and national level is essential to boost the country’s health service satisfaction.

  7. The use of positive reinforcement in conditioning attending behavior.

    Science.gov (United States)

    Walker, H M; Buckley, N K

    1968-01-01

    Individual conditioning techniques were applied in a controlled setting to increase attending behavior of an underachieving 9-yr-old male subject. The procedure involved: (1) determining a stable response pattern, (2) introducing a treatment variable to establish a high rate of task-attending behavior, (3) measuring the effect of withdrawal of the treatment variable after attaining criterion performance, and (4) transferring control to the classroom. The interval of attending behavior required for reinforcement was systematically increased from 30 sec to 600 sec as the behavior came under experimental control. Manipulating the reinforcing contingencies measurably changed the proportion of attending behavior and the frequency and duration of non-attending events. Once the behaviors were under experimental control, procedures were established to program generalization and to maintain the behavior outside the experimental setting. PMID:16795182

  8. Do 12-step meeting attendance trajectories over 9 years predict abstinence?

    OpenAIRE

    Witbrodt, Jane; Mertens, Jennifer; Kaskutas, Lee Ann; Bond, Jason; Chi, Felicia; Weisner, Constance

    2011-01-01

    This study grouped treatment-seeking individuals (n=1825) by common patterns of 12-step attendance using 5 waves of data (75% interviewed year-9) to isolate unique characteristics and use-related outcomes distinguishing each class profile. The high class reported the highest attendance and abstention. The descending class reported high baseline alcohol severity, long treatment episodes, and high initial attendance and abstinence; but by year-5 their attendance and abstinence dropped. The earl...

  9. Fatigue Experiences Among OCD Outpatients.

    Science.gov (United States)

    Pasquini, Massimo; Piacentino, Daria; Berardelli, Isabella; Roselli, Valentina; Maraone, Annalisa; Tarsitani, Lorenzo; Biondi, Massimo

    2015-12-01

    Patients with OCD are impaired in multiple domains of functioning and quality of life. While associated psychopathology complaints and neuropsychological deficits were reported, the subjective experience of general fatigue and mental fatigue was scarcely investigated. In this single-center case-control study we compared 50 non-depressed OCD outpatients consecutively recruited and 50 panic disorder (PD) outpatients, to determine whether they experienced fatigue differently. Assessment consisted of structured clinical interview for DSM-IV criteria by using the SCID-I and the SCID-II. Symptom severity was assessed using the Yale-Brown Obsessive-Compulsive Scale, the Hamilton Anxiety Rating Scale, the Hamilton Depression Rating Scale, the Clinical Global Impressions Scale, severity and the Global Assessment of Functioning Scale. Fatigue was assessed by using the Multidimensional Fatigue Inventory (MFI). Regarding MFI physical fatigue, an OR of 0.196 (95 % CI 0.080-0.478) was found, suggesting that its presence is associated with lower odds of OCD compared to PD. The same can be said for MFI mental fatigue, as an OR of 0.138 (95 % CI 0.049-0.326) was found, suggesting that its presence is associated with lower odds of OCD. Notably, OCD patients with OCDP co-morbidity reported higher scores of mental fatigue. In this study fatigue, including mental fatigue, seems not to be a prominent experience among adult non-depressed OCD patients. PMID:25814268

  10. Evaluation of patients' attitudes to their care during oral and maxillofacial surgical outpatient consultations: the importance of waiting times and quality of interaction between patient and doctor.

    Science.gov (United States)

    Dimovska, E O F; Sharma, S; Trebble, T M

    2016-06-01

    Knowing what patients think about their care is fundamental to the provision of an effective, quality service, and it can help to direct change and reduce costs. Much of the work in oral and maxillofacial departments concerns the treatment of outpatients, but as little is known about what they think about their care, we aimed to find out which aspects were associated with satisfaction. Consecutive patients (n=244) who attended the oral and maxillofacial outpatient department at Southampton University Hospital NHS Foundation Trust over a 7-day period were given a questionnaire to complete before and after their consultation. It included questions with Likert scale responses on environmental, procedural, and interactive aspects of the visit, and a 16-point scale to rank their priorities. A total of 187 patients (77%) completed the questionnaires. No association was found between expected (p=0.93) or actual (p=0.41) waiting times, and 90% of patients were satisfied with their visit. Seeing the doctor, having confidence in the treatment plan, being listened to, and the ability of the doctor to recognise their personal needs, were ranked as important. Environmental and procedural aspects were considered the least important. These findings may be of value in the development of services to improve patient-centred care. PMID:26994564

  11. 42 CFR 419.22 - Hospital outpatient services excluded from payment under the hospital outpatient prospective...

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Hospital outpatient services excluded from payment under the hospital outpatient prospective payment system. 419.22 Section 419.22 Public Health CENTERS... PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES Categories of Hospitals and...

  12. Put yourself in their shoes … the vulnerability of children and their families when attending for radiotherapy treatment: The role of the specialist paediatric radiotherapy radiographer

    International Nuclear Information System (INIS)

    Childhood cancer is rare; only 1 in 600 children under the age of 15 years develop a cancer. The treatment of childhood cancers is usually a multimodality approach and can involve surgery, chemotherapy and radiotherapy. Radiotherapy is used in the management of tumours of the central nervous system, solid tumours, leukaemia's and Hodgkin's Lymphoma in the paediatric setting. Paediatric patients make up just 1% of the workload in radiotherapy departments, therefore they tend to be very adult orientated environments and treating children can be complex and challenging for staff. As healthcare professionals we must acknowledge the vulnerability of children and their families when they are coming for radiotherapy treatment. The role of the specialist paediatric radiographer has evolved to work alongside the children and their families to alleviate some of the families and staff anxieties, acting as an advocate, a key point of contact and resource. The very nature of radiotherapy treatment means parents will be separated from their children whilst the treatment is delivered. As radiographers we must ensure we put ourselves in their shoes and acknowledge how difficult this is for children and their parents. The key to every interaction with families is excellent communication and this is not just between professionals, the children and families but also between colleagues to ensure care is co-ordinated. Radiographers working with paediatric patients must have refined communication skills, be able to build rapports, offer support and comfort to children and their parents to ensure they receive the best possible care that is tailored to the individual families holistic needs. The specialist paediatric radiotherapy radiographer is in a unique position to deliver this expert care and support

  13. Study protocol: a stepped wedge cluster randomised controlled trial of a healthy lifestyle intervention for people attending residential substance abuse treatment

    OpenAIRE

    Kelly, Peter J; Baker, Amanda L.; Deane, Frank P.; Callister, Robin; Collins, Clare E.; Oldmeadow, Christopher; Attia, John R.; Townsend, Camilla J; Ingram, Isabella; Byrne, Gerard; Keane, Carol A

    2015-01-01

    Background Cardiovascular disease and cancer are leading causes of mortality for people with a history of alcohol or other substance use disorders. These chronic diseases share the same four primary behavioural risk factors i.e. excessive alcohol use, smoking, low intake of fruit and vegetables and physical inactivity. In addition to addressing problematic alcohol use, there is the potential for substance abuse treatment services to also address these other behaviours. Healthy Recovery is an ...

  14. Antidepressant chronotherapeutics in a group of drug free outpatients.

    Science.gov (United States)

    Dallaspezia, Sara; van Jaarsveld, Astrid

    2016-07-30

    The combination of Total Sleep Deprivation (TSD) and Light Therapy (LT) has been shown to prevent the early relapses characterizing response to TSD. Despite their proved efficacy, TSD and LT are still far from being considered standard therapy in the inpatient units and no study has assessed their efficacy and feasibility in outpatient settings. We studied 27 drug-free out-patients affected by Major Depression, divided in 7 groups according to the date of the wake night. Patients were administered one night of TSD and received LT during consecutive mornings following a predictive algorithm based on Morningness-Eveningness Questionnaire scores. Severity of depression was rated on Back Depression Inventory Scale (BDI) at baseline, one week and three months after the end of treatment. BDI scores significantly decreased during treatment with no difference between the seven consecutively treated groups of patients. Significant differences in BDI scores were confirmed between the baseline and both one week and three months after the end of treatment. TSD and LT caused a significant amelioration of depressive symptoms in an outpatient setting. Similar effects were observed in seven independent groups, suggesting that there is repeatability in findings. Chronotherapeutics confirmed their efficacy in the treatment of depression. PMID:27173655

  15. Out-patient drug treatment of pneumonia among children under two years of age in Fortaleza, Brazil Tratamento ambulatorial das pneumonias nas crianças menores de dois anos em Fortaleza, Brasil

    Directory of Open Access Journals (Sweden)

    Chizuru Misago

    1997-01-01

    Full Text Available Results are reported from a study on drug use in treatment of children with pneumonia in a pediatric hospital in the city of Fortaleza, Northeastern Brazil. There were 171 out-patients; prescription details were obtained for 149. The most commonly prescribed antimicrobial drug was procaine penicillin, accounting for 33% of antimicrobial prescriptions, followed by benzathine penicillin (31%, ampicillin or amoxicillin (12%, and cotrimoxazole (8%. Benzathine penicillin was frequently given with other drugs, but was the sole antimicrobial agent for 31 children. Compliance with antimicrobial treatment was 52% overall and was higher for the injectables. Prescription patterns varied from child to child, and children were often prescribed more than one antimicrobial in the same or repeat prescriptions; combining this information with compliance, 81 (54% of the children were estimated to have received 5 or more days of appropriate antimicrobial treatment for pneumonia. This percentage is not high, and five days were often reached after using more than one antimicrobial and after repeat visits. The authors concluded that the need remains for simple antimicrobial regimes, attractive to comply with, that can be expected to be consistently used. Other drugs were chiefly analgesics and bronchodilators.Estudou-se a aderência ao tratamento de pneumonia em crianças, em serviço ambulatorial de hospital pediátrico em Fortaleza, Brasil. Foram investigadas 171 crianças com diagnóstico de pneumonia. Através de questionário foram coletadas informações referentes à prescrição médica e estimada a aderência ao tratamento de 149 crianças. Os antimicrobianos mais comumente prescritos foram penicilina procaína (33%, penicilina benzatina (31%, ampicilina ou amoxacilina (12% e cotrimoxazol (8%. Embora tenha sido freqüente a associação de antimicrobianos com outros medicamentos, tratamento exclusivo com penicilina procaina foi prescrito para 31 crianças. A

  16. [Attitudes toward estrogen replacement therapy. Study conducted on a sample population of women attending an ambulatory care center for the treatment of menopause].

    Science.gov (United States)

    Perrone, G; Capri, O; Borrello, M; Galoppi, P

    1993-12-01

    Hormonal Replacement Therapy (HRT) is the most effective treatment of menopausal disturbances and has an established role in reducing the cardiovascular risk and in preventing the postmenopausal osteoporosis. Nevertheless several reports have evidenced that compliance with hormonal replacement therapy was not as good as expected, and that physician's and women's opinions can strongly influence the HRT choice, and the continuation of HRT use. The aim of this study was to assess the opinions and the expectations of menopausal women toward HRT. PATIENT AND METHODS. We utilized a questionnaire exploring social and affective conditions, and in particular women's opinions and experiences on menopause, hormonal therapy, the possibility of information, the reasons for accepting or refusing hormonal therapy. The questionnaires were administered to 226 menopausal clinic patients (Menopausal age: 2-10 years) in spontaneous menopause. RESULTS. 28% of the women were taking HRT at the time of the survey. Worries about menopause were reported by 27.4% of the group; this percentage was similar in both user and non-user groups. 70% received information on HRT from family doctors, and 63% from mass-media or conversations. 70% believes that the main problem of menopause is osteoporosis, and its prevention represents the most frequent aim that patients feel can be achieved by HRT. 67.5% of the group is afraid that long term treatment can be dangerous, however only 57% asked for detailed information to the doctor. To the question "Are you informed that HRT can reinduce menstrual bleeding?", 57.5% of the patients answered yes; 30% considered it to be a problem. CONCLUSIONS. Our study was carried out in a menopausal clinic and this can influence the answers of the respondents. Most women received some information on HRT, but their knowledge was only partial and did not eliminate the unrational fear of hormone therapy. Although long term use of HRT is to prevent CVD and menopausal

  17. Fadiga em adultos acompanhantes de pacientes em tratamento ambulatorial Fatiga en adultos acompañantes de pacientes en tratamiento en ambulatorios Fatigue in adults accompanying patients in outpatient treatment

    Directory of Open Access Journals (Sweden)

    Natália Fialho Mota

    2010-06-01

    ,4 (escala de 9 a 45. La fatiga fue más intensa (p=0,005 y más frecuente (p=0,001 en las mujeres y se correlacionó positivamente con depresión (rs=0,47; p=0,000. La fatiga por esfuerzo se correlacionó positivamente con depresión (rs=0,39; p=0,000 y fue más frecuente entre las mujeres (p=0,001. CONCLUSIÓN: Las características de la fatiga en una muestra de acompañantes de pacientes son semejantes a las de pacientes con enfermedades crónicas. La interpretación de los datos sobre fatiga en enfermedades crónicas precisaría considerar los datos de fatiga en la población general.OBJECTIVES: To describe fatigue and fatigue by efforts in people without chronic diseases and to verify the association between fatigue or fatigue by efforts with gender, age, education, marital cohabitation, depression, physical activity, smoking, body mass index (BMI, dyspnea and depression. METHODS: It is a descriptive study comprising 93 patients from outpatient attendance who reported about smoking, fatigue, fatigue by efforts, depression, and physical activity. RESULTS: Of the 93 volunteers (65.6% female - average age 33.4 ± 10.1 years, 52.7% had fatigue and 34.4% had fatigue by efforts. The average score of fatigue was 16.3 ± 6.6 (scale from 8 to 40 and fatigue by efforts12.6 ± 4.4 (scale from 9 to 45. The fatigue was more intense (p = 0.005 and more frequent (p = 0.001 in women and was positively correlated with depression (rs=0,47; p=0,000. The fatigue by efforts was positively correlated with depression (rs=0,39; p=0,000 and was more frequent among women (p = 0.001. CONCLUSION: The characteristics of fatigue in a sample of patient companions are similar to those of patients with chronic diseases. The interpretation of data on fatigue, in patients with chronic diseases, should consider the fatigue data, in the general population.

  18. Laboratory testing improves diagnosis and treatment outcomes in primary health care facilities

    Directory of Open Access Journals (Sweden)

    Jane Y. Carter

    2011-12-01

    Full Text Available Objective: To determine if use of basic laboratory tests improves diagnosis and treatment outcomes in outpatients attending rural primary health care facilities.Setting: Six rural health centres in Kenya.Design: Cross-sectional study to observe change in diagnosis and treatment made by clinical officers after laboratory testing in outpatients attending six rural health centres in Kenya.Subject: The diagnosis and treatment of 1134 patients attending outpatient services in six rural health centres were compared before and after basic laboratory testing. Essential clinical diagnostic equipment and laboratory tests were established at each health centre. Clinical officers and laboratory technicians received on-site refresher training in good diagnostic practices and laboratory procedures before the study began.Results: Laboratory tests were ordered on 704 (62.1% patients. Diagnosis and treatment were changed in 45% of tested patients who returned with laboratory results (21% of all patients attending the clinics. 166 (23.5% patients did not return to the clinician for a final diagnosis and management decision after laboratory testing. Blood slide examination for malaria parasites, wet preparations, urine microscopy and stool microscopy resulted in most changes to diagnosis. There was no significant change in drug costs after laboratory testing. The greatest changes in numbers of recorded diseases following laboratory testing was for intestinal worms (53% and malaria (21%.Conclusion: Effective use of basic laboratory tests at primary health care level significantly improves diagnosis and patient treatment. Use of laboratory testing can be readily incorporated into routine clinical practice. On-site refresher training is an effective means of improving the quality of patient care and communication between clinical and laboratory staff.

