Leong, T-Y
2012-01-01
This paper summarizes the recent trends and highlights the challenges and opportunities in decision support and knowledge management for patient-centered, personalized, and personal health care. The discussions are based on a broad survey of related references, focusing on the most recent publications. Major advances are examined in the areas of i) shared decision making paradigms, ii) continuity of care infrastructures and architectures, iii) human factors and system design approaches, iv) knowledge management innovations, and v) practical deployment and change considerations. Many important initiatives, projects, and plans with promising results have been identified. The common themes focus on supporting the individual patients who are playing an increasing central role in their own care decision processes. New collaborative decision making paradigms and information infrastructures are required to ensure effective continuity of care. Human factors and usability are crucial for the successful development and deployment of the relevant systems, tools, and aids. Advances in personalized medicine can be achieved through integrating genomic, phenotypic and other biological, individual, and population level information, and gaining useful insights from building and analyzing biological and other models at multiple levels of abstraction. Therefore, new Information and Communication Technologies and evaluation approaches are needed to effectively manage the scale and complexity of biomedical and health information, and adapt to the changing nature of clinical decision support. Recent research in decision support and knowledge management combines heterogeneous information and personal data to provide cost-effective, calibrated, personalized support in shared decision making at the point of care. Current and emerging efforts concentrate on developing or extending conventional paradigms, techniques, systems, and architectures for the new predictive, preemptive, and
Cheema, Marvi K; MacQueen, Glenda M; Hassel, Stefanie
2015-01-01
Impulsivity and risk-taking behaviours are reported in bipolar disorder (BD). We examined whether financial management skills are related to impulsivity in patients with BD. We assessed financial management skills using the Executive Personal Finance Scale (EPFS), impulsivity using the Barratt Impulsiveness Scale (BIS) and response inhibition using an emotional go/no-go task in bipolar individuals (N = 21) and healthy controls (HC; N = 23). Patients had fewer financial management skills and higher levels of impulsivity than HC. In patients and controls, increased impulsivity was associated with poorer personal financial management. Patients and HC performed equally on the emotional go/no-go task. Higher BIS scores were associated with faster reaction times in HC. In patients, however, higher BIS scores were associated with slower reaction times, possibly indicating compensatory cognitive strategies to counter increased impulsivity. Patients with BD may have reduced abilities to manage personal finances, when compared against healthy participants. Difficulty with personal finance management may arise in part as a result of increased levels of impulsivity. Patients may learn to compensate for increased impulsivity by modulating response times in our experimental situations although whether such compensatory strategies generalize to real-world situations is unknown.
Directory of Open Access Journals (Sweden)
Azita Noroozi
2014-01-01
Full Text Available Abstract Background: Diabetes is a serious problem and self- management is effective factor for diabetes control. Personality trait is one of the important factors in diabetes self- management. In this study, purpose was determination of effective personality traits in self- management. Material and Methods: In this cross sectional study, data were collected from a convenience sample of 396 diabetic patients, using self- management and Big five personality Scales. For data analysis, multiple linear regression models were used. Results: Among five personality traits, the most effective traits in self- management were conscientiousness, openness, and extraversion (R2= 32%. Conscientiousness and openness were significant predictors for all of self- management aspects. Extraversion was effective factors in self- regulation, self- integration, and following treatment. Conclusion: The education for diabetic patients with neuroticism and agreeableness traits is necessary and Patients with conscientiousness, openness, and extraversion traits can be used as model in educational process.
Incorporating Personal Health Records into the Disease Management of Rural Heart Failure Patients
Baron, Karen Parsley
2012-01-01
Personal Health Records (PHRs) allow patients to access and in some cases manage their own health records. Their potential benefits include access to health information, enhanced asynchronous communication between patients and clinicians, and convenience of online appointment scheduling and prescription refills. Potential barriers to PHR use…
The patients' active role in managing a personal electronic health record: a qualitative analysis.
Baudendistel, Ines; Winkler, Eva; Kamradt, Martina; Brophy, Sarah; Längst, Gerda; Eckrich, Felicitas; Heinze, Oliver; Bergh, Bjoern; Szecsenyi, Joachim; Ose, Dominik
2015-09-01
The complexity of illness and cross-sectoral health care pose challenges for patients with colorectal cancer and their families. Within a patient-centered care paradigm, it is vital to give patients the opportunity to play an active role. Prospective users' attitudes regarding the patients' role in the context of a patient-controlled electronic health record (PEPA) were explored. A qualitative study across regional health care settings and health professions was conducted. Overall, 10 focus groups were performed collecting views of 3 user groups: patients with colorectal cancer (n = 12) and representatives from patient support groups (n = 2), physicians (n = 17), and other health care professionals (HCPs) (n = 16). Data were audio- and videotaped, transcribed verbatim and thematically analyzed using qualitative content analysis. The patients' responsibility as a gatekeeper and access manager was at the center of the focus group discussions, although HCPs addressed aspects that would limit patients taking an active role (e.g., illness related issues). Despite expressed concerns, PEPAs possibility to enhance personal responsibility was seen in all user groups. Giving patients an active role in managing a personal electronic health record is an innovative patient-centered approach, although existing restraints have to be recognized. To enhance user adoption and advance PEPAs potential, key user needs have to be addressed.
Zhang, Yi-Fan; Gou, Ling; Zhou, Tian-Shu; Lin, De-Nan; Zheng, Jing; Li, Ye; Li, Jing-Song
2017-08-01
Chronic diseases are complex and persistent clinical conditions that require close collaboration among patients and health care providers in the implementation of long-term and integrated care programs. However, current solutions focus partially on intensive interventions at hospitals rather than on continuous and personalized chronic disease management. This study aims to fill this gap by providing computerized clinical decision support during follow-up assessments of chronically ill patients at home. We proposed an ontology-based framework to integrate patient data, medical domain knowledge, and patient assessment criteria for chronic disease patient follow-up assessments. A clinical decision support system was developed to implement this framework for automatic selection and adaptation of standard assessment protocols to suit patient personal conditions. We evaluated our method in the case study of type 2 diabetic patient follow-up assessments. The proposed framework was instantiated using real data from 115,477 follow-up assessment records of 36,162 type 2 diabetic patients. Standard evaluation criteria were automatically selected and adapted to the particularities of each patient. Assessment results were generated as a general typing of patient overall condition and detailed scoring for each criterion, providing important indicators to the case manager about possible inappropriate judgments, in addition to raising patient awareness of their disease control outcomes. Using historical data as the gold standard, our system achieved a rate of accuracy of 99.93% and completeness of 95.00%. This study contributes to improving the accessibility, efficiency and quality of current patient follow-up services. It also provides a generic approach to knowledge sharing and reuse for patient-centered chronic disease management. Copyright © 2017 Elsevier Inc. All rights reserved.
Anesthetic management of a patient with stiff-person syndrome and thymoma: a case report
Institute of Scientific and Technical Information of China (English)
QIN Xiang; WANG Dong-xin; WU Xin-min
2006-01-01
@@ Stiff-person syndrome (SPS, also called stiff-man syndrome) is a rare neurological disease with autoimmune features. It is characterized by fluctuating and progressive muscle rigidity, and episodic spasm that prominently involve axial and limb musculature.1,2 Herein we report a case of anesthetic management of a patient with SPS for thymectomy and review several other cases.
Personality of the tinnitus patient.
House, P R
1981-01-01
Personality and coping mechanisms are related to patients' perceptions of their tinnitus. Although the occurrence of tinnitus is not unusual, its nature varies from infrequent, barely noticeable sound to an unrelenting, absorbing disturbance of critical significance. Tinnitus is a subjective complaint: the same level of tinnitus may be described by one patient as intolerable and by another as barely noticeable. Stress is intricately related to tinnitus: persons with severe tinnitus experience excessive stress. This has debilitating effects on their defences and coping can become very difficult. Patients may demonstrate a cluster of hysterical defences or a serious degree of depression. Many tinnitus patients focus on their problem, objectifying it and thus intensifying the disturbance. Most tinnitus patients can be helped by psychological intervention. A small percentage of tinnitus patients can be classified as disturbed, with borderline personalities. These patients are usually not suitable for therapy or biofeedback training. Tinnitus can be stress-related disorder. As a person is faced with conflict, physiological changes occur as a result of the "fight or flight" reaction. This state of stress can be responsible for the onset or exacerbation of a tinnitus episode. Treatment by management of stress can be successful, promoting relief through a shift of focus, repose from a state of tension, and support of constructive defences.
Bernanke, Joel; McCommon, Benjamin
2018-01-01
Given many competing demands, psychotherapy training to competency is difficult during psychiatric residency. Good Psychiatric Management for borderline personality disorder (GPM) offers an evidence-based, simplified, psychodynamically informed framework for the outpatient management of patients with borderline personality disorder, one of the most challenging disorders psychiatric residents must learn to treat. In this article, we provide an overview of GPM, and show that training in GPM meets a requirement for training in supportive psychotherapy; builds on psychodynamic psychotherapy training; and applies to other severe personality disorders, especially narcissistic personality disorder. We describe the interpersonal hypersensitivity model used in GPM as a straightforward way for clinicians to collaborate with patients in organizing approaches to psychoeducation, treatment goals, case management, use of multiple treatment modalities, and safety. A modification of the interpersonal hypersensitivity model that includes intra-personal hypersensitivity can be used to address narcissistic problems often present in borderline personality disorder. We argue that these features make GPM ideally suited for psychiatry residents in treating their most challenging patients, provide clinical examples to illustrate these points, and report the key lessons learned by a psychiatry resident after a year of GPM supervision.
Stienen, Jozette Jc; Ottevanger, Petronella B; Wennekes, Lianne; Dekker, Helena M; van der Maazen, Richard Wm; Mandigers, Caroline Mpw; van Krieken, Johan Hjm; Blijlevens, Nicole Ma; Hermens, Rosella Pmg
2015-01-09
An overload of health-related information is available for patients on numerous websites, guidelines, and information leaflets. However, the increasing need for personalized health-related information is currently unmet. This study evaluates an educational e-tool for patients with non-Hodgkin's lymphoma (NHL) designed to meet patient needs with respect to personalized and complete health-related information provision. The e-tool aims to help NHL patients manage and understand their personal care pathway, by providing them with insight into their own care pathway, the possibility to keep a diary, and structured health-related information. Together with a multidisciplinary NHL expert panel, we developed an e-tool consisting of two sections: (1) a personal section for patients' own care pathway and their experiences, and (2) an informative section including information on NHL. We developed an ideal NHL care pathway based on the available (inter)national guidelines. The ideal care pathway, including date of first consultation, diagnosis, and therapy start, was used to set up the personal care pathway. The informative section was developed in collaboration with the patient association, Hematon. Regarding participants, 14 patients and 6 laymen were asked to evaluate the e-tool. The 24-item questionnaire used discussed issues concerning layout (6 questions), user convenience (3 questions), menu clarity (3 questions), information clarity (5 questions), and general impression (7 questions). In addition, the panel members were asked to give their feedback by email. A comprehensive overview of diagnostics, treatments, and aftercare can be established by patients completing the questions from the personal section. The informative section consisted of NHL information regarding NHL in general, diagnostics, therapy, aftercare, and waiting times. Regarding participants, 6 patients and 6 laymen completed the questionnaire. Overall, the feedback was positive, with at least 75
Personality disorder: still the patients psychiatrists dislike?
Chartonas, Dimitrios; Kyratsous, Michalis; Dracass, Sarah; Lee, Tennyson; Bhui, Kamaldeep
2017-02-01
Aims and method In 1988, Lewis and Appleby demonstrated that psychiatrists hold negative attitudes towards patients with personality disorder. We assessed the attitudes of psychiatry trainees towards patients with borderline personality disorder and depression, expecting an improvement. 166 trainees were block randomised to receive one of four case vignettes that varied by diagnosis and ethnic group. We used Lewis and Appleby's original questionnaire and the Attitudes to Personality Disorder Questionnaire (APDQ). Results We received 76 responses. Lewis and Appleby's questionnaire showed more negative attitudes towards personality disorder than depression, with no significant patient ethnic group effects, and the APDQ also showed a (weak) trend towards more negative attitudes to personality disorder. In subgroup analysis, only in the White British patient group were there significantly more negative attitudes to personality disorder. Factor analysis showed significantly less sense of purpose when working with personality disorder. Clinical implications The perceived greater lack of purpose in working with personality disorder should be the target of clinical training and intervention. Targeted interventions that include training in managing personality disorder, supervision and practice in non-specialist, general psychiatry settings are important.
Kondylakis, Haridimos; Spanakis, Emmanouil G; Sfakianakis, Stelios; Sakkalis, Vangelis; Tsiknakis, Manolis; Marias, Kostas; Xia Zhao; Hong Qing Yu; Feng Dong
2015-08-01
The advancements in healthcare practice have brought to the fore the need for flexible access to health-related information and created an ever-growing demand for the design and the development of data management infrastructures for translational and personalized medicine. In this paper, we present the data management solution implemented for the MyHealthAvatar EU research project, a project that attempts to create a digital representation of a patient's health status. The platform is capable of aggregating several knowledge sources relevant for the provision of individualized personal services. To this end, state of the art technologies are exploited, such as ontologies to model all available information, semantic integration to enable data and query translation and a variety of linking services to allow connecting to external sources. All original information is stored in a NoSQL database for reasons of efficiency and fault tolerance. Then it is semantically uplifted through a semantic warehouse which enables efficient access to it. All different technologies are combined to create a novel web-based platform allowing seamless user interaction through APIs that support personalized, granular and secure access to the relevant information.
Lv, Nan; Xiao, Lan; Simmons, Martha L; Rosas, Lisa G; Chan, Albert; Entwistle, Martin
2017-09-19
EMPOWER-H (Engaging and Motivating Patients Online With Enhanced Resources-Hypertension) is a personalized-care model facilitating engagement in hypertension self-management utilizing an interactive Web-based disease management system integrated with the electronic health record. The model is designed to support timely patient-provider interaction by incorporating decision support technology to individualize care and provide personalized feedback for patients with chronic disease. Central to this process were patient-generated health data, including blood pressure (BP), weight, and lifestyle behaviors, which were uploaded using a smartphone. The aim of this study was to evaluate the program among patients within primary care already under management for hypertension and with uncontrolled BP. Using a 6-month pre-post design, outcome measures included office-measured and home-monitored BP, office-measured weight, intervention contacts, diet, physical activity, smoking, knowledge, and health-related quality of life. At 6 months, 55.9% of participants (N=149) achieved office BP goals (total intervention, behavioral, pharmaceutical contacts had significantly lower odds of achieving home BP goals but higher improvements in office BP (all Pmanagement. The experience gained in this study provides support for the feasibility and value of using carefully managed patient-generated health data in the day-to-day clinical management of patients with chronic conditions. A large-scale, real-world study to evaluate sustained effectiveness, cost-effectiveness, and scalability is warranted. ©Nan Lv, Lan Xiao, Martha L Simmons, Lisa G Rosas, Albert Chan, Martin Entwistle. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 19.09.2017.
Personal diabetes management system based on ubiquitous computing technology.
Park, Kyung-Soon; Kim, Nam-Jin; Hong, Joo-Hyun; Park, Mi-Sook; Cha, Eun-Jung; Lee, Tae-Soo
2006-01-01
Assisting diabetes patients to self manage blood glucose test and insulin injection is of great importance for their healthcare. This study presented a PDA based system to manage the personal glucose level data interfaced with a small glucometer through a serial port. The data stored in the PDA can be transmitted by cradle or wireless communication to the remote web-server, where further medical analysis and service is provided. This system enables more efficient and systematic management of diabetes patients through self management and remote medical practice.
Empowerment, patient centred care and self-management.
Pulvirenti, Mariastella; McMillan, John; Lawn, Sharon
2014-06-01
Patient or person centred care is widely accepted as the philosophy and practice that underpins quality care. An examination of the Australian National Chronic Disease Strategy and literature in the field highlights assumptions about the self-manager as patient and a focus on clinical settings. This paper considers patient or person centred care in the light of empowerment as it is understood in the health promotion charters first established in Alma Ata in 1977. We argue that patient or person centred care can be reconfigured within a social justice and rights framework and that doing so supports the creation of conditions for well-being in the broader context, one that impacts strongly on individuals. These arguments have broader implications for the practice of patient centred care as it occurs between patient and health professional and for creating shared responsibility for management of the self. It also has implications for those who manage their health outside of the health sector. © 2011 John Wiley & Sons Ltd.
Keuroghlian, Alex S; Palmer, Brian A; Choi-Kain, Lois W; Borba, Christina P C; Links, Paul S; Gunderson, John G
2016-08-01
The effect that attending a 1-day workshop on Good Psychiatric Management (GPM) had on attitudes about borderline personality disorder (BPD) was assessed among 297 clinicians. Change was recorded by comparing before and after scores on a 9-item survey previously developed to assess the effects of workshops on Systems Training for Emotional Predictability and Problem Solving (STEPPS). Participants reported decreased inclination to avoid borderline patients, dislike of borderline patients, and belief that BPD's prognosis is hopeless, as well as increased feeling of competence, belief that borderline patients have low self-esteem, feeling of being able to make a positive difference, and belief that effective psychotherapies exist. Less clinical experience was related to an increased feeling of competence and belief that borderline patients have low self-esteem. These findings were compared to those from the STEPPS workshop. This assessment demonstrates GPM's potential for training clinicians to meet population-wide needs related to borderline personality disorder.
Wu, Huijuan
2013-01-01
Healthcare technologies are evolving from a practitioner-centric model to a patient-centric model due to the increasing need for technology that directly serves healthcare consumers, including healthy people and patients. Personal health information management (PHIM) technology is one of the technologies designed to enhance an individual's ability…
Case management for persons with substance use disorders
DEFF Research Database (Denmark)
Hesse, Morten; Vanderplasschen, Wouter; Rapp, Richard
2007-01-01
). Reference searching; personal communication; conference abstracts; book chapters on case management. Selection criteria Randomized controlled studies that compared a specific model of case management with either treatment as usual or another treatment model, included only patients with at least one alcohol...... or drug related problem. Data collection & analysis Two groups of reviewers extracted the data independently . Standardized mean difference was estimated. Main results In total, we could extract results from 15 studies. Outcome on illicit drug use was reported from 7 studies with 2391 patients. The effect...
van Vugt, M.; de Wit, M.; Sieverink, Floor; Roelofsen, Y.; Hendriks, S.H.; Bilo, H.J.G.; Snoek, F.J.
2016-01-01
We studied the use, uptake, and effects of e-Vita, a personal health record, with self-management support and personalized asynchronized coaching, for type 2 diabetes patients treated in primary care. Patients were invited by their practice nurse to join the study aimed at testing use and effects of
Assessment and importance of personality disorders in medical patients: an update.
Dhossche, D M; Shevitz, S A
1999-06-01
Personality disorders in medical patients have received less attention than depression, anxiety, or somatization. We conducted a selective literature search to assess the role of personality disorders in medical patients. Review of recent studies suggests a high prevalence and morbidity of personality disorders in medical populations. Important correlates in selected groups are depression, somatization, noncompliance, sexual risk taking, and substance abuse. Difficulties in physician-patient relationships are also frequently reported. Psychiatric interventions are considered beneficial, though no single treatment of choice is available. We recommend that physicians consider the possibility of personality disorders in medical patients to choose appropriate treatments for selected symptoms. Training in interviewing skills may enhance recognition of personality disorders and management of associated psychiatric conditions.
A PRIVACY MANAGEMENT ARCHITECTURE FOR PATIENT-CONTROLLED PERSONAL HEALTH RECORD SYSTEM
Directory of Open Access Journals (Sweden)
MD. NURUL HUDA
2009-06-01
Full Text Available Patient-controlled personal health record systems can help make health care safer, cheaper, and more convenient by facilitating patients to 1 grant any care provider access to their complete personal health records anytime from anywhere, 2 avoid repeated tests and 3 control their privacy transparently. In this paper, we present the architecture of our Privacy-aware Patient-controlled Personal Health Record (P3HR system through which a patient can view her integrated health history, and share her health information transparently with others (e.g., healthcare providers. Access to the health information of a particular patient is completely controlled by that patient. We also carry out intuitive security and privacy analysis of the P3HR system architecture considering different types of security attacks. Finally, we describe a prototype implementation of the P3HR system that we developed reflecting the special view of Japanese society. The most important advantage of P3HR system over other existing systems is that most likely P3HR system provides complete privacy protection without losing data accuracy. Unlike traditional partially anonymous health records (e.g., using k-anonymity or l-diversity, the health records in P3HR are closer to complete anonymity, and yet preserve data accuracy. Our approach makes it very unlikely that patients could be identified by an attacker from their anonymous health records in the P3HR system.
Suarez, Angel; Ternier, Stefaan; Specht, Marcus
2014-01-01
The Personal Inquiry Manager (PIM) is an integration approach based on a mobile application, based on Android, to support the IBL process and gives users mobile access to their inquiries. Moreover it facilitates a more self-directed approach as it enables to set up their own personal inquiries. The
Gander, Michelle
2014-01-01
Everyone has a personal brand. To ensure success at work you need to manage your personal brand which is made up of your tangible and intangible attributes. This paper reviews the literature around personal branding, looks at some of the attributes and discusses ways you can reflect and begin to build your personal brand in a higher education…
Personalized Management of Hyperglycemia in Type 2 Diabetes
Raz, Itamar; Riddle, Matthew C.; Rosenstock, Julio; Buse, John B.; Inzucchi, Silvio E.; Home, Philip D.; Del Prato, Stefano; Ferrannini, Ele; Chan, Juliana C.N.; Leiter, Lawrence A.; LeRoith, Derek; DeFronzo, Ralph; Cefalu, William T.
2013-01-01
In June 2012, 13 thought leaders convened in a Diabetes Care Editors’ Expert Forum to discuss the concept of personalized medicine in the wake of a recently published American Diabetes Association/European Association for the Study of Diabetes position statement calling for a patient-centered approach to hyperglycemia management in type 2 diabetes. This article, an outgrowth of that forum, offers a clinical translation of the underlying issues that need to be considered for effectively person...
Nes, A.A.G.; Eide, H.; Kristjánsdóttir, O.B.; Dulmen, S. van
2013-01-01
Objective: Chronic illness places high demands on patients. Interventions supporting self-management and providing personalized feedback might help patients to gain new perspectives and enhance use of constructive self-management strategies. We developed three comparable web-based CBT-grounded
Ancker, Jessica S; Witteman, Holly O; Hafeez, Baria; Provencher, Thierry; Van de Graaf, Mary; Wei, Esther
2015-06-04
A critical problem for patients with chronic conditions who see multiple health care providers is incomplete or inaccurate information, which can contribute to lack of care coordination, low quality of care, and medical errors. As part of a larger project on applications of consumer health information technology (HIT) and barriers to its use, we conducted a semistructured interview study with patients with multiple chronic conditions (MCC) with the objective of exploring their role in managing their personal health information. Semistructured interviews were conducted with patients and providers. Patients were eligible if they had multiple chronic conditions and were in regular care with one of two medical organizations in New York City; health care providers were eligible if they had experience caring for patients with multiple chronic conditions. Analysis was conducted from a grounded theory perspective, and recruitment was concluded when saturation was achieved. A total of 22 patients and 7 providers were interviewed; patients had an average of 3.5 (SD 1.5) chronic conditions and reported having regular relationships with an average of 5 providers. Four major themes arose: (1) Responsibility for managing medical information: some patients perceived information management and sharing as the responsibility of health care providers; others—particularly those who had had bad experiences in the past—took primary responsibility for information sharing; (2) What information should be shared: although privacy concerns did influence some patients' perceptions of sharing of medical data, decisions about what to share were also heavily influenced by their understanding of health and disease and by the degree to which they understood the health care system; (3) Methods and tools varied: those patients who did take an active role in managing their records used a variety of electronic tools, paper tools, and memory; and (4) Information management as invisible work
Ontology-based knowledge management for personalized adverse drug events detection.
Cao, Feng; Sun, Xingzhi; Wang, Xiaoyuan; Li, Bo; Li, Jing; Pan, Yue
2011-01-01
Since Adverse Drug Event (ADE) has become a leading cause of death around the world, there arises high demand for helping clinicians or patients to identify possible hazards from drug effects. Motivated by this, we present a personalized ADE detection system, with the focus on applying ontology-based knowledge management techniques to enhance ADE detection services. The development of electronic health records makes it possible to automate the personalized ADE detection, i.e., to take patient clinical conditions into account during ADE detection. Specifically, we define the ADE ontology to uniformly manage the ADE knowledge from multiple sources. We take advantage of the rich semantics from the terminology SNOMED-CT and apply it to ADE detection via the semantic query and reasoning.
The value of personal health records for chronic disease management: what do we know?
Tenforde, Mark; Jain, Anil; Hickner, John
2011-05-01
Electronic personal health records (PHRs) allow patients access to their medical records, self-management tools, and new avenues of communication with their health care providers. They will likely become a valuable component of the primary care Patient-centered Medical Home model. Primary care physicians, who manage the majority of chronic disease, will use PHRs to help patients manage their diabetes and other chronic diseases requiring continuity of care and enhanced information flow between patient and physician. In this brief report, we explore the evidence for the value of PHRs in chronic disease management. We used a comprehensive review of MEDLINE articles published in English between January 2000 and September 2010 on personal health records and related search terms. Few published articles have described PHR programs designed for use in chronic disease management or PHR adoption and attitudes in the context of chronic disease management. Only three prospective randomized trials have evaluated the benefit of PHR use in chronic disease management, all in diabetes care. These trials showed small improvements in some but not all diabetes care measures. All three trials involved additional interventions, making it difficult to determine the influence of patient PHR use in improved outcomes. The evidence remains sparse to support the value of PHR use for chronic disease management. With the current policy focus on meaningful use of electronic and personal health records, it is crucial to investigate and learn from new PHR products so as to maximize the clinical value of this tool.
Barrecheguren, Miriam; Bourbeau, Jean
2018-03-01
Self-management has gained increased relevance in the management of chronic obstructive pulmonary disease patients. The heterogeneity in self-management interventions has complicated the development of recommendations for clinical practice. In this review, we present the latest findings regarding conceptual definition, effectiveness of self-management interventions and self-management strategies in chronic obstructive pulmonary disease as a first step toward personalized medicine: what, how and to whom? Self-management interventions have shown benefits in improving health-related quality of life and reducing hospital admissions. Favorable outcomes can only be achieved if patients have an ultimate goal, that is their desired achievements in their life. In the continuum of care, the components of the self-management program will vary to adapt to the condition of the patient (disease severity, comorbidities) and to factors such as patient motivation, confidence (self-efficacy), access to health care, family and social support. A combination of education, case management and patient-centric action plan has shown the best chance of success. The individual patient's needs, own preferences and personal goals should inform the design of any intervention with a behavioral component. A continuous loop process has to be implemented to constantly assess what work and does not work, aiming at achieving the desired outcomes for a given patient.
Managing the innovation supply chain to maximize personalized medicine.
Waldman, S A; Terzic, A
2014-02-01
Personalized medicine epitomizes an evolving model of care tailored to the individual patient. This emerging paradigm harnesses radical technological advances to define each patient's molecular characteristics and decipher his or her unique pathophysiological processes. Translated into individualized algorithms, personalized medicine aims to predict, prevent, and cure disease without producing therapeutic adverse events. Although the transformative power of personalized medicine is generally recognized by physicians, patients, and payers, the complexity of translating discoveries into new modalities that transform health care is less appreciated. We often consider the flow of innovation and technology along a continuum of discovery, development, regulation, and application bridging the bench with the bedside. However, this process also can be viewed through a complementary prism, as a necessary supply chain of services and providers, each making essential contributions to the development of the final product to maximize value to consumers. Considering personalized medicine in this context of supply chain management highlights essential points of vulnerability and/or scalability that can ultimately constrain translation of the biological revolution or potentiate it into individualized diagnostics and therapeutics for optimized value creation and delivery.
Yoshida, Hiroshi; Shimetani, Naoto
2014-11-01
The Japanese Society of Laboratory Medicine has been running its own Medical Safety Committee, and holding a symposium on medical safety during the annual meeting. The medical world is filled with a considerable amount of personal information, including genetic information, the ultimate personal information. We, as medical staff, have to manage such personal information not only in times of peace but also during disasters or emergency situations. In Japan, the Act on the Protection of Personal Information is currently being implemented, but a number of problems remain. Human beings have entered the information technology era, including electrical medical record systems, which is useful for research and education besides medical practice. This is why personal information must be more effectively protected from leakage, misconception, and abuse. We should create a sound system to manage personal information, with the spirit of protecting patient information that originated from the Oath of Hippocrates.
Lahiri, Sharon W
2017-12-01
IN BRIEF Caring for people with type 2 diabetes requires a patient-centered approach to treatment targets and medication regimens. Focusing on patients' individual characteristics, needs, and treatment responses can improve compliance and clinical outcomes. Medication selection can be guided by the mechanisms of action, advantages, disadvantages, and costs of available options; patients' behavioral and psychological variables, personal preferences, and socioeconomic status also should be taken into account. This article provides an overview of patient-centered and individualized diabetes management, offers pharmacological recommendations for specific clinical scenarios, and describes a complicated case illustrating the patient-centered approach in clinical practice.
Forensic nursing interventions with patients with personality disorder: a holistic approach.
Byrt, Richard
2013-01-01
Research findings suggest that nursing assessment and care and psychotherapy of forensic patients with personality disorder should be based on a holistic approach that addresses a wide range of their needs. Such an approach should be in collaboration with patients, informal carers, and other professionals and informed by appropriate education, training, clinical supervision, and support. Holistic care includes areas (such as physical health, cultural, spiritual, and psychosexual needs) that are addressed to a limited extent in the literature on patients with personality disorder. Despite limitations in research evidence, findings suggest that some patients with personality disorder benefit from psychotherapies, sometimes facilitated by nurse-therapists, and therapeutic community principles. These interventions should take account of patients' cultural and spiritual needs and perspectives. Helping patients to manage anger has potentially positive consequences for their physical health, personal and work relationships, and other areas. Research is needed to consider how to deliver holistic care with limited resources and in organizations, such as prisons, with conflicting goals.
Avallin, Therese; Muntlin Athlin, Åsa; Sorensen, Erik Elgaard; Kitson, Alison; Björck, Martin; Jangland, Eva
2018-06-12
To explore and describe the impact of the organizational culture on and the patient-practitioner patterns of actions that contribute to or detract from successful pain management for the patient with acute abdominal pain across the acute care pathway. Although pain management is a recognised human right, unmanaged pain continues to cause suffering and prolong hospital care. Unanswered questions about how to successfully manage pain relate to both organizational culture and individual practitioners' performance. Focused ethnography, applying the Developmental Research Sequence and the Fundamentals of Care framework. Participant observation and informal interviews (92 hours) were performed at one emergency department and two surgical wards at a University Hospital during April - November 2015. Data includes 261 interactions between patients, aged ≥18 years seeking care for acute abdominal pain at the emergency department and admitted to a surgical ward (N = 31; aged 20-90 years; 14 men, 17 women; 9 with communicative disabilities) and healthcare practitioners (N =198). The observations revealed an organizational culture with considerable impact on how well pain was managed. Well managed pain presupposed the patient and practitioners to connect in a holistic pain management including a trustful relationship, communication to share knowledge and individualized analgesics. Person-centred pain management requires an organization where patients and practitioners share their knowledge of pain and pain management as true partners. Leaders and practitioners should make small behavioural changes to enable the crucial positive experience of pain management. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Personality Model in Human Resources Management
Jovan Zubovic
2008-01-01
This paper presents the new „Personality model” of managing human resources in an organisation. The model analyses administrative personnel (usually called management) in an organisation and divides them into three core categories: managers, executives and advisors. Unlike traditional models which do not recognise advisors as part of an organisation, this model gives to advisors the same ranking as managers and executives. Model traces 11 categories of personality traits for every employee, r...
ECONOMIC CIRCUMSTANCES AND PERSONAL FINANCE MANAGEMENT
Branko Matic; Hrvoje Serdarusic; Maja Vretenar Cobovic
2014-01-01
The authors examine the impact of changed economic circumstances to manage personal finances. Analyze financial involvement, level of education and the management of personal finances population in Croatia. The paper used the method of analysis, synthesis, induction, deduction, and a survey poll.
Directory of Open Access Journals (Sweden)
Havas K
2017-11-01
Full Text Available Kathryn Havas,1,2 Clint Douglas,1 Ann Bonner1–3 1School of Nursing, Queensland University of Technology, 2NHMRC Chronic Kidney Disease Centre for Research Excellence, University of Queensland, 3Kidney Health Service, Metro North Hospital and Health Service, Brisbane, QLD, Australia Purpose: The provision of self-management support (SMS for people with earlier stages (1–4 of chronic kidney disease (CKD can improve patient outcomes and extend time to dialysis. However, attempts to deliver such support have often not taken patient preferences into account. After the development, implementation, and quantitative evaluation of the person-centered CKD-SMS intervention, the aim of this study was to investigate participant experiences and perceptions of the program, as well as to seek suggestions to improve future SMS attempts.Patients and methods: Semi-structured, face-to-face interviews were conducted with almost all (63/66 participants in the CKD-SMS. Deductive categories were derived from previous research into self-management from the CKD patient’s perspective, and this was supplemented by categories that emerged inductively during multiple readings of interview transcripts. Content analysis was used to analyze interview data.Results: Participants recognized self-management of CKD as complex and multifaceted. They felt that the CKD-SMS helped them develop skills to engage in necessary self-management tasks, as well as their knowledge about their condition and confidence to take an active role in their healthcare. These participants experience a healthcare environment that is characterized by complexity and inconsistency, and participation in the intervention helped them to navigate it. The benefit of participating in this research to contribute to the scientific literature was also recognized by participants. Overall, participants found the CKD-SMS useful in its current format, and made some suggestions for future interventions
Camerini, Luca; Camerini, Anne-Linda; Schulz, Peter J
2013-08-01
To evaluate the effectiveness of an Internet-based patient education intervention, which was designed upon principles of personalization and participatory design. Fifteen months after the first release of the website, 209 fibromyalgia patients recruited through health professionals completed an online questionnaire to assess patients' use of the website, health knowledge, self-management behavior, and health outcomes. These constructs were combined into an a-priory model that was tested using a structural equation modeling approach. Results show that the usage of certain tools of the website - designed and personalized involving the end users - impacts patients' health knowledge, which in turn impacts self-management. Improvements in self-management ultimately lower the impact of Fibromyalgia Syndrome leading to better health outcomes. This study empirically confirmed that the adoption of a participatory approach to the design of eHealth interventions and the use of personalized contents enhance the overall effectiveness of systems. More time and effort should be invested in involving patients in the preliminary phases of the development of Internet-based patient education interventions and in the definition of models that can guide the systems' evaluation beyond technology-related variables such as usability, accessibility or adoption. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Do personality traits of nurses have an effect on conflict management strategies?
Erdenk, Nigar; Altuntaş, Serap
2017-07-01
This research was conducted in a descriptive, correlational and cross-sectional design to determine whether personality traits of nurses have an effect on conflict management strategies. It is known that integration, avoidance and compromise conflict management strategies are the most frequent strategies used among nurses and obligation and domination are the least frequent. However, the reasons behind their strategy choice are not known. It is predicted that one of the reasons is the personality characteristics of the nurses. The study was conducted with the participation of 237 nurses working in three different hospitals. Research data were collected by using the 'Personal Information Form', 'Rahim Organisational Conflict Inventory-II' and 'Five Factor Personality Inventory' between December 2013 and February 2014. Ethical approval and the organisations' approvals were obtained before data collection. The collected data were analysed using frequency and percentage distributions, descriptive statistics, Pearson product-moment correlation analysis, t-test, Cronbach's alpha coefficient and simple linear regression analysis tests. The majority of nurses had conflict especially with patients' relatives several times a month. It was found that the personality traits of nurses were mostly 'conscientiousness' and 'openness' and when they had a conflict, they tended to use 'integration' strategy. It was also found that the personality traits of nurses had an effect on some of the conflict management strategies adopted by them. It was found that the personality traits of nurses had an effect on some conflict management strategies adopted by them. Nurse managers should support nurses who adopt appropriate conflict management strategies and there should be conflict management programmes that can teach appropriate skills to other nurses. © 2017 John Wiley & Sons Ltd.
Moukaddam, Nidal; AufderHeide, Erin; Flores, Araceli; Tucci, Veronica
2015-11-01
Difficult patients are often those who present with a mix of physical and psychiatric symptoms, and seem refractory to usual treatments or reassurance. such patients can include those with personality disorders, those with somatization symptoms; they can come across as entitled, drug-seeking, manipulative, or simply draining to the provider. Such patients are often frequent visitors to Emergency Departments. Other reasons for difficult encounters could be rooted in provider bias or countertransference, rather than sole patient factors. Emergency providers need to have high awareness of these possibilities, and be prepared to manage such situations, otherwise workup can be sub-standard and dangerous medical mistakes can be made. Copyright © 2015 Elsevier Inc. All rights reserved.
Personal Information Management (PIM): an Introduction
Rasoul Zavaraqi; Michael Safaie
2012-01-01
The aim of this paper was to present detailed texts about necessities of personal information management (PIM) and has been written by literature survey. Historical investigation of this new born research area showed PIM is an extension to primary personal information management in offices and other bureaucratic centers. PIM is the result of new ICT developments and its followings as information overload and pollution, which is combination of information retrieval, database management systems...
Personalized Health Monitoring System for Managing Well-Being in Rural Areas.
Nedungadi, Prema; Jayakumar, Akshay; Raman, Raghu
2017-12-14
Rural India lacks easy access to health practitioners and medical centers, depending instead on community health workers. In these areas, common ailments that are easy to manage with medicines, often lead to medical escalations and even fatalities due to lack of awareness and delayed diagnosis. The introduction of wearable health devices has made it easier to monitor health conditions and to connect doctors and patients in urban areas. However, existing initiatives have not succeeded in providing adequate health monitoring to rural and low-literate patients, as current methods are expensive, require consistent connectivity and expect literate users. Our design considerations address these concerns by providing low-cost medical devices connected to a low-cost health platform, along with personalized guidance based on patient physiological parameters in local languages, and alerts to medical practitioners in case of emergencies. This patient-centric integrated healthcare system is designed to manage the overall health of villagers with real-time health monitoring of patients, to offer guidance on preventive care, and to increase health awareness and self-monitoring at an affordable price. This personalized health monitoring system addresses the health-related needs in remote and rural areas by (1) empowering health workers in monitoring of basic health conditions for rural patients in order to prevent escalations, (2) personalized feedback regarding nutrition, exercise, diet, preventive Ayurveda care and yoga postures based on vital parameters and (3) reporting of patient data to the patient's health center with emergency alerts to doctor and patient. The system supports community health workers in the diagnostic procedure, management, and reporting of rural patients, and functions well even with only intermittent access to Internet.
Personality functioning in patients with avoidant personality disorder and social phobia.
Eikenaes, Ingeborg; Hummelen, Benjamin; Abrahamsen, Gun; Andrea, Helene; Wilberg, Theresa
2013-12-01
Avoidant personality disorder (APD) and social phobia (SP) are closely related, such that they are suggested to represent different severity levels of one social anxiety disorder. This cross-sectional study aimed to compare patients with APD to patients with SP, with particular focus on personality dysfunction. Ninety-one adult patients were examined by diagnostic interviews and self-report measures, including the Index of Self-Esteem and the Severity Indices of Personality Problems. Patients were categorized in three groups; SP without APD (n = 20), APD without SP (n = 15), and APD with SP (n = 56). Compared to patients with SP without APD, patients with APD reported more symptom disorders, psychosocial problems, criteria of personality disorders, and personality dysfunction regarding self-esteem, identity and relational problems. These results indicate that APD involves more severe and broader areas of personality dysfunction than SP, supporting the conceptualization of APD as a personality disorder as proposed for DSM-5.
Patient accounts managers: the reality behind the myth.
Hackett, K L
1988-10-01
Rising receivables and slowed cash flow have put a greater emphasis on the position of patient accounts manager. As the patient accounts manager becomes increasingly important to the long-term viability of hospitals, the person filling that role is placed in the spotlight. In the first survey of its kind, HFMA and the American Guild of Patient Accounts Management profile today's patient accounts manager. The average patient accounts manager is a male in large institutions and female in smaller facilities, has a college degree, is between 31 and 50 years of age, and has been in the healthcare field for almost 10 years. In addition, they earn $33,600 a year and aspire to higher positions including consultant and chief financial officer.
Personal knowledge management: the foundation of organisational knowledge management
Directory of Open Access Journals (Sweden)
Priti Jain
2011-01-01
Full Text Available The purpose of this small-scale study was to explore how people perceived Personal Knowledge Management (PKM, whether people were aware of the PKM concept, and how PKM can have an impact on organisational knowledge management and productivity. A questionnaire survey with quantitative and qualitative questions was used. The study revealed that a majority (63% of respondents were not aware of the PKM concept; 33% were aware, while 2% had a vague idea about it. Eighty three (83% felt that it was important to manage personal knowledge and that PKM could increase individual productivity and organisational performance. The major recommendations included creating awareness about PKM. It should be at the heart of each employee-development programme, alignment of personal and organisational goals and adequate facilities and training in PKM.
FITSManager: Management of Personal Astronomical Data
Cui, Chenzhou; Fan, Dongwei; Zhao, Yongheng; Kembhavi, Ajit; He, Boliang; Cao, Zihuang; Li, Jian; Nandrekar, Deoyani
2011-07-01
With the increase of personal storage capacity, it is easy to find hundreds to thousands of FITS files in the personal computer of an astrophysicist. Because Flexible Image Transport System (FITS) is a professional data format initiated by astronomers and used mainly in the small community, data management toolkits for FITS files are very few. Astronomers need a powerful tool to help them manage their local astronomical data. Although Virtual Observatory (VO) is a network oriented astronomical research environment, its applications and related technologies provide useful solutions to enhance the management and utilization of astronomical data hosted in an astronomer's personal computer. FITSManager is such a tool to provide astronomers an efficient management and utilization of their local data, bringing VO to astronomers in a seamless and transparent way. FITSManager provides fruitful functions for FITS file management, like thumbnail, preview, type dependent icons, header keyword indexing and search, collaborated working with other tools and online services, and so on. The development of the FITSManager is an effort to fill the gap between management and analysis of astronomical data.
Person-centred pain management for the patient with acute abdominal pain
DEFF Research Database (Denmark)
Avallin, Therese; Muntlin Athlin, Åsa; Sorensen, Erik Elgaard
2018-01-01
AIMS: To explore and describe the impact of the organizational culture on and the patient-practitioner patterns of actions that contribute to or detract from successful pain management for the patient with acute abdominal pain across the acute care pathway. BACKGROUND: Although pain management...... is a recognised human right, unmanaged pain continues to cause suffering and prolong hospital care. Unanswered questions about how to successfully manage pain relate to both organizational culture and individual practitioners' performance. DESIGN: Focused ethnography, applying the Developmental Research Sequence...... and the Fundamentals of Care framework. METHODS: Participant observation and informal interviews (92 hours) were performed at one emergency department and two surgical wards at a University Hospital during April - November 2015. Data includes 261 interactions between patients, aged ≥18 years seeking care for acute...
