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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...

  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

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

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

    NARCIS (Netherlands)

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

    2007-01-01

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

  5. 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.

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    Cárdenas-Elizalde MR

    2012-03-01

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

  8. 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...

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

    Science.gov (United States)

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

    2012-01-01

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

  10. 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...

  11. 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

  12. 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.

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

    DEFF Research Database (Denmark)

    Jeppesen, Maja Haunstrup; Ainsworth, Mark Andrew

    2015-01-01

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

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

    Science.gov (United States)

    Mason, C

    1992-05-01

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

  16. 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...

  17. 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: ...

  18. Reinforcement-based outpatient treatment for opiate and cocaine abusers.

    Science.gov (United States)

    Katz, E C; Gruber, K; Chutuape, M A; Stitzer, M L

    2001-01-01

    A reinforcement-based intensive outpatient treatment was delivered to 37 recently detoxified, inner city, heroin and/or cocaine abusers who did not want methadone treatment. Attendance was scheduled and urine collected daily for the first 2 weeks, four times weekly for the next 2 weeks, and then thrice weekly for the final 8 weeks. As attendance incentives, patients received transportation assistance (bus tokens), and $28-$30 per week in vouchers to be spent on activities/items chosen and agreed upon with their counselor. As abstinence incentives, patients received weekend supported recreational activities, lunches, $42-$45 per week in vouchers, and rent or utilities payment ($150 over 4 weeks). Total potential earnings was $1,435 per patient; actual mean earnings was $583. Forty-three percent (n=16) completed 10 or more weeks of treatment. These 16 long-stay patients submitted 92% (SD=19) opiate- and cocaine-negative urines during their enrollment compared with 56% (SD=42) drug-negative urines submitted by 21 drop-outs, F(1,35)=9.99, p=0.003. Overall, 32% of clients became employed during their treatment episode; 94% of long-stay patients were employed at the end of their treatment episode. Patients who were drug-positive at intake were highly likely to drop out. Treatment outcomes compare favorably with those reported in the literature for outpatient nonmethadone treatment of opiate and cocaine abusers. Continued evaluation of this new treatment appears warranted.

  19. 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

  20. 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. ...

  1. 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...

  2. 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.

  3. 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.

  4. 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

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

    Directory of Open Access Journals (Sweden)

    N.P. Ntamo

    2013-12-01

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

  6. 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…

  7. Transportation and retention in outpatient drug abuse treatment programs.

    Science.gov (United States)

    Friedmann, P D; Lemon, S C; Stein, M D

    2001-09-01

    To determine whether certain types of transportation assistance improve outpatient treatment retention beyond thresholds shown to have therapeutic benefits, we analyzed data from 1,144 clients in 22 outpatient methadone maintenance (OMM) programs and 2,031 clients in 22 outpatient drug-free (ODF) programs in the Drug Abuse Treatment Outcomes Study (DATOS), a national, 12-month, longitudinal study of drug abuse treatment programs. Directors' surveys provided information about provision of car, van, or contracted transportation services or individual vouchers/payment for public transportation. Chart-abstracted treatment retention was dichotomized at 365 days for OMM and 90 days for ODF. Separate multivariate hierarchical linear models revealed that provision of car, van, or contracted transportation services improved treatment retention beyond these thresholds for both OMM and ODF, but individual vouchers or payment for public transportation did not. Future research should validate whether car, van, or contracted transportation services improve retention and other treatment outcomes in outpatient drug abuse treatment.

  8. 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...

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

    DEFF Research Database (Denmark)

    Jeppesen, Maja Haunstrup; Ainsworth, Mark Andrew

    2015-01-01

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

  10. 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.

  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. 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

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

    Directory of Open Access Journals (Sweden)

    Mohammad Zafir Al-Shahri

    2012-01-01

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

  15. 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.

  16. 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.

  17. 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

  18. The Treatment Motivation Scales for Forensic Outpatient Treatment (TMS-F) : Construction and Psychometric Evaluation

    NARCIS (Netherlands)

    Drieschner, Klaus H.; Boomsma, Anne

    2008-01-01

    The Treatment Motivation Scales for forensic outpatient treatment (TMS-F) is a Dutch 85-item self-report questionnaire for the motivation of forensic outpatients to engage in their treatment and six cognitive and affective determinants of this motivation. Following descriptions of the conceptual bas

  19. The Treatment Motivation Scales for forensic outpatient treatment (TMS-F) - Construction and psychometric evaluation

    NARCIS (Netherlands)

    Drieschner, Klaus H.; Boomsma, Anne

    2008-01-01

    The Treatment Motivation Scales for forensic outpatient treatment (TMS-F) is a Dutch 85-item self-report questionnaire for the motivation of forensic outpatients to engage in their treatment and six cognitive and affective determinants of this motivation. Following descriptions of the conceptual bas

  20. 42 CFR 410.155 - Outpatient mental health treatment limitation.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Outpatient mental health treatment limitation. 410.155 Section 410.155 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Payment of SMI...

  1. 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…

  2. 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)

  3. 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

  4. Day treatment for cocaine dependence: incremental utility over outpatient counseling and voucher incentives.

    Science.gov (United States)

    Marlowe, Douglas B; Kirby, Kimberly C; Festinger, David S; Merikle, Elizabeth P; Tran, Giao Q; Platt, Jerome J

    2003-03-01

    Urban, poor, crack cocaine-dependent clients were randomly assigned to outpatient addiction counseling (n=39) or day treatment (n=40). Participants in both conditions received equivalent individual cognitive-behavioral counseling and earned equivalent payment vouchers for providing cocaine-negative urine samples. However, day treatment participants attended significantly more psychoeducational and recreational groups and received two meals per day. Prior to random assignment, more participants expressed a preference for day treatment and participants were more likely to return for an initial appointment following assignment to day treatment. However, no significant between-groups differences in tenure or abstinence were detected during the 3-month course of treatment. These null findings were attributable to an absence of a dose-response effect for the group interventions in the day treatment condition. In addition, there may have been a ceiling effect from the vouchers, which masked the influence of the additional day treatment components.

  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. 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...

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

    DEFF Research Database (Denmark)

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

    1980-01-01

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

  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. 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...... 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-5 in outpatient clinics in Denmark, Germany, and New Mexico (USA) are invited to participate in a RCT...

  12. 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

  13. Utilization of outpatient mental health services after inpatient alcoholism treatment.

    Science.gov (United States)

    Booth, B M; Cook, C A; Blow, F C; Bunn, J Y

    1992-01-01

    It is generally agreed that use of aftercare services following discharge from alcoholism treatment is optimum for patients to achieve long-term recovery. However, the quantity and duration of utilization of such services in non-experimental settings are generally unknown. Using secondary data sources, we studied 5,635 alcoholics completing formal extended inpatient treatment and 1,860 alcoholics discharged from brief inpatient hospitalizations in Department of Veterans Affairs medical centers. Weekly use of outpatient mental health services (OPMH) prior to hospital admission was equally low for both patient groups (approximately 2-3% of patients) until four weeks prior to admission, at which time OPMH use increased, particularly for the extended treatment group. In the four weeks after discharge, use of OPMH services was substantially higher for patients with extended treatment compared to those with brief hospitalizations (40% vs. 18%), with 22% of patients completing treatment utilizing such services in the first week after discharge. Utilization steadily decreased until only 8% and 4% of both groups, respectively, were using OPMH services at the end of six months after discharge. Study results suggest the need to examine barriers to outpatient mental health utilization after discharge as well as interventions to increase compliance with long-term aftercare.

  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. 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.

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

    NARCIS (Netherlands)

    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 = 6

  17. 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.

  18. The Treatment Engagement Rating scale (TER) for forensic outpatient treatment : Description, psychometric properties, and norms

    NARCIS (Netherlands)

    Drieschner, Klaus Heinrich; Boomsma, Anne

    2008-01-01

    The Treatment Engagement Rating scale (TER) is a Dutch therapist rating instrument for treatment engagement (TE) of forensic outpatients. It yields scores for nine components of TE, which are aggregated in a total score. Following an analysis of the concept of TE, the TER is described, and various p

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

    DEFF Research Database (Denmark)

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

    1998-01-01

    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...

  20. 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…

  1. 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

  2. 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.

  3. 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

  4. 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

  5. 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

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

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    Kalaiselvi Selvaraj

    2016-01-01

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

  7. 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

  8. 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 ...

  9. 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...

  10. 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

  11. [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

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

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    Pitamber Datt Garkoti

    2015-06-01

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

  13. 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...

  14. 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...

  15. 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

  16. 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......, time to relapse and patient satisfaction were measured. Patients assessed their symptoms using the Short Alcohol Withdrawal Scale (SAWS). Patient satisfaction was monitored by the Diabetes Treatment Satisfaction Questionnaire. We used the Well-Being Index and the European addiction severity index...

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

    NARCIS (Netherlands)

    Exterkate, C.C.; Vriesendorp, P.F.; Jong, C.A.J. de

    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 Nervo

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

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    Robinson Caroline

    2012-08-01

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

  19. 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...... stable; they have no organ failure, they are able to take oral medications, and they do not suffer from acute leukemia. Low-risk prediction also may be based on the Multinational Association for Supportive Care in Cancer risk index Udgivelsesdato: 2008/5......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...... treatment failure (P risk febrile neutropenia is safe, effective, and comparable to standard hospital-based therapy. Patients at low risk are outpatients and are hemodynamically...

  20. 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...... investigated the role of pretreatment coping strategies in outcome of outpatient treatment for alcohol abuse. The pretreatment coping strategies of 136 clients receiving outpatient treatment for alcohol abuse were examined as a predictor of drinking pattern after treatment. The pretreatment coping strategies...... treatment for alcohol abuse. Restraint coping was found predictive of a positive drinking pattern at follow-up while the use of alcohol to cope was found predictive of a negative drinking pattern. Furthermore, the results showed tendencies towards the possibility that some coping strategies co...

  1. 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...

  2. 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

  3. Combination use of anti-inflammatory drugs and myorelaxants in the treatment of patients with ankylosing spondylitis in outpatient settings

    Directory of Open Access Journals (Sweden)

    Inna Zurabievna Gaidukova

    2015-01-01

    Full Text Available Objective: to assess different treatment regimens for ankylosing spondylitis (AS. The specific features of using topical and oral nonsteroidal anti-inflammatory drugs (NSAIDs and myorelaxants in outpatient settings were retrospectively analyzed.Subjects and methods. The investigation enrolled 96 AS patients admitted to the Department of Rheumatology, Saratov Regional Clinical Hospital, in 2010 to 2012, who took nimesulide during the last year (at least three 14-day cycles. The patients' mean age was 42.6±10.9 years; disease duration was 11.9±8.2 years; 83.33% were male. The diagnosis of AS was based on the 1984 modified New York criteria. Physical examination (clinical blood analysis, clinical urinalysis, C-reactive protein, total protein, albumins, urea, creatinine, glucose, bilirubin, serum aspartate aminotransferase and alanine aminotransferase was made. AS activity was determined using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI. Axial skeleton mobility and cervical spine rotation were evaluated. Therapy received by the patients at the moment of hospitalization and the attending physicians' recommendations for discharging patients from the hospital were analyzed. Saratov outpatient physicians were interviewed using a questionnaire to specify the aims and procedures of using anti-inflammatory drugs.Results. The outpatient physicians (n=100 were shown to use three-, two-, and one-component therapy in 53.12, 45, and 2% of the AS patients, respectively. Higher lumbar spine mobility and comparably reduced pain were established in the patients receiving threecomponent therapy (a combination of nimesulide 200 mg/day, tizanidine 4–8 mg/day, and topical NSAIDs than those who had NSAIDs only.

  4. 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.

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

    Science.gov (United States)

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

    1998-01-01

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

  6. 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.

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

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    Wandwalo Eliud R

    2009-07-01

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

  8. 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...

  9. 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 ...

  10. 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...

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

    NARCIS (Netherlands)

    A. Bartak; H. Andrea; M.D. Spreeuwenberg; U.M. Ziegler; J. Dekker; B.V. Rossum; E.F.M Hamers; W. Scholte; J. Aerts; J.J.V. Busschbach; R. Verheul; T. Stijnen; P.M.G. Emmelkamp

    2011-01-01

    Background: For patients with cluster B personality disorders there is no consensus regarding the optimal treatment setting. The aim of this study was to compare the effectiveness of different psychotherapeutic settings for patients with cluster B personality disorders, i.e. outpatient, day hospital

  12. 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

  13. Outpatient Group Treatment of Chronic Pain: Effects of Spouse Involvement.

    Science.gov (United States)

    Moore, James E.; Chaney, Edmund F.

    1985-01-01

    Assigned 43 chronic pain patients to couples group treatment, patient-only group treatment, or waiting-list control. The 16-hour cognitive-behavioral program produced reduction in pain, spouse-observed pain behavior, physical and psychosocial dysfunction, marital satisfaction, and use of health care resources. Spouse involvement did not facilitate…

  14. 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...

  15. 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...

  16. 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.

  17. 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

  18. 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

    of clinical and demographic parameters, including pain pattern and severity, opioid use and parameters related to the nutritional state, were analysed for their association with hospitalisation rates. RESULTS: Of the 170 patients, 57 (33.5%) were hospitalised during the follow-up period (median 11.4 months...... [IQR 3.8-26.4]). The cumulative hospitalisation incidence was 7.6% (95% CI; 4.5-12.2) after 30 days and 28.8% (95% CI; 22.2-35.7) after 1 year. Eighteen of the hospitalised patients (32%) had three or more admissions per year. High dose opioid treatment (>100 mg per day) (Hazard Ratio 3.1 [95% CI; 1...... outpatients account for the majority of hospital admissions and associated risk factors are high dose opioid treatment and hypoalbuminemia. This information should be implemented in outpatient monitoring strategies to identify risk patients and improve treatment....

  19. 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.

  20. [Emotional responsiveness of substance abusers under outpatient treatment].

    Science.gov (United States)

    Chicharro, Juan; Pérez-García, Ana M; Sanjuán, Pilar

    2012-01-01

    The emotions predispose to action providing information from both internal and external environment. There is evidence indicating that the emotional response in drugdependent patients is different from that of the not consuming population. The present work analyzed the emotions of drugdependent under ambulatory treatment (N=57), following the Lang's theory of emotion, considering the dimensions of valence, arousal and dominance or control, across the International Affective Picture System (IAPS), individually applied. The results were contrasted with a control group of not consuming persons (N=44) of similar age, since this variable concerns emotional experience. The influence of sex was also analyzed, considering the possible differences between men and women in emotional experience. The results can be summarized in the following points: (1) There were significant differences between substance abusers and not consumers in the dimension of valence, valuing the consumers the emotional stimuli of the most extreme form (the agreeable ones as better, and the disagreeable ones as worse); (2) there were no differences between both groups in the arousal and dominance dimensions; and (3) women reported more arousal before aversive images, and less before the sexual ones, than males, independently of they were or not substance abusers. Finally, it is suggested the need to deep into the analysis of sex differences and into the images selected, as well as into the usefulness of the emotion centred therapies for the treatment of drugdependency.

  1. Triagem para o tratamento ambulatorial da neutropenia febril Screening for the outpatient treatment of febrile neutropenia

    Directory of Open Access Journals (Sweden)

    Marcelo Bellesso

    2010-01-01

    Full Text Available A neutropenia febril (NF é uma complicação frequente e potencialmente fatal nos pacientes em tratamento quimioterápico. Entendemos hoje que a neutropenia febril é considerada uma emergência clínica e que a administração de antibióticos de amplo espectro diminui drasticamente a mortalidade. Estudos sugerem que a neutropenia febril compreende um grupo extremamente heterogêneo e que dados clínicos como febre domiciliar, ausência de hipotensão, ausência de desidratação, ausência de doença pulmonar obstrutiva crônica, ausência de outros sintomas, ausência de infecção fúngica prévia e idade Febrile neutropenia is a frequent and potentially fatal adverse event of chemotherapy. Nowadays, febrile neutropenia is considered an emergency and it is known that prompt infusion of antibiotics decreases mortality. Several studies demonstrated that febrile neutropenia is a heterogeneous group of diseases and that factors such as outpatient status, no hypotension, no dehydration, no chronic obstructive pulmonary disease, no symptoms, no previous fungal infection and age < 60 years are protective factors against serious complications as demonstrated by the Multinational Association for Supportive Care in Cancer (MASCC. These data show that outpatient treatment and early discharge is safer and much research has shown lower costs for outpatient treatment in low-risk patients with febrile neutropenia. The aim of this work is to review and discuss tools (in particular the MASCC index for safe screening of febrile neutropenia for outpatient treatment in addition to demonstrate results of research.

  2. 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

  3. 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

  4. 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.)

  5. Involuntary outpatient treatment (iot) for severe mental patients: current situation in Spain.

    Science.gov (United States)

    Cañete-Nicolás, Carlos; Hernández-Viadel, Miguel; Bellido-Rodríguez, Carmen; Lera-Calatayud, Guillem; Asensio-Pascual, Pedro; Pérez-Prieto, Juan F; Calabuig-Crespo, Roman; Leal-Cercós, Carmen

    2012-01-01

    Involuntary Outpatient Treatment (IOT) expects to improve treatment compliance and, therefore, prevent the impairment of patients with severe mental illness, as well as the risk for them and others. Besides IOT introduction defenders and opponent's states, scientific literature offers contradictory results. Legislative changes have been taken in the vast majority of our neighbouring countries in order to regulate IOT application. There is no legal regulation in Spain; however, OIT application is possible in certain Spanish cities. This article reviews IOT in Spain and surrounding countries.

  6. 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

  7. 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

  8. 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

  9. 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…

  10. 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 ...

  11. 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.

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

    Directory of Open Access Journals (Sweden)

    Jeya Balaji1

    2014-06-01

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

  13. 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

  14. 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

  15. School Behavior and Attendance during the First Year of Treatment for Childhood Cancer.

    Science.gov (United States)

    Stehbens, James A.; And Others

    1983-01-01

    Investigated school behavior and attendance of children with cancer (N=36) and hemophilia (N=26). Teacher ratings of students' behavior showed no differences before and after treatment. Children with cancer were absent four times more than healthy children; absenteeism of hemophiliacs was twice the normal rate. Academic performance was negatively…

  16. Treatment of Trichuris trichiura infections improves growth, spelling scores and school attendance in some children.

    Science.gov (United States)

    Simeon, D T; Grantham-McGregor, S M; Callender, J E; Wong, M S

    1995-07-01

    The effects of treating Trichuris trichiura infections were investigated in 407 Jamaican children age 6 to 12 y. The children were randomly assigned to receive treatment (albendazole) or a placebo. The outcome variables included growth, tests of reading, spelling and arithmetic, and school attendance. After 6 mo of treatment, there was no significant main effect on any of the outcomes. However, there were significant treatment-by-infection intensity interactions with spelling (P < 0.05) and body mass index (P < 0.01), and a significant treatment-by-stunting interaction with school attendance (P < 0.01). In spelling, the children with heavy infections showed improvements with treatment that approached significance (P = 0.06), whereas those with lower intensities did not. However, the children with lower infection intensities had increased body mass index with treatment (P = 0.02), although there was no difference in children with heavy infections. In school attendance, the stunted children improved with treatment (P < 0.04), whereas there was no difference in the nonstunted children. These findings suggest that in the sample of Jamaican children examined, the treatment of T. trichiura was more likely to benefit school performance in children of poor nutritional status and those with heavy infections, and to improve weight gain in children with lighter infection intensities.

  17. [Local treatment of chronic skin wounds in a Swiss out-patient wound centre 2010].

    Science.gov (United States)

    Baumgartner, Marc; Tanner, Daniel; Hunziker, Thomas

    2011-03-01

    In Switzerland around 30,000 patients suffer from chronic skin wounds. Appropriate topical wound care along with treatment of the causes of the wounds enables to heal a lot of these patients and to avoid secondary disease such as infections. Thereby, the final goal of wound care is stable reepithelisation. Based on experience with chronic leg ulcers mainly in our out-patient wound centre, we give a survey of the wound dressings we actually use and discuss their wound-phase adapted application. Furthermore, we address the two tissue engineering products reimbursed in Switzerland, Apligraf and EpiDex, as well as the biological matrix product Oasis. The crucial question, which treatment options will be offered in future to the wound patients by our health regulatory and insurance systems, is open to debate.

  18. [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

  19. 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

  20. 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

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

    Institute of Scientific and Technical Information of China (English)

    刘旭; 尹道馨; 徐睿; 张东亮; 刘文虎

    2011-01-01

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

  2. 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

  3. Mental Health and Substance Use Characteristics of Flight Attendants Enrolled in an In-Patient Substance Abuse Treatment Program

    Science.gov (United States)

    Horton, Gail; Diaz, Naelys; McIlveen, John; Weiner, Michael; Mullaney, Donald

    2011-01-01

    The purpose of this study was to explore the prevalence rates of co-occurring mental health problems among 70 flight attendants in substance abuse treatment. Results indicated that flight attendants in treatment were more likely to experience alcohol dependency than drug dependency. A high proportion of participants reported clinical levels of…

  4. 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

  5. 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.

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

    Directory of Open Access Journals (Sweden)

    Ryder Niamh

    2009-06-01

    Full Text Available 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 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 challenging.