  19. Outpatient parenteral antimicrobial therapy (OPAT) in patients with cystic fibrosis

    OpenAIRE

    Pedersen, Maya Graham; Jensen-Fangel, Søren; Olesen, Hanne Vebert; Tambe, San deep Prataprao; Petersen, Eskild

    2015-01-01

    Background To determine complications during outpatient parenteral antimicrobial therapy (OPAT) administrated through a peripheral venous line, PICC-line or PORT-A-CATH (PAC). Methods Catheter related complications in patients with cystic fibrosis during OPAT were identified through a retrospective review of patient files supplemented by an interview. Results In 64 treatment episodes with a peripheral venous line, 51 (79.7 %) used bolus injection and 13 (20.3 %) used infusion pump. 27 out of ...

  20. Oral transmucosal fentanyl pretreatment for outpatient general anesthesia.

    OpenAIRE

    Moore, P. A.; Cuddy, M. A.; Magera, J. A.; Caputo, A. C.; A.H. Chen; Wilkinson, L. A.

    2000-01-01

    The oral transmucosal formulation of fentanyl citrate (OTFC) has been reported to be an effective sedative, providing convenient and atraumatic sedation for children prior to general anesthesia or painful diagnostic procedures. Thirty-three young children (24-60 months of age) scheduled for outpatient general anesthesia for treatment of dental caries were enrolled in this randomized placebo-controlled clinical trial. To determine the effectiveness of the OTFC premedication, patient behavior w...

  1. 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...

  2. Risky behaviours among young people living with HIV attending care and treatment clinics in Dar Es Salaam, Tanzania: implications for prevention with a positive approach

    Directory of Open Access Journals (Sweden)

    Aisa Mhalu

    2013-10-01

    Full Text Available Introduction: Prevention with a positive approach has been advocated as one of the main strategies to reduce new instances of HIV infection. Risky sexual behaviours among people living with HIV/AIDS are the cornerstone for this approach. Understanding the extent to which infected individuals practice risky behaviours is fundamental in designing appropriate population-specific interventions. With the HIV infection transmission rates remaining high among young people in sub-Saharan Africa, continued prevention among them remains a priority. This study therefore seeks to describe the magnitude and determinants of risky sexual behaviours among young people living with HIV. Methods: A cross-sectional study was conducted between June and July 2010 in selected Care and Treatment Clinics (CTCs in Dar Es Salaam, Tanzania. A total of 282 HIV-positive patients aged 15–24 were interviewed about their sexual behaviours using a questionnaire. Results: Prevalence of unprotected sex was 40.0% among young males and 37.5% among young females (p<0.001. Multiple sexual partnerships were reported by 10.6% of males and 15.9% of females (p<0.005. More than 50% of the participants did not know about the HIV status of their sexual partners. A large proportion of participants had minimal knowledge of transmission (46.7% males vs. 60.4% females and prevention (65.3% males vs. 73.4% females of sexually transmitted infections (STIs. Independent predictors of condom use included non-use of alcohol [adjusted odds ratio (AOR, 0.40 95% confidence interval (CI; 0.17–0.84] and younger age (15–19 years (AOR, 2.76, 95% CI: 1.05–7.27. Being on antiretroviral therapy (AOR, 0.38, 95% CI: 0.17–0.85 and not knowing partners’ HIV sero-status (AOR, 2.62, 95% CI: 1.14–5.10 predicted the practice of multiple sexual partnership. Conclusions: Unprotected sex and multiple sexual partnerships were prevalent among young people living with HIV. Less knowledge on STI and lack of HIV

  3. Potential prescription patterns and errors in elderly adult patients attending public primary health care centers in Mexico City

    Directory of Open Access Journals (Sweden)

    José Antonio Corona-Rojo

    2009-08-01

    Full Text Available José Antonio Corona-Rojo1, Marina Altagracia-Martínez1, Jaime Kravzov-Jinich1, Laura Vázquez-Cervantes1, Edilberto Pérez-Montoya2, Consuelo Rubio-Poo31Division of Biological Sciences and Health, Metropolitan Autonomous University, Campus Xochimilco (UAM-X, Xochimilco, México; 2National Polytechnical Institute (IPN, México DF; 3Faculty of Higher Studies – Zaragoza (FES-Zaragoza, National Autonomous University of México (UNAM, México City, MéxicoIntroduction: Six out of every 10 elderly persons live in developing countries.Objective: To analyze and assess the drug prescription patterns and errors in elderly outpatients attending public health care centers in Mexico City, Mexico.Materials and methods: A descriptive and retrospective study was conducted in 2007. Fourteen hundred prescriptions were analyzed. Prescriptions of ambulatory adults aged >70 years who were residents of Mexico City for at least two years were included. Prescription errors were divided into two groups: (1 administrative and legal, and (2 pharmacotherapeutic. In group 2, we analyzed drug dose strength, administration route, frequency of drug administration, treatment length, potential drug–drug interactions, and contraindications. Variables were classified as correct or incorrect based on clinical literature. Variables for each drug were dichotomized as correct (0 or incorrect (1. A Prescription Index (PI was calculated by considering each drug on the prescription. SPSS statistical software was used to process the collected data (95% confidence interval; p < 0.05.Results: The drug prescription pattern in elderly outpatients shows that 12 drugs account for 70.72% (2880 of prescribed drugs. The most prescribed drugs presented potential pharmacotherapeutic errors (as defined in the present study. Acetylsalicylic acid–captopril was the most common potential interaction (not clinically assessed. Potential prescription error was high (53% of total prescriptions. Most

  4. Assessment of the clinical outcome of a symptom-based outpatient hyperglycemia protocol

    OpenAIRE

    Armor, Becky; Harrison, Don; Lawler, Frank

    2011-01-01

    Introduction Acute hyperglycemia (blood glucose [BG] ≥400 mg/dL) is common in primary care. An outpatient protocol was developed to streamline the treatment of acute hyperglycemia. The objective was to determine if an outpatient hyperglycemia protocol could achieve a BG level of 400 mg/dL) without acute illness were recruited. Enrolled patients were managed with a protocol that included administration of 0.15 units/kg rapid-acting insulin given subcutaneously, hydration, hourly fingerstick bl...

  5. Outpatient percutaneous nephrolithotomy in a renal transplant patient: World’s first case

    OpenAIRE

    McAlpine, Kristen; Leveridge, Michael J.; Beiko, Darren

    2015-01-01

    Percutaneous nephrolithotomy (PCNL) is an established safe and effective surgical treatment option for renal calculi in renal allografts. The advent of tubeless PCNL has led to reports of ambulatory or outpatient PCNL. This case report describes the successful outpatient management of a 49-year-old female with a symptomatic renal pelvic calculus in her transplanted kidney. Tubeless PCNL successfully removed the stone, free of complication, and the patient was discharged 2 hours and 17 minutes...

  6. FROZEN SHOULDER TREATMENT: TRIAMCENALONE OR METHYLPREDNISOLONE INJECTION

    OpenAIRE

    Sanjib; Prabin Ch

    2015-01-01

    OBJECTIVE: To compare the effectiveness of Triamcinolone acetonide [40mg] and Methylprednisolone acetate [40mg] in 210 patients attending the Outpatient Department of Orthopedics of FAAMCH Barpeta with primary and secondary frozen shoulder. METHODS: A total number o f 210 patients with frozen shoulder who attended the Outpatient clinic of Orthopedics at FAAMCH from Jan 2013 to Jan 2015 were enrolled in our study. The diagnosis of frozen shoulder was made using...

  7. 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

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

    OpenAIRE

    Nursel Dilek; Ahmet Yaşar Yücel; Aziz Ramazan Dilek; Yunus Saral; Zülal Aşcı Toraman

    2009-01-01

    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) ...

  9. Class attendance and university performance

    OpenAIRE

    Hoffmann, Anna-Lena; Lerche, Katharina

    2016-01-01

    Using survey data collected at Göttingen University, Germany, this paper evaluates the effect of attending the lecture and/or tutorial on the grade achieved in two basic courses in business administration and economics. The analysis shows that going to class has no significant impact on student performance in most specifications. Although the identification of a causal effect may not be possible with the data at hand, the results suggest that, in the given framework, attending class and study...

  10. School attendance 1880-1939

    OpenAIRE

    Sheldon, Nicola; Professor Jane Humphries; Janet Howarth

    2008-01-01

    The thesis covers two sides of the truancy problem in the period following compulsory school attendance - the truanting children and their parents, and the local authorities charged with enforcing the law. The introduction covers current concerns about truancy and school attendance, which have increased in prominence since the 1980s. Chapter 2 reviews the historiography, which has mainly debated working-class attitudes towards compulsory schooling in the nineteenth century. Th...

  11. School attendance and parental disability

    OpenAIRE

    Raccanello, Kristiano; Garñudo Estrada, León; Herrera Escalante, Andrea; Uribe Cruz, Gabriel

    2011-01-01

    Socio economic problems exacerbate school drop-out that harms youths by limiting their knowledge and future development. Scholars have investigated both the variables linked to school attendance and the problems faced by impaired children. However, it has not yet been considered whether school attendance is harmed when parents are impaired. In order to partially fill this gap, we test the hypothesis that parental disability increases school drop-out through a sample of 598 youths between 14 a...

  12. Using Attendance Worksheets to Improve Student Attendance, Participation, and Learning

    Science.gov (United States)

    Rhoads, Edward

    2013-06-01

    As science instructors we are faced with two main barriers with respect to student learning. The first is motivating our students to attend class and the second is to make them active participants in the learning process once we have gotten them to class. As we head further into the internet age this problem only gets exacerbated as students have replaced newspapers with cell phones which can surf the web, check their emails, and play games. Quizzes can motivated the students to attend class but do not necessarily motivate them to pay attention. Active learning techniques work but we as instructors have been bombarded by the active learning message to the point that we either do it already or refuse to. I present another option which in my classroom has doubled the rate at which students learn my material. By using attendance worksheets instead of end of class quizzes I hold students accountable for not just their attendance but for when they show up and when they leave the class. In addition it makes the students an active participant in the class even without using active learning techniques as they are writing notes and answering the questions you have posed while the class is in progress. Therefore using attendance worksheets is an effective tool to use in order to guide student learning.

  13. Single dose oral dexamethasone versus multi-dose prednisolone in the treatment of acute exacerbations of asthma in children who attend the emergency department: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Cronin John

    2012-08-01

    Full Text Available Abstract Background Asthma is a major cause of pediatric morbidity and mortality. In acute exacerbations of asthma, corticosteroids reduce relapses, subsequent hospital admission and the need for ß2-agonist therapy. Prednisolone is relatively short-acting with a half-life of 12 to 36 hours, thereby requiring daily dosing. Prolonged treatment course, vomiting and a bitter taste may reduce patient compliance with prednisolone. Dexamethasone is a long-acting corticosteroid with a half-life of 36 to 72 hours. It is used frequently in children with croup and bacterial meningitis, and is well absorbed orally. The purpose of this trial is to examine whether a single dose of oral dexamethasone (0.3 mg/kg is clinically non-inferior to prednisolone (1 mg/kg/day for three days in the treatment of exacerbations of asthma in children who attend the Emergency Department. Methods/design This is a randomized, non-inferiority, open-label clinical trial. After informed consent with or without assent, patients will be randomized to either oral dexamethasone 0.3 mg/kg stat or prednisolone 1 mg/kg/day for three days. The primary outcome measure is the comparison between the Pediatric Respiratory Assessment Measure (PRAM across both groups on Day 4. The PRAM score, a validated, responsive and reliable tool to determine asthma severity in children aged 2 to 16 years, will be performed by a clinician blinded to treatment allocation. Secondary outcomes include relapse, hospital admission and requirement for further steroid therapy. Data will be analyzed on an intention-to-treat and a per protocol basis. With a sample size of 232 subjects (105 in each group with an estimated 10% loss to follow-up, we will be able to reject the null hypothesis - that the population means of the experimental and control groups are equal with a probability (power of 0.9. The Type I error probability associated with this test (of the null hypothesis is 0.05. Discussion This

  14. The quality of outpatient antimicrobial prescribing

    DEFF Research Database (Denmark)

    Malo, Sara; Bjerrum, Lars; Feja, Cristina;

    2013-01-01

    The aim of the study was to analyse and compare the quality of outpatient antimicrobial prescribing in Denmark and Aragón (in northeastern Spain), with the objective of assessing inappropriate prescribing....

  15. Hospital Outpatient PPS Partial Hospitalization Program LDS

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Outpatient Prospective Payment System (OPPS) Partial Hospitalization Program LDS This file contains select claim level data and is derived from 2010 claims...

  16. Medicare Provider Utilization and Payment Data - Outpatient

    Data.gov (United States)

    U.S. Department of Health & Human Services — The data provided here include estimated hospital-specific charges for 30 Ambulatory Payment Classification (APC) Groups paid under the Medicare Outpatient...

  17. 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 ...

  18. 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 ...

  19. FROZEN SHOULDER TREATMENT: TRIAMCENALONE OR METHYLPREDNISOLONE INJECTION

    Directory of Open Access Journals (Sweden)

    Sanjib

    2015-10-01

    Full Text Available OBJECTIVE: To compare the effectiveness of Triamcinolone acetonide [40mg] and Methylprednisolone acetate [40mg] in 210 patients attending the Outpatient Department of Orthopedics of FAAMCH Barpeta with primary and secondary frozen shoulder. METHODS: A total number o f 210 patients with frozen shoulder who attended the Outpatient clinic of Orthopedics at FAAMCH from Jan 2013 to Jan 2015 were enrolled in our study. The diagnosis of frozen shoulder was made using the guidelines for shoulder complain issued by the Dutch C ollege of General Practitioners. Intra - articular injections of Triamcinolone acetonide [40mg] was used in 110 patients [ M ale - 50, female - 60] and 40mg Methylprednisolone was given to 100 patients [M ale - 35, female 65]. Injection was repeated every 3 weeks [ N o t more than 3 injections] by the posterior route. RESULTS: Triamcinolone acetonide was found to be more effective in diabetic patients with frozen shoulder in comparison to Methyprednisolone acetate. Triamcinolone acetonide was found to be more effective i n those patients presenting with severe grades of frozen shoulder and also these patients required lesser number of injections compared to Methylprednisolone acetate. However both Triamcinolone acatonide and Methyprednisolone were equally effective in prim ary frozen shoulder. CONCLUSION: We conclude that Triamcinolone acetonide and Methylprednisolone acetate are effective in the treatment of painful stiff shoulder; however injection Triamcinolone acetonide is a superior alternative in the treatment of diabe tics with frozen shoulder & resistant cases, with less number of injections.