Key personality traits of sales managers.
Lounsbury, John W; Foster, Nancy A; Levy, Jacob J; Gibson, Lucy W
2014-01-01
Sales managers are crucial for producing positive sales outcomes for companies. However, there has been a relative dearth of scholarly investigations into the personal attributes of sales managers. Such information could prove important in the recruitment, selection, training needs identification, career planning, counseling, and development of sales managers. Drawing on Holland's vocational theory, we sought to identify key personality traits that distinguish sales managers from other occupations and are related to their career satisfaction. The main sample was comprised of a total of 978 sales managers employed in a large number of companies across the United States (along with a comparison sample drawn from 79,512 individuals from other professional occupations). Participants completed an online version of Resource Associates' Personal Style Inventory as well a measure of career satisfaction. Our sample of 978 sales managers had higher levels of Assertiveness, Customer Service Orientation, Extraversion, Image Management, Optimism, and Visionary Style; and lower levels of Conscientiousness, Agreeableness, Intrinsic Motivation, Openness, and Tough-Mindedness than a sample of 79,512 individuals in a variety of other occupations. Nine of these traits were significantly correlated with sales managers' career satisfaction. Based on the results, a psychological profile of sales managers was presented as were implications for their recruitment, selection, training, development, and mentoring.
Danilov, D S
To assess the efficacy and tolerability of pericyazine in the treatment of patients with mental disorders manifesting with psychopathic-like symptoms and correction of pathocharacterological disorders in patients with personality disorders during the short-term admission to the hospital or the long-term outpatient treatment. Sixty-three patients with schizotypal personality disorder and organic personality disorder with psychopathic-like symptoms and pathocharacterological changes within the diagnosis of dissocial personality disorder and borderline personality disorder were examined. Patients received pericyazine during the short-term admission to the hospital (6 weeks) or the long-term outpatient treatment (6 month). Efficacy, tolerability and compliance were assessed in the study. Treatment with pricyazine was effective in all patients. The improvement was seen in patients with organic personality disorders and patients with personality disorders (psychopathy). The maximal effect was observed in inpatients and this effect remained during outpatient treatment. The improvement of mental state of patients with schizotypal personality disorder achieved during inpatient treatment with pericyazine continued during the long-term outpatient treatment. Side-effects were restricted to extrapyramidal symptoms, the frequency of metabolic syndrome was low. During outpatient treatment, the compliance was higher if the patient was managed by the same psychiatrist during inpatient- and outpatient treatment.
Raz, Itamar; Riddle, Matthew C; Rosenstock, Julio; Buse, John B; Inzucchi, Silvio E; Home, Philip D; Del Prato, Stefano; Ferrannini, Ele; Chan, Juliana C N; Leiter, Lawrence A; Leroith, Derek; Defronzo, Ralph; Cefalu, William T
2013-06-01
In June 2012, 13 thought leaders convened in a Diabetes Care Editors' Expert Forum to discuss the concept of personalized medicine in the wake of a recently published American Diabetes Association/European Association for the Study of Diabetes position statement calling for a patient-centered approach to hyperglycemia management in type 2 diabetes. This article, an outgrowth of that forum, offers a clinical translation of the underlying issues that need to be considered for effectively personalizing diabetes care. The medical management of type 2 diabetes has become increasingly complex, and its complications remain a great burden to individual patients and the larger society. The burgeoning armamentarium of pharmacological agents for hyperglycemia management should aid clinicians in providing early treatment to delay or prevent these complications. However, trial evidence is limited for the optimal use of these agents, especially in dual or triple combinations. In the distant future, genotyping and testing for metabolomic markers may help us to better phenotype patients and predict their responses to antihyperglycemic drugs. For now, a personalized ("n of 1") approach in which drugs are tested in a trial-and-error manner in each patient may be the most practical strategy for achieving therapeutic targets. Patient-centered care and standardized algorithmic management are conflicting approaches, but they can be made more compatible by recognizing instances in which personalized A1C targets are warranted and clinical circumstances that may call for comanagement by primary care and specialty clinicians.
Case managers' experiences of personal growth: learning from consumers.
Stein, Catherine H; Craft, Scott A
2007-04-01
This study examines aspects of case managers' perceived personal growth in their work with consumers. Using a sample of 98 case managers, the psychometric properties of a brief self-report measure of personal growth of case managers were examined. The Case Manager Personal Growth Scale (CMPG) showed good reliability and construct validity as evidenced by negative correlations with scores on professional burnout and positive correlations with personal accomplishment and job satisfaction scores. CMPG scores were unrelated to social desirability scores or caseload size and positively related to age and tenure in the mental health system. Results suggest the strong relevance of the construct of personal growth for case managers.
Information literacy and personal knowledge management
DEFF Research Database (Denmark)
Schreiber, Trine; Harbo, Karen
2004-01-01
The aim of the paper is to discuss a new subject called personal knowledge management and to compare it with the better-known concept information literacy. Firstly, the paper describes and discusses the course called personal knowledge management. People from three institutions, the Library...... the participants partly how to manage information in such a way that it supports a learning process, and partly how to negotiate with the colleagues about the information needs, locate the information, and mediate it in such a way that the colleagues will use it. At the end of the course the participants construct...... a ´knowledge map´, which constitutes the mediation of the information to the workplace. The course has got a very positively reception. Secondly, the paper compares the course of personal knowledge management with the concept of information literacy. There exist a number of different definitions of the last...
Stupperich, Alexandra; Ihm, Helga; Strack, Micha
2009-01-01
Concerning the discussion about the connection of personality traits, personality disorders, and mental illness, this study focused on the personality profiles of male forensic patients, prison inmates, and young men without criminal reports. The main topic centered on group-specific personality profiles and identifying personality facets…
Manager personality, manager service quality orientation, and service climate: test of a model.
Salvaggio, Amy Nicole; Schneider, Benjamin; Nishii, Lisa H; Mayer, David M; Ramesh, Anuradha; Lyon, Julie S
2007-11-01
This article conceptually and empirically explores the relationships among manager personality, manager service quality orientation, and climate for customer service. Data were collected from 1,486 employees and 145 managers in grocery store departments (N = 145) to test the authors' theoretical model. Largely consistent with hypotheses, results revealed that core self-evaluations were positively related to managers' service quality orientation, even after dimensions of the Big Five model of personality were controlled, and that service quality orientation fully mediated the relationship between personality and global service climate. Implications for personality and organizational climate research are discussed. (c) 2007 APA
Brief strategic therapy in patients with social phobia with or without personality disorder.
Rakowska, Jadwiga Malgorzata
2011-07-01
The aim of this study was to test the effects of brief strategic therapy in people with social phobia distinguished by the presence or absence of DSM anxious personality disorder. A group of 120 outpatients with social phobia, 60 of them with comorbid DSM anxious personality disorder, were randomly assigned to 10 weeks of brief strategic therapy or minimal supportive therapy. Outcome analyses were conducted on the intent-to-treat sample at posttreatment and 3-month follow-up using self-report interpersonal sensitivity and phobic anxiety measures, and at 6-month follow-up using social phobia diagnostic status. Brief strategic therapy was superior to minimal supportive therapy in patients with social phobia only. It was not significantly better in patients with comorbid personality disorder. It was concluded that 10 weeks of brief strategic therapy shows promise as a cost-effective method for management of social phobia. It has limited value as a method for management of social phobia with personality disorder.
Clarke, Sue; Taylor, Georgina; Bolderston, Helen; Lancaster, Joanna; Remington, Bob
2015-11-01
Patients diagnosed with a personality disorder (PD) are often stigmatized by the healthcare staff who treat them. This study aimed to compare the impact on front-line staff of a self-management Acceptance and Commitment Therapy-based training intervention (ACTr) with a knowledge- and skills-based Dialectical Behaviour Training intervention (DBTr). A service-based randomized controlled trial was conducted comparing the effects of 2-day ACTr (N = 53) and DBTr (N = 47) staff workshops over 6 months. Primary outcome measures were staff attitudes towards patients and staff-patient relationships. For both interventions, staff attitudes, therapeutic relationship, and social distancing all improved pre- to postintervention, and these changes were maintained at 6-month follow-up. Although offering different resources to staff, both ACTr and DBTr were associated with an improved disposition towards PD patients. Future research could evaluate a combined approach, both for staff working with PD patients and those working with other stigmatized groups.
Management of the acutely violent patient.
Petit, Jorge R
2005-09-01
Violence in the work place is a new but growing problem for our profession. It is likely that at some point a psychiatrist will be confronted with a potentially violent patient or need to assess a violent patient. Understanding predictors and associated factors in violence as well as having a clear and well-defined strategy in approaching and dealing with the violent patient, thus, are crucial. Ensuring patient, staff, and personal safety is the most important aspect in the management of a violent patient. All of the staff must be familiar with management strategies and clear guidelines that are implemented and followed when confronted with a violent patient. The more structured the approach to the violent patient, the less likely a bad outcome will occur. Manipulating one's work environment to maximize safety and understanding how to de-escalate potentially mounting violence are two steps in the approach to the violent patient. Restraint, seclusion, and psychopharmacologic interventions also are important and often are necessary components to the management of the violent patient.
Sara, a patient with borderline personality structure: A "crisis" management
Directory of Open Access Journals (Sweden)
Paola Marinelli
2015-05-01
Full Text Available In this article the author examines some significant passages of his treatment of a patient with borderline personality structure, with the intention of giving a formative contribution to the delicate issue of the search for congruence between theory and clinic operations. This reflection is therefore an opportunity to integrate these aspects. The individualization of the therapeutic relationship in the theoretical framework of group analysis allowed the emotional investment in the person of the therapist, which is useful in the construction of a meaningful relationship on the human, emotional and cognitive plane; a space within which it has become increasingly possible for Sara, share and process emotions, re-build, contact parts of the self frustrated and disappointed, perceive less and less the void and become less vulnerable, being able to pull over to the original trauma.
Smart wireless continence management system for persons with dementia.
Wai, Aung Aung Phyo; Fook, Victor Foo Siang; Jayachandran, Maniyeri; Biswas, Jit; Nugent, Chris; Mulvenna, Maurice; Lee, Jer-En; Kiat, Philp Yap Lian
2008-10-01
Incontinence is highly prevalent in the elderly population, especially in nursing home residents with dementia. It is a distressing and costly health problem that affects not only the patients but also the caregivers. Effective continence management is required to provide quality care, and to eliminate high labor costs and annoyances to the caregivers resulting from episodes of incontinence. This paper presents the design, development, and preliminary deployment of a smart wireless continence management system for dementia-impaired elderly or patients in institutional care settings such as nursing homes and hospitals. Specifically, the mote wireless platform was used to support the deployment of potentially large quantities of wetness sensors with wider coverage and with dramatically less complexity and cost. It consists of an intelligent signal relay mechanism so that the residents are free to move about in the nursing home or hospital and allows personalized continence management service. Preliminary results from a trial in a local nursing home are promising and can significantly improve the quality of care for patients.
Edwards, Ian; Jones, Mark; Thacker, Michael; Swisher, Laura Lee
2014-03-01
There has been a widespread call for an ethics in the management of patients with chronic pain which is patient centered and takes into account the lived experience of the patient. It has been argued in literature that current "duty" or principlist-based models of ethics (so-called 3rd person ethics) have not adequately addressed the needs of either patients or practitioners in this area. Two strands of literature within phenomenology were reviewed: the literature of interpretative phenomenological analysis and the study of the lived experience of the person with chronic pain; and the contribution of phenomenology in neo-Aristotelian virtue ethics (1st person ethics). Patients experience chronic pain in existential and moral terms in addition to their biomedical issues, facing dilemmas in understanding their own self-identity and in attempting to recover a sense of moral worth and agency. We outline a patient-centered ethics to underpin contemporary collaborative, multimodal approaches in the management of chronic pain. We firstly describe an agency-oriented, neo-Aristotelian 1st person ethics and then outline a hermeneutic relationship with extant "duty-based," 3rd person bioethics. The utility of the ethics model we propose (the ethical reasoning bridge) lies in its capacity for developing a sense of moral agency for both practitioner and patient, resonating with the current emphasis of seeking active engagement of patients in management. Wiley Periodicals, Inc.
RI management by personal computer
International Nuclear Information System (INIS)
Ono, Isamu; Hiyoshi, Katsunori; Ono, Kazuhiko; Morimitsu, Wataru
1983-01-01
For RI-handling facilities up to medium scale, it has been studied whether a personal computer is applicable to the practical management of radioisotopes. In the present system, the number of writing in mini floppy disks is 1280 articles per diskette, which is the sufficient capacity for a storage medium for one year in variety of books. The correction of radioactivity decay as well as various totalizations can be made easily, so that the state of RI storage and use for the whole RI-handling facility can be grasped. Further, by the improvement of the output formats, the transfer to the books as obligated to write is possible. From the above reason, a personal computer is practically applicable with the management system and also leads to labor saving in RI management personnel. (Mori, K.)
Software for Managing Personal Files.
Lundeen, Gerald
1989-01-01
Discusses the special characteristics of personal file management software and compares four microcomputer software packages: Notebook II with Bibliography and Convert, Pro-Cite with Biblio-Links, askSam, and Reference Manager. Each package is evaluated in terms of the user interface, file maintenance, retrieval capabilities, output, and…
Activity Recognition for Personal Time Management
Prekopcsák, Zoltán; Soha, Sugárka; Henk, Tamás; Gáspár-Papanek, Csaba
We describe an accelerometer based activity recognition system for mobile phones with a special focus on personal time management. We compare several data mining algorithms for the automatic recognition task in the case of single user and multiuser scenario, and improve accuracy with heuristics and advanced data mining methods. The results show that daily activities can be recognized with high accuracy and the integration with the RescueTime software can give good insights for personal time management.
Conservative management of neuromuscular scoliosis: personal experience and review of literature.
Kotwicki, Tomasz; Jozwiak, Marek
2008-01-01
The principles of conservative management of neuromuscular scoliosis in childhood and adolescence are presented. Analysis of personal experience and literature review. The topic is discussed separately for patients with flaccid or spastic paresis. These demonstrate that conservative management might be proposed for patients with neuromuscular scoliosis in many clinical situations. In spastic disorders, it maintains the symmetry around the hip joints. Bracing is technically difficult and often is not tolerated well by cerebral palsy children. In patients with flaccid paresis, the fitting and the use of brace is easier than in spastic patients. The flexibility of the spinal curvature is more important. Functional benefits of conservative management of neuromuscular scoliosis comprise stable sitting, easier use of upper limbs, discharge of the abdomen from the collapsing trunk, increased diaphragm excursion, and, not always, prevention of curve progression. Specific natural history and multiple medical problems associated with the disease make the treatment of children with neuromuscular scoliosis an extremely complex issue, best addressed when a team approach is applied. Continuously improving techniques of conservative management, comprising bracing and physiotherapy, together with correctly timed surgery incorporated in the process of rehabilitation, provide the optimal care for patients.
Obstetrical ultrasound data-base management system by using personal computer
International Nuclear Information System (INIS)
Jeon, Hae Jeong; Park, Jeong Hee; Kim, Soo Nyung
1993-01-01
A computer program which performs obstetric calculations on Clipper Language using the data from ultrasonography was developed for personal computer. It was designed for fast assessment of fetal development, prediction of gestational age, and weight from ultrasonographic measurements which included biparietal diameter, femur length, gestational sac, occipito-frontal diameter, abdominal diameter, and etc. The Obstetrical-Ultrasound Data-Base Management System was tested for its performance. The Obstetrical-Ultrasound Data-Base Management System was very useful in patient management with its convenient data filing, easy retrieval of previous report, prompt but accurate estimation of fetal growth and skeletal anomaly and production of equation and growth curve for pregnant women
An XML-based framework for personalized health management.
Lee, Hiye-Ja; Park, Seung-Hun; Jeong, Byeong-Soo
2006-01-01
This paper proposes a framework for personalized health management. In this framework, XML technology is used for representing and managing the health information and knowledge. Major components of the framework are Health Management Prescription (HMP) Expert System and Health Information Repository. The HMP Expert System generates a HMP efficiently by using XML-based templates. Health Information Repository provides integrated health information and knowledge for personalized health management by using XML and relational database together.
Personality, function and satisfaction in patients undergoing total hip or knee replacement.
Ramaesh, Rishikesan; Jenkins, Paul; Lane, Judith V; Knight, Sara; Macdonald, Deborah; Howie, Colin
2014-03-01
The aim of this study was to investigate the relationships between personality and joint-specific function, general physical and general mental health in patients undergoing total hip (THA) and knee arthroplasty (TKA). One hundred and eighty-four patients undergoing THA and 205 undergoing TKA were assessed using the Eysneck Personality Questionnaire, brief version (EPQ-BV). General physical and mental health was measured using the Short-Form 12 (SF-12) questionnaire and the EuroQol (EQ-5D). Joint-specific function was measured using the Oxford hip or knee score. The "unstable introvert" personality type was associated with poorer pre-operative function and health in patients with hip arthrosis. In patients with knee arthrosis, there was poorer general health in those with "stable extrovert" and "unstable introvert" types. Personality was not an independent predictor of outcome following TKA or THA. The main predictor was pre-operative function and health. Comorbidity was an important covariate of both pre-operative and postoperative function. Personality may play a role in the interaction of these disease processes with function and health perception. It may also affect the response and interpretation of psychometric and patient-reported outcome measures. It may be important to characterise and identify these traits in potential arthroplasty patients as it may help deliver targeted education and management to improve outcomes in certain groups.
Allergic contact dermatitis: Patient management and education.
Mowad, Christen M; Anderson, Bryan; Scheinman, Pamela; Pootongkam, Suwimon; Nedorost, Susan; Brod, Bruce
2016-06-01
Allergic contact dermatitis is a common diagnosis resulting from exposure to a chemical or chemicals in a patient's personal care products, home, or work environment. Once patch testing has been performed, the education and management process begins. After the causative allergens have been identified, patient education is critical to the proper treatment and management of the patient. This must occur if the dermatitis is to resolve. Detailed education is imperative, and several resources are highlighted. Photoallergic contact dermatitis and occupational contact dermatitis are other considerations a clinician must keep in mind. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.
Managing your brand career management and personal PR for librarians
Still, Julie
2015-01-01
Managing Your Brand: Career Management and Personal PR for Librarians sets out guidelines for developing career pathways, including options for career change and the exploration of community service, as an avenue that can provide new opportunities. The text allows librarians at all levels to maximize their talents, providing them with career planning strategies that will facilitate professional development and personal satisfaction. Early chapters provide advice and strategies to readers, with later chapters addressing working relationships, librarianship, scholarship, and other forms
Nahm, Eun-Shim; Diblasi, Catherine; Gonzales, Eva; Silver, Kristi; Zhu, Shijun; Sagherian, Knar; Kongs, Katherine
2017-04-01
Personal health records and patient portals have been shown to be effective in managing chronic illnesses. Despite recent nationwide implementation efforts, the personal health record and patient portal adoption rates among patients are low, and the lack of support for patients using the programs remains a critical gap in most implementation processes. In this study, we implemented the Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit in a large diabetes/endocrinology center and assessed its preliminary impact on personal health record and patient portal knowledge, self-efficacy, patient-provider communication, and adherence to treatment plans. Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit is composed of Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit-General, clinic-level resources for clinicians, staff, and patients, and Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit Plus, an optional 4-week online resource program for patients ("MyHealthPortal"). First, Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit-General was implemented, and all clinicians and staff were educated about the center's personal health record and patient portal. Then general patient education was initiated, while a randomized controlled trial was conducted to test the preliminary effects of "MyHealthPortal" using a small sample (n = 74) with three observations (baseline and 4 and 12 weeks). The intervention group showed significantly greater improvement than the control group in patient-provider communication at 4 weeks (t56 = 3.00, P = .004). For other variables, the intervention group tended to show greater improvement; however, the differences were not significant. In this preliminary study, Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit showed potential for filling the gap in the current
Torres, Carlos A.
2011-01-01
This study investigated college students' attitudes toward and intentions to use personal health portals (PHPs) for managing their personal health information using a survey method. The study also aimed to examine the roles electronic Personal Health Information Management (PHIM) anxiety and apathy play in influencing students' attitudes toward…
Vashist, Sandeep Kumar; Schneider, E Marion; Luong, John H T
2014-08-18
Smartphone-based devices and applications (SBDAs) with cost effectiveness and remote sensing are the most promising and effective means of delivering mobile healthcare (mHealthcare). Several SBDAs have been commercialized for the personalized monitoring and/or management of basic physiological parameters, such as blood pressure, weight, body analysis, pulse rate, electrocardiograph, blood glucose, blood glucose saturation, sleeping and physical activity. With advances in Bluetooth technology, software, cloud computing and remote sensing, SBDAs provide real-time on-site analysis and telemedicine opportunities in remote areas. This scenario is of utmost importance for developing countries, where the number of smartphone users is about 70% of 6.8 billion cell phone subscribers worldwide with limited access to basic healthcare service. The technology platform facilitates patient-doctor communication and the patients to effectively manage and keep track of their medical conditions. Besides tremendous healthcare cost savings, SBDAs are very critical for the monitoring and effective management of emerging epidemics and food contamination outbreaks. The next decade will witness pioneering advances and increasing applications of SBDAs in this exponentially growing field of mHealthcare. This article provides a critical review of commercial SBDAs that are being widely used for personalized healthcare monitoring and management.
Person-centered pain management - science and art.
Braš, Marijana; Đorđević, Veljko; Janjanin, Mladen
2013-06-01
We are witnessing an unprecedented development of the medical science, which promises to revolutionize health care and improve patients' health outcomes. However, the core of the medical profession has always been and will be the relationship between the doctor and the patient, and communication is the most widely used clinical skill in medical practice. When we talk about different forms of communication in medicine, we must never forget the importance of communication through art. Although one of the simplest, art is the most effective way to approach the patient and produce the effect that no other means of communication can achieve. Person-centered pain management takes into account psychological, physical, social, and spiritual aspects of health and disease. Art should be used as a therapeutic technique for people who suffer from pain, as well as a means of raising public awareness of this problem. Art can also be one of the best forms of educating medical professionals and others involved in treatment and decision-making on pain.
Maturation in patients with borderline personality disorder.
Levallius, Johanna; Rydén, Göran; Norring, Claes
2015-08-30
Patients with borderline personality disorder have a characteristic and extreme personality associated with psychopathology. The aim was to investigate personality change in relation to suicidality following treatment. 21 patients were assessed before and after psychotherapy on personality (NEO PI-R) and suicidality (SUAS). At follow-up, Neuroticism and Conscientiousness normalized along with six lower-order facets; Depression, Impulsiveness, Competence, Achievement Striving, Self-Discipline and Deliberation. Thirteen patients showed a positive personality development paralleled by a lesser degree of suicidality. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Personal Information Management (PIM: an Introduction
Directory of Open Access Journals (Sweden)
Rasoul Zavaraqi
2012-10-01
Full Text Available The aim of this paper was to present detailed texts about necessities of personal information management (PIM and has been written by literature survey. Historical investigation of this new born research area showed PIM is an extension to primary personal information management in offices and other bureaucratic centers. PIM is the result of new ICT developments and its followings as information overload and pollution, which is combination of information retrieval, database management systems (DBMS, information science, human-computer interaction, cognitive psychology, and artificial intelligence. The research area tries to address to old challenges by new mechanisms. The paper introduced the new born research area and discussed about its appearance, definitions, history, benefits, performance and researches which has been done about it.
The Impact of Personality Traits on Conflict Management Methods
Directory of Open Access Journals (Sweden)
Muharrem Tuna
2015-12-01
Full Text Available It is widely accepted that the personality traits influence the occurrence of conflicts and that the managers have important responsibilities to deal with these conflicts. The subject of this work is to find the relationship between the personal traits of the managers and the conflict management methods that they use. Within this context, a survey was conducted on A group travel agencies and three, four and five star hotels operating in the seven regions of Turkey. Reliability and validity of the scale used to measure the opinions of the 1098 managers has been analyzed and correlation and regression analysis have been conducted. The findings suggest that the managers with dominant, revengeful and cold personal traits employ the management method of domination, that the introvert managers and the managers that can be exploited use the avoidance method and that the altruistic and the extrovert managers employ the accomodation method of conflict management.
The role of the ward manager in promoting patient safety.
Pinnock, David
In this article the role of the ward manager in promoting patient safety is explored. The background to the development of the patient safety agenda is briefly discussed and the relationship between quality and safety is illustrated. The pivotal importance of the role of the ward manager in delivering services to patients is underlined and literature on patient safety is examined to identify what a ward manager can do to make care safer. Possible actions of the ward manager to improve safety discussed in the literature are structured around the Leadership Framework. This framework identifies seven domains for the leadership of service delivery. Ward managers use their personal qualities, and network and work within teams, while managing performance and facilitating innovation, change and measurement for improvement. The challenge of promoting patient safety for ward managers is briefly explored and recommendations for further research are made.
Tully, Phillip J; Selkow, Terina
2014-12-30
Several international guidelines recommend routine depression screening in cardiac disease populations. No previous study has determined the prevalence and comorbidities of personality disorders in patients presenting for psychiatric treatment after these screening initiatives. In the first stage 404 heart failure (HF) patients were routinely screened and 73 underwent structured interview when either of the following criteria were met: (a) Patient Health Questionnaire ≥10; (b) Generalized Anxiety Disorder Questionnaire ≥7); (c) Response to one item panic-screener. Or (d) Suicidality. Patients with personality disorders were compared to the positive-screen patients on psychiatric comorbidities. The most common personality disorders were avoidant (8.2%), borderline (6.8%) and obsessive compulsive (4.1%), other personality disorders were prevalent in less than patients. Personality disorder patients had significantly greater risk of major depression (risk ratio (RR) 1.2; 95% confidence interval (CI) 1.2-13.3), generalized anxiety disorder (RR 3.2; 95% CI 1.0-10.0), social phobia (RR 3.8; 95% CI 1.3-11.5) and alcohol abuse/dependence (RR 3.2; 95% 1.0-9.5). The findings that HF patients with personality disorders presented with complex psychiatric comorbidity suggest that pathways facilitating the integration of psychiatric services into cardiology settings are warranted when routine depression screening is in place. Crown Copyright © 2014. Published by Elsevier Ireland Ltd. All rights reserved.
Downing, Gregory J; Boyle, Scott N; Brinner, Kristin M; Osheroff, Jerome A
2009-10-08
Advances in technology and the scientific understanding of disease processes are presenting new opportunities to improve health through individualized approaches to patient management referred to as personalized medicine. Future health care strategies that deploy genomic technologies and molecular therapies will bring opportunities to prevent, predict, and pre-empt disease processes but will be dependent on knowledge management capabilities for health care providers that are not currently available. A key cornerstone to the potential application of this knowledge will be effective use of electronic health records. In particular, appropriate clinical use of genomic test results and molecularly-targeted therapies present important challenges in patient management that can be effectively addressed using electronic clinical decision support technologies. Approaches to shaping future health information needs for personalized medicine were undertaken by a work group of the American Health Information Community. A needs assessment for clinical decision support in electronic health record systems to support personalized medical practices was conducted to guide health future development activities. Further, a suggested action plan was developed for government, researchers and research institutions, developers of electronic information tools (including clinical guidelines, and quality measures), and standards development organizations to meet the needs for personalized approaches to medical practice. In this article, we focus these activities on stakeholder organizations as an operational framework to help identify and coordinate needs and opportunities for clinical decision support tools to enable personalized medicine. This perspective addresses conceptual approaches that can be undertaken to develop and apply clinical decision support in electronic health record systems to achieve personalized medical care. In addition, to represent meaningful benefits to personalized
Directory of Open Access Journals (Sweden)
Brinner Kristin M
2009-10-01
Full Text Available Abstract Background Advances in technology and the scientific understanding of disease processes are presenting new opportunities to improve health through individualized approaches to patient management referred to as personalized medicine. Future health care strategies that deploy genomic technologies and molecular therapies will bring opportunities to prevent, predict, and pre-empt disease processes but will be dependent on knowledge management capabilities for health care providers that are not currently available. A key cornerstone to the potential application of this knowledge will be effective use of electronic health records. In particular, appropriate clinical use of genomic test results and molecularly-targeted therapies present important challenges in patient management that can be effectively addressed using electronic clinical decision support technologies. Discussion Approaches to shaping future health information needs for personalized medicine were undertaken by a work group of the American Health Information Community. A needs assessment for clinical decision support in electronic health record systems to support personalized medical practices was conducted to guide health future development activities. Further, a suggested action plan was developed for government, researchers and research institutions, developers of electronic information tools (including clinical guidelines, and quality measures, and standards development organizations to meet the needs for personalized approaches to medical practice. In this article, we focus these activities on stakeholder organizations as an operational framework to help identify and coordinate needs and opportunities for clinical decision support tools to enable personalized medicine. Summary This perspective addresses conceptual approaches that can be undertaken to develop and apply clinical decision support in electronic health record systems to achieve personalized medical care. In
41 CFR 109-1.5205 - Personal property management system changes.
2010-07-01
... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Personal property management system changes. 109-1.5205 Section 109-1.5205 Public Contracts and Property Management Federal... Personal property management system changes. Any proposed significant change to a designated contractor's...
Personality functioning in patients with avoidant personality disorder and social phobia
Eikenaes, I.; Hummelen, B.; Abrahamsen, G.; Andrea, H.; Wilberg, T.
2013-01-01
Avoidant personality disorder (APD) and social phobia (SP) are closely related, such that they are suggested to represent different severity levels of one social anxiety disorder. This cross-sectional study aimed to compare patients with APD to patients with SP, with particular focus on personality
Personal Knowledge Management for Employee Commoditization
Schild, Susie A.
2013-01-01
Knowledge management thinking has resulted in the perception that the organization is the relevant beneficiary of knowledge. Individual approaches to and experiences with personal knowledge management are not well documented in empirical studies, which uncovered the specific problem that the situatedness of knowledge worker contemporaries within…
Zanutto, Alberto
2017-06-01
One of the most significant changes in the healthcare field in the past 10 years has been the large-scale digitalization of patients' healthcare data, and an increasing emphasis on the importance of patients' roles in cooperating with healthcare professionals through digital infrastructures. A project carried out in the North of Italy with the aim of creating a personal health record has been evaluated over the course of 5 years by means of mixed method fieldwork. Two years after the infrastructure was put into regular service, the way in which patients are represented in the system and patient practices have been studied using surveys and qualitative interviews. The data show that, first, patients have become co-actors in describing their clinical histories; second, that they have become co-actors in the diagnosis process; and finally, they have become co-actors in the management of time and space as regards their specific state of health.
Kiefer, Stephan; Schäfer, Michael; Bransch, Marco; Brimmers, Peter; Bartolomé, Diego; Baños, Janie; Orr, James; Jones, Dave; Jara, Maximilian; Stockmann, Martin
2014-01-01
A personal health system platform for the management of patients with chronic liver disease that incorporates a novel approach to integrate decision support and guidance through care pathways for patients and their doctors is presented in this paper. The personal health system incorporates an integrated decision support engine that guides patients and doctors through the management of the disease by issuing tasks and providing recommendations to both the care team and the patient and by controlling the execution of a Care Flow Plan based on the results of tasks and the monitored health status of the patient. This Care Flow Plan represents a formal, business process based model of disease management designed off-line by domain experts on the basis of clinical guidelines, knowledge of care pathways and an organisational model for integrated, patient-centred care. In this way, remote monitoring and treatment are dynamically adapted to the patient's actual condition and clinical symptoms and allow flexible delivery of care with close integration of specialists, therapists and care-givers.
Ceriello, Antonio; Barkai, László; Christiansen, Jens Sandahl; Czupryniak, Leszek; Gomis, Ramon; Harno, Kari; Kulzer, Bernhard; Ludvigsson, Johnny; Némethyová, Zuzana; Owens, David; Schnell, Oliver; Tankova, Tsvetalina; Taskinen, Marja-Riitta; Vergès, Bruno; Weitgasser, Raimund; Wens, Johan
2012-10-01
As non-communicable or chronic diseases are a growing threat to human health and economic growth, political stakeholders are aiming to identify options for improved response to the challenges of prevention and management of non-communicable diseases. This paper is intended to contribute ideas on personalized chronic disease management which are based on experience with one major chronic disease, namely diabetes mellitus. Diabetes provides a pertinent case of chronic disease management with a particular focus on patient self-management. Despite advances in diabetes therapy, many people with diabetes still fail to achieve treatment targets thus remaining at risk of complications. Personalizing the management of diabetes according to the patient's individual profile can help in improving therapy adherence and treatment outcomes. This paper suggests using a six-step cycle for personalized diabetes (self-)management and collaborative use of structured blood glucose data. E-health solutions can be used to improve process efficiencies and allow remote access. Decision support tools and algorithms can help doctors in making therapeutic decisions based on individual patient profiles. Available evidence about the effectiveness of the cycle's constituting elements justifies expectations that the diabetes management cycle as a whole can generate medical and economic benefit. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Directory of Open Access Journals (Sweden)
Sandeep Kumar Vashist
2014-08-01
Full Text Available Smartphone-based devices and applications (SBDAs with cost effectiveness and remote sensing are the most promising and effective means of delivering mobile healthcare (mHealthcare. Several SBDAs have been commercialized for the personalized monitoring and/or management of basic physiological parameters, such as blood pressure, weight, body analysis, pulse rate, electrocardiograph, blood glucose, blood glucose saturation, sleeping and physical activity. With advances in Bluetooth technology, software, cloud computing and remote sensing, SBDAs provide real-time on-site analysis and telemedicine opportunities in remote areas. This scenario is of utmost importance for developing countries, where the number of smartphone users is about 70% of 6.8 billion cell phone subscribers worldwide with limited access to basic healthcare service. The technology platform facilitates patient-doctor communication and the patients to effectively manage and keep track of their medical conditions. Besides tremendous healthcare cost savings, SBDAs are very critical for the monitoring and effective management of emerging epidemics and food contamination outbreaks. The next decade will witness pioneering advances and increasing applications of SBDAs in this exponentially growing field of mHealthcare. This article provides a critical review of commercial SBDAs that are being widely used for personalized healthcare monitoring and management.
Bulger, Carrie A; Matthews, Russell A; Hoffman, Mark E
2007-10-01
While researchers are increasingly interested in understanding the boundaries surrounding the work and personal life domains, few have tested the propositions set forth by theory. Boundary theory proposes that individuals manage the boundaries between work and personal life through processes of segmenting and/or integrating the domains. The authors investigated boundary management profiles of 332 workers in an investigation of the segmentation-integration continuum. Cluster analysis indicated consistent clusters of boundary management practices related to varying segmentation and integration of the work and personal life domains. But, the authors suggest that the segmentation-integration continuum may be more complicated. Results also indicated relationships between boundary management practices and work-personal life interference and work-personal life enhancement. Less flexible and more permeable boundaries were related to more interference, while more flexible and more permeable boundaries were related to more enhancement.
Directory of Open Access Journals (Sweden)
Subhas C. Misra
2018-06-01
Full Text Available Biomedical engineering has grown as a vast field of research that includes many areas of engineering and technology also. Personalized Medicine is an emerging approach in today’s medicare system. It bears a very strong potential to consolidate modern e-health systems fundamentally. Scientists have already discovered some of the personalized drugs that can shift the whole medicare system into a new dimension. However, bringing the change in the whole medicare system is not an easy task. There are several factors that can affect the successful adoption of Personalized Medicine systems in the healthcare management sector. This paper aims at identifying the critical factors with the help of an empirical study. A questionnaire was distributed amongst some clinicians, clinical researchers, practitioners in pharmaceutical industries, regulatory board members, and a larger section of patients. The response data collected thereby were analyzed by using appropriate statistical methods. Based on the statistical analysis, an attempt is made to prepare a list of critical success factors in the adoption of personalized medicine in healthcare management. The study indicates that eight of the thirteen hypothesized factors have statistical relationship with “Success”. The important success factors detected are: data management, team work and composition, privacy and confidentiality, mind-set, return on investment, sufficient time, R&D and alignment. To the best of our knowledge, this is the first academic paper in which an attempt has been made to model the vital critical factors for the successful implementation of Personalized Medicine in healthcare management. The study bears the promise of important applications in healthcare engineering and technology. Keywords: Healthcare management, Personalized medicine, E-health, Success factors, Medicare systems, Regression analysis
Ritter, Kathrin; Roepke, Stefan; Merkl, Angela; Heuser, Isabella; Fydrich, Thomas; Lammers, Claas-Hinrich
2010-01-01
Patients with a narcissistic personality disorder (NPD) do not often consult a psychotherapist or psychiatrist because of their NPD, but rather, because of co-occurring psychiatric disorders, or higher general symptom stress. Until now there is no actual data about rates of co-occurrence disorders and general symptom stress. Which axis I and axis II disorders occur typically in NPD in comparison to patients with a borderline personality disorder (BPD)? How are general symptom stress and depressive symptoms related? Prevalence of co-occurring disorders (Structured Clinical Interview for DSM-IV for Axis I and Axis II) and general symptom stress (SCL-90-R) and depression (BDI) were investigated in 62 patients with a NPD, 62 patients with a BPD and 59 patients with a double diagnosis NPD/BPD. Affective disorders (64.5%) and substance use disorders (35.5%) were the most comorbid psychiatric disorders in patients with NPD. Substance use disorders (pdisorder (PTSD) (pdisorders (ppersonality disorder (pdisorders and antisocial personality disorder. Patients with NPD showed lowest rates of co-occurring disorders and lowest scores in general symptom stress and depression than the other two groups. In general, patients with NPD showed similar co-occurring disorders as patients with BPD, or with the co-diagnosis NPD and BPD, but they showed lower scores for general symptom stress and depression. (c) Georg Thieme Verlag KG Stuttgart New York.
Real-time personal dose monitoring and management system
International Nuclear Information System (INIS)
Zhang Zhiyong; Cheng Chang; Yang Huating; Liu Zhengshan; Deng Changming; Li Mei
2000-01-01
This paper mainly describes a real-time personal dose monitoring and management system. The system is composed of three parts that include SDM-98 semiconductor detector personal dosimeters, Data Readers and a Management System Software. It can be used for personal dose monitoring and management and other controlling actions in a radioactive controlled area. Adopting semiconductor detector and microcontroller, SDM-98 Personal Dosimeter is used to measure personal accumulated dose equivalent and dose rate caused by X-ray and Gamma ray. The results can be read directly on LCD. All the data stored in dosimeter can be transmitted into a data reader by infrared optical link. The alarm threshold can be adjusted successively in whole range of dose or dose rate. The Data Reader is an intelligent interface between the dosimeter and master computer. The data received from dosimeter will be sent to a master computer through RS-232 serial interface. According to the master computer's order, the Data Reader can turn on the dosimeter's power at entrance and shutdown it at exit. The Management System Software which written by Visual BASIC 5.0 runs on MS Win95. All the measuring data from dosimeters can be analyzed and treated according to requirements and stored in database. Therefore, some figures and tables relative to dose or rate can be shown on screen or printed out. (author)
Patient personality and therapist response: an empirical investigation.
Colli, Antonello; Tanzilli, Annalisa; Dimaggio, Giancarlo; Lingiardi, Vittorio
2014-01-01
The aim of this study was to examine the relationship between therapists' emotional responses and patients' personality disorders and level of psychological functioning. A random national sample of psychiatrists and clinical psychologists (N=203) completed the Therapist Response Questionnaire to identify patterns of therapists' emotional response, and the Shedler-Westen Assessment Procedure-200 to assess personality disorders and level of psychological functioning in a randomly selected patient currently in their care and with whom they had worked for a minimum of eight sessions and a maximum of 6 months (one session per week). There were several significant relationships between therapists' responses and patients' personality pathology. Paranoid and antisocial personality disorders were associated with criticized/mistreated countertransference, and borderline personality disorder was related to helpless/inadequate, overwhelmed/disorganized, and special/overinvolved countertransference. Disengaged countertransference was associated with schizotypal and narcissistic personality disorders and negatively associated with dependent and histrionic personality disorders. Schizoid personality disorder was associated with helpless/inadequate responses. Positive countertransference was associated with avoidant personality disorder, which was also related to both parental/protective and special/overinvolved therapist responses. Obsessive-compulsive personality disorder was negatively associated with special/overinvolved therapist responses. In general, therapists' responses were characterized by stronger negative feelings when working with lower-functioning patients. Patients' specific personality pathologies are associated with consistent emotional responses, which suggests that clinicians can make diagnostic and therapeutic use of their responses to patients.
Affective disorders among patients with borderline personality disorder.
Sjåstad, Hege Nordem; Gråwe, Rolf W; Egeland, Jens
2012-01-01
The high co-occurrence between borderline personality disorder and affective disorders has led many to believe that borderline personality disorder should be considered as part of an affective spectrum. The aim of the present study was to examine whether the prevalence of affective disorders are higher for patients with borderline personality disorder than for patients with other personality disorders. In a national cross-sectional study of patients receiving mental health treatment in Norway (N = 36 773), we determined whether psychiatric outpatients with borderline personality disorder (N = 1 043) had a higher prevalence of affective disorder in general, and whether they had an increased prevalence of depression, bipolar disorder or dysthymia specifically. They were compared to patients with paranoid, schizoid, dissocial, histrionic, obsessive-compulsive, avoidant, dependent, or unspecified personality disorder, as well as an aggregated group of patients with personality disorders other than the borderline type (N = 2 636). Odds ratios were computed for the borderline personality disorder group comparing it to the mixed sample of other personality disorders. Diagnostic assessments were conducted in routine clinical practice. More subjects with borderline personality disorder suffered from unipolar than bipolar disorders. Nevertheless, borderline personality disorder had a lower rate of depression and dysthymia than several other personality disorder groups, whereas the rate of bipolar disorder tended to be higher. Odds ratios showed 34% lower risk for unipolar depression, 70% lower risk for dysthymia and 66% higher risk for bipolar disorder in patients with borderline personality disorder compared to the aggregated group of other personality disorders. The results suggest that borderline personality disorder has a stronger association with affective disorders in the bipolar spectrum than disorders in the unipolar spectrum. This association may reflect
Affective disorders among patients with borderline personality disorder.