  7. 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...

  8. 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...

  9. 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...

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

    Science.gov (United States)

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

    2013-05-01

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

  11. 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

  12. 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

  13. 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

  14. 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

  15. Impact of organizational change on the intake, referral and treatment of outpatients at a community mental health center.

    Science.gov (United States)

    Salta, L; Buick, W P

    1989-01-01

    The authors evaluated two indices of services for 349 outpatients who requested an initial appointment for screening and evaluation at a community mental health center over a one-month period in April of 1981, 1984, and 1988. Intake waiting time after initial screening and evaluation was 15.2 treatment days in 1981, 15.4 treatment days in 1984 and reduced to 2.7 treatment days in 1988. For patients who were referred for continued outpatient treatment, the dropout rates were reduced from 54.3 percent in 1981, to 28.51 percent in 1984 and further reduced to 19.19 percent in 1988. A divisional structure was designed with the purpose of reducing organizational barriers in order to provide greater access to services and to enhance continuity of care to patients. These results suggest that systematic organizational changes and the implementation of clearly defined clinical and administrative policies and procedures can impact favorably upon the intake, referral and treatment of outpatients.

  16. Impact of organizational change on the intake, referral and treatment of outpatients at a community mental health center.

    Science.gov (United States)

    Salta, L; Buick, W P

    1989-01-01

    The authors evaluated two indices of services for 349 outpatients who requested an initial appointment for screening and evaluation at a community mental health center over a one-month period in April of 1981, 1984, and 1988. Intake waiting time after initial screening and evaluation was 15.2 treatment days in 1981, 15.4 treatment days in 1984 and reduced to 2.7 treatment days in 1988. For patients who were referred for continued outpatient treatment, the dropout rates were reduced from 54.3 percent in 1981, to 28.51 percent in 1984 and further reduced to 19.19 percent in 1988. A divisional structure was designed with the purpose of reducing organizational barriers in order to provide greater access to services and to enhance continuity of care to patients. These results suggest that systematic organizational changes and the implementation of clearly defined clinical and administrative policies and procedures can impact favorably upon the intake, referral and treatment of outpatients. PMID:10295614

  17. 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)

  18. 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

    2014-01-01

    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.

  19. 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 ...

  20. 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

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

    Science.gov (United States)

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

    2015-01-01

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

  2. 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

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

    Science.gov (United States)

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

    2016-11-01

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

  4. 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

  5. Dental anxiety reduction and dental attendance after treatment in a dental fear clinic: A follow-up study.

    NARCIS (Netherlands)

    I.H.A. Aartman; A. de Jongh; P.C. Makkes; J. Hoogstraten

    2000-01-01

    The aim of the present study was to assess treatment outcome in terms of dental anxiety reduction at a post-treatment assessment and dental anxiety reduction and dental attendance one year later. Furthermore, it was determined to what extent psychopathological characteristics were related to treatme

  6. Measures of motivation for psychiatric treatment based on self-determination theory: psychometric properties in Dutch psychiatric outpatients.

    Science.gov (United States)

    Jochems, Eline C; Mulder, Cornelis L; Duivenvoorden, Hugo J; van der Feltz-Cornelis, Christina M; van Dam, Arno

    2014-08-01

    Self-determination theory is potentially useful for understanding reasons why individuals with mental illness do or do not engage in psychiatric treatment. The current study examined the psychometric properties of three questionnaires based on self-determination theory-The Treatment Entry Questionnaire (TEQ), Health Care Climate Questionnaire (HCCQ), and the Short Motivation Feedback List (SMFL)-in a sample of 348 Dutch adult outpatients with primary diagnoses of mood, anxiety, psychotic, and personality disorders. Structural equation modeling showed that the empirical factor structures of the TEQ and SMFL were adequately represented by a model with three intercorrelated factors. These were interpreted as identified, introjected, and external motivation. The reliabilities of the Dutch TEQ, HCCQ, and SMFL were found to be acceptable but can be improved on; congeneric estimates ranged from 0.66 to 0.94 depending on the measure and patient subsample. Preliminary support for the construct validities of the questionnaires was found in the form of theoretically expected associations with other scales, including therapist-rated motivation and treatment engagement and with legally mandated treatment. Additionally, the study provides insights into the relations between measures of motivation based on self-determination theory, the transtheoretical model and the integral model of treatment motivation in psychiatric outpatients with severe mental illness.

  7. 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

  8. Treatment Adherence of Tuberculosis Patients Attending Two Reference Units in Equatorial Guinea.

    Science.gov (United States)

    Fagundez, Gabriela; Perez-Freixo, Hugo; Eyene, Juan; Momo, Juan Carlos; Biyé, Lucia; Esono, Teodoro; Ondó Mba Ayecab, Marcial; Benito, Agustín; Aparicio, Pilar; Herrador, Zaida

    2016-01-01

    Equatorial Guinea has one of the highest burden of tuberculosis (TB) in Africa. Incomplete adherence to TB treatment has been identified as one of the most serious remaining problem in tuberculosis control. The following study is aimed at determining the adherence to anti-tuberculosis treatment in Equatorial Guinea and its determinants, as well as at assessing the knowledge of the people about the disease. In this cross-sectional study, participants were recruited by non-probabilistic consecutive sampling amongst patients who attended the reference units for TB in Bata and Malabo between March and July 2015. Socio-demographic and clinical data were collected. Adherence to treatment and knowledge about TB were assessed by Morisky-Green-Levine and Batalla tests and a questionnaire on adherence related factors specifically prepared for this research. Descriptive statistics were computed to summarize the data and bivariate analyses by adherence profile were performed with χ2 test for categorical data. A total of 98 patients with TB were interviewed. 63.27% of interviewees had good knowledge about TB (Batalla test) while 78.57% of respondents were adherent according to the Morisky-Green-Levine test. A low educational level, lack of family support and lack of medical advice about the disease were significantly associated to lower adherence level. Patients with re-infection (due to relapse or treatment failure) and those who have suffered from drug shortages were also less adherents. The National Programme for TB Control should consider improving the early diagnosis and follow-up of TB cases, as well as the implementation of all components of DOTS (Directly observed Treatment, short-course) strategy all over the country.

  9. Treatment Adherence of Tuberculosis Patients Attending Two Reference Units in Equatorial Guinea.

    Science.gov (United States)

    Fagundez, Gabriela; Perez-Freixo, Hugo; Eyene, Juan; Momo, Juan Carlos; Biyé, Lucia; Esono, Teodoro; Ondó Mba Ayecab, Marcial; Benito, Agustín; Aparicio, Pilar; Herrador, Zaida

    2016-01-01

    Equatorial Guinea has one of the highest burden of tuberculosis (TB) in Africa. Incomplete adherence to TB treatment has been identified as one of the most serious remaining problem in tuberculosis control. The following study is aimed at determining the adherence to anti-tuberculosis treatment in Equatorial Guinea and its determinants, as well as at assessing the knowledge of the people about the disease. In this cross-sectional study, participants were recruited by non-probabilistic consecutive sampling amongst patients who attended the reference units for TB in Bata and Malabo between March and July 2015. Socio-demographic and clinical data were collected. Adherence to treatment and knowledge about TB were assessed by Morisky-Green-Levine and Batalla tests and a questionnaire on adherence related factors specifically prepared for this research. Descriptive statistics were computed to summarize the data and bivariate analyses by adherence profile were performed with χ2 test for categorical data. A total of 98 patients with TB were interviewed. 63.27% of interviewees had good knowledge about TB (Batalla test) while 78.57% of respondents were adherent according to the Morisky-Green-Levine test. A low educational level, lack of family support and lack of medical advice about the disease were significantly associated to lower adherence level. Patients with re-infection (due to relapse or treatment failure) and those who have suffered from drug shortages were also less adherents. The National Programme for TB Control should consider improving the early diagnosis and follow-up of TB cases, as well as the implementation of all components of DOTS (Directly observed Treatment, short-course) strategy all over the country. PMID:27622461

  10. Treatment Adherence of Tuberculosis Patients Attending Two Reference Units in Equatorial Guinea

    Science.gov (United States)

    Eyene, Juan; Momo, Juan Carlos; Biyé, Lucia; Esono, Teodoro; Ondó Mba Ayecab, Marcial; Benito, Agustín; Aparicio, Pilar

    2016-01-01

    Equatorial Guinea has one of the highest burden of tuberculosis (TB) in Africa. Incomplete adherence to TB treatment has been identified as one of the most serious remaining problem in tuberculosis control. The following study is aimed at determining the adherence to anti-tuberculosis treatment in Equatorial Guinea and its determinants, as well as at assessing the knowledge of the people about the disease. In this cross-sectional study, participants were recruited by non-probabilistic consecutive sampling amongst patients who attended the reference units for TB in Bata and Malabo between March and July 2015. Socio-demographic and clinical data were collected. Adherence to treatment and knowledge about TB were assessed by Morisky-Green-Levine and Batalla tests and a questionnaire on adherence related factors specifically prepared for this research. Descriptive statistics were computed to summarize the data and bivariate analyses by adherence profile were performed with χ2 test for categorical data. A total of 98 patients with TB were interviewed. 63.27% of interviewees had good knowledge about TB (Batalla test) while 78.57% of respondents were adherent according to the Morisky-Green-Levine test. A low educational level, lack of family support and lack of medical advice about the disease were significantly associated to lower adherence level. Patients with re-infection (due to relapse or treatment failure) and those who have suffered from drug shortages were also less adherents. The National Programme for TB Control should consider improving the early diagnosis and follow-up of TB cases, as well as the implementation of all components of DOTS (Directly observed Treatment, short-course) strategy all over the country. PMID:27622461

  11. 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...

  12. National trends in outpatient surgical treatment of degenerative cervical spine disease.

    Science.gov (United States)

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

    2014-08-01

    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 revision Clinical Modification (ICD-9-CM) codes were used to identify operations for degenerative cervical spine diseases in adults (age > 20 years). Disposition and complication rates were examined. Results There was an increase in cervical spine surgeries performed in an ambulatory setting during the study period. Anterior cervical diskectomy and fusion accounted for 68% of outpatient procedures; posterior decompression made up 21%. Younger patients predominantly underwent anterior fusion procedures, and patients in the eighth and ninth decades of life had more posterior decompressions. Charlson comorbidity index and complication rates were substantially lower for ambulatory cases when compared with inpatients. The majority (>99%) of patients were discharged home following ambulatory surgery. Conclusions Recently, the number of cervical spine surgeries has increased in general, and more of these procedures are being performed in an ambulatory setting. The majority (>99%) of patients are discharged home but the nature of analyzing administrative data limits accurate assessment of postoperative complications and thus patient safety. This increase in outpatient cervical spine surgery necessitates further discussion of its safety.

  13. 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...

  14. Supplementing claims data with outpatient laboratory test results to improve confounding adjustment in effectiveness studies of lipid-lowering treatments

    Directory of Open Access Journals (Sweden)

    Schneeweiss Sebastian

    2012-11-01

    Full Text Available Abstract Background Adjusting for laboratory test results may result in better confounding control when added to administrative claims data in the study of treatment effects. However, missing values can arise through several mechanisms. Methods We studied the relationship between availability of outpatient lab test results, lab values, and patient and system characteristics in a large healthcare database using LDL, HDL, and HbA1c in a cohort of initiators of statins or Vytorin (ezetimibe & simvastatin as examples. Results Among 703,484 patients 68% had at least one lab test performed in the 6 months before treatment. Performing an LDL test was negatively associated with several patient characteristics, including recent hospitalization (OR = 0.32, 95% CI: 0.29-0.34, MI (OR = 0.77, 95% CI: 0.69-0.85, or carotid revascularization (OR = 0.37, 95% CI: 0.25-0.53. Patient demographics, diagnoses, and procedures predicted well who would have a lab test performed (AUC = 0.89 to 0.93. Among those with test results available claims data explained only 14% of variation. Conclusions In a claims database linked with outpatient lab test results, we found that lab tests are performed selectively corresponding to current treatment guidelines. Poor ability to predict lab values and the high proportion of missingness reduces the added value of lab tests for effectiveness research in this setting.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  16. 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

  17. 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.

  18. A Randomized Evaluation of Multidimensional Treatment Foster Care: Effects on School Attendance and Homework Completion in Juvenile Justice Girls.

    Science.gov (United States)

    Leve, Leslie D; Chamberlain, Patricia

    2007-11-01

    Despite growing evidence that child welfare youth are at increased risk for juvenile delinquency, little is known about gender-specific processes and effective treatment programs for girls. Multidimensional Treatment Foster Care (MTFC), an empirically validated intervention for child welfare and juvenile justice populations, has demonstrated efficacy in reducing arrest rates in delinquent boys and girls. In this study, the efficacy of MTFC on school attendance and homework completion was examined in juvenile justice girls who were referred to out-of-home care (N = 81). Results from this randomized intervention trial suggest that MTFC was more effective than group care in increasing girls' school attendance and homework completion while in treatment and at 12 months postbaseline. In addition, the previously reported effect of MTFC on reducing girls' days in locked settings was mediated by homework completion while girls were enrolled in the intervention setting. Implications for policy and practice are described.

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

    Science.gov (United States)

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

    2016-02-01

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

  20. 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…

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

    Science.gov (United States)

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

    2016-02-01

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

  2. IQ as a moderator of outcome in severity of children’s mental health status after treatment in outpatient clinics

    Directory of Open Access Journals (Sweden)

    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.

  3. 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…

  4. 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

  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...... and quality of life were assessed using instruments validated in a Danish context. It was judged that, after some adjustments to fit the Danish assertive community treatment, CAT treatment was feasible in a Danish setting....

  6. 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...... and quality of life were assessed using instruments validated in a Danish context. It was judged that, after some adjustments to fit the Danish assertive community treatment, CAT treatment was feasible in a Danish setting....

  7. 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...

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

    Directory of Open Access Journals (Sweden)

    Mitchell William S

    2007-07-01

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

  9. 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.

  10. 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

  11. Implementation of a Smoking Cessation Treatment Study at Substance Abuse Rehabilitation Programs: Smoking Behavior and Treatment Feasibility Across Varied Community-based Outpatient Programs.

    Science.gov (United States)

    Reid, Malcolm S; Fallon, Bryan; Sonne, Susan; Nunes, Edward V; Lima, Jennifer; Jiang, Huiping; Tyson, Clare; Hiott, Robert; Arfken, Cynthia; Bohs, Rhonda; Orr, Deborah; Muir, Joan; Pihlgren, Eric; Loree, Amy; Fuller, Brett E; Giordano, Louis; Robinson, James; Rotrosen, John

    2007-09-01

    Cigarette smoking is widely prevalent among individuals in treatment for drug or alcohol dependence; however, the treatment of nicotine addiction in this population has numerous obstacles at both programmatic and patient levels. Despite these difficulties, recent studies have demonstrated moderate success in implementing smoking cessation treatment in drug rehabilitation programs. The National Drug Abuse Treatment Clinical Trials Network sponsored a smoking cessation study in 13 community-based outpatient substance abuse rehabilitation programs across the country. The study evaluated the effectiveness of smoking cessation treatment provided as an adjunct to substance abuse treatment-as-usual. This report summarizes the practical and clinical experiences encountered at each of the study sites with regard to implementing the smoking cessation treatment intervention. Smoking behavior of the treatment clientele was assessed by anonymous survey at each site. In addition, sites were systematically characterized by using program review and assessment tools completed by the respective staff and program directors at the site. Survey and recruitment data indicated that cigarette smoking is more prevalent and that smoking cessation treatment is more feasible, in methadone maintenance treatment programs. Other factors associated with smoking behavior and with the recruitment of drug- and alcohol-dependent individuals into the smoking cessation treatment study are described.

  12. 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

  13. 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

  14. 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

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

    Directory of Open Access Journals (Sweden)

    Ana Paula P. Vitiello

    2007-06-01

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

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

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    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

  17. 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,…

  18. 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.

  19. 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

  20. 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...

  1. 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

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    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

  2. 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.

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

    DEFF Research Database (Denmark)

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

    1984-01-01

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

  4. 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

  5. Systematic Outpatient Treatment of Sexual Trauma in Women: Application of Cognitive and Behavioral Protocols

    Science.gov (United States)

    Castillo, Diane T.

    2004-01-01

    Effective therapies for treating posttraumatic stress disorder (PTSD) have been described in the literature, particularly cognitive and behavioral interventions, and have consistently demonstrated a reduction in PTSD symptoms. However, the applied versions of cognitive and behavioral treatments offered in most programs diverge from the forms of…

  6. Assessing Treatment Acceptability with Consumers of Outpatient Child Behavior Management Services.

    Science.gov (United States)

    Miltenberger, Raymond G.; And Others

    1989-01-01

    Parents' and grandparents' ratings of alternative treatments for children with behavior disorders were assessed. Differential reinforcement of other behavior (DRO), time-out, response cost, spanking, and medication were applied to noncompliance, aggression, tantrums, and hyperactivity. DRO, response cost, and time-out were found significantly more…

  7. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  9. 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

  10. Three- and five-year follow-up of a combined inpatient-outpatient treatment of obese children and adolescents.

    Science.gov (United States)

    Adam, Sibylle; Westenhoefer, Joachim; Rudolphi, Birgit; Kraaibeek, Hanna-Kathrin

    2013-01-01

    Aim. "The combined DAK therapy for obesity in children and adolescents" combines a 6-week inpatient with a 10.5-month outpatient treatment. The aim of the study is to evaluate whether the therapeutic achievements are maintained two and four years after intervention. Method. All subjects who had participated in the 12-month program in 2004/2005 were included in the follow-up study. Body weight, height, and physical fitness were assessed through direct measurements, behaviour, and quality of life by self-report questionnaires. Statistical analysis is based on an intention-to-treat analysis. Results. The response rate after three years was 63.4% and 42.2% after five years. Within three years, participants reduced their BMI-SDS significantly by 0.20 (SD 0.49) and by 0.15 (SD 0.51) within five years. Significant positive changes could be observed with respect to the participants eating behaviour. Similarly, the food intake, particularly the consumption of calorie-reduced beverages, increased significantly while that of nonrecommended foods decreased. Improvement was also seen in the subjective quality of life as well as several aspects of self-perception. Conclusion. Compared to baseline data, significant reduction of BMI-SDS and positive changes of health-related behaviours could be observed even three and five years after the start of the initial program.

  11. Three- and Five-Year Follow-Up of a Combined Inpatient-Outpatient Treatment of Obese Children and Adolescents

    Directory of Open Access Journals (Sweden)

    Sibylle Adam

    2013-01-01

    Full Text Available Aim. “The combined DAK therapy for obesity in children and adolescents” combines a 6-week inpatient with a 10.5-month outpatient treatment. The aim of the study is to evaluate whether the therapeutic achievements are maintained two and four years after intervention. Method. All subjects who had participated in the 12-month program in 2004/2005 were included in the follow-up study. Body weight, height, and physical fitness were assessed through direct measurements, behaviour, and quality of life by self-report questionnaires. Statistical analysis is based on an intention-to-treat analysis. Results. The response rate after three years was 63.4% and 42.2% after five years. Within three years, participants reduced their BMI-SDS significantly by 0.20 (SD 0.49 and by 0.15 (SD 0.51 within five years. Significant positive changes could be observed with respect to the participants eating behaviour. Similarly, the food intake, particularly the consumption of calorie-reduced beverages, increased significantly while that of nonrecommended foods decreased. Improvement was also seen in the subjective quality of life as well as several aspects of self-perception. Conclusion. Compared to baseline data, significant reduction of BMI-SDS and positive changes of health-related behaviours could be observed even three and five years after the start of the initial program.

  12. Long-term functional improvements in the 2-year treatment of schizophrenia outpatients with olanzapine long-acting injection

    Directory of Open Access Journals (Sweden)

    Ascher-Svanum H

    2014-06-01

    Full Text Available Haya Ascher-Svanum,1 Diego Novick,2,3 Josep Maria Haro,4 Jordan Bertsch,4 David McDonnell,1 Holland Detke11Eli Lilly and Company, Indianapolis, IN, USA; 2Eli Lilly and Company, Windlesham, Surrey, UK; 3Departament de Psiquiatria, Universitat Autonoma de Barcelona, Spain; 4Parc Sanitari Sant Joan de Déu, Centro de Investigación Biomédica en Red en el Área de Salud Mental, Universitat de Barcelona, Barcelona, SpainBackground: Little is known about the long-term changes in the functioning of schizophrenia patients receiving maintenance therapy with olanzapine long-acting injection (LAI, and whether observed changes differ from those seen with oral olanzapine.Methods: This study describes changes in the levels of functioning among outpatients with schizophrenia treated with olanzapine-LAI compared with oral olanzapine over 2 years. This was a secondary analysis of data from a multicenter, randomized, open-label, 2-year study comparing the long-term treatment effectiveness of monthly olanzapine-LAI (405 mg/4 weeks; n=264 with daily oral olanzapine (10 mg/day; n=260. Levels of functioning were assessed with the Heinrichs–Carpenter Quality of Life Scale. Functional status was also classified as “good”, “moderate”, or “poor”, using a previous data-driven approach. Changes in functional levels were assessed with McNemar’s test and comparisons between olanzapine-LAI and oral olanzapine employed the Student’s t-test. Results: Over the 2-year study, the patients treated with olanzapine-LAI improved their level of functioning (per Quality of Life total score from 64.0–70.8 (P<0.001. Patients on oral ­olanzapine also increased their level of functioning from 62.1–70.1 (P<0.001. At baseline, 19.2% of the olanzapine-LAI-treated patients had a “good” level of functioning, which increased to 27.5% (P<0.05. The figures for oral olanzapine were 14.2% and 24.5%, respectively (P<0.001. Results did not significantly differ between

  13. 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...