  20. Seizure related injuries among outpatients in two tertiary hospitals in South East Nigeria

    Directory of Open Access Journals (Sweden)

    Ezeala-Adikaibe A Birinus

    2012-01-01

    Full Text Available Introduction: Epilepsy is the most prevalent and serious neurological disorder occurring in the community. The large treatment gap in developing countries places a lot of patients at risk of severe seizure-related injuries and death. Accurate data on the prevalence and pattern of epilepsy-related injuries does not exist in south-east Nigeria. Aims: To determine the prevalence and pattern of seizure-related injuries in patients with epilepsy attending the neurology clinics. Setting: Neurology clinic of 2 urban referral centers in south-east Nigeria. Design: Questionnaire-based cross-sectional study. Materials and Methods: All patients above 18 years with active epilepsy were included and were interviewed. Injuries included in the study were those directly related to seizures or of unknown cause but suspected to be due to seizures. Injuries that patients believed were of a non-seizure related etiology were excluded. Data was analyzed using SPSS v 17. Results: 86(98.9% patients reported a history of injury related to seizures; 28 (32.1% patients had moderate to severe injuries while 59(67.8% patients had only minor injuries. Loss of teeth and injury to the head were the commonest forms of injury (10.3 and 9.1% respectively. There was a slightly higher rate of serious injuries in women and in patients above 45 years. Conclusion: Severe body injuries are common in outpatients with active epilepsy. Loss of tooth and head injuries were the most common forms of severe injuries encountered. Adequate treatment and precautions are needed to prevent seizure-related injury from impacting negatively on the quality of their lives.

  1. Decreased prefrontal, anterior cingulate, insula, and ventral striatal metabolism in medication-free depressed outpatients with bipolar disorder

    OpenAIRE

    Brooks, John O.; Wang, Po W.; Bonner, Julie C.; Rosen, Allyson C.; Hoblyn, Jennifer C.; Hill, Shelley J.; Ketter, Terence A.

    2008-01-01

    This study explored whether cerebral metabolic changes seen in treatment resistant and rapid cycling bipolar depression inpatients are also found in an outpatient sample not specifically selected for treatment resistance or rapid cycling. We assessed 15 depressed outpatients with bipolar disorder (six type I and nine type II) who were medication-free for at least 2 weeks and were not predominantly rapid cycling. The average 28-item Hamilton Depression Scale (HAM-D) total score was 33.9. The h...

  2. Factors associated to patients' noncompliance with hypertension treatment Factores asociados a la no adhesión de los pacientes al tratamiento de hipertensión arterial Fatores associados à não adesão dos pacientes ao tratamento de hipertensão arterial

    OpenAIRE

    Camila Dosse; Claudia Bernardi Cesarino; José Fernando Vilela Martin; Maria Carolina Andrade Castedo

    2009-01-01

    The greatest challenge posed by Systemic Hypertension (SH) is related to patients' compliance with treatment. Thus, this study aimed to determine attendance of these patients to medical appointments and the percentage of adherence to medication and non-medication regimens, and also identify the main reasons hypertensive patients report for non-adherence. This is a descriptive study with 68 hypertensive patients (64.71% women with average age of 63.9 years) at a teaching outpatient clinic. The...

  3. 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…

  4. Group Outpatient Physical and Behavioral Therapy for Chronic Low Back Pain.

    Science.gov (United States)

    Cohen, Michael J.; And Others

    1983-01-01

    Compared the effectiveness of behavioral (BT) or physical therapy (PT) for treating chronic low back pain (CLBP), for 13 BT patients and 12 PT patients. Treatments were conducted in a group outpatient setting. Posttreatment results showed general improvement for patients in both groups, but few treatment-specific differences in outcome measures.…

  5. Retention in care and outpatient costs for children receiving antiretroviral therapy in Zambia: a retrospective cohort analysis.

    Directory of Open Access Journals (Sweden)

    Callie A Scott

    Full Text Available BACKGROUND: There are few published estimates of the cost of pediatric antiretroviral therapy (ART in Africa. Our objective was to estimate the outpatient cost of providing ART to children remaining in care at six public sector clinics in Zambia during the first three years after ART initiation, stratified by service delivery site and time on treatment. METHODS: Data on resource utilization (drugs, diagnostics, outpatient visits, fixed costs and treatment outcomes (in care, died, lost to follow up were extracted from medical records for 1,334 children at six sites who initiated ART at 50% at four sites. At the two remaining sites, outpatient visits and fixed costs together accounted for >50% of outpatient costs. The distribution of costs is slightly skewed, with median costs 3% to 13% lower than average costs during the first year after ART initiation depending on site. CONCLUSIONS: Outpatient costs for children initiating ART in Zambia are low and comparable to reported outpatient costs for adults. Outpatient costs and retention in care vary widely by site, suggesting opportunities for efficiency gains. Taking advantage of such opportunities will help ensure that targets for pediatric treatment coverage can be met.

  6. A multi-centre randomised controlled study of pre-IVF outpatient hysteroscopy in women with recurrent IVF implantation failure: Trial of Outpatient Hysteroscopy - [TROPHY] in IVF

    OpenAIRE

    Khalaf Yacoub; Sunkara Sesh; Campo Rudi; El-Toukhy Tarek; Coomarasamy Arri

    2009-01-01

    Abstract Background The success rate of IVF treatment is low. A recent systematic review and meta-analysis found that the outcome of IVF treatment could be improved in patients who have experienced recurrent implantation failure if an outpatient hysteroscopy (OH) is performed before starting the new treatment cycle. However, the trials were of variable quality, leading to a call for a large and high-quality randomised trial. This protocol describes a multi-centre randomised controlled trial t...

  7. 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...

  8. Parameters of Multiple College Attendance.

    Science.gov (United States)

    Dillon, Paul H.

    This is a report analyzing the multiple community college attendance patterns of students from nine colleges in the Los Angeles Community College District (California) from 1990-2000. The assessment utilizes the Multiple College Index (MCI), which is a measure based on the proportion of units a student earns at different colleges. The study…

  9. Optimization of therapy in outpatients with chronic lumbago

    OpenAIRE

    A A Averchenkova

    2014-01-01

    Lumbago is one of the most common lower back pain syndromes in medical practice, which is benign in the vast majority of cases and caused by spinal osteochondrosis, injury, and muscle strain or spasm. The primary task of examining a patient with lumbago is to be certain that the pain is musculoskeletal and unassociated with a potentially dangerous spinal disease requiring emergency special therapy.Objective: to analyze the efficiency of treatment in outpatients with chronic lumbago.Patients a...

  10. 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

  11. [Paediatric gynaecological outpatient department--a report on 600 patients].

    Science.gov (United States)

    Grünberger, W; Fischl, F

    1982-11-26

    Problems arising during the examination and treatment of paediatric gynaecological patients are described. 387 out of 600 girls seen at the outpatient department for infants and juveniles of the 1st Department of Obstetrics and Gynaecology of the University of Vienna were premenarchal and 213 were post-menarchal (average age 7.45 years). The most frequent diagnosis was vulvovaginitis (43%), followed by pathological vaginal bleeding (12%), vulval disorders (6%) and pubertas praecox (5%); about twenty additional conditions were diagnosed. Absolute and extended indications for gynaecological and vaginoscopic examinations are demonstrated. PMID:7164465

  12. Outpatient parenteral antimicrobial therapy in children with febrile urinary tract infection: a prospective randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Nasiri Kalmarzi R

    2009-01-01

    Full Text Available "nBackground: Acute pyelonephritis may lead to permanent renal scarring. The standard recommendation for treatment of febrile children with urinary tract infection (UTI is hospitalization for intravenous antibiotics. The purpose of this study was to compare the efficacy of outpatient intravenous ceftriaxone and cefixime versus inpatient of the same regimen for children with febrile UTI.   "nMethods: In a randomized clinical trial, we compared the efficacy of administration two days intravenous ceftriaxone followed by an oral cefixime for eight days (as outpatient group versus four days intravenous ceftriaxone followed by an oral cefixime for six days (as inpatient group, in 203 children (99 cases in outpatient group and 104 cases in inpatient group 3 months to 15 years of age with febrile UTI, in terms of short-term clinical outcomes (sterilization of the urine and defeverescence and long-term morbidity (incidence of reinfection and renal scarring documented by DMSA scintigraphy. "nResults: Repeat urine cultures were sterile within 48 hours in all children, mean time to defeverescence was 27.58 (SD=±12.62 and 31.44 (SD=±17.06 hours for children in outpatient and inpatient groups, respectively (P=0.067. Reinfection occurred in 9.1% of outpatient and 13.4% of inpatient group (P=0.326. Renal scarring developed in 11% of children of outpatient and 7.6% of children of inpatient group (P=0.884. There was no significant difference between the two groups in respect of renal scarring. "nConclusions: Outpatient ceftriaxone for two days followed by cefixime to complete a 10 days course can be recommended as a safe and effective treatment for children with febrile UTI.

  13. 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

  14. Cough Variant Asthma in Medical Outpatient Department of a Tertiary Care Hospital in Bangladesh

    Directory of Open Access Journals (Sweden)

    Rukhsana Parvin

    2013-01-01

    Full Text Available Background: Cough variant asthma (CVA is a subset of asthma where the only symptom is chronic persistent cough. Many cases go unrecognized due to lack of proper evaluation. Response to asthma medication with features supportive of airway hypersensitivity helps in management of this disease. Objective: To find out the proportion of cough variant asthma among the patients attending medicine outpatient department of Enam Medical College, Savar, Dhaka. Materials and Methods: This cross sectional study was conducted in Enam Medical College Hospital, Savar, Dhaka over a period of two years from July 2009 to July 2011. Cough variant asthma was diagnosed mainly on clinical ground as chronic cough without wheezing, fever, weight loss, shortness of breath or sputum or any other apparent cause that persisted for more than eight weeks with absolutely normal physical examination of chest, normal chest radiography and blood count except raised eosinophil count and IgE level. Patients who met these criteria were given 2 weeks course of inhaler beclomethasone propionate and were assessed for improvement. Those who improved after steroid inhalation were categorised as having cough variant asthma. Results: Out of purposively selected 148 patients complaining only of chronic dry cough for more than eight weeks, 92 patients met the primary selection criteria for cough variant asthma. These 92 patients were given 2 weeks trial of 250 ìgm beclomethasone inhalation twice daily. Seventy nine patients reported almost complete recovery from chronic cough after 2 weeks and were categorized as having CVA. Thirteen patients did not improve and were not categorized as CVA. Conclusion: These findings suggest that cough variant asthma is the most common among the patients with chronic cough not due to any apparent cause. The efficacy of inhaled corticosteroid suggests that early intervention is effective in the treatment of this disease.

  15. Dexamethasone for pain after outpatient shoulder surgery

    DEFF Research Database (Denmark)

    Bjørnholdt, K. T.; Mønsted, P. N.; Søballe, Kjeld;

    2014-01-01

    Background Dexamethasone has analgesic properties when given intravenously before surgery, but the optimal dose has not been determined. We hypothesised that a dose of 40 mg dexamethasone would improve analgesia after outpatient shoulder surgery compared with 8 mg. Methods A randomised, double......-blind, placebo-controlled clinical trial was conducted at Horsens Regional Hospital, Denmark. Patients scheduled for arthroscopic subacromial decompression and/or acromioclavicular joint resection as an outpatient procedure (n = 101) were randomised to receive intravenous dexamethasone 40 mg (D40), 8 mg (D8) or...... a dose–response relationship, increasing the dexamethasone dose from 8 to 40 mg did not improve analgesia significantly after outpatient shoulder surgery....

  16. Prospective Controlled Assessment of Impact of Feedback on Gastroenterology Trainees in Outpatient Practice.

    LENUS (Irish Health Repository)

    Harewood, Gavin C

    2011-03-29

    BACKGROUND AND AIMS: Previous studies have demonstrated the value of systematic feedback in enhancing endoscopic procedure performance. It remains unknown whether feedback may play a role in modifying physician performance in outpatient practice. This study aimed to assess the impact of systematic feedback on duration of office visits of gastroenterology (GI) trainees in outpatient practice. METHODS: Patients attending a GI outpatient department in an academic medical center were prospectively followed over 4 months. The duration of office visits for consecutive patients seen by five GI fellows of similar experience level were recorded for 2 months (pre-feedback); confidential feedback was then provided to each fellow on a weekly basis for 2 months detailing their individual consultation times and the comparative, anonymous times of the other fellows (post-feedback). RESULTS: Over the course of the study, 1,647 outpatients were seen by five GI fellows. Pre-feedback consultation durations differed significantly with one fellow taking 2.5 times longer than their colleague. Following feedback, times shortened significantly for all fellows, with the greatest impact observed in those trainees taking longer at baseline. There were no significant differences in satisfaction levels among patients seen by each trainee. CONCLUSIONS: There was a wide disparity in the consultation times among GI fellows. Systematic feedback shortened times among all trainees and enhanced uniformity by having the greatest impact among those fellows taking longer at baseline. Routine provision of feedback may be valuable in enhancing uniformity of outpatient practice although clinicians should ensure that shortening consultation visits does not compromise quality of patient care. Future larger studies of feedback in this setting will be enhanced by incorporating objective measures of quality of care and patient satisfaction.

  17. Prospective controlled assessment of impact of feedback on gastroenterology trainees in outpatient practice.

    LENUS (Irish Health Repository)

    Harewood, Gavin C

    2012-02-01

    BACKGROUND AND AIMS: Previous studies have demonstrated the value of systematic feedback in enhancing endoscopic procedure performance. It remains unknown whether feedback may play a role in modifying physician performance in outpatient practice. This study aimed to assess the impact of systematic feedback on duration of office visits of gastroenterology (GI) trainees in outpatient practice. METHODS: Patients attending a GI outpatient department in an academic medical center were prospectively followed over 4 months. The duration of office visits for consecutive patients seen by five GI fellows of similar experience level were recorded for 2 months (pre-feedback); confidential feedback was then provided to each fellow on a weekly basis for 2 months detailing their individual consultation times and the comparative, anonymous times of the other fellows (post-feedback). RESULTS: Over the course of the study, 1,647 outpatients were seen by five GI fellows. Pre-feedback consultation durations differed significantly with one fellow taking 2.5 times longer than their colleague. Following feedback, times shortened significantly for all fellows, with the greatest impact observed in those trainees taking longer at baseline. There were no significant differences in satisfaction levels among patients seen by each trainee. CONCLUSIONS: There was a wide disparity in the consultation times among GI fellows. Systematic feedback shortened times among all trainees and enhanced uniformity by having the greatest impact among those fellows taking longer at baseline. Routine provision of feedback may be valuable in enhancing uniformity of outpatient practice although clinicians should ensure that shortening consultation visits does not compromise quality of patient care. Future larger studies of feedback in this setting will be enhanced by incorporating objective measures of quality of care and patient satisfaction.

  18. 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. PMID:20058573

  19. 慢性支气管炎急性发作采用阿奇霉素与左氧氟沙星门诊治疗的临床体会%Clinical Experience of Azithromycin and Levofloxacin in the Treatment of Acute Exacerbation of Chronic Bronchitis in Outpatient

    Institute of Scientific and Technical Information of China (English)

    杨鸿雁

    2014-01-01

    目的:研究慢性支气管炎急性发作采用阿奇霉素与左氧氟沙星门诊治疗的临床效果。方法选取68例患者将其分为治疗组和对照组,均34例,对比治疗效果。结果对比两组患者临床治疗总有效率和症状缓解时间,治疗组患者同对照组患者间具有明显差异性,P<0.05。结论阿奇霉素与左氧氟沙星对慢性支气管炎急性发作效果显著。%Objective The clinical effect of azithromycin and levofloxacin in the treatment of outpatients of acute exacerbations of chronic bronchitis. Methods 68 patients were divided into treatment group and control group were 34 cases, treatment effect, comparison. Results The clinical treatment of the two groups were compared and the total effective rate and the duration of remission, patients in the treatment group with the control has obvious differences between the groups with P<0.05. Conclusion Azithromycin and levofloxacin on acute attack of chronic bronchitis effect.