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Hege Nordem Sjåstad
Full Text Available BACKGROUND: The high co-occurrence between borderline personality disorder and affective disorders has led many to believe that borderline personality disorder should be considered as part of an affective spectrum. The aim of the present study was to examine whether the prevalence of affective disorders are higher for patients with borderline personality disorder than for patients with other personality disorders. METHODS: In a national cross-sectional study of patients receiving mental health treatment in Norway (N = 36 773, we determined whether psychiatric outpatients with borderline personality disorder (N = 1 043 had a higher prevalence of affective disorder in general, and whether they had an increased prevalence of depression, bipolar disorder or dysthymia specifically. They were compared to patients with paranoid, schizoid, dissocial, histrionic, obsessive-compulsive, avoidant, dependent, or unspecified personality disorder, as well as an aggregated group of patients with personality disorders other than the borderline type (N = 2 636. Odds ratios were computed for the borderline personality disorder group comparing it to the mixed sample of other personality disorders. Diagnostic assessments were conducted in routine clinical practice. RESULTS: More subjects with borderline personality disorder suffered from unipolar than bipolar disorders. Nevertheless, borderline personality disorder had a lower rate of depression and dysthymia than several other personality disorder groups, whereas the rate of bipolar disorder tended to be higher. Odds ratios showed 34% lower risk for unipolar depression, 70% lower risk for dysthymia and 66% higher risk for bipolar disorder in patients with borderline personality disorder compared to the aggregated group of other personality disorders. CONCLUSIONS: The results suggest that borderline personality disorder has a stronger association with affective disorders in the bipolar spectrum than
Affective Disorders among Patients with Borderline Personality Disorder
Sjåstad, Hege Nordem; Gråwe, Rolf W.; Egeland, Jens
2012-01-01
Background The high co-occurrence between borderline personality disorder and affective disorders has led many to believe that borderline personality disorder should be considered as part of an affective spectrum. The aim of the present study was to examine whether the prevalence of affective disorders are higher for patients with borderline personality disorder than for patients with other personality disorders. Methods In a national cross-sectional study of patients receiving mental health treatment in Norway (N = 36 773), we determined whether psychiatric outpatients with borderline personality disorder (N = 1 043) had a higher prevalence of affective disorder in general, and whether they had an increased prevalence of depression, bipolar disorder or dysthymia specifically. They were compared to patients with paranoid, schizoid, dissocial, histrionic, obsessive-compulsive, avoidant, dependent, or unspecified personality disorder, as well as an aggregated group of patients with personality disorders other than the borderline type (N = 2 636). Odds ratios were computed for the borderline personality disorder group comparing it to the mixed sample of other personality disorders. Diagnostic assessments were conducted in routine clinical practice. Results More subjects with borderline personality disorder suffered from unipolar than bipolar disorders. Nevertheless, borderline personality disorder had a lower rate of depression and dysthymia than several other personality disorder groups, whereas the rate of bipolar disorder tended to be higher. Odds ratios showed 34% lower risk for unipolar depression, 70% lower risk for dysthymia and 66% higher risk for bipolar disorder in patients with borderline personality disorder compared to the aggregated group of other personality disorders. Conclusions The results suggest that borderline personality disorder has a stronger association with affective disorders in the bipolar spectrum than disorders in the unipolar
Directory of Open Access Journals (Sweden)
Luc Bissonnette
2012-05-01
Full Text Available Infectious disease management essentially consists in identifying the microbial cause(s of an infection, initiating if necessary antimicrobial therapy against microbes, and controlling host reactions to infection. In clinical microbiology, the turnaround time of the diagnostic cycle (>24 hours often leads to unnecessary suffering and deaths; approaches to relieve this burden include rapid diagnostic procedures and more efficient transmission or interpretation of molecular microbiology results. Although rapid nucleic acid-based diagnostic testing has demonstrated that it can impact on the transmission of hospital-acquired infections, we believe that such life-saving procedures should be performed closer to the patient, in dedicated 24/7 laboratories of healthcare institutions, or ideally at point of care. While personalized medicine generally aims at interrogating the genomic information of a patient, drug metabolism polymorphisms, for example, to guide drug choice and dosage, personalized medicine concepts are applicable in infectious diseases for the (rapid identification of a disease-causing microbe and determination of its antimicrobial resistance profile, to guide an appropriate antimicrobial treatment for the proper management of the patient. The implementation of point-of-care testing for infectious diseases will require acceptance by medical authorities, new technological and communication platforms, as well as reimbursement practices such that time- and life-saving procedures become available to the largest number of patients.
Person-Centered Management in Project Administration.
Caraway, James E.
The theories of several contemporary management theorists are examined in order to demonstrate that their administrative stance is that of a person-intensive approach to management. After exploring leadership theory and the positions of Douglas McGregor, John J. Morse, Jay W. Lorsch, Rensis Likert, Bernard M. Bass, William Reddin, George H. Rice,…
[Relation between personality traits and personal values in cocaine-dependent patients].
Saiz, Jesús; Álvaro, José Luis; Martínez, Isabel
2011-01-01
To describe the relationship between personal values and personality traits in cocaine-using patients and analyze their specificity in the explanation of different types of constructs. A study was carried out to explore the association between these variables in a group of 230 patients receiving treatment for cocaine dependence. The Portrait Values Questionnaire was used for measuring personal values, while the Big-Five Factors Questionnaire was used to measure personality traits. In addition, we explored the relationship of values and traits with the variables "degree of satisfaction with life" (life satisfaction) and "belonging to a religious association" (religiosity). A significant association was found between personal values and personality traits. At the same time, their conceptual and empirical differences were revealed, as it was demonstrated that personal values better explain "belonging to a religious association", whilst personality traits better explain "degree of satisfaction with life". Thus, it was found that personal values better explain behaviours that depend on greater cognitive control, while personality traits would have more influence on tendencies and behaviours that are subject to lower cognitive control levels. Considering the relationship between the two constructs, and given that cocaine use is associated with both high and low cognitive control, in explanations of cocaine use it would be appropriate to take into account the explanatory contribution of personal values and personality traits in a complementary way.
Developing a framework to investigate the personal financial management knowledge of individuals
Directory of Open Access Journals (Sweden)
Miemie Struwig
2013-02-01
Full Text Available This article focuses on the development of a framework for investigating the personal financial management knowledge of individuals. Content analysis is used to derive the components included in the personal financial management requirements framework. The framework developed includes six components, namely basic concepts in personal finances, management of personal finances, risk management, future planning, investing in financial resources and miscellaneous factors. A qualitative validation process revealed that the framework indeed covers what the average South African citizen is required to know about personal financial planning. The real test of this framework will be to use it in developing an instrument to test individuals’ knowledge of personal financial management. This process of empirically testing the framework, using such an instrument, warrants a separate article.
Factors Affecting Usage of a Personal Health Record (PHR) to Manage Health
Taha, Jessica; Czaja, Sara J.; Sharit, Joseph; Morrow, Daniel G.
2018-01-01
As the health care industry shifts into the digital age, patients are increasingly being provided with access to electronic personal health records (PHRs) that are tethered to their provider-maintained electronic health records. This unprecedented access to personal health information can enable patients to more effectively manage their health, but little is actually known about patients’ ability to successfully use a PHR to perform health management tasks or the individual factors that influence task performance. This study evaluated the ability of 56 middle-aged adults (40–59 years) and 51 older adults (60–85 years) to use a simulated PHR to perform 15 common health management tasks encompassing medication management, review/interpretation of lab/test results, and health maintenance activities. Results indicated that participants in both age groups experienced significant difficulties in using the PHR to complete routine health management tasks. Data also showed that older adults, particularly those with lower numeracy and technology experience, encountered greater problems using the system. Furthermore, data revealed that the cognitive abilities predicting one’s task performance varied according to the complexity of the task. Results from this study identify important factors to consider in the design of PHRs so that they meet the needs of middle-aged and older adults. As deployment of PHRs is on the rise, knowledge of the individual factors that impact effective PHR use is critical to preventing an increase in health care disparities between those who are able to use a PHR and those who are not. PMID:24364414
Coping and personality in older patients with bipolar disorder.
Schouws, Sigfried N T M; Paans, Nadine P G; Comijs, Hannie C; Dols, Annemiek; Stek, Max L
2015-09-15
Little is known about coping styles and personality traits in older bipolar patients. Adult bipolar patients show a passive coping style and higher neuroticism scores compared to the general population. Our aim is to investigate personality traits and coping in older bipolar patients and the relationship between coping and personality. 75 Older patients (age > 60) with bipolar I or II disorder in a euthymic mood completed the Utrecht Coping List and the NEO Personality Inventory FFI and were compared to normative data. Older bipolar patients show more passive coping styles compared to healthy elderly. Their personality traits are predominated by openness, in contrast conscientiousness and altruism are relatively sparse. Neuroticism was related to passive coping styles, whereas conscientiousness was related to an active coping style. Older bipolar patients have more passive coping styles. Their personality is characterized by openness and relatively low conscientiousness and altruism. Our sample represents a survival cohort; this may explain the differences in personality traits between older patients in this study and in adult bipolar patients in other studies. The association between coping styles and personality traits is comparable to reports of younger adult patients with bipolar disorder. Longitudinal studies are warranted to explore if coping and personality change with ageing in bipolar patients and to determine which coping style is most effective in preventing mood episodes. Copyright © 2015 Elsevier B.V. All rights reserved.
Patients with Borderline Personality Disorder in Emergency Departments
Shaikh, Untara; Qamar, Iqra; Jafry, Farhana; Hassan, Mudasar; Shagufta, Shanila; Odhejo, Yassar Islamail; Ahmed, Saeed
2017-01-01
Borderline personality disorder (BPD) patients, when in crisis, are frequent visitors of emergency departments (EDs). When these patients exhibit symptoms such as aggressiveness, impulsivity, intense anxiety, severe depression, self-harm, and suicidal attempts or gestures, diagnosis, and treatment of the BPD becomes challenging for ED doctors. This review will, therefore, outline advice to physicians and health-care providers who face this challenging patient population in the EDs. Crisis intervention should be the first objective of clinicians when dealing with BPD in the emergency. For the patients with agitation, symptom-specific pharmacotherapy is usually recommended, while for non-agitated patients, short but intensive psychotherapy especially dialectical behavior therapy (DBT) has a positive effect. Although various psychotherapies, either alone or integrated, are preferred modes of treatment for this group of patients, the effects of psychotherapies on BPD outcomes are small to medium. Proper risk management along with developing a positive attitude and empathy toward these patients will help them in normalizing in an emergency setting after which treatment course can be decided. PMID:28824467
The effect of personality traits of managers/supervisor on job ...
African Journals Online (AJOL)
The effect of personality traits of managers/supervisor on job satisfaction of medical ... of their time life in their workplace therefore investigation for job satisfaction related ... Keywords: Employees, Job satisfaction, Managers, Personality trait ...
Personality traits in patients with cluster headache: a comparison with migraine patients.
Muñoz, I; Hernández, M S; Santos, S; Jurado, C; Ruiz, L; Toribio, E; Sotelo, E M; Guerrero, A L; Molina, V; Uribe, F; Cuadrado, M L
2016-01-01
Cluster headache (CH) has been associated with certain personality traits and lifestyle features, but there are few studies assessing personality profiles in CH. We aimed to analyze personality traits in patients with CH, and to compare them with those found in migraine. We included all consecutive patients with CH attending 5 outpatient offices between January and December 2013. Personality traits were evaluated using the Salamanca screening test, a validated inventory assessing 11 personality traits grouped in 3 clusters. We analyzed the test results in this population, and compared them with those of a migraine population previously assessed with the same test. Eighty patients with CH (75 men, 5 women; mean age, 43.2 ± 9.9 years) were recruited. The reference population consisted of 164 migraine patients (30 men, 134 women; mean age 36.4 ± 12.7 years). In CH patients, the most frequent personality traits were anancastic (52.5 %), anxious (47.5 %), histrionic (45 %), schizoid (42.5 %), impulsive (32.5 %) and paranoid (30 %). When compared to migraine patients, paranoid (p traits (p = 0.007; χ2 test) were significantly more prevalent in CH patients. In logistic regression analysis the paranoid trait was significantly associated with CH (p = 0.001; OR: 3.27, 95 % CI [1.66-6.43]). According to the Salamanca screening test, personality traits included in cluster A (odd or eccentric disorders) are more prevalent in CH patients than in a population of migraineurs. Larger studies are needed to determine whether certain personality traits are related to CH.
International Nuclear Information System (INIS)
Muralidhar, Vinayak; Chen, Ming-Hui; Reznor, Gally; Moran, Brian J.; Braccioforte, Michelle H.; Beard, Clair J.; Feng, Felix Y.; Hoffman, Karen E.; Choueiri, Toni K.; Martin, Neil E.; Sweeney, Christopher J.; Trinh, Quoc-Dien; Nguyen, Paul L.
2015-01-01
Purpose: To define and validate a classification of favorable high-risk prostate cancer that could be used to personalize therapy, given that consensus guidelines recommend similar treatments for all radiation-managed patients with high-risk disease. Methods and Materials: We studied 3618 patients with cT1-T3aN0M0 high-risk or unfavorable intermediate-risk prostate adenocarcinoma treated with radiation at a single institution between 1997 and 2013. Favorable high-risk was defined as T1c disease with either Gleason 4 + 4 = 8 and prostate-specific antigen 20 ng/mL. Competing risks regression was used to determine differences in the risk of prostate cancer–specific mortality (PCSM) after controlling for baseline factors and treatment. Our results were validated in a cohort of 13,275 patients using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Results: Patients with favorable high-risk disease had significantly better PCSM than other men with high-risk disease (adjusted hazard ratio [AHR] 0.42, 95% confidence interval [CI] 0.18-0.996, P=.049) and similar PCSM as men with unfavorable intermediate-risk disease (AHR 1.17, 95% CI 0.50-2.75, P=.710). We observed very similar results within the SEER-Medicare cohort (favorable high-risk vs other high-risk: AHR 0.21, 95% CI 0.11-0.41, P<.001; favorable high-risk vs unfavorable intermediate-risk: AHR 0.67, 95% CI 0.33-1.36, P=.268). Conclusions: Patients with favorable high-risk prostate cancer have significantly better PCSM than other patients with high-risk disease and similar PCSM as those with unfavorable intermediate-risk disease, who are typically treated with shorter-course androgen deprivation therapy. This new classification system may allow for personalization of treatment within high-risk disease, such as consideration of shorter-course androgen deprivation therapy for favorable high-risk disease.
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Muralidhar, Vinayak [Harvard-MIT Division of Health Sciences and Technology, Harvard Medical School, Boston, Massachusetts (United States); Chen, Ming-Hui [Department of Statistics, University of Connecticut, Storrs, Connecticut (United States); Reznor, Gally [Center for Surgery and Public Health, Brigham and Women' s Hospital/Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts (United States); Moran, Brian J.; Braccioforte, Michelle H. [Prostate Cancer Foundation of Chicago, Westmont, Illinois (United States); Beard, Clair J. [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States); Feng, Felix Y. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Hoffman, Karen E. [Department of Radiation Oncology, M. D. Anderson Cancer Center, Houston, Texas (United States); Choueiri, Toni K. [Department of Medical Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Harvard Medical School, Boston, Massachusetts (United States); Martin, Neil E. [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States); Sweeney, Christopher J. [Department of Medical Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Harvard Medical School, Boston, Massachusetts (United States); Trinh, Quoc-Dien [Department of Urology, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Nguyen, Paul L., E-mail: pnguyen@LROC.harvard.edu [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States)
2015-11-15
Purpose: To define and validate a classification of favorable high-risk prostate cancer that could be used to personalize therapy, given that consensus guidelines recommend similar treatments for all radiation-managed patients with high-risk disease. Methods and Materials: We studied 3618 patients with cT1-T3aN0M0 high-risk or unfavorable intermediate-risk prostate adenocarcinoma treated with radiation at a single institution between 1997 and 2013. Favorable high-risk was defined as T1c disease with either Gleason 4 + 4 = 8 and prostate-specific antigen <10 ng/mL or Gleason 6 and prostate-specific antigen >20 ng/mL. Competing risks regression was used to determine differences in the risk of prostate cancer–specific mortality (PCSM) after controlling for baseline factors and treatment. Our results were validated in a cohort of 13,275 patients using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Results: Patients with favorable high-risk disease had significantly better PCSM than other men with high-risk disease (adjusted hazard ratio [AHR] 0.42, 95% confidence interval [CI] 0.18-0.996, P=.049) and similar PCSM as men with unfavorable intermediate-risk disease (AHR 1.17, 95% CI 0.50-2.75, P=.710). We observed very similar results within the SEER-Medicare cohort (favorable high-risk vs other high-risk: AHR 0.21, 95% CI 0.11-0.41, P<.001; favorable high-risk vs unfavorable intermediate-risk: AHR 0.67, 95% CI 0.33-1.36, P=.268). Conclusions: Patients with favorable high-risk prostate cancer have significantly better PCSM than other patients with high-risk disease and similar PCSM as those with unfavorable intermediate-risk disease, who are typically treated with shorter-course androgen deprivation therapy. This new classification system may allow for personalization of treatment within high-risk disease, such as consideration of shorter-course androgen deprivation therapy for favorable high-risk disease.
Laverman, M.; Schonk, J.H.M.; Boog, P.J.M. van der; Neerincx, M.A.
2010-01-01
Motivation - It is becoming necessary to seriously consider self-management in the treatment of chronically ill patients. A number of self-management applications have already been developed, but an explicit theoretical model is lacking. The PERISCOPE-project aims to provide (1) a conceptual
Gao, Qianqian; Ma, Guorong; Zhu, Qisha; Fan, Hongying; Wang, Wei
2016-01-01
Detecting personality disorders in the illiterate population is a challenge, but nonverbal tools measuring personality traits such as the Five-Factor Nonverbal Personality Questionnaire (FFNPQ) might help. We hypothesized that FFNPQ traits are associated with personality disorder functioning styles in a predictable way, especially in a sample of personality disorder patients. We therefore invited 106 personality disorder patients and 205 healthy volunteers to answer the FFNPQ and the Parker Personality Measure (PERM) which measures 11 personality disorder functioning styles. Patients scored significantly higher on the FFNPQ neuroticism and conscientiousness traits and all 11 PERM styles. In both groups, the 5 FFNPQ traits displayed extensive associations with the 11 PERM styles, respectively, and the associations were more specific in patients. Associations between neuroticism, extraversion and agreeableness traits and most PERM styles were less exclusive, but conscientiousness was associated with antisocial (-) and obsessive-compulsive styles, and openness to experience with schizotypal and dependent (-) styles. Our study has demonstrated correlations between FFNPQ traits and PERM styles, and implies the nonverbal measure of personality traits is capable of aiding the diagnoses of personality disorders in the illiterate population. Enlarging sample size and including the illiterate might make for more stable results. © 2016 S. Karger AG, Basel.
Patient-centered activity monitoring in the self-management of chronic health conditions.
Chiauzzi, Emil; Rodarte, Carlos; DasMahapatra, Pronabesh
2015-04-09
As activity tracking devices become smaller, cheaper, and more consumer-accessible, they will be used more extensively across a wide variety of contexts. The expansion of activity tracking and personal data collection offers the potential for patient engagement in the management of chronic diseases. Consumer wearable devices for activity tracking have shown promise in post-surgery recovery in cardiac patients, pulmonary rehabilitation, and activity counseling in diabetic patients, among others. Unfortunately, the data generated by wearable devices is seldom integrated into programmatic self-management chronic disease regimens. In addition, there is lack of evidence supporting sustained use or effects on health outcomes, as studies have primarily focused on establishing the feasibility of monitoring activity and the association of measured activity with short-term benefits. Monitoring devices can make a direct and real-time impact on self-management, but the validity and reliability of measurements need to be established. In order for patients to become engaged in wearable data gathering, key patient-centered issues relating to usefulness in care, motivation, the safety and privacy of information, and clinical integration need to be addressed. Because the successful usage of wearables requires an ability to comprehend and utilize personal health data, the user experience should account for individual differences in numeracy skills and apply evidence-based behavioral science principles to promote continued engagement. Activity monitoring has the potential to engage patients as advocates in their personalized care, as well as offer health care providers real world assessments of their patients' daily activity patterns. This potential will be realized as the voice of the chronic disease patients is accounted for in the design of devices, measurements are validated against existing clinical assessments, devices become part of the treatment 'prescription', behavior
Prakash, Om; Sharma, Neelu; Singh, Amool R; Sengar, K S; Chaudhury, Suprakash; Ranjan, Jay Kumar
2015-01-01
To assess personality disorder (PD), emotional intelligence (EI), and locus of control of alcohol dependent (AD) patients and its comparison with normal controls. Based on purposive sampling technique, 33 AD patients were selected from the De-Addiction Ward of Ranchi Institute of Neuro-Psychiatry and Allied Sciences (RINPAS) and 33 matched normal subjects were selected from Ranchi and nearby places. Both the groups were matched on various sociodemographic parameters, that is, age, gender, and socioeconomic level. All participants were assessed with Millon Clinical Multiaxial Inventory-III, Mangal EI Inventory, and Locus of Control scale. Obtained responses were scored by using standard scoring procedures and subsequently statistically analyzed by using Chi-square test. AD patients have more comorbid pathological personality traits and disorders in comparison to their normal counterparts. Depressive, narcissistic, and paranoid PDs were prominent among AD group; followed by schizotypal, antisocial, negativistic, dependent, schizoid, sadistic, masochistic, and borderline PD. In comparison to normal participants, AD patients were significantly deficient in almost all the areas of EI and their locus of control was externally oriented. Patients with AD have significantly higher PDs, low EI, and an external orientation on the locus of control. Identification and management of these comorbid conditions are likely to improve the management and outcome of AD.
The Manager - as Personality and Motivator
Directory of Open Access Journals (Sweden)
J. Starc
2013-06-01
Full Text Available A manager is somebody who is capable of coping with changes, has a positive attitude towards them and by knowing well the environment is able to constantly adapt, plan and implement changes to achieve the sustainable growth of a company. By communicating with and integrating employees s/he is able to reduce their resistance to changes. In order to create and manage the knowledge of employees, every manager must possess strategic, organisational, operational personal qualities and must be a leader. As such s/he makes use of his/her charisma and intellectual stimulation, cares individually for the development of every single employee in terms of needs, inspires and designs appropriate goals for the co-workers. Among all of the roles a manager has to play, the good leader role, i.e. somebody to be trusted and respected, is the most important one. The article presents the results of a study involving 150 employees in the economy. It brings the opinions of the respondents about what the manager should be like: a great personality and motivator who wants to create and manage the knowledge of employees. The study has found that the employees favour most those managers, who encourage them to reach the desired goals, which trust their employees and stimulate them to solve problems together. They must be aware of the importance of the well-being of their employees, value their work and knowledge and encourage team work.
Personalized management of atrial fibrillation
DEFF Research Database (Denmark)
Kirchhof, Paulus; Breithardt, Günter; Aliot, Etienne
2013-01-01
The management of atrial fibrillation (AF) has seen marked changes in past years, with the introduction of new oral anticoagulants, new antiarrhythmic drugs, and the emergence of catheter ablation as a common intervention for rhythm control. Furthermore, new technologies enhance our ability......, and hospitalizations. During the fourth Atrial Fibrillation competence NETwork/European Heart Rhythm Association (AFNET/EHRA) consensus conference, we identified the following opportunities to personalize management of AF in a better manner with a view to improve outcomes by integrating atrial morphology and damage...
Older persons' lived experiences of depression and self-management.
Holm, Anne Lise; Lyberg, Anne; Lassenius, Erna; Severinsson, Elisabeth; Berggren, Ingela
2013-10-01
Mental ill-health, such as depression in the elderly, is a complex issue that is influenced by the life-world perspective of older persons. Their self-management ability should be strengthened based on an understanding of their situation, perspectives, and vulnerability. The aim of this study was to explore and increase understanding of old persons' lived experiences of depression and self-management using an interpretative explorative design. Understanding was developed by means of hermeneutic interpretation. One theme, Relationships and Togetherness, and four subthemes, A Sense of Carrying a Shoulder Bag, Walking on Eggshells, Holding the Reins, and Estrangement--a Loss of Togetherness, emerged. A collaborative approach can be important for empowering older persons through self-development and management. Although the findings of the present study cannot be considered conclusive or definitive, they nevertheless contribute new knowledge of older persons' lived experiences of depression in everyday life.
Design and implementation of the standards-based personal intelligent self-management system (PICS).
von Bargen, Tobias; Gietzelt, Matthias; Britten, Matthias; Song, Bianying; Wolf, Klaus-Hendrik; Kohlmann, Martin; Marschollek, Michael; Haux, Reinhold
2013-01-01
Against the background of demographic change and a diminishing care workforce there is a growing need for personalized decision support. The aim of this paper is to describe the design and implementation of the standards-based personal intelligent care systems (PICS). PICS makes consistent use of internationally accepted standards such as the Health Level 7 (HL7) Arden syntax for the representation of the decision logic, HL7 Clinical Document Architecture for information representation and is based on a open-source service-oriented architecture framework and a business process management system. Its functionality is exemplified for the application scenario of a patient suffering from congestive heart failure. Several vital signs sensors provide data for the decision support system, and a number of flexible communication channels are available for interaction with patient or caregiver. PICS is a standards-based, open and flexible system enabling personalized decision support. Further development will include the implementation of components on small computers and sensor nodes.
Martin, T; Daffern, M
2006-02-01
Inpatient mental health clinicians need to feel safe in the workplace. They also require confidence in their ability to work with aggressive patients, allowing the provision of therapeutic care while protecting themselves and other patients from psychological and physical harm. The authors initiated this study with the predetermined belief that a comprehensive and integrated organizational approach to inpatient aggression was required to support clinicians and that this approach increased confidence and staff perceptions of personal safety. To assess perceptions of personal safety and confidence, clinicians in a forensic psychiatric hospital were surveyed using an adapted version of the Confidence in Coping With Patient Aggression Instrument. In this study clinicians reported the hospital as safe. They reported confidence in their work with aggressive patients. The factors that most impacted on clinicians' confidence to manage aggression were colleagues' knowledge, experience and skill, management of aggression training, use of prevention and intervention strategies, teamwork and the staff profile. These results are considered with reference to an expanding literature on inpatient aggression. It is concluded that organizational resources, policies and frameworks support clinician perceptions of safety and confidence to manage inpatient aggression. However, how these are valued by clinicians and translated into practice at unit level needs ongoing attention.
Personality of mothers of substance-dependent patients
Directory of Open Access Journals (Sweden)
David Baron
2010-04-01
Full Text Available David Baron1, Samir AbolMagd2, Salwa Erfan2, Mona El Rakhawy21Temple University School of Medicine, Philadelphia, PA, USA; 2University of Cairo School of Medicine, Cairo, EgyptAbstract: Drug addicts often come from dysfunctional families. The prevailing view in the literature is that mothers of drug-dependent patients can be characterized by strong emotional bonds and overprotection. Studies suggest that maternal rejection could be a major risk factor of developing drug addiction. This work is a continuation of our previous study of childhood parenting experiences of substance-dependent patients. The aims were to compare the personality profile of mothers of substance-dependent patients and that of mothers of matched control subjects; and to examine the relation between the personality of mothers of addicts, and severity of their offspring’s addiction. The study group consisted of 20 mothers of substance-dependent patients and a control group of 35 mothers of non-dependent subjects; mothers of both groups were age matched. Patients were diagnosed according to DSM IV criteria. Personalities of mothers of both groups were assessed using the Minnesota Multiphasic Personality Inventory (MMPI. Substance-dependent patients (sons were administered the Addiction Severity Index (ASI. The mean scores of the MMPI Scales were higher for mothers of dependent patients compared to mothers of non-dependent subjects. Scores on the depression, hysteria and paranoia scales were significantly higher for mothers of patients (P = 0.03, 0.02, and 0.03, respectively. There was a significant positive correlation between scores of hysteria, and psychopathic deviance and the ASI (P = 0.03 and 0.01, respectively. There were significant negative correlations between scores of social introversion and the ASI drug/alcohol use status (P = 0.007, and family history dimensions (P = 0.003. Mothers of substance-dependent patients showed disturbances in aspects of personalities
Translating Personality Psychology to Help Personalize Preventive Medicine for Young-Adult Patients
Israel, Salomon; Moffitt, Terrie E.; Belsky, Daniel W.; Hancox, Robert J.; Poulton, Richie; Roberts, Brent; Thomson, W. Murray; Caspi, Avshalom
2014-01-01
The rising number of newly insured young adults brought on by healthcare reform will soon increase demands on primary-care physicians. Physicians will face more young-adult patients which presents an opportunity for more prevention-oriented care. In the current study, we evaluated whether brief observer reports of young adults’ personality traits could predict which individuals would be at greater risk for poor health as they entered midlife. Following the Dunedin Study cohort of 1,000 individuals, we show that very brief measures of young adults’ personalities predicted their midlife physical health across multiple domains (metabolic abnormalities, cardiorespiratory fitness, pulmonary function, periodontal disease, and systemic inflammation). Individuals scoring low on the traits of Conscientiousness and Openness-to-Experience went on to develop poorer health even after accounting for preexisting differences in education, socioeconomic status, smoking, obesity, self-reported health, medical conditions, and family medical history. Moreover, personality ratings from peer informants who knew participants well, and from a nurse and receptionist who had just met participants for the first time, predicted health decline from young adulthood to midlife despite striking differences in level of acquaintance. Personality effect sizes were on par with other well-established health-risk factors such as socioeconomic status, smoking, and self-reported health. We discuss the potential utility of personality measurement to function as an inexpensive and accessible tool for healthcare professionals to personalize preventive medicine. Adding personality information to existing healthcare electronic infrastructures could also advance personality theory by generating opportunities to examine how personality processes influence doctor-patient communication, health service use, and patient outcomes. PMID:24588093
[Written personalized action plan for atopic dermatitis: a patient education tool].
Gabeff, R; Assathiany, R; Barbarot, S; Salinier, C; Stalder, J-F
2014-07-01
Atopic dermatitis (AD) is the most frequent children's chronic skin disease. Management of AD can be difficult because local treatments must be adapted to the skin's condition. Between consultations, sudden changes in the state of the disease can make it difficult to manage local treatment. Parents and children need information that will help them adapt their treatment to the course of their disease. Aiming to enable parents to better treat their atopic child by themselves, we have developed a personalized action plan in order to simplify, personalize, and adapt the medical prescription to the state of the disease. The Personalized Written Action Plan for Atopics (PA2P) is based on the model used in the treatment of asthma, with integrated specificities for AD in children. The aim of this study was to assess the feasibility and pertinence of the PA2P for pediatricians to use in private practice. A total of 479 pediatricians answered a questionnaire sent by e-mail. The vast majority of the respondents gave positive reviews of the tool: 99% of the pediatricians declared the tool to be pertinent, qualifying it as clear and logical. The PA2P appeared to be appropriate for the atopic patient because it improves the families' involvement in the application of local treatment by offering personalized care and by simplifying the doctor's prescription. Finally, 72% of doctors responding to the questionnaire were willing to take part in future studies involving parents. More than a gadget, the PA2P could become a useful tool for therapeutic patient education. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
Mercadante, Sebastiano; Adile, Claudio; Lanzetta, Gaetano; Mystakidou, Kyriaki; Maltoni, Marco; Soares, Luiz Guilherme; De Santis, Stefano; Ferrera, Patrizia; Valenti, Marco; Rosati, Marta; Rossi, Romina; Cortegiani, Andrea; Masedu, Francesco; Marinangeli, Franco; Aielli, Federica
2018-05-16
The aim of this study was to assess the patients' global impression (PGI) after symptom management, as well as the achievement of personalized symptom goals (PSG). The secondary outcome was to assess related factors. Subjects, Materials, and Methods . Advanced cancer patients admitted to palliative care units rated symptom intensity by using the Edmonton Symptom Assessment Score (ESAS) at admission and then after 1 week. For each symptom, patient-reported PGI and PSG, as well as the rate of PSG response, were evaluated. Eight hundred seventy-six patients were taken into consideration for this study. A mean of 1.71-2.16 points was necessary to perceive a bit better improvement of symptom intensity. Most patients had a PSG of ≤3. A statistically significant number of patients achieved their PSG after starting palliative care. Patients with high intensity of ESAS items at admission achieved a more favorable PGI response. In the multivariate analysis, symptom intensity and PSG were the most frequent factors independently associated to a best PGI, whereas high levels of Karnofsky had a lower odd ratio. PSG and PGI seem to be relevant for patients' assessment and decision-making process, translating in terms of therapeutic intervention. Some factors may be implicated in determining the individual target and clinical response. Personalized symptom goals and global impression of change are relevant for patients' assessment and decision-making process, translating in terms of therapeutic intervention. Some factors may be implicated in determining the individual target and clinical response. © AlphaMed Press 2018.
Duprez, Veerle; Beeckman, Dimitri; Verhaeghe, Sofie; Van Hecke, Ann
2017-09-01
Chronic conditions put a heavy burden on healthcare in every country. Supporting persons with a chronic illness to take an active role in the management of their condition is a core component in the Chronic Care Model. It implies confidence and good skills from professionals. To date, there is no evidence on final year nursing students' performance in supporting patients' self-management, nor on factors associated with this performance. To explore self-reported performance of supporting patients' self-management by final year nursing students, and person-related factors associated with this performance. A correlational multi-centre study of final year nursing students (N=256) from eight nursing schools. Students were recruited from a convenience sample of eight nursing schools. All final year students were invited to participate. Data were collected between January 2015 and May 2016 using self-administered validated questionnaires. Theoretical behavioural frameworks were used to select hypothesized associated factors for self-management support: self-efficacy to perform self-management support and socio-structural factors (Social Cognitive Theory); needs for autonomy, competence and relatedness, and patient-invested contingent self-esteem (Self-Determination Theory); and attitudes towards supporting patients' self-management (Theory of Planned Behaviour). Final year nursing students (N=256) reported an overall low level of performance in delivering self-management support during internship. Students lacked mainly competencies in collaborative goal setting and shared decision making. Students reported a significant gap between their confidence and their actual performance in self-management support (pLearning opportunities can be introduced in classroom activities and on internship. Copyright © 2017 Elsevier Ltd. All rights reserved.
Directory of Open Access Journals (Sweden)
Om Prakash
2015-01-01
Full Text Available Aim: To assess personality disorder (PD, emotional intelligence (EI, and locus of control of alcohol dependent (AD patients and its comparison with normal controls. Materials and Methods: Based on purposive sampling technique, 33 AD patients were selected from the De-Addiction Ward of Ranchi Institute of Neuro-Psychiatry and Allied Sciences (RINPAS and 33 matched normal subjects were selected from Ranchi and nearby places. Both the groups were matched on various sociodemographic parameters, that is, age, gender, and socioeconomic level. All participants were assessed with Millon Clinical Multiaxial Inventory-III, Mangal EI Inventory, and Locus of Control scale. Obtained responses were scored by using standard scoring procedures and subsequently statistically analyzed by using Chi-square test. Results: AD patients have more comorbid pathological personality traits and disorders in comparison to their normal counterparts. Depressive, narcissistic, and paranoid PDs were prominent among AD group; followed by schizotypal, antisocial, negativistic, dependent, schizoid, sadistic, masochistic, and borderline PD. In comparison to normal participants, AD patients were significantly deficient in almost all the areas of EI and their locus of control was externally oriented. Conclusion: Patients with AD have significantly higher PDs, low EI, and an external orientation on the locus of control. Identification and management of these comorbid conditions are likely to improve the management and outcome of AD.
Hörz-Sagstetter, Susanne; Diamond, Diana; Clarkin, John F; Levy, Kenneth N; Rentrop, Michael; Fischer-Kern, Melitta; Cain, Nicole M; Doering, Stephan
2017-07-31
This study examines psychopathology and clinical characteristics of patients with borderline personality disorder (BPD) and comorbid narcissistic personality disorder (NPD) from two international randomized controlled trials. From a combined sample of 188 patients with BPD, 25 also fulfilled criteria for a comorbid diagnosis of NPD according to DSM-IV. The BPD patients with comorbid NPD, compared to the BPD patients without comorbid NPD, showed significantly more BPD criteria (M = 7.44 vs. M = 6.55, p personality disorders, and were more likely to meet criteria for full histrionic PD diagnosis (44.0% vs. 14.2%, p disorders (M = 2.68 vs. M = 3.75, p = .033). No differences could be found in general functioning, self-harming behavior, and suicide attempts.
McMain, Shelley F; Links, Paul S; Gnam, William H; Guimond, Tim; Cardish, Robert J; Korman, Lorne; Streiner, David L
2009-12-01
The authors sought to evaluate the clinical efficacy of dialectical behavior therapy compared with general psychiatric management, including a combination of psychodynamically informed therapy and symptom-targeted medication management derived from specific recommendations in APA guidelines for borderline personality disorder. This was a single-blind trial in which 180 patients diagnosed with borderline personality disorder who had at least two suicidal or nonsuicidal self-injurious episodes in the past 5 years were randomly assigned to receive 1 year of dialectical behavior therapy or general psychiatric management. The primary outcome measures, assessed at baseline and every 4 months over the treatment period, were frequency and severity of suicidal and nonsuicidal self-harm episodes. Both groups showed improvement on the majority of clinical outcome measures after 1 year of treatment, including significant reductions in the frequency and severity of suicidal and nonsuicidal self-injurious episodes and significant improvements in most secondary clinical outcomes. Both groups had a reduction in general health care utilization, including emergency visits and psychiatric hospital days, as well as significant improvements in borderline personality disorder symptoms, symptom distress, depression, anger, and interpersonal functioning. No significant differences across any outcomes were found between groups. These results suggest that individuals with borderline personality disorder benefited equally from dialectical behavior therapy and a well-specified treatment delivered by psychiatrists with expertise in the treatment of borderline personality disorder.
Inpatient Physiotherapy Management for Stiff-Person Syndrome: A Case Report
Directory of Open Access Journals (Sweden)
Kahraman
2016-01-01
Full Text Available Introduction Stiff-person syndrome (SPS is a rare autoimmune neurological disorder presenting with inability to perform daily activities independently. Because SPS is a rare disorder, the efficacy of physiotherapy in the management of SPS is not yet known. Case Presentation The patient was a 65-year-old female with SPS diagnosed 1 year before. Assessments were performed, such as range of motion, muscle strength, pain, balance, and functional mobility. She had shoulder pain, with a score of 5/10 on the numerical pain rating scale for both shoulders. Moreover, her muscle strength was impaired. Although the patient could not maintain an upright position or walk, she had sitting balance. The physiotherapy functional mobility profile (PFMP was scored as 35/63. She received 14 sessions of physiotherapy intervention, which included exercises to improve strength, flexibility, posture, balance, and functional mobility. Walking exercises were performed after the patient gained the ability to maintain an upright stance. Her muscle strength and posture improved, and her pain disappeared. The patient could maintain upright position and began to walk with a walker. At the end of the physiotherapy program, the PFMP was scored as 49/63, and the patient was able to walk 20 m with a walker without need to rest. Conclusions Inpatient physiotherapy management for SPS seems effective in improving balance, gait, and functional mobility.
Personality profiles in patients with eating disorders
Tomotake, Masahito; Ohmori, Tetsuro
2002-01-01
The present review focused on the personality profiles of patients with eating disorders. Studies using the Structured Clinical Interview for DSM-III-R Personality Disorder showed high rates of diagnostic co-occurrence between eating disorders and personality disorders. The most commonly observed were histrionic, obsessive-compulsive, avoidant, dependent and borderline personality disorders. Studies using the Cloninger’s personality theory suggested that high Harm Avoidance might be relevant ...
Fan, Hongying; Zhu, Qisha; Ma, Guorong; Shen, Chanchan; Zhang, Bingren; Wang, Wei
2016-08-30
Cultural and personality factors might contribute to the clinical differences of psychiatric patients all over the world including China. One cultural oriented Chinese Adjective Descriptors of Personality (CADP) designed to measure normal personality traits, might be specifically associated with different personality disorder functioning styles. We therefore have invited 201 healthy volunteers and 67 personality disorder patients to undergo CADP, the Parker Personality Measure (PERM), and the Plutchik-van Praag Depression Inventory (PVP) tests. Patients scored significantly higher on PVP scale and all 11 PERM personality disorder functioning styles, as well as CADP Emotional and Unsocial traits. The PVP was significantly correlated with some CADP traits and PERM styles in both groups. In healthy volunteers, only one CADP trait, Unsocial, prominently predicted 11 PERM styles. By contrast in patients, CADP Intelligent predicted the PERM Narcissistic and Passive-Aggressive styles; CADP Emotional the PERM Paranoid, Borderline, and Histrionic styles; CADP Conscientious the PERM Obsessive-Compulsive style; CADP Unsocial the PERM Schizotypal, Antisocial, Narcissistic, Avoidant, Dependent, and Passive-Aggressive styles; CADP Agreeable the PERM Antisocial style. As a preliminary study, our results demonstrated that, in personality disorder patients, all five CADP traits were specifically associated with almost all 11 personality disorder functioning styles, indicating that CADP might be used as an aid to diagnose personality disorders in China.
Evaluation and Management of Patch Test-Negative Patients With Generalized Dermatitis.
Spiker, Alison; Mowad, Christen M
Patients with generalized dermatitis are common in dermatology practices. Allergic contact dermatitis is often suspected, and patients frequently undergo patch testing. When the patch testing result is negative, further evaluation and management of these patients are challenging. The purpose of this study was to survey members of the American Contact Dermatitis Society regarding the evaluation and management of patch test-negative patients with generalized dermatitis. Generalized dermatitis was the most common term identified for patch test-negative patients with diffuse dermatitis. After having negative expanded patch testing results, most physicians proceeded with additional testing including skin biopsy, complete blood cell count with differential, and liver and renal function tests. The most commonly used systemic treatment is prednisone, followed by methotrexate. Narrow-band ultraviolet B (UVB) is the most commonly used light source. Antihistamines are frequently prescribed. Food allergy is not felt to be causative. This cohort of patients experiences significant impairment in quality of life, stress on personal relationships, and time off work. The management of patch test-negative patients with generalized dermatitis is challenging. This study provides insight into management of these complex patients. It also demonstrates practice gaps in the management of these patients, indicating a need for further studies to direct the evaluation and management of this patient population.
van Manen, Janine G; Andrea, Helene; van den Eijnden, Ellen; Meerman, Anke M M A; Thunnissen, Moniek M; Hamers, Elisabeth F M; Huson, Nelleke; Ziegler, Uli; Stijnen, Theo; Busschbach, Jan J V; Timman, Reinier; Verheul, Roel
2011-10-01
Within a large multi-center study in patients with personality disorders, we investigated the relationship between patient characteristics and treatment allocation. Personality pathology, symptom distress, treatment history, motivational factors, and sociodemographics were measured at intake in 923 patients, who subsequently enrolled in short-term or long-term outpatient, day hospital, or inpatient psychotherapy for personality pathology. Logistic regressions were used to examine the predictors of allocation decisions. We found a moderate relationship (R(2) = 0.36) between patient characteristics and treatment setting, and a weak relationship (R(2) = 0.18) between patient characteristics and treatment duration. The most prominent predictors for setting were: symptom distress, cluster C personality pathology, level of identity integration, treatment history, motivation, and parental responsibility. For duration the most prominent predictor was age. We conclude from this study that, in addition to pathology and motivation factors, sociodemographics and treatment history are related to treatment allocation in clinical practice.
Salivary cortisol in depressed patients versus control persons
DEFF Research Database (Denmark)
Knorr, Ulla; Vinberg, Maj; Kessing, Lars V
2010-01-01
The pathophysiology of depression has been associated to dysregulation of the hypothalamic-pituitary-adrenal axis and the use of salivary cortisol measures is increasingly being incorporated into research. The aim of the present study was to investigate whether salivary cortisol differs...... for patients with depression and control persons. We did a systematic review with sequential meta-analysis and meta-regression according to the PRISMA Statement based on comprehensive database searches for studies of depressed patients compared to control persons in whom salivary cortisol was measured. Twenty...... case-control studies, including 1354 patients with depression and 1052 control persons were identified. In a random-effects meta-analysis salivary cortisol was increased for depressed patients as compared to control persons on average 2.58 nmol/l (95% C.I.: 0.95-4.21) p=0.002 in the morning...