  14. Counselor Attitudes Toward Contingency Management for Substance Use Disorder: Effectiveness, Acceptability, and Endorsement of Incentives for Treatment Attendance and Abstinence.

    Science.gov (United States)

    Aletraris, Lydia; Shelton, Jeff S; Roman, Paul M

    2015-10-01

    Despite research demonstrating its effectiveness, use of contingency management (CM) in substance use disorder treatment has been limited. Given the vital role that counselors play as arbiters in the use of therapies, examination of their attitudes can provide insight into how further use of CM might be effectively promoted. In this paper, we examine 731 counselors' attitudes toward the effectiveness and acceptability of CM in treatment, as well as their specific attitudes toward both unspecified and tangible incentives for treatment attendance and abstinence. Compared to cognitive behavioral therapy, motivational interviewing, and community reinforcement approach, counselors rated CM as the least effective and least acceptable psychosocial intervention. Exposure through the use of CM in a counselor's employing organization was positively associated with perceptions of acceptability, agreement that incentives have a positive effect on the client-counselor relationship, and endorsement of tangible incentives for abstinence. Endorsement of tangible incentives for treatment attendance was significantly greater among counselors with more years in the treatment field, and counselors who held at least a master's degree. Counselors' adaptability or openness to innovations was also positively associated with attitudes toward CM. Further, female counselors and counselors with a greater 12-step philosophy were less likely to endorse the use of incentives. A highlight of our study is that it offers the first specific assessment of the impact of "Promoting Awareness of Motivational Incentives" (PAMI), a Web-based tool based on findings of CM protocols tested within the Clinical Trials Network (CTN), on counselors employed outside the CTN. We found that 10% of counselors had accessed PAMI, and those who had accessed PAMI were more likely to report a higher degree of perceived effectiveness of CM than those who had not. This study lays the groundwork for vital research on the

  15. ‘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...

  16. 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...

  17. ATTAINMENT OF TREATMENT TARGETS AMONG TYPE 2 DIABETIC PATIENTS FIRST ATTENDING A TERTIARY CARE SETTING IN SUBURBAN KERALA

    Directory of Open Access Journals (Sweden)

    Sajeeth Kumar

    2016-03-01

    Full Text Available BACKGROUND Type 2 diabetes is growing in epidemic proportions worldwide, particularly in Asian subcontinent and especially in India. The disease takes a toll on the health system of a country, especially the developing nations. AIMS AND OBJECTIVES To study the attainment of metabolic and anthropometric goals of individuals with type 2 diabetes attending a tertiary care centre. MATERIALS AND METHODS i Informed consents were obtained. ii The study subjects were subjected to a detailed clinical, anthropometrical and biochemical evaluation at baseline by a dedicated diabetologist. iii These data were collected using a structured questionnaire and were analysed using EPI INFO (Ver 3.4.1. RESULTS A total of 350 cases were studied. Overall, 76.3% of patients could not achieve ADA A1c goal and 36.3% had very poor glycaemic control as evidenced by A1c >9%. CONCLUSIONS Despite the increasing awareness of type 2 diabetes both among attending physicians and patients, attainment of treatment targets still is a challenge even at a tertiary care setting. The lifestyle and dietary habits may be a main contributing factor for this situation. More focus needs to be given to nutritional aspects and physical exercise in not only in patients with type 2 diabetes mellitus, but also in apparently healthy individuals of the productive age group so that the disease can be delayed if not prevented.

  18. 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...

  19. 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...

  20. The Palliative Treatment Plan as a Bone of Contention between Attending Physicians and Nurses

    Directory of Open Access Journals (Sweden)

    Wolfgang Lederer

    2015-10-01

    Full Text Available Acute vital crisis in end-of-life situations may result in hospitalization and intensive care without recognizable benefit in many cases. Advance directives regarding indications for resuscitation, hospitalization, and symptomatic treatment help ensure that acute complications can be managed quickly and satisfactorily in the patient’s customary surroundings. A plan was designed and implemented in Austrian nursing homes to provide emergency physicians with rapidly obtainable information on the patient’s current situation, and whether resuscitation attempts and hospitalization are advised or not. This palliative treatment plan is arranged by a physician together with caregivers, close relatives, and the patient or his court-appointed health care guardian or holder of power of attorney. Four years after implementation of the plan, a user satisfaction survey was carried out. The majority of participating nurses, emergency physicians and family doctors judged application and design of the palliative treatment plan positively. However, the low response rate of family doctors indicates nonconformity. In particular, the delegation of symptomatic treatment to nurses proved to be controversial. There is still a need to provide up-to-date information and training for health professionals in order for them to understand advance directives as extended autonomy for patients who have lost their ability to make their own decisions.

  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. 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...

  3. The Maudsley Outpatient Study of Treatments for Anorexia Nervosa and Related Conditions (MOSAIC):Comparison of the Maudsley Model of Anorexia Nervosa Treatment for Adults (MANTRA) With Specialist Supportive Clinical Management (SSCM) in Outpatients With Broadly Defined Anorexia Nervosa: A Randomized Controlled Trial

    OpenAIRE

    Schmidt, Ulrike; Magill, Nicholas; Renwick, Bethany; Keyes, Alexandra; Kenyon, Martha; DeJong, Hannah; Lose, Anna; Broadbent, Hannah; Loomes, Rachel; Yasin, Huma; Watson, Charlotte; Ghelani, Shreena; Bonin, Eva-Maria; Serpell, Lucy; Richards, Lorna

    2015-01-01

    OBJECTIVE: Anorexia nervosa (AN) in adults has poor outcomes, and treatment evidence is limited. This study evaluated the efficacy and acceptability of a novel, targeted psychological therapy for AN (Maudsley Model of Anorexia Nervosa Treatment for Adults; MANTRA) compared with Specialist Supportive Clinical Management (SSCM).METHOD: One hundred forty-two outpatients with broadly defined AN (body mass index [BMI] ≤ 18.5 kg/m2) were randomly allocated to receive 20 to 30 weekly sessions (depen...

  4. 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.

  5. 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

  6. 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.

  7. 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

  8. 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.

  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. 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.

  11. 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 frequent in cardiology outpatients. Even in cases where the cardiologists identified psychological problems, the diagnosis had no consequence, as none of the patients was offered relevant treatment Udgivelsesdato: 2008...

  12. 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......-as-usual group (n = 34). The primary outcome was the HbA1c measurement. The secondary outcomes were life skills development (assessed by self-reported psychometric scales), self-monitored blood glucose levels, and hypo- and hyperglycemic episodes. The analysis followed an intention-to-treat basis. RESULTS: Fifty...

  13. 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

  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. The value of serum procalcitonin in treatment of community acquired pneumonia in outpatient%血清降钙素原监测在门诊治疗社区获得性肺炎中的作用

    Institute of Scientific and Technical Information of China (English)

    龙威; 邓星奇; 唐建国; 谢娟; 张奕翠; 张羽; 高育瑶; 陆刚

    2009-01-01

    目的 探讨血清降钙素原(PCT)监测在门诊接受治疗的社区获得性肺炎(CAP)患者的抗生素使用中的临床意义.方法 选2006年11月-2008年2月符合CAP诊断标准的门诊接受治疗的CAP患者127例,随机分为PCT监测组(63例)和常规治疗组(64例),人选患者监测血清PCT水平.在相旧常规治疗的基础上,常规治疗组由经治医师按照我国CAP治疗指南决定抗生素治疗方案;PCT监测组按照血清PCT水平决定是否使用抗生素,在血清PCT≥0.25μg/L时进行抗生素治疗,PCT0.05),PCT监测组的抗生素使用率、抗生素疗程及抗生素费用均低于常规治疗组(P值均小于0.05),2组患者的预后无明显差异.结论 门诊接受治疗的CAP患者可以依据PCT水平指导抗生素应用,能够减少抗生素用量,缩短抗生素疗程,降低抗生素费用.%Objective To evaluate the value of serum procalcitonin (PCT)on antibiotic use in treatment of community acquired pneumonia (CAP) in outpatient. Methods From November 2006 to February 2008, a total of 127 patients with CAP in outpatient were randomly assigned into two groups:PCT group(n=63)and control group(n =64). PCT levels of all patients were measured after study admission. On the base of similarly normal treatment, the control group received antibiotics according to the attending physicians and the PCT group were treated with antibiotics according to serum PCT levels: antibiotic treatment was applied with PCT level ≥ 0. 25 μg/L and was discouraged with PCT level 0.05) ;rate and costs of antibiotics use was lower, antibiotic duration of the PCT group was shorter than that ofthecontroigroup(P<0.05,P<0.001,P<0.001).Conclusion PCT could be used in treatment of CAP for antibiotic use in outpatient, which may reduce antibiotic use, shorten antibiotic duration and lower costs of antibiotic.

  16. A randomized, controlled trial of the efficacy of an interoceptive exposure-based CBT for treatment-refractory outpatients with opioid dependence.

    Science.gov (United States)

    Otto, Michael W; Hearon, Bridget A; McHugh, R Kathryn; Calkins, Amanda W; Pratt, Elizabeth; Murray, Heather W; Safren, Steven A; Pollack, Mark H

    2014-01-01

    Many patients diagnosed with opioid dependence do not adequately respond to pharmacologic, psychosocial, or combination treatment, highlighting the importance of novel treatment strategies for this population. The current study examined the efficacy of a novel behavioral treatment focusing on internal cues for drug use (Cognitive Behavioral Therapy for Interoceptive Cues; CBT-IC) relative to an active comparison condition, Individual Drug Counseling (IDC), when added to methadone maintenance treatment (MMT) among those who had not responded to MMT. Participants (N=78) were randomly assigned to receive 15 sessions of CBT-IC or IDC as an adjunct to ongoing MMT and counseling. Oral toxicology screens were the primary outcome. Results indicated no treatment differences between CBT-IC and IDC and a small, significant reduction of self-reported drug use, but no change on toxicology screens. Tests of potential moderators, including sex, anxiety sensitivity, and coping motives for drug use, did not yield significant interactions. Among opioid-dependent outpatients who have not responded to MMT and counseling, the addition of IDC or CBT-IC did not result in additive outcome benefits. These results highlight the need for more potent treatment strategies for opioid dependence, particularly among those who do not fully respond to frontline treatment.

  17. The Relationship between Substance Abuse Performance Measures and Mutual Help Group Participation after Treatment.

    Science.gov (United States)

    Strickler, Gail K; Reif, Sharon; Horgan, Constance M; Acevedo, Andrea

    2012-01-01

    We examined the relationship between treatment quality, using during-treatment process measures, and mutual help group (e.g., Alcoholics Anonymous) attendance after outpatient substance use disorder (SUD) treatment for 739 clients in the Alcohol and Drug Services Study. Logistic regression models estimated any and regular mutual help attendance after treatment. Clients referred to mutual help groups were significantly more likely to attend any mutual help after treatment. Results were mixed for facility offered mutual help groups; treatment engagement and retention were not significant. These findings offer treatment providers further evidence of the importance of referring clients to post-treatment mutual help groups, an effective, low-cost option.

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

    OpenAIRE

    Akindayomi Yinka; Oredugba Folakemi A

    2008-01-01

    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 ...

  19. 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...

  20. A psychometric assessment of the GAIN individual severity scale (GAIN-GISS) and short screeners (GAIN-SS) among adolescents in outpatient treatment programs.

    Science.gov (United States)

    Stucky, Brian D; Edelen, Maria Orlando; Ramchand, Rajeev

    2014-02-01

    The global appraisal of individual needs (GAIN)-general individual severity scale (GAIN-GISS), and GAIN-short screener (GAIN-SS) are widely used diagnostic measures of internalizing disorders, externalizing disorders, substance abuse, and criminal and violent behavior. Although prevalent in clinical and research settings, there is only limited psychometric evidence of the dimensional structure of these scales. Our investigation used intake data from 6,909 adolescents presenting to outpatient substance abuse treatment facilities in the United States. Our analytic approach used exploratory and item factor analyses to evaluate the underlying factor structure. Multi- and unidimensional item response theory models were employed to evaluate the utility of the scales at providing precise score estimates at various locations of severity. Most scales were confirmed as unidimensional; scales with evidence of multidimensionality, identified as having a weak general dimension and strong specific dimensions using a bifactor IRT model, include the Crime and Violence Scale and the GAIN-SS.

  1. A Psychometric Assessment of the GAIN General Individual Severity Scale (GAIN-GISS) and Short Screeners (GAIN-SS) Among Adolescents in Outpatient Treatment Programs

    Science.gov (United States)

    Stucky, Brian D.; Edelen, Maria Orlando; Ramchand, Rajeev

    2013-01-01

    The Global Appraisal of Individual Needs (GAIN) - General Individual Severity Scale (GAIN-GISS), and GAIN-Short Screener (GAIN-SS) are widely used diagnostic measures of internalizing disorders, externalizing disorders, substance abuse, and criminal and violent behavior. Though prevalent in clinical and research settings, there is only limited psychometric evidence of the dimensional structure of these scales. Our investigation used intake data from 6,909 adolescents presenting to outpatient substance abuse treatment facilities in the United States. Our analytic approach used exploratory and item factor analyses to evaluate the underlying factor structure. Multi- and unidimensional item response theory models were employed to evaluate the utility of the scales at providing precise score estimates at various locations of severity. Most scales were confirmed as unidimensional; scales with evidence of multidimensionality, identified as having a weak general dimension and strong specific dimensions using a bifactor IRT model, include the Crime Violence Scale and the GAIN-SS. PMID:23994048

  2. 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.

  3. 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。

  4. 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…

  5. 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.

  6. 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…

  7. ART treatment costs and retention in care in Kenya: a cohort study in three rural outpatient clinics

    OpenAIRE

    Larson, Bruce A.; Margaret Bii; Sarah Henly-Thomas; Kelly McCoy; Fredrick Sawe; Douglas Shaffer; Sydney Rosen

    2013-01-01

    Introduction: After almost 10 years of PEPFAR funding for antiretroviral therapy (ART) treatment programmes in Kenya, little is known about the cost of care provided to HIV-positive patients receiving ART. With some 430,000 ART patients, understanding and managing costs is essential to treatment programme sustainability. Methods: Using patient-level data from medical records (n=120/site), we estimated the cost of providing ART at three treatment sites in the Rift Valley Province of Kenya (a c...

  8. Osteoarthrosis in outpatient practice

    Directory of Open Access Journals (Sweden)

    Elena Andreyevna Galushko

    2012-01-01

    Full Text Available Objective: to elucidate the awareness of osteoarthrosis - OA (the most common location and treatment methods among primary care physicians. Subjects and methods. The questionnaire developed at the Research Institute of Rheumatology, Russian Academy of Medical Sciences, was used to interview 1912 specialists (therapists, rheumatologists, neurologists, and surgeons who made a primary outpatient reception in the local polyclinics of 25 Russian Federation’s cities with a population of more than 500,000. Results. In the opinion of the physicians of all specialties, knee joints turned out to be the most location of OA. In practice, the rheumatologists encountered knee, hip, and hand joint lesions in OA in 92, 42, and 38%, respectively. Analysis of therapeutic preferences has shown that virtually all the physicians prescribe nonsteroidal anti-inflammatory drugs and only two thirds do structure-modifying drugs (chondroprotectors for OA patients. When treating OA, only the rheumatologists use slow-acting drugs in practically 100% of cases, by preferring chondroitin sulfate. The physicians of all specialties use topical glucocorticoid therapy extensively. The rheumatologists use this therapy most probably due to the fact that patients with severe polyarticular OA come to see them. Notwithstanding the fact that new guidelines for the treatment of OA were published in 2008, most physicians are oriented to the 1995 guidelines, frequently giving rise to therapeutic errors and wrong treatment.

  9. 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…

  10. 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.

  11. Balneological outpatient treatment for patients with knee osteoarthritis; an effective non-drug therapy option in daily routine?

    Science.gov (United States)

    Özkuk, Kaǧan; Gürdal, Hatice; Karagülle, Mine; Barut, Yasemin; Eröksüz, Rıza; Karagülle, Müfit Zeki

    2016-10-01

    This study aims to compare the effects of balneological treatments applied at consecutive and intermittent sessions without interfering with their daily routine in patients with knee osteoarthritis. This is a randomized, controlled, single-blind clinical trial. Fifty patients diagnosed with knee osteoarthritis were included. The patients were divided into two groups. All patients were given a total of ten sessions of balneological treatment consisting of hydrotherapy and mud pack therapy. Group 1 received consecutive treatment for 2 weeks, while group 2 received intermittent treatment for 5 weeks. Local peloid packs at 45 °C were applied for 20 min, after a tap water (38 °C) bath. Evaluations were conducted before, after treatment, and at 12th week of post-treatment by Pain (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Short Form-36 (SF-36). Both balneological treatment regimens of knee osteoarthritis had statistically significant clinical effects as well as effects on the quality of life. Patients' well-being continued at 3 months, except for joint stiffness (WOMAC), role-emotional (SF-36), and vitality (SF-36) in group 1 and for mental health (SF-36) in both groups. Both patient groups had improved compared to baseline. However, at 3 months after the treatment, the well-being of group 2 was unable to be maintained in terms of role-physical (SF-36) parameter, while the well-being of group 1 was unable to be maintained in terms of pain, WOMAC (pain, physical functions, total), and SF-36 (physical functioning, role-physical, pain, role-emotional, and mental health) variables, compared to data obtained immediately after treatment. Our study suggests that traditional and intermittent balneological therapies have similar efficacy in patients with knee osteoarthritis.

  12. 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.

  13. 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...

  14. 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

  15. Efficacy of Botulinum toxin type A in treatment of different forms of focal dystonias in the Serbian population: Experience of the Botulinum Toxin Outpatients Department

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    Tomić Aleksandra

    2015-01-01

    Full Text Available Background/Aim. Botulinum toxin (BTX irreversibly inhibits presynaptic acetylcholine release with subsequent relaxation of abnormally contracting muscles. It is an effective and well tolerated treatment with long-term benefit in a variety of movement disorders and other neurological and non-neurological disturbances. The aim of our study was to present our experience with BTX type A in treatment of different forms of focal dystonias. Мethods. А hundred of patients with different focal dystonias (spastic torticollis, blepharospasm and graphospasm from the Botulinum Toxin Outpatients Department, Clinic for Neurology, Clinical Center of Serbia, were included in the study. All the patients were examined and rated at baseline visit prior to BTX application and on the following visit, after 3-4 months, using self-assessment improvement questionnaire and standardized rating scales. Results. The improvement of ≥ 50% was presented in 68.2% of all (199 the analyzed applications. Independent predictors of good response to the therapy (improvement ≥ 50% were male sex (p = 0.011, the presence of sensory trick (p = 0.013 and the total number of BTX applications (p = 0.002. The patients with spastic torticollis and blepharospasm showed a statistically significantly better BTX effect (improvement 57.3 ± 27.5% and 54.1 ± 28.3%, respectively than the graphospasm group (26.7 ± 25.6%. Most of the patients did not have therapy complications (81.4% and 72% in two applications. Side effects in the remaining patients (muscle weakness, dysphagia, ptosis, double vision, neck weakness and lacrimal dysfunction lasted for 28.3 ± 18.6 days after the first treatment and 32.5 ± 36.2 days after the second one. Conclusion. BTX is safe and highly effective in long-term treatment of patients with different forms of focal dystonia, with only mild and well-tolerated side-effects. [Projekat Ministarstva nauke Republike Srbije, br. 175090

  16. 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...

  17. 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…

  18. 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

  19. 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

  20. 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.

  1. Irrational Prescribing of Antibiotics in Pediatric Outpatients: A Need for Change

    Directory of Open Access Journals (Sweden)

    Edita Alili-Idrizi

    2015-12-01

    Full Text Available Background and Aims: Antibiotics play a major role in the treatment of infectious diseases and are among the drugs most commonly prescribed for children. Respiratory tract infections in pediatric patients are a common cause of antibiotic prescribing which increases morbidity, mortality, patient cost and the likelihood for emergence of antibiotics-resistant microorganisms. This study was undertaken to determine the proportion of common respiratory tract infections and to generate data on the extent of rational/irrational prescribing of antibiotics in patients attending the pediatric out-patient department. Material and Methods: retrospective study carried out during one year (January to December, 2013 in the pediatric out-patient department of the Clinical Center in Tetovo. Patients of either sex at age group between 1 week and 14 years who attended the pediatric out-patient department and were prescribed antibiotics for respiratory tract infections were included in the study. The data was compared against national guideline-based medicine, major antibiotic guidelines recommended by World Health Organization (WHO and American Academy of Pediatrics (AAP, and cross-referenced against Cochrane studies. Results: Children aged >1 - ≤3 years received 49.6% of antibiotics. The most common prescribed antibiotics were penicillins (62.2%, followed by cephalosporins (32.5%. Sore throat (61.5% was identified as the most common diagnosis. There was a significant relationship (r=0.234, p< 0.05 between diagnosis and antibiotic prescribing. Ninety two percent of pediatric patients with common cold, laryngitis, viral sore throat, acute otitis media and bronchitis were prescribed antibiotics irrationally, that represents a major deviation from the recommendations from the guidelines. High levels (90% of antibiotic irrational prescribing were revealed in pediatric outpatients diagnosed with pneumonia. Conclusion: This study reinforces the need to implement

  2. Is treatment in groups a useful alternative for psychiatry in low-income countries? An evaluation of a psychiatric outpatient unit in Nicaragua.