  20. What physicians need to know about renal function in outpatients with heart failure.

    Science.gov (United States)

    Waldum-Grevbo, Bård

    2015-01-01

    The majority of outpatients with heart failure (HF) have chronic kidney disease (CKD) as an important comorbidity. Both glomerular filtration rate and abnormal urinary albumin excretion are major predictors of outcome in HF patients. Despite this, patients with renal dysfunction have been systematically excluded from the large randomized HF trials. There is lack of evidence for optimal treatment in these cardiorenal patients and treatment nihilism may account in part for their bad prognosis. Identifying and monitoring the progression of renal disease and making an effort to preserve renal function should be an important task in the management of all patients with HF. In this review, the current understanding of the pathophysiology of renal dysfunction in outpatients with HF will be summarized. Furthermore, important principles of the identification and management of cardiorenal patients will be described in order to make the physician more capable of managing outpatients with HF and renal dysfunction. PMID:25966919

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

    Directory of Open Access Journals (Sweden)

    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

  2. Practice and Effectiveness of Outpatient Psycho-Oncological Counseling for Cancer Patients

    Directory of Open Access Journals (Sweden)

    Ute Goerling, Deniz Tagmat, Elvira Muffler, Nancy Schramm, Klaus-Dieter Wernecke, Peter M. Schlag

    2010-01-01

    Full Text Available Objective: Because of various types of psychological distress, cancer patients are encouraged to attend outpatient psycho-oncological and psychosocial counseling. The aim of this prospective study was an analysis of the impact and success of existing counseling resources.Methods: All cancer patients who had applied at a central counseling center were given a standardized questionnaire (FBK-R23, designed to assess the type and degree of cancer patients' difficulties prior to their first counseling session. Additionally, the psychological condition of the patients was assessed psycho-oncologically by a third party (PO-Bado. After at least 2 and no more than 5 sessions, patients underwent both self-evaluation and third-party assessment, using the same instruments.Results: During the period from September 2008 and August 2009, we looked at a total of 447 people seeking counseling, including 186 family members (42%, 33 professional caregivers (7%, and 228 patients (51%. Out of the 228 patients, 48 attended our counseling sessions personally and 20 of these additionally completed the second questionnaire. Counseling led to only a tendency toward improvement, on average, of total psychological distress (p=0.08. In individual areas - for example, “Social Distress” and “Everyday Limitations”- no change could be measured. Only the problem area identified as “Information Deficit” was improved, on average, after 3 counseling sessions (p=0.008.Conclusion: Our results indicate that while short-term counseling has no concrete effect on the improvement of a patient's psychological well-being, these support sessions do serve to decrease the patient's so-called “Information Deficit”, thereby bringing about an indirect improvement in the sufferer's psychological state. The course of treatment offered should be determined according to the patient's needs. In order to ensure that even the very sickest of the tumor patient group seek outreach groups

  3. Examining possible gender differences among cocaine-dependent outpatients.

    Science.gov (United States)

    Wong, Conrad J; Badger, Gary J; Sigmon, Stacey C; Higgins, Stephen T

    2002-08-01

    Potential differences in sociodemographics, drug use, and measures of treatment outcome were examined among 137 male and 51 female cocaine-dependent outpatients. More women than men were unemployed, received public assistance, and were living with their children. Women reported fewer years of regular cocaine use, spending less money per week on cocaine, less prior treatment for cocaine abuse, and were more likely than men to test positive for cocaine at intake. With respect to other drug use, fewer women than men reported using sedatives and tested positive for sedatives at intake. Women reported a lower frequency of alcohol use before intake, and fewer women than men met criteria for cannabis dependence. Men and women experienced comparable improvement during the course of treatment and follow-up. PMID:12233993

  4. [Dimensional modeling analysis for outpatient payments].

    Science.gov (United States)

    Guo, Yi-zhong; Guo, Yi-min

    2008-09-01

    This paper introduces a data warehouse model for outpatient payments, which is designed according to the requirements of the hospital financial management while dimensional modeling technique is combined with the analysis on the requirements. This data warehouse model can not only improve the accuracy of financial management requirements, but also greatly increase the efficiency and quality of the hospital management. PMID:19119657

  5. 45 CFR 1305.8 - Attendance.

    Science.gov (United States)

    2010-10-01

    ..., RECRUITMENT, SELECTION, ENROLLMENT AND ATTENDANCE IN HEAD START § 1305.8 Attendance. (a) When the monthly... as well as special family support service activities provided by program staff must be documented....

  6. Prevalence and etiologic agents of female reproductive tract infection among in-patients and out-patients of a tertiary hospital in Benin city, Nigeria

    Directory of Open Access Journals (Sweden)

    Richard Omoregie

    2010-01-01

    Full Text Available Background: Reproductive tract infections are public health problems in women of reproductive age and can result in serious consequences if not treated. Aims: To determine the prevalence and causes of reproductive tract infections among in-patients and out-patients attending a tertiary health institution in Benin City. The antimicrobial susceptibility profiles of bacterial agents will also be determined. Patients and methods: High vaginal swabs or endocervical swabs and blood were collected from 957 patients consisting of 755 out-patients and 202 in-patients. The swabs were processed and microbial isolates identified using standard technique. Disc susceptibility tests were also performed on microbial isolates. The blood samples were used for serological diagnosis of syphilis. Results: There was no significant difference in the prevalence of female reproductive tract infections between in-patients (52.48% and out-patients (47.02%, although in-patients showed a significantly higher risk of developing mixed infections (in-patients vs. out-patients; 34.91% vs. 22.25%, OR = 1.873 95% CI = 1.169, 3.001; P = 0.01. Candida albicans was the most prevalent etiologic agent among out-patients studied while Staphylococcus aureus was the most prevalent etiologic agent among in-patients. Trichomonas vaginalis was observed only among out-patients. Ceftriaxone, ciprofloxacin and ofloxacin were the most active antibacterial agents. Syphilis was not detected in any patient. Conclusion: An overall prevalence of 48.17% of female reproductive tract infection was observed among the study population. Although there was no significant difference between in-patients and out-patients, in-patients appeared to have 1-3-fold increase risk of developing mixed infections. The most prevalent etiologic agent differs between in-patients and out-patients. Despite the high activity of ceftriaxone, ciprofloxacin and ofloxacin against bacterial isolates from both in-patients and out-patients

  7. Establishing an outpatient anticoagulation clinic in a community hospital.

    Science.gov (United States)

    Norton, J L; Gibson, D L

    1996-05-15

    The establishment of a pharmacist-managed out-patient anticoagulation clinic in a private community hospital is described. Discussions by pharmacy with office-based physicians at a 187-bed, private, nonprofit community medical center indicated that the traditional system of anticoagulation management was not ideal for the physicians or their patients. Development of a pharmacist-managed anticoagulation clinic began in fall 1993; operations began in spring 1994. Planning included analyzing existing practices, reviewing the relevant literature, obtaining physician input, visiting an established anticoagulation clinic, formulating a business plan, and developing clinical protocols. Collaborative relationships were established with the hospital laboratory, business office, and risk management, information services, and medical records departments. Two pharmacists were trained to work in the clinic and provide coverage 24 hours a day. Services include patient assessment, monitoring of anticoagulation, warfarin dosage adjustment, medication management, patient education, follow-up care, and providing feedback to referring and attending physicians. The clinic has met with physician and patient satisfaction, has reduced the number of admissions to treat warfarin-related bleeding, and has been able to cover its direct costs. A pharmacist-managed anti-coagulation clinic was successfully established in a private community hospital. PMID:8734675

  8. Using RFID Technology to Track Attendance

    OpenAIRE

    Mehmet F. Dicle; John Levendis

    2013-01-01

    The relationship between class attendance and academic performance continues to be of interest. The most common methods of tracking attendance, however, have their shortcomings and biases. We provide researchers with a method to collect unbiased and reliable attendance data. Late arrivals and early departures can also be recorded with ease, allowing researchers to evaluate these behaviors as well. Our method is intended to collect valuable attendance data at a minimal cost of time or money: s...

  9. Attendance Control System based on RFID technology

    OpenAIRE

    Nurbek Saparkhojayev; Selim Guvercin

    2012-01-01

    In Kazakhstan, checking students' attendance is one of the important issues for universities, because many universities evaluate students attendance and while giving the final grade, professors consider their total number of appearances on classes during the whole semester. This brings to the idea of having some tool to control students attendance. Some universities prefer to use paper sheet for controlling attendance, whereas some universities prefer to use paper sheet for checking students'...

  10. Minor injury attendance times to the ED.

    LENUS (Irish Health Repository)

    Conlon, Ciaran

    2009-07-01

    The Health Service Executive (HSE) highlights the need for effective patient throughput and management, whilst providing appropriate staffing and therapeutic interventions. It acknowledges that patient need is integral to the development of a nurse led service and advocates planning staffing levels to reflect arrival times of patients. An observational study of all patients who presented to the emergency department in July 2005 and February 2006 was undertaken (n=7768). The study identified 1577 patients suitable for treatment by the Advanced Nurse Practitioner (ANP) in these two months, which represents 20% of all patient attendances to the ED in this time period. A data collection tool was devised collectively by the ANPs to identify appropriate patients. The findings of the study revealed that 73% of patients suitable for the ANP service presented between the hours of 0800 and 2000, of which 54% attended between 0800 and 1600 h. Sunday emerged as the busiest day in July 2005 whereas Monday was found to be the busiest day in February 2006. Friday was found to be consistently busy for both months.

  11. Evaluation of Skin Findings in Adult Obese Dermatology Outpatients

    Directory of Open Access Journals (Sweden)

    Hilal

    2011-12-01

    Full Text Available Background: The relationship between systemic diseases and obesity is well-known, but the dermatological effects of obesity are ignored. In the literature, a few articles have appeared concerning the skin findings related to obesity. Our objective was to evaluate the skin findings in obese patients who applied to dermatology outpatient clinic and to compare obese and non-obese outpatients. Material and Method: A total 640 patients (300-in study group, 340-in control group were included in the study. All subjects were asked questions about socio-demographic features and presence of coexisting systemic diseases. Body mass index was calculated, dermatologic examination was performed, and diagnosis was recorded. Data were evaluated statistically. Results: Three-hundred obese patients (study group; 229 females, 71 males, mean age: 45.89 years and 340 non-obese outpatients (control group; 160 females, 180 males, mean age: 38.99 years were included in our study. There were more females in the study group and the mean age was higher than the control group. Most common skin findings of obese patients were: Skin tag (53.3%, plantar hyperkeratosis (29.6%, fungal infections (25.3%, striae (20.3% and acanthosis nigricans (15.3%. Fungal infections, intertrigo, varicose veins and keratosis pilaris were more common in females than males in the study group. Within the study group, patients with skin tag, acanthosis nigricans and plantar hyperkeratosis had higher BMI.Conclusion: Skin tag, plantar hyperkeratosis, fungal infections, striae and acanthosis nigricans were found to be the most common skin diseases in obese patients in our study. Studies related with pathophysiologic features of the skin of obese patients will give more information about the development and treatment of these diseases. (Turk­derm 2011; 45: 184-7

  12. 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

  13. 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

  14. Obesity and outpatient rehabilitation using mobile technologies: the potential mHealth approach.

    OpenAIRE

    GianlucaCastelnuovo; StefaniaCorti; SusanSimpson

    2014-01-01

    Obesity is currently an important public health problem of epidemic proportions (globesity). Inpatient rehabilitation interventions that aim at improving weight-loss, reducing obesity-related complications and changing dysfunctional behaviors, should ideally be carried out in a multidisciplinary context with a clinical team composed of psychologists, dieticians, psychiatrists, endocrinologists, nutritionists, physiotherapists, etc. Long-term outpatient multidisciplinary treatments are likely ...

  15. Obesity and outpatient rehabilitation using mobile technologies: the potential mHealth approach

    OpenAIRE

    Castelnuovo, Gianluca; Manzoni, Gian Mauro; Pietrabissa, Giada; Corti, Stefania; Giusti, Emanuele Maria; Molinari, Enrico; Simpson, Susan

    2014-01-01

    Obesity is currently an important public health problem of epidemic proportions (globesity). Inpatient rehabilitation interventions that aim at improving weight-loss, reducing obesity-related complications and changing dysfunctional behaviors, should ideally be carried out in a multidisciplinary context with a clinical team composed of psychologists, dieticians, psychiatrists, endocrinologists, nutritionists, physiotherapists, etc. Long-term outpatient multidisciplinary treatments are likely ...

  16. Attendance and Attainment in a Calculus Course

    Science.gov (United States)

    Meulenbroek, Bernard; van den Bogaard, Maartje

    2013-01-01

    In this paper the relationship between attendance and attainment in a standard calculus course is investigated. Calculus could in principle be studied without attending lectures due to the wealth of material available (in hardcopy and online). However, in this study we will show that the pass rate of students attending classes regularly (>75%…

  17. Personality of outpatients with malignant tumors: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Wang Zhuo

    2012-09-01

    Full Text Available Abstract Background There have been scarce large-scale studies investigating the personality of patients with malignant tumors. The purpose of this study is to determine the characteristic personality in malignant tumors outpatients. Methods Three thousand and three among 5013 consecutive outpatients who consented to answer the Japanese Maudsley Personality Inventory questionnaires were divided into two groups. 603 outpatients diagnosed with malignant tumors (M group and the other 2400 outpatients (non-M group were enrolled in this study. We determined three scores such as introversion/extroversion (E-score, neuroticism (N-score, and lie detection (L-score. All data were used to compare the two groups. Results Average E-score was slightly higher, and average N-score was slightly lower in M group than that in non-M group, and no significant differences between the two groups. However, the average L-score in M group was significant higher than that in non-M group (p  Conclusion Outpatients with malignant tumors showed a significantly higher L-score on MPI when compared with patients with non-malignant tumors. These results stress the importance of taking the mentality of patients with cancer into consideration when conducting treatment and care.

  18. Prevalence and associated factors of polypharmacy among adult Saudi medical outpatients at a tertiary care center

    Directory of Open Access Journals (Sweden)

    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.

  19. 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.

  20. Mining association rules between abnormal health examination results and outpatient medical records.

    Science.gov (United States)

    Chao Huang, Yi

    2013-01-01

    Currently, interpretation of health examination reports relies primarily on the physician's own experience. If health screening data could be integrated with outpatient medical records to uncover correlations between disease and abnormal test results, the physician could benefit from having additional reference resources for medical examination report interpretation and clinic diagnosis. This study used the medical database of a regional hospital in Taiwan to illustrate how association rules can be found between abnormal health examination results and outpatient illnesses. The rules can help to build up a disease-prevention knowledge database that assists healthcare providers in follow-up treatment and prevention. Furthermore, this study proposes a new algorithm, the data cutting and sorting method, or DCSM, in place of the traditional Apriori algorithm. DCSM significantly improves the mining performance of Apriori by reducing the time to scan health examination and outpatient medical records, both of which are databases of immense sizes. PMID:23736654

  1. 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

  2. Patients' experiences of NPWT in an outpatient setting in Denmark

    DEFF Research Database (Denmark)

    Ottosen, B; Pedersen, B D

    2013-01-01

    OBJECTIVE: To study patients' experiences of negative pressure wound therapy (NPWT) used for wounds of various aetiologies in the outpatient setting and the influences on daily life. METHOD: In this qualitative study, a phenomenological-hermeneutic approach was used. Ten patients underwent...... qualitative interviews regarding their NPWT treatment. The French philosopher, Ricoeur's,theory of interpretation guided the data analysis, which included three levels: naive reading, structural analysis and critical interpretation and discussion. RESULTS: The patients experienced a high level of dependency......, particularly after delivery of a baby and wound treatment following caesarean section. Some patients were embarrassed due to the appearance and smell of the exudate. CONCLUSION: Use of NPWT clearly influences patients' daily life. Patients have a feeling of being dependent on and attached to the equipment, and...