Fahlgren, Elin; Nima, Ali A; Archer, Trevor; Garcia, Danilo
2015-01-01
Background. Osteopathic philosophy and practice are congruent with the biopsychosocial model, a patient-centered approach when treating disease, and the view of the person as a unity (i.e., body, mind, and soul). Nevertheless, a unity of being should involve a systematic person-centered understanding of the patient's personality as a biopsychosociospiritual construct that influences health (i.e., well-being and ill-being). We suggest Cloninger's personality model, comprising temperament (i.e., body) and character (i.e., mind and soul), as a genuine paradigm for implementation in osteopathic practice. As a first step, we investigated (1) the relationships between personality and health among osteopathic patients, (2) differences in personality between patients and a control group, and (3) differences in health within patients depending on the presenting problem and gender. Method. 524 osteopathic patients in Sweden (age mean = 46.17, SD = 12.54, 388 females and 136 males) responded to an online survey comprising the Temperament and Character Inventory and measures of health (well-being: life satisfaction, positive affect, harmony in life, energy, and resilience; ill-being: negative affect, anxiety, depression, stress, and dysfunction and suffering associated to the presenting problem). We conducted two structural equation models to investigate the association personality-health; graphically compared the patients' personality T-scores to those of the control group and compared the mean raw scores using t-tests; and conducted two multivariate analyses of variance, using age as covariate, to compare patients' health in relation to their presenting problem and gender. Results. The patients' personality explained the variance of all of the well-being (R (2) between .19 and .54) and four of the ill-being (R (2) between .05 and .43) measures. Importantly, self-transcendence, the spiritual aspect of personality, was associated to high levels of positive emotions and
Real-Time Management of Multimodal Streaming Data for Monitoring of Epileptic Patients.
Triantafyllopoulos, Dimitrios; Korvesis, Panagiotis; Mporas, Iosif; Megalooikonomou, Vasileios
2016-03-01
New generation of healthcare is represented by wearable health monitoring systems, which provide real-time monitoring of patient's physiological parameters. It is expected that continuous ambulatory monitoring of vital signals will improve treatment of patients and enable proactive personal health management. In this paper, we present the implementation of a multimodal real-time system for epilepsy management. The proposed methodology is based on a data streaming architecture and efficient management of a big flow of physiological parameters. The performance of this architecture is examined for varying spatial resolution of the recorded data.
Transtorno de personalidade na terceira idade Personality disorders in an elderly patient
Directory of Open Access Journals (Sweden)
Fernanda Speggiorin Pereira
2007-01-01
Full Text Available CONTEXTO: Dificuldades interpessoais, instabilidade afetiva, distorções da relação médico-paciente e respostas imprevisíveis às intervenções são características centrais aos transtornos de personalidade que são encontradas tanto em pacientes jovens, como em adultos idosos. RELATO DE CASO: Encontra-se aqui descrito um caso de transtorno de personalidade em paciente de 68 anos de idade, com transtorno de personalidade do tipo histriônica e outras comorbidades psiquiátricas. CONCLUSÃO: Transtorno de personalidade é um diagnóstico raramente aventado no tratamento psiquiátrico no paciente idoso de difícil manejo. Deve-se nestes casos fazer uma investigação mais aprofundada do funcionamento da personalidade, pois a presença e a severidade do transtorno de personalidade têm implicações no plano da assistência de ambos os tratamentos psicológico e farmacológico.CONTEXT: Interpersonal difficulties, affective instability, distortions of the clinician-patient relationship, and unpredictable responses to clinical interventions, are characteristics found in older adults as well as in younger patients with personality disorders. CASE REPORT: We report the case of a 68 years old patient with histrionic personality disorder and other psychiatric comorbidities. CONCLUSION: Personality disorders are frequently overlooked in the diagnostic workout of complex psychogeriatric syndromes, and require a comprehensive assessment of personality traits. The correct identification of personality disorders and their subtypes is critical for planning the therapeutic approach, including pharmacotherapy and psychological management.
Vierck, Esther; Joyce, Peter R
2015-10-30
A majority of bipolar patients (BD) show functional difficulties even in remission. In recent years cognitive functions and personality characteristics have been associated with occupational and psychosocial outcomes, but findings are not consistent. We assessed personality and cognitive functioning through a range of tests in BD and control participants. Three cognitive domains-verbal memory, facial-executive, and spatial memory-were extracted by principal component analysis. These factors and selected personality dimensions were included in hierarchical regression analysis to predict psychosocial functioning and the use of self-management strategies while controlling for mood status. The best determinants of good psychosocial functioning were good verbal memory and high self-directedness. The use of self-management techniques was associated with a low level of harm-avoidance. Our findings indicate that strategies to improve memory and self-directedness may be useful for increasing functioning in individuals with bipolar disorder. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Sim, Jin Ah; Chang, Yoon Jung; Shin, Aesun; Noh, Dong-Young; Han, Wonshik; Yang, Han-Kwang; Kim, Young Whan; Kim, Young Tae; Jeong, Seoung-Yong; Yoon, Jung-Hwan; Kim, Yoon Jun; Heo, Daesuk; Kim, Tae-You; Oh, Do-Youn; Wu, Hong-Gyun; Kim, Hak Jae; Chie, Eui Kyu; Kang, Keon Wook; Kim, Ju Han; Yun, Young Ho
2017-11-01
The use of information communication technology (ICT)-based tailored health management program can have significant health impacts for cancer patients. Information provision, health-related quality of life (HRQOL), and decision conflicts were analyzed for their relationship with need for an ICT-based personalized health management program in Korean cancer survivors. The health program needs of 625 cancer survivors from two Korean hospitals were analyzed in this cross-sectional study. Multivariate logistic regression was used to identify factors related to the need for an ICT-based tailored health management system. Association of the highest such need with medical information experience, HRQOL, and decision conflicts was determined. Furthermore, patient intentions and expectations for a web- or smartphone-based tailored health management program were investigated. Cancer survivors indicated high personalized health management program needs. Patients reporting the highest need included those with higher income (adjusted odds ratio [aOR], 1.70; 95% [confidence interval] CI, 1.10-2.63), those who had received enough information regarding helping themselves (aOR, 1.71; 95% CI, 1.09-2.66), and those who wished to receive more information (aOR, 1.59; 95% CI, 0.97-2.61). Participants with cognitive functioning problems (aOR, 2.87; 95%CI, 1.34-6.17) or appetite loss (aOR, 1.77; 95% CI, 1.07-2.93) indicated need for a tailored health care program. Patients who perceived greater support from the decision-making process also showed the highest need for an ICT-based program (aOR, 0.49; 95% CI, 0.30-0.82). We found that higher income, information provision experience, problematic HRQOL, and decisional conflicts are significantly associated with the need for an ICT-based tailored self-management program. Copyright © 2017 John Wiley & Sons, Ltd.
Nyberg, Anna; Leineweber, Constanze; Magnusson Hanson, Linda
2015-11-01
To explore differences in psychosocial work factors, work-personal life interface, and well-being between managers and non-managers, female and male managers, and managers in the public and private sectors. Data were drawn from the Swedish Longitudinal Occupational Survey of Health (SLOSH) 2010, including 602 female managers, 4174 female non-managers, 906 male managers, and 2832 male non-managers. Psychosocial work factors, work-personal life interface, satisfaction, and well-being were investigated among non-managers and managers and male and female managers, using logistic regression analyses adjusted for age, educational level, staff category, and labour market sector. Both female and male managers reported high job demands and interference between work and personal life, but also high influence, high satisfaction with work and life, and low amount of sickness absence more often than non-managers of the same sex. However, female managers reported high quantitative and emotional demands, low influence, and work-personal life interference more frequently than male managers. More psychosocial work stressors were also reported in the public sector, where many women work. Male managers more often reported conflicts with superiors, lack of support, and personal life-work interference. Female managers reported poor well-being to a greater extent than male managers, but were more satisfied with their lives. Lack of motivation due to limited increase in satisfaction and organisational benefits is not likely to hinder women from taking on managerial roles. Managerial women's higher overall demands, lower influence at work, and poorer well-being relative to men's could hinder female managers from reaching higher organisational levels.
Kaptein, Ad A; Fischer, Maarten J; Scharloo, Margreet
2014-01-01
In this narrative review, we put self-management in the context of a 50-year history of research about how patients with COPD respond to their illness. We review a definition of self-management, and emphasize that self-management should be combined with disease management and the chronic care model in order to be effective. Reviewing the empirical status of self-management in COPD, we conclude that self-management is part and parcel of modern, patient-oriented biopsychosocial care. In pulmonary rehabilitation programs, self-management is instrumental in improving patients' functional status and quality of life. We conclude by emphasizing how studying the way persons with COPD make sense of their illness helps in refining self-management, and thereby patient-reported outcomes in COPD.
Characteristics associated with family money management for persons with psychiatric disorders.
Labrum, Travis
2018-05-11
Persons with psychiatric disorders (PD) commonly have their money officially or unofficially managed by others, with money managers most commonly being family members. (i) Identify characteristics of persons with PD, adult family members, and interactions with each other significantly associated with family money management (FMM). (ii) Identify significant differences in aforementioned characteristics between official versus unofficial FMM. Five hundred and seventy-three adults residing in USA with an adult relative with PD completed a survey. Among persons with PD, FMM was positively associated with lower income, diagnosis of schizophrenia/schizoaffective or bipolar disorder, psychiatric hospitalization, and arrest history. FMM was negatively associated with family members having a mental health diagnosis. FMM was positively associated with interaction characteristics of co-residence, financial assistance, caregiving, and use of limit-setting practices. Compared to official FMM, when unofficial FMM was present, persons with PD were less likely to have been psychiatrically hospitalized or to have regularly attended mental health treatment. When unofficial FMM was present, adult family members were less likely to be a parent of the person with PD. Practitioners should assess the level of burden experienced by family money managers and assess and address with family money managers the use of limit-setting practices.
Personality characteristics in patients with somatized disorder
Directory of Open Access Journals (Sweden)
Ekaterina Anatolyevna Tolkach
2010-01-01
Full Text Available Objective: to study personality characteristics, behavioral style, and modes of relations with their people in patients with somatized disorder. Subjects and methods. Eighty-six patients diagnosed as having somatized disorder were examined using Leary's interpersonal diagnosis system. Results. The author revealed the following personality characteristics and behavioral styles: a depressed need for authoritarianism, dominance, autonomy, aggressiveness, a display of qualities, such as superfriendliness, benevolence, submissiveness, dependency, and suspiciousness. These characteristics give an insight into the development of somatization in patients with somatized disorder.
Analysis on personality traits in patients undergoing LASIK
Directory of Open Access Journals (Sweden)
Yong Wang
2014-07-01
Full Text Available AIM: To analyze personality traits in preoperative patients who undergolaser in situ keratomileusis(LASIKand to provide psychological basis for the selection of refractive surgery.METHODS: Eligible patientswere seeking customized LASIK(group A n=53, conventional LASIK(group B n=75and non-operation patients with ametropia(group C n=71, who completed 16 personality factor questionnaires(16PF. Statistical analyses were performed with one-way ANOVA by SPSS11.0 software package.RESULTS: Compared to group C, patients in group A scored high on dominance and tension levels, and low on emotional stability level(PPPCONCLUSION: The data indicates that personality profiles of LASIK patients with refractive error influence their decision for correction. Patients need suitable psychological assessment before surgery who actively chose customized LASIK seem to be more assertive and suspicious.
Patients Know Best: Qualitative Study on How Families Use Patient-Controlled Personal Health Records
Schneider, Hanna; Hill, Susan
2016-01-01
Background Self-management technologies, such as patient-controlled electronic health records (PCEHRs), have the potential to help people manage and cope with disease. Objective This study set out to investigate patient families’ lived experiences of working with a PCEHR. Methods We conducted a semistructured qualitative field study with patient families and clinicians at a children’s hospital in the UK that uses a PCEHR (Patients Know Best). All families were managing the health of a child with a serious chronic condition, who was typically under the care of multiple clinicians. As data gathering and analysis progressed, it became clear that while much of the literature assumes that patients are willing and waiting to take more responsibility for and control over their health management (eg, with PCEHRs), only a minority of participants in our study responded in this way. Their experiences with the PCEHR were diverse and strongly shaped by their coping styles. Theory on coping identifies a continuum of coping styles, from approach to avoidance oriented, and proposes that patients’ information needs depend on their style. Results We identified 3 groups of patient families and an outlier, distinguished by their coping style and their PCEHR use. We refer to the outlier as controlling (approach oriented, highly motivated to use PCEHR), and the 3 groups as collaborating (approach oriented, motivated to use PCEHR), cooperating (avoidance oriented, less motivated to use PCEHR), and avoiding (very avoidance oriented, not motivated to use PCEHR). Conclusions The PCEHR met the needs of controller and collaborators better than the needs of cooperators and avoiders. We draw on the Self-Determination Theory to propose ways in which a PCEHR design might better meet the needs of avoidance-oriented users. Further, we highlight the need for families to also relinquish control at times, and propose ways in which PCEHR design might support a better distribution of control
Chronic disease self-management support for persons with dementia, in a clinical setting
Directory of Open Access Journals (Sweden)
Ibrahim JE
2017-01-01
Full Text Available Joseph Elias Ibrahim,1 Laura J Anderson,1 Aleece MacPhail,2 Janaka Jonathan Lovell,2 Marie-Claire Davis,1 Margaret Winbolt3 1Department of Forensic Medicine, Monash University, Southbank, 2Ballarat Health Services, Ballarat, 3Australian Centre for Evidence Based Aged Care, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, Australia Abstract: The burden of chronic disease is greater in individuals with dementia, a patient group that is growing as the population is aging. The cornerstone of optimal management of chronic disease requires effective patient self-management. However, this is particularly challenging in older persons with a comorbid diagnosis of dementia. The impact of dementia on a person’s ability to self-manage his/her chronic disease (eg, diabetes mellitus or heart failure varies according to the cognitive domain(s affected, severity of impairment and complexity of self-care tasks. A framework is presented that describes how impairment in cognitive domains (attention and information processing, language, visuospatial ability and praxis, learning and memory and executive function impacts on the five key processes of chronic disease self-management. Recognizing the presence of dementia in a patient with chronic disease may lead to better outcomes. Patients with dementia require individually tailored strategies that accommodate and adjust to the individual and the cognitive domains that are impaired, to optimize their capacity for self-management. Management strategies for clinicians to counter poor self-management due to differentially impaired cognitive domains are also detailed in the presented framework. Clinicians should work in collaboration with patients and care givers to assess a patient’s current capabilities, identify potential barriers to successful self-management and make efforts to adjust the provision of information according to the patient’s skill set. The increasing prevalence of
Information needs of case managers caring for persons living with HIV.
Schnall, Rebecca; Cimino, James J; Currie, Leanne M; Bakken, Suzanne
2011-05-01
The goals of this study were to explore the information needs of case managers who provide services to persons living with HIV (PLWH) and to assess the applicability of the Information Needs Event Taxonomy in a new population. The study design was observational with data collection via an online survey. Responses to open-ended survey questions about the information needs of case managers (n=94) related to PLWH of three levels of care complexity were categorized using the Information Needs Event Taxonomy. The most frequently identified needs were related to patient education resources (33%), patient data (23%), and referral resources (22%) accounting for 79% of all (N=282) information needs. Study limitations include selection bias, recall bias, and a relatively narrow focus of the study on case-manager information needs in the context of caring for PLWH. The study findings contribute to the evidence base regarding information needs in the context of patient interactions by: (1) supporting the applicability of the Information Needs Event Taxonomy and extending it through addition of a new generic question; (2) providing a foundation for the addition of context-specific links to external information resources within information systems; (3) applying a new approach for elicitation of information needs; and (4) expanding the literature regarding addressing information needs in community-based settings for HIV services.
Personal and Parents’ Life Stories in Patients with Borderline Personality Disorder
DEFF Research Database (Denmark)
Lind, Majse; Thomsen, Dorthe Kirkegaard; Bøye, Rikke
. Thirty patients with BPD and thirty matched control participants described and answered questions about their personal life stories and their parents’ life stories and completed measures of identity disturbance, alexithymia, empathy, and emotional intelligence. Compared to the control group, patients...
Relationship of self-management to personality types and indices.
Williams, R L; Verble, J S; Price, D E; Layne, B H
1995-06-01
This study addressed the relationship between self-management (as measured by the Lifestyle Approaches Inventory, Williams, Moore, Pettibone, & Thomas, 1992) and personality types and indexes (as measured by the Myers-Briggs Type Indicator, Myers & McCaulley, 1985) in a sample of 347 university students. Correlational analyses indicated that the self-management factor most consistently linked to the Myers-Briggs indices was Organization of Physical Space. The Myers-Briggs index most consistently correlated with the self-management factors was Judgment-Perception. Overall, male and female subjects showed similar patterns of relationships between the self-management and personality indices. When the self-management scores were compared for the various Myers-Briggs types, the analysis indicated that types having a J (planful and organized) or S (precise and practical) in the typology tended to score higher than those having a P (spontaneous and flexible) or N (imaginative and insightful).
Designing a patient-centered personal health record to promote preventive care
Directory of Open Access Journals (Sweden)
Krist Alex H
2011-11-01
Full Text Available Abstract Background Evidence-based preventive services offer profound health benefits, yet Americans receive only half of indicated care. A variety of government and specialty society policy initiatives are promoting the adoption of information technologies to engage patients in their care, such as personal health records, but current systems may not utilize the technology's full potential. Methods Using a previously described model to make information technology more patient-centered, we developed an interactive preventive health record (IPHR designed to more deeply engage patients in preventive care and health promotion. We recruited 14 primary care practices to promote the IPHR to all adult patients and sought practice and patient input in designing the IPHR to ensure its usability, salience, and generalizability. The input involved patient usability tests, practice workflow observations, learning collaboratives, and patient feedback. Use of the IPHR was measured using practice appointment and IPHR databases. Results The IPHR that emerged from this process generates tailored patient recommendations based on guidelines from the U.S. Preventive Services Task Force and other organizations. It extracts clinical data from the practices' electronic medical record and obtains health risk assessment information from patients. Clinical content is translated and explained in lay language. Recommendations review the benefits and uncertainties of services and possible actions for patients and clinicians. Embedded in recommendations are self management tools, risk calculators, decision aids, and community resources - selected to match patient's clinical circumstances. Within six months, practices had encouraged 14.4% of patients to use the IPHR (ranging from 1.5% to 28.3% across the 14 practices. Practices successfully incorporated the IPHR into workflow, using it to prepare patients for visits, augment health behavior counseling, explain test results
Personal peculiarities in patients with middle cerebral artery infarction
Directory of Open Access Journals (Sweden)
Antonova N.A.
2013-12-01
Full Text Available The purpose of the work is to reveal personal peculiarities in patients who have suffered middle cerebral artery infarction. Material and Methods. 39 patients with middle cerebral artery infarction have been under the study. All patients have received clinical instrumental inspection (neurologic survey, duplex ultrasound investigation of vessels of neck, head and brain, the research CT or MRT. Personal peculiarities have been studied by "The standard multiple-factor method of research of the personality" (PITCHES. Results. Psychological reactions for the disease have been determined. They include hypochondria, depression, psychasthenia and anxiety. Conclusion. Personal peculiarities in patients suffered from middle cerebral artery infarction may be characterized by the appearance of psychological response to the psychotraumatic situation. Therefore it is necessary to give psychotherapeutic aid.
Personality characteristics and quality of life in patients treated for Cushing's syndrome.
Sonino, Nicoletta; Bonnini, Stefano; Fallo, Francesco; Boscaro, Marco; Fava, Giovanni A
2006-03-01
Psychological distress does not always disappear upon proper endocrine treatment of Cushing's syndrome, and quality of life may still be compromised. Little is known on the personality correlates that may be involved. The aim of this study was to provide a controlled assessment of personality characteristics and quality of life in patients successfully treated for Cushing's syndrome. A single-centred, controlled, prospective study. Twenty-four consecutive outpatients who were in remission upon proper treatment of Cushing's syndrome for at least 1 year and no more than 3 years (20 with pituitary-dependent Cushing's disease and four with a cortisol-secreting adrenal adenoma; 5 M/19 F; mean age 34.5, SD = 10.6; range 18-57 years) were compared with 24 healthy control subjects matched for sociodemographic variables. Both patients and controls were administered two self-rating scales: (a) tridimensional personality questionnaire (TPQ), a 100-item inventory that yields three scales: novelty seeking, harm avoidance and reward dependence. (b) symptom rating test (SRT), a 46-item scale for assessing psychological distress and quality of life with six subscales (anxiety, depression, somatic symptoms, anger-hostility, cognitive symptoms, psychotic symptoms). There were no significant differences in personality dimensions, as measured by the TPQ, between patients and controls. The results did not change when the four patients with an adrenal adenoma were excluded and only the 20 with pituitary-dependent Cushing's disease were considered. As to the SRT scale, patients with Cushing's syndrome displayed significantly higher scores in anxiety (P= 0.046), depression (P= 0.013), and psychotic symptoms (P= 0.006), with a generalized compromised quality of life (P= 0.02). Again, no differences were found in evaluating the 20 patients with Cushing's disease separately. Even though personality traits other than those explored here may be involved, the results seem to exclude the
Reference architecture of application services for personal wellbeing information management.
Tuomainen, Mika; Mykkänen, Juha
2011-01-01
Personal information management has been proposed as an important enabler for individual empowerment concerning citizens' wellbeing and health information. In the MyWellbeing project in Finland, a strictly citizen-driven concept of "Coper" and related architectural and functional guidelines have been specified. We present a reference architecture and a set of identified application services to support personal wellbeing information management. In addition, the related standards and developments are discussed.
Shah, Rajendra; Faruqui, Rafey A
2013-01-01
This study presents a case report on the emergence of delusional jealousy and person-directed hostility in a patient following anoxic brain injury. The patient did not have a pre-injury history of mental illness, nor a family history of a psychotic disorder. This patient was followed-up over a 5-year period and his history of treatment response, violence risk management and successful rehabilitation are presented. This study also highlights issues in relation to continuation of treatment with antipsychotic medication, use of compulsory admission under the Mental Health Act and principles of risk assessment and risk management.
Continuum Thinking and the Contexts of Personal Information Management
Huvila, Isto; Eriksen, Jon; Häusner, Eva-Maria; Jansson, Ina-Maria
2014-01-01
Introduction: Recent personal information management literature has underlined the significance of the contextuality of personal information and its use. The present article discusses the applicability of the records continuum model and its generalisation, continuum thinking, as a theoretical framework for explicating the overlap and evolution of…
Bladder management methods and urological complications in spinal cord injury patients
Directory of Open Access Journals (Sweden)
Roop Singh
2011-01-01
Full Text Available Background: The optimal bladder management method should preserve renal function and minimize the risk of urinary tract complications. The present study is conducted to assess the overall incidence of urinary tract infections (UTI and other urological complications in spinal cord injury patients (SCI, and to compare the incidence of these complications with different bladder management subgroups. Materials and Methods: 545 patients (386 males and 159 females of traumatic spinal cord injury with the mean age of 35.4±16.2 years (range, 18 - 73 years were included in the study. The data regarding demography, bladder type, method of bladder management, and urological complications, were recorded. Bladder management methods included indwelling catheterization in 224 cases, clean intermittent catheterization (CIC in 180 cases, condom drainage in 45 cases, suprapubic cystostomy in 24 cases, reflex voiding in 32 cases, and normal voiding in 40 cases. We assessed the incidence of UTI and bacteriuria as the number of episodes per hundred person-days, and other urological complications as percentages. Results: The overall incidence of bacteriuria was 1.70 / hundred person-days. The overall incidenceof urinary tract infection was 0.64 / hundered person-days. The incidence of UTI per 100 person-days was 2.68 for indwelling catheterization, 0.34 for CIC, 0.34 for condom drainage, 0.56 for suprapubic cystostomy, 0.34 for reflex voiding, and 0.32 for normal voiding. Other urological complications recorded were urethral stricture (n=66, 12.1%, urethritis (n=78, 14.3%, periurethral abscess (n=45, 8.2%, epididymorchitis (n=44, 8.07%, urethral false passage (n=22, 4.03%, urethral fistula (n=11, 2%, lithiasis (n=23, 4.2%, hematuria (n=44, 8.07%, stress incontinence (n=60, 11%, and pyelonephritis (n=6, 1.1%. Clean intermittent catheterization was associated with lower incidence of urological complications, in comparison to indwelling catheterization. Conclusions
Guidelines on the management of patients treated with iodine-131
International Nuclear Information System (INIS)
1993-03-01
The purpose of these guidelines is to assist health care institutions establish protocols for the management of patients treated with iodine-131. These guidelines are written primarily for the use of Na 131 I in the treatment of benign and malignant thyroid disease. The principles have some application for the use of complex 131 I-labelled radiopharmaceuticals in that the treated patient will become a temporary radiation source and since contamination with body fluids of treated patients must be guarded against. The document outlines radiation protection and logistical concerns associated with the management of 131 I patients before, during and after therapy. These concerns include the safety of health care personnel, visitors, and any other persons who are at risk; and protection of the environment. (L.L.) 23 refs., 2 tabs
Harden, Cynthia L; Jovine, Luydmilla; Burgut, Fadime T; Carey, Bridget T; Nikolov, Blagovest G; Ferrando, Stephen J
2009-03-01
We sought to determine the type of personality disorder cluster associated with patients with nonepileptic psychogenic seizures (NES) compared with that of patients with epileptic seizures (ES). Consecutive adult patients admitted for video/EEG monitoring found to have NES were compared with a simultaneously admitted patient with confirmed epilepsy. Personality was assessed using the Structured Clinical Interview for DSM-IV-TR Axis II Personality Disorders. Personality disorders were then divided into personality clusters described in the DSM-IV-TR: A = paranoid, schizotypal, schizoid; B = borderline, histrionic, antisocial, narcissistic; or C = avoidant, dependent, obsessive-compulsive. Thirteen of 16 patients with NES and 12 of 16 patients with ES met criteria for personality disorders. Patients with NES were more likely to meet criteria for a personality disorder in Cluster A or B, compared with patients with ES, who were more likely to have Cluster C personality disorders (chi(2) test, P=0.007). We propose that the personality traits of patients with NES contribute to the development of nonepileptic psychogenic seizures. However, the large proportion of patients with ES with Cluster C personality disorders was unexpected, and further, for the patients with epilepsy, the direction of the association of their personality traits with the development of epilepsy is unknown.
Integrating Personalized and Community Services for Mobile Travel Planning and Management
Yu, Chien-Chih
Personalized and community services have been noted as keys to enhance and facilitate e-tourism as well as mobile applications. This paper aims at proposing an integrated service framework for combining personalized and community functions to support mobile travel planning and management. Major mobile tourism related planning and decision support functions specified include personalized profile management, information search and notification, evaluation and recommendation, do-it-yourself planning and design, community and collaboration management, auction and negotiation, transaction and payment, as well as trip tracking and quality control. A system implementation process with an example prototype is also presented for illustrating the feasibility and effectiveness of the proposed system framework, process model, and development methodology.
Management of Patients with Post- Traumatic Exposed Bones at Moi ...
African Journals Online (AJOL)
Background: The global frequency for open long bone fracture is at least 11.5 cases per 100,000 persons per year. Precise published research information regarding the characteristics and the management of patients with post- traumatic exposed bones for Africa, Kenya and Moi Teaching and Referral Hospital- Eldoret is ...
Farsham, Aida; Abbaslou, Tahereh; Bidaki, Reza; Bozorg, Bonnie
2017-04-01
Objective: No research has been conducted on facial emotional recognition on patients with borderline personality disorder (BPD) and schizotypal personality disorder (SPD). The present study aimed at comparing facial emotion recognition in these patients with the general population. The neurocognitive processing of emotions can show the pathologic style of these 2 disorders. Method: Twenty BPD patients, 16 SPD patients, and 20 healthy individuals were selected by available sampling method. Structural Clinical Interview for Axis II, Millon Personality Inventory, Beck Depression Inventory and Facial Emotional Recognition Test was were conducted for all participants. Discussion: The results of one way ANOVA and Scheffe's post hoc test analysis revealed significant differences in neuropsychology assessment of facial emotional recognition between BPD and SPD patients with normal group (p = 0/001). A significant difference was found in emotion recognition of fear between the 2 groups of BPD and normal population (p = 0/008). A significant difference was observed between SPD patients and control group in emotion recognition of wonder (p = 0/04(. The obtained results indicated a deficit in negative emotion recognition, especially disgust emotion, thus, it can be concluded that these patients have the same neurocognitive profile in the emotion domain.
Cooper, Joanne M; Collier, Jacqueline; James, Veronica; Hawkey, Christopher J
2010-12-01
Inflammatory Bowel Disease is a collective term for two distinct long term conditions: Ulcerative Colitis and Crohn's disease. There is increasing emphasis on patients taking greater personal control and self-management of this condition, reflecting earlier research into the management of chronic illness. Nurses play a pivotal role in this process, yet how optimal personal control is self-assessed and self-managed in Inflammatory Bowel Disease is poorly understood. This study set out to explore beliefs about personal control and self-management of Inflammatory Bowel Disease. It focused on the role of physical, psychological and socio-economic factors within the individual's life experience. A qualitative approach was used comprising 24, one-to-one, semi-structured interviews with participants aged 30-40 years. Participants with a histological diagnosis of Inflammatory Bowel Disease for at least 12 months were eligible and recruited by gastrointestinal specialist staff from outpatient clinics at a large National Health Service Trust in the United Kingdom. Interviews were transcribed verbatim. Data analysis was informed by existing theories of personal control and used the 'systematic framework analysis' approach. In addition to existing theories of personal control, self-discrepancy theory helped to explain how people viewed the control and self-management of Inflammatory Bowel Disease. One main theme emerged from the findings: 'Reconciliation of the self in IBD', this was supported by three sub-themes and eight basic themes. Some participants found that being unable to control and predict the course of their condition was distressing, however for others this limited control was not viewed as a negative outcome. Being able to share control of IBD with specialist health care staff was beneficial, and participants stated that other priorities in life were as equally important to manage and control. A key barrier to ensuring greater personal control and self-management
Personalized Medicine and Infectious Disease Management.
Jensen, Slade O; van Hal, Sebastiaan J
2017-11-01
A recent study identified pathogen factors associated with an increased mortality risk in Staphylococcus aureus bacteremia, using predictive modelling and a combination of genotypic, phenotypic, and clinical data. This study conceptually validates the benefit of personalized medicine and highlights the potential use of whole genome sequencing in infectious disease management. Copyright © 2017 Elsevier Ltd. All rights reserved.
Personal characteristics of effective managers in organizational cultures of different types.
Directory of Open Access Journals (Sweden)
Zakharova L.N.
2015-07-01
Full Text Available Since the 1990s Russian enterprises have been experiencing difficulties in transitioning to the market-innovative model of development. In the context of the current variability of management paradigms, we had an opportunity to study the internal and external regulators of organizational changes that are typical for a transitioning economy. Organizational culture (ОС was studied as an external factor, while the personal traits of middle managers were viewed as internal factors because these managers are the agents for values and for behavior models, from corporate directives to “front-desk’ personnel. The goal of this theoretical and empirical study was to determine the personality traits of middle managers who were deemed effective by top management in companies transitioning to the market-innovative model of development in the context of different types of OCs. During the preliminary stage, we conducted a comparative analysis of the requirements for the personal traits of middle managers who are working in stable conditions as well as in conditions of transfer to the market-innovative model of development, and we selected the relevant methods of empirical research. During the first stage of the empirical part of our research we defined a group of four enterprises with OCs of different types, identified their effective mid-level managers based on expert evaluations by the top leadership, and formed test groups. During the second stage we studied the personal characteristics of these managers. We determined that the personality traits of managers deemed effective by their leaders form integral complexes, which in turn correlate in a certain way with the type of ОС of an enterprise. We identified four models of an effective manager: Mentor, Dictator, Innovator, and Businessman; these managers have varying degrees of work productivity, value priorities in the development of ОС, personal self-concepts, organizational leadership skills
Relationship between Personality Traits and Happiness in Patients with Thalassemia
Directory of Open Access Journals (Sweden)
Babollah Bakhshipour
2014-12-01
Full Text Available Background: The aim of this study was determining the relationship between personality traits and happiness in patients with major thalassemia. Materials and Methods: The design of this study was descriptive (correlational study. The target population of this study was all under-treated patients with major thalassemia in Amirkola thalassemia center in 2011. Among these patients, 150 patients were sampled using simple random sampling method and Morgan's table. The data were analyzed by means of calculating Pearson correlation coefficients and multiple linear regression analysis. The patients were asked to complete NEO-five factor Inventory (short form and Oxford happiness inventory. Results: Based on the results, the coefficient of regression analysis of NEO personality factors (big five and happiness was 0.45, which shows a linear relationship between personality factors of NEO and happiness in patients with thalassemia. Thus, there is a statistically significant relationship among personality traits (neuroticism, extroversion, openness, agreeableness, conscientiousness and happiness. Conclusion: Among personality traits, extroversion, flexibility, agreeableness and conscientiousness had positive statistically meaningful relationship with happiness i.e. patients with lower scores in neuroticism, were happier.
DEFF Research Database (Denmark)
Barfoed, Benedicte L; Paulsen, Maja S; Christensen, Palle M
2016-01-01
BACKGROUND: Previous studies suggest that doctors' personal lifestyle, risk taking personality and beliefs about risk reducing therapies may affect their clinical decision-making. Whether such factors are further associated with patients' adherence with medication is largely unknown. OBJECTIVE...... statin treatment as important, how they managed non-adherence and whether non-adherence annoyed them. The Jackson Personality Inventory-revised was used to measure risk attitude. The GPs' responses were linked to register data on their patients' redeemed statin prescriptions. Mixed effect logistic...
ANANKASTIK PERSONALITY DISORDER IN SCHIZOPHRENIA PARANOID PATIENT: A CASE REPORT
Damarnegara ..; A. A. Ngr. Andika
2014-01-01
Anankastik personality disorder is a health problem that can disturb the activities of person and can accompany a variety of other mental health problems. The patient in thiscase is a patient with an anankastik or obsessive compulsive personality disorder withthe axis I diagnoses is Paranoid Schizophrenia and was given haloperidol 2x5mg, buthave not done psychotherapy because the patient has not been cooperative. Theprognosis is dependent on patient compliance in taking medication and control...
Patients with Gilles de la Tourette syndrome have widespread personality differences.
Trillini, Morounke O; Müller-Vahl, Kirsten R
2015-08-30
Only little is known about pathological personality traits in patients with Gilles de la Tourette syndrome (GTS). The aim of this study was to further investigate the prevalence of personality traits in adults with GTS. We used a variety of rating scales to assess not only personality traits, but also severity of tics, quality of life, and comorbidities (obsessive-compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), depression), in a large group (n=50) of patients. Our major finding was that pathological personality traits are very common in patients with GTS encompassing a wide range of different personality traits, but most typically personality traits related to cluster C. Demand-anxious was the most common personality trait, while histrionic personality trait was absent. Patients' quality of life was more impaired by personality traits than comorbidities. Personality traits were more common in patients with comorbid OCD and depression, while comorbid ADHD had no influence. Our findings, therefore, corroborate the hypothesis that GTS plus OCD represents a more severe subtype of GTS, and support the assumption that OCD and depression, but not ADHD, are part of the GTS spectrum. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Real-time personal dose measurement and management system
International Nuclear Information System (INIS)
Zhang Zhiyong; Cheng Chang; Liu Zhengshan; Yang Huating; Deng Changming; Zhang Xiu; Guo Zhanjie
2001-01-01
The composition and design of a real-time personal dose measurement and management system are described. Accordingly, some pertinent hardware circuits and software codes including their operation modes are presented
How do urology residents manage personal finances?
Teichman, J M; Bernheim, B D; Espinosa, E A; Cecconi, P P; Meyer, J; Pearle, M S; Preminger, G M; Leveillee, R J
2001-05-01
To examine personal financial management among residents to answer three research questions: do residents make reasonable financial choices; why do some residents not save; and what steps can be taken to improve residents' personal financial decisions. Portions of the Federal Reserve Board's Survey of Consumer Finances were modified and piloted to elicit demographic, expense, saving, and income data. The final questionnaire was completed by 151 urology residents at 20 programs. Comparing residents with the general population in the same age and income categories, the median debt/household income ratio was 2.38 versus 0.64. Residents had greater educational debt, greater noneducational debt, and lower savings. Resident participation in retirement accounts was 100% at institutions with employer-matching 401k or 403b plans, 63% at institutions with nonmatching 401k or 403b plans, and 48% at institutions without retirement plans for residents (P = 0.002). Fifty-nine percent of residents budgeted expenses, 27% had cash balances below $1000, 51% had paid interest charges on credit cards within the previous year, and 12% maintained unpaid credit card balances greater than $10,000. The median resident income was $38,400. A significant minority of residents appear not to make reasonable financial choices. Some residents save little because of a failure to budget, indebtedness, high projected income growth, or insufficient attention to personal financial management. Residents save more when they are eligible for tax-deferred retirement plans, particularly when their institution matches their contributions. Many residents would benefit from instruction concerning prudent financial management.
Relationship between personality traits and cooperation of adolescent orthodontic patients.
Amado, Joaquín; Sierra, Angela Maria; Gallón, Alejandro; Alvarez, Cristina; Baccetti, Tiziano
2008-07-01
To establish the relationship between the personality traits of the adolescent and his or her cooperation with the orthodontic treatment. From a sample of 70 adolescent orthodontic patients (46 girls and 24 boys) between 12 and 15 years of age (average age, 13.4 +/- 1.1 years), the patients' personality traits were evaluated by using a personality questionnaire (16 Personality Factors-Adolescent Personal Questionnaire) and the degree of patient cooperation was assessed through the cooperation test (Orthodontic Patient Cooperation Scale [OPCS]). The cutting point for the assessment of cooperation on the OPCS questionnaire (noncooperation vs cooperation) was carried out through the receiver operating characteristic (ROC) analysis of curves. A chi2 test with Yates correction (P < or = .05) was applied to evaluate the associations between the degree of cooperation and the scales of personality, gender, or age. The cutting point for cooperation as assessed by the OPCS by means of ROC analysis was 380. No statistically significant relations were found between the degree of cooperation and the scales of personality, gender, or age. The results of the current study indicate that the personality traits alone of adolescents do not predict cooperation during treatment.
Patient guardians as an instrument for person centered care.
Basu, Lopa; Frescas, Ruben; Kiwelu, Humphrey
2014-05-08
Person-centered care involves keeping the person at the center of the care planning and decision-making process. While the theory behind person-centered care is commonly shared, its application in healthcare settings is more challenging. In a number of African countries, a lesson emerges involving the application of person-centered care through the use of patient guardians. Patient guardians, often family or close friends, act as an extension of the patient's hospital care team. Medical teams engage with these self-designated individuals who invest their time and efforts in the care of the patient. More importantly, the guardian continues this role and relationship when the patient is released from the hospital to return home. Healthcare workers view patient guardians as a valuable resource. In a structured manner, guardians become stewards of information regarding topics such as hand hygiene and infection control. The knowledge gained can help the recovering patient upon discharge and potentially spread the information to others in the community. Further study of this model may show clear applicability to help improve health literacy in underserved settings in both low-income and high-income countries.
Hirsh, Jacob B; Quilty, Lena C; Bagby, R Michael; McMain, Shelley F
2012-08-01
The working alliance between therapist and patient is an important component of effective interventions for borderline personality disorder (BPD). The current study examines whether client personality affects the development of the working alliance during the treatment of BPD, and whether this influences treatment effectiveness. Data was based on 87 patients with BPD who were participants in a randomized controlled trial comparing Dialectical Behavior Therapy (DBT) and general psychiatric management. Higher levels of trait Agreeableness were associated with steeper increases in working alliance throughout treatment, but only in the DBT condition. Increases in working alliance were in turn associated with better clinical outcomes. Mediation models revealed a significant indirect path from Agreeableness to better clinical outcomes, mediated through larger improvements in working alliance over time. These results highlight the role that patient personality can play during the therapeutic process, with a specific focus on the importance of Agreeableness for alliance development.
Care plan for the patient with a dependent personality disorder
Directory of Open Access Journals (Sweden)
Ana María Ruiz Galán
2010-11-01
Full Text Available Personality is unique for each individual and can be defined as the dynamic collection of characteristics relative to emotions, thought and behaviour.Personality trout’s only mean a Personality Disorder (PD when they are inflexible and maladjusted and cause notable functional deterioration or uneasiness.According to Bermudez personality is “the enduring organization of structural and functional features, innate and acquired under the special conditions of each one’s development that shape the particular and specific collection of behaviour to face different situations”.According to the Diagnostic a Statistical Manual of Mental Disorders (DSM-IV, a Personality Disorder is “an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the person’s culture is pervasive and an inflexible, is stable over time and leads to distress or impairment. The onset of these patterns of behaviour is the beginning of the adulthood and, in rare instances, early adolescence”.There are several types of Personality Disorders (paranoid, schizoid, borderline, antisocial, dependent…. Dependent Personality Disorder is one of the most frequent in the Mental Health Services.People who suffer from this disorder are unable to take a decision by themselves because they don’t have confidence in themselves. They need a lot of social support and affection until the point of deny their individuality by subordinating their desires to other person’s desires and permitting these persons to manage their lives. Maybe they feel desolated by separation and loss and can support any situation, even maltreatment to keep a relationship.As we a deduce this diagnosis is sensible to cultural influences. This work aims to elaborate an standarized plan of cares for the patient with Dependent Personality Disorder by using nursing Diagnosis of NANDA II, Outcomes Criteria (NOC and Interventions Criteria (NIC.
Self-esteem in patients with borderline and avoidant personality disorders.
Lynum, L I; Wilberg, T; Karterud, S
2008-10-01
This study compared self-esteem in patients with avoidant personality disorder (APD) and borderline personality disorder (BPD). Patients diagnosed with one or more personality disorders answered the questionnaire Index of Self Esteem as part of a comprehensive evaluation within the setting of a treatment trial. Our hypotheses were that (1) both patients with APD and patients with BPD would report low levels of self-esteem, (2) patients with APD would report lower self-esteem than patients with BPD. We further expected that (3) patients with higher levels of depression would report lower levels of self-esteem, but that (4) both borderline and avoidant personality pathology would contribute to explained variance in self-esteem beyond what would be accounted for by depression. All of our hypotheses were supported. The results from our study showed a significant difference in self-esteem level between the two personality disorders, patients with APD reporting lower self-esteem than patients with BPD. Subjects with both disorders were measured to have self-esteem levels within the range that presumes clinical problems. Self-esteem represents an important quality of subjective experience of the self, and the study of self-esteem in PDs can offer new and important knowledge of PDs as self-pathology.