    Science.gov (United States)

    Caldera, T; Kullgren, G; Penayo, U; Jacobsson, L

    1995-11-01

    Centro de Atención Psicosocial in León, Nicaragua is a psychiatric outpatient unit that has developed a group-oriented model of working, in which 80% of all visits are in groups: first-admission groups, insight-oriented group psychotherapy, psycho-educative, family groups and relatives groups. The aim of the present study was to analyze patient characteristics and make a preliminary study of improvement, compliance and patient satisfaction in a 1-year perspective. One hundred consecutive visits were assessed, 44 of them first admissions. They were assessed according to all axes of DSM-III-R plus the Structural Clinical Interview for DSM-III Disorders. A 1-year follow up was conducted on 39 of 41 selected patients within the major diagnostic groups. One of 4 patients had a psychotic disorder where schizophrenia dominated. Among nonpsychotics major depression, anxiety and adjustment disorders were most frequent. Personality disorders were common (80%) among nonpsychotic patients, paranoid, obsessive-compulsive, passive-aggressive and masochistic personality disorders dominating. The illiteracy rate was 10%, but 50% had high school or university background. Severity of mental disorders and functional level did not differ between educational levels. There was a strong male dominance in all diagnostic, socioeconomic and educational level strata and few old patients. Improvement in functional level was clinically and statistically significant in all groups, and more than two thirds were very satisfied with the group treatment offered.

  3. 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 ...

  4. ART treatment costs and retention in care in Kenya: a cohort study in three rural outpatient clinics

    Directory of Open Access Journals (Sweden)

    Bruce A Larson

    2013-01-01

    Full Text Available Introduction: After almost 10 years of PEPFAR funding for antiretroviral therapy (ART treatment programmes in Kenya, little is known about the cost of care provided to HIV-positive patients receiving ART. With some 430,000 ART patients, understanding and managing costs is essential to treatment programme sustainability. Methods: Using patient-level data from medical records (n=120/site, we estimated the cost of providing ART at three treatment sites in the Rift Valley Province of Kenya (a clinic at a government hospital, a hospital run by a large agricultural company and a mission hospital. Costs included ARV and non-ARV drugs, laboratory tests, salaries to personnel providing patient care, and infrastructure and other fixed costs. We report the average cost per patient during the first 12 months after ART initiation, stratified by site, and the average cost per patient achieving the primary outcome, retention in care 12 months after treatment initiation. Results: The cost per patient initiated on ART was $206, $252 and $213 at Sites 1, 2 and 3, respectively. The proportion of patients remaining in care at 12 months was similar across all sites (0.82, 0.80 and 0.84. Average costs for the subset of patients who remained in care at 12 months was also similar (Site 1, $229; Site 2, $287; Site 3, $237. Patients not retained in care cost substantially less (Site 1, $104; Site 2, $113; Site 3, $88. For the subset of patients who remained in care at 12 months, ART medications accounted for 51%, 44% and 50% of the costs, with the remaining costs split between non-ART medications (15%, 11%, 10%, laboratory tests (14%, 15%, 15%, salaries to personnel providing patient care (9%, 11%, 12% and fixed costs (11%, 18%, 13%. Conclusions: At all three sites, 12-month retention in care compared favourably to retention rates reported in the literature from other low-income African countries. The cost of providing treatment was very low, averaging $224 in the first

  5. 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

  6. 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...

  7. 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...

  8. 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...

  9. 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...

  10. Anxiety among people living with HIV/AIDS on antiretroviral treatment attending tertiary care hospitals in Lucknow, Uttar Pradesh, India

    Directory of Open Access Journals (Sweden)

    Mukesh Shukla

    2016-07-01

    Conclusions: People living with HIV/AIDS need to be periodically educated and informed about various issues associated with the disease severity and antiretroviral treatment along with its side-effects so that they could better cope with disease and its treatment outcomes over time and be able to seek early treatment accordingly. [Int J Res Med Sci 2016; 4(7.000: 2897-2901

  11. 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

  12. A Randomized Evaluation of Multidimensional Treatment Foster Care: Effects on School Attendance and Homework Completion in Juvenile Justice Girls

    Science.gov (United States)

    Leve, Leslie D.; Chamberlain, Patricia

    2007-01-01

    Despite growing evidence that child welfare youth are at increased risk for juvenile delinquency, little is known about gender-specific processes and effective treatment programs for girls. Multidimensional Treatment Foster Care (MTFC), an empirically validated intervention for child welfare and juvenile justice populations, has demonstrated…

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

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    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

  14. 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

  15. Patterns of drug abuse among drug users with regular and irregular attendance for treatment as detected by comprehensive UHPLC-HR-TOF-MS.

    Science.gov (United States)

    Sundström, Mira; Pelander, Anna; Simojoki, Kaarlo; Ojanperä, Ilkka

    2016-01-01

    The most severe consequences of drug abuse include infectious diseases, overdoses, and drug-related deaths. As the range of toxicologically relevant compounds is continually changing due to the emergence of new psychoactive substances (NPS), laboratories are encountering analytical challenges. Current immunoassays are insufficient for determining the whole range of the drugs abused, and a broad-spectrum screening method is therefore needed. Here, the patterns of drug abuse in two groups of drug users were studied from urine samples using a comprehensive screening method based on high-resolution time-of-flight mass spectrometry. The two groups comprised drug abusers undergoing opioid maintenance treatment (OMT) or drug withdrawal therapy and routinely visiting a rehabilitation clinic, and drug abusers with irregular attendance at a harm reduction unit (HRU) and suspected of potential NPS abuse. Polydrug abuse was observed in both groups, but was more pronounced among the HRU subjects with a mean number of concurrent drugs per sample of 3.9, whereas among the regularly treated subjects the corresponding number was 2.1. NPS and pregabalin were more frequent among HRU subjects, and their abuse was always related to drug co-use. The most common drug combination for an HRU subject included amphetamine, cannabis, buprenorphine, benzodiazepine, and alpha-pyrrolidinovalerophenone. A typical set of drugs for treated subjects was buprenorphine, benzodiazepine, and occasionally amphetamine. Abuse of several concurrent drugs poses a higher risk of drug intoxication and a threat of premature termination of OMT. Since the subjects attending treatment used fewer concurrent drugs, this treatment could be valuable in reducing polydrug abuse.

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

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    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.

  17. Study protocol: a randomized controlled trial of a computer-based depression and substance abuse intervention for people attending residential substance abuse treatment

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    Kelly Peter J

    2012-02-01

    Full Text Available Abstract Background A large proportion of people attending residential alcohol and other substance abuse treatment have a co-occurring mental illness. Empirical evidence suggests that it is important to treat both the substance abuse problem and co-occurring mental illness concurrently and in an integrated fashion. However, the majority of residential alcohol and other substance abuse services do not address mental illness in a systematic way. It is likely that computer delivered interventions could improve the ability of substance abuse services to address co-occurring mental illness. This protocol describes a study in which we will assess the effectiveness of adding a computer delivered depression and substance abuse intervention for people who are attending residential alcohol and other substance abuse treatment. Methods/Design Participants will be recruited from residential rehabilitation programs operated by the Australian Salvation Army. All participants who satisfy the diagnostic criteria for an alcohol or other substance dependence disorder will be asked to participate in the study. After completion of a baseline assessment, participants will be randomly assigned to either a computer delivered substance abuse and depression intervention (treatment condition or to a computer-delivered typing tutorial (active control condition. All participants will continue to complete The Salvation Army residential program, a predominantly 12-step based treatment facility. Randomisation will be stratified by gender (Male, Female, length of time the participant has been in the program at the commencement of the study (4 weeks or less, 4 weeks or more, and use of anti-depressant medication (currently prescribed medication, not prescribed medication. Participants in both conditions will complete computer sessions twice per week, over a five-week period. Research staff blind to treatment allocation will complete the assessments at baseline, and then 3, 6, 9

  18. TV Outpatient Department Is Welcomed

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    A middle school teacher living in Huairou, located on the outskirts of Beijing, dialed the number of the "Outpatient Department" on the Beijing TV Station. She asked the medical specialists about cervical cancer. A woman professor answered: "Of all the pernicious tumors, cervical cancer responds the best to treatment. After an operation the five-year survival rate is 60 percent. Commonly speaking, the earlier the cancer is found, the better the chance for cure. The five-year survival rate of the first stage of cervical cancer call be more than 90 percent."

  19. Florida's outpatient commitment law: a lesson in failed reform?

    Science.gov (United States)

    Petrila, John; Christy, Annette

    2008-01-01

    An involuntary outpatient commitment law became effective in Florida in January 2005. However, only 71 orders for outpatient commitment have been issued in three years, even though during that period 41,997 adults had two or more 72-hour involuntary emergency examinations under Florida's civil commitment law. This column describes the criteria for outpatient commitment in the Florida statute and discusses possible reasons for its low rate of use, including additional statutory criteria that make filing a petition for outpatient commitment difficult, lack of community treatment resources, and lack of enforcement mechanisms.

  20. 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

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    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

  1. The longer-term cognitive effects of adjunctive antiepileptic treatment with lacosamide in comparison with lamotrigine and topiramate in a naturalistic outpatient setting.

    Science.gov (United States)

    Helmstaedter, Christoph; Witt, Juri-Alexander

    2013-02-01

    In this retrospective controlled study, the impact of adjunctive lacosamide (LCM) on cognition in patients with epilepsy was evaluated and compared with that of topiramate (TPM) and lamotrigine (LTG) in a naturalistic outpatient setting. Cognition was investigated by means of objective assessment of executive functions (EpiTrack®) and verbal memory and by subjective ratings of self-perceived side effects (cognition, mood, and vegetative). Quality of life was assessed using the QOLIE-10 questionnaire. Patients underwent assessment at baseline and after a median follow-up interval of 32 weeks. Forty-four patients were treated with LCM, 11 with LTG, and 15 with TPM. Treatment arms differed with regard to the age at onset of epilepsy (LTG>TPM) and to seizure control from baseline to follow-up, which was best in patients whose seizures were treated with LTG (55% vs. 16% in patients whose seizures were treated with LCM and 13% in patients whose seizures were treated with TPM). Groups did not differ in the type of epilepsy, daily drug load or drug load change, nor in baseline seizure frequency. Repeated measures statistics controlling for epilepsy onset and seizure outcome showed deteriorated executive functions with TPM (F=7.5, p=0.001). On an individual level (reliable change indices), 53% of the patients whose seizures were treated with TPM showed losses in this domain (LCM 14%, LTG 27%) and none of the patients showed improvement (LCM 23%, LTG 27%; χ(2)=11.8, p=0.019). No differences in memory, quality of life, or mood were noted among patients in the three treatment arms. Subjective cognitive complaints increased in 5 of the 9 patients whose seizures were treated with TPM (LCM 1/9, LTG 0/9; χ(2)=11.9, p=0.025). The findings of this study demonstrate for the first time that the cognitive side effect profile of LCM is comparable to that of LTG and superior to that of TPM. This is indicated by both subjective and objective measures. Given the naturalistic setting and

  2. 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...

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

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    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.

  4. Effect of intermittent preventive treatment of malaria on the outcome of pregnancy among women attending antenatal clinic of a new Nigerian teaching hospital, Ado-Ekiti

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    Aduloju Olusola Peter

    2013-01-01

    Full Text Available Background: Malaria is a public health problem globally especially in the Sub-Saharan Africa and among the under five children and pregnant women and is associated with a lot of maternal and foetal complications. Objective: The study was on the effect of intermittent preventive treatment of malaria in pregnancy on the prevalence of malaria in pregnancy and the outcome of pregnancy. Materials and Methods: In a descriptive cross-sectional study, a semi-structured questionnaire was administered to women admitted in Ekiti State University Teaching Hospital labour ward, Ado-Ekiti. About 4,200 women participated in the study and the inclusion criteria were women who were booked in the hospital, attended at least four antenatal clinic visits, and consented to the study while the exclusion criteria were those who didn′t book in the hospital and failed to give their consent. Results: The study revealed that about 75% of the pregnant women studied had access to intermittent preventive treatment of malaria. Among the women attending the antenatal clinic that received sulphadoxine-pyrimethamine (SP, about 78% of them took two doses of SP. The prevalence of clinical malaria was statistically higher in women who did not receive intermittent preventive treatment with SP during pregnancy (44.7% vs. 31.3%, P = 0.0001 and among women who had one dose of the drug instead of two doses (40.0% vs. 28.7%, P = 0.0001. There was no statistical significant difference in the mean age in years (31.53 ± 5.238 vs. 31.07 ± 4.751, P = 0.09 and the gestational age at delivery (38.76 ± 1.784 vs. 38.85 ± 1.459, P = 0.122 between the women who did not receive SP and those who had it. There was a statistical significant difference in the outcome of pregnancy among women who had Intermittent Preventive Treatment in pregnancy (IPTp and those who did not viz.-a-viz. in the duration of labor (8.6 ± 1.491 vs. 8.7 ± 1.634, P = 0.011 and the birth weight of the babies (3.138 ± 0

  5. 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

  6. Economic grand rounds: Can states implement involuntary outpatient commitment within existing state budgets?

    Science.gov (United States)

    Swartz, Marvin S; Swanson, Jeffrey W

    2013-01-01

    Many states have not implemented involuntary outpatient commitment, possibly believing that the program is too costly. A review of New York State's experience found that even though the state had appropriated funds for implementing outpatient commitment, overall cost savings were realized. This column presents an analysis in which net costs of outpatient commitment were calculated by using data from a randomized controlled study in North Carolina, where court-ordered treatment was implemented without additional appropriations. The analysis found that outpatient commitment in North Carolina was relatively cost-neutral when relevant costs for persons on outpatient commitment were compared with costs for persons not on outpatient commitment, regardless of commitment duration. Outpatient commitment of six months or more, combined with provision of outpatient services, appeared to result in cost savings of 40%. Findings suggest that states with adequate services to provide consumers on outpatient commitment may implement a program without new funding.

  7. 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

  8. 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

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

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    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

  10. 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.

  11. Clinical Characteristics and Pharmacological Treatment of Psychotic Patients Attending the Mental Health Services of the Pediatric Hospital of Cienfuegos

    Directory of Open Access Journals (Sweden)

    Beatriz Sabina Roméu

    2016-06-01

    Full Text Available Background: the mental health services of the Pediatric Hospital of Cienfuegos receive all patients in the province that need to be hospitalized. Among them, children and adolescents functioning at the psychotic level are of great clinical and social importance. Objective: to describe the clinical characteristics and pharmacological treatment of psychotic patients treated in the mental health services. Methods: a case series study of 35 psychotic patients admitted to the mental health unit of the Pediatric Hospital of Cienfuegos was conducted between 2008 and 2012. Demographic variables, in addition to variables related to clinical data and pharmacotherapeutic aspects were analyzed. Results: sixty five point seven percent of patients were adolescents and 77.1% were of urban origin. The most common diagnoses were acute and transient psychotic disorder and schizophrenia. Sixty three percent had a family history of psychiatric disorder. Forty percent were treated with trifluoperazine and an equal percent took haloperidol. Psychotic symptoms were controlled in 58% of patients during the first weeks. Conclusion: white adolescent patients from urban areas with a family history of psychiatric illness predominated. They received regular psychiatric attention and experienced the symptoms for a short time before being treated. The most frequently prescribed medications were typical antipsychotic drugs, which caused adverse reactions in a third of the patients. In the first few weeks, psychotic symptoms were controlled in most patients, although half of them experienced a recurrence of symptoms, which evolved into conditions with worse prognosis.

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

    Directory of Open Access Journals (Sweden)

    João Maria Corrêa Filho

    2012-12-01

    Full Text Available OBJECTIVE: One of the factors associated with low rates of compliance in the treatment for alcoholism seems to be the intensity of craving for alcohol. This study aimed to evaluate the associations between alcohol craving and biopsychosocial addiction model-related variables and to verify whether these variables could predict treatment retention. METHODS: The sample consisted of 257 male alcoholics who were enrolled in two different pharmacological trials conducted at the Universidade de São Paulo in Brazil. Based on four factors measured at baseline - biological (age, race, and family alcoholism, psychiatric (depression symptoms, social (financial and marital status, and addiction (craving intensity, severity of alcohol dependence, smoking status, drinking history, preferential beverage, daily intake of alcohol before treatment - direct logistic regression was performed to analyze these factors' influence on treatment retention after controlling for medication groups and AA attendance. RESULTS: Increasing age, participation in Alcoholics Anonymous groups, and beer preference among drinkers were independently associated with higher treatment retention. Conversely, higher scores for depression increased dropout rates. CONCLUSION: Health services should identify the treatment practices and therapists that improve retention. Information about patients' characteristics linked to dropouts should be studied to render treatment programs more responsive and attractive, combining pharmacological agents with more intensive and diversified psychosocial interventions.OBJETIVO: Um dos fatores associados com baixas taxas de adesão ao tratamento para alcoolismo parece ser a intensidade da fissura pelo álcool. Este estudo objetiva avaliar a associação entre a fissura pelo álcool e variáveis relacionadas ao modelo biopsicossocial de dependência, bem como verificar se estas variáveis prevêem retenção ao tratamento. MÉTODO: A amostra foi composta por

  13. The Clinical Significance of Establishing Wound Treatment Center and Developing Outpatient Nursing%建立创面治疗中心及开展护理门诊的临床意义

    Institute of Scientific and Technical Information of China (English)

    任素琴; 孟凡慧; 王玉英

    2016-01-01

    随着临床业务拓展的迫切需求,开展专科护理门诊是护理学科发展的必然趋势.某院在借鉴国内外多家医院开设护理门诊经验基础上,经过充分的专家论证,在新门诊大楼内增设了创面治疗中心,并开设了伤口护理门诊、造口/失禁护理门诊、经外周中心静脉置管(PICC)护理门诊等专科护理门诊.其合理的布局设置,科学的功能分区,规范的工作流程,通过一支专业化护理队伍的全方位建设,使其诊疗范畴不断扩增.设立的伤口护理与造口/失禁护理门诊不但提高了患者伤口愈合速度,缩短了伤口愈合时间,而且通过承担出院患者的延续护理服务,降低了平均住院日,加快了病房床位周转,同时提升了护理人员的社会价值感,获得了较好的经济效益和社会效益.%As the urgent needs of clinical business development, the carrying out of outpatient nursing is the inevitable trend of the disciplinary development. On the basis of development of outpatient nursing experience from home and abroad, as well as full demonstration of experts, we added wound therapy center in the new outpatient building and opened a wound care clinic, ostomy/incontinence care clinic, peripherally inserted central venous catheter(PICC) nursing specialist care in outpatient clinics. The reasonable layout, the scientific function, standardized work process through a full range of professional nursing team construction, its diagnosis and treatment scope was continuously expanding. The establishment of wound nursing and ostomy/incontinence outpatients nursing not only improved the speed of wound healing, shortened the healing time, and reduced the average length of stay, speeded up the ward beds turnover and enhanced the social value of the nursing staff, and received good economic and social benefits at the same time.

  14. 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

  15. Demographic study of port wine stain patients attending a laser clinic: family history, prevalence of naevus anaemicus and results of prior treatment.

    Science.gov (United States)

    Mills, C M; Lanigan, S W; Hughes, J; Anstey, A V

    1997-07-01

    All patients with port wine stains (PWS) attending a tunable dye laser clinic were examined by one author (SWL), forming a large group which has allowed study of the demographic data of such patients. Two hundred and eighty-three patients, 217 females (median age 24 years, range 0.5-73) and 66 males (median age 20 years, range 0.75-72), were examined. The PWS were on the face in 226, neck in 69, trunk in 36, upper limb in 35 and lower limb in 29. The commonest lesional colour was purple (63 patients), while 39 naevi were pink/red, 35 pink/ purple and 35 pink. The naevus was flat in 255 patients, cobblestoned in 28, associated with hypertrophy in 31 and with scarring in 22. Seventy-two patients (25.4%) had a positive family history of birthmarks, 20 strawberry haemangiomas and 22 PWS, the family history of PWS being higher than expected for the prevalence of this naevus in the population. One hundred and forty-six patients were also examined for naevus anaemicus which was noted in 12 (8.2%), confirming an association between these two naevi. Ninety-four patients had received previous treatment, most commonly with the argon laser (56 patients), of whom only five reported a good result, and 17 of 22 patients with treatment-related scarring had been treated with this laser. Cosmetic camouflage was used in 109 (38.5%) of patients, who usually had PWS on the face (94%), of whom only 46 (16%) had received advice of its use. PMID:9499604

  16. 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...