  3. Attendance and Performance: How Important Is It for Students To Attend Class?

    Science.gov (United States)

    Moore, Randy

    2003-01-01

    Explores the correlation between class attendance and performance in a biology course. Shows that class attendance by most students in nonmajor science classes is influenced by whether they receive points for attending class. Indicates the value of stressing to introductory science students the importance of class attendance to their academic…

  4. 美沙酮维持治疗门诊服药人员的不安全性行为及其相关因素%Unsafe sexual behaviors and associated factors among clients attending methadone maintenance treatment clinics

    Institute of Scientific and Technical Information of China (English)

    张欢; 陈涛; 庞琳; 刘恩武; 柔克明; 张洪波; 吴尊友

    2013-01-01

    目的 了解目前美沙酮维持治疗(MMT)门诊服药人员的不安全性行为状况及相关因素.方法 在重庆、广东、江苏三省(直辖市)6个MMT门诊,选取符合条件的服药人员进行问卷调查及尿液检测,收集研究对象的一般情况、性行为状况、美沙酮服药情况及多药滥用信息.结果 共调查1 202人,平均年龄(39.7±6.8)岁;其中男性占75.7%(910人),平均吸食海洛因年限(15.6±4.8)年.758人(63.1%)过去6个月有过性行为,其中10.2%(77/758)存在不安全性行为.男性、未婚单身/离异丧偶、与家人关系差、存在药物滥用、HIV阳性与不安全性行为的发生存在正向的统计学关联(P<0.05).结论 不安全性行为普遍存在于所调查的MMT门诊服药人员中,针对服药人员不安全性行为的健康教育和行为干预需要进一步加强.%Objective To understand the unsafe sexual behaviors among heroin addicts attending methadone maintenance treatment (MMT) clinics and to analyze the associated factors. Methods A total of 1 202 clients from 6 MMT clinics from Chongqing, Guangdong and Jiangsu were included in the study. The information of social demographics, sexual behaviors, multi drug use-related behaviors was collected by a questionnaire survey and urine samples were tested to identify if heroin or methamphetamine or ecstasy or benzodiazepine or buprenorphine had been used. Results The average age of the 1 202 clients was (39.7 ± 6.8) years. Among them, 75.7% were males, the average year of using heroin was (15. 6 ± 4. 8)years. Among all the participants, 758(63. 1%) had sexual behavior in the last 6 months, and 10. 2%(77/758) had unsafe sexual behavior. In males, who were unmarried, divorced or widowed, or had a bad relationship with their families, or used multi drugs, HIV positive status was positively correlated with unsafe sexual behavior (P<0. 05). Conclusion The clients of MMT also have a high percentage of unsafe sexual

  5. A Cross-Sectional Study on Socioeconomic Systems Supporting Outpatients With Parkinson’s Disease in Japan

    Directory of Open Access Journals (Sweden)

    Aiko Matsushima

    2016-04-01

    Full Text Available Objectives: We conducted a cross-sectional study to evaluate the socioeconomic systems supporting outpatients with Parkinson’s disease (PD in Japan. Methods: The study was performed in 2013 at two private hospitals and one clinic in Hokkaido Prefecture, Japan. A survey was conducted with 248 consecutive PD patients, and the data from 237 PD outpatients were analyzed after excluding 11 patients who did not meet inclusion criteria. Monthly medical and transportation payments as a PD outpatient were selected as outcome variables, and their association with various explanatory variables, such as utilization of support systems for PD outpatients, were evaluated using logistic regression model analysis. Results: After controlling for potential confounding variables, the utilization of the system providing financial aid for treatment for patients with intractable disease was significantly inversely associated with monthly medical payment among PD outpatients (OR 0.46; 95% CI, 0.22–0.95. Experience of hospital admission for PD treatment was significantly positively associated with monthly transportation payment (OR 4.74; 95% CI, 2.18–10.32. Monthly medical payment was also significantly positively associated with monthly transportation payment (OR 4.01; 95% CI, 2.23–7.51. Conclusions: Use of Japanese public financial support systems may be associated with reductions in medical payments for PD outpatients. However, those systems may not have supported transportation payments, and higher transportation payments may be associated with an increased risk of hospitalization.

  6. Conceptualizing services research on outpatient commitment.

    Science.gov (United States)

    Draine, J

    1997-01-01

    Issues affecting the research of outcomes of involuntary outpatient commitment (OC) of persons with serious mental illness are explored. These issues include the reliance on hospital recidivism as a primary measure of outcome, the role of family members and coercion in the process of outpatient commitment, and the conceptualization and design of studies. A conceptual framework that attempts to incorporate responses to these issues is proposed. Continued research on OC should build on conceptual models that include family role and burden, services delivered, an accounting for varied coercive mechanisms, and client-level outcomes. Rehospitalization should be conceptualized as an intermediate variable between OC and client-level outcomes rather than as an ultimate outcome. PMID:9230572

  7. Naivete, projection bias, and habit formation in gym attendance

    OpenAIRE

    Acland, Dan; Levy, Matthew

    2013-01-01

    We develop a model capturing habit formation, projection bias, and present bias in an intertemporal-choice setting, and conduct a field experiment to identify its main parameters. We elicit subjects' pre- and post-treatment predictions of post-treatment gym attendance, using a habit-formation intervention based on Charness and Gneezy (2009) as an exogenous shock to treated subjects' gym preferences. Projection-biased subjects, projecting their current habit state onto their future expectation...

  8. Administration of methohexital for pediatric outpatient dentistry.

    OpenAIRE

    Hunter, M. J.; Griswold, J. D.; Rosenberg, M

    1990-01-01

    Rectally administered methohexital is a safe, effective sedative to ameliorate the stress of the surgical experience for the uncooperative child. The rapid onset, relatively short duration, and patient acceptance of this technique make it applicable for many pediatric outpatient procedures. Induction doses of 20-30 mg/kg of a 10% methohexital solution can produce sleep in 7-8 minutes. In some situations, the rectal route of administration has advantages over more commonly used techniques.

  9. Pricing commodity outpatient procedures assessing the impact.

    Science.gov (United States)

    Cleverley, William O

    2015-10-01

    Hospitals should carefully consider all relevant factors before choosing to lower prices and payments for certain outpatient commodity services in an effort to remain competitive in their market. Key steps to take in the evaluation process include: Determining current profitability. Assessing profitability by payer class. Understanding overall cost positions. Assessing the relative payment terms of current commercial contracts. Determining the net revenue effect of proposed changes. PMID:26595979

  10. Corticosteróides inalatórios e crescimento em crianças asmáticas ambulatoriais Inhaled corticosteroid treatment and growth of asthmatic children seen at outpatient clinics

    Directory of Open Access Journals (Sweden)

    Elisete E. Arend

    2006-06-01

    Full Text Available OBJETIVO: Verificar o efeito do uso de corticosteróides inalatórios no aumento estatural e ponderal de crianças asmáticas tratadas ambulatorialmente MÉTODOS: Foi realizado um estudo de coorte prospectivo de 1 ano, no qual 124 crianças asmáticas com 3 a 16 anos de idade que haviam recebido prescrição para uso de corticosteróides inalatórios há pelo menos 12 meses foram avaliadas quanto aos escore z altura/idade, peso/idade, índice de massa corporal e altura alvo parental estimada para a idade atual. Os critérios de exclusão foram: peso de nascimento menor que 2.500 g, desnutrição, doenças crônicas e uso de corticóide sistêmico por mais de 7 dias consecutivos. RESULTADOS: A média ± desvio padrão dos escores z altura/idade inicial e final foi, respectivamente, de 0,06±1,2 e 0,01±1,2, (IC95% 0,05-0,11; dos escores z peso/idade inicial e final foi de 0,6±1,5 e 0,5±1,5, respectivamente (IC95% 1,84-6,6. Esses valores não diferiram significativamente (p = 0,199 e p = 0,808. Quando estratificados em grupos bem e mal controlados da asma, púberes e não-púberes, também não houve perda estatural. CONCLUSÃO: Em relação às curvas NCHS (National Center for Health Statistics, não houve prejuízo na estatura e peso corporal de crianças/adolescentes que utilizaram corticosteróides inalatórios por mais de 1 ano nas doses preconizadas para prevenir asma.OBJECTIVE: To ascertain the effect of inhaled corticosteroid use on gain in height and weight of asthmatic pediatric outpatients. METHODS: A one-year prospective cohort study was carried out with 124 asthmatic children aged 3 to 16 years who were prescribed inhaled corticosteroids for at least 12 months, evaluating z-scores for height/age, weight/age, body mass index and parental target height for current age. Exclusion criteria were: birth weight less than 2,500 g, malnutrition, chronic diseases and systemic corticoid use for more than 7 consecutive days. RESULTS: The mean

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Re-attenders to the emergency department of a major urban hospital serving a population of 290,000.

    LENUS (Irish Health Repository)

    Ramasubbu, B

    2015-01-01

    The national Emergency Medicine Programme (EMP) in Ireland, defines a re-attender as any patient re-presenting to the Emergency Department (ED) within 28 days with the same chief complaint. A retrospective, electronic patient record audit was carried out on all re-attenders to Connolly ED during November 2012. There were 2919 attendances made up from 2530 patients; 230 patients re-attended a total of 389 times. The re-attendance rate was 13% (389\\/2919). 63 (27%) were frequent presenters. There was a significantly higher admission rate at second attendance than first (89 (39%) vs 39 (17%), p < 0.001). 25% (57\\/230) of patients \\'left before completion of treatment\\' (LBCT) at first attendance (significantly higher than the number at second attendance (p < 0.01)). 14\\/57 (25%) of those who LBCT at first attendance required admission at second attendance. 28\\/89 (31%) of second attendance admissions were failed discharges from first attendance. Reasons for re-attendance are multi-factorial and include both patient and departmental factors.

  13. Can Minnesota Multiphasic Personality Inventory-2 predict response to selective serotonin reuptake inhibitors in depressed outpatients?

    Science.gov (United States)

    Kertzman, Semion; Vainder, Michael; Reznik, Ilya; Gotzlav, Yossef; Weizman, Abraham; Kotler, Moshe; Iancu, Iulian

    2012-05-01

    There is growing evidence that individual differences among patients with major depressive disorder (MDD) on psychological and demographic measures may predict the therapeutic response to selective serotonin reuptake inhibitors (SSRIs). In this retrospective chart review, 108 outpatients with current major depressive episodes were treated with citalopram, paroxetine, or fluvoxamine. The Hamilton Depression Rating Scale and the Minnesota Multiphasic Personality Inventory-2 were administered before and after 8 weeks of SSRIs treatment. Clinical response was defined as a 50% or greater decrease in the 17-item Hamilton Depression Rating Scale total score (final visit minus baseline). This naturalistic short-term follow-up outcome study demonstrates that among depressive outpatients who responded to an 8-week trial, 57.4% achieved a good response to SSRIs. Statistical analysis showed that SSRI treatment may be 3.03 times more advantageous for MDD outpatients who are younger than 39 years. The patients with an elevated score of above 66T on the Social Introversion Minnesota Multiphasic Personality Inventory-2 scale are approximately 0.37 times as likely to be SSRI responders as are patients with a Social Introversion score less than 66T. Thus, it seems that in MDD outpatient age is the strongest predictor of response to SSRIs. PMID:22415223

  14. Attendance and attainment in a Calculus course

    Science.gov (United States)

    Meulenbroek, Bernard; van den Bogaard, Maartje

    2013-10-01

    In this paper the relationship between attendance and attainment in a standard calculus course is investigated. Calculus could in principle be studied without attending lectures due to the wealth of material available (in hardcopy and online). However, in this study we will show that the pass rate of students attending classes regularly (>75% of the classes) is much higher than the pass rate of students attending fewer classes. We use a logistic model to investigate whether this correlation is significant. We will argue why we believe that this correlation between attendance and attainment is causal, i.e. why it is necessary for most students to attend classes in order to (improve their chances to) pass the exam.

  15. Effects of Rural Mutual Health Care on outpatient service utilization in Chinese village medical institutions: evidence from panel data.

    Science.gov (United States)

    Zhou, Zhongliang; Gao, Jianmin; Xue, Qinxiang; Yang, Xiaowei; Yan, Ju'e

    2009-07-01

    To solve the problem of 'Kan bing nan, kan bing gui' (medical treatment is difficult to access and expensive), a Harvard-led research team implemented a community-based health insurance scheme known as Rural Mutual Health Care (RMHC) in Chinese rural areas from 2004 to 2006. Two major policies adopted by RMHC included insurance coverage of outpatient services (demand-side policy) and drug policy (supply-side policy). This paper focuses on the effects of these two policies on outpatient service utilization in Chinese village clinics. The data used in this study are from 3-year household follow-up surveys. A generalized negative binomial regression model and a Heckman selection model were constructed using panel data from 2005 to 2007. The results indicate that the price elasticities of demand for outpatient visits and per-visit outpatient expenses were -1.5 and -0.553, respectively. After implementing the supply-side policy, outpatient visits and per-visit outpatient expenses decreased by 94.7 and 55.9%, respectively, controlling for insurance coverage. These findings can be used to make recommendations to the Chinese government on improving the health care system. PMID:19548324

  16. Off-label prescribing of psychotropic drugs in a Danish child and adolescent psychiatric outpatient clinic

    DEFF Research Database (Denmark)

    Nielsen, Eva Skovslund; Hellfritzsch, Maja; Sørensen, Merete Juul; Rasmussen, Helle; Thomsen, Per Hove; Laursen, Torben

    2015-01-01

    This study aimed to describe the level of off-label treatment with psychotropic drugs at a child and adolescent psychiatric outpatient clinic in Denmark. We performed a cross-sectional study assessing records on patients treated with medicine at two outpatient clinics at the child and adolescent...... prescriptions were off-label, which corresponds to 27.6 %. Attention deficit hyperkinetic disorder (ADHD) drugs were prescribed 450 times (73.2 %) of which 11 prescriptions were off-label (2.4 %). Other psychotropic drugs comprised 165 (26.8 %) prescriptions and of these 159 (96.4 %) were off-label. With 106...... prescriptions, melatonin was the most prescribed of these drugs; all prescriptions were off-label. The main reasons for classifying prescriptions as off-label were age and indication of treatment. This cross-sectional study reveals that medical treatment of children with other psychotropic drugs than ADHD drugs...

  17. 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.

  18. 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

  19. Accuracy of serological testing for the diagnosis of prevalent neurocysticercosis in outpatients with epilepsy, Eastern Cape Province, South Africa.