Personality assessment of substance-dependent patients in a therapeutic community.
Moffett, L A; Steinberg, S L; Rohde, P
1996-01-01
The design and implementation of a personality assessment system for severely substance-dependent men in a therapeutic community (TC) are described. The system was designed from a treatment utility perspective (Hayes, Nelson, & Jarrett, 1987) and uses the Personality Research Form E (Jackson, 1984) to provide each patient with feedback (a) describing his normal personality traits, (b) predicting his probable pattern of adjustment to the treatment setting, and (c) prescribing specific actions he can take to address potentially problematic behaviors. Discussing the the results with the patient helps him cope with the TC. Reviewing the assessment results with the staff promotes their empathy for the patient as a person whose behavior can be understood as an interaction of his personality with the specific demands of the TC rather than seeing the patient in exclusively pathological terms. Specific suggestions for behavior change guide both the patient and the staff and are potentially useful in various treatment settings.
Howard, Rick; Khalifa, Najat; Duggan, Conor; Lumsden, John
2012-02-01
In 1999, the UK government initiated a programme for the assessment and treatment of individuals deemed to have 'dangerous and severe personality disorder' (DSPD). After over 10 years of specialist service development, it is not clear whether DSPD patients represent a distinct group. The aim of this study was to establish whether people admitted to DSPD hospital units could be distinguished in presentation or personality traits from people with personality disorder admitted to standard secure hospital services. Thirty-eight men detained in high-security hospital DSPD units were compared with 62 men detained in conventional medium or high security hospital units, using the Psychopathy Checklist-Revised (PCL-R) and other standard personality disorder, clinical and offending measures. Compared with their counterparts in standard services, the DSPD group had higher scores on PCL-R psychopathy, significantly more convictions before age 18 years, greater severity of institutional violence and more prior crimes of sexual violence. Regression analysis confirmed that only PCL-R Factor 1, reflecting core interpersonal and affective features of psychopathy, predicted group membership. The DSPD group emerged as having higher psychopathy scores, but as there is currently no evidence that the core personality features of psychopathy are amenable to treatment, there is little justification for treating high-psychopathy forensic patients differently from those with other disorders of personality. Copyright © 2011 John Wiley & Sons, Ltd.
Mirawati, Mirawati; Sitorus, Rico Januar; Hasyim, Hamzah
2011-01-01
Background : Hospital food hygiene and sanitation are generally less awake, which originated in the less hygienic food processing particularly related to personal hygiene of food handlers and poor food handling at every stage of implementation. This study aims to analyze the personal hygiene and food handling on Patients Food management in RSUP Dr. Mohammad Hoesin Palembang, 2010. Method : This study was descriptive using a qualitative approach. Sources of information in this study amounted...
Directory of Open Access Journals (Sweden)
Aida Farsham
2017-04-01
Full Text Available Objective: No research has been conducted on facial emotional recognition on patients with borderline personality disorder (BPD and schizotypal personality disorder (SPD. The present study aimed at comparing facial emotion recognition in these patients with the general population. The neurocognitive processing of emotions can show the pathologic style of these 2 disorders. Method: Twenty BPD patients, 16 SPD patients, and 20 healthy individuals were selected by available sampling method. Structural Clinical Interview for Axis II, Millon Personality Inventory, Beck Depression Inventory and Facial Emotional Recognition Test was were conducted for all participants.Discussion: The results of one way ANOVA and Scheffe’s post hoc test analysis revealed significant differences in neuropsychology assessment of facial emotional recognition between BPD and SPD patients with normal group (p = 0/001. A significant difference was found in emotion recognition of fear between the 2 groups of BPD and normal population (p = 0/008. A significant difference was observed between SPD patients and control group in emotion recognition of wonder (p = 0/04(.The obtained results indicated a deficit in negative emotion recognition, especially disgust emotion, thus, it can be concluded that these patients have the same neurocognitive profile in the emotion domain.
Andreasson, Kate; Krogh, Jesper; Rosenbaum, Bent; Gluud, Christian; Jobes, David A; Nordentoft, Merete
2014-05-29
In Denmark 8,000 to 10,000 people will attempt suicide each year. The Centre of Excellence in Suicide Prevention in the Capital Region of Denmark is treating patients with suicidal behavior, and a recent survey has shown that 30% of the patients are suffering from borderline personality disorder. The majority of patients (70% to 75%) with borderline personality disorder have a history of deliberate self-harm and 10% have a lifetime risk to die by suicide. The DiaS trial is comparing dialectical behavior therapy with collaborative assessment and management of suicidality-informed supportive psychotherapy, for the risk of repetition of deliberate self-harm in patients with a recent suicide attempt and personality traits within the spectrum of borderline personality disorder. Both treatments have previously shown effects in this group of patients on suicide ideation and self-harm compared with treatment as usual. The trial is designed as a single-center, two-armed, parallel-group observer-blinded randomized clinical superiority trial. We will recruit 160 participants with a recent suicide attempt and at least two traits of the borderline personality disorder from the Centre of Excellence in Suicide Prevention, Capital Region of Denmark. Randomization will be performed though a centralized and computer-generated approach that conceals the randomization sequence. The interventions that are offered are a modified version of a dialectical behavior therapy program lasting 16 weeks versus collaborative assessment and management of suicidality-informed supportive psychotherapy, where the duration treatment will vary in accordance with established methods up to 16 weeks. The primary outcome measure is the ratio of deliberate self-harming acts including suicide attempts measured at week 28. Other exploratory outcomes are included such as severity of symptoms, suicide intention and ideation, depression, hopelessness, self-esteem, impulsivity, anger, and duration of respective
Inpatient management of borderline personality disorder at Helen ...
African Journals Online (AJOL)
Inpatient management of borderline personality disorder at Helen Joseph Hospital, Johannesburg. ... South African Journal of Psychiatry ... to the acute inpatient psychiatric assessment unit at the Helen Joseph Hospital, in Johannesburg, over ...
Personality, treatment choice and satisfaction in patients with localized prostate cancer
International Nuclear Information System (INIS)
Block, Craig A.; Erickson, Brad; Carney-Doebbling, Caroline; Gordon, Susanna; Fallon, Bernard; Konety, Badrinath R.
2007-01-01
Radical prostatectomy (RP), external beam radiation (XRT) and brachytherapy (BTX) are the most commonly used treatments for localized prostate cancer. We studied whether patient personality influences treatment choice and overall treatment satisfaction. From 1998 to 2002, 219 consecutive patients treated with RP (n=74), XRT (n=73), or BTX (n=72) at our institution who remained free of biochemical recurrence were sent the Big Five Inventory (BFI) and a satisfaction/treatment participation questionnaire. We compared personality, satisfaction and participation scores between the three groups. Correlation between personality and satisfaction was determined. Multivariate regression was used to determine association between personality and satisfaction/participation after controlling for patient- and disease-related factors. Higher mean satisfaction and participation scores were observed within the RP and XRT groups, respectively (P=NS). No significant differences in personality were observed between groups. XRT patients tended to have higher extroversion, openness and agreeability scores, while RP patients tended to be more neurotic and conscientious (all P=NS). After controlling for other factors, a negative correlation was found between openness scores and satisfaction and a positive correlation between conscientiousness scores and satisfaction. Specific personality traits were associated with interest in participation in care for both RP and BTX patients but not for XRT patients. There are mild variations in personality as measured by the BFI between patients undergoing treatment for localized prostate cancer. Certain BFI-measured personality traits may be associated with levels of satisfaction following therapy. Disease concerns and provider recommendations may override the influence of personality in the decision-making process. (author)
Personality, treatment choice and satisfaction in patients with localized prostate cancer.
Block, Craig A; Erickson, Brad; Carney-Doebbling, Caroline; Gordon, Susanna; Fallon, Bernard; Konety, Badrinath R
2007-11-01
Radical prostatectomy (RP), external beam radiation (XRT) and brachytherapy (BTX) are the most commonly used treatments for localized prostate cancer. We studied whether patient personality influences treatment choice and overall treatment satisfaction. From 1998 to 2002, 219 consecutive patients treated with RP (n = 74), XRT (n = 73), or BTX (n = 72) at our institution who remained free of biochemical recurrence were sent the Big Five Inventory (BFI) and a satisfaction/treatment participation questionnaire. We compared personality, satisfaction and participation scores between the three groups. Correlation between personality and satisfaction was determined. Multivariate regression was used to determine association between personality and satisfaction/participation after controlling for patient- and disease-related factors. Higher mean satisfaction and participation scores were observed within the RP and XRT groups, respectively (P = NS). No significant differences in personality were observed between groups. XRT patients tended to have higher extroversion, openness and agreeability scores, while RP patients tended to be more neurotic and conscientious (all P = NS). After controlling for other factors, a negative correlation was found between openness scores and satisfaction and a positive correlation between conscientiousness scores and satisfaction. Specific personality traits were associated with interest in participation in care for both RP and BTX patients but not for XRT patients. There are mild variations in personality as measured by the BFI between patients undergoing treatment for localized prostate cancer. Certain BFI-measured personality traits may be associated with levels of satisfaction following therapy. Disease concerns and provider recommendations may override the influence of personality in the decision-making process.
Kim, Sujin; Huber, Jeffrey T
2017-10-01
The study characterized three groups with different levels of familiarity with personal health information management (PHIM) in terms of their demographics, health knowledge, technological competency, and information sources and barriers. In addition, the authors examined differences among PHIM groups in subjective self-ratings and objective test scores for health literacy. A total of 202 survey participants were recruited using Amazon's Mechanical Turk (mTurk) service, a crowdsourcing Internet service. Using K-means clustering, three groups with differing levels of familiarity with PHIM were formed: Advanced, Intermediate, and Basic. The Advanced group was the youngest, and the Basic group contained the highest proportion of males, whereas the Intermediate group was the oldest and contained the fewest males. The Advanced group was significantly more likely to engage in provider- or hospital-initiated PHIM activities such as emailing with providers, viewing test results online, and receiving summaries of hospital visits via email or websites than the other groups. The Basic group had significantly lower information management skills and Internet use than the other groups. Advanced and Basic groups reported significant differences in several information barriers. While the Advanced group self-reported the highest general literacy, they scored lowest on an objective health literacy test. For effective personal health records management, it is critical to understand individual differences in PHIM using a comprehensive measure designed to assess personal health records-specific activities. Because they are trained to perform an array of information management activities, medical librarians or patient educators are well positioned to promote the effective use of personal health records by health consumers.
van Manen, Janine; Kamphuis, Jan Henk; Visbach, Geny; Ziegler, Uli; Gerritsen, Ad; Van Rossum, Bert; Rijnierse, Piet; Timman, Reinier; Verheul, Roel
2008-11-01
Treatment selection in clinical practice is a poorly understood, often largely implicit decision process, perhaps especially for patients with personality disorders. This study, therefore, investigated how intake clinicians use information about patient characteristics to select psychotherapeutic treatment for patients with personality disorder. A structured interview with a forced-choice format was administered to 27 experienced intake clinicians working in five specialist mental health care institutes in the Netherlands. Substantial consensus was evident among intake clinicians. The results revealed that none of the presented patient characteristics were deemed relevant for the selection of the suitable treatment setting. The appropriate duration and intensity are selected using severity or personal strength variables. The theoretical orientation is selected using personal strength variables.
Brenk-Franz, Katja; Strauß, Bernhard; Tiesler, Fabian; Fleischhauer, Christian; Schneider, Nico; Gensichen, Jochen
2017-06-01
The conceptual model of attachment theory has been applied to understand the predispositions of patients in medical care and the patient-provider relationship. In patients with chronic conditions insecure attachment was connected to poorer self-management. The patient-provider relationship is associated with a range of health related outcomes and self-management skills. We determined whether the quality of the patient-provider relationship mediates the link between adult attachment and self-management among primary care patients with multiple chronic diseases. 209 patients with a minimum of three chronic diseases (including type II diabetes, hypertension and at least one other chronic condition) between the ages of 50 and 85 from eight general practices were included in the APRICARE cohort study. Adult attachment was measured via self-report (ECR-RD), self-management skills by the FERUS and the patient-provider relationship by the PRA-D. The health status and chronicity were assessed by the GP. Multiple mediation analyses were used to examine whether aspects of the patient-provider relationship (communication, information, affectivity) are a mediators of associations between adult attachment and self-management. The analysis revealed that the quality of the patient-provider relationship mediated the effect of attachment on self-management in patients with multiple chronic conditions. Particularly the quality of communication and information over the course of treatment has a significant mediating influence. A personalized, attachment-related approach that promotes active patient-provider communication and gives information about the treatment to the patient may improve self-management skills in patients. Copyright © 2017 Elsevier Inc. All rights reserved.
Effectiveness of Case Management for Homeless Persons: A Systematic Review
de Vet, Renée; van Luijtelaar, Maurice J. A.; Brilleslijper-Kater, Sonja N.; Vanderplasschen, Wouter; Beijersbergen, Mariëlle D.
2013-01-01
We reviewed the literature on standard case management (SCM), intensive case management (ICM), assertive community treatment (ACT), and critical time intervention (CTI) for homeless adults. We searched databases for peer-reviewed English articles published from 1985 to 2011 and found 21 randomized controlled trials or quasi-experimental studies comparing case management to other services. We found little evidence for the effectiveness of ICM. SCM improved housing stability, reduced substance use, and removed employment barriers for substance users. ACT improved housing stability and was cost-effective for mentally ill and dually diagnosed persons. CTI showed promise for housing, psychopathology, and substance use and was cost-effective for mentally ill persons. More research is needed on how case management can most effectively support rapid-rehousing approaches to homelessness. PMID:23947309
Concierge: Personal database software for managing digital research resources
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Hiroyuki Sakai
2007-11-01
Full Text Available This article introduces a desktop application, named Concierge, for managing personal digital research resources. Using simple operations, it enables storage of various types of files and indexes them based on content descriptions. A key feature of the software is a high level of extensibility. By installing optional plug-ins, users can customize and extend the usability of the software based on their needs. In this paper, we also introduce a few optional plug-ins: literaturemanagement, electronic laboratory notebook, and XooNlps client plug-ins. XooNIps is a content management system developed to share digital research resources among neuroscience communities. It has been adopted as the standard database system in Japanese neuroinformatics projects. Concierge, therefore, offers comprehensive support from management of personal digital research resources to their sharing in open-access neuroinformatics databases such as XooNIps. This interaction between personal and open-access neuroinformatics databases is expected to enhance the dissemination of digital research resources. Concierge is developed as an open source project; Mac OS X and Windows XP versions have been released at the official site (http://concierge.sourceforge.jp.
ANANKASTIK PERSONALITY DISORDER IN SCHIZOPHRENIA PARANOID PATIENT: A CASE REPORT
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Damarnegara ..
2014-02-01
Full Text Available Anankastik personality disorder is a health problem that can disturb the activities of person and can accompany a variety of other mental health problems. The patient in thiscase is a patient with an anankastik or obsessive compulsive personality disorder withthe axis I diagnoses is Paranoid Schizophrenia and was given haloperidol 2x5mg, buthave not done psychotherapy because the patient has not been cooperative. Theprognosis is dependent on patient compliance in taking medication and controls for thesetting of the dose, and the support of her family.
Personality Traits in Patients with Subjective Idiopathic Tinnitus
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Mahboobeh Adami Dehkordi
2015-09-01
Full Text Available Introduction: Tinnitus is a common complaint in patients referred to otorhinolaryngology clinics and is a condition where one hears a sound without any distinguishable external acoustic source or electrical stimulus. About 3-30% of adults experience different degrees of tinnitus during their life. This study aims to ascertain and compare personality traits between patients with tinnitus and a control group. Materials and Methods: In a case control study, 66 participants were assessed. The case group consisted of 33 patients who suffered from tinnitus for at least two months, in addition to 33 healthy volunteers who were selected among their family (preferably of the same age and sex. A standard demographic questionnaire and an Eyzenck personality questionnaire were filled for both groups. A tinnitus severity index (TSI questionnaire was only filled for the case group. Data from each group was compared by Mann-Whitney U and Chi-Square tests. SPSS V.18 was the selected software. Results: Statistical analysis showed a meaningful difference in neuroticism (P=0.001 and extraversion (P=0.001 between the patients and the controls; however, there was no statistical difference between these groups regarding psychotism. Conclusion: Tinnitus can be associated with personality characteristics. This study showed that in patients with tinnitus, neuroticism increases and extraversion decreases. Considering the personality and psychotic traits observed in the patients with tinnitus, psychiatric consultation is recommended.
Personality styles in patients with fibromyalgia, major depression and healthy controls
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Stiles Tore C
2007-03-01
Full Text Available Abstract Background The fibromyalgia syndrome (FMS is suggested to be a manifestation of depression or affective spectrum disorder. We measured the cognitive style of patients with FMS to assess personality styles in 44 patients with fibromyalgia syndrome (FMS by comparing them with 43 patients with major depressive disorder (MDD and 41 healthy controls (HC. Methods Personality styles were measured by the Sociotropy and Autonomy Scale (SAS and the Dysfunctional Attitude Scale (DAS. The Structured Clinical interview for DSM Axis I was applied to Axis I disorders, while the Beck Depression Inventory was used to measure depression severity. Results Patients with FMS in general have a sociotropic personality style similar to patients with MDD, and different from HC, but FMS patients without a lifetime history of MDD had a cognitive personality style different from patients with MDD and similar to HC. Conclusion These findings suggest that a depressotypic personality style is related to depressive disorder, but not to FMS.
Personality Traits in Panic Disorder Patients With and Without Comorbidities.
Zugliani, Morena M; Martin-Santos, Rocio; Nardi, Antonio Egidio; Freire, Rafael Christophe
2017-11-01
Panic disorder (PD) is often correlated with high neuroticism and low extraversion. This study aims to ascertain whether PD patients differ from healthy controls in regard to personality traits and determine if these traits are correlated with comorbid disorders, anxiety, and depression symptoms. Personality traits of 69 PD patients and 42 controls were compared using the Maudsley Personality Inventory. In PD patients, comorbidities, anxiety, and depression symptoms were also evaluated. PD patients showed higher neuroticism and lower extraversion compared with healthy controls. Patients without comorbidities presented similar results to controls, whereas those with comorbidities presented higher neuroticism and lower extraversion scores. PD per se may be unrelated to deviant personality traits, although comorbidities with major depressive disorder and agoraphobia are probably associated with high neuroticism and low extraversion. These traits show a strong correlation with the accumulation and severity of these disorders.
Mabuchi, Fumihiko; Yoshimura, Kimio; Kashiwagi, Kenji; Shioe, Kunihiko; Kanba, Shigenobu; Iijima, Hiroyuki; Tsukahara, Shigeo
2005-01-01
Several characteristic personality types have been reported for glaucoma patients in previous studies. However, none of the previous studies used a common structural theory of personality. In this study, we conducted a multicenter cross-sectional case-control study using the recently established five-factor model of personality structure. Personality was evaluated using the Neuroticism Extraversion Openness Five-Factor Inventory (NEO-FFI), which is a questionnaire specifically designed to test the five-factor model of personality: neuroticism (N), extraversion (E), openness (O), agreeableness (A), and conscientiousness (C). Eligible questionnaires were obtained from 196 patients with primary open-angle glaucoma (POAG) (99 men, 97 women) and 223 reference subjects with no ocular disease except cataract (87 men, 136 women). The mean score of each NEO-FFI factor for POAG patients was compared to the scores for the reference subjects. Compared with the reference subjects, the mean N score was significantly higher (P = 0.013), the mean scores for A and C were significantly lower (P = 0.007 and P = 0.001, respectively), and the mean E score tended to be lower (P = 0.055) in male POAG patients. The mean E score was significantly lower (P = 0.023) in female POAG patients. Characteristic personality traits were noted in POAG patients, and a more significant relationship was found between personality and glaucoma in men than in women.
2013-03-14
... and Criteria for Approval of Providers of a Personal Financial Management Instructional Course by... personal financial management instructional course (``providers'') satisfy all prerequisites of the United... in an instructional course concerning personal financial management (``instructional course'' or...
Application of cloud database in the management of clinical data of patients with skin diseases.
Mao, Xiao-fei; Liu, Rui; DU, Wei; Fan, Xue; Chen, Dian; Zuo, Ya-gang; Sun, Qiu-ning
2015-04-01
To evaluate the needs and applications of using cloud database in the daily practice of dermatology department. The cloud database was established for systemic scleroderma and localized scleroderma. Paper forms were used to record the original data including personal information, pictures, specimens, blood biochemical indicators, skin lesions,and scores of self-rating scales. The results were input into the cloud database. The applications of the cloud database in the dermatology department were summarized and analyzed. The personal and clinical information of 215 systemic scleroderma patients and 522 localized scleroderma patients were included and analyzed using the cloud database. The disease status,quality of life, and prognosis were obtained by statistical calculations. The cloud database can efficiently and rapidly store and manage the data of patients with skin diseases. As a simple, prompt, safe, and convenient tool, it can be used in patients information management, clinical decision-making, and scientific research.
Hopia, Hanna; Punna, Mari; Laitinen, Teemu; Latvala, Eila
2015-12-01
Background: Digital technologies have transformed nearly every aspect of our lives. However, for many of us, they have not yet improved the way we receive or participate in our health services and disease care. Hostetter et al. (2014) explore in a new multimedia essay the changes occurring with the arrival of new digital tools, from mobile apps and data-driven software solutions to wearable sensors that transmit information to a patient's team of health care providers. Digitisation will revolutionise health technology to a new extent, as the self-measurement, cloud services, teleconsultation and robotics technologies are being used to get health expenditure under control. In the future, robots will dispense drugs, and treatment routines will utilise cloud services (Biesdorf and Niedermann, 2014; Grain and Sharper, 2013). According to the rationale of the Horizon 2020 (European Commission, 2013b) work programme, personalising health and care has been stated to empower citizens and patients to manage their own health and disease, which can result in more cost-effective healthcare systems by enabling the management of chronic diseases outside institutions, improving health outcomes, and by encouraging healthy citizens to remain so. Solutions should be developed and tested with the use of open innovation platforms, such as large-scale demonstrators for health and service innovation. It is a fact that ICT/new health technology and personal health applications are transforming patients' self-management in many ways. A huge amount of personal health application solutions are being offered in the marketplace, which engage in activities that promote health, monitoring the symptoms and signs of illness, and managing the impact of illness (European Commission eHealth Action Plan 2012-2020, 2012). The WHO (2011) has conducted a comprehensive study and published a report on Member States' use of mHealth (mobile Health) as well as the readiness and barriers to its use. The
Personality profiles in patients with eating disorders.
Tomotake, Masahito; Ohmori, Tetsuro
2002-08-01
The present review focused on the personality profiles of patients with eating disorders. Studies using the Structured Clinical Interview for DSM-III-R Personality Disorder showed high rates of diagnostic co-occurrence between eating disorders and personality disorders. The most commonly observed were histrionic, obsessive-compulsive, avoidant, dependent and borderline personality disorders. Studies using the Cloninger's personality theory suggested that high Harm Avoidance might be relevant to the pathology of anorexia nervosa and high Novelty Seeking and Harm Avoidance to bulimia nervosa. Moreover, high Self-Directedness was suggested to be associated with favorable outcome in bulimia nervosa. The assessment of personality in a cross-sectional study, however, might be influenced by the various states of the illness. Therefore, a sophisticated longitudinal study will be required to advance this area of research.
Quality of life in rheumatological patients: The impact of personality disorders.
Uguz, Faruk; Kucuk, Adem; Cicek, Erdinc; Kayhan, Fatih; Salli, Ali; Guncu, Hatice; Çilli, Ali Savas
2015-01-01
Rheumatological diseases are associated with lower quality of life (QoL) levels. Psychiatric disturbances are frequently observed in these patients. This study examined the impact of personality disorders on the QoL of patients with rheumatological diseases. The study sample consisted of 142 participants including patients suffering from rheumatological disease with a personality disorder (n = 30), without any personality disorder (n = 112), and healthy control participants without physical or psychiatric disorders (n = 60). The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID-I) and the Structured Clinical Interview for DSM, Revised Third Edition Personality Disorders (SCID-II) were used to determine Axis I and Axis II psychiatric disorders, respectively. QoL levels were assessed by means of the World Health Organization QoL Assessment-Brief. The subscale scores of physical health, psychological health, and social relationships were significantly lower in patients with rheumatological disease regardless of the existence of personality disorder compared with the control participants. Rheumatological patients with a personality disorder had significantly lower subscale scores of psychological health (p = 0.003) and social relationships (p personality disorder. Personality disorders seem to be a relevant factor that maybe associated with QoL in patients suffering from rheumatological disease. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
The Features of Female Managers' Personality Traits in Organization
Gabdreeva, Guzel Sh.; Khalfieva, Alisa R.
2016-01-01
The relevance of the "female" management features study is driven by the active penetration of women to management in various fields and the emergence of a new social category "Business-women". The article contains the results of a study aimed to identify the features of personal properties and structure of low-level,…
Personality Disorders in patients with disorders in eating behaviors
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Vanesa Carina Góngora
2016-02-01
Full Text Available The interest for the systematic study of personality disorder in patients with eating disorders starts in 1980 with the edition of the DSM III multiaxial classification system. Since then, several publications have been focused on the prevalence and the effect on treatment of personality disorders in bulimic and anorexic patients. These researches showed inconsistent results due to conceptual and methodological divergences. In this paper, the more relevant findings of these studies are presented and the possible sources of discrepancy are analyzed. In general, there is a moderate comorbidity between personality disorders and eating disorders. The most frequent disorders are borderline, histrionic, obsessive-compulsive, dependent and avoidant personality disorders. Borderline and histrionic personality disorders are more frequently associated with bulimia, whereas avoidant and obsessive- compulsive personality disorders are more characteristic of anorexia nervosa. Nevertheless, the effect of the relationship between eating disorders and personality disorders in treatment remains uncertain, giving raise to several controversies and researches.
2010-07-01
... of a personal financial management instructional course. 58.25 Section 58.25 Judicial Administration... Qualifications for approval as providers of a personal financial management instructional course. (a) Definition... personal financial management instructional course must be in compliance with all applicable laws and...
Reach, Gérard
2016-01-01
Patient education (PE) is expected to help patients with a chronic disease to manage their lives and give them the possibility of adopting, in an appropriate manner, beneficial changes in health behaviors that are prescribed by their physicians. It is aimed at delineating, agreeing on, and implementing a patient's personal action plan and is therefore an essential constituent of the person-centered model of care. The aim of this article is to examine the idea that PE may sometimes be a manipulation that is organized for the good of patients in a paternalistic framework. Theoretically, PE differs from manipulation by addressing the reflective intelligence of patients in full light and helping them make autonomous choices. In this article, we examined some analogies between PE and nudge (ie, techniques used to push people to make good choices by organizing their environment). This analysis suggests that PE is not always as transparent and reflective as it is supposed to be and that unmasking these issues may be useful for improving the ethical quality of educational practice that must be performed in a framework of a trusting patient-doctor relationship. Under this condition, PE may sometimes represent a form of persuasion without being accused of patient deception and manipulation: trust is therefore the core of the person-centered model of care.
Personality traits in aesthetic surgery patients
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S. Visal Buturak
2016-09-01
Full Text Available Purpose: It has been known that psychological factors have an important effect on the decision to undergo aesthetic surgery. In this study, we aimed to test the hypothesis that the personality traits of people admitted for aesthetic surgery differ from those of people who have never planned to undergo aesthetic surgery in their lives. Material and Methods: Forty-seven patients who were referred to the outpatient clinic of the Faculty of Medicine, Department of Plastic, Reconstructive, and Aesthetic Surgery, Kirikkale University to undergo aesthetic surgery were enrolled in the study. Forty-three subjects who neither underwent nor planned to undergo aesthetic surgery at any time in their lives were included in the study as a control group. Psychometric evaluation of the patients and the control group was conducted using the Turkish version of the Minnesota Multiphasic Personality Inventory (MMPI. Results: Taking 65 as a cut-off point, the ratio of patients who scored and #8805;65 on the hysteria subscale of the MMPI was found to be significantly higher in the sugery group than in the control group and the ratio on social introversion subscale was also higher in the patient group than in the control group, very closely approaching significance. Conclusion: It should be kept in mind that people who have personality traits that can be partially improved with psyachiatric treatment, such as social introverted, lonely, timid, shy, and hysterical and feel the need for validation by others, may be more often admitted for aesthetic surgery. [Cukurova Med J 2016; 41(3.000: 554-558
A Review of Organizational Structures of Personal Information Management
Indratmo, J; Vassileva, Julita
2008-01-01
Personal information management (PIM) covers a large area of research fragmented into separate sub-areas such as file management, web bookmark organization, and email management. Consequently, it is hard to obtain a unified view of the various approaches to PIM developed in these different sub-areas. In this article, we synthesize and classify existing research on PIM based on the approach used to organize information items. We classify the organizational structures into five categories: hier...
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Hui Lei
2017-06-01
Full Text Available Objective: To explore the effect of comorbid obsessive-compulsive personality disorder (OCPD on response inhibition functions in patients with obsessive-compulsive disorder (OCD. Methods: Forty-five obsessive-compulsive patients with obsessive-compulsive personality disorder (OCD + OCPD, 42 obsessive-compulsive patients without obsessive-compulsive personality disorder (OCD - OCPD and 54 healthy volunteers were selected for the stop-signal task. Results: Obsessive-compulsive patients with obsessive-compulsive personality disorder had a higher score of depression and anxiety and more severe obsessive-compulsive symptoms than that of obsessive-compulsive patients without obsessive-compulsive personality disorder. The two groups of obsessive-compulsive patients of had a greater stop-signal reaction time (SSRT during the inhibition process than the healthy volunteers of the control group (OCD + OCPD: 221.45 ± 31.78; OCD - OCPD: 218.36 ± 31.78; Controls: 199.29 ± 22.80; p < 0.05. However, no significant difference was found between the two groups of obsessive-compulsive patients. Conclusion: The findings show that the comorbid obsessive-compulsive personality disorder has no effect on response inhibition function of obsessive-compulsive patients.
Managing the difficult penile prosthesis patient.
Trost, Landon W; Baum, Neil; Hellstrom, Wayne J G
2013-04-01
Inflatable penile prostheses (IPPs) are associated with excellent long-term outcomes and patient/partner satisfaction. A small percentage of patients remain dissatisfied, despite acceptable surgical results. This study aims to evaluate factors associated with patient satisfaction and dissatisfaction, define patient characteristics, which may identify elevated risk of postoperative dissatisfaction, and describe management strategies to optimize functional and psychological patient outcomes. A review of urologic and non-urologic cosmetic surgery literature was performed to identify factors associated with patient satisfaction/dissatisfaction. Emphasis was placed on articles defining "high risk" or psychologically challenging patients. Preoperative factors associated with patient satisfaction/dissatisfaction and character traits, which may identify elevated risk of postoperative dissatisfaction or otherwise indicate a psychologically challenging patient. Contemporary patient and partner satisfaction rates following IPP are 92-100% and 91-95%, respectively. Factors associated with satisfaction include decreased preoperative expectations, favorable female partner sexual function, body mass index ≤30, and absence of Peyronie's disease or prior prostatectomy. Determinants of dissatisfaction include perceived/actual loss of penile length, decreased glanular engorgement, altered erectile/ejaculatory sensation, pain, diminished cosmetic outcome, difficulty with device function, partner dissatisfaction and perception of unnatural sensation, complications, and extent of alternative treatments offered. Personality characteristics which may indicate psychologically challenging IPP patients include obsessive/compulsive tendencies, unrealistic expectations, patients undergoing revision surgery, those seeking multiple surgical opinions, feeling of entitlement, patients in denial of their prior erectile/sexual function and current disease status, or those with other psychiatric
Fleming-Castaldy, Rita P
2011-01-01
To examine the relationships between satisfaction with and self-management of personal assistance services (PAS) and the quality of life (QoL) of persons with disabilities. To test the postulate that consumer-directed PAS can fulfil the human need for control and contribute to a satisfactory life. A survey compared the perspectives of persons using consumer-directed PAS versus those using agency-directed. A Personal Data Form obtained demographics and PAS characteristics. The Quality of Life Inventory measured life satisfaction. A PAS questionnaire measured perceptions about the management of, desire for control of, and satisfaction with PAS. Data were analysed using SPSS®- 14. Significant relationships were found between QoL and satisfaction with PAS (p perceived control of PAS and satisfaction with PAS (p satisfaction with their PAS (p satisfaction, and QoL support the value of consumer-directed programmes. Rehabilitation professionals can use this knowledge to develop, implement and research practises that enable self-management.
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Simon eCoulombe
2016-04-01
participants on recovery indicators suggests the relationship between health engagement and recovery is more intricate than anticipated. Practitioners should strive for a holistic understanding of their clients’ self-management strategies and recovery indicators to provide support personalized to their profile. While people presenting risk factors would benefit from person-centered support, societal efforts are needed in the long term to reduce global health inequalities. The integration of constructs from diverse fields (patient-centered care, chronic illness, positive psychology and the use of person-oriented analysis yielded new insights into people’s engagement in their health and well-being.
Physicians' perspectives and practices regarding the fertility management of obese patients.
Harris, Isiah D; Python, Johanne; Roth, Lauren; Alvero, Ruben; Murray, Shona; Schlaff, William D
2011-10-01
To assess the practice patterns and personal beliefs of fertility physicians who care for obese patients seeking assisted reproduction, we conducted a national survey of fertility program directors from both private and academic practices and discovered that although few practices have firm guidelines regarding the management of obese patients, the overwhelming majority of providers believe that body mass index guidelines or cutoffs should exist. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
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Kuhn Ulrike
2012-11-01
Full Text Available Abstract Background In Germany, case management in a palliative care unit was first implemented in 2005 at the Department of Palliative Medicine at the University Hospital Cologne. One of the purposes of this case management is to deal with enquiries from patients and their relatives as well as medical professionals. Using the Case Management Process Model of the Case Management Society of America as a reference, this study analysed (a how this case management was used by different enquiring groups and (b how patients were identified for case management and for palliative care services. The first thousand enquiries were analysed considering patient variables, properties of the enquiring persons and the content of the consultations. Results Most enquiries to the case management were made by telephone. The majority of requests regarded patients with oncological disease (84.3 %. The largest enquiring group was composed of patients and relatives (40.8 %, followed by internal professionals of the hospital (36.1 %. Most of the enquiring persons asked for a patient’s admission to the palliative care ward (46.4 %. The second most frequent request was for consultation and advice (30.9 %, followed by requests for the palliative home care service (13.3 %. Frequent reasons for actual admissions were the need for the treatment of pain, the presence of symptoms and the need for nursing care. More than half of the enquiries concerning admission to the palliative care ward were followed by an admission. Conclusions Case management has been made public among the relevant target groups. Case management as described by the Case Management Process Model helps to identify patients likely to benefit from case management and palliative care services. In addition, with the help of case management palliative patients may be allocated to particular health care services.
Distinction of leukemia patients' and healthy persons' serum using FTIR spectroscopy
Sheng, Daping; Liu, Xingcun; Li, Weizu; Wang, Yuchan; Chen, Xianliang; Wang, Xin
2013-01-01
In this paper, FTIR spectroscopy was applied to compare the serum from leukemia patients with the serum from healthy persons. IR spectra of leukemia patients' serum were similar with IR spectra of healthy persons' serum, and they were all made up of proteins, lipids and nucleic acids, etc. In order to identify leukemia patients' serum and healthy persons' serum, the H1075/H1542, H1045/H1467, H2959/H2931 ratios were measured. The H2959/H2931 ratio had the highest significant difference among these ratios and might be a useful factor for identifying leukemia patients' serum and healthy persons' serum. Furthermore, from curve fitting, the RNA/DNA (A1115/A1028) ratios were observed to be lower in leukemia patients' serum than those in healthy persons' serum. The results indicated FTIR spectroscopic study of serum might be a useful tool in the field of leukemia research and diagnosis.
Personality and workplace impression management: correlates and implications.
Bourdage, Joshua S; Wiltshire, Jocelyn; Lee, Kibeom
2015-03-01
In the present study, we investigated the role of personality in understanding impression management (IM) behaviors. We hypothesized that the HEXACO model of personality could provide an intricate understanding of the dispositional bases of IM behaviors, as well as coworkers' ability to accurately perceive the IM of those they work with. Using 2 samples (N = 176 and N = 366), we found that the common core underlying 5 IM behaviors possesses a strong negative relationship with the personality trait of Honesty-Humility, such that individuals low in this trait were more likely to report using all IM behaviors. Furthermore, we found that the unique variance associated with specific IM behaviors can be understood using other traits included in the HEXACO personality model, including Emotionality, Extraversion, Agreeableness, and Conscientiousness. In a subset of the data (N = 100), we examined self-coworker convergence in IM and personality. We found that while coworkers are adequate at judging traditional personality traits, the self-coworker convergence for all 5 IM behaviors, as well as the personality trait of Honesty-Humility, were not significant. This adds to a growing body of evidence that coworkers may not be good at accurately perceiving IM or Honesty-Humility in the workplace. PsycINFO Database Record (c) 2015 APA, all rights reserved.
Developing the Personal Competence Manager Evaluation Work: ‘EPIQ Business Demonstrator’
Shoikova, Elena; Denishev, Vladislav; Milanov, Radoslav
2008-01-01
Shoikova, E., Denishev, V., & Milanov, R. (2008). Developing the Personal Competence Manager Evaluation Work: ‘EPIQ Business Demonstrator’. In R. Koper, K. Stefanov & D. Dicheva (Eds.), Proceedings of the 5th International TENCompetence Open Workshop "Stimulating Personal Development and Knowledge
Zhao, Yueren
2011-01-01
, which help us along the Trust Path. The more patients and staff trust and understand each other the easier it is to climb up the Initial Treatment Path. We need to build up trustful relations so we can share personal goals and make a proper assessment and diagnosis, and talk about the safety, efficacy, cost and suitability of the initial treatment. Secondly, we need to take a rest and make more plans for the Recovery Path. It is on this path that we decide on comprehensive treatment together. We may be able to improve the patient's cognitive functions by using atypical anti-psychotic agents. We can then give them information, instructions and warnings about medicine usage so the patient is able to understand their condition. It is only after the patient can understand these things fully and act positively that we can start to climb the final path, the Achievement Path. We should review the suitability and efficacy of the treatment again, and it is at this stage that the mountain guide steps back and watches the mountain climber take the final steps towards the mountain peak goal. Lastly, the patient will feel elation and a sense of fulfillment and self-pride, and no doubt will be ready to look for the next mountain peak to climb. In order for you to enjoy the benefits at the clinical scene, all you need is a piece of paper, a pen, and a limitless imagination for better personal goal sharing. At Meisei hospital we promote the 'Minotake Team Approach', which calls for flexible management so we hospital staff can help each other as professionals. We treat patients as individuals using words and expressions they understand (such as local dialect and nonmedical terms), and give them access to easy to understand resources such as leaflets delivered by universities or pharmaceutical companies. We ask our staff to act naturally with the patients, and to just do what they can do to help the patients work towards their personal goals.
Comorbidity of substance dependency in patients with cluster B personality disorders
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Faezeh Tatari
2016-01-01
Full Text Available Background: Personality disorders are considered as a risk factor for the development and intensification of substance dependency. This study was aimed to determine the comorbidity of substance dependency in patients with cluster B personality disorders. Method: This cross-sectional study was performed on 96 patients (71 males and 25 females referring to Farabi Hospital, Kermanshah, Iran .The data were gathered using a questionnaire. Data analysis was performed by SPSS software. Results: Data analysis revealed that borderline personality disorder with one year substance abuse, combination of histrionic, borderline, narcissistic and anti-social disorders with two years of substance abuse, borderline personality disorder or a combination of borderline, histrionic, narcissistic and anti-social disorders with three years of substance abuse and combination of narcissistic, borderline, histrionic and anti-social disorders in patients with more than three years of substance dependency had the highest prevalence. Narcissistic personality disorder in patients with no attempts to quit and combination of histrionic, borderline, narcissistic and anti-social disorders in patients with two or three attempts to quit had the highest prevalence. Conclusion: The results showed a relationship between substance dependency and cluster B personality disorders. Considering the prevalence of personality disorders among drug abusers, psychological and psychiatric interventions along with medication are necessary in substance abuse treatment centers.
Alvarez-Bermejo, J A; Hernández-Capel, D M; Belmonte-Ureña, L J; Roca-Piera, J
2009-01-01
Ensuring the quality of services provided in centres where dependent persons are seen by specialist services, by improving and enhancing how information -salary, control of tasks, patients' records, etc.- is shared between staff and carers. A web information system has been developed and experimentally deployed to accomplish this. The accuracy of the system was evaluated by assessing how confident the employees were with it rather than relying on statistical data. It was experimentally deployed since January 2009 in Asociación de Personas con Discapacidad "El Saliente" that manages several day centres in Almeria, for dependent persons over 65 years old, particularly those affected by Alzheimer' disease. Incidence data was collected during the experimental period. A total of 84% of the employees thought that the system helped to manage documents, administrative duties, etc., and 92.4% said they could attend to really important tasks because the system was responsible for alerting them of every task, such as medication timetables, checking all patients were present (to prevent an Alzheimer affected person leaving the centre) etc. During this period the incidences reported were reduced by about a 30%, although data is still partially representative. As the life expectancy of the population gets longer, these centres will increase. Providing systems such as the one presented here would be of great help for administrative duties (sensitive data protection...) as well as ensuring high quality care and attention.
THE IMPACT OF PERSONALITY AND LEADERSHIP STYLES ON LEADING CHANGE CAPABILITY OF MALAYSIAN MANAGERS
Ali Hussein Alkahtani; Ismael Abu-Jarad; Mohamed Sulaiman; Davoud Nikbin
2011-01-01
This study was conducted to investigate the influence of the Big Five Dimensions of personality of the Malaysian Managers and the leadership styles these managers use on their leading change capabilities. Total sample of 105 managers was used in this study. The results of this study revealed that the Malaysian managers tend to enjoy personalities that are conscious and open to experience. These managers tend to use consultative leadership style. However, they use autocratic, democratic and so...
Altunsoy, Neslihan; Şahiner, Şafak Yalçın; Cingi Külük, Merve; Okay, Tuncer; Ulusoy Kaymak, Semra; Aydemir, Çiğdem; Göka, Erol
2015-09-01
Although substance abuse is an important clinical problem in schizophrenic patients, very little evidence explains why these patients use drugs and alcohol. This study therefore aimed to examine whether premorbid personality disorders affect substance abuse. The sample included 40 male schizophrenic patients with and 40 male schizophrenic patients without substance use disorder comorbidity who had applied to Ankara Numune Research and Training Hospital. Each participant and a family member were interviewed in a structured clinical interview that addressed premorbid personality disorders. Altogether, 32 patients (80%) in the group with comorbidity and 28 (70%) in the group without comorbidity had a premorbid personality disorder. Antisocial (35% vs. 0%; ppersonality disorders were more often detected in the group with comorbidity, while avoidant (10% vs. 35%; p=.014) and obsessive-compulsive (0% vs. 15%; p=.026) personality disorders were less frequently found in this group. Comparing the group with comorbidity with premorbid personality types, schizophrenic patients with premorbid antisocial personality disorder were more frequently unemployed and hospitalized as well as had an earlier onset age of schizophrenia (p=.034, p=.038 and p=.035, respectively). Schizophrenic patients with premorbid borderline personality disorder had a significantly earlier onset age of substance use (19±5; p=.028). Schizophrenic patients with substance use comorbidity variously differ from those without comorbidity and some of these differences may be associated with premorbid personality disorders.