  17. 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.

  18. Cervical pre-malignant lesions in HIV infected women attending Care and Treatment Centre in a tertiary hospital, Dar es Salaam, Tanzania.

    Science.gov (United States)

    Balandya, Belinda S; Pembe, Andrea B; Mwakyoma, Henry A

    2011-09-01

    The aims of this study was to determine proportion of HIV infected women with cervical pre-malignant lesions; and compare the use of Visual Inspection of the cervix after application of Acetic acid (VIA) and Papanicolau (Pap) smear in screening for cervical premalignant lesions in HIV positive women attending Care and Treatment Centre (CTC) at Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania. A total of 316 women aged 18-70 years had a Pap smear taken for cytology, followed by spraying onto the cervix with 4% acetic acid and then inspecting it. Cytology was considered negative when there was no Cervical Intraepithelial Neoplasia (CIN) lesion reported from the Pap smear taken, and positive if CIN lesion 1, 2 or 3 was reported. Detection of a well-defined, opaque acetowhite lesion close to the squamocolumnar junction or close to the external cervical os constituted a positive VIA. Out of 316 women, 132 women had acetowhite lesions on VIA, making the proportion of abnormal cervical lesions to be 42.4%. One hundred and one out of 312 women (32.4%) had CIN lesions detected on Pap smear. The proportion of agreement between these two tests was 0.3. The proportion of agreement was moderate in women with advanced WHO HIV clinical stage of the disease and in women not on ART (Anti Retroviral Therapy). Women with CD-4 count less than 200 cells/mm3 had more abnormal cervical lesions. There is considerable proportion of HIV positive women with premalignant lesions of the cervix. Considering the proportion of HIV women with abnormal lesions and the difficulty in logistics of doing Pap smear in low resource settings, these results supports the recommendation to introduce screening of premalignant lesions of the cervix using VIA to all HIV infected women.

  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. Patterns of complementary and alternative medicine use amongst outpatients in Tokyo, Japan

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    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.

  1. 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...

  2. 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

  3. 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.

  4. 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.

  5. 34 CFR 668.21 - Treatment of title IV grant and loan funds if the recipient does not begin attendance at the...

    Science.gov (United States)

    2010-07-01

    ... institution. (a) If a student does not begin attendance in a payment period or period of enrollment— (1) The... institution or disbursed directly to the student for that payment period or period of enrollment, for Federal... student to the institution for that payment period or period of enrollment, up to the total amount of...

  6. 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.

  7. 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…

  8. Estrutura fatorial da Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES em dependentes de álcool tratados ambulatorialmente Factor structure of the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES in alcohol dependent outpatients

    Directory of Open Access Journals (Sweden)

    Neliana Buzi Figlie

    2004-06-01

    Full Text Available OBJETIVO: O objetivo deste estudo foi o de investigar a confiabilidade e a estrutura fatorial da Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES, versão 8,¹ instrumento com 19 itens que mensura a prontidão para a mudança em dependentes de álcool. MÉTODOS: Uma análise fatorial confirmatória da SOCRATES foi realizada em uma amostra de 326 dependentes de álcool, tratados ambulatorialmente, tendo como base a estrutura fatorial demonstrada por Miller & Tonigan² e Maisto et al.³ O questionário foi traduzido e adaptado culturalmente para o idioma português, sendo posteriormente submetido ao procedimento da retradução para o idioma inglês. Durante esse procedimento, foram realizadas algumas modificações, visando a simplificar alguns itens que apresentaram formato complexo. RESULTADOS: As análises estatísticas mostraram a existência de dois fatores correlacionados que melhor exploraram o modelo, sendo este achado similar ao estudo de Maisto et al.³ CONCLUSÕES: Foi constatada menor evidência para o modelo de três fatores. Esses resultados são comparados com estudos prévios e as discrepâncias são discutidas neste artigo.OBJECTIVE: The aim of this study was to investigate the reliability and factor structure of the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES, version 8,¹ a 19-item self-reported instrument developed to measure readiness to change in alcohol-dependent alcoholics. METHODS: A Confirmatory Factor analysis of the SOCRATES was performed based on the factor structures previously demonstrated by Miller & Tonigan² and Maisto et al.³ in a sample with 326 alcohol-dependent outpatients. The questionnaire was translated into Portuguese, cross-culturally adapted and back-translated into English. During this process SOCRATES underwent some modifications to simplify some complex question formats. RESULTS: The analysis showed that two correlated factors provided the best fit for the

  9. 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.

  10. 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

  11. 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

  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. 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...

  14. 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.

  15. 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.

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

    Science.gov (United States)

    Jaffe, Joshua S.

    2008-01-01

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

  17. 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

  18. 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...

  19. Milnacipran and venlafaxine at flexible doses (up to 200 mg/day in the outpatient treatment of adults with moderate-to-severe major depressive disorder: a 24-week randomized, double-blind exploratory study

    Directory of Open Access Journals (Sweden)

    Jean-Pierre Olié

    2010-03-01

    Full Text Available Jean-Pierre Olié1, David Gourion2, Agnès Montagne3, Michel Rostin4, Marie-France Poirier11Service de Santé Mentale et Thérapeutique, Centre Hospitalier Sainte-Anne, Paris, France; 217 rue des Marronniers, 75016 Paris, France; 3Pierre Fabre Médicament, Labège, France; 4Pierre Fabre Médicament, Castres, FranceAbstract: The objective of this exploratory, multicenter, randomized, double-blind study, was to evaluate the efficacy and safety/tolerability of milnacipran and venlafaxine administered at flexible doses (100, 150 or 200 mg/day, bid administration for 24 weeks (including 4 weeks up titration period in the outpatient treatment of adults presenting with a moderate or severe episode of major depressive disorder (MDD without high suicidal risk (MINI-DSM IV-TR. Of the 195 patients included, 134 (68.7% completed the study. At baseline the two groups were similar, except there was a higher proportion of patients whose episode was severe-DSM IV in the milnacipran group (63.3% versus 54.0% in the venlafaxine group. The initial MADRS score (mean 31.0 decreased progressively during the study, and this decrease was in the two treatment groups (n = 177: 90 milnacipran; 87 venlafaxine at week 24 (observed case/OC, mean change –23.1 milnacipran; –22.4 venlafaxine. The rate of MADRS response (reduction ≥ 50% at week 8 and week 24-last observation carried forward/LOCF was similar in the two groups (week 8: 64.4% milnacipran; 65.5% venlafaxine; week 24: 70% milnacipran; 77% venlafaxine, as was the rate of MADRS remission (score ≤ 10 (week 8: 42.2% milnacipran; 42.5% venlafaxine; week 24: 52.2% milnacipran; 62.1% venlafaxine. In both groups, the most common adverse events were: nausea, dizziness, headache, hyperhidrosis and, in males, genito-urinary problems. The overall safety/tolerability and efficacy profiles of milnacipran and venlafaxine administered at flexible dosages (up to 200 mg/day were similar in the long term treatment of adults

  20. 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

  1. 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...... the study and inform about the first preliminary results. Perspectives If this study detects a positive relationship between exercise as a supplement to alcohol treatment and patients’ alcohol intake, quality of life, fitness, well-being, anxiety, depression and interpersonal problems...

  2. 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...

  3. 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

  4. Tongue tonsil hypertrophy sex microwave local treatment to snore disease outpatient clinical study%舌扁桃体肥大性鼾症的门诊微波局部治疗临床探讨

    Institute of Scientific and Technical Information of China (English)

    王坤; 李静

    2013-01-01

      Tonsil hypertrophy is caused by tonsil by bacteria and virus infection, one of the most common bacterial infection, pathogenic bacteria for hemolytic streptococcus, staphylococcus aureus, pneumococcus. Is a disease in which abnormal pharyngeal tonsil hypertrophy, enlarged tonsils not treated for a long time, can cause tympanitis, snoring, trachea, and bronchitis. Traditional tonsil surgery including peel and squeeze cut method, traumatic big, bleeding, and with general anesthesia, great harm to the child's body. The amygdala has certain body immune function, is especially important for children up to the age of 4. Removal of the tonsils, will affect the local immune response, reduce the body's ability to fight infection, lead to bacteria invasion, cause many diseases. Microwave therapy apparatus is simple, convenient operation, short treatment time, suitable for outpatient department to carry out, in this paper, the microwave local tongue tonsil hypertrophy sex to snore disease outpatient treatment effect, and conducted a series of discussion.%  扁桃体肥大是由于扁桃体被细菌和病毒的感染,其中细菌感染最多见,病原菌多为溶血性链球菌、葡萄球菌、肺炎球菌。长期肥大的扁桃体不及时治疗,可导致中耳炎、打呼噜、气管及支气管炎。传统的扁桃体手术包括剥离法和挤切法,创伤性大,出血多,全身麻醉对孩子的身体危害极大。而扁桃体具有一定的人体免疫功能,对4岁以前的儿童尤为重要。切除扁桃体后,会影响局部的免疫反应,降低身体抗感染的能力,导致细菌的入侵,引起多种疾病。微波治疗设备简单,操作方便,治疗时间短,适合在门诊开展,本文就舌扁桃体肥大性鼾症的门诊微波局部治疗效果进行了探讨。

  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. 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...

  7. 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

  8. Psychometric Properties of the Modified Posttraumatic Stress Disorder Symptom Scale among Women with Posttraumatic Stress Disorder and Substance Use Disorders Receiving Outpatient Group Treatments

    Science.gov (United States)

    Ruglass, Lesia M; Papini, Santiago; Trub, Leora; Hien, Denise A

    2015-01-01

    Objective The use of psychometrically sound measures to assess and monitor PTSD treatment response over time is critical for better understanding the relationship between PTSD symptoms and Substance Use Disorder (SUD) symptoms throughout treatment. We examined the psychometric properties of the Modified Posttraumatic Stress Disorder (PTSD) Symptom Scale, Self-Report (MPSS-SR). Methods Three hundred fifty three women diagnosed with co-occurring PTSD (full or sub-threshold) and SUD who participated in a multisite treatment trial completed the MPSS-SR at pre-treatment, weekly during treatment, and posttreatment. Reliability and validity analyses were applied to the data. Results Internal consistency was excellent throughout the course of the trial demonstrating the MPSS-SR's high reliability. Strong correlations between MPSS-SR scores and the Brief Symptom Inventory and the Clinician Administered PTSD Scale (CAPS) severity scores demonstrated the MPSS-SR's convergent and concurrent validity. We conducted a classification analysis at posttreatment and compared the MPSS-SR at various cutoff scores with the CAPS diagnosis. A cutoff score of 29 on the MPSS-SR yielded a sensitivity rate of 89%, a specificity rate of 77%, and an overall classification rate of 80%, indicating the measure's robust ability to accurately identify individuals with PTSD in our sample at posttreatment. Conclusions Findings support the use of the MPSS-SR as a reliable and valid tool to assess and monitor changes in PTSD symptoms over the course of treatment and as an alternative to structured clinical interviews to assess PTSD symptoms among populations with SUDs. PMID:26543877

  9. Experiences with an outpatient relapse program (CRA) combined with naltrexone in the treatment of opioid dependence: effect on addictive behaviours and the predictive value of psychiatric comorbidity.

    NARCIS (Netherlands)

    Roozen, H.G.; Kerkhof, A.J.F.M.; Brink, van den W.

    2003-01-01

    Background: There is increasing interest in naltrexone, an opiate antagonist, in the treatment of opiate addicts. The effects of naltrexone are often compromised by a lack of compliance and drop-out. The effects of this compound are probably more favorable when combined with a psychosocial intervent

  10. Persistent frequent attenders in primary care: costs, reasons for attendance, organisation of care and potential for cognitive behavioural therapeutic intervention

    Directory of Open Access Journals (Sweden)

    Morriss Richard

    2012-07-01

    Full Text Available Abstract Background The top 3% of frequent attendance in primary care is associated with 15% of all appointments in primary care, a fivefold increase in hospital expenditure, and more mental disorder and functional somatic symptoms compared to normal attendance. Although often temporary if these rates of attendance last more than two years, they may become persistent (persistent frequent or regular attendance. However, there is no long-term study of the economic impact or clinical characteristics of regular attendance in primary care. Cognitive behaviour formulation and treatment (CBT for regular attendance as a motivated behaviour may offer an understanding of the development, maintenance and treatment of regular attendance in the context of their health problems, cognitive processes and social context. Methods/design A case control design will compare the clinical characteristics, patterns of health care use and economic costs over the last 10 years of 100 regular attenders (≥30 appointments with general practitioner [GP] over 2 years with 100 normal attenders (6–22 appointments with GP over 2 years, from purposefully selected primary care practices with differing organisation of care and patient demographics. Qualitative interviews with regular attending patients and practice staff will explore patient barriers, drivers and experiences of consultation, and organisation of care by practices with its challenges. Cognitive behaviour formulation analysed thematically will explore the development, maintenance and therapeutic opportunities for management in regular attenders. The feasibility, acceptability and utility of CBT for regular attendance will be examined. Discussion The health care costs, clinical needs, patient motivation for consultation and organisation of care for persistent frequent or regular attendance in primary care will be explored to develop training and policies for service providers. CBT for regular attendance will

  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. 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…

  14. The technology and progress of sedative and analgesia treatment in outpatient oral disease therapy%口腔疾病镇静痛治疗常用技术与进展

    Institute of Scientific and Technical Information of China (English)

    郁葱; 赵楠

    2013-01-01

    How to eliminate the fear or the pain of the pa-tients during dental therapy process has been paid more atten-tion by dentists across the country,as the dental painless ther-apeutic area involvs a wide range subjects,covering the stoma-tology,anesthesiology,hospital management,et al. We sum-marized the characteristics of sedative and analgesia technolo-gy during outpatient oral therapy,reviewed the common seda-tive and analgesia treatment technology,introduced our suc-cessful experience and predicted the trends of this area.%如何消除患者因口腔疾病及在牙病治疗过程中出现的疼痛或恐惧感逐渐受到全国口腔医疗专业人员的重视,由于口腔门诊无痛治疗领域涉及多个学科,故对该领域的临床实践与深入研究尚待加强。本文总结了实施口腔镇静镇痛治疗的特点,回顾了常用的技术,并对该领域的发展进行了阐述。

  15. 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

  16. 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

  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. 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...

  1. Uso potencial dos anticonvulsivantes no tratamento ambulatorial da dependência de álcool Potential use of the anticonvulsants in the outpatient treatment of alcohol dependence

    Directory of Open Access Journals (Sweden)

    Luís André Castro

    2006-01-01

    Full Text Available Atualmente três medicações (dissulfiram, naltrexona e acamprosato são aprovadas pela Food and Drug Administration (FDA para tratar a dependência de álcool. As drogas anticonvulsivantes clássicas são raramente empregadas como alternativa por causa dos seus efeitos colaterais, mas a sua última geração pode ser útil. Os anticonvulsivantes podem ser uma alternativa aos benzodiazepínicos (BZD e a outros tratamentos farmacológicos na prevenção de complicações na desintoxicação por apresentarem ausência de propriedades aditivas e um melhor perfil de efeitos adversos do que os anticonvulsivantes clássicos. Anticonvulsivantes como carbamazepina, ácido valpróico, gabapentina e topiramato demonstraram-se excelentes tratamentos para síndrome de abstinência do álcool e prevenção de recaídas. Embora nenhum desses agentes tenha sido aprovado pela FDA, existe uma crescente evidência na literatura que apóia o seu uso.Currently three medications (disulfiram, naltrexone and acamprosate are approved by the FDA to treat alcohol dependence by the FDA. The classical anticonvulsive drugs are rarely employed as an alternative because of their side effects, but the latest generation of anticonvulsants could be useful. The anticonvulsants can be a alternative to BZD and other pharmacological treatments in the prevention of complications during the detoxification therapy, because of the absence of addictive properties and a better adverse effects profile than classical anticonvulsant drugs. Anticonvulsants such as carbamazepine, valproic acid, gabapentin and topiramate have shown to be excellent treatment for alcohol withdrawal and for the prevention of alcohol relapse. Although none of these agents have been approved by the FDA yet, there is growing evidence in the literature to support their use.

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

    Science.gov (United States)

    Corona-Rojo, José Antonio; Altagracia-Martínez, Marina; Kravzov-Jinich, Jaime; Vázquez-Cervantes, Laura; Pérez-Montoya, Edilberto; Rubio-Poo, Consuelo

    2009-01-01

    Introduction 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 of the prescription errors were due to omissions of dosage, administration route, and length of treatment and may potentially cause harm to the elderly outpatients. Conclusions A high number of potential prescription errors were found, mainly due to omissions. The drug prescription pattern of the study population is mainly constituted by 12 drugs. The results indicate that prescription quality depends on the number of prescribed drugs per prescription (p < 0

  6. 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.

  7. 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.

  8. 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.

  9. 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…

  10. [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

  11. The use of positive reinforcement in conditioning attending behavior1

    Science.gov (United States)

    Walker, Hill M.; Buckley, Nancy 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

  12. 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.

  13. 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

  14. 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...

  15. 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.

  16. 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 ...

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

    DEFF Research Database (Denmark)

    Bager, Palle; Hentze, Runa; Markussen, Toto

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

  18. 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.

  19. [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

  20. Outpatient treatment capacity of hospital ship in overseas medical service:analysis with analytic hierarchy process%医院船海外医疗服务门诊救治能力分析及对策研究

    Institute of Scientific and Technical Information of China (English)

    赵嘉华; 朱敏; 钱阳明; 孙强; 田丽丽

    2015-01-01

    目的:结合以往任务经验,分析医院船海外医疗服务门诊救治能力的关键因素,寻找提高医院船整体救治能力的对策。方法通过现场调研、文献回顾和专家咨询确定评价体系模型,运用层次分析法绘制模型并计算各指标权重。结果本研究中各判断矩阵具有高度一致性,并获得了可接受、符合逻辑的评价指标权重值。结论本研究对医院船海外医疗服务门诊救治中存在问题提出了优化方案,为进一步提高医院船整体救治能力奠定了基础。%In order to investigate the key factors influencing the capacity of rescue and treatment for out-patients abroad during overseas medical service, Delphi method was used to consult 37 experts from military medical university, navy health administration, navy hospital, and hospital ship medical center. The data thus collected was analyzed by the analytic hierarchy process. In the first level indices, there is no significant difference among the weight values of equipment, facility, and peresonnel, showing that they are equally important. In the second level indices, the weight values of component of personnel and area of specific professional room are important influential factors of rescue and treatment capacity of the hospital ship. In the third level indices the triage personnel and triage computer terminal have the highest weight velues, thus directly influencing the effects of management of the patients. In the health personnel the highest weigh values are possessed by physician, nurse, and technician, and medics shows a low weight value.

  1. Identifying priority actions for improving patient satisfaction with outpatient cancer care.

    Science.gov (United States)

    Gesell, Sabina B; Gregory, Nancy

    2004-01-01

    In parallel to developing new cancer therapies, the healthcare community has the responsibility of creating positive treatment experiences for patients. Data from 5907 cancer outpatients treated at 23 hospitals across the United States were analyzed to identify the top priorities for service improvement in outpatient cancer treatment facilities. They included meeting patients' emotional needs, providing information to patients and family members, reducing waiting times, and providing convenience and coordinated care among physicians and other care providers.

  2. 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.

  3. A Group-Administered social Skills Training for 8- to 12- Year-Old, high-Functioning Children With Autism Spectrum Disorders : An Evaluation of its Effectiveness in a Naturalistic Outpatient Treatment Setting

    NARCIS (Netherlands)

    Deckers, Anne; Muris, Peter; Roelofs, Jeffrey; Arntz, Arnoud

    2016-01-01

    A social skills training (SST) for high-functioning children with autism spectrum disorders (ASD) was evaluated in an outpatient setting using a combined between- and within-subject design in which SST and a waiting list condition were compared. According to parents and teachers, the SST produced gr

  4. 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...

  5. 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...