    Directory of Open Access Journals (Sweden)

    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

  20. Outpatient percutaneous renal biopsy in adult patients

    International Nuclear Information System (INIS)

    To study the safety and efficacy of performing percutanaeous renal biopsy in the outpatient department compared to the traditional inpatient policy, we studied 44 consecutive patients with proteinuria and other urinary sediment abnormalities, at King Fahd Hospital of the University, Al-Khobar, Saudi Arabia, during the period from September 2004 to August 2006. The patients were divided into two groups: group I, in whom kidney biopsy was performed and followed by 1-day hospital admission; and group II, in whom renal biopsy was performed in the outpatient department and followed by 6 hours observation period and then by regular outpatient visits. All biopsies were performed with the use of real-time ultrasound and automated biopsy needle. Patients with a history of bleeding diathesis or abnormal coagulation profile and those receiving warfarin, heparin, aspirin or nonsteroidal anti-inflammatory drugs were excluded from the study. Only minor biopsy-related complications such as gross hematuria, perinephric hematoma that resolved without the need for blood transfusion or surgical intervention occurred in three (13.6%) patients in group I and in two (9.1%) patients in group II. The complications were apparent within 6 hours in all but one patient (97.7%). Overall, hematuria was identified in 52% of patients at <-72 hours, 85% at <-4 hours and 97.7% at <- 6 hours. The 24-hour hematocrit levels were not significantly different between the study groups. One (4.5%) patient from group II had a small perinephric hematoma, which was detected by ultrasound examination at 24 hours but not at 6 hours post biopsy period; it resolved spontaneously without intervention. We conclude that in selected patients, same day discharge after 6 hours of renal biopsy may be given safety without increased risk of complications. (author)

  1. Regular clinic attendance in two large San Francisco HIV primary care settings.

    Science.gov (United States)

    Cohen, Jenny K; Santos, Glenn-Milo; Moss, Nicholas J; Coffin, Phillip O; Block, Nikolas; Klausner, Jeffrey D

    2016-05-01

    Although poor clinic attendance is associated with increased morbidity and mortality among HIV-infected individuals, less is known about predictors of retention and the acceptability of targeted interventions to increase regular clinic attendance. To better understand which patients are at risk for irregular clinic attendance and to explore interventions to aid in retention to care, we surveyed patients attending two outpatient HIV clinics affiliated with the University of California, San Francisco. A total of 606 participants were surveyed, and the analysis was restricted to the 523 male respondents. Of this group, 45% (N = 299) reported missing at least one visit a year. Missing a clinic visit was associated with being African American (aOR = 1.99; 95%CI 1.12-3.52), being a man who has sex with both men and women (aOR=2.72; 95%CI 1.16-6.37), and reporting at least weekly methamphetamine use (aOR=5.79; 95%CI 2.47-13.57). Participants who reported a monthly income greater than $2000 were less likely to miss an appointment (aOR = 0.56; 95%CI 0.34-0.93). Regarding possible retention interventions, most patients preferred phone calls over other forms of support. These findings support the need for ongoing engagement support with particular attention to at-risk sub-groups. PMID:26654093

  2. A Study on Attendance and Academic Achievement

    DEFF Research Database (Denmark)

    Sund, Kristian J.; Bignoux, Stephane

    -all degree classification, which we see as a proxy for academic ability. We suggest that attendance may simply be a reflection of student conscientiousness, engagement and motivation. We also challenge the assumptions about gender differences found in prior research on student attendance and student...

  3. Análisis comparativo de costos directos y funcionamiento global en personas afectadas por trastorno bipolar I y II, en tratamiento ambulatorio Comparative Analysis for Direct Costs and Global Functions in Persons Affected By Bipolar Disorders I and II in Outpatient Treatment

    Directory of Open Access Journals (Sweden)

    Ana Igoa

    2011-10-01

    Full Text Available Objetivo: Evaluar los costos directos, el nivel de funcionamiento y la tasa de empleo reportada en una muestra aleatoria de personas con trastorno bipolar (TB I y II que se atienden en forma ambulatoria. Métodos: Se analizaron y compararon los costos directos de los tratamientos ambulatorios de 165 pacientes con diagnóstico de trastorno bipolar tipo I y II (el costo mensual del tratamiento farmacológico, el número de consultas mensuales, el número de internaciones y días de internación. Se estimó el funcionamiento global y se consignó la condición laboral. Resultados: El 51,5% (n=85 de los pacientes presentaba diagnóstico de TB tipo I y 48,5% (n=80 de TB tipo II. El 40,6% de los pacientes se encontraba desocupado; el puntaje de GAF fue 73 ± 12,59. Los costos mensuales del tratamiento farmacológico fueron de $480 ± $350,4 por paciente sin diferencia entre los TB. Un mayor porcentaje de pacientes con TB I había tenido internaciones y recibía antipsicóticos, mientras que un mayor porcentaje de pacientes con TB II recibía antidepresivos y asistía al psicólogo. Discusión: Los pacientes con diagnóstico de TB I y TB II deben afrontar tratamientos farmacológicos que implican un costo promedio equivalente a un cuarto del ingreso mínimo en nuestro país, independientemente del tipo de trastorno bipolar que padezcan. Ambos grupos de pacientes presentaban una elevada tasa de desempleo y puntajes de funcionamiento global relativamente bajos.Objective: To evaluate the direct costs, the functional level and the employment rate reported for a random sample of people with Bipolar Disorders (BD I and II that are cared for as outpatients. Methods: The direct costs of outpatient treatment for 165 patients diagnosed with types I and II bipolar disorders were compared and analyzed (the monthly cost of pharmacological treatments, the number of consultations per month, the number of hospitalizations and the days spent in hospital. Global

  4. 口腔医生对门诊突发医疗事件及处理认知水平的调查%A survey on the cognition of emergency and treatment during outpatient service among dentists

    Institute of Scientific and Technical Information of China (English)

    苏静; 刘静明; 龚怡; 郑东翔

    2012-01-01

    目的 了解北京地区口腔医生对门诊突发医疗事件及处理的认知水平,探讨提高口腔医生急救处理能力的方式.方法 采用自行设计调查问卷,对北京696名口腔医生进行常见门诊突发医疗事件及紧急处理能力的调查,对数据进行描述和统计分析.结果 口腔医生门诊常遇到的13项突发医疗事件中,晕厥、低血糖、轻度过敏反应、体位性低血压发生频率位居前4位,分别为65.92%、51.27%、34.53%、21.08%.不足30%的口腔医生充分了解基础生命支持-心肺复苏(BLS-CPR)的相关知识.非营利性、二或三级医疗机构的口腔医生急救能力高于在营利性、规模小的医疗机构的口腔医生.结论 应提高口腔医生应对突发医疗事件的认识和预防意识,加强基本急救能力的培养,口腔医学院应开展急救实践操作训练以提高口腔医生综合执业能力.%Objective To invesligale the cognition and treatment of emergent evenls during oulpalienl service among denlisls. Methods The self-designed questionnaires were dislribuled Lo 696 denlisls who practised in Beijing area. The data were collected and statistically analyzed. Results Among the 13 emergent events reported by the respondents, the most prevalent emergency was syncope(65. 92% ) ,followed by orthostatic hypotension(51. 7% ) ,moderate allergic reactions( 34. 53% ) and hypoglycemia (21.08%). Less than 30% of the dentists thoroughly understood the knowledge concerning BLS-CPR. The ability of treating emergency among the dentists in larger scale hospitals was higher than those in small scale medical settings. Conclusion It is necessary to improve the awareness of emergency prevention and strengthen the cultivation on ability of emergency treatment among dentists.

  5. Frequent attenders in out-of-hours general practice care: attendance prognosis

    DEFF Research Database (Denmark)

    Vedsted, Peter; Olesen, Frede

    1999-01-01

    OBJECTIVE: We aimed to describe the use of out-of-hours service and analyse attendance prognosis for frequent attenders and other groups of attenders, and to present a concept describing frequent attendance over time. METHODS: All adult attenders in 1990 were included in a 4-year follow-up study...... or three contacts per year. The setting was out-of-hours general practice in Aarhus County, Denmark. Data were collected from the database of the Public Health Insurance, Aarhus County. The county had approximately 600,000 inhabitants, of whom 465,000 were aged 18 years and over. The subjects were...

  6. Comparison of the patient satisfaction from inpatient and outpatient fissurectomy in Motahari clinic and Shahid Faghihi hospital, Shiraz, Iran

    Directory of Open Access Journals (Sweden)

    L Mohammadinia

    2014-01-01

    Full Text Available Introduction: Satisfaction of the patients is considered as an important index in evaluating the performance of the hospitals and is highly effective in developing and improving the quality of the provided services .so, the present study aims to compare the satisfaction of the patients suffering from anal fissure from inpatient and outpatient treatments. Method: This cross-sectional study was conducted on 212 subjects who were selected through systematic sampling from the patients with anal fissure referring to Motahari clinic and Shahid Faghihi hospital. In order to compare the patient satisfaction in two inpatient and outpatient groups, 21-item questionnaire was designed in order to assess the patient satisfaction. Independent t-test and chi-square test were used to analyze this data. Results: satisfaction of the inpatients was significantly more than that of the outpatients (P0.001, quality, and other services compared to the outpatients (P=0.041. Conclusion: According to the advantages that mentioned, outpatient operations can be a better choice for small surgeries; of course, health planners should pay more attention to its importance and necessity and provide more equipments and welfare facilities in treatment centers.

  7. Effectiveness of medical supportive team for outpatients treated with sorafenib: a retrospective study

    OpenAIRE

    Kajizono, Makoto; Aoyagi, Megumu; Kitamura,Yoshihisa; Sendo, Toshiaki

    2015-01-01

    Background It is well known that molecular-targeted drugs, of which sorafenib (Nexavar®) is one, differ from previous anticancer drugs and cause various unusual adverse drug reactions. Treatment with sorafenib causes adverse drug reactions such as hand-foot skin reactions, hypertension, and diarrhea. Physicians spend a lot of time monitoring adverse drug reactions to sorafenib in outpatients. As such, at Okayama University Hospital, pharmacists and nurses have organized a medical supportive t...

  8. Predictors of response and adherence to outpatient multimodal rehabilitation in patients with chronic low back pain

    OpenAIRE

    Dhondt, Evy; Van Oosterwijck, Jessica; Cagnie, Barbara; Adnan, Rahmat; Schouppe, Stijn; Van Akeleyen, Jens; Logghe, Tine; Danneels, Lieven

    2015-01-01

    BACKGROUND AND AIMS: There is a growing need to identify patient pre-treatment characteristics that could predict the responsiveness to specific interventions. Therefore this study aimed to identify predictors of response to outpatient multimodal rehabilitation (favourable versus non-favourable outcome) and predictors of therapeutic adherence (drop-out versus adherence to therapy) in patients with chronic low back pain. METHODS: A total of 273 chronic low back patients participated in an e...

  9. Influence of age at onset on social functioning in outpatients with schizophrenia

    OpenAIRE

    Ochoa, S; J. Usall; V. Villalta-Gil; M. Vilaplana; M. Márquez; M. Valdelomar; Haro, J. M.

    2006-01-01

    Background and Objectives: There are different factors that have been found to predict disability in schizophrenia. The aim of our study is to evaluate the influence of age at onset on social functioning in schizophrenia in a large sample of schizophrenic outpatients controlling for gender. Methods: Two hundred and thirty-one subjects with schizophrenia (DSM-IV criteria) were randomly selected from a register that included all patients under treatment in five mental health care centers (MHCC)...

  10. Antimicrobial Non-Susceptibility of Escherichia coli from Outpatients and Patients Visiting Emergency Rooms in Taiwan

    OpenAIRE

    Wang, Jann-Tay; Chang, Shan-Chwen; Chang, Feng-Yee; Fung, Chang-Phone; Chuang, Yin-Ching; Chen, Yao-Shen; Shiau, Yih-Ru; Tan, Mei-Chen; Wang, Hui-Ying; Lai, Jui-Fen; Huang, I-Wen; Yang Lauderdale, Tsai-Ling

    2015-01-01

    Longitudinal nationwide surveillance data on antimicrobial non-susceptibility and prevalence of extended-spectrum β-lactamases (ESBLs) as well as AmpC β-lactamases producers among Escherichia coli from different sources in the community settings are limited. Such data may impact treatment practice. The present study investigated E. coli from outpatients and patients visiting emergency rooms collected by the Taiwan Surveillance of Antimicrobial Resistance (TSAR) program. A total of 3481 E. col...

  11. Caregiver Participation in Community-based Mental Health Services for Children Receiving Outpatient Care

    OpenAIRE

    Fawley-King, Kya; Haine-Schlagel, Rachel; Trask, Emily V.; Zhang, Jinjin; Garland, Ann F

    2013-01-01

    Caregiver participation in child mental health treatment has been associated with better youth outcomes, but little is known about the amount and type of caregiver participation in usual care services for children. This study examined 1255 caregivers’ reports of their participation in the outpatient services their children received through a large, public mental health system in the Southwest. The majority of the caregivers reported that they participated in their child's services. Extent of ...

  12. Dynamics of occupational and relational functioning of outpatients with mental disorders in two-year observation

    OpenAIRE

    Rymaszewska, Joanna; Mazurek, Justyna; Szczepańska-Gieracha, Joanna

    2014-01-01

    Objectives: The aim of the project was to assess changes of occupational and relational functioning within 2 years period of ambulatory treatment of persons suffering from different mental disorders. Material and method: Outpatients (n=184) at the age of 18-54 from five diagnostic groups – according to ICD-10: psychotic disorders (F2), affective disorders (F3), anxiety disorders (F4), eating disorders (F5) and personality disorders (F6) were enrolled in the prospective study with 6, 12 and...

  13. Outpatient antibiotic prescriptions from 1992 to 2001 in The Netherlands

    NARCIS (Netherlands)

    Kuyvenhoven, MM; van Balen, FAM; Verheij, TJM

    2003-01-01

    Objectives: Although Dutch outpatient antibiotic prescription rates are low compared with other European countries, continuing to scrutinize trends in outpatient antibiotic use is important in order to identify possible increases in antibiotic use or inappropriate increases in the use of particular

  14. User-driven innovation of an outpatient department

    DEFF Research Database (Denmark)

    Broberg, Ole; Edwards, Kasper

    2012-01-01

    This paper presents experiences from a user-driven innovation process of an outpatient department in a hospital. The mixing of methods from user-driven innovation and participatory design contributed to develop an innovative concept of the spatial and organizational design of an outpatient depart...