Shame in patients with narcissistic personality disorder.
Ritter, Kathrin; Vater, Aline; Rüsch, Nicolas; Schröder-Abé, Michela; Schütz, Astrid; Fydrich, Thomas; Lammers, Claas-Hinrich; Roepke, Stefan
2014-02-28
Shame has been described as a central emotion in narcissistic personality disorder (NPD). However, there is a dearth of empirical data on shame in NPD. Patients with NPD (N=28), non-clinical controls (N=34) and individuals with borderline personality disorder (BPD, N=31) completed self-report measures of state shame, shame-proneness, and guilt-proneness. Furthermore, the Implicit Association Test (IAT) was included as a measure of implicit shame, assessing implicit shame-self associations relative to anxiety-self associations. Participants with NPD reported higher levels of explicit shame than non-clinical controls, but lower levels than patients with BPD. Levels of guilt-proneness did not differ among the three study groups. The implicit shame-self associations (relative to anxiety-self associations) were significantly stronger among patients with NPD compared to nonclinical controls and BPD patients. Our findings indicate that shame is a prominent feature of NPD. Implications for diagnosis and treatment are discussed. © 2013 Published by Elsevier Ireland Ltd.
Comín, Marina; Redondo, Santiago; Daigre, Constanza; Grau-López, Lara; Casas, Miguel; Roncero, Carlos
2016-12-30
The aim of this study is to compare the features of two groups of cocaine dependent patients in treatment, one of them with co-morbid diagnosis of antisocial personality disorder and the other not. Cross-sectional design, with 143 cocaine-dependent patients attending a drug unit, distributed in two groups: patients with and without Antisocial Personality Disorder. As results, we found that the 15.38% of the sample were diagnosed with an Antisocial Personality Disorder. In relation to socio-demographic variables, Antisocial Personality Disorder patients have less probability of being working or studying (9.1% vs. 47.9%). After multivariate analysis it was found that significantly Antisocial Personality Disorder patients have more opiates dependence (OR: 0.219; 95% IC 0.072-0.660), sedative dependence (OR: 0.203; 95% IC 0.062-0.644) and in more cases show Borderline Personality Disorder (OR: 0.239; 95% IC 0.077-0.746). This study highlights significant differences between cocaine addicts with or without an Antisocial Personality Disorder. All these differences are good indicators of the complexity of the patients with this personality disorder. Better knowledge of their profile will help us to improve the design of specific treatment programs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Jones, Spencer S; Caloyeras, John; Mattke, Soeren
2011-01-01
The passage of the Patient Protection and Affordable Care Act has piqued employers' interest in new benefit designs because it includes numerous provisions that favor cost-reducing strategies, such as workplace wellness programs, value-based insurance design (VBID), and consumer-directed health plans (CDHPs). Consumer-controlled personal health management systems (HMSs) are a class of tools that provide encouragement, data, and decision support to individuals. Their functionalities fall into the following three categories: health information management, promotion of wellness and healthy lifestyles, and decision support. In this study, we review the evidence for many of the possible components of an HMS, including personal health records, web-based health risk assessments, integrated remote monitoring data, personalized health education and messaging, nutrition solutions and physical activity monitoring, diabetes-management solutions, medication reminders, vaccination and preventive-care applications, integrated incentive programs, social-networking tools, comparative data on price and value of providers, telehealth consultations, virtual coaching, and an integrated nurse hotline. The value of the HMS will be borne out as employers begin to adopt and implement these emerging technologies, enabling further assessment as their benefits and costs become better understood.
Patient relationship management: an overview and study of a follow-up system.
Oinas-Kukkonen, Harri; Räisänen, Teppo; Hummastenniemi, Niko
2008-01-01
Customer relationship management research is utilized to explain the need for a more patient-oriented support in patient care. This article presents a European study on how various hospital units of a single healthcare organization have utilized a patient relationship management system--in particular a patient treatment follow-up system--and how it affects patient care and the knowledge work performed by the medical staff. Eight physicians were interviewed at a university hospital on whether patient treatment was improved through a follow-up system that had been in use in the case organization for three years. The interviewees represented various hospital units, and all of them had used the system at their own unit. The results indicate that it is possible to improve patient care through more personalized treatment. The follow-up treatment system seems to be a tool to create and maintain better communication with the patients rather than just a technological solution. It may help better understand and analyze both individual patients and patient groups. For individual physicians it provides a way to reflect professional skills. The system was lacking in its support for one-to-one communication with patients. Nevertheless, the system is an example of patient relationship management which may help healthcare units to move towards a more patient-oriented care.
A Study of Personal Information Management Strategies for Online Faculty
Kearns, Lorna R.; Frey, Barbara A.; Tomer, Christinger; Alman, Susan
2014-01-01
The literature suggests that personal information management is a serious challenge for many computer users. Online faculty are especially challenged because of the large number of electronic files necessitated by teaching online. Those who have experience in this environment may offer valuable insights regarding information management challenges…
Managers' Feedback Seeking Propensities on their Intra- Personal ...
African Journals Online (AJOL)
Based on the idea that feedback seeking enhances job performance, the study was aimed at investigating managers' feedback seeking tendencies on their intra personal, interpersonal and leadership skills, and their preferred feedback sources: subordinates, peers and superiors. Using cross-sectional survey design, 156 ...
Stienen, J.J.C.; Ottevanger, P.B.; Wennekes, L.; Dekker, H.M.; Maazen, R.W.M. van der; Mandigers, C.M.; Krieken, J.H.J.M. van; Blijlevens, N.M.A.; Hermens, R.P.M.G.
2015-01-01
BACKGROUND: An overload of health-related information is available for patients on numerous websites, guidelines, and information leaflets. However, the increasing need for personalized health-related information is currently unmet. OBJECTIVE: This study evaluates an educational e-tool for patients
Enmarker, Ingela; Olsen, Rose; Hellzen, Ove
2011-06-01
Studies indicate that physical and pharmacological restraints are still often in the frontline of aggression management in a large number of nursing homes. In the present literature review the aim was to describe, from a nursing perspective, aggressive and violent behaviour in people with dementia living in nursing home units and to find alternative approaches to the management of dementia related aggression as a substitute to physical and chemical restraints. A systematic literature review in three phases, including a content analysis of 21 articles published between 1999 and August 2009 has been conducted. The results could be summarised in two themes: 'origins that may trigger violence' and 'activities that decrease the amount of violent behaviour'. Together, the themes showed that violence was a phenomenon that could be described as being connected to a premorbid personality and often related to the residents' personal care. It was found that if the origin of violent actions was the residents' pain, it was possible to minimise it through nursing activities. This review also indicated that an organisation in special care units for residents who exhibit aggressive and violent behaviour led to the lesser use of mechanical restraints, but also an increased use of non-mechanical techniques. The optimal management of aggressive and violent actions from residents with dementia living in nursing homes was a person-centred approach to the resident. Qualitative studies focusing on violence were sparsely found, and this underlines the importance of further research in this area to elucidate how violence and aggressiveness is experienced and understood by both staff and patients. To communicate with people with dementia provides a challenge for nurses and other health caregivers. To satisfy the needs of good nursing care, an important aspect is therefore to get knowledge and understanding about aggressive and violent behaviour and its management. © 2010 Blackwell
EMR management system for patient pulse data.
Lee, Junyoung
2012-10-01
The purpose of this study is to build an integrated medical information system for effective database management of clinical information and to improve the existing Electronic Medical Record (EMR)-based system that is currently being used in hospitals. The integrated medical information system of hospitals consists of an Order Communication System (OCS), Picture Archiving Communication System (PACS), and Laboratory Information System (LIS), as well as Electronic Medical Record (EMR). It is designed so that remote health screening and patient data search can be accessed through a high speed network-even in remote areas-in order to effectively manage data on medical treatment that patients received at their respective hospitals. The existing oriental treatment system is one in which the doctor requires the patient to visit the hospital in person, so as to be able to check the patient's pulse and measure it with his hand for proper diagnosis and treatment. However, due to the recent development of digitalized medical measurement equipment, not only can doctors now check a patient's pulse without touching it directly, but the measured data are computerized and stored into the database as the electronic obligation record. Thus, even if a patient cannot visit the hospital, proper medical treatment is available by analyzing the patient's medical history and diagnosis process in the remote area. Furthermore, when a comprehensive medical testing center system including the people medical examination and diverse physical examination is established, the quality of medical service is expected to be improved than now.
The Effect of Stress Management Training on Hope in Hemodialysis Patients.
Poorgholami, Farzad; Abdollahifard, Sareh; Zamani, Marzieh; Kargar Jahromi, Marzieh; Badiyepeyma Jahromi, Zohreh
2015-11-18
Chronic renal failure exposes patients to the risk of several complications, which will affect every aspect of patient's life, and eventually his hope. This study aims to determine the effect of stress management group training on hope in hemodialysis patients. In this quasi-experimental single-blind study, 50 patients with renal failure undergoing hemodialysis at Motahari Hospital in Jahrom were randomly divided into stress management training and control groups. Sampling was purposive, and patients in stress management training group received 60-minute in-person training by the researcher (in groups of 5 to 8 patients) before dialysis, over 5 sessions, lasting 8 weeks, and a researcher-made training booklet was made available to them in the first session. Patients in the control group received routine training given to all patients in hemodialysis department. Patients' hope was recorded before and after intervention. Data collection tools included demographic details form, checklist of problems of hemodialysis patients and Miller hope scale (MHS). Data were analyzed in SPSS-18, using Chi-square, one-way analysis of variance, and paired t-test. Fifty patients were studied in two groups of 25 each. No significant difference was observed between the two groups in terms of age, gender, or hope before intervention. After 8 weeks of training, hope reduced from 95.92±12.63 to 91.16±11.06 (P=0.404) in the control group, and increased from 97.24±11.16 to 170.96±7.99 (P=0.001) in the stress management training group. Significant differences were observed between the two groups in hope scores after the intervention. Stress management training by nurses significantly increased hope in hemodialysis patients. This low cost intervention can be used to improve hope in hemodialysis patients.
Bateman, Anthony; O'Connell, Jennifer; Lorenzini, Nicolas; Gardner, Tessa; Fonagy, Peter
2016-08-30
Antisocial personality disorder (ASPD) is an under-researched mental disorder. Systematic reviews and policy documents identify ASPD as a priority area for further treatment research because of the scarcity of available evidence to guide clinicians and policymakers; no intervention has been established as the treatment of choice for this disorder. Mentalization-based treatment (MBT) is a psychotherapeutic treatment which specifically targets the ability to recognise and understand the mental states of oneself and others, an ability shown to be compromised in people with ASPD. The aim of the study discussed in this paper is to investigate whether MBT can be an effective treatment for alleviating symptoms of ASPD. This paper reports on a sub-sample of patients from a randomised controlled trial of individuals recruited for treatment of suicidality, self-harm, and borderline personality disorder. The study investigates whether outpatients with comorbid borderline personality disorder and ASPD receiving MBT were more likely to show improvements in symptoms related to aggression than those offered a structured protocol of similar intensity but excluding MBT components. The study found benefits from MBT for ASPD-associated behaviours in patients with comorbid BPD and ASPD, including the reduction of anger, hostility, paranoia, and frequency of self-harm and suicide attempts, as well as the improvement of negative mood, general psychiatric symptoms, interpersonal problems, and social adjustment. MBT appears to be a potential treatment of consideration for ASPD in terms of relatively high level of acceptability and promising treatment effects. ISRCTN ISRCTN27660668 , Retrospectively registered 21 October 2008.
Inpatient management of borderline personality disorder at Helen Joseph Hospital, Johannesburg
Directory of Open Access Journals (Sweden)
Laila Paruk
2016-06-01
Full Text Available Objective: The aim of this report was to establish a profile of patients with borderline personality disorder (BPD admitted to the acute inpatient psychiatric assessment unit at the Helen Joseph Hospital, in Johannesburg, over the course of 1 year. Methods: A retrospective record review was conducted to investigate the prevalence, demographics, reasons for admission, treatment, length of stay and follow-up of a group of inpatients during 2010 with a diagnosis of BPD, based on DSM-IV-TR diagnostic criteria, allocated on discharge. Results: Considering evidence retrospectively, the quality of the BPD diagnosis allocated appeared adequate. Statistical analysis revealed findings mainly in keeping with other reports, for example, that patients with BPD are above-average users of resources who make significantly more use of emergency services and that they generally do not adhere well to their scheduled outpatient follow-up arrangements. The longer average length of inpatient stay of this group with BPD, however, exceeded the typically brief period generally recommended for acute inpatient containment and emergency intervention. Conclusion: Implementation of targeted prevention and early intervention strategies, based on systematised programmes such as dialectical behavioural therapy and mentalisation based therapy, may be useful in addressing these problems experienced with integrating the in- and outpatient management of BPD. Keywords: Borderline personality; inpatient; acute
Lamprinos, Ilias; Demski, Hans; Mantwill, Sarah; Kabak, Yildiray; Hildebrand, Claudia; Ploessnig, Manuela
2016-07-01
It is estimated that more than 382 million people suffer from diabetes across the globe, most of which are between the age of 40 and 59 years. ICT can play a key role in better management of diabetes and in patient empowerment. Patient empowerment involves patients to a greater extent in their own healthcare process and disease management becomes an integrated part of their daily life. Self-management opens the possibility for patients to contribute to their own healthcare as well as to be more in control of their disease. The objective of our study was to explore the impact of an ICT-based patient empowerment framework in diabetes self-management. A modular patient empowerment framework that fosters diabetes self-management was designed and implemented. The framework incorporates expert knowledge in the form of clinical guidelines, and it supports patients in the specification of personalized activities that are based on medical recommendations and personal goals, and in the collection of observations of daily living. The usability and usefulness of the proposed framework were assessed in a pilot study with the participation of 60 patients and 12 health professionals. The study revealed that a patient empowerment approach based on self-management ICT tools is useful and accepted by both the patients and the physicians. For those patients who were already disciplined in their disease management the piloted solution served as a facilitator for data logging. For the rest, it served as an incentive for better adherence to disease management principles. The ICT tools prompted many patients into becoming more physically active and into making dietary habits' adjustments. However, this impact proved to be tightly correlated with the sociocultural background of the subjects. The study also demonstrated that even in patient-centric self-management interventions the physicians still have a key role to play. However, the acceptance of such interventions by the healthcare
Reach, Gérard
2016-01-01
Patient education (PE) is expected to help patients with a chronic disease to manage their lives and give them the possibility of adopting, in an appropriate manner, beneficial changes in health behaviors that are prescribed by their physicians. It is aimed at delineating, agreeing on, and implementing a patient’s personal action plan and is therefore an essential constituent of the person-centered model of care. The aim of this article is to examine the idea that PE may sometimes be a manipulation that is organized for the good of patients in a paternalistic framework. Theoretically, PE differs from manipulation by addressing the reflective intelligence of patients in full light and helping them make autonomous choices. In this article, we examined some analogies between PE and nudge (ie, techniques used to push people to make good choices by organizing their environment). This analysis suggests that PE is not always as transparent and reflective as it is supposed to be and that unmasking these issues may be useful for improving the ethical quality of educational practice that must be performed in a framework of a trusting patient–doctor relationship. Under this condition, PE may sometimes represent a form of persuasion without being accused of patient deception and manipulation: trust is therefore the core of the person-centered model of care. PMID:27103791
Relationship between personality and disability in patients with major depressive disorder.
Güleç, Medine Yazici; Hocaoğlu, Ciçek
2011-01-01
The co-morbidity of major depressive disorder (MDD ) with personality disorders (PDs) in patients with long-standing work disability at a psychiatry clinic was investigated. The purpose of our study was to evaluate personality for contributing to disability in patients with MDD and to investigate the relationship with these two psychometric characters in patients with MDD. Seventy-two patients with a MDD and 72 healthy controls were assessed by means of both clinician and self-rating scales for depression, anxiety, disability, and the SCID-II personality inventory. There was no difference between the personality parameters of the groups regarding schizotypal and antisocial PDs. Avoidant personality was found to be less common in the patient group (p=0.030). Dependent (p less than 0.001), obsessive (p=0.003), passive-aggressive (p=0.025), self-defeating (p less than 0.001), paranoid (p less than 0.001), schizoid (p=0.012), histrionic (p=0.001), narcissistic (p less than 0.001), and borderline (p less than 0.001) PDs in patients were more common than in controls. On the disability sub-scales, physical role limitation, vitality, social functioning, emotional role limitation, and mental health were significantly lower in patient group than normal control group. While Cluster A was not related to any disability subscale, Cluster B had a positive correlation with vitality and mental health, whereas Cluster C and Cluster NOS had a negative correlation with emotional role limitation. Only the emotional role limitation predicts the presence of depression, whereas only self-defeating, obsessive, paranoid, and passive aggressive personality predict the emotional role limitation. Patients with MDD have personality and disability problems. PDs in depression contribute to disability. Our results demonstrated that the emotional role limitation is the unique sub-scale that predicts the MDD group.
Eren, Nurhan
2014-12-01
In this study, we aimed to develop two reliable and valid assessment instruments for investigating the level of difficulties mental health workers experience while working with patients with personality disorders and the attitudes they develop tt the patients. The research was carried out based on the general screening model. The study sample consisted of 332 mental health workers in several mental health clinics of Turkey, with a certain amount of experience in working with personality disorders, who were selected with a random assignment method. In order to collect data, the Personal Information Questionnaire, Difficulty of Working with Personality Disorders Scale (PD-DWS), and Attitudes Towards Patients with Personality Disorders Scale (PD-APS), which are being examined for reliability and validity, were applied. To determine construct validity, the Adjective Check List, Maslach Burnout Inventory, and State and Trait Anxiety Inventory were used. Explanatory factor analysis was used for investigating the structural validity, and Cronbach alpha, Spearman-Brown, Guttman Split-Half reliability analyses were utilized to examine the reliability. Also, item reliability and validity computations were carried out by investigating the corrected item-total correlations and discriminative indexes of the items in the scales. For the PD-DWS KMO test, the value was .946; also, a significant difference was found for the Bartlett sphericity test (pKMO, the value was .925; a significant difference was found in Bartlett sphericity test (p<.001); the computed reliability coefficient based on continuity was .806; and the Cronbach alpha value of the total test score was .913. Analyses on both scales were based on total scores. It was found that PD-DWS and PD-APS have good psychometric properties, measuring the structure that is being investigated, are compatible with other scales, have high levels of internal reliability between their items, and are consistent across time. Therefore
Personality characteristics of depressed and non-depressed patients with Parkinson's Disease
DEFF Research Database (Denmark)
Damholdt, Malene Flensborg; Callesen, Mette Buhl; Møller, Arne
2014-01-01
traits as risk factors for depression. The personality profiles of 290 non-depressed and 119 depressed patients with PD were compared. The depressed patients were characterized by elevated neuroticism, reduced extroversion, and reduced conscientiousness and less convincing findings of reduced openness......Depression and a specific personality profile are often outlined as premorbid characteristics of Parkinson's disease (PD). However, few studies have explored possible relations between personality and depression in PD despite research in non-parkinsonian samples identifying specific personality...
[The satisfaction of personal needs in patients with pulmonary tuberculosis].
Sukhova, E V
2005-01-01
The founder of humanistic psychology A. Maslow divided the needs of a personality into several levels--from the lowest to the highest ones. Higher-leveled needs rise when the lower-leveled needs are satisfied. A great deal of factors affect the origination and satisfaction of needs, but they are always interrelated with social values. The extent to which personality needs are satisfied in patients with pulmonary tuberculosis has not been studied. A special questionnaire has been drawn up to study the extent to which personality needs are met. Its suitability has been determined, by using a group of patients with bronchial asthma. The extent to which personality needs are satisfied in patients with pulmonary tuberculosis was studied in 178 patients with infiltrative pulmonary tuberculosis and 253 patients with fibrocavernous pulmonary tuberculosis. The results have shown that the extent to which personality needs are satisfied in patients with tuberculosis is lower than that in apparently healthy individuals of the same social status. In females with infiltrative pulmonary tuberculosis, the needs for safety are satisfied to a lesser extent. In those with fibrocavernous pulmonary tuberculosis, the extent to which the physiological, safety, and self-realization needs is decreased. In males with infiltrative pulmonary tuberculosis, the physiological, noetic, and self-realization needs are satisfied to a lesser extent. In those with fibrocavernous pulmonary tuberculosis, the extent to which the physiological, safety, group decision-making, noetic and self-realization needs is decreased.
Spencer, Sarah-Jane; Rutter, Deborah; Tyrer, Peter
2010-01-01
Nidotherapy is a new treatment aimed at the systematic alteration of the environment in order to make a better fit for a person with chronic mental health difficulties. Preliminary work has suggested that it might have particular value in those with antisocial personality disorder. To examine the views of patients with mental illness combined with antisocial personality features about the acceptability and value of nidotherapy when given over a six-month period as an adjunct to conventional care. A two-phase study was used. First, a set of key informant interviews was carried out to determine how nidotherapy was perceived in order to identify potentially important themes. Specific topic guides derived from these themes were drawn up for use in the second stage of the study, involving semi-structured interviews with a sample of patients, members of their care teams and their nidotherapists. Nine patients were purposively selected to ensure that a range of demographic and clinical factors was covered. Analysis of the results showed that the common threads of the perception of nidotherapy were that it was both feasible and acceptable to those with antisocial personality disturbance and that the nidotherapists were felt to be valuable allies in what was otherwise seen as a hostile world. It was also seen to improve adherence to other therapies. It was much less valuable when the staff on the clinical teams were not able to embrace the collaborative approach necessary with this therapy. Nidotherapy is an acceptable form of management and was perceived in this study to have largely positive results for both patients and clinical teams as it offered intervention beyond that provided by conventional teams. It was felt to require more than six months of treatment and was less successful when there was inadequate communication between the nidotherapist and clinical teams and when the philosophy of care was not congruent.
Berlin, Heather A; Rolls, Edmund T
2004-08-01
To investigate how time perception may contribute to the symptoms of self-harming Borderline Personality Disorder (BPD) patients, 19 self-harming BPD inpatients and 39 normal controls were given measures of time perception, impulsivity, personality, emotion, and BPD characteristics. A test sensitive to orbitofrontal cortex (OFC) function ("Frontal" Behavior Questionnaire) was also administered, as the OFC has been associated with impulsivity and time perception. BPD patients produced less time than controls, and this correlated with impulsiveness and other characteristics commonly associated with BPD. BPD patients were also less conscientious, extraverted, and open to experience, as well as more impulsive (self-report and behaviorally), emotional, neurotic, and reported more BPD characteristics, compared to controls. The results suggest that some of these core characteristics of BPD may be on a continuum with the normal population and, impulsivity in particular, may be related to time perception deficits (i.e., a faster subjective sense of time). Finally, BPD patients scored higher on the Frontal Behavior Questionnaire, suggesting that some symptoms of the BPD syndrome may be related to problems associated with the OFC. A control spatial working memory task (SWM) revealed that SWM deficits could not explain any of the BPD patients' poor performance. While impulsivity was correlated with time perception across all participants, emotionality, introversion, and lack of openness to experience were not. This suggests that different symptoms of the borderline personality syndrome may be separable, and therefore, related to different cognitive deficits, and potentially to different brain systems. This may have important implications for treatment strategies for BPD.
Sexual dysfunction, mood, anxiety, and personality disorders in female patients with fibromyalgia.
Kayhan, Fatih; Küçük, Adem; Satan, Yılmaz; İlgün, Erdem; Arslan, Şevket; İlik, Faik
2016-01-01
We aimed to investigate the current prevalence of sexual dysfunction (SD), mood, anxiety, and personality disorders in female patients with fibromyalgia (FM). This case-control study involved 96 patients with FM and 94 healthy women. The SD diagnosis was based on a psychiatric interview in accordance with the Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria. Mood and anxiety disorders were diagnosed using the Structured Clinical Interview. Personality disorders were diagnosed according to the Structured Clinical Interview for DSM, Revised Third Edition Personality Disorders. Fifty of the 96 patients (52.1%) suffered from SD. The most common SD was lack of sexual desire (n=36, 37.5%) and arousal disorder (n=10, 10.4%). Of the 96 patients, 45 (46.9%) had a mood or anxiety disorder and 13 (13.5%) had a personality disorder. The most common mood, anxiety, and personality disorders were major depression (26%), generalized anxiety disorder (8.3%), and histrionic personality disorder (10.4%). SD, mood, and anxiety disorders are frequently observed in female patients with FM. Pain plays a greater role in the development of SD in female patients with FM.
Bolster, Danielle; Manias, Elizabeth
2010-02-01
individualised patient assessment and management. These interactions were based on nurses' perceptions of what was important for the patient and did not provide opportunities for patient participation. Two main contextual barriers in relation to a person-centred approach to medication activities were identified as multidisciplinary communication and time constraints. While some nurse-patient interactions during medication activities were consistent with the principles of person-centred care, the study results highlighted factors that influence the nature of these interactions, and identified opportunities to improve nursing practice. To ensure person-centred care is applied to medication activities, nurses should undertake ongoing assessment of patients' needs in relation to their medications and encourage opportunities for increased patient participation. Crown Copyright 2009. Published by Elsevier Ltd. All rights reserved.
The personal receiving document management and the realization of email function in OAS
Li, Biqing; Li, Zhao
2017-05-01
This software is an independent software system, suitable for small and medium enterprises, contains personal office, scientific research project management and system management functions, independently run in relevant environment, and to solve practical needs. This software is an independent software system, using the current popular B/S (browser/server) structure and ASP.NET technology development, using the Windows 7 operating system, Microsoft SQL Server2005 Visual2008 and database as a development platform, suitable for small and medium enterprises, contains personal office, scientific research project management and system management functions, independently run in relevant environment, and to solve practical needs.
Alexander, Carla S; Pappas, Gregory; Henley, Yvonne; Kangalawe, Angela Kaiza; Oyebola, Folaju Olusegun; Obiefune, Michael; Nwene, Ejike; Stanis-Ezeobi, Winifred; Enejoh, Victor; Nwizu, Chidi; Nwandu, Anthea Nwandu; Memiah, Peter; Etienne-Mesubi, Martine; Oni, Babatunji; Amoroso, Anthony; Redfield, Robert R
2015-08-01
Pain management (PM) has not been routinely incorporated into HIV/AIDS care and treatment in resource-constrained settings. We describe training for multidisciplinary teams tasked with integrating care management into HIV clinics to address pain for persons living with HIV in Nigeria. Education on PM was provided to mixed-disciplinary teams including didactic and iterative sessions following home and hospital visits. Participants identified challenges and performed group problem solving. HIV trainers identified barriers to introducing PM reflecting views of the patient, providers, culture, and the health environment. Implementation strategies included (1) building upon existing relationships; (2) preliminary advocacy; (3) attention to staff needs; and (4) structured data review. Implementing PM in Nigerian HIV clinics requires recognition of cultural beliefs. © The Author(s) 2014.
Comparison of personality beliefs between depressed patients and healthy controls.
Yucens, Bengu; Kuru, Erkan; Safak, Yasir; Karadere, Mehmet Emrah; Turkcapar, Mehmet Hakan
2014-11-01
According to the cognitive model, the common mechanism underlying all psychological disorders is distorted or dysfunctional thoughts that affect mood and behaviors. Dysfunctional thoughts predispose an individual to depression and are among the processes that form the basis of personality traits. Elucidating the personality beliefs associated with depression and dysfunctional thoughts is important to understanding and treating depression. The aim of the present study is to determine whether depressed patients exhibited pathological personality beliefs compared with healthy controls. Furthermore, we investigated which personality beliefs were more common among such depressed patients. A total of 70 patients who were admitted to the Department of Psychiatry at Ankara Diskapi Yildirim Beyazit Training and Research Hospital (Ankara, Turkey) and diagnosed with major depressive disorder according to The Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) diagnostic criteria were included in the study. Additionally, 70 healthy controls matched for age, marital status, and education were included in the study. The Sociodemographic Data Form and Personality Belief Questionnaire-Short form (PBQ-SF) were administered to the participants. A comparison of the depression group with the healthy controls revealed higher scores in dependent, passive-aggressive, obsessive-compulsive, antisocial, histrionic, paranoid, borderline, and avoidant personality subscales in the depressive group. These results suggest that personality beliefs at the pathological level are more common in depressive patients and that the detection of these beliefs would be useful for predicting the prognosis of the disease and determining appropriate treatment methods. Copyright © 2014 Elsevier Inc. All rights reserved.
Personality traits and psychotic symptoms in recent onset of psychosis patients.
Sevilla-Llewellyn-Jones, Julia; Cano-Domínguez, Pablo; de-Luis-Matilla, Antonia; Peñuelas-Calvo, Inmaculada; Espina-Eizaguirre, Alberto; Moreno-Kustner, Berta; Ochoa, Susana
2017-04-01
Personality in patients with psychosis, and particularly its relation to psychotic symptoms in recent onset of psychosis (ROP) patients, is understudied. The aims of this research were to study the relation between dimensional and categorical clinical personality traits and symptoms, as well as the effects that symptoms, sex and age have on clinically significant personality traits. Data for these analyses were obtained from 94 ROP patients. The Millon Clinical Multiaxial Inventory and the Positive and Negative Syndrome Scale were used to assess personality and symptoms. Correlational Analysis, Mann-Whitney test, and, finally, logistic regression were carried out. The negative dimension was higher in patients with schizoid traits. The excited dimension was lower for those with avoidant and depressive traits. The anxiety and depression dimension was higher for patients with dependent traits. The positive dimension was lower for patients with histrionic and higher for patients with compulsive traits. Logistic regression demonstrated that gender and the positive and negative dimensions explained 35.9% of the variance of the schizoid trait. The excited dimension explained 9.1% of the variance of avoidant trait. The anxiety and depression dimension and age explained 31.3% of the dependent trait. Gender explained 11.6% of the histrionic trait, 14.5% of the narcissistic trait and 11.6% of the paranoid trait. Finally gender and positive dimension explained 16.1% of the compulsive trait. The study highlights the importance of studying personality in patients with psychosis as it broadens understating of the patients themselves and the symptoms suffered. Copyright © 2017 Elsevier Inc. All rights reserved.
Itasaka, H; Matsumata, T; Taketomi, A; Yamamoto, K; Yanaga, K; Takenaka, K; Akazawa, K; Sugimachi, K
1994-12-01
A simple outpatient follow-up system was developed with a laptop personal computer to assist management of patients with hepatocellular carcinoma after hepatic resections. Since it is based on a non-relational database program and the graphical user interface of Macintosh operating system, those who are not a specialist of the computer operation can use it. It is helpful to promptly recognize current status and problems of the patients, to diagnose recurrences of the disease and to prevent lost from follow-up cases. A portability of the computer also facilitates utilization of these data everywhere, such as in clinical conferences and laboratories.
Janiszewski, Debra; O'Brian, Catherine A; Lipman, Ruth D
2015-08-01
The purpose of this study is to gain insight about patient experience of diabetes self-management education in a patient-centered medical home. Six focus groups consisting of 37 people with diabetes, diverse in race and ethnicity, were conducted at 3 sites. Participants described their experience in the program and their challenges in diabetes self-management; they also suggested services to meet their diabetes care needs. The most common theme was ongoing concerns about care and support. There was much discussion about the value of the support provided by health navigators integrated in the diabetes health care team. Frequent concerns expressed by participants centered on personal challenges in engaging in healthy lifestyle behaviors. Ongoing programmatic support of self-management goals was widely valued. Individuals who received health care in a patient-centered medical home and could participate in diabetes self-management education with integrated support valued both activities. The qualitative results from this study suggest need for more formalized exploration of effective means to meet the ongoing support needs of people with diabetes. © 2015 The Author(s).
Assessment of Personality Types and Locus of Control in Multiple Sclerosis Patients
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Sh. Mazaheri
2008-07-01
Full Text Available Introduction & Objective: Multiple sclerosis (MS is an autoimmune disease with unknown cause. MS is one of the disabling neurologic diseases in adult especially young range that myelin part of central nervous system (CNS is destructed. The aim of this study was assessment of types A and B personality and internal and external locus of control in multiple sclerosis (MS patients and comparison of the results with control group.Materials & Methods: In a case-control study, 30 patients with MS and 30 normal persons as control group evaluated with neurological examination, Rotter locus of control test and Friedman-Rosenman questionnaire for detection of types A and B personality. We employed to analyze the results.Results: 43 percent and 57 percent of MS patients had internal and external locus of control respectively. 63 percent and 37 percent of MS patients had type A and B personality respectively. 60 percent and 40 percent of control group had internal and external locus of control respectively. 20 percent and 80 percent of control group had type A and B personality respectively. Difference between personality type in two groups was significant (P<0.01.Conclusions: In this study, MS patients had more type A personality in comparison to control group.
Cook, David J; Moradkhani, Anilga; Douglas, Kristin S Vickers; Prinsen, Sharon K; Fischer, Erin N; Schroeder, Darrell R
2014-04-01
The objective of this investigation was to assess whether a new electronic health (e-health) platform, combining mobile computing and a content management system, could effectively deliver modular and "just-in-time" education to older patients following cardiac surgery. Patients were provided with iPad(®) (Apple(®), Cupertino, CA) tablets that delivered educational modules as part of a daily "to do" list in a plan of care. The tablet communicated wirelessly to a dashboard where data were aggregated and displayed for providers. A surgical population of 149 patients with a mean age of 68 years utilized 5,267 of 6,295 (84%) of education modules delivered over a 5.3-day hospitalization. Increased age was not associated with decreased use. We demonstrate that age, hospitalization, and major surgery are not significant barriers to effective patient education if content is highly consumable and relevant to patients' daily care experience. We also show that mobile technology, even if unfamiliar to many older patients, makes this possible. The combination of mobile computing with a content management system allows for dynamic, modular, personalized, and "just-in-time" education in a highly consumable format. This approach presents a means by which patients may become informed participants in new healthcare models.
Carroll, A E; Saluja, S; Tarczy-Hornoch, P
2001-01-01
Personal Digital Assistants (PDAs) offer clinicians the ability to enter and manage critical information at the point of care. Although PDAs have always been designed to be intuitive and easy to use, recent advances in technology have made them even more accessible. The ability to link data on a PDA (client) to a central database (server) allows for near-unlimited potential in developing point of care applications and systems for patient data management. Although many stand-alone systems exist for PDAs, none are designed to work in an integrated client/server environment. This paper describes the design, software and hardware selection, and preliminary testing of a PDA based patient data and charting system for use in the University of Washington Neonatal Intensive Care Unit (NICU). This system will be the subject of a subsequent study to determine its impact on patient outcomes and clinician efficiency.
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Reach G
2016-04-01
Full Text Available Gérard Reach1,2 1Department of Endocrinology, Diabetes and Metabolic Diseases, Avicenne Hospital AP-HP, 2EA 3412, Centre de Recherche en Nutrition Humaine Ile-de-France (CRNH-IDF, Paris 13 University, Sorbonne Paris Cité, Bobigny, France Abstract: Patient education (PE is expected to help patients with a chronic disease to manage their lives and give them the possibility of adopting, in an appropriate manner, beneficial changes in health behaviors that are prescribed by their physicians. It is aimed at delineating, agreeing on, and implementing a patient’s personal action plan and is therefore an essential constituent of the person-centered model of care. The aim of this article is to examine the idea that PE may sometimes be a manipulation that is organized for the good of patients in a paternalistic framework. Theoretically, PE differs from manipulation by addressing the reflective intelligence of patients in full light and helping them make autonomous choices. In this article, we examined some analogies between PE and nudge (ie, techniques used to push people to make good choices by organizing their environment. This analysis suggests that PE is not always as transparent and reflective as it is supposed to be and that unmasking these issues may be useful for improving the ethical quality of educational practice that must be performed in a framework of a trusting patient–doctor relationship. Under this condition, PE may sometimes represent a form of persuasion without being accused of patient deception and manipulation: trust is therefore the core of the person-centered model of care. Keywords: patient education, adherence, autonomy, nudge, persuasion, manipulation, deception, trust, person-centered care model, shared decision-making
Huygens, Martine W J; Vermeulen, Joan; Swinkels, Ilse C S; Friele, Roland D; van Schayck, Onno C P; de Witte, Luc P
2016-07-08
Self-management is considered as an essential component of chronic care by primary care professionals. eHealth is expected to play an important role in supporting patients in their self-management. For effective implementation of eHealth it is important to investigate patients' expectations and needs regarding self-management and eHealth. The objectives of this study are to investigate expectations and needs of people with a chronic condition regarding self-management and eHealth for self-management purposes, their willingness to use eHealth, and possible differences between patient groups regarding these topics. Five focus groups with people with diabetes (n = 14), COPD (n = 9), and a cardiovascular condition (n = 7) were conducted in this qualitative research. Separate focus groups were organized based on patients' chronic condition. The following themes were discussed: 1) the impact of the chronic disease on patients' daily life; 2) their opinions and needs regarding self-management; and 3) their expectations and needs regarding, and willingness to use, eHealth for self-management purposes. A conventional content analysis approach was used for coding. Patient groups seem to differ in expectations and needs regarding self-management and eHealth for self-management purposes. People with diabetes reported most needs and benefits regarding self-management and were most willing to use eHealth, followed by the COPD group. People with a cardiovascular condition mentioned having fewer needs for self-management support, because their disease had little impact on their life. In all patient groups it was reported that the patient, not the care professional, should choose whether or not to use eHealth. Moreover, participants reported that eHealth should not replace, but complement personal care. Many participants reported expecting feelings of anxiety by doing measurement themselves and uncertainty about follow-up of deviant data of measurements. In addition
Quantifying the role of personal management style in the success of investment portfolios
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E.A. Wagenaar
2014-01-01
Full Text Available It is extremely difficult to quantify the effect of different management styles of portfolio managers upon the success of their portfolios. Various mathematical models in the literature attempt to predict the risk and returns of portfolios according to changes in the economic arena, but these models usually do not take into account the personal styles of portfolio managers. The aim of this paper is a modest attempt at quantifying the effect of different managerial styles upon decisions regarding portfolios. This is accomplished by the formulation of a mathematical performance index that portrays the influence of a portfolio manager's personal and managerial characteristics on the success of his portfolio.
Veiga-Branco, Augusta; Correia, Ana Almeida
2011-01-01
Managing Emotions as an Emotional Intelligence capacity (Mayer-Salovey, 1997) has presented a significant correlation with Emotional Competence (r=.679; α=.68) and (r=.69.5; α=.80) (Veiga-Branco, 2004; 2007) in previous quantitative studies. This study contribute to explain how Managing of Negative Emotions occurs, but, only caused by personal decisions. Aim: To acknowledge the causes and consequences of Negative Emotions Management when triggered by personal decisions. M...
Tawara, Satoru; Yonemochi, Yasuhiro; Kosaka, Takayuki; Kouzaki, Yanosuke; Takita, Tomohiro; Tsuruta, Toshihisa
2013-01-01
To explore the opinions of outpatients concerning a new communication method: the self-management of assessed personal problems in health information records (SAPPHIRE) using patients' mobile phones to store and share medical content (medical SAPPHIRE, or m-SAPPHIRE). A cross-sectional questionnaire survey. Patients Outpatients who visited us from March 1 to May 30, 2012, were asked to complete a questionnaire survey regarding SAPPHIRE and m-SAPPHIRE. The m-SAPPHIRE data consisted of a problem list, height, weight, waist size and active medication list. Ten questions were asked regarding the usefulness of m-SAPPHIRE, the sharing of m-SAPPHIRE and the use of mobile phones to store m-SAPPHIRE data. One hundred and ninety-three patients (male/female, 79/114; mean age, 57±21 years) were registered: 95.9% answered that m-SAPPHIRE would be useful, 98% agreed to manage their personal health records by themselves, and 95.8%, 93.8%, and 92.8% of the patients responded that they would allow m-SAPPHIRE information to be shared with family members, medical workers, and health care providers, respectively. Of the patients, 75.1% responded that they owned a mobile phone, and 43.5% answered that they could enter m-SAPPHIRE information into a mobile phone by themselves, while 27.5% responded that they could do so with someone's help. Patients believe that m-SAPPHIRE would be useful for retrieving their health records during emergency situations or for sharing with family members and medical and health care providers. SAPPHIRE using mobile phones could be an inexpensive and legal method for sharing medical data.
Topp, Marie; Vestbo, Jørgen; Mortensen, Erik Lykke
2016-12-01
Previous research has shown that personality traits are associated with self-reported health status in the general population. COPD Assessment Test (CAT) is increasingly used to assess health status such as the impact of chronic obstructive pulmonary disease (COPD) on patients' daily life, but knowledge about the influence of personality traits on CAT score is lacking. The aim of this study was to examine the influence of Big Five personality traits on CAT score and the relation between personality traits and mental symptoms with respect to their influence on CAT score. A sample of 168 patients diagnosed with COPD was consecutively recruited in a secondary care outpatient clinic. All participants completed CAT, NEO Five-Factor Inventory, and Hospital Depression and Anxiety Scale. Multiple linear regression analysis was used to explore the association between personality traits and CAT scores and how this association was influenced by mental symptoms. The personality traits neuroticism, agreeableness and conscientiousness; and the mental symptoms depression and anxiety showed significant influence on CAT score when analysed in separate regression models. Identical R-square (R = 0.24) was found for personality traits and mental symptoms, but combining personality traits and mental symptoms in one regression model showed substantially reduced effect estimates of neuroticism, conscientiousness and anxiety, reflecting the strong correlations between personality traits and mental symptoms. We found that the impact of COPD on daily life measured by CAT was related to personality and mental symptoms, which illustrates the necessity of taking individual differences in personality and mental status into account in the management of COPD.
Amini, Mehdi; Pourshahbaz, Abbas; Mohammadkhani, Parvaneh; Khodaie Ardakani, Mohammad Reza; Lotfi, Mozhgan
2015-01-01
Background: Fundamental problems with Personality Disorders (PD) diagnostic system in the previous version of DSM, led to the revision of DSM. Therefore, a multidimensional system has been proposed for diagnosis of personality disorder features in DSM-5. In the dimensional approach of DSM-5, personality disorders diagnosis is based on levels of personality functioning (Criteria A) and personality trait domains (Criteria B). Objectives: The purpose of this study was firstly, to examine the DSM-5 levels of personality functioning in antisocial and borderline personality disorders, and second, to explore which levels of personality functioning in patients with antisocial and borderline personality disorders can better predicted severity than others. Patients and Methods: This study had a cross sectional design. The participants consisted of 252 individuals with antisocial (n = 122) and borderline personality disorders (n = 130). They were recruited from Tehran prisoners, and clinical psychology and psychiatry centers of Razi and Taleghani Hospitals, Tehran, Iran. The sample was selected based on judgmental sampling. The SCID-II-PQ, SCID-II and DSM-5 levels of personality functioning were used to diagnose and assess personality disorders. The data were analyzed by correlation and multiple regression analysis. All statistical analyses were performed using the SPSS 16 software. Results: Firstly, it was found that DSM-5 levels of personality functioning have a strong correlation with antisocial and borderline personality symptoms, specially intimacy and self-directedness (P antisocial personality disorder severity (P personality disorder severity, as well (P personality functioning are a significant predictor of personality disorders severity. The results partially confirm existing studies. PMID:26430521
Controlled sharing of personal content using digital rights management
Conrado, C.; Petkovic, M.; Veen, van der M.; Velde, van der W.H.