  6. 美沙酮维持治疗者中枢神经递质功能的变化%Functional change of neurotransmitters in central nervous system for outpatients with methadone maintenance treatment

    Institute of Scientific and Technical Information of China (English)

    龚斌; 朱千

    2014-01-01

    Objective To detect neurotransmitters function in the brain and the brain functional index of outpatients with methadone maintenance treatment,and understand the change features of brain function.Methods Collect brain electrical power signals were collected from 58 outpatients with methadone maintenance treatment (MMT) and 44 healthy adults,and the correlations between the power of the neurotransmitters and the brain functional status were analyzed.Results (1) In MMT group,all neurotransmitters were lower generally than those in the control group,and the differences of GABA ((17.73±3.54) μV2 vs.(121.48±44.64) iμV2,P<0.01),Glu ((42.18±12.84) μV2 vs.(105.31 ± 34.95) μV2,P<0.05) were significant.(2) The relative powers of GABA ((17.10±51.72) μV2 vs.(78.67± 10.93) μV2,P<0.001) and Glu((30.48±21.61) μV2 vs.(69.23±42.26) μV2,P<0.001) reduced significantly,while 5-HT((297.18±31.54) μ V2 vs.(280.18±31.54) μV2,P<0.01),ACh ((235.08±37.72) μV2 vs.(217.23±40.60)μV2,P<0.05),NE((164.11±33.05) μV2 vs (146.39±30.80) μV2,P <0.01),DA((98.87±22.48) μV2 vs.(91.49±21.04)μV2,P<0.05) rised significantly in MMT group.(3)The global power was lower((1012.01± 195.09)μV2 Vs.(1775.94±458.99) μV2,P<0.01),and the excitement-inhibition index(2.19± 1.46 vs.0.99±0.47,P<0.001) and the relative entropy((89.45±9.71) % vs.(75.48±9.97) %,P <0.01)were higher than those in the controls.(4) In MMT group,there were positive correlation between all neurotransmitters and global power,as well as that between Glu and excitement-inhibition index (r=0.264,P<0.05),NE and Vasomotor index(r=0.269,P<0.05),but negative correlation between relative entropy and 5-HT(r=-0.276,P<0.05) as well as DA(r=-0.375,P<0.01)significantly.Conclusion The brain function of outpatients with MMT are lower than the normal significantly,and there are clearly imbalance between the excitement and inhibition among the brain neurotransmitters.%目的

  7. 门诊促排卵监测指导同房及并发症处理%Ovulation Induction and Timed Intercourse for Outpatients and Treatment of Complications

    Institute of Scientific and Technical Information of China (English)

    杨一华; 欧建平

    2016-01-01

    The ovulation induction (OI) and timed intercourse was the most simple and common assisted reproductive procedure for those infertile outpatients. Recent publications on this topic, combined with our clinical experiences, were reviewed, which is benefit to improve clinical practice for doctors of reproductive medicine. The following fileds were focused in this review: examination,valuation and preparation before OI, indication and contraindication of OI, the mechanisms and usage of common OI drugs, guidance of timed intercourse, as well as treatments of complications. Some important aspects were emphasized:to rule out the contraindications of pregnancy and OI before OI, to know well the mechanisms of common OI drugs and their dosages and administrations, to evaluate follicular growth and to predict ovulation time by means of various methods, and to prevent and treat timely OI complications.%门诊促排卵监测指导同房是最简单、常用且有效的助孕手段。在参考国内外相关文献基础上,结合临床实践经验,从门诊促排卵前的检查、评估及准备,门诊促排卵的适应证和禁忌证,常用促排卵药物的作用机制和用法,评估卵泡发育情况和指导同房时机,以及促排卵并发症的预防和处理等5个方面进行简要阐述,并特别强调促排卵监测前要排除妊娠禁忌证和促排卵禁忌证,熟练掌握各种促排卵药物的作用机制和用法,灵活运用多种手段评估卵泡发育情况及预测排卵时间,及时预防和诊治各种并发症。

  8. 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.

  9. 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

  10. Medical Assessment and Outpatient Treatment on 82 Cases of Bee Stings in Huangshan Mountain Scenic Area%黄山景区蜂蜇伤82例病情评估及门诊救治体会

    Institute of Scientific and Technical Information of China (English)

    汪晓春; 潘海波

    2012-01-01

    procrastination. Upon receiving bee stings patient, the out-patient doctors should assess their medical condition promptly and at early stage to determine patients of laryngeal edema, allergic shock and of other potential medical risk etc. to administer adrenalin and glucocorticoid as early aa possible is the key in the proper treatment of severe bee stings patients.

  11. [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.

  12. 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.

  13. 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...

  14. 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...

  15. 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...

  16. 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

  17. 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

  18. Danish Patients are positive towards fees for non-attendance in public hospitals

    DEFF Research Database (Denmark)

    Lou, Stina; Frumer, Michal; Olesen, Steen;

    2016-01-01

    Introduction: Patients’ non-attendance is a significant problem in modern healthcare. Non-attendance delays treatment, reduces efficiency and increases healthcare costs. For several years, the introduction of financial incentives such as a non-attendance fee has been discussed in Denmark. Set in ...

  19. 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.

  20. Helicobacter pylori in out-patients of a general practitioner

    DEFF Research Database (Denmark)

    Rothenbacher, D; Bode, G; Winz, T;

    1997-01-01

    Data on prevalence and determinants of Helicobacter pylori infection in well-defined populations are scarce. We investigated the prevalence and determinants of active H. pylori infection in a population of out-patients attending a general practitioner in Southern Germany. Infection status.......4%). Prevalence of H. pylori infection increased with age from 10.8% (95% CI 5.7-18.1%) in the age group 15-29 years to 30.8% (95% CI 22.1-40.6%) in the age group 60-79 years and was 20.3%, 30.4% and 28.2% for the age groups 30-39, 40-49 and 50-59 years, respectively. Education and childhood living conditions...

  1. 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.

  2. 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...

  3. 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...

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

    Science.gov (United States)

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

    2015-01-01

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

  5. Interesting in- and outpatient attendances at Hogwarts Infirmary and St Mungo's Hospital for magical maladies.

    Science.gov (United States)

    Lim, Erle C H; Pomfrey, Poppy M; Quek, Amy M L; Seet, Raymond C S

    2006-02-01

    Ailments afflicting wizarding folk are underreported in the muggle world. The recent integration of muggles and magical folk with the return of You-Know-Who (aka He Who Must Not Be Named) may result in a similar affliction of inhabitants of both worlds. We describe interesting maladies afflicting muggles and wizarding folk alike, arising from the use and misuse of magic. We also provide a basic glossary of magical ailments, and describe their muggle corollaries. Further studies will hopefully result in the development of immunity against the unforgivable curses.

  6. 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

  7. 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 ...

  8. A mindful eating group as an adjunct to individual treatment for eating disorders: a pilot study.

    Science.gov (United States)

    Hepworth, Natasha S

    2011-01-01

    The objective of this study was to investigate potential benefits of a Mindful Eating Group as an adjunct to long-term treatment for a variety of eating disorders. Individuals (N = 33) attending treatment at an outpatient treatment facility participated in the 10-week intervention designed to enhance awareness around hunger and satiety cues. Disordered eating symptoms were assessed pre- and post-intervention using the EAT-26. Significant reductions were found on all subscales of the EAT-26 with large effect sizes. No significant differences were identified between eating disorder diagnoses. Results suggest potential benefits of an adjunct mindfulness group intervention when treating a variety of eating disorders. Limitations are discussed.

  9. 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...

  10. Current status of diagnosis and treatment for benign prostatic hyperplasia in geriatrics outpatient%老年科良性前列腺增生的诊治现状

    Institute of Scientific and Technical Information of China (English)

    周哲; 祝世法; 王建业; 张祥华; 于普林; 董碧蓉; 蹇在金; 鲁翔; 钱芸娟; 方宁远; 高海青

    2011-01-01

    Objective To evaluate the current status of diagnosis and treatment for benign prostatic hyperplasia (BPH) in geriatrics department,and to promote the standardization of diagnosis and treatment.Methods The BPH patients in geriatrics outpatients from 23 cities were included.General conditions,diagnosis and treatment,and the effect of treatment were recorded in registry questionnaire.Results The analysis of 4001 questionnaires showed that the mean international prostate symptom score (IPSS) was (18.8±5.9),and the percent of the moderate and severe symptom was 53.8% and 42.0%,respectively.The morbidities of coexist diseases were 63.9% (hypertension),40.4 % (coronary disease),32.4 % (diabetes mellitus) and 25.7 % (hyperlipidemia).BPH-related complications were urinary infection (21.0%),urinary stone (8.3%),recurrent hematuria (1.8%),hydronephrosis (1.7%),and hernia (0.6%).In the initial evaluation of BPH,27.2% of doctors didn't finish digital rectal examination,and 89.5% of doctors didn't complete PSA test.Among patients with medical therapy,a-receptor blocker was used in 68.1%,5α-reductase inhibitor in 92.9%,Chinese medicine and plant drugs in 11.8%,and M-receptor blocker in 0.4% of the prescriptions.During the first prescription,monotherapy was recorded in 51.1%,and combination therapy with two drugs was recorded in 46.6 %.In the patients with moderate and severe symptoms,60.6% of patients took the drugs regularly,13.9% of patients withdrew the drugs.The reasons for drug adjustment were poor efficacy (23.4%),serious side effects (5.4%),high cost (3.5%),taking inconveniently (2.9%),etc.Conclusions Most BPH patients in geriatrics department have moderate and severe symptoms.Coexist diseases and BPH-related complications should be considered during treatment of BPH.Doctors should realize the importance of digital rectal examination and PSA test.Combination therapy has more efficacy for improving lower urinary symptoms

  11. 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…

  12. Student Satisfaction with Attending Systems.

    Science.gov (United States)

    McConnell, Thomas A.; And Others

    1993-01-01

    A survey of 252 dental students in three schools measured student satisfaction with (1) the patient care system in the dental school clinic; and (2) the responsibilities of the attending faculty, who manage 10-student teams. Results indicated general satisfaction but point to some problems in individual situations. (MSE)

  13. Validation and results of a questionnaire for functional bowel disease in out-patients

    Directory of Open Access Journals (Sweden)

    Skordilis Panagiotis

    2002-05-01

    Full Text Available Abstract Background The aim was to evaluate and validate a bowel disease questionnaire in patients attending an out-patient gastroenterology clinic in Greece. Methods This was a prospective study. Diagnosis was based on detailed clinical and laboratory evaluation. The questionnaire was tested on a pilot group of patients. Interviewer-administration technique was used. One-hundred-and-forty consecutive patients attending the out-patient clinic for the first time and fifty healthy controls selected randomly participated in the study. Reliability (kappa statistics and validity of the questionnaire were tested. We used logistic regression models and binary recursive partitioning for assessing distinguishing ability among irritable bowel syndrome (IBS, functional dyspepsia and organic disease patients. Results Mean time for questionnaire completion was 18 min. In test-retest procedure a good agreement was obtained (kappa statistics 0.82. There were 55 patients diagnosed as having IBS, 18 with functional dyspepsia (Rome I criteria, 38 with organic disease. Location of pain was a significant distinguishing factor, patients with functional dyspepsia having no lower abdominal pain (p Conclusions This questionnaire for functional bowel disease is a valid and reliable instrument that can distinguish satisfactorily between organic and functional disease in an out-patient setting.

  14. 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...

  15. 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...

  16. Outpatient varicocelectomy performed under local anesthesia

    Institute of Scientific and Technical Information of China (English)

    Geng-Long Hsu; Pei-Ying Ling; Cheng-Hsing Hsieh; Chii-Jye Wang; Cheng-Wen Chen; Hsien-Sheng Wen; Hsiu-Mei Huang; E. Ferdinand Einhorn; Guo-Fang Tseng

    2005-01-01

    Aim: To report a series of varicocelectomy performed under pure local anesthesia. Methods: From July 1988 to June 2003, a total of 575 patients, aged between 15 and 73 years, underwent high ligation of the internal spermatic vein for treatment of a varicocele testis under a regional block in which a precise injection of 0.8 % lidocaine solution was delivered to involved tissues after exact anatomical references were made. A 100-mm visual analog scale (VAS)was used to assess whether the pain level was acceptable. Results: The surgeries were bilateral in 52 cases, and unilateral in 523 cases. All were successfully performed on an outpatient basis except in the case of two patients, who were hospitalized because their surgeries required general anesthesia. Overall, 98.6 % (567/575) of men could go back to work by the end of the first post-operative week and only 8 (1.4 %) men reported feeling physical discomfort on the eighth day. The VAS scores varied from 11 mm to 41 mm with an average of (18.5 ± 11.3) mm that was regarded as tolerable. Conclusion: This study has shown varicocelectomy under local anesthesia to be possible,simple, effective, reliable and reproducible, and a safe method with minimal complications. It offers the advantages of more privacy, lower morbidity, with no notable adverse effects resulting from anesthesia, and a more rapid return to regular physical activity with minor complications.

  17. 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 ...

  18. 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.

  19. Managing disability benefits as part of treatment for persons with severe mental illness and comorbid drug/alcohol disorders. A comparative study of payee and non-payee participants.

    Science.gov (United States)

    Ries, R K; Comtois, K A

    1997-01-01

    The objective of this pilot study is to describe the use of a Social Security representative payee program as a clinical intervention integrated into long-term, dual-disorder treatment of severely mentally ill outpatients with comorbid drug/alcohol disorders. Compared with non-payees, patients selected to be payee participants were more likely to be male, have a diagnosis of schizophrenia, have a history of high inpatient utilization, and have higher current ratings of psychiatric symptoms, substance use, and functional disability. Despite these higher severity ratings, which usually predict poor outpatient compliance and higher rate of adverse outcomes, the payee participants attended about twice the number of outpatient service sessions as non-payees and were no more likely to be currently homeless, hospitalized, or incarcerated. The payee intervention is described, and ethical and research issues are discussed.

  20. 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...

  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. Prescribing Practices of Topical Corticosteroids in the Outpatient Dermatology Department of a Rural Tertiary Care Teaching Hospital

    OpenAIRE

    Suvarna S. Rathod; Vijay M. Motghare; Vinod S. Deshmukh; Rushikesh P Deshpande; Chetanraj G. Bhamare; Patil, Jyoti R

    2013-01-01

    Background: Inappropriate or excessive use of topical corticosteroids can lead to cutaneous and systemic adverse effects which occur more commonly with the use of very potent steroids. Monitoring and analysis of the prescription practices of topical steroids can help to achieve rational prescription of these drugs. Aim: The present study was carried out to study and analyze the pattern of prescribing topical corticosteroids among outpatients attending the dermatology clinic in a rural tertiar...

  3. 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. 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.

  5. Desfechos de tratamento de tuberculose em pacientes hospitalizados e não hospitalizados no município de São Paulo Outcomes of tuberculosis treatment among inpatients and outpatients in the city of São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Mirtes Cristina Telles Perrechi

    2011-12-01

    Full Text Available OBJETIVO: Comparar os desfechos de tratamento de tuberculose em pacientes hospitalizados e aqueles tratados exclusivamente na atenção primária na cidade de São Paulo (SP, bem como determinar as variáveis mais associadas à internação. MÉTODOS: Pesquisa prospectiva e longitudinal, realizada entre janeiro e dezembro de 2007 em dois hospitais de grande porte e em serviços de saúde em duas regiões na cidade de São Paulo. Os dados foram coletados através de um questionário estruturado, no caso dos pacientes internados, e no Banco de Dados de Tuberculose da Secretaria Estadual de Saúde de São Paulo. RESULTADOS: Dos 474 pacientes incluídos no estudo, 166 estavam hospitalizados, e 308 eram pacientes ambulatoriais. A análise multivariada mostrou associações entre internação por tuberculose e diagnóstico de tuberculose em hospital/pronto-socorro (OR = 55,42, coinfecção por HIV (OR = 18,57, retratamento (OR = 18,51 e procura por outro serviço anteriormente (OR = 12,32. Para os pacientes hospitalizados e ambulatoriais, as taxas gerais de cura foram de 41,6% e 78,3%, respectivamente, ao passo que, para aqueles coinfectados por HIV, essas foram de 30,4% e 58,5%, enquanto as taxas gerais de mortalidade foram de 29,5% e 2,6%, respectivamente, ao passo que, para aqueles coinfectados por HIV, essas foram de 45,7% e 9,8%. CONCLUSÕES: Este estudo evidenciou maior gravidade, maior dificuldade de diagnóstico, menor taxa de cura e maior taxa de mortalidade nos pacientes internados que naqueles ambulatoriais. Além disso, os desfechos foram piores no subgrupo de pacientes coinfectados com HIV.OBJECTIVE: To compare inpatient and outpatient treatment of tuberculosis, in terms of outcomes, in the city of São Paulo, Brazil, as well to determine which variables are most frequently associated with hospitalization. METHODS: A prospective, longitudinal study carried out between January and December of 2007, at two large hospitals and at outpatient

  6. 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...

  7. 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'...

  8. O uso de praguicidas por trabalhadores do setor agrícola atendidos ambulatorialmente em Maringá no período de 2002 a 2003 - DOI: 10.4025/actascihealthsci.v26i2.1583 Pesticide use by agricultural workers in outpatients attendance in Maringá in the periods of 2002 and 2003 - DOI: 10.4025/actascihealthsci.v26i2.1583

    Directory of Open Access Journals (Sweden)

    Miguel Machinski Junior

    2004-04-01

    Full Text Available Os impactos de origem ambiental e ocupacional, relacionados ao uso de praguicidas, têm como alvo imediato a saúde coletiva, pois os resíduos liberados do ambiente ou remanescentes nas culturas estão sendo progressivamente transferidos para a água, para os alimentos e para o homem. Este trabalho teve como objetivo caracterizar a utilização de praguicidas por trabalhadores do setor agrícola, atendidos no Ambulatório de Toxicologia e Saúde do Trabalhador do Centro de Controle de Intoxicações de Maringá (CCI-Maringá, a fim de avaliar os impactos sobre o ambiente e a saúde dessa população. Durante o período de 2002 a 2003, foi realizado um estudo descritivo retrospectivo em vinte e cinco pacientes atendidos devido à intoxicação por praguicidas. Os resultados demonstraram que os praguicidas representam um importante risco à saúde da população estudada e ao meio ambiente.The environmental and occupational origin impacts concerning the use of pesticides have the public health as immediate target. The environment residues or remainders in the crops are being gradually transferred to water, food and human being. The purpose of this paper was to characterize the use of pesticides by agricultural workers in the outpatient’s attendance of the Toxicology and Worker Health Clinic of the Poisoning Control Center of Maringá (Brazil, in order to evaluate their impacts on the environment and on the population’s health. During the period 2002-2003, a retrospective descriptive study was carried out in twenty-five patients attended for pesticide poisoning. The results showed that the pesticides represent an important risk to the health of the studied population as well as to the environment.

  9. 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.

  10. 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%…

  11. 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...

  12. [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

  13. 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...... 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...

  14. 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

  15. 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

  16. 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.

  17. 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.

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

    Science.gov (United States)

    Jaafar, N; Nor, G M

    2000-02-01

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

  19. 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.

  20. 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.

  1. 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

  2. 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.

  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. 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

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

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    Gut Rikke

    2011-10-01

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

  6. 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

  7. 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

  8. Bilevel Fuzzy Chance Constrained Hospital Outpatient Appointment Scheduling Model

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    Xiaoyang Zhou

    2016-01-01

    Full Text Available Hospital outpatient departments operate by selling fixed period appointments for different treatments. The challenge being faced is to improve profit by determining the mix of full time and part time doctors and allocating appointments (which involves scheduling a combination of doctors, patients, and treatments to a time period in a department optimally. In this paper, a bilevel fuzzy chance constrained model is developed to solve the hospital outpatient appointment scheduling problem based on revenue management. In the model, the hospital, the leader in the hierarchy, decides the mix of the hired full time and part time doctors to maximize the total profit; each department, the follower in the hierarchy, makes the decision of the appointment scheduling to maximize its own profit while simultaneously minimizing surplus capacity. Doctor wage and demand are considered as fuzzy variables to better describe the real-life situation. Then we use chance operator to handle the model with fuzzy parameters and equivalently transform the appointment scheduling model into a crisp model. Moreover, interactive algorithm based on satisfaction is employed to convert the bilevel programming into a single level programming, in order to make it solvable. Finally, the numerical experiments were executed to demonstrate the efficiency and effectiveness of the proposed approaches.

  9. 麝香保心丸治疗门诊老年冠心病患者的临床疗效观察%Heart of musk pil treatment of outpatient service in elderly patients with coronary heart disease clinical curative effect observation

    Institute of Scientific and Technical Information of China (English)

    马松权

    2013-01-01

    objective: to observe the heart of musk pil treatment of outpatient service in elderly patients with coronary heart disease clinical curative effect. Selection methods: from 2011 at present to 04, 2013 clinics in 90 cases of elderly patients with coronary heart disease, were randomly divided into observation group and the control group and observation group patients were given conventional treatment based on the use of musk heart pil treatment, control group patients were only given routine therapy. Results: two groups of patients in ecg ST - T changed, attack frequency of angina pectoris, cardiac function improvement on significant difference, statisticaly significant (P < 0.05); Two groups of patients after treatment there was no serious adverse reactions. Conclusion: heart of musk pil treatment of outpatient elderly coronary heart disease clinical curative effect is remarkable.%  目的观察麝香保心丸治疗门诊老年冠心病患者的临床疗效。方法选取我院在2011年02月到2013年04月门诊就诊的90例老年冠心病患者,随机分为观察组和对照组,观察组患者给予常规治疗基础上加用麝香保心丸治疗,对照组患者仅给予常规治疗。结果两组患者在心电图ST-T改变、心绞痛发作次数、心功能改善上存在显著差异性,具有统计学意义(P<0.05);两组患者经过治疗都没有出现严重的不良反应。结论麝香保心丸治疗门诊老年冠心病取得的临床疗效显著。

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

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    Christopher Aye Egbe

    2010-10-01

    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

  11. 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

  12. Laparoscopic cholecystectomy in the treatment of biliary lithiasis: outpatient surgery or short stay unit? Colecistectomía laparoscópica en el tratamiento de la litiasis biliar: ¿cirugía mayor ambulatoria o corta estancia?