  15. A model to inform community pharmacy's collaboration in outpatient care.

    Science.gov (United States)

    Smith, Megan G; Ferreri, Stefanie P

    2016-01-01

    Value-driven health care and team-based care are gaining momentum from policymakers, payers, and providers. An important facet to examine is the health care team, especially in outpatient care. Community pharmacy is a significant aspect of the patient's health experience and a valuable component of outpatient care. An in-depth look into how community pharmacy can participate in the outpatient care team is described. To function as a team, it is crucial to address collaboration among outpatient practices, while making it easier for patients to navigate the outpatient health system. Previously published characteristics, principles, and values of effective health care teams within primary care can aid in establishing teams across practice settings including community pharmacy. PMID:26314920

  16. Prescribing Pattern in Outpatient Departments of Two Tertiary Care Teaching Hospitals in Dhaka

    Directory of Open Access Journals (Sweden)

    Halima Begum

    2015-09-01

    Full Text Available Background: Medically inappropriate, ineffective and economically inefficient use of drugs is very common in our country. About 40% or more drugs expenditure may be wasted through irrational prescribing and dispensing. The need for promoting rational use of drugs is not only because of economic considerations; also it is an essential element for achieving quality of the health and medical care for patients and the community. For this purpose a cross sectional study was carried out among the individuals attending the outpatient departments (OPD of Medicine, Surgery, Gynecology & Obstetrics, Pediatrics, Orthopedics, Dermatology & Venereology, Ophthalmology and Otolaryngology of two tertiary care teaching hospitals of Dhaka, Bangladesh. Objective: To observe the prescribing pattern in outpatient departments of two tertiary care teaching hospitals (Dhaka by using World Health Organization (WHO core prescribing indicators. Materials and Methods: Six hundred prescriptions of patients attending the OPD of Medicine, Surgery, Gynecology & Obstetrics, Pediatrics, Orthopedics, Dermatology & Venereology, Ophthalmology and Otolaryngology of Enam Medical College Hospital (private hospital and Sir Salimullah Medical College Hospital (public hospital were collected randomly on working days from April to September 2014. Then the prescriptions were analyzed by following the “Prescribing indicators form” as recommended by the International Organization of Rational Use of Drugs (INRUD/WHO. Results: Average number of drugs per prescription was significantly high (3.07 in public hospital and 3.00 in private hospital. Generic prescribing was significantly lower in private hospital (4.00% than that in public hospital (21.00%. Antibiotic prescription was higher in private hospital (42.35%. Injection prescribed in public hospital was 5.74% whereas 5.66% in private hospital. Drugs prescribed from Essential Drug List of Bangladesh were less in both the hospitals (42

  17. 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.

  18. BACTERIAL SPECTRUM AND PATTERN OF ANTIMICROBIAL SENSITIVITY AMONG OUTPATIENTS WITH PNEUMONIA IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Sushma

    2015-04-01

    Full Text Available OBJECTIVES: To outline the spectrum of bacteria causing pneumonia and the pattern of antimicrobial sensitivity in outpatients with pneumonia in a tertiary care hospital in Himachal Pradesh. METHODS: Sputum of 108 immuno competent pneumonia patients attending outpatient departments of Medicine and Pulmonary medicine of Dr. R. P. Government Medical College , Kangra at Tanda was sent for Gram staining and culture and sensitivity testing. RESULTS: Commensals were detected in most of the cases (32 , 29.6% followed by Staphylococcus aureus in 17(15.7% and Streptococcus pneumoniae in 16(14.8%. This was followed by three Gram negative organisms namely E Coli (11 , 10.2% , Pseudomonas (10 , 9.2% and Klebsiella (8 , 7.2%. No growth was obtained in 7(6.5% and other organisms were isolated in 7(6.5% specimens. Staphylococcus aureus was sensitive to vancomycin , clindamycin , cefoxitin , azithromycin and cotrimoxazole. Streptococcus pneumoniae was found to be sensitive to vancomycin , clindamycin , gentamicin , azithromycin , penicillin , cotrimoxazole , amoxicillin +clavulanic acid. Klebsiella was found to be sensitive to imipenem , azithromycin , ciprofloxacin , gentamicin and amoxicillin +clavulanic acid. E coli was sensitive to imipenem , gentamicin and amoxicillin +clavulanic acid. Pseudomonas aeruginosa was found to be sensitive to gentamicin , cefta zidime , imipenem , ticarcillin and piperacillin. CONCLUSION: Staphylococcus aureus and Streptococcus pneumoniae are the commonest organism causing pneumonia. Streptococcus pneumoniae is resistant to many antibiotics. Azithromycin can be the first line therapy for pneumonia.

  19. As (impossibilidades de brincar para o escolar com câncer em tratamento ambulatorial Las (imposibilidades de jugar para el escolar con cáncer en tratamiento en ambulatorio The (impossibilities of play for children with outpatient cancer treatment

    Directory of Open Access Journals (Sweden)

    Liliane Faria da Silva

    2010-06-01

    posibilidades. CONCLUSIÓN: Los profesionales que atienden a estos niños deben buscar conocimientos acerca de las necesidades que estos clientes tienen considerando que son seres en desarrollo, identificando situaciones que pueden determinar (imposibilidades del jugar y, junto con el niño y la familia, transformarlas en otras posibilidades.OBJECTIVES: To identify the mediators of play in the lives of children with cancer in outpatient treatment, and review the opportunities of using them, considering the limitations imposed by the disease and the treatment. METHODS: Qualitative research, according to the creative and sensitive method implemented; it was focused on group dynamics "Playing on stage." Twelve (12 children participated, who were being treated for cancer in an outpatient service at a hospital in Rio de Janeiro. RESULTS: Two themes emerged: mediators of the possibilities of play (instruments and signs, and mediators of the possibilities of play in social interaction (people and environment. In situations of impossibilities and restrictions, the children found alternatives to overcome the obstacles and to continue playing, within their abilities. CONCLUSION: The professionals who care for these children must seek knowledge about the needs the children have (as human beings in development, identifying situations that may determine the possibilities of playing and, along with the child and family, transforming them into other possibilities.

  20. Pure analgesics in a rheumatological outpatient clinic

    Directory of Open Access Journals (Sweden)

    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.

  1. 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

  2. The Correlation between Attendence and Achievement

    OpenAIRE

    Davis, Adrian

    2011-01-01

    In a global context it is generally accepted that the retention and associated completion rates for first year students is an area for concern in third level institutions. One are of particular interest is the low levels of completion on some degree programmes. Earlier studies of a similar nature have indicated that these students who attend at high levels not only pass examinations but also attain higher grades. Whilst attendance itself is not the cause of learning, even the most basic expos...

  3. Attendance and Exam Performance at University

    OpenAIRE

    David O Allen; Webber, Don J

    2006-01-01

    Marburger (2006) explored the link between absenteeism and exam performance by assessing the impact on absenteeism of removing a university wide policy of mandatory attendance for a single class. His results indicate that while an attendance policy has a strong impact on reducing absenteeism the link between absenteeism and exam performance is weak.This paper presents an alternative exploration into the link between absenteeism and exam performance by assessing the impact of implementing a mo...

  4. Consumer decision-making on festival attendance

    OpenAIRE

    Noman, Md. Abu

    2012-01-01

    It has been challenging for the festival organizers to sell their festival tickets due to overcrowded festival market. To increase the ticket sale it is becoming more important to know the consumers and their decision making on festival attendance. There are many factors that influence people to make decision over festival attendance and the main purpose of this study was to identify those factors. The research was conducted for GigsWiz.com Ltd. to help the company gather information about fe...

  5. 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

  6. 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

  7. Attendance Control System based on RFID technology

    Directory of Open Access Journals (Sweden)

    Nurbek Saparkhojayev

    2012-05-01

    Full Text Available In Kazakhstan, checking students' attendance is one of the important issues for universities, because many universities evaluate students attendance and while giving the final grade, professors consider their total number of appearances on classes during the whole semester. This brings to the idea of having some tool to control students attendance. Some universities prefer to use paper sheet for controlling attendance, whereas some universities prefer to use paper sheet for checking students' attendance and after this, fill out these information into a system manually, like Kazakh-British Technical University does. However, this is not an efficient way since there will be spent much of time for calling students names and putting marks like presence or absence if the class is a lecture class, and in this class at least 5 groups are presented. Moreover, some students may call his/her friend as presence even though this student is currently absent. After thinking all these issues, authors of the following research paper decided to create a system that makes easier to check students attendance automatically, and this system is implemented in Suleyman Demirel University, Kazakhstan. Actually, this is the first time when such kind of system is being used in educational system of Kazakhstan. The system is based on RFID technology, and in this paper, details of this system are presented.

  8. The Convergent Validity of the Trauma Symptom Checklist for Young Children for a Sample of Sexually Abused Outpatients

    Science.gov (United States)

    Wherry, Jeffrey N.; Graves, Lauren E.; Rhodes King, Heidi M.

    2008-01-01

    The convergent validity of the Trauma Symptom Checklist for Young Children (TSCYC) was examined with a sample of 172 sexually abused outpatient treatment-seeking children and their caregivers. The TSCYC evidenced good convergent validity with other parent ratings (e.g., the Child Behavior Checklist, Child Sexual Behavior Inventory, and the…

  9. 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

  10. Optimizing transition of care through the facilitation of a pharmacist-managed deep vein thrombosis treatment program.

    Science.gov (United States)

    Davis, Kyle A; Miyares, Marta A; Price-Goodnow, Venessa S

    2013-08-01

    A pharmacist-managed deep vein thrombosis (DVT) treatment program was put into operation at Jackson Memorial Hospital in Miami, Florida to provide appropriate transition of care to the outpatient setting for patients diagnosed with DVT. A postgraduate year 1 pharmacy practice resident partnered with a clinical pharmacist to establish and implement the DVT pilot program in the emergency department (ED). Once contacted, the pharmacy resident or the clinical pharmacist communicated with the ED physician and made recommendations regarding appropriate anticoagulation. The pharmacist met with the patient to obtain informed consent and provide counseling regarding the anticoagulants. A timely outpatient appointment at the pharmacy-managed warfarin clinic was arranged for the patient and contact information was exchanged between the patient and the pharmacist. On average, patients enrolled in the DVT program from the ED were released 18.29 hours (±7.06) following the time of arrival. Following release from the hospital, 91% of patients attended their outpatient follow-up appointment at the warfarin clinic. Since the initiation of the DVT program, 1 patient experienced a recurrent DVT and major bleed during their treatment course. Due to successful implementation of this pharmacist-managed DVT program in the ED, the services were subsequently extended to inpatients with DVT. PMID:23172896

  11. ASYMPTOMATIC BACTERIURIA AMONG PREGNANT WOMEN ATTENDING THE OUTPATIENT CLINIC OF CHITWAN MEDICAL COLLEGE TEACHING HOSPITAL, CHITWAN, NEPAL

    OpenAIRE

    Mamata Sharma Neupane; Kalpana Sharma Dhakal; Harish Chandra Neupane; Shital Adhikari; Bijay Aryal

    2012-01-01

    Urinary Tract Infection (UTI) refers to both microbial colonization of the urine and tissue invasion of any structure of the urinary tract. Pregnancy enhances the progression from asymptomatic to symptomatic bacteriuria which could lead to pyelonephritis and adverse obstetric outcomes such as prematurity, low-birth weight, and higher fetal mortality rates. This study was undertaken to determine the prevalence of asymptomatic bacteriuria in pregnancy; its causative agents and their antimicrobi...

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

    OpenAIRE

    Pitamber Datt Garkoti; CMS Rawat; Rajesh Kumar Singh; Vinita Rawat; Janki Bartwal; Neha Goyal

    2015-01-01

    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 att...

  13. 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.

  14. Inpatient admissions and outpatient visits in persons with and without HIV infection in Denmark, 1995-2007

    DEFF Research Database (Denmark)

    Engsig, Frederik Neess; Hansen, Ann-Brit Eg; Gerstoft, Jan;

    2010-01-01

    HIV patients and a cohort of population controls matched on sex and date of birth. The study period was 1995-2007. We calculated inpatient admission rates and outpatient visit rates stratified by medical speciality and International Classification of Diseases-10 diagnose categories. Relative risks...... and a small increase in relative risk due to cardiovascular disease. CONCLUSION: After the introduction of HAART, the inpatient treatment of HIV-infected patients has decreased, especially at departments of infectious disease. In contrast, this population's use of outpatient facilities has increased....... The risk ratio (95% CI) fell from 6.2 (6.0-6.5) to 3.1 (3.1-3.2) predominantly due to reduced inpatient admission rates to departments of infectious diseases. The overall outpatient visit rates (95% CI) for the HIV-infected patients increased from 744 (737-751) to 877 (872-882)/100 person-years, mainly due...

  15. The Effect of Contingent Reinforcement on Target Variables in Outpatient Psychotherapy for Depression: A Successful and Unsuccessful Case Using Functional Analytic Psychotherapy

    Science.gov (United States)

    Kanter, Jonathan W.; Landes, Sara J.; Busch, Andrew M.; Rusch, Laura C.; Brown, Keri R.; Baruch, David E.; Holman, Gareth I.

    2006-01-01

    The current study investigated a behavior-analytic treatment, functional analytic psychotherapy (FAP), for outpatient depression utilizing two single-subject A/A+B designs. The baseline condition was cognitive behavioral therapy. Results demonstrated treatment success in 1 client after the addition of FAP and treatment failure in the 2nd. This…

  16. Student attitudes about class absences, class attendance, and requiring attendance at Virginia Tech

    OpenAIRE

    Hileman, Annmarie Long

    1992-01-01

    Seventy-nine undergraduate students were interviewed in February, 1992, to determine attitudes about class attendance, class absences, and required attendance. Three hundred undergraduates were selected in a random sample; seventy-nine attended one of the six group interview sessions. The reasons students gave for skipping classes included being lazy or tired, dislike of the professor, material for the class was seen as unimportant, bad or nice weather, early mornin...

  17. Epidemiology of frequent attenders: a 3-year historic cohort study comparing attendance, morbidity and prescriptions of one-year and persistent frequent attenders

    Directory of Open Access Journals (Sweden)

    ter Riet Gerben

    2009-01-01

    Full Text Available Abstract Background General Practitioners spend a disproportionate amount of time on frequent attenders. So far, trials on the effect of interventions on frequent attenders have shown negative results. However, these trials were conducted in short-term frequent attenders. It would be more reasonable to target intervention at persistent frequent attenders. Typical characteristics of persistent frequent attenders, as opposed to 1-year frequent attenders and non-frequent attenders, may generate hypotheses regarding modifiable factors on which new randomized trials may be designed. Methods We used the data of all 28,860 adult patients from 5 primary healthcare centers. Frequent attenders were patients whose attendance rate ranked in the (age and sex adjusted top 10 percent during 1 year (1-year frequent attenders or 3 years (persistent frequent attenders. All other patients on the register over the 3-year period were referred to as non-frequent attenders. The lists of medical problems coded by the GP using the International Classification of Primary Care (ICPC were used to assess morbidity. First, we determined which proportion of 1-year frequent attenders was still a frequent attender during the next two consecutive years and calculated the GPs' workload for these patients. Second, we compared morbidity and number of prescriptions for non-frequent attenders, 1-year frequent attenders and persistent frequent attenders. Results Of all 1-year frequent attenders, 15.4% became a persistent frequent attender equal to 1.6% of all patients. The 1-year frequent attenders (3,045; 10.6% were responsible for 39% of the face-to-face consultations; the 470 patients who would become persistent frequent attenders (1.6% were responsible for 8% of all consultations in 2003. Persistent frequent attenders presented more social problems, more psychiatric problems and medically unexplained physical symptoms, but also more chronic somatic diseases (especially diabetes

  18. New modalities of pain treatment after outpatient orthopaedic surgery.

    Science.gov (United States)

    Beaussier, M; Sciard, D; Sautet, A

    2016-02-01

    Postoperative pain relief is one of the cornerstones of success of orthopaedic surgery. Development of new minimally-invasive surgical procedures, as well as improvements in pharmacological and local and regional techniques should result in optimal postoperative pain control for all patients. The analgesic strategy has to be efficient, with minimal side effects, and be easy to manage at home. Multimodal analgesia allows for a reduction of opiate use and thereby its side effects. Local and regional analgesia is a major component of this multimodal strategy, associated with optimal pain relief, even upon mobilization, and it has beneficial effects on postoperative recovery. Ultrasound guidance improves the success rate of distal nerve blocks and makes distal selective blockade possible, helping to preserve the limb's motility. Besides peripheral nerve blocks, local infiltration (incisional and/or intra-articular) is also important to consider. Duration of the nerve blockade is limited after a single injection. This must be taken into consideration to avoid the recurrence of pain when the patient returns home. Continuous perineural blocks using catheters are an option that can be easily managed at home with monitoring by home-care nurses. Extended-release liposomal bupivacaine and adjuvants such as dexamethasone could significantly enhance the duration of the sensory block, thereby reducing the indications for pain pumps. Non-pharmacological approaches, such as cryotherapy, hypnosis and acupuncture should not be ignored. PMID:26803223

  19. Incorporating Nondrug Social & Recreational Activities in Outpatient Chemical Dependency Treatment

    Science.gov (United States)

    Siporin, Sheldon; Baron, Lisa

    2012-01-01

    "Contingency Management programs (CMP) and non-drug social and recreational activities (NDSRA) are interventions premised on behavior theory that rely on external sources of reinforcement alternative to drug-based forms to decrease drug use. CMP usually employs vouchers as reinforcement for negative toxicologies. Despite research support, CMP…

  20. Social Welfare Centers Protect Outpatients with Mood Disorders from Risk of Hospital Admission.

    Directory of Open Access Journals (Sweden)

    Kyu-Tae Han

    Full Text Available South Korea faces difficulties in the management of mental disorders, and those difficulties are expected to gradually worsen. Therefore, we analyzed the relationship between social welfare centers and hospital admission after outpatient treatment for mood disorders.We used data from the National Health Insurance Service National Sample Cohort 2002-2013, which included all medical claims filed for the 50,160 patients who were newly diagnosed with a mood disorder among the 1,025,340 individuals in a nationally representative sample. We performed a logistic regression analysis using generalized estimating equation (GEE models to examine the relationship between social welfare centers and hospital admission after outpatient treatment for mood disorders (ICD-10: F3.There was a 3.9% admission rate among a total of 99,533 person-years. Outpatients who lived in regions with more social welfare centers were less likely to be admitted to a hospital (per increase of five social welfare centers per 100,000 people; OR: 0.958; 95% CI: 0.919-0.999. Social welfare centers had an especially strong protective effect on patients with relatively mild mood disorders and those who were vulnerable to medical expenditures.Considering the protective role of social welfare centers in managing patients with mood disorders, health-policy makers need to consider strategies for activating mental healthcare.