2006-01-01
This paper describes a system which allows controlled distribution of personal digital content by users. The system extends an existing Digital Rights Management system for the protection of commercial copyrighted content by essentially allowing users to become content providers. This fact, however,
Employability attributes and personality preferences of postgraduate business management students
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Ingrid Potgieter
2013-05-01
Research purpose: The purpose of the study was to determine the relationship between employees’ employability attributes (as the Employability Attributes Scale measures them and their personality preferences (as the Myers-Briggs Type indicator, Form M, measures them. Motivation for the study: There seems to be a paucity of information about how employees’ personality preferences relate to their employability attributes in South Africa’s multicultural organisational context. Research design, approach and method: The authors conducted a quantitative survey. It involved a non-probability sample of 304 early career adults enrolled for an Honour’s degree in business management in an open distance learning higher education institution. They used correlational statistics and multiple regression analyses to analyse the data. Main findings: The authors observed a number of significant relationships between the participants’ personality preferences and their employability attributes. Practical/managerial implications: Career counsellors and human resource practitioners need to recognise how employees’ personality preferences influence their employability attributes in the management of their career development and employability. Contribution/value add: The findings add to the existing career literature on the career metacompetencies that influence employees’ employability. They also provide valuable information that organisations can use for career development support and counselling practices in the contemporary world of work.
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He Wei
2011-07-01
Full Text Available Abstract Background Hypnotic susceptibility is one of the stable characteristics of individuals, but not closely related to the personality traits such as those measured by the five-factor model in the general population. Whether it is related to the personality disorder functioning styles remains unanswered. Methods In 77 patients with personality disorders and 154 healthy volunteers, we administered the Stanford Hypnotic Susceptibility Scale: Form C (SHSSC and the Parker Personality Measure (PERM tests. Results Patients with personality disorders showed higher passing rates on SHSSC Dream and Posthypnotic Amnesia items. No significant correlation was found in healthy volunteers. In the patients however, SHSSC Taste hallucination (β = 0.26 and Anosmia to Ammonia (β = -0.23 were significantly correlated with the PERM Borderline style; SHSSC Posthypnotic Amnesia was correlated with the PERM Schizoid style (β = 0.25 but negatively the PERM Narcissistic style (β = -0.23. Conclusions Our results provide limited evidence that could help to understand the abnormal cognitions in personality disorders, such as their hallucination and memory distortions.
Personality traits in patients with Parkinson's disease: assessment and clinical implications.
Poletti, Michele; Bonuccelli, Ubaldo
2012-06-01
This study reviews empirical evidence on the association between personality traits and Parkinson's disease (PD), with a twofold aim. First, to better identify non-motor symptoms, such as affective symptoms and personality changes, that could help to define the pre-motor phase of PD; second, to better understand the neurobiological bases of personality traits, a goal that is not fully accomplished by a purely anatomical approach. A literature review was performed on studies of personality traits in PD patients, in electronic databases ISI Web of Knowledge, Medline and PsychInfo, conducted in July 2011. We found evidence that the existence of a characteristic premorbid personality profile of PD patients is not actually sustained by robust empirical evidence, mainly due to the methodological bias of the retrospective assessment of personality; PD patients present a personality profile of low novelty seeking and high harm avoidance. We concluded that the definition of a pre-motor phase of PD, based on non-motor symptoms, should search for the presence of concomitant affective disorders and for a positive psychiatric history for affective disorders rather than for a typical personality profile or personality changes. The low novelty seeking profile is probably related to the dopaminergic deficit, while the high harm avoidance profile is probably associated with the presence of affective disorders. Clinical implications of these findings, in regard to personality assessment and pharmacological treatments in PD, are also discussed.
Kwan, Bethany M; Jortberg, Bonnie; Warman, Meredith K; Kane, Ilima; Wearner, Robyn; Koren, Romona; Carrigan, Thomas; Martinez, Vincent; Nease, Donald E
2017-06-01
Self-management support (SMS) for patients with diabetes can improve adherence to treatment, mitigate disease-related distress, and improve health outcomes. Translating this evidence into real-world practice is needed, as it is not clear which SMS models are acceptable to patients, and feasible and sustainable for primary care practices. To use the Boot Camp Translation (BCT) method to engage patient, practice, community resource and research stakeholders in translation of evidence about SMS and diabetes distress into mutually acceptable care models and to inform patient-centred outcomes research (PCOR). Twenty-seven diabetes care stakeholders, including patients and providers from a local network of federally qualified health centres participated. Stakeholders met in-person and by conference call over the course of 8 months. Subject matter experts provided education on the diabetes SMS evidence. Facilitators engaged the group in discussions about barriers to self-management and opportunities for improving delivery of SMS. BCT participants identified lack of social support, personal resources, trust, knowledge and confidence as barriers to diabetes self-management. Intervention opportunities emphasized peer support, use of multidisciplinary care teams and centralized systems for sharing information about community and practice resources. BCT informed new services and a PCOR study proposal. Patients and family engaged in diabetes care research value peer support, group visits, and multidisciplinary care teams as key features of SMS models. SMS should be tailored to an individual patient's health literacy. BCT can be used to engage multiple stakeholders in translation of evidence into practice and to inform PCOR. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Improved weight management using genetic information to personalize a calorie controlled diet
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Florou Anna
2007-10-01
Full Text Available Abstract Background Gene-environment studies demonstrate variability in nutrient requirements depending upon individual variations in genes affecting nutrient metabolism and transport. This study investigated whether the inclusion of genetic information to personalize a patient's diet (nutrigenetics could improve long term weight management. Methods Patients with a history of failures at weight loss were offered a nutrigenetic test screening 24 variants in 19 genes involved in metabolism. 50 patients were in the nutrigenetic group and 43 patients attending the same clinic were selected for comparison using algorithms to match the characteristics: age, sex, frequency of clinical visits and BMI at initial clinic visit. The second group of 43 patients did not receive a nutrigenetic test. BMI reduction at 100 and > 300 days and blood fasting glucose were measured. Results After 300 days of follow-up individuals in the nutrigenetic group were more likely to have maintained some weight loss (73% than those in the comparison group (32%, resulting in an age and gender adjusted OR of 5.74 (95% CI 1.74–22.52. Average BMI reduction in the nutrigenetic group was 1.93 kg/m2(5.6% loss vs. an average BMI gain of 0.51 kg/m2(2.2% gain (p 100 mg/dL, 57% (17/30 of the nutrigenetic group but only 25% (4/16 of the non-tested group had levels reduced to 90 days of weight management therapy (OR for lowering glucose to Conclusion Addition of nutrigenetically tailored diets resulted in better compliance, longer-term BMI reduction and improvements in blood glucose levels.
Martino, Francesca; Lia, Loredana; Bortolotti, Biancamaria; Menchetti, Marco; Monari, Marco; Ridolfi, Maria Elena; Sanza, Michele; Sasdelli, Anna; Berardi, Domenico
2014-01-01
The scientific literature focused on factors involved in the onset of borderline personality disorder (BPD) has given a central role to the families of these patients. The role of the family in understanding the disorder has gradually changed thanks to research that investigated the interaction of several factors in the development of this psychopathology. Recently, scientific literature on DBP has allowed to consider parents as no longer "responsible" for the development of the disorder, but as directly involved in interpersonal problems of patients and therefore a potential "ally" in the management of crisis. The aim of this study is to describe and quantify the family burden of BPD patients and browse specific interventions for the family of these patients. PubMed and PsycINFO have been used for review with the following keywords: "borderline personality disorder", "family", "psychopathology", "burden", "psychoeducation", "caregiver", "caretaker". Studies on family burden of BPD patients are still few. Research shows that the family burden of BPD patients is comparable with that of families of patients with schizophrenia. Clinical trials of interventions for caregivers of patients with BPD show that specific strategies can reduce the family burden and improve their self-efficacy. Scientific literature highlights the relevance of problems of families with a BPD member and the importance of involving them in the treatment of these patients.
Role of Personality Functioning in the Quality of Life of Patients with Depression.
Crempien, Carla; Grez, Marcela; Valdés, Camila; López, María José; de la Parra, Guillermo; Krause, Mariane
2017-09-01
Depression is associated with reduced quality of life (QoL), and personality pathology is associated with higher impairment and poorer treatment outcomes in patients with depression. This study aims to analyze the effects of personality functioning on the QoL of patients with depression. Severity of depressive symptoms (Beck Depression Inventory), level of personality functioning (Operationalized Psychodynamic Diagnosis Structure Questionnaire), and QoL (Medical Outcome Study 36-item Short-Form) were assessed in a sample of 84 depressive outpatients. Personality functioning showed main effects on both the mental and physical components of QoL. A moderating effect of personality functioning on the relationship between depressive symptoms and QoL was tested but not confirmed. Severity of depressive symptoms was found to mediate the effect of personality functioning on the mental component of QoL. These results suggest that the effect of personality functioning on the QoL of patients with depression may be related to the higher severity of depressive symptoms found in patients with lower levels of personality functioning.
Research of personal features of patients with rosacea
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Davydova A.V.
2014-09-01
Full Text Available Aim: to study the personal characteristics of patients with different subtypes of rosacea and the establishment of the relationship with the clinical manifestations of dermatosis. Materials and methods. Through questionnaires of dermato-logical quality of life, SKINDEKS-29, The Zung Self-Rating Anxiety Scale, The Hamilton Anxiety Rating Scale, Toronto Alexithymia Scale and the method of «Type of attitude to the disease» interviewed 42 patients with different subtypes of rosacea. The data obtained were processed statistically. Results. Rosacea reduces the quality of life of patients, increases the subjective assessment of anxiety scales Zung and Hamilton with a predominance of performance anxiety in the mind. Diagnosed with intermediate degree of alexithymia and anosognosic, ergopathic, anxious and the sensitive types of attitude towards the disease. Conclusions. Predisposition, as well as the development of anxiety disorders, impaired social adjustment, reduced quality of life of patients with rosacea emphasizes the need to implement their algorithm survey assessment of personal characteristics.
Personalized Information Management by Online Stores in 4C Model. Case Study
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Kubicka Anna
2016-01-01
Full Text Available The increasing complexity of the business environment, growing knowledge requirements, development of information technologies, and competitiveness implies the need of implementation of information management systems. Moreover, welter of information about online customers, their individual behavior, and their expectations force entrepreneurs to manage information in a personalized way. Monitoring Internet users behavior, creating their profiles (based on data about age, sex, lifestyle, interests, family, work, etc., and controlling current traffic on the Web site give wide range of possibilities in creating a real model of potential customers preference and using it in online communication. This study concentrates on possibilities of using personalized communication in the information management by online stores in 4C model.
Patient credentialing as a population health management strategy: a diabetes case study.
Watson, Lindsay L; Bluml, Benjamin M; Skoufalos, Alexandria
2015-06-01
When given the opportunity to become actively involved in the decision-making process, patients can positively impact their health outcomes. Understanding how to empower patients to become informed consumers of health care services is an important strategy for addressing disparities and variability in care. Patient credentialing identifies people who have a certain diagnosis and have achieved certain levels of competency in understanding and managing their disease. Patient credentialing was developed to meet 3 core purposes: (1) enhance patient engagement by increasing personal accountability for health outcomes, (2) create a mass customization strategy for providers to deliver high-quality, patient-centered collaborative care, and (3) provide payers with a foundation for properly aligning health benefit incentives. The Patient Self-Management Credential for Diabetes, a first-of-its-kind, psychometrically validated tool, has been deployed within 3 practice-based research initiatives as a component of innovative diabetes care. Results from these projects show improved clinical outcomes, reduced health care costs, and a relationship between credential achievement levels and clinical markers of diabetes. Implementing patient credentialing as part of collaborative care delivered within various settings across the health care system may be an effective way to reduce disparities, improve access to care and appropriate treatments, incentivize patient engagement in managing their health, and expend time and resources in a customized way to meet individual needs.
Personality assessment of patients with complex regional pain syndrome type I.
Monti, D A; Herring, C L; Schwartzman, R J; Marchese, M
1998-12-01
There is controversy regarding the importance of psychological/psychiatric factors in the development of the Complex Regional Pain Syndrome (CRPS). Our objective was to determine whether CRPS type I patients were psychiatrically different from other chronic pain patients, with particular attention to personality pathology. A standardized clinical assessment of all major psychiatric categories, including personality disorders, was performed on 25 CRPS type I patients and a control group of 25 patients with chronic low back pain from disc-related radiculopathy. Both sections of the Structured Clinical Interview for the Diagnostic and Statistical Manual (3rd ed., rev.) and the visual analog scale. Both groups were similar in terms of pain intensity and duration. Statistical analysis showed both groups to have a significant amount of major psychiatric comorbidity, in particular major depressive disorder, and a high incidence of personality disorders. Therefore, intense chronic pain was associated with significant psychiatric comorbidity in both groups and in similar proportions. The high incidence of personality pathology in both groups may represent an exaggeration of maladaptive personality traits and coping styles as a result of a chronic, intense, state of pain.
Comorbid personality disorders and violent behavior in psychotic patients.
Volavka, Jan
2014-03-01
Schizophrenia without any comorbidity confers a modest, but statistically significant elevation of the risk for violence. That risk is considerably increased by comorbid antisocial personality disorder or psychopathy as well as by comorbid substance use disorders. These comorbidities are frequent. Conduct disorder and conduct disorder symptoms elevate the risk for aggressive behavior in patients with schizophrenia. Violence among adults with schizophrenia may follow at least two distinct pathways-one associated with premorbid conditions, including antisocial conduct, and another associated with the acute psychopathology of schizophrenia. Aggressive behavior in bipolar disorder occurs mainly during manic episodes, but it remains elevated in euthymic patients in comparison with controls. The risk of violent behavior is increased by comorbidity with borderline personality disorder, antisocial personality disorder, and substance use disorders. These comorbidities are frequent. Borderline personality disorder and bipolar disorder are related in their phenomenology and response to medication. These two disorders share a tendency to impulsiveness, and impulsive behavior, including impulsive aggression, is particularly expressed when they co-occur.
Improving Self-Care of Patients with Chronic Disease using Online Personal Health Record
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Amol Wagholikar
2012-09-01
Full Text Available Background Effective management of chronic diseases such as prostate cancer is important. Research suggests a tendency to use self-care treatment options such as over-the-counter (OTC complementary medications among prostate cancer patients. The current trend in patient-driven recording of health data in an online Personal Health Record (PHR presents an opportunity to develop new data-driven approaches for improving prostate cancer patient care. However, the ability of current online solutions to share patients’ data for better decision support is limited. An informatics approach may improve online sharing of self-care interventions among these patients. It can also provide better evidence to support decisions made during their self-managed care.Aims To identify requirements for an online system and describe a new case-based reasoning (CBR method for improving self-care of advanced prostate cancer patients in an online PHR environment. Method A non-identifying online survey was conducted to understand self-care patterns among prostate cancer patients and to identify requirements for an online information system. The pilot study was carried out between August 2010 and December 2010. A case-base of 52 patients was developed. Results The data analysis showed self-care patterns among the prostate cancer patients. Selenium (55% was the common complementary supplement used by the patients. Paracetamol (about 45% was the commonly used OTC by the patients. Conclusion The results of this study specified requirements for an online case-based reasoning information system. The outcomes of this study are being incorporated in design of the proposed Artificial Intelligence (AI driven patient journey browser system. A basic version of the proposed system is currently being considered for implementation.
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Setareh Jani
2016-12-01
Full Text Available Introduction: Given the disruptive effects of personality disorders on personal and family life, it is essential to recognize their predisposing factors to understand them more accurately, and identify their preventive measures treatment facilitators. Therefore, the present study aimed to examine the relationship of severe personality disorders with behavioral activation and inhibition systems in patients with paranoid, borderline and schizotypal personality disorders. Methods: The present descriptive-correlational study recruited patients with paranoid, borderline and schizotypal personality disorders presenting to psychiatry clinics in Ardabil using convenient sampling method. A total of 30 paranoid patients, 30 borderline patients and 20 schizotypal patients were selected by a psychiatrist through psychiatric examination, clinical interview and completing Millon Clinical Multiaxial Inventory (MCMI-III. The following instruments were used: MCMI- III and behavioral activation-inhibition system scale (BIS-BAS. The data were analyzed with Pearson’s correlation coefficient and stepwise regression. Results: BIS and BAS systems were both significant for predicting borderline and paranoid personality disorders, but only BIS was significant for predicting schizotypal personality disorder. Conclusion: These findings can help experts to have a better and more accurate understanding of personality disorders and use proper methods to predict the probability of these disorders and develop treatments.
Masupe, T K; Ndayi, K; Tsolekile, L; Delobelle, P; Puoane, T
2018-02-01
The colliding epidemics of non-communicable diseases including diabetes with chronic infectious diseases in Sub-Saharan Africa requires contextualized innovative disease management strategies. This qualitative study conducted in a peri-urban township near Cape Town, South Africa aimed to identify and gain in-depth understanding of contextual and environmental issues pertinent to the patient that could influence Type 2-diabetes mellitus (T2DM) care and self-management. Participants included purposively sampled diabetics or pre-diabetics from the community, PURE study database, facility health club and health care providers. Data collection employed in-depth interviews, focus group discussions (FGDs) using structured interviews and FGD topic guides. Thematic data analysis was done to identify recurrent themes. Themes identified: knowledge and awareness about T2DM; health-seeking behaviour; weight perceptions; healthy lifestyles; self-management; health education needs and health care provider experiences. Patients defined T2DM as a physically and emotionally dangerous disease caused by socio-cultural factors, influenced by the sufferers' food and socio-cultural environment with significance placed on physical, social and emotional effects of T2DM diagnosis. Patient-centred definition of T2DM is key to enhancing T2DM self-management. Patients suggested that personally rewarding benefits of physical activity and healthy diet such as anti-ageing, brain boosting, energy boosting which are commonly harnessed by food, tobacco and beauty industry should be considered in T2DM self-management strategies.
The impact of quality management on patient satisfaction in a hospital: brief report
Directory of Open Access Journals (Sweden)
Ali Mohammad Mosadeghrad
2017-06-01
Full Text Available Background: Patient satisfaction is an important indicator of healthcare quality and effectiveness. Quality management as an organizational strategy enhances the quality of hospital services through continuously improving hospital structures and processes. This study aimed to examine the impact of quality management on patient satisfaction. Methods: A participatory action research was conducted in respiratory intensive care unit, at Labafinejad hospital, Tehran, Iran, in 2013. A quality improvement team was established. Operational processes were improved using a quality management model. The quality improvement team standardized processes, identified quality goals for the processes and improved them until achieved quality goals. Patients’ satisfaction data was collected before and after the intervention using a valid and reliable questionnaire. Results: Patients’ satisfaction was 75 percent at the beginning of the study. Patients were mostly dissatisfied with the nutrition services, amenities, lack of attention to their personal needs and lack of involving them in their treatment processes. An action plan was developed for improving patient satisfaction. After the quality management intervention, patient satisfaction reached to 81 percent at the end of this study. The quality management model improved the quality of services by 54.5 percent and consequently increased patient satisfaction by 7.2 percent. Almost half of the patients at the beginning of this study were definitely willing to recommend the hospital to their friends and relatives. This figure increased to 76 percent. The rest of patients stated that they may recommend the hospital to others. Conclusion: Implementing an appropriate quality management model appropriately in a supportive environment helps improve the quality of services and enhance patient satisfaction and loyalty.
Zhu, Wei; Luo, Lingyun; Jain, Tarun; Boxer, Rebecca S; Cui, Licong; Zhang, Guo-Qiang
2016-01-01
Heart disease is the leading cause of death in the United States. Heart failure disease management can improve health outcomes for elderly community dwelling patients with heart failure. This paper describes DCDS, a real-time data capture and personalized decision support system for a Randomized Controlled Trial Investigating the Effect of a Heart Failure Disease Management Program (HF-DMP) in Skilled Nursing Facilities (SNF). SNF is a study funded by the NIH National Heart, Lung, and Blood Institute (NHLBI). The HF-DMP involves proactive weekly monitoring, evaluation, and management, following National HF Guidelines. DCDS collects a wide variety of data including 7 elements considered standard of care for patients with heart failure: documentation of left ventricular function, tracking of weight and symptoms, medication titration, discharge instructions, 7 day follow up appointment post SNF discharge and patient education. We present the design and implementation of DCDS and describe our preliminary testing results.
Band, Rebecca; Bradbury, Katherine; Morton, Katherine; May, Carl; Michie, Susan; Mair, Frances S; Murray, Elizabeth; McManus, Richard J; Little, Paul; Yardley, Lucy
2017-02-23
This paper describes the intervention planning process for the Home and Online Management and Evaluation of Blood Pressure (HOME BP), a digital intervention to promote hypertension self-management. It illustrates how a Person-Based Approach can be integrated with theory- and evidence-based approaches. The Person-Based Approach to intervention development emphasises the use of qualitative research to ensure that the intervention is acceptable, persuasive, engaging and easy to implement. Our intervention planning process comprised two parallel, integrated work streams, which combined theory-, evidence- and person-based elements. The first work stream involved collating evidence from a mixed methods feasibility study, a systematic review and a synthesis of qualitative research. This evidence was analysed to identify likely barriers and facilitators to uptake and implementation as well as design features that should be incorporated in the HOME BP intervention. The second work stream used three complementary approaches to theoretical modelling: developing brief guiding principles for intervention design, causal modelling to map behaviour change techniques in the intervention onto the Behaviour Change Wheel and Normalisation Process Theory frameworks, and developing a logic model. The different elements of our integrated approach to intervention planning yielded important, complementary insights into how to design the intervention to maximise acceptability and ease of implementation by both patients and health professionals. From the primary and secondary evidence, we identified key barriers to overcome (such as patient and health professional concerns about side effects of escalating medication) and effective intervention ingredients (such as providing in-person support for making healthy behaviour changes). Our guiding principles highlighted unique design features that could address these issues (such as online reassurance and procedures for managing concerns). Causal
Liberato, D; Granato, S; Grimaldi, D; Rossi, F M; Tahani, N; Gianfrilli, D; Anzuini, A; Lenzi, A; Cavaggioni, G; Radicioni, A F
2017-11-01
Klinefelter's syndrome (KS) is associated with specific neurobehavioral features and personality traits. The aim of our study was to investigate fluid intelligence, personality traits and personality disorders (PD) and possible correlations with testosterone in a cohort of adult KS patients. We analyzed 58 adult KS patients with the classic 47, XXY karyotype. The Structured Clinical Interview for axis II disorders was used to assess DSM IV personality disorders. Personality traits were assessed using MMPI-2. Fluid intelligence was tested by using Raven's Standard Progressive Matrices (SPM) Test. Testosterone blood concentration was measured by CMIA. PD prevalence was 31%. Four altered MMPI scales (Social Responsibility, Dominance, Ego Strength and Repression) were found in more than 40% of patients. Overcontrolled hostility and MacAndrew Alcoholism Scale-Revised scales were altered in the PD- group only. Biz-Odd Thinking and Post-Traumatic Stress Disorder scale were associated with the presence of personality disorder. The raw SPM score was 44 ± 10.8 without any significant correlation with testosterone. No significant difference in mean age, SPM raw score and MMPI score was observed between eugonadal, hypogonadal and treated patients. Most KS patients had average fluid intelligence. PD prevalence was higher than in the general population. Testosterone was not correlated with fluid intelligence, personality traits or PD, but a reduction in marital distress was observed in treated patients. This could suggest that testosterone therapy can improve physical symptoms and this effect could also improve relationship abilities and wellness awareness.
Personal Information Management for Nurses Returning to School.
Bowman, Katherine
2015-12-01
Registered nurses with a diploma or an associate's degree are encouraged to return to school to earn a Bachelor of Science in Nursing degree. Until they return to school, many RNs have little need to regularly write, store, and retrieve work-related papers, but they are expected to complete the majority of assignments using a computer when in the student role. Personal information management (PIM) is a system of organizing and managing electronic information that will reduce computer clutter, while enhancing time use, task management, and productivity. This article introduces three PIM strategies for managing school work. Nesting is the creation of a system of folders to form a hierarchy for storing and retrieving electronic documents. Each folder, subfolder, and document must be given a meaningful unique name. Numbering is used to create different versions of the same paper, while preserving the original document. Copyright 2015, SLACK Incorporated.
41 CFR 102-36.45 - What are our responsibilities in the management of excess personal property?
2010-07-01
... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What are our responsibilities in the management of excess personal property? 102-36.45 Section 102-36.45 Public Contracts and... § 102-36.45 What are our responsibilities in the management of excess personal property? (a) Agency...
41 CFR 105-64.104 - What must the system manager tell me when soliciting personal information?
2010-07-01
... manager tell me when soliciting personal information? 105-64.104 Section 105-64.104 Public Contracts and... Responsibilities § 105-64.104 What must the system manager tell me when soliciting personal information? When soliciting information from you or a third party for a system of records, system managers must: Cite the...
Therapeutic Touch in the Management of Responsive Behavior in Patients With Dementia.
Kumarappah, Ananthavalli; Senderovich, Helen
2016-01-01
Patients with dementia experience various behavioral symptoms in the course of their illnesses, which greatly affect their quality of life. Current treatment modalities are not always effective, and, thus, nonpharmacological approaches are the preferred first-line therapy for managing such symptoms. They generally address the basic needs of the person with dementia and provide humane care, often producing noticeable improvements in symptoms. Thus, such therapies should precede pharmacological interventions. The following literature review of 5 publications from 2010 to 2015 evaluates the use of therapeutic touch (TT) in the management of responsive behavior in patients with dementia. The results of the review suggest that TT may be beneficial in reducing agitation in individuals with dementia; however, further research is needed to assess the use of TT.
Distinctive personality profiles of fibromyalgia and chronic fatigue syndrome patients
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Jacob N. Ablin
2016-09-01
Full Text Available Objective The current study is an innovative exploratory investigation, aiming at identifying differences in personality profiles within Fibromyalgia Syndrome (FMS and Chronic Fatigue Syndrome (CFS patients. Method In total, 344 participants (309 female, 35 male reported suffering from FMS and/or CFS and consented to participate in the study. Participants were recruited at an Israeli FM/CFS patient meeting held in May 2013, and through an announcement posted on several social networks. Participants were asked to complete a research questionnaire, which included FMS criteria and severity scales, and measures of personality, emotional functioning, positivity, social support and subjective assessment of general health. In total, 204 participants completed the research questionnaire (40.7% attrition rate. Results A cluster analysis produced two distinct clusters, which differed significantly on psychological variables, but did not differ on demographic variables or illness severity. As compared to cluster number 2 (N = 107, participants classified into cluster number 1 (N = 97 showed a less adaptive pattern, with higher levels of Harm Avoidance and Alexithymia; higher prevalence of Type D personality; and lower levels of Persistence (PS, Reward dependence (RD, Cooperation, Self-directedness (SD, social support and positivity. Conclusion The significant pattern of results indicates at least two distinct personality profiles of FM and CFS patients. Findings from this research may help improve the evaluation and treatment of FM and CFS patients, based on each patient’s unique needs, psychological resources and weaknesses, as proposed by the current trend of personalized medicine.
Temperament and personality in bipolar I patients with and without mixed episodes.
Röttig, Dörthe; Röttig, Stephan; Brieger, Peter; Marneros, Andreas
2007-12-01
Personality and temperament are supposed to have an impact on the clinical expression and course of an affective disorder. There is some indication, that mixed episodes result from an admixture of inverse temperamental factors to a manic syndrome. In a preliminary report [Brieger, P., Roettig, S., Ehrt, U., Wenzel, A., Bloink, R., Marneros, A., 2003. TEMPS-a scale in 'mixed' and 'pure' manic episodes: new data and methodological considerations on the relevance of joint anxious-depressive temperament traits. J. Affect. Disord. 73, 99-104] we reported support for this assumption. The present study completes the preliminary results and compares patients with and without mixed episodes with respect to personality and personality disorders in addition. Patients who had been hospitalized for bipolar I disorder were reassessed after 4.8 years. We examined temperament (TEMPS-A), personality (NEO-FFI) and frequency of personality disorders (SCID-II). Furthermore, illness-related parameters like age at first treatment, depressive and manic symptomatology, frequency and type of episodes and level of functioning were obtained and patients with and without mixed episodes were compared. Patients with (n=49) and without mixed episodes (n=86) did not differ significantly with regard to the illness-related parameters and personality dimensions. The frequency of personality disorders was significantly higher in patients with prior mixed episodes. With respect to temperament, scores of the depressive, cyclothymic, irritable and anxious temperament were significantly higher in patients with mixed episodes. We were not able to assess premorbid temperament and premorbid personality. The findings of the present study support the assumption of Akiskal [Akiskal, H.S., 1992b. The distinctive mixed states of bipolar I, II, and III. Clin. Neuropharmacol. 15 Suppl 1 Pt A, 632-633.] that mixed episodes are more frequent in subjects with inverse temperament.
Franklin, Marika; Lewis, Sophie; Willis, Karen; Rogers, Anne; Venville, Annie; Smith, Lorraine
2018-06-01
A person-centered approach to goal-setting, involving collaboration between patients and health professionals, is advocated in policy to support self-management. However, this is difficult to achieve in practice, reducing the potential effectiveness of self-management support. Drawing on observations of consultations between patients and health professionals, we examined how goal-setting is shaped in patient-provider interactions. Analysis revealed three distinct interactional styles. In controlled interactions, health professionals determine patients' goals based on biomedical reference points and present these goals as something patients should do. In constrained interactions, patients are invited to present goals, yet health professionals' language and questions orientate goals toward biomedical issues. In flexible interactions, patients and professionals both contribute to goal-setting, as health professionals use less directive language, create openings, and allow patients to decide on their goals. Findings suggest that interactional style of health professionals could be the focus of interventions when aiming to increase the effectiveness of goal-setting.
Garcia, Gladys M; Snyder, Margie E; McGrath, Stephanie Harriman; Smith, Randall B; McGivney, Melissa Somma
2009-01-01
To identify effective strategies for marketing pharmacist-provided medication therapy management (MTM) services to patients in a self-insured employer setting. Qualitative study. University of Pittsburgh during March through May 2008. 26 university employees taking at least one chronic medication. Three focus group sessions were conducted using a semistructured topic guide to facilitate the discussion. Employees' perceived medication-related needs, perceived benefits of pharmacist-provided MTM, potential barriers for employee participation in MTM, and effective strategies for marketing MTM. Participants reported concerns with timing of doses, medication costs, access, and ensuring adherence. Participants generally felt positively toward pharmacists; however, the level of reported patient contact with pharmacists varied among participants. Some participants questioned pharmacists' education and qualifications for this enhanced role in patient care. Perceived benefits of MTM noted by participants included the opportunity to obtain personalized information about their medications and the potential for improved communication among their health providers. Barriers to patient participation were out-of-pocket costs and lack of time for MTM visits. Participants suggested use of alternative words to describe MTM and marketing approaches that involve personal contact. Pharmacists should emphasize parts of MTM that patients feel are most beneficial (i.e., provision of a personal medication record) and use patient-friendly language to describe MTM when marketing their practice. Patients will need greater exposure to the concept of MTM and the pharmacists' role in order to correctly describe and assign value to this type of pharmacist patient care practice.
Directory of Open Access Journals (Sweden)
David Reeves
Full Text Available Evidence for the effectiveness of patient education programmes in changing individual self-management behaviour is equivocal. More distal elements of personal social relationships and the availability of social capital at the community level may be key to the mobilisation of resources needed for long-term condition self-management to be effective.To determine how the social networks of people with long-term conditions (diabetes and heart disease are associated with health-related outcomes and changes in outcomes over time.Patients with chronic heart disease (CHD or diabetes (n = 300 randomly selected from the disease registers of 19 GP practices in the North West of England. Data on personal social networks collected using a postal questionnaire, alongside face-to-face interviewing. Follow-up at 12 months via postal questionnaire using a self-report grid for network members identified at baseline.Multiple regression analysis of relationships between health status, self-management and health-economics outcomes, and characteristics of patients' social networks.Findings indicated that: (1 social involvement with a wider variety of people and groups supports personal self-management and physical and mental well-being; (2 support work undertaken by personal networks expands in accordance with health needs helping people to cope with their condition; (3 network support substitutes for formal care and can produce substantial saving in traditional health service utilisation costs. Health service costs were significantly (p<0.01 reduced for patients receiving greater levels of illness work through their networks.Support for self-management which achieves desirable policy outcomes should be construed less as an individualised set of actions and behaviour and more as a social network phenomenon. This study shows the need for a greater focus on harnessing and sustaining the capacity of networks and the importance of social involvement with community
Vater, Aline; Schröder-Abé, Michela; Ritter, Kathrin; Renneberg, Babette; Schulze, Lars; Bosson, Jennifer K; Roepke, Stefan
2013-01-01
The Narcissistic Personality Inventory (NPI) has dominated research on narcissism in the field of social and personality psychology. Surprisingly, it is unclear whether the NPI is useful for identifying pathological narcissism in patients with Narcissistic Personality Disorder (NPD). The goal of this study was to close this research gap. We used an extreme-group approach by including NPD patients and healthy controls and comparing their narcissism scores. We further investigated whether explicit self-esteem (assessed with the Rosenberg Self-Esteem Scale) suppressed the relationship between group membership and NPI narcissism. According to our results, NPD patients do not score higher on the NPI in comparison to healthy controls. Analysis of indirect effects revealed that differences in NPI scores are suppressed by NPD patients' low self-esteem. Our results indicate that the NPI is not a valid indicator of NPD, unless one controls for self-esteem. Implications for future research are discussed.
Directory of Open Access Journals (Sweden)
Joko Gunawan
2016-10-01
Full Text Available Dear Editor, “Complex role in complex times” that is what nurse managers have as the one on the most key roles in the hospital.1 They are not just about managing staff schedules, but also need to have a vision and able to inspire them.2 Thus, competent nurse managers are needed. Research suggests that employees and employers are looking for similar characteristics or personality traits in their leaders. Personality trait refers to the dimensions of individual differences in tendencies to show consistent patterns of thoughts, feelings and actions.3 Personality trait seems able to explain why a person acts the way he/she does when in a leadership position. Research aggregated the results of 222 correlations contained in 73 studies of personality and leadership performance by involving 25,000 managers from every level in organizations across every industry sector.4 There were four of the five dimensions of the big five personality were significantly correlated with leadership emergence and effectiveness with adjustment / emotional stability as the best predictor, and agreeableness as the weakest predictor.4 Scholars who believe in data, these findings definitively indicate that personality predicts leadership behaviors across all organizational levels and industry sectors, and does so more powerfully than any known alternative.5 Personality traits relate to leader behaviors to a greater extent and less ambiguously than earlier reviews had suggested.6 However, although there are clear evidences in examining the relationship between personality and leadership or managerial behavior, it is also important that there are cons about the degree to which personality is related to managerial or leadership behavior Literature indicates that personality traits cannot be concluded to determine leadership with some considerations: (1 it is impossible to find one specific personality trait that characterizes leaders and (2 it is impossible to isolate a
Thorpe, Karran; Loo, Robert
2003-09-01
The objectives of this research were to explore and describe emerging new roles of First-Line Nurse Managers (F-LNMs i.e. individuals who oversee the daily operations of nursing units, regardless of their titles) in one Canadian province, identify their requisite knowledge, skills, competencies, and determine the training and development needs of these managers. F-LNMs, recognized as key players in health care systems, face major challenges (e.g. continuing organizational change, lack of resources) daily. These challenges affect their ability to achieve quality work experiences for their staff members and quality of nursing care for their patients and for themselves. The research design entails a triangulation of investigators (nursing and management), methods (interviews and a Delphi Study), samples (interviews with 26 F-LNMs and a Delphi Study with 62 panelists), and data (qualitative and quantitative). Institutions were randomly selected and then F-LNMs were randomly selected to participate in personal interviews and the remaining F-LNMs, along with nominated senior administrators, were invited to participate in the Delphi Study. Key findings relate to role changes (e.g. job enlargement and emphasis on efficiency), challenges (e.g. staffing and retention, frustrations), and recommendations for administrators (e.g. provide resources, training and development) and educators (e.g. link education to organizational needs). Ultimately, organizational changes and challenges affect how F-LNMs perceive their future professional (e.g. providing quality of patient care) and personal (e.g. high quality of life) satisfaction levels. This research suggests that the role of F-LNMs continues to evolve, consistent with the changing health care system. F-LNMs face challenges that compromise performance of their functions as they believe their work should be completed. To enhance satisfaction in their roles, F-LNMs express a desire for balance in their professional and personal
Mamykina, Lena; Heitkemper, Elizabeth M; Smaldone, Arlene M; Kukafka, Rita; Cole-Lewis, Heather J; Davidson, Patricia G; Mynatt, Elizabeth D; Cassells, Andrea; Tobin, Jonathan N; Hripcsak, George
2017-12-01
To outline new design directions for informatics solutions that facilitate personal discovery with self-monitoring data. We investigate this question in the context of chronic disease self-management with the focus on type 2 diabetes. We conducted an observational qualitative study of discovery with personal data among adults attending a diabetes self-management education (DSME) program that utilized a discovery-based curriculum. The study included observations of class sessions, and interviews and focus groups with the educator and attendees of the program (n = 14). The main discovery in diabetes self-management evolved around discovering patterns of association between characteristics of individuals' activities and changes in their blood glucose levels that the participants referred to as "cause and effect". This discovery empowered individuals to actively engage in self-management and provided a desired flexibility in selection of personalized self-management strategies. We show that discovery of cause and effect involves four essential phases: (1) feature selection, (2) hypothesis generation, (3) feature evaluation, and (4) goal specification. Further, we identify opportunities to support discovery at each stage with informatics and data visualization solutions by providing assistance with: (1) active manipulation of collected data (e.g., grouping, filtering and side-by-side inspection), (2) hypotheses formulation (e.g., using natural language statements or constructing visual queries), (3) inference evaluation (e.g., through aggregation and visual comparison, and statistical analysis of associations), and (4) translation of discoveries into actionable goals (e.g., tailored selection from computable knowledge sources of effective diabetes self-management behaviors). The study suggests that discovery of cause and effect in diabetes can be a powerful approach to helping individuals to improve their self-management strategies, and that self-monitoring data can
Primary Patient-Derived Cancer Cells and Their Potential for Personalized Cancer Patient Care
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David P. Kodack
2017-12-01
Full Text Available Personalized cancer therapy is based on a patient’s tumor lineage, histopathology, expression analyses, and/or tumor DNA or RNA analysis. Here, we aim to develop an in vitro functional assay of a patient’s living cancer cells that could complement these approaches. We present methods for developing cell cultures from tumor biopsies and identify the types of samples and culture conditions associated with higher efficiency of model establishment. Toward the application of patient-derived cell cultures for personalized care, we established an immunofluorescence-based functional assay that quantifies cancer cell responses to targeted therapy in mixed cell cultures. Assaying patient-derived lung cancer cultures with this method showed promise in modeling patient response for diagnostic use. This platform should allow for the development of co-clinical trial studies to prospectively test the value of drug profiling on tumor-biopsy-derived cultures to direct patient care.
The impact of personality on adult patients' adjustability to orthodontic appliances.
Cooper-Kazaz, Rena; Ivgi, Inbal; Canetti, Laura; Bachar, Eytan; Tsur, Boaz; Chaushu, Stella; Shalish, Miriam
2013-01-01
To evaluate the impact of psychological traits on patients' choice of orthodontic appliances and their adjustability to orthodontic treatment. The sample consisted of 68 adult patients divided into three groups (28 buccal, 19 lingual, and 21 clear aligners). Prior to treatment participants filled out the Brief Symptom Inventory to assess symptoms of mental distress and the Narcissistic Vulnerability Scale to assess narcissistic personality traits. During the first week after appliance delivery and on day 14, patients completed a Health-Related Quality of Life questionnaire to assess their perception of pain and four areas of dysfunction. The correlation between personality traits and patients' reaction to treatment was evaluated. Somatization was the only trait that affected the choice of lingual and clear aligner appliance. Reduced self-esteem regulation was associated with increased pain in all patients, while exploitation was associated with pain in lingual patients. Narcissistic vulnerability slightly influenced patients' adaptability to orthodontic appliances. Although adjustability to lingual appliances was the most difficult, only two parameters were affected by personality features. In the buccal group, adjustability was affected by numerous parameters. Adaptation to the clear aligner appliance was relatively uneventful and least affected by psychological features. Anxious individuals tend to prefer lingual and clear aligner appliances. The selection of lingual and clear aligner appliances governs the patient's response and recovery process, leaving little room for the effect of psychological features. On the other hand, the buccal appliance allows for greater impact of personality traits on adjustability.
Predictors of comorbid personality disorders in patients with panic disorder with agoraphobia.
Latas, M; Starcevic, V; Trajkovic, G; Bogojevic, G
2000-01-01
The aim of this study was to ascertain predictors of comorbid personality disorders in patients with panic disorder with agoraphobia (PDAG). Sixty consecutive outpatients with PDAG were administered the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) for the purpose of diagnosing personality disorders. Logistic regressions were used to identify predictors of any comorbid personality disorder, any DSM-IV cluster A, cluster B, and cluster C personality disorder. Independent variables in these regressions were gender, age, duration of panic disorder (PD), severity of PDAG, and scores on self-report instruments that assess the patient's perception of their parents, childhood separation anxiety, and traumatic experiences. High levels of parental protection on the Parental Bonding Instrument (PBI), indicating a perception of the parents as overprotective and controlling, emerged as the only statistically significant predictor of any comorbid personality disorder. This finding was attributed to the association between parental overprotection and cluster B personality disorders, particularly borderline personality disorder. The duration of PD was a significant predictor of any cluster B and any cluster C personality disorder, suggesting that some of the cluster B and cluster C personality disorders may be a consequence of the long-lasting PDAG. Any cluster B personality disorder was also associated with younger age. In conclusion, despite a generally nonspecific nature of the relationship between parental overprotection in childhood and adult psychopathology, the findings of this study suggest some specificity for the association between parental overprotection in childhood and personality disturbance in PDAG patients, particularly cluster B personality disorders.
International Nuclear Information System (INIS)
1988-10-01
The Technical Committee Meeting considered the current effort in the implementation and use of PSA information for day-to-day operational safety management on Personal Computers. Due to the very recent development of the necessary hardware and software for Personal Computers, the application of PSA information for day-to-day operational safety management on PCs is essentially still in a pioneering stage. There is at present only one such system for end users existing, the PRISIM (Plant Risk Status Information Management) program for which a limited practical application experience is available. Others are still in the development stage. The main aim of the Technical Committee Meeting was to discuss the present status of PSA based systems for operational safety management support on small computers, to consider practical aspects when implementing these systems into a nuclear installation and to address problems related to the further work in the area. A separate abstract was prepared for the summary of the Technical Committee Meeting and for the 8 papers presented by the participants. Refs, figs and tabs
In person versus computer screening for intimate partner violence among pregnant patients.