    Directory of Open Access Journals (Sweden)

    A. Martínez Vieira

    2004-07-01

    Full Text Available Objective: analysis of clinical and surgical factors in a series of patients subjected to laparoscopic cholecystectomy in an outpatient unit and their relationship with time of discharge and patient acceptance. Patients and method: eighty one consecutive patients underwent to elective laparoscopic cholecystectomy during year 2002 within S.A.S. (Andalusian Health Service from a surgical waiting list. Retrospective and comparative study between two groups: group A includes patients discharged between 24 and 48 hours after intervention; group B includes patients discharged in less than 24 hours. We analyse the clinical and surgical characteristics and post-operative outcome of both groups of patients. Results: group A was composed of 53 patients and group B of 28 patients. Factors of clinical significance which determined discharge after 24 hours included: early post-surgical incidences or complications (p = 0.017, inability to tolerate oral diet (p = 0.002, and doubts and feelings insecurity of patients regarding discharge by traditional means 62.3% (p = 0.0003. Conclusions: outpatient laparoscopic cholecystectomy is a safe and reliable procedure with a high acceptance rate and few complications. Perhaps traditional culture has to be changed to obtain better results.Objetivo: analizar los factores clínicos y quirúrgicos que en una serie de pacientes sometidos a colecistectomía laparoscópica ambulatoria influyeron en la decisión del momento del alta y cuál fue la aceptación de los pacientes al alta. Pacientes y método: en este estudio fueron incluidos 81 pacientes consecutivos procedentes de la lista de espera quirúrgica en quienes se realizó una colecistectomía laparoscópica electiva a lo largo del año 2002. Es un estudio retrospectivo y comparativo que incluye dos grupos de pacientes: los del grupo A fueron dados de alta entre 24 a 48 horas tras la intervención; los del grupo B lo fueron en menos de 24 horas. Analizamos las caracter

  13. Diagnosis and follow-up of treatment of latent tuberculosis; the utility of the QuantiFERON-TB Gold In-tube assay in outpatients from a tuberculosis low-endemic country

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    Blomberg Bjørn

    2010-03-01

    Full Text Available Abstract Background Interferon-gamma (IFN-γ Release Assays (IGRA are more specific than the tuberculosis skin test (TST in the diagnosis of latent tuberculosis (TB infection (LTBI. We present the performance of the QuantiFERON®-TB Gold In-tube (QFT-TB assay as diagnostic test and during follow-up of preventive TB therapy in outpatients from a TB low-endemic country. Methods 481 persons with suspected TB infection were tested with QFT-TB. Thoracic X-ray and sputum samples were performed and a questionnaire concerning risk factors for TB was filled. Three months of isoniazid and rifampicin were given to patients with LTBI and QFT-TB tests were performed after three and 15 months. Results The QFT-TB test was positive in 30.8% (148/481 of the total, in 66.9% (111/166 of persons with origin from a TB endemic country, in 71.4% (20/28 previously treated for TB and in 100% (15/15 of those diagnosed with active TB with no inconclusive results. The QFT-TB test was more frequently positive in those with TST ≥ 15 mm (47.5% compared to TST 11-14 mm (21.3% and TST 6-10 mm (10.5%, (p 0.05. Conclusion Only one third of those with suspected TB infection had a positive QFT-TB test. Recent immigration from TB endemic countries and long duration of exposure are risk factors for a positive QFT-TB test and these groups should be targeted through screening. Since most patients remained QFT-TB positive after therapy, the test should not be used to monitor the effect of preventive therapy. Prospective studies are needed in order to determine the usefulness of IGRA tests during therapy.

  14. Evaluation of Skin Findings in Adult Obese Dermatology Outpatients

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    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

  15. 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.

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

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    Salih Bin Salih

    2013-01-01

    Full Text Available Objective: The objective of this study was to assess the prevalence of polypharmacy (PP and the associated factors in medical outpatients. Materials and Methods: A cross-sectional, observational, descriptive study was carried out in adult medical outpatients attending internal medicine clinics at King Abdulaziz Medical City, Riyadh, Saudi Arabia from 1 March 2009 to 31 December 2009. PP was defined as the concomitant use of ≥5 medications daily. The number of medications being currently taken by patient was recorded. Effect of patients′ age, gender, educational level, number of prescribers, disease load and disease type on PP was assessed by multivariate analysis using Statistical Package for Social Sciences Incorporated (SPSS Inc Version 18. Results: Out of 766 patients included in the study, 683 (89% had PP. The mean number of prescribed medications, oral pills and doses was 8.8, 9.6 and 12.1, respectively. Factors significantly associated with PP included age (≥61 years, disease load and the number of prescribers. Gender had no impact on PP while education beyond primary education significantly decreased PP. Hypertension, diabetes mellitus and dyslipidemia alone and as a cluster increased PP. Conclusion: We found an extremely high level of PP in medical outpatients at our tertiary care center. The impact of PP on medication compliance and control of underlying diseases in Saudi Arabia is unknown and needs to be studied at different levels of care.

  17. 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.

  18. Cost-effectiveness of an Intensive Smoking Cessation Intervention for COPD Outpatients

    NARCIS (Netherlands)

    Christenhusz, L.C.A.; Prenger, H.C.; Pieterse, M.E.; Seydel, E.R.; Palen, van der J.

    2012-01-01

    Introduction: To determine the cost-effectiveness of a high-intensity smoking cessation program (SmokeStop Therapy; SST) versus a medium-intensity treatment (Minimal Intervention Strategy for Lung patients [LMIS]) for chronic obstructive pulmonary disease outpatients. Methods: The cost-effectiven

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  20. 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

  1. 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

  2. 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

  3. 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.

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

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    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.

  5. The use of the mini C-arm in the outpatient setting: evolving practice.

    Science.gov (United States)

    Swindells, M G; O'Brien, C M; Armstrong, D J; Arundell, M K; Quinton, D N; Burke, F D

    2011-05-01

    The mini C-arm image intensifier (mini C-arm) has now become an established diagnostic tool in the hand surgery outpatient department. This study reviews the use of the mini C-arm and formal radiographs (X-rays) in the outpatient hand surgery setting. X-rays provide a standard image whereas the mini C-arm can obtain non-standard images to aid diagnosis and treatment. The mini C-arm enables the clinician to obtain dynamic images and perform interventions such as manipulations or injections. The mini C-arm results in a significantly lower radiation exposure for the patients than a formal X-ray. Use of the mini C-arm may be cheaper, and can lead to a shorter outpatient visit with less travel between hospital departments.

  6. 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.

  7. Comparison of efficacy and safety of treatment for low pulmonary embolism severity index outpatient versus inpatient with acute pulmonary embolism%低肺栓塞严重程度指数急性肺栓塞患者住院及非住院治疗的疗效及安全性比较

    Institute of Scientific and Technical Information of China (English)

    陈中华; 余定红; 刘满生

    2013-01-01

    目的 评估对低肺栓塞严重程度指数(PESI)急性肺栓塞(APE)患者进行院外自我抗凝管理的疗效及安全性.方法 将PESI分级Ⅰ~Ⅱ级的68例APE患者按随机数字表法分为院外治疗组和住院治疗组,每组34例.所有患者均给予低分子量肝素联合口服抗凝药物治疗,院外治疗组进行自我抗凝管理.观察两组患者治疗后2周及3个月时的疗效,包括静脉血栓栓塞(VTE)的复发情况、国际标准化比值(INR)达标时间、VTE相关的急救次数、出血事件的发生及总体病死率.结果 治疗期间住院治疗组2例(5.9%,2/34)VTE复发,院外治疗组仅1例(2.9%,1/34) VTE复发,差异无统计学意义(P>0.05).住院治疗组INR达标时间(8.5±2.9)d,明显短于院外治疗组的(16.1±4.4)d,差异有统计学意义(P<0.01).两组患者VTE相关的急救次数比较差异无统计学意义(P>0.05).68例患者中仅院外治疗组发生1例严重出血、1例死亡.结论 对于PESI分级Ⅰ~Ⅱ级的APE患者早期进行院外自我抗凝管理,安全有效,可大大缩短住院时间,减轻患者的物质及精神负担.%Objective To evaluate the efficacy and safety of self-management anticoagulation treatment for low pulmonary embolism severity index (PESI) outpatient with acute pulmonary embolism (APE).Methods Sixty-eight patients with APE of PESI grade Ⅰ-Ⅱ were divide into inpatient group and outpatient group with 34 cases each by random digits table.All the patients were treated with low molecular heparin followed by oral anticoagulation,and self-management was used in outpatient group.The efficacy was observed within 14 days and 3 months.The efficacy outcome included recurrent venous thromboembolism (VTE),standardization time of international normalized ratio (INR),VTE-related emergency department visit times,bleeding events and total mortality.Results There were 2 cases(5.9%,2/34) in inpatient group and 1 case (2.9%,1/34) in outpatient group with

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

    Directory of Open Access Journals (Sweden)

    Ines Hungerbuehler

    2015-06-01

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

  9. Outpatient experience with oesophageal endoscopic dilation.

    Science.gov (United States)

    Jani, P G; Mburugu, P G

    1998-07-01

    Between March 1990 and August 1997, outpatient endoscopic balloon dilation was performed for oesophageal strictures which developed secondary to malignancies, peptic strictures, post surgical narrowing, achalasia cardia, corrosive ingestion and other causes. A total of 169 dilations were performed in the 92 cases with an average of 1.8 dilation/case (Range 1 to 8). Dilation was possible in all 92 cases without the need for fluoroscopic monitoring. Twenty three (13.6%) of the dilations were performed using pneumatic balloon while in 146(86.4%) cases wire guided metal olives were used. There were nine minor complications which were treated with medication on an outpatient basis and four major complications which required inpatient care. Three of these had perforation of the oesophagus and one died. One other patient developed aspiration pneumonia and subsequently died.

  10. 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.

  11. Attending Behavior of Children Near a Child Who is Reinforced for Attending

    Science.gov (United States)

    Okovita, Hymie Wolf; Bucher, Bradley

    1976-01-01

    The present study investigated effects of a token program for one child on the attending behavior of other children sitting near him. Results show the rewarded child's attending increased in the reinforcement conditions and the unrewarded children's attending increased when they were sitting on either side of the rewarded child. (Author)

  12. 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......In this study we attempt to answer Romer’s (1993) question: “Should attendance be mandatory?” Contrary to many existing studies, we conclude that in the case of business and management programs the answer is ‘no’. In a study of over 900 undergraduate strategy students, spanning four academic years......, we examine the link between attendance and exam results. Unlike prior research on this topic, our findings show that attendance is not the best determinant of student performance. We find instead that the best determinant of student performance for third year bachelor students is their over...

  13. 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

  14. Health Services OutPatient Experience questionnaire: factorial validity and reliability of a patient-centered outcome measure for outpatient settings in Italy

    Directory of Open Access Journals (Sweden)

    Coluccia A

    2014-09-01

    Full Text Available Anna Coluccia, Fabio Ferretti, Andrea PozzaDepartment of Medical Sciences, Surgery and Neurosciences, Santa Maria alle Scotte University Hospital, University of Siena, Siena, ItalyPurpose: The patient-centered approach to health care does not seem to be sufficiently developed in the Italian context, and is still characterized by the biomedical model. In addition, there is a lack of validated outcome measures to assess outpatient experience as an aspect common to a variety of settings. The current study aimed to evaluate the factorial validity, reliability, and invariance across sex of the Health Services OutPatient Experience (HSOPE questionnaire, a short ten-item measure of patient-centeredness for Italian adult outpatients. The rationale for unidimensionality of the measure was that it could cover global patient experience as a process common to patients with a variety of diseases and irrespective of the phase of treatment course.Patients and methods: The HSOPE was compiled by 1,532 adult outpatients (51% females, mean age 59.22 years, standard deviation 16.26 receiving care in ten facilities at the Santa Maria alle Scotte University Hospital of Siena, Italy. The sample represented all the age cohorts. Twelve percent were young adults, 57% were adults, and 32% were older adults. Exploratory and confirmatory factor analyses were conducted to evaluate factor structure. Reliability was evaluated as internal consistency using Cronbach’s α. Factor invariance was assessed through multigroup analyses.Results: Both exploratory and confirmatory analyses suggested a clearly defined unidimensional structure of the measure, with all the ten items having salient loadings on a single factor. Internal consistency was excellent (α=0.95. Indices of model fit supported a single-factor structure for both male and female outpatient groups. Young adult outpatients had significantly lower scores on perceived patient-centeredness relative to older adults. No

  15. 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.

  16. Inpatient and outpatient cardiac rehabilitation programmes improve cardiometabolic risk in revascularized coronary patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Claudiu Avram

    2010-12-01

    Full Text Available The purpose of this paper is to evaluate cardiometabolic risk reduction of diabetic patients following coronary revascularizationprocedures after participation in outpatients or inpatients cardiac rehabilitation programmes. Materials and methods: weperformed a retrospective analytical study which included a group of 103 revascularized coronary patients with diabetesmellitus. Depending on participation in a cardiac rehabilitation program we have defined the following subgroups of patients:Group O (N=37 - attended the outpatient cardiac rehabilitation program; Group H (N=37 - attended the inpatient cardiacrehabilitation program; Group C (N=34 - did not participate in any cardiac rehabilitation program. Between those two momentsof assessment: T0 - revascularization / early post-revascularization and T1 - time of the interview (16±2.3 months afterrevascularization, patients in groups A and S participated in outpatient cardiac rehabilitation program (12 weeks, 3sessions/week of exercise training, with clinical and paraclinical evaluation scheduled at 1, 6, 12 months afterrevascularization, or inpatient cardiac rehabilitation program (3 weeks, intensive sessions, scheduled at 1, 3, 6 and 12months after revascularization. Results: at the end of the study, we found significant differences among the three groups forthe following parameters: body mass index (p=0.01, systolic blood pressure (p=0.002, total cholesterol (p<0.001, LDLcholesterol(p<0.001 and non-HDL cholesterol (p=0.004 in favor of groups A and S, that have participated in comprehensivecardiac rehabilitation programs. Conclusions: comprehensive cardiac rehabilitation programmes, performed outpatient orinpatient, are effective methods of reducing the high cardiometabolic risk, specific in revascularized coronary patients withdiabetes.

  17. 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

  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. 基于沈阳市医疗保险门诊自助就医系统的设计与应用%Design and Application of the Self-service Treatment System in Outpatient Department Based on Shenyang City Medical Insurance

    Institute of Scientific and Technical Information of China (English)

    高轶; 王文翠; 汪洋; 秦芳; 李亚东

    2015-01-01

    搭建基于医疗保险的门诊自助就医系统,使医院与医疗保险患者实现双赢。医保患者持卡就医时可以自助挂号、自助缴费,提高了社保卡银行功能的使用率,从而达到减少挂号收费窗口、减少现金交易、降低人力成本和设备投入等。%Build self-service treatment system in outpatient department based on medical insurance to achieve a win-win situation between hospital and patients with medical insurance. The patients with medical insurance can do self-help registration and self-help charging when they seek medical advice with Medical card, so the bank function of medical card is aroused obviously. And the number of the registration window and the charging window is decreased, cash transactions are reduced, manpower cost and equipment cost are reduced also.

  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. CPAFFC Delegation Attends China-Mexico Forum

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    <正>From October 29 to 31, 2007, the CPAFFC delegation, the goodwill delegation and the entrepreneurs’ delega- tion led by CPAFFC Vice President Li Xiaolin attended the Forum of China-Mexico: Strategic Partners of the 21st Century

  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. 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.

  5. 414例美沙酮维持治疗门诊患者偷吸海洛因相关因素分析%Methadone maintenance treatment of 414 outpatients steal heroin-related factors

    Institute of Scientific and Technical Information of China (English)

    杨跃进; 贠赟

    2013-01-01

    目的了解开封地区美沙酮维持治疗门诊患者在治疗期间偷吸海洛因的情况及影响偷吸的相关因素分析.方法对开封市美沙酮维持治疗门诊所有知情同意的受治者进行面对面问卷调查和尿液吗啡定性检测,并收集一般社会人口学、治疗前药物成瘾情况、门诊在治患者情况和偷吸海洛因情况等信息进行分析.结果在414名调查对象中男性336人(81.2%),女性78人(18.8%),年龄(40.6±6.8)岁,文化程度初中及以下322人(77.8%),以无业为主238人(57.5%),尿检吗啡阳性率37.9%.Logistic多因素回归分析显示男性、无业、对美沙酮门诊工作质量不是很满意、与家人关系不很融洽、和毒友交往次数多的患者更容易偷吸毒品,这些因素是影响患者偷吸海洛因的相关因素.结论美沙酮门诊患者在受治期间偷吸毒品较为常见,应该加强美沙酮门诊工作质量,建立有效的家庭和社会支持系统,减少患者治疗期间偷吸率.%Objective:To determine the proportion of heroin use among patients of Methadone maintenance treatment(MMT) program and to identify the risk factors associated with heroin use in Kaifeng City. Methods:Conduct questionnaire survey and random urine morphine qualitative detection with informed patients in MMT, explore the demographics, drug addiction before treatment, situation of daily treatment of the patients and heroin used. Result:Of the 414 patients, 81.2%were males. The mean age was (40.6±6.8)years old while 77.8%had an education level of primary school or below and 57.5%were unemployed. On average,37.9%urine samples showed positive opiate evidence. The Logistic regression analysis shows the correlative factor of heroin use were males, unemployed, not satisfied with the quality of work of MMT, relationship with family disharmoniously, frequent contact with somebody who usually drug. Conclusion:Patients of MMT used to drug during treatment. It is

  6. Mobile phones improve antenatal care attendance in Zanzibar

    DEFF Research Database (Denmark)

    Lund, Stine; Nielsen, Birgitte B; Hemed, Maryam;

    2014-01-01

    BACKGROUND: Applying mobile phones in healthcare is increasingly prioritized to strengthen healthcare systems. Antenatal care has the potential to reduce maternal morbidity and improve newborns' survival but this benefit may not be realized in sub-Saharan Africa where the attendance and quality...... measure was four or more antenatal care visits during pregnancy. Secondary outcome measures were tetanus vaccination, preventive treatment for malaria, gestational age at last antenatal care visit, and antepartum referral. RESULTS: The mobile phone intervention was associated with an increase in antenatal...... care attendance. In the intervention group 44% of the women received four or more antenatal care visits versus 31% in the control group (OR, 2.39; 95% CI, 1.03-5.55). There was a trend towards improved timing and quality of antenatal care services across all secondary outcome measures although...

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

    Science.gov (United States)

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

    2016-01-01

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

  8. Outpatient provider concentration and commercial colonoscopy prices.

    Science.gov (United States)

    Pozen, Alexis

    2015-01-01

    The objective was to evaluate the magnitude of various contributors to outpatient commercial colonoscopy prices, including market- and provider-level factors, especially market share. We used adjudicated fee-for-service facility claims from a large commercial insurer for colonoscopies occurring in hospital outpatient department or ambulatory surgery center from October 2005 to December 2012. Claims were matched to provider- and market-level data. Linear fixed effects regressions of negotiated colonoscopy price were run on provider, system, and market characteristics. Markets were defined as counties. There were 178,433 claims from 169 providers (104 systems). The mean system market share was 76% (SD = 0.34) and the mean real (deflated) price was US$1363 (SD = 374), ranging from US$169 to US$2748. For every percentage point increase in a system or individual facility's bed share, relative price increased by 2 to 4 percentage points; this result was stable across a number of specifications. Market population and price were also consistently positively related, though this relation was small in magnitude. No other factor explained price as strongly as market share. Price variation for colonoscopy was driven primarily by market share, of particular concern as the number of mergers increases in wake of the recession and the Affordable Care Act. Whether variation is justified by better quality care requires further research to determine whether quality is subsumed in prices.

  9. Outpatient Provider Concentration and Commercial Colonoscopy Prices

    Directory of Open Access Journals (Sweden)

    Alexis Pozen PhD

    2015-04-01

    Full Text Available The objective was to evaluate the magnitude of various contributors to outpatient commercial colonoscopy prices, including market- and provider-level factors, especially market share. We used adjudicated fee-for-service facility claims from a large commercial insurer for colonoscopies occurring in hospital outpatient department or ambulatory surgery center from October 2005 to December 2012. Claims were matched to provider- and market-level data. Linear fixed effects regressions of negotiated colonoscopy price were run on provider, system, and market characteristics. Markets were defined as counties. There were 178 433 claims from 169 providers (104 systems. The mean system market share was 76% (SD = 0.34 and the mean real (deflated price was US$1363 (SD = 374, ranging from US$169 to US$2748. For every percentage point increase in a system or individual facility’s bed share, relative price increased by 2 to 4 percentage points; this result was stable across a number of specifications. Market population and price were also consistently positively related, though this relation was small in magnitude. No other factor explained price as strongly as market share. Price variation for colonoscopy was driven primarily by market share, of particular concern as the number of mergers increases in wake of the recession and the Affordable Care Act. Whether variation is justified by better quality care requires further research to determine whether quality is subsumed in prices.

  10. 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...