  1. 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

  2. Sex therapy in an in-patient and out-patient setting.

    Science.gov (United States)

    Kratochvíl, S

    1980-01-01

    This paper summarizes the experience with sex therapy in an in-patient ward for neurotics (N = 82), where it could be combined with interpersonally oriented group psychotherapy in a therapeutic community setting. Outcome data are compared with an out-patient form of sex therapy, used in several counseling centers (N = 111). The in-patient form of therapy had a success rate of 76% at completion of treatment and 52% after a follow-up period of 15 months. The out-patient therapy was successful in 71% but no follow-up was carried out. Almost 50% of the couples who originally started therapy dropped out. Three illustrative successful cases are described. PMID:7205970

  3. PSYCHIATRIC MORBIDITY AMONG PATIENTS ATTENDING CARDIAC OPD

    OpenAIRE

    Goyal, Ashok; Bhojak, M.M.; Verma, K. K.; Singhal, Ashok; Jhirwal, O.P.; Bhojak, Maneesh

    2001-01-01

    One hundred patients were selected from the cardiology outpatient department by non-probability purposive method. Each patient was evaluated by a psychiatrist and a consultant cardiologist The informations were recorded in a self designed proforma. The Hindi version of Goldberg′s General Health Questionnaire and modified adjective check list for type A and type B personality characteristics were administered. Seventy five percent of the patients were having psychiatric problems. The cardiac p...

  4. 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)

  5. Etiological beliefs of patients with neurological disorders attending a tertiary care center: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Bhupender Kumar Bajaj

    2013-01-01

    Full Text Available Background: The understanding and management of neurological disorders is undergoing revolutionary changes over the last three decades in the background of ever increasing advances in medical technologies, diagnostic techniques, therapeutic processes and, molecular and genetic medicine. The fruits of these advances can reach patients only if the psychosocial hurdles in their delivery are identified, acknowledged and addressed. Aim: To explore the beliefs and practices of patients with neurological disorders in a tertiary care center in the eastern Nepal. Materials and Methods: One hundred patients attending neurology/medicine outpatient for neurological disorders were interviewed about their beliefs regarding the triggering factors, causation and treatment-seeking behavior particularly from traditional healers. Result: Of the 100 patients (49 males, 51 females recruited in the study, 51% expressed having ′no idea′ about their illness. Only 20% patients gave medically congruent explanation for their illness. Psychological factors were attributed as triggering factors by 16% of patients, of which two-thirds were females. Chance, destiny and ′jadu tona′ topped the list of triggering factors. Forty-four percent patients had sought help of traditional faith healers (′Dhami Jhakri′ before seeking medical help. Traditional faith healers were approached by patients irrespective of their educational background. Fifty-nine percent of patients who first sought traditional faith healers, believed in ′jadu-tona′. Of those interviewed, 16% were planning to go to a faith healer in near future. Conclusion: The beliefs of patients with neurological disorders frequently do not conform to current medical opinion. There is need for greater communication and education of patients by their treating physicians.

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Intermittent attendance at breast cancer screening

    Directory of Open Access Journals (Sweden)

    Padraic Fleming

    2013-09-01

    Full Text Available Background. To determine why women skip rounds and factors influencing return of previous non attenders (PNAs to breast screening. Design and methods. Retrospective, quantitative, structured questionnaire posted to 2500 women. First PNAs did not attend their first screening appointment in 2007/2008 but then attended in 2010; First Controls first attended in 2010 without missed previous appointments. Women who attended screening in 2006 or earlier then skipped a round but returned in 2010 were Subsequent PNAs; Subsequent Controls attended all appointments.Results. More First Controls than First PNAs had family history of cancer (72.7% vs 63.2%; P=0.003; breast cancer (31.3% vs 24.8%; P=0.04. More PNAs lived rurally; more First PNAs had 3rd level education (33.2% vs 23.6%; P=0.002 and fewer had private insurance than First Controls (57.7% vs 64.8%; P=0.04. Excellent/good health was reported in First PNAs and First Controls (82.9% vs 83.2%, but fewer Subsequent PNAs than Subsequent Controls (72.7% vs 84.9%; P=0.000. Common considerations at time of missed appointment were had mammogram elsewhere (33% First PNA and postponed to next round (16% First PNA, 18.8% Subsequent PNA. Considerations when returning to screening were similar for First PNAs and Subsequent PNAs: I am older (35.4%, 29.6%, I made sure I remembered (29%, 23.6%, could reschedule (17.6%, 20.6%, illness of more concern (16.5%, 19%. More First PNAs stated my family/friends advised (22.3% vs 15.2% or my GP (12.6% vs 4.6% advised me to attend, heard good things about BreastCheck (28.8% vs 13.6%.Conclusions. Intermittent attenders do not fit socio-demographic patterns of non-attenders; GP recommendation and word of mouth were important in women’s return to screening. Fear and anxiety seem to act as a screening facilitator rather than an inhibitor.

  8. Father attendance in nurse home visitation.

    Science.gov (United States)

    Holmberg, John R; Olds, David L

    2015-01-01

    Our aim was to examine the rates and predictors of father attendance at nurse home visits in replication sites of the Nurse-Family Partnership (NFP). Early childhood programs can facilitate father involvement in the lives of their children, but program improvements require an understanding of factors that predict father involvement. The sample consisted of 29,109 low-income, first-time mothers who received services from 694 nurses from 80 sites. We conducted mixed-model multiple regression analyses to identify population, implementation, site, and nurse influences on father attendance. Predictors of father attendance included a count of maternal visits (B = 0.12, SE = 0.01, F = 3101.77), frequent contact between parents (B = 0.61, SE = 0.02, F = 708.02), cohabitation (B = 1.41, SE = 0.07, F = 631.51), White maternal race (B = 0.77, SE = 0.06, F = 190.12), and marriage (B = 0.42, SE = 0.08, F = 30.08). Random effects for sites and nurses predicted father-visit participation (2.7 & 6.7% of the variance, respectively), even after controlling for population sociodemographic characteristics. These findings suggest that factors operating at the levels of sites and nurses influence father attendance at home visits, even after controlling for differences in populations served. Further inquiry about these influences on father visit attendance is likely to inform program-improvement efforts. PMID:25521707

  9. Effects of therapeutic goal management (TGM) on treatment attendance and drug abstinence among men with co-occurring substance use and axis I mental disorders who are homeless: results of the Birmingham EARTH program

    OpenAIRE

    Davidson, Anna; Jensen, Michael; Burgess, Emilee; Stevens, Angee; Hayes, Lauren; Sieweke, Susan; Stough, Karen; Wright, Anne; McCarty, Robin; Eddleman, Lillian; Kim, Young-Il; Milby, Jesse B.; Schumacher, Joseph E.

    2013-01-01

    Purpose This study describes the implementation and impact of Therapeutic Goal Management (TGM) in a Substance Abuse and Mental Health Services Administration (SAMHSA)-sponsored demonstration project entitled Enhanced Addiction Recovery through Housing (EARTH). Participants The sample included 28 male participants followed at six months who completed some treatment. Forty-three percent were Caucasian, and 57% were African American. The average age of participants was 42 years. Design The rela...

  10. 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...

  11. Veterinary Teaching Hospital to launch small animal outpatient imaging service

    OpenAIRE

    Jackson, Christy

    2009-01-01

    Beginning in June 2009, the Virginia-Maryland Regional College of Veterinary Medicine at Virginia Tech's Veterinary Teaching Hospital will introduce a new outpatient advanced imaging service for surrounding small animal veterinarian practices.

  12. 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.

  13. 76 FR 49458 - TRICARE; Hospital Outpatient Radiology Discretionary Appeal Adjustments

    Science.gov (United States)

    2011-08-10

    ... of the Secretary TRICARE; Hospital Outpatient Radiology Discretionary Appeal Adjustments AGENCY... hospitals of an opportunity for net adjusted payments for radiology services for which TRICARE payments were... radiology services specified in the regulation as being reimbursed under the allowable charge...

  14. Creating an outpatient center of excellence in CT.

    Science.gov (United States)

    Itri, Jason N; Bakow, Eric; Woods, Jordan

    2014-12-01

    CT examinations represent a substantial portion of the workload for many radiology departments, and optimizing service delivery is a critical function to ensure customer satisfaction. This article describes how the Six Sigma methodology was used in the radiology department at a large academic hospital to improve the patient experience and increase CT capacity while reducing waste and improving staff satisfaction. The 5 distinct phases of Six Sigma are reviewed as they apply to our CT Center of Excellence project: define, measure, analyze, improve, and control. Process metrics used in this project include the percentage of outpatient CT exams started within 5 minutes of the scheduled appointment time, and the number of studies with protocols selected >48 hours before the CT exam is performed. Outcome metrics include monthly department expense per scan and CT Press Ganey "standard test and treatment" mean scores. An approach to developing interventions is described based on identifying critical sources of variation, ranking these by creating risk prioritization numbers, performing root cause analysis, and utilizing the failure mode and effects analysis tool to prioritize possible solutions. Finally, the key features of action plans and a control plan are reviewed. PMID:25467726

  15. Air pollution and unscheduled hospital outpatient and emergency room visits.

    OpenAIRE

    X. Xu; Li, B.; Huang, H.

    1995-01-01

    We conducted a time-series analysis of daily hospital visits and air pollution data to assess acute effects of air pollution on daily unscheduled outpatient visits to internal medicine, pediatric, and emergency departments in the No. 3 Affiliated Hospital of Beijing Medical University in Beijing, China. Sulfur dioxide was marginally significantly associated with total outpatient visits (beta = 41.5, SE = 24.2) and significantly associated with internal medicine (beta = 14.6, SE = 6.7), pediat...

  16. Migraine predicts physical and pain symptoms among psychiatric outpatients

    OpenAIRE

    Hung, Ching-I; Liu, Chia-Yih; Wang, Shuu-Jiun

    2013-01-01

    Background No study has been performed to compare the impacts of migraine and major depressive episode (MDE) on depression, anxiety and somatic symptoms, and health-related quality of life (HRQoL) among psychiatric outpatients. The aim of this study was to investigate the above issue. Methods This study enrolled consecutive psychiatric outpatients with mood and/or anxiety disorders who undertook a first visit to a medical center. Migraine was diagnosed according to the International Classific...

  17. 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...

  18. Evaluation of Skin Findings in Adult Obese Dermatology Outpatients

    OpenAIRE

    Hilal; Gonca; Sevim; İlknur

    2011-01-01

    Background: The relationship between systemic diseases and obesity is well-known, but the dermatological effects of obesity are ignored. In the literature, a few articles have appeared concerning the skin findings related to obesity. Our objective was to evaluate the skin findings in obese patients who applied to dermatology outpatient clinic and to compare obese and non-obese outpatients. Material and Method: A total 640 patients (300-in study group, 340-in control group) were included in th...

  19. A review of attendance and non-attendance studies at sporting events

    Directory of Open Access Journals (Sweden)

    JOHN DOUVIS

    2007-12-01

    Full Text Available Despite its rapid growth, in the last few years the GreekProfessional Basketball League has been concerned with the significant decrease in the general interest surrounding the game of basketball, which has resulted in a fewer number offans attending the league’s games. The Basketball Spectator Non-Attendance Scale is an instrument that facilitates the identification of factors associated with non-attendanceat professional basketball games in Greece. The scale was successfully tested for validity and reliability with a convenience sample of 270 students at the University of Athens. The design of the instrument, its practical applications and results from our initial findings are reported and explained. The paper also provides a review of attendance and non-attendance studies at sporting events, which are discussed in the context of current theoretical perspectives. Tentative recommendations are made for reaching this rather sizablenon-attendance market.

  20. Patterns of psychotropic medication use in inpatient and outpatient psychiatric settings in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Alosaimi FD

    2016-04-01

    (27.9%, and antianxiety (6.2%. However, compared to outpatients, the current use of medications for inpatients was more frequent (93.8% vs 89.9%, P=0.019 with inpatients more likely to be treated with multiple medications (2.1 vs 1.8 medications. A similar trend was observed in the case of antipsychotics, high potency first-generation antipsychotics, second-generation antipsychotics, mood stabilizers, and antianxiety medicines where inpatients were more frequently treated with these medications for all psychiatric diagnoses when compared with outpatients. On the contrary, in the case of antidepressant treatment, an opposite trend was observed with more number of treated outpatients in comparison to inpatients. Among elderly patients, 75.9% received antipsychotics, mainly second-generation formulations (67.2%, whereas only 41% received antidepressants and 13.8% received mood stabilizers.Conclusion: Based upon the present study data, it is concluded that among all the psychotropic medications, antipsychotics were heavily used and the frequency was found to be significantly high in the case of inpatients compared with outpatients. Such a practice may lead to multiple negative consequences among the Saudi psychiatric patient population. Further, extensive use of sodium valproate in the case of bipolar disorder, and also among females either in childbearing age or during pregnancy is also the cause of concern and warrants logical use. Overall, this study may help in assessing the burden of psychiatric illness within specific patient demographics and might be effectively used to strategically plan health resources allocation, generate new treatment hypothesis, or be used as a source of evidence that could further integrate other observational studies.Keywords: psychotropic, inpatient, outpatient, antipsychotics, antidepressants, mood stabilizers, Saudi Arabia