  11. A case-control study of outpatients on methadone maintenance treatment%美沙酮维持治疗门诊受治者治疗依从性的病例对照研究

    Institute of Scientific and Technical Information of China (English)

    张波; 王逸超; 杨丽萍; 李吉祥; 姬红瑞; 王华; 李瑜; 徐艳; 许秀峰

    2014-01-01

    目的 分析影响美沙酮维持治疗(MMT)依从性的因素.方法 采用病例对照研究方法,以MMT依从性较差者为病例组,依从性较好者为对照组,应用复合性国际诊断访谈问卷(CIDI-3.0)、Beck抑郁问卷(BDI)、社会支持评定量表(SSRS)等,对昆明市9个MMT门诊符合条件的受治者进行调查.结果 病例组156人,对照组270人.单因素分析显示,婚姻状况(P<0.05)、职业情况(P<0.05)、现住址居住时间(P<0.05)、偷吸毒品(P<0.05)为治疗依从性的影响因素.多因素非条件Logistic回归分析显示,无职业[比值比(OR) =2.610,95%可信区间(CI):1.378~3.983]、偷吸海洛因(OR=3.468,95%CI:2.084~5.769)、重度抑郁终身患病率(OR=4.276,95%CI:1.222~14.961),自我讨厌感:对自己丧失信心(OR=1.164,95%CI:1.066~2.817)、对自己失望(OR=1.882,95%CI:1.300~3.323),丧失兴趣:兴趣比以往减少(OR=1.709,95%CI:1.093~2.673)、丧失大部分兴趣(OR=2.895,95%CI:1.448~5.778)为治疗依从性差的危险因素.结论 美沙酮维持治疗门诊治疗依从性好的受治者中,有自杀意念的比例较高,无职业、偷吸海洛因、重度抑郁终身患病率、自我讨厌感、丧失兴趣可能为治疗依从性的危险因素.%Objective To investigate factors influencing adherence of methadone maintenance treatment (MMT).Methods A case-control study was conducted on patients innine methadone maintenance treatment clinics of Kunming city,and they were interviewed with Composite International Diagnostic Interview (CIDI-3.0),Beck Depression Inventory (BDI) and Social Support Rating Scale (SSRS).Results There were 156 subjects in case group and 270 subjects in control group.Single factor analysis showed that marital status (P<0.05),occupation (P<0.05),dwelling time at present place (P<0.05) and occasionally using heroin (P<0.05) were risk factors for treatment adherence.Multivariate non-conditional logistic regression analysis

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

    Directory of Open Access Journals (Sweden)

    ALIREZA ESTEGHAMATI

    2016-04-01

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

  13. 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

  14. 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....... Frequent attenders (FAs) were defined as those 10% among the attenders who most frequently used the out-of-hours service during a calendar year (12 months). This gave an intersection point of four or more contacts for frequent attenders. Three more groups were defined according to whether they had one, two......,321 individuals aged 18 years and over who contacted the out-of-hours service in 1990. Outcome measures were attendance per year, age and sex. RESULTS: FAs made 42% of the out-of-hours contacts in 1990, and 33% of those who were FAs in 1990 were also FAs in 1991. Among the 1990 FAs, 67% contacted the out...

  15. Analysis of clinical treatment and current condition of 186 Children outpatients with nemophilia in He'nan%河南省186例儿童血友病门诊患者临床治疗与现状分析

    Institute of Scientific and Technical Information of China (English)

    蒋慧

    2014-01-01

    目的:通过对河南省红十字血液中心门诊部就诊的186例儿童血友病患者的临床治疗情况和现状分析,为进一步加强儿童血友病综合防治工作提供临床依据。方法回顾分析河南省红十字血液门诊部2012年7月~2013年12月186例儿童血友病患者的门诊治疗病历资料。结果一般情况:186例儿童血友病患者来自河南省18个市、地区,年龄5.5~18岁,平均12.6岁,其中城镇儿童患者24例(12.9%),农村儿童患者162例(87.1%)。均为男性,血友病A患者162例,血友病B患者19例,血友病C患者5例。血友病甲患者首次出血年龄(1.2±2.1)岁,初次确诊年龄(3.2±1.3)岁。临床情况:(1)农村血友病儿童患者所占比例较高,因为经济,交通等问题普遍存在治疗不及时,治疗量不足的情况。(2)儿童患者以关节出血居多,其次为肌肉出血、黏膜、皮下出血;血尿、消化道出血、脑出血情况较少见。(3)关节、肌肉出血后,运动能力明显受障,致残率高。(4)治疗及时疗效较好。结论血友病儿童患者一旦出现症状就要及时治疗,越早治疗,治疗效果越好。本研究建议采取家庭医院结合治疗的办法。%Objective To analyze the clinical treatment and current condition of 186 children hemophilic outpatients from outpatient department of Henan Red Cross Blood Center with an aim to provide the basic data for further studies and comprehensive care in Henan. Methods The imaging data of 186 children patients with hemophilia were retrospectively analyzed,who were treated in outpatient department of He'nan Red Cross Blood Centre from July 2012 to December 2013. Results General information:the 186 children patients came from 18 cities or regions in Henan,whose average age was 12.6 year, and median age was 11.4year(range from 5.5-18 years old).24 children came from city or town (12.9%),and 162 children came

  16. 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.

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

    Science.gov (United States)

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

    2016-10-01

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

  18. DTSQs量表在2型糖尿病患者中应用的信度、效度和反应度初步评价%Using satisfaction questionnaire status version (DTSQs) to study on the reliability, construct validity and responsiveness of diabetes treatment among Chinese diabetic outpatients

    Institute of Scientific and Technical Information of China (English)

    刘兆兰; 付朝伟; 陈维清; 王伟炳; 徐飚

    2008-01-01

    目的 初步评价糖尿病治疗满意度问卷当前版(DTSQs)最表在中国2型糖尿病患者中应用的信度、效度和反应度.方法 以上海市3家医院和广州市4家医院门诊2型糖尿病病例为研究对象,采用中文版DTSQs问卷调查结合实验室检测的方法 收集资料,应用信度分析、因子分析结合结构方程模型、多元协方差分析分别评价DTSQs的信度、效度和反应度.结果 满意度维度分半信度系数为0.807,Cronbach α系数为0.717;探索性因子分析结果 显示,3个公因子累计方差贡献率为67.656%;拟合度检验结果 显示,相对χ2=4.95,DK=0.18;不同性别、不同血糖控制水平组患者DTSQs量表3个维度得分向量不同.研究数据支持DTSOs量表的理论假设,中文版DTSQs量表具有较高的信度和结构效度.结论 初步认为DTSQs量表中文版可以在中国2型糖尿病患者中应用.%Objective Using 'diabetes treatment satisfaction questionnaire status version(DTSQs)'to evaluate the reliability, validity and responsiveness, among Chinese type 2 diabeties mellitus (T2DM) outpatients Methods A cross-sectional study was carried out in 749 T2DM outpatients from seven hospitals in Guangzhou and Shanghai, China. The DTSQs was self-administered by patients, under the help from interviewers for those having difficulties in reading. Split-half reliability correlation coefficient,Cronbaeh a and Spearman' were used to test the reliability. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were employed separately to examine the construct validity of the scale.The responsiveness of the scale was appraised by the multiple analysis of covarianee (MANCOVA). Results The split-half correlation coefficient was 0.807 and the Cronbaeh a was 0.717 of the six items on satisfaction of treatment. The three factors extracted by EFA explained 67. 656 % of the overall variance.Tberelative χ2 was 4.95 and DK was 0.18 in the goodness of test by CFA

  19. 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.

  20. 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.

  1. Religious Affiliation, Religious Service Attendance, and Mortality.

    Science.gov (United States)

    Kim, Jibum; Smith, Tom W; Kang, Jeong-han

    2015-12-01

    Very few studies have examined the effects of both religious affiliation and religiosity on mortality at the same time, and studies employing multiple dimensions of religiosity other than religious attendance are rare. Using the newly created General Social Survey-National Death Index data, our report contributes to the religion and mortality literature by examining religious affiliation and religiosity at the same time. Compared to Mainline Protestants, Catholics, Jews, and other religious groups have lower risk of death, but Black Protestants, Evangelical Protestants, and even those with no religious affiliation are not different from Mainline Protestants. While our study is consistent with previous findings that religious attendance leads to a reduction in mortality, we did not find other religious measures, such as strength of religious affiliation, frequency of praying, belief in an afterlife, and belief in God to be associated with mortality. We also find interaction effects between religious affiliation and attendance. The lowest mortality of Jews and other religious groups is more apparent for those with lower religious attendance. Thus, our result may emphasize the need for other research to focus on the effects of religious group and religious attendance on mortality at the same time.

  2. 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

  3. 42 CFR 410.60 - Outpatient physical therapy services: Conditions.

    Science.gov (United States)

    2010-10-01

    ... corporation or other incorporated physical therapy practice. (D) An employee of a physician group. (E) An... 42 Public Health 2 2010-10-01 2010-10-01 false Outpatient physical therapy services: Conditions... Services § 410.60 Outpatient physical therapy services: Conditions. (a) Basic rule. Except as specified...

  4. 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

  5. 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 ...

  6. 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...

  7. 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)...

  8. 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.

  9. 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.

  10. Clozapine prescribing in a Canadian outpatient population.

    Directory of Open Access Journals (Sweden)

    Silvia Alessi-Severini

    Full Text Available OBJECTIVE: Description of demographics of an outpatient population of clozapine users. METHODS: Retrospective chart review study of an urban population diagnosed with schizophrenia. Assessment of therapeutic histories in relation to clinical practice guidelines. RESULTS: Seventy-seven of the 467 patients were on clozapine therapy. Average patients' age was 39.4 ± 11.8 years and 68% were males. The majority of patients (68% had tried 3 or more antipsychotics before switching to clozapine, 21% had tried two and 11% had tried one. Median length of therapy prior to clozapine initiation was 8.9 years in males and 7.7 years in females. CONCLUSION: Until 2010, the use of clozapine was often delayed and more than 2 antipsychotic medications were tried for relatively long periods of time before patients were switched to this effective agent.

  11. Assaults against psychiatrists in outpatient settings.

    Science.gov (United States)

    Dubin, W R; Wilson, S J; Mercer, C

    1988-09-01

    Questionnaires were sent to 3800 psychiatrists in Pennsylvania, New Jersey, and Delaware to investigate assaults against psychiatrists in outpatient settings. Ninety-one questionnaires were returned: 32 psychiatrists reported serious assaults (gun or knife), and 59 reported less serious assaults (object or physical attack). Significantly more personal injury and property damage resulted from the less serious assaults. Coping strategy was significantly related to the type of assault; positive verbal intervention was the most effective. Thirty-one (36%) of 87 respondents stated that they had moderate to strong feelings before the attack that the patient was potentially violent. Experienced psychiatrists were as likely to be victims of assault as were inexperienced psychiatrists. Forty-eight (59%) of 81 psychiatrists continued to treat the patients who had assaulted them. Only 20 (23%) of 87 psychiatrists had security arrangements at the time of the assault. The authors present four case vignettes which typify the different types of assaults, interventions, and outcomes.

  12. 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.

  13. Errors associated with outpatient computerized prescribing systems

    Science.gov (United States)

    Rothschild, Jeffrey M; Salzberg, Claudia; Keohane, Carol A; Zigmont, Katherine; Devita, Jim; Gandhi, Tejal K; Dalal, Anuj K; Bates, David W; Poon, Eric G

    2011-01-01

    Objective To report the frequency, types, and causes of errors associated with outpatient computer-generated prescriptions, and to develop a framework to classify these errors to determine which strategies have greatest potential for preventing them. Materials and methods This is a retrospective cohort study of 3850 computer-generated prescriptions received by a commercial outpatient pharmacy chain across three states over 4 weeks in 2008. A clinician panel reviewed the prescriptions using a previously described method to identify and classify medication errors. Primary outcomes were the incidence of medication errors; potential adverse drug events, defined as errors with potential for harm; and rate of prescribing errors by error type and by prescribing system. Results Of 3850 prescriptions, 452 (11.7%) contained 466 total errors, of which 163 (35.0%) were considered potential adverse drug events. Error rates varied by computerized prescribing system, from 5.1% to 37.5%. The most common error was omitted information (60.7% of all errors). Discussion About one in 10 computer-generated prescriptions included at least one error, of which a third had potential for harm. This is consistent with the literature on manual handwritten prescription error rates. The number, type, and severity of errors varied by computerized prescribing system, suggesting that some systems may be better at preventing errors than others. Conclusions Implementing a computerized prescribing system without comprehensive functionality and processes in place to ensure meaningful system use does not decrease medication errors. The authors offer targeted recommendations on improving computerized prescribing systems to prevent errors. PMID:21715428

  14. Pure analgesics in a rheumatological outpatient clinic

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    M.A. Cimmino

    2011-09-01

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

  15. 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

  16. Etiological beliefs of patients with neurological disorders attending a tertiary care center: A cross-sectional study

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    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.

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

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    Sandeep Grover

    2012-01-01

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

  18. Current status in outpatient parenteral antimicrobial therapy: a practical view.

    Science.gov (United States)

    Candel, Francisco Javier; Julián-Jiménez, Agustin; González-Del Castillo, Juan

    2016-04-01

    Outpatient parenteral antimicrobial therapy (OPAT) programs are a current and widely spread trend in clinical practice because of it's a cost-effective option, it's associated with a greater comfort for the patient, a lower risk of nosocomial complications and an important cost saving for the health care system. OPAT is used for treating a wide range of infections, including skin and soft tissue infections, osteoarticular infections, bacteraemia, endocarditis and complex intra-abdominal and urinary tract infections, even in presence of multiresistant microorganisms. Correct choice of antimicrobial agent and adequate patient selection are crucial for reaching therapeutic success and avoiding readmissions, treatment prolongation or treatment-related toxicity. The optimal antimicrobial for OPAT must be highly effective, have a long half-life and an adequate spectrum of action. Ceftriaxone and teicoplanin are currently the most prescribed antibiotics for OPAT, though daptomycin and ertapenem are also on the rise, due to their high efficiency, safety and wide spectrum of action. Antibiotics that are stable at room temperature can be administered through a continuous perfusion, though self-administration is preferable although it requires training of the patient or the caregiver. Factors that are most frequently associated with OPAT failure include advanced age, recent hospitalization and isolation of multiresistant microorganisms. PMID:27014770

  19. 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

  20. 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…

  1. 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

  2. Modification of school attendance for an elementary population.

    Science.gov (United States)

    Barber, R M; Kagey, J R

    1977-01-01

    The staff and students of a school composed of Grades 1 through 3 participated in a program to increase school attendance. Children earned the opportunity to attend part or all of a monthly party by their attendance. Immediate feedback occurred each morning by placing stars on a classroom chart for each child present. The school's attendance during the program was compared both with attendance during preceding years and with attendance at other schools. The experimental school's attendance improved dramatically to become the best of all elementary schools in the system. PMID:16795547

  3. Adolescent Marijuana Use and School Attendance

    Science.gov (United States)

    Roebuck, M. Christopher; French, Michael T.; Dennis, Michael L.

    2004-01-01

    This paper explores the relationship between adolescent marijuana use and school attendance. Data were pooled from the 1997 and 1998 National Household Surveys on Drug Abuse to form a sample of 15 168 adolescents, aged 12-18 years, who had not yet complete high school. The analysis determined the role of marijuana use in adolescent school dropout…

  4. CPAFFC Delegation Attends Global Zero Summit

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    <正>CPAFFC President Chen Haosu led a delegation to attend the Global Zero Summit in Paris,France from February 2 to 4.The event aimed to promote a new phase in the"Global Zero"movement:working to reach a binding and verifiable agreement on elimination of all nuclear weapons worldwide.More than 200

  5. Hidden Transcripts of Flight Attendant Resistance.

    Science.gov (United States)

    Murphy, Alexandra G.

    1998-01-01

    Analyzes (using flight attendants) hidden transcripts--interactions, stories, myths, and rituals in which employees participate beyond direct observation--to provide an avenue to identify resistance and change in the organizing process. Challenges the outdated ideal of transmissional meaning, questions organizational power by including the…

  6. 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...

  7. 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

  8. 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…

  9. The Behavioral Treatment of Depression in Elderly Outpatients.

    Science.gov (United States)

    Gallagher, Dolores

    The behavioral view that depression results from inadequate, ineffective and/or insufficient reinforcers was explored. Since the depressed person does not act in a manner open to positive reinforcement by others, he suffers ongoing and deepening depression. The task of the therapist is to improve behavior, especially social skills, so that the…

  10. Self-perceived needs are related to violent behavior among schizophrenia outpatients.

    Science.gov (United States)

    Martínez-Martín, Nuria; Fraguas, David; García-Portilla, María Paz; Sáiz, Pilar Alejandra; Bascarán, María Teresa; Arango, Celso; Bobes, Julio

    2011-09-01

    This study assessed the relationship between self-perceived clinical and social needs and aggressive behavior in outpatients with schizophrenia. A total of 895 outpatients with schizophrenia were enrolled. The presence of aggressive episodes was assessed using the Modified Overt Aggression Scale. Self-perceived needs were assessed using the Camberwell Assessment of Need in six areas of needs (food, household skills, self-care, daytime activities, psychotic symptoms, satisfaction with treatment, and company). The most common areas of needs were "psychotic symptoms" (81.6%), "daytime activities" (60.6%), and "household skills" (57.5%). More needs were expressed by patients who had more severe illnesses (p < 0.001) and more aggressive behavior (p < 0.001). Multivariate analysis showed that, in schizophrenia outpatients, self-perceived needs were associated with aggressive behavior (adjusted odds ratio, 11.43; 95% confidence interval, 5.11 to 25.56). Appropriate compliance with antipsychotic treatment was related with lower aggressive behavior (p < 0.001).

  11. 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.

  12. 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

  13. Inpatients' and outpatients' satisfaction: the mediating role of perceived quality of physical and social environment.

    Science.gov (United States)

    Campos Andrade, Cláudia; Lima, Maria Luísa; Pereira, Cícero Roberto; Fornara, Ferdinando; Bonaiuto, Marino

    2013-05-01

    This study analyses the processes through which the physical environment of health care settings impacts on patients' well-being. Specifically, we investigate the mediating role of perceptions of the physical and social environments, and if this process is moderated by patients' status, that is, if the objective physical environment impacts inpatients' and outpatients' satisfaction by different social-psychological processes. Patients (N=206) evaluated the physical and social environments of the care unit where they were receiving treatment, and its objective physical conditions were independently evaluated by two architects. Results showed that the objective environmental quality affects satisfaction through perceptions of environmental quality, and that patients' status moderates this relationship. For inpatients, it is the perception of quality of the social environment that mediates the relationship between objective environmental quality and satisfaction, whereas for outpatients it is the perception of quality of the physical environment. This moderated mediation is discussed in terms of differences on patients' experiences of health care environments.

  14. 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)

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

    Directory of Open Access Journals (Sweden)

    Nursel Dilek

    2009-06-01

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

  16. 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......) or placebo (D0) before surgery. The primary outcome was pain intensity 8 h after surgery rated on a numeric rating scale of 0 to 10. Secondary outcomes were pain intensity, analgesic consumption and side effects during the first 3 days after surgery. Results Data from 73 patients were available for analysis......: (D40: 25, D8: 26, D0: 22 patients). Eight hours after surgery, pain intensity were: [median (interquartile range)] group D40: 2 (1–4), group D8: 2.5 (1–5), group D0: 4 (2–7). There was no significant difference in pain intensity between group D40 and D8 after 8 h (P = 0.46) or at any other time. When...

  17. Blood glucose concentration in pediatric outpatient surgery.

    Science.gov (United States)

    Somboonviboon, W; Kijmahatrakul, W

    1996-04-01

    Blood glucose concentration was measured in 84 pediatric patients who were scheduled for outpatient surgery at Chulalongkorn Hospital. They were allocated into 3 groups according to their ages, group 1:less than 1 year of age, group 2:1 to 5 years of age and group 3:over 5 years. The fasting times were approximately 8-12 hours. All patients received standard general anesthesia under mask. No glucose solution was given during operation. Preoperative mean blood glucose were 91.09 +/- 17.34, 89.55 +/- 18.69 and 82.14 +/- 16.14 mg/dl in group 1, 2 and 3 while the postoperative mean glucose values were 129.07 +/- 37.90, 115.62 +/- 29.63 and 111.53 +/- 23.07 mg/dl respectively. The difference between pre- and post-operative values were statistically significant difference (P postoperative glucose values may be due to stress response from surgery and anesthesia. We would suggest that the parents give the fluid to their children according to our instructions in order to prevent dehydration and hypoglycemia especially in small infants.

  18. 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...

  19. Using simulation in out-patient queues: a case study.

    Science.gov (United States)

    Huarng, F; Lee, M H

    1996-01-01

    Overwork and overcrowding in some periods was an important issue for the out-patient department of a local hospital in Chia-Yi in Taiwan. The hospital administrators wanted to manage the patient flow effectively. Describes a study which focused on the utilization of doctors and staff in the out-patient department, the time spent in the hospital by an out-patient, and the length of the out-patient queue. Explains how a computer simulation model was developed to study how changes in the appointment system, staffing policies and service units would affect the observed bottleneck. The results show that the waiting time was greatly reduced and the workload of the doctor was also reduced to a reasonable rate in the overwork and overcrowding periods.

  20. 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.