Chang, Judy C; Dado, Diane; Schussler, Sara; Hawker, Lynn; Holland, Cynthia L; Burke, Jessica G; Cluss, Patricia A
2012-09-01
To compare in person versus computerized screening for intimate partner violence (IPV) in a hospital-based prenatal clinic and explore women's assessment of the screening methods. We compared patient IPV disclosures on a computerized questionnaire to audio-taped first obstetric visits with an obstetric care provider and performed semi-structured interviews with patient participants who reported experiencing IPV. Two-hundred and fifty patient participants and 52 provider participants were in the study. Ninety-one (36%) patients disclosed IPV either via computer or in person. Of those who disclosed IPV, 60 (66%) disclosed via both methods, but 31 (34%) disclosed IPV via only one of the two methods. Twenty-three women returned for interviews. They recommended using both types together. While computerized screening was felt to be non-judgmental and more anonymous, in person screening allowed for tailored questioning and more emotional connection with the provider. Computerized screening allowed disclosure without fear of immediate judgment. In person screening allows more flexibility in wording of questions regarding IPV and opportunity for interpersonal rapport. Both computerized or self-completed screening and in person screening is recommended. Providers should address IPV using non-judgmental, descriptive language, include assessments for psychological IPV, and repeat screening in person, even if no patient disclosure occurs via computer. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Brusa, L; Pavino, V; Massimetti, M C; Ceravolo, R; Stefani, S; Stanzione, P
2016-07-15
Impulse control disorders (ICDs) are clinically relevant in Parkinson disease (PD) patients, with an established association with PD medication. Aim of our study was to study whether the increased frequency of pathological gambling (PG), reported in subgroups of PD patients, is related to specific personality tracts additional to dopaminergic medications. Thirty-seven PD patients with a personal history of PG where enrolled. Twenty one PD patients, matched for disease and dopaminergic therapy, never experiencing PG, were enrolled as controls. All subjects were tested with the Minnesota Multiphasic Inventory Personality scales (MMPI-2). Our data showed that PD group with PG exhibited significantly higher mean values of the three validity scales in comparison to the non-PG-PD group, demonstrating an higher tendency to lie. Content scales showed a significant increase of cynicism and bizarre ideation scales score in the PG-PD group, not exhibiting pathological values at the validity scales, (p: 0.02) in comparison to non-PG PD patients. According to our results, PG seems to be associated with precise personality tracts. Personality profiles of cluster A personality disturbances - Axys 2 according with DSM-5 TR (paranoid type) at MMPI-2 might be a warning index helpful in selecting dopaminergic treatment, to avoid subsequent ICDs appearance. Copyright © 2016 Elsevier B.V. All rights reserved.
Correlates of MSW Students’ Perceptions of Preparedness to Manage Risk and Personal Liability
Directory of Open Access Journals (Sweden)
Michael N. Kane
2002-12-01
Full Text Available Few studies in the discipline of social work have identified correlates of preparedness to manage risk and personal liability among practitioners or students. This study investigated predictors of MSW students’ perceptions of managing personal risk and liability (N=116. Four correlates were identified from the standard regression model that accounts for 43% of the adjusted variance. These predictor variables included: (a concern and worry about lawsuits (Beta=-.458, p=.00, (b understanding the fit between client advocacy and managed care (Beta=.328,p=.00, (c understanding agency documentation requirements (Beta=-.164, p=.05, and (d perceptions of field preparation for documentation (Beta=.162, p=.05. Implications are discussed.
Relationship between Personality Disorders and Relapses among Sample of Substance Abuse Patients
Osama Hasan Gaber
2016-01-01
This study aimed to examine the relationship between Personality Disorders and Relapses among Sample of 75 Substance Abuse Patients (personality disorder scale (prepared by the researchers) were used Pearson Correlation Coefficient showed that there are statistically significant relationship between Antisocial personality disorder(ASPD), Borderline personality disorder (BPD, Avoidant personality disorder (AVPD) and Dependent personality disorder (DPD) and substance abuse relapses (P≤=0.00)...
Morris, Andrea M.; Ricci, Karen A.; Griffin, Anne R.; Heslin, Kevin C.; Dobalian, Aram
2016-01-01
Background Adequate hospital staffing during and after a disaster is critical to meet increased health care demands and to ensure continuity of care and patient safety. However, when a disaster occurs, staff may become both victim and responder, decreasing their ability and willingness to report for work. This qualitative study assessed the personal and professional challenges that affected staff decisions to report to work following a natural disaster and examined the role of management in a...
Fagerberg, Tomas; Söderman, Erik; Gustavsson, J Petter; Agartz, Ingrid; Jönsson, Erik G
2016-08-01
Personality is considered as an important aspect that can affect symptoms and social function in persons with schizophrenia. The personality questionnaire Swedish universities Scales of Personality (SSP) has not previously been used in psychotic disorder. To investigate if SSP has a similar internal consistency and factor structure in a psychosis population as among healthy controls and if patients with psychotic disorders differ from non-psychotic individuals in their responses to the SSP. Patients with psychotic disorders (n = 107) and healthy controls (n = 119) completed SSP. SSP scores were analyzed for internal consistency and case-control differences by Cronbach's alfa and multiple analysis of covariance, respectively. Internal consistencies among patients were overall similar to that of controls. The patients scored significantly higher in seven (Somatic trait anxiety, Psychic trait anxiety, Stress susceptibility, Lack of assertiveness, Detachment, Embitterment, Mistrust) and lower in three (Physical trait aggression, Verbal trait aggression, Adventure seeking) of the 13 scales of the inventory. In three scales (Impulsiveness, Social desirability and Trait irritability) there was no significant difference between the scoring of patients and healthy controls. The reliability estimates suggest that SSP can be used by patients with psychotic disorders in stable remission. Patients score higher on neuroticism-related scales and lower on aggression-related scales than controls, which is in accordance with earlier studies where other personality inventories were used.
Disturbed emotion recognition in patients with narcissistic personality disorder.
Marissen, Marlies A E; Deen, Mathijs L; Franken, Ingmar H A
2012-07-30
Although theoretically the lack of empathy is a supposed key symptom of narcissistic personality disorder (NPD), empirical studies examining empathy in NPD are scarce. In the present study it was examined whether patients with NPD differ from healthy controls and a psychiatric control group in their empathic abilities. In order to examine this question, 20 patients with NPD, 20 patients with a personality disorder in the Cluster C spectrum and 20 healthy control participants were presented with a questionnaire and a facial recognition task designed to measure empathic abilities. It was found that patients with NPD did not differ from the two control groups on a self-report questionnaire indicating that patients regard themselves as sensitive to the feelings of others. On the contrary, it was found NPD patients generally performed worse on a facial emotion recognition task compared to both control groups. In addition to this general deficit in emotion recognition, patients with NPD showed a specific deficit for emotions representing fear and disgust. These results provide the first empirical evidence for impaired emotion recognition in patients with NPD. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.
Personalized Trust Management for Open and Flat P2P Communities
Institute of Scientific and Technical Information of China (English)
ZUO Min; LI Jian-hua
2008-01-01
A personalized trust management scheme is proposed to help peers build up trust between each other in open and flat P2P communities. This scheme totally abandons the attempt to achieve a global view. It evaluates trust from a subjective point of view and gives personalized decision support to each peer. Simulation experiments prove its three advantages: free of central control, stronger immunity to misleading recommendations, and limited traffic overload.
Using Personality Data to Make Decisions about Global Managers
Ramesh, Anuradha; Hazucha, Joy F.; Bank, Jurgen
2008-01-01
A major challenge that decisions makers face in multi-national organizations is how to compare managers from different parts of the globe. This challenge is both psychometric and practical. We draw on the cross-cultural psychology literature to propose a three-step framework to compare personality data from different countries. The first step…
Patient understanding of diabetes self-management: participatory decision-making in diabetes care.
Quinn, Charlene C; Royak-Schaler, Renee; Lender, Dan; Steinle, Nanette; Gadalla, Shahinaz; Zhan, Min
2011-05-01
Our aim was to determine whether patient participation in decision-making about diabetes care is associated with understanding of diabetes self-management and subsequent self-care practices. We also identified issues that would impact messaging for use in mobile diabetes communication. A cross-sectional observational study was conducted with type 2 diabetes patients (n = 81) receiving their care at the University of Maryland Joslin Diabetes Center. A convenience sample of patients were eligible to participate if they were aged 25-85 years, had type 2 diabetes, spoke English, and visited their physician diabetes manager within the past 6 months. In-person patient interviews were conducted at the time of clinic visits to assess patient understanding of diabetes management, self-care practices, and perceptions of participation in decision-making about diabetes care. African Americans reported fewer opportunities to participate in decision-making than Caucasians, after controlling for education [mean difference (MD) = -2.4, p = .02]. This association became insignificant after controlling for patient-physician race concordance (MD = -1.5, p = .21). Patient understanding of self-care was predicted by having greater than high school education (MD = 3.6, p = .001) and having physicians who involved them in decision-making about their care. For each unit increase in understanding of diabetes self-care, the mean patient self-care practice score increased by 0.16 (p = .003), after adjustment for patient race and education. Patient participation in decision-making is associated with better understanding of care. Participation in decision-making plays a key role in patient understanding of diabetes self-management and subsequent self-care practices. Patients with limited education need specific instruction in foot care, food choices, and monitoring hemoglobin A1c. © 2011 Diabetes Technology Society.
Patient blood management -- the GP's guide.
Minck, Sandra; Robinson, Kathryn; Saxon, Ben; Spigiel, Tracey; Thomson, Amanda
2013-05-01
There is accumulating evidence of a strong association between blood transfusion and adverse patient outcomes. Patient blood management aims to achieve improved patient outcomes by avoiding unnecessary exposure to blood products through effective conservation and management of a patient's own blood. To introduce the general practitioner's role in patient blood management. There are a number of ways in which GPs can contribute to patient blood management, particularly in the care of patients scheduled for elective surgery. These include awareness, identification, investigation and management of patients with or at risk of anaemia; assessment of the adequacy of iron stores in patients undergoing planned procedures in which substantial blood loss is anticipated; awareness and assessment of medications and complementary medicines that might increase bleeding risk; and awareness of and ability to discuss with patients, the possible risks associated with blood transfusion and alternatives that may be available.
MANAGEMENT PATIENT OF SWINE INFLUENZA
Directory of Open Access Journals (Sweden)
Endra Gunawan
2015-05-01
Full Text Available Influenza is an acute respiratory diseases caused by various influenza virus which infect the upper and lower respiratory tract and often accompanied by systemic symptoms such as fever, headache and muscle pain. Influenza spreads through the air. Swine influenza comes from swine and can cause an outbreaks in pig flocks. Even this is a kind of a rare case but the swine influenza could be transmitted to human by direct contact with infected swine or through environment that already being contaminated by swine influenza virus. There are 3 types of swine influenza virus namely H1N1, H3N2 and H1N2. Type H1N1 swine-virus had been known since 1918. Avian influenza virus infection is transmitted from one person to another through secret containing virus. Virus is binded into the mucous cells of respiratory tract before it is finally infecting the cells itself. Management patients with H1N1 influenza is based on the complications and the risk. Besides, it is also need to consider the clinical criteria of the patient. Therapy medicamentosa is applied to the patients by giving an antiviral, antibiotics and symptomatic therapy. Prevention can be done by avoid contact with infected animal or environment, having antiviral prophylaxis and vaccination.
The relevance of personality assessment in patients with hyperventilation symptoms.
Decuyper, Mieke; De Bolle, Marleen; Boone, Eva; De Fruyt, Filip
2012-05-01
Relatively few data are available concerning the relations between hyperventilation symptoms and general personality traits in clinical populations. A clear picture of the personality traits associated with hyperventilation symptoms could enhance early detection of those individuals who are at risk for developing hyperventilation. The aim of this study was to investigate the role of general personality in hyperventilation syndrome. Patients (N = 364) with symptoms not explained by an organic disease and supposedly caused by hyperventilation completed the NEO Five-Factor Inventory, the General Health Questionnaire--12, and the Nijmegen Questionnaire. Patients were also subjected to a hyperventilation provocation test and transcutaneous carbon dioxide (TcPCO(2)) values were registered. The results showed that patients with hyperventilation obtained mean Neuroticism scores above the normative mean. Moreover, only Neuroticism was positively linked with self-reported hyperventilation symptoms, and personality traits were more strongly related to self-reported complaints than to objective physical information. Neuroticism clearly differentiated between different diagnostic groups on the basis of Nijmegen Questionnaire and TcPCO(2) values, and an additional small effect of Agreeableness was observed. The present study contributes to the evidence that Neuroticism is strongly associated with self-reported hyperventilation symptoms, and provides substantial evidence that Neuroticism is a vulnerability factor in the development of hyperventilation. Therefore, personality assessment may be helpful in advancing the understanding and the early detection of hyperventilation symptoms.
A roadmap towards personalized immunology.
Delhalle, Sylvie; Bode, Sebastian F N; Balling, Rudi; Ollert, Markus; He, Feng Q
2018-01-01
Big data generation and computational processing will enable medicine to evolve from a "one-size-fits-all" approach to precise patient stratification and treatment. Significant achievements using "Omics" data have been made especially in personalized oncology. However, immune cells relative to tumor cells show a much higher degree of complexity in heterogeneity, dynamics, memory-capability, plasticity and "social" interactions. There is still a long way ahead on translating our capability to identify potentially targetable personalized biomarkers into effective personalized therapy in immune-centralized diseases. Here, we discuss the recent advances and successful applications in "Omics" data utilization and network analysis on patients' samples of clinical trials and studies, as well as the major challenges and strategies towards personalized stratification and treatment for infectious or non-communicable inflammatory diseases such as autoimmune diseases or allergies. We provide a roadmap and highlight experimental, clinical, computational analysis, data management, ethical and regulatory issues to accelerate the implementation of personalized immunology.
[Process management in the hospital pharmacy for the improvement of the patient safety].
Govindarajan, R; Perelló-Juncá, A; Parès-Marimòn, R M; Serrais-Benavente, J; Ferrandez-Martí, D; Sala-Robinat, R; Camacho-Calvente, A; Campabanal-Prats, C; Solà-Anderiu, I; Sanchez-Caparrós, S; Gonzalez-Estrada, J; Martinez-Olalla, P; Colomer-Palomo, J; Perez-Mañosas, R; Rodríguez-Gallego, D
2013-01-01
To define a process management model for a hospital pharmacy in order to measure, analyse and make continuous improvements in patient safety and healthcare quality. In order to implement process management, Igualada Hospital was divided into different processes, one of which was the Hospital Pharmacy. A multidisciplinary management team was given responsibility for each process. For each sub-process one person was identified to be responsible, and a working group was formed under his/her leadership. With the help of each working group, a risk analysis using failure modes and effects analysis (FMEA) was performed, and the corresponding improvement actions were implemented. Sub-process indicators were also identified, and different process management mechanisms were introduced. The first risk analysis with FMEA produced more than thirty preventive actions to improve patient safety. Later, the weekly analysis of errors, as well as the monthly analysis of key process indicators, permitted us to monitor process results and, as each sub-process manager participated in these meetings, also to assume accountability and responsibility, thus consolidating the culture of excellence. The introduction of different process management mechanisms, with the participation of people responsible for each sub-process, introduces a participative management tool for the continuous improvement of patient safety and healthcare quality. Copyright © 2012 SECA. Published by Elsevier Espana. All rights reserved.
Borderline personality disorder in the primary care setting.
Dubovsky, Amelia N; Kiefer, Meghan M
2014-09-01
Borderline personality disorder is estimated to be present in approximately 6% of outpatient primary care settings. However, the time and energy spent on this population can greatly exceed what primary care doctors are able to spend. This article gives an overview of borderline personality disorder, including the clinical characteristics, epidemiology, and comorbidities, as well as pharmacologic and most important behavioral management. It is our hope that, with improved understanding of the disorder and skills for managing this population, caring for patients with the disorder can be more satisfying and less taxing for both primary care doctors and their patients. Copyright © 2014 Elsevier Inc. All rights reserved.
Sahama, Tony; Liang, Jian; Iannella, Renato
2012-01-01
Most social network users hold more than one social network account and utilize them in different ways depending on the digital context. For example, friendly chat on Facebook, professional discussion on LinkedIn, and health information exchange on PatientsLikeMe. Thus many web users need to manage many disparate profiles across many distributed online sources. Maintaining these profiles is cumbersome, time consuming, inefficient, and leads to lost opportunity. In this paper we propose a framework for multiple profile management of online social networks and showcase a demonstrator utilising an open source platform. The result of the research enables a user to create and manage an integrated profile and share/synchronise their profiles with their social networks. A number of use cases were created to capture the functional requirements and describe the interactions between users and the online services. An innovative application of this project is in public health informatics. We utilize the prototype to examine how the framework can benefit patients and physicians. The framework can greatly enhance health information management for patients and more importantly offer a more comprehensive personal health overview of patients to physicians.
de Vries, J; DeJongste, MJL; Versteegen, GJ; Durenkamp, A; Staal, MJ
Objectives. To study the impact of personality traits on the effect of neurostimulation in patients with chest pain and normal coronary arteries. Materials and Methods. Using the Dutch personality questionnaire, we retrospectively studied the personality traits in 33 patients treated with
Type D Personality Predicts Poor Medication Adherence in Patients with Heart Failure in the USA
Wu, Jia-Rong; Moser, Debra K.
2015-01-01
Background Type D (distressed) personality and medication nonadherence have been associated with poor health outcomes. Type D personality is associated with poor medication adherence in patients with coronary artery disease. However, the relationship between type D personality and medication adherence in patients with heart failure (HF) remains unknown. Purpose Therefore, the goal of this study was to examine the association between type D personality and medication adherence in patients with HF. Method This was a sub-analysis of baseline data from a randomized controlled trial with 84 patients with HF in the USA. Demographic, clinical, and psychological data were collected at baseline by interview, questionnaires, and medical record review. Type D personality was assessed using the Type D Personality Scale (DS14). Medication adherence was measured using both objective (Medication Event Monitoring System, MEMS) and self-reported (Morisky Medication Adherence Scale, MMAS-4) measures. Patients started medication adherence monitoring with the MEMS bottle at baseline and is used continuously for a month. Multiple regressions were used to explore the relationships between type D personality and medication adherence while adjusting for demographic, clinical, and psychological factors. Results Patients with type D personality were more likely to have poor medication adherence. Type D personality was associated with medication adherence before and after adjusting for covariates when it was analyzed as a categorical variable. However, type D personality was not associated with medication adherence when analyzed as a dimensional construct. Negative affectivity, a component of type D personality, was associated with medication adherence. Conclusion As a dimensional construct, type D personality may not reflect the components of the personality associated with poor outcomes. Negative affectivity was associated with medication adherence in patients with HF. Interventions aiming
The effect of personalized versus standard patient protocols for radiostereometric analysis (RSA).
Muharemovic, O; Troelsen, A; Thomsen, M G; Kallemose, T; Gosvig, K K
2018-05-01
Increasing pressure in the clinic requires a more standardized approach to radiostereometric analysis (RSA) imaging. The aim of this study was to investigate whether implementation of personalized RSA patient protocols could increase image quality and decrease examination time and the number of exposure repetitions. Forty patients undergoing primary total hip arthroplasty were equally randomized to either a case or a control group. Radiographers in the case group were assisted by personalized patient protocols containing information about each patient's post-operative RSA imaging. Radiographers in the control group used a standard RSA protocol. At three months, radiographers in the case group significantly reduced (p RSA patient protocols have a positive effect on image quality and radiation dose savings. Implementation of personal patient protocols as a RSA standard will contribute to the reduction of examination time, thus ensuring a cost benefit for department and patient safety. Copyright © 2017 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.
Directory of Open Access Journals (Sweden)
Kirsten eCatthoor
2015-07-01
Full Text Available Stigmatization is a major hindrance in adult psychiatric patients with Axis-I diagnoses, as shown consistently in most studies. Significantly fewer studies on the emergence of psychiatric stigma in adult patients with personality disorders exist, although the resulting evidence is conclusive. Some authors consider patients with personality disorders at risk for severe stigmatization because of intense difficulties during interpersonal contact, even in a psychotherapeutic relationship. The aim of this study was primarily the assessment of pre-existing stigma in patients referred for intensive treatment for personality disorders. The study enrolled 214 patients admitted to the adult department of a highly specialized mental health care institute offering psychotherapy for patients with severe and complex personality pathology. All patients underwent a standard assessment with self-report questionnaires and a semi-structured interview to measure Axis II personality disorders. The Stigma Consciousness Questionnaire (SCQ and the Perceived Devaluation-Discrimination Questionnaire (DDQ, both validated instruments, were used to measure perceived and actual experiences of stigma. Independent sample t-tests were used to investigate differences in the mean total stigma scores for patients both with and without a personality disorder. One-way ANOVA’s were performed to assess the differences between having a borderline personality disorder, another personality disorder, or no personality disorder diagnosis.Multiple regression main effect analyses were conducted in order to explore the impact of the different personality disorder diagnosis on the level of stigma. The mean scores across all patient groups were consistent with rather low stigma. No differences were found for patients with or without a personality disorder diagnosis. Level of stigma in general was not associated with an accumulating number of personality disorders.
The User-Subjective Approach to Personal Information Management Systems.
Bergman, Ofer; Beyth-Marom, Ruth; Nachmias, Rafi
2003-01-01
Explains personal information management (PIM) systems and suggests a user-subjective approach to PIM system design. Advocates that PIM systems relate to the subjective value-added attributes that the user gives the stored data so that the user can find information again, recall it when needed, and use it effectively in the next interaction.…
Wilski, Maciej; Tomczak, Maciej
2017-04-01
Discrepancies between physicians' assessment and patients' subjective representations of the disease severity may influence physician-patient communication and management of a chronic illness, such as multiple sclerosis (MS). For these reasons, it is important to recognize factors that distinguish patients who differently estimate the impact of MS. The purpose of this study was to verify if the patients who overestimate or underestimate the impact of MS differ in their perception of personal resources from individuals presenting with a realistic appraisal of their physical condition. A total of 172 women and 92 men diagnosed with MS completed Multiple Sclerosis Impact Scale, University of Washington Self Efficacy Scale, Rosenberg Self-Esteem Scale, Body Esteem Scale, Brief Illness Perception Questionnaire, Treatment Beliefs Scale, Actually Received Support Scale, and Socioeconomic resources scale. Physician's assessment of health status was determined with Expanded Disability Status Scale. Linear regression analysis was conducted to identify the subsets of patients with various patterns of subjective health and Expanded Disability Status Scale (EDSS) scores. Patients overestimating the impact of their disease presented with significantly lower levels of self-esteem, self-efficacy in MS, and body esteem; furthermore, they perceived their condition more threatening than did realists and underestimators. They also assessed anti-MS treatment worse, had less socioeconomic resources, and received less support than underestimators. Additionally, underestimators presented with significantly better perception of their disease, self, and body than did realists. Self-assessment of MS-related symptoms is associated with specific perception of personal resources in coping with the disease. These findings may facilitate communication with patients and point to new directions for future research on adaptation to MS.
Alertness management in two-person long-haul flight operations
Rosekind, M. R.; Gander, P. H.
1992-01-01
Long-haul flight operations involve cumulative sleep loss, circadian disruption, and extended and irregular duty schedules. These factors reduce pilot alertness and performance on the flightdeck. Conceptually and operationally, alertness management in flight operations can be divided into preventive strategies and operational countermeasures. Preventive strategies are utilized prior to a duty period to mitigate or reduce the effects of sleep loss, circadian disruption and fatigue during subsequent flight operations. Operational countermeasures are used during operations as acute techniques for maintaining performance and alertness. Results from previous NASA Ames field studies document the sleep loss and circadian disruption in three-person long-haul flying and illustrate the application of preventive strategies and operational countermeasures. One strategy that can be used in both a preventive and operational manner is strategic napping. The application and effectiveness of strategic napping in long-haul operations will be discussed. Finally, long-haul flying in two-person highly automated aircraft capable of extended range operations will create new challenges to maintaining pilot alertness and performance. Alertness management issues in this flight environment will be explored.
Evert, Alison; Trence, Dace; Catton, Sarah; Huynh, Peter
2009-01-01
The purpose of this article is to describe the development and implementation of an educational program for the initiation of real-time continuous glucose monitoring (CGM) technology for personal use, not 3-day CGMS diagnostic studies. The education program was designed to meet the needs of patients managing their diabetes with either diabetes medications or insulin pump therapy in an outpatient diabetes education center using a team-based approach. Observational research, complemented by literature review, was used to develop an educational program model and teaching strategies. Diabetes educators, endocrinologists, CGM manufacturer clinical specialists, and patients with diabetes were also interviewed for their clinical observations and experience. The program follows a progressive educational model. First, patients learn in-depth about real-time CGM technology by attending a group presensor class that provides detailed information about CGM. This presensor class facilitates self-selection among patients concerning their readiness to use real-time CGM. If the patient decides to proceed with real-time CGM use, CGM initiation is scheduled, using a clinic-centered protocol for both start-up and follow-up. Successful use of real-time CGM involves more than just patient enthusiasm or interest in a new technology. Channeling patient interest into a structured educational setting that includes the benefits and limitations of real-time CGM helps to manage patient expectations.
Managing Transition in Patients Treated with Growth Hormone
Directory of Open Access Journals (Sweden)
Berthold P. Hauffa
2017-12-01
Full Text Available Growth hormone (GH promotes growth in children, but is also essential for bone strength, body composition, metabolic factors, such as lipid profile, and maintenance of quality of life. The Merck KGaA (Germany funded “360° GH in Europe” meeting, held in Lisbon, Portugal, in June 2016, comprised three sessions entitled “Short Stature Diagnosis and Referral,” “Optimizing Patient Management and Adherence,” and “Managing Transition.” The scientific program covered all stages of pediatric GH treatment, and reported here are the outcomes of the third session of the meeting, which considered transition from pediatric GH treatment to teenage and young adult GH therapy. A large number of patients with chronic diseases, including GH deficiency, drop out of therapy during the transition period. Multiple factors are associated with this, such as lack of understanding of the disease process, insufficient knowledge of treatment options, the patient becoming more independent, and requirement for interaction with a new set of health-care workers. Education regarding disease management and treatment options should be provided from an early age and right through the transition period. However, endocrine specialists will view the transition period differently, depending on whether they are pediatric endocrinologists who mainly deal with congenital diseases, in which auxology is important, or adult endocrinologists who are more concerned with body composition and metabolic factors. View points of both a pediatric and an adult endocrine specialist are presented, together with a case study outlining practical aspects of transition. It was noted in the meeting discussion that having one person to guide a patient through transition from an early age is important, but may be constrained by various factors such as finances, and options will differ by country.
The effect of personalized versus standard patient protocols for radiostereometric analysis (RSA)
DEFF Research Database (Denmark)
Muharemovic, O; Troelsen, A; Thomsen, M G
2018-01-01
INTRODUCTION: Increasing pressure in the clinic requires a more standardized approach to radiostereometric analysis (RSA) imaging. The aim of this study was to investigate whether implementation of personalized RSA patient protocols could increase image quality and decrease examination time...... imaging. Radiographers in the control group used a standard RSA protocol. RESULTS: At three months, radiographers in the case group significantly reduced (p .... No significant improvements were found in the control group at any time point. CONCLUSION: There is strong evidence that personalized RSA patient protocols have a positive effect on image quality and radiation dose savings. Implementation of personal patient protocols as a RSA standard will contribute...
High prevalence of personality disorders among circadian rhythm sleep disorders (CRSD) patients.
Dagan, Y; Sela, H; Omer, H; Hallis, D; Dar, R
1996-10-01
The purpose of this study was to examine systematically our previous clinical impression regarding the prevalence of personality disorders in patients suffering from circadian rhythm sleep disorders (CRSD). We hypothesized that, in a group of patients suffering from CRSD, there would be a higher frequency of personality disorders than in a group of healthy controls. The experimental group consisted of CRSD patients diagnosed according to a clinical interview and actigraphic recordings. The control group consisted of healthy volunteers in whom CRSD had been ruled out by means of a self-administered questionnaire. Both groups were assessed for personality disorders using the MCMI, a diagnostic tool based on Millon's biopsychosocial theory of personality and the PRQ-R, a diagnostic tool based on the DMS-III-R. Both tests provided clear and significant support for the hypothesis that individuals suffering from CRSD are characterized to a greater extent by personality disorders than a control group. No specific characteristic pattern or profile of personality disorders was clearly detected. Correct early diagnosis and treatment of CRSD may improve afflicted individuals' adaptive capabilities and perhaps even prevent the development of a personality disorder. This suggests how important a greater awareness of CRSD on the part of the professional community may be.
Development of personnel exposure management system with personal computer
International Nuclear Information System (INIS)
Yamato, Ichiro; Yamamoto, Toshiki
1992-01-01
In nuclear power plants, large scale personnel exposure management systems have been developed and established by utilities. Though being common in the base, the implementations are specific by plants. Contractors must control their workers' exposures by their own methods and systems. To comply with the utilities' parental systems, contractors' systems tend to differ by plants, thus make it difficult for contractors to design a standard system that is common to all relevant plants. Circumstances being as such, however, we have developed a system which is applicable to various customer utilities with minimal variations, using personal computers with database management and data communication softwares, with relatively low cost. We hope that this system will develop to the standard model for all Japanese contractors' personnel exposure management systems. (author)
A roadmap towards personalized immunology
DEFF Research Database (Denmark)
Delhalle, Sylvie; Bode, Sebastian F N; Balling, Rudi
2018-01-01
Big data generation and computational processing will enable medicine to evolve from a "one-size-fits-all" approach to precise patient stratification and treatment. Significant achievements using "Omics" data have been made especially in personalized oncology. However, immune cells relative to tu......-communicable inflammatory diseases such as autoimmune diseases or allergies. We provide a roadmap and highlight experimental, clinical, computational analysis, data management, ethical and regulatory issues to accelerate the implementation of personalized immunology....
Laporte, Lise; Paris, Joel; Guttman, Herta; Russell, Jennifer
2011-08-01
The aim of this study was to document and compare adverse childhood experiences, and personality profiles in women with borderline personality disorder (BPD) and their sisters, and to determine how these factors impact current psychopathology. Fifty-six patients with BPD and their sisters were compared on measures assessing psychopathology, personality traits, and childhood adversities. Most sisters showed little evidence of psychopathology. Both groups reported dysfunctional parent-child relationships and a high prevalence of childhood trauma. Subjects with BPD reported experiencing more emotional abuse and intrafamilial sexual abuse, but more similarities than differences between probands and sisters were found. In multilevel analyses, personality traits of affective instability and impulsivity predicted DIB-R scores and SCL-90-R scores, above and beyond trauma. There were few relationships between childhood adversities and other measures of psychopathology. Sensitivity to adverse experiences, as reflected in the development of psychopathology, appears to be influenced by personality trait profiles.
Boritz, Tali; Barnhart, Ryan; McMain, Shelley F
2016-06-01
The aim of this study was to determine the influence of posttraumatic stress disorder (PTSD) on treatment outcomes in patients with borderline personality disorder (BPD). Participants were 180 individuals diagnosed with BPD enrolled in a randomized controlled trial that compared the clinical and cost effectiveness of dialectical behavior therapy (DBT) and general psychiatric management (GPM). Multilevel linear models and generalized linear models were used to compare clinical outcomes of BPD patients with and without PTSD. BPD patients with comorbid PTSD reported significantly higher levels of global psychological distress at baseline and end of treatment compared to their non-PTSD counterparts. Both groups evidenced comparable rates of change on suicide attempts and non-suicidal self-injury (NSSI), global psychological distress, and BPD symptoms over the course of treatment and post-treatment follow-up. DBT and GPM were effective for BPD patients with and without PTSD across a broad range of outcomes.
Anesthetic Implications of Ebola Patient Management: A Review of the Literature and Policies.
Missair, Andres; Marino, Michael J; Vu, Catherine N; Gutierrez, Juan; Missair, Alfredo; Osman, Brian; Gebhard, Ralf E
2015-09-01
As of mid-October 2014, the ongoing Ebola epidemic in Western Africa has affected approximately 10,000 patients, approached a 50% mortality rate, and crossed political and geographic borders without precedent. The disease has spread throughout Liberia, Guinea, and Sierra Leone. Isolated cases have arrived in urban centers in Europe and North America. The exponential growth, currently unabated, highlights the urgent need for effective and immediate management protocols for the various health care subspecialties that may care for Ebola virus disease patients. We conducted a comprehensive review of the literature to identify key areas of anesthetic care affected by this disease. The serious potential for "high-risk exposure" and "direct contact" (as defined by the Centers for Disease Control and Prevention) of anesthesiologists caring for Ebola patients prompted this urgent investigation. A search was conducted using MEDLINE/PubMed, MeSH, Cochrane Review, and Google Scholar. Key words included "anesthesia" and/or "ebola" combined with "surgery," "intubation," "laryngoscopy," "bronchoscopy," "stethoscope," "ventilation," "ventilator," "phlebotomy," "venous cannulation," "operating room," "personal protection," "equipment," "aerosol," "respiratory failure," or "needle stick." No language or date limits were applied. We also included secondary-source data from government organizations and scientific societies such as the Centers for Disease Control and Prevention, World Health Organization, American Society of Anesthesiologists, and American College of Surgeons. Articles were reviewed for primary-source data related to inpatient management of Ebola cases as well as evidence-based management guidelines and protocols for the care of Ebola patients in the operative room, infection control, and health care worker personal protection. Two hundred thirty-six articles were identified using the aforementioned terminology in the scientific database search engines. Twenty articles
Mason, T; Hall, R; Caulfied, M; Melling, K
2010-03-01
Anecdotally, forensic psychiatric nurses generally have a more negative perception of people diagnosed with a personality disorder and this negativity is focused more towards managing the behaviours rather than on treatment efficacy and clinical outcomes. This study reports on research carried out across the High, Medium and Low secure psychiatric services in the UK. One thousand two hundred questionnaires were distributed with a response rate of 34.6%. The results indicated a statistically significant difference across High (z = 9.69; P < or = 0.01), Medium (z = 11.06; P < or = 0.01) and Low (z= 9.57; P= 0.01) security with a focus on the management of people with a personality disorder using the Wilcoxon paired samples test. There was also a statistically significant difference in relation to a more clinical/treatment focus for those with a diagnosis of mental illness in Medium (z = 9.69; P < or = 0.01) and Low (z = 9.57; P < or = 0.01) security but not in the High security services. Finally, the results showed significant differences between High, Medium and Low security on each of the four scales of Personality Disorder Clinical-Personality Disorder Management and Mental Illness Clinical-Mental Illness Management. This raises issues of stigma, prejudice and discrimination and suggests a refocus on skills development, acquisition and application for those with a label of personality disorder.
Social support and self-management behaviour among patients with Type 2 diabetes
DEFF Research Database (Denmark)
Schiøtz, M. L.; Bøgelund, M.; Almdal, T.
2012-01-01
Aims To investigate the relationship between structural and functional social support and patient activation, diabetes-related emotional distress, perceived diabetes care, self-management behaviour and HbA 1c levels among patients with Type2 diabetes. Methods Self-administered questionnaires were...... emotional distress, negative assessment of care, less health-promoting eating habits and less frequent foot examinations. Conclusions Good social support is significantly associated with health-promoting behaviours and well-being among patients with Type2 diabetes. However, HbA 1c levels are higher...... for cohabitant persons, indicating barriers for social support. Intervention research is needed to investigate the causal relationship between social networks and health-promoting behaviours. This knowledge should be used in clinical practice when targeting and designing education, support and care for patients...
Comorbidity of substance dependency in patients with cluster B personality disorders
Faezeh Tatari; Seyed Ali Mousavi; Jalal shakeri; Nasrin Abdoli; Valieh Mohamadi Zavaleh; Kiomars Zarafshani
2016-01-01
Background: Personality disorders are considered as a risk factor for the development and intensification of substance dependency. This study was aimed to determine the comorbidity of substance dependency in patients with cluster B personality disorders. Method: This cross-sectional study was performed on 96 patients (71 males and 25 females) referring to Farabi Hospital, Kermanshah, Iran .The data were gathered using a questionnaire. Data analysis was performed by SPSS software. Result...
DEFF Research Database (Denmark)
Jess, P; von der Lieth, L; Matzen, Peter
1989-01-01
stressful life events before entrance to the study (P less than 0.05) and, like the neurotic patients, they had lower ego-strength to cope with such events (P less than 0.05). The results indicate that personality assessments make it possible to distinguish between subgroups of duodenal ulcer patients......One hundred consecutive out-patients with duodenal ulceration from a hospital and a gastroenterological clinic were tested with the Minnesota Multiphasic Personality Inventory (MMPI). This was carried out in order to investigate whether neuroticism or other personality disorders were...... characteristics of duodenal ulcer patients, and whether the presence of such possible personality disorders might influence the prognosis of the disease. Neuroticism occurred in 53% of the patients, but only in 5% of controls (P less than 0.0001). Overall, personality disorders were present in 69% of the patients...
Patient explanations for non-attendance at type 2 diabetes self-management education
DEFF Research Database (Denmark)
Schwennesen, Nete; Henriksen, Jan Erik; Willaing, Ingrid
2016-01-01
AIM: To explore reasons for non-attendance at type 2 diabetes self-management education. METHODS: To elicit the main themes explaining non-attendance, 15 semi-structured interviews were conducted with persons referred to, but not attending, self-management education. Systematic text condensation...... as reasons for non-attendance. CONCLUSIONS: In this study, patients cited both individual and organisational factors as explaining non-attendance at type 2 diabetes self-management education. Further studies should take into account the importance of timing and of tailoring schedules and content...... to individuals' life situations and resources. As organisational factors are likely to vary across programmes and settings, more case studies are needed to further elucidate the dynamic relationship between individual and organisational factors to explain non-attendance at type 2 diabetes self...
[Personalized holistic approach to a patient with mixed leg ulcer].
Kovacević, Jadranka; Sinozić, Tamara
2014-10-01
Holistic approach as the philosophical orientation to care underpins the fundamental wholeness of human being and emphasizes the importance of balance within the person and between the person and his/her environment. It includes elements of the physiological, sociological, economic, psychological and spiritual dimensions, and thus providesan opportunity to assess the patient as a whole and in relation to his/ her living context. Such an integrated approach is part of the basic knowledge and skills of general practitioners/family doctors and makes them equal members of a multidisciplinary team in chronic wound patient care. In this case report on a patient with mixed leg ulcer, we will try to bring closer holistic approach in care for this kind of patients in daily practice of general practitioners/family doctors.
Personality characteristics of patients with psychosis – perception of self and others
Directory of Open Access Journals (Sweden)
Emil Benedik
2001-12-01
Full Text Available The Perception of Self and Other People Questionnaire has been used for assessment of differences between psychotic and other psychiatric patients (including healthy persons according to the theory of disturbances of self and object representations. Results show that the questionnaire, which has been constructed on the basis of Kernberg's criteria for identity diffusion, has two dimensions: the first describes perception of self and primarily separates patients with (borderline personality disorders from the healthy controls. The second one describes quality of relationships and characterises patients with psychosis, mostly schizophrenics, which have more schizoid characteristics than other patients and healthy persons. The major weakness of the study lies in the fact that usage of self-assessment inventories in psychiatry is limited because of the very nature of psychiatric illnesses.
Directory of Open Access Journals (Sweden)
Shahnaz Mohammadi
2015-06-01
Full Text Available The aim of this study is to investigate the relationship between personality traits of HSE managers and burnout. In this order, a general hypothesis and five secondary hypotheses are formed. Research method is applied kind and is descriptive aspect of data collection and cross correlation and model-based structural equation. The sample of study has been considered using Cochran formula and included 200 industry executives in Karaj road. The research data were collected using a questionnaire and the validity and reliability is appropriate. Alpha Cronbach coefficients of questionnaire for burnout and personality traits of managers are 0.85 and 0.79 respectively. Findings show that there is a significant relationship between personality traits of managers (OCD - extroversion- Flexibility - Adaptability - Generosity with burnout and are -0.27, 0.38, -0.41, -0.25, 0.36, and 0.49 respectively. Results suggest that whatever the personality traits of managers be more positive and productive, job burnout in managers becomes less and equals 0.27. In other words, with an increase of one unit in the personality traits of managers, burnout in these people decreases to 0.27.
Self-management education and support in chronic disease management.
McGowan, Patrick T
2012-06-01
With the changing health care environment, prevalence of chronic health conditions, and burgeoning challenges of health literacy, obesity, and homelessness, self-management support provides an opportunity for clinicians to enhance effectiveness and, at the same time, to engage patients to participate in managing their own personal care. This article reviews the differences between patient education and self-management and describes easy-to-use strategies that foster patient self-management and can be used by health care providers in the medical setting. It also highlights the importance of linking patients to nonmedical programs and services in the community. Copyright © 2012 Elsevier Inc. All rights reserved.
Waßmuth, Ralf
2015-01-01
Certification of conformity in health care should provide assurance of compliance with quality standards. This also includes risk management and patient safety. Based on a comprehensive definition of quality, beneficial effects on the management of risks and the enhancement of patient safety can be expected from certification of conformity. While these effects have strong face validity, they are currently not sufficiently supported by evidence from health care research. Whether this relates to a lack of evidence or a lack of investigation remains open. Advancing safety culture and "climate", as well as learning from adverse events rely in part on quality management and are at least in part reflected in the certification of healthcare quality. However, again, evidence of the effectiveness of such measures is limited. Moreover, additional factors related to personality, attitude and proactive action of healthcare professionals are crucial factors in advancing risk management and patient safety which are currently not adequately reflected in certification of conformity programs.
Information workers and their personal information management: a literature review
A.A.J. (Jos) van Helvoort
2011-01-01
The research described in this paper provides insights into tools and methods which are used by professional information workers to keep and to manage their personal information. A literature study was carried out on 23 scholar papers and articles, retrieved from the ACM Digital Library and Library
International Nuclear Information System (INIS)
Takao, Hideaki; Yoshida, Masahiro; Kaneko, Mamoru; Miura, Miwa; Hayashida, Rika; Okumura, Yutaka; Matsuda, Naoki
2006-01-01
For accurate and efficient radiation safety management in facilities using radioisotopes, two-dimensional barcode (2-DC) was applied to the optical identification of radiation sources and personal dosimeters. The mobile personal computer (PC) equipped with a barcode reader, which has imported inventory records from the pre-existing radiation management system, enabled us to finish inventory procedures for 170 2-DC-labelled radiation sources in as short as 20min by one person. Identification of 270 personal dosimeters in their monthly replacement procedures also successfully completed within 20 min by incorporating pre-labeled 2-DC to PC installed with inventory records of dosimeters and radiation workers. As equipments and software required for 2-DC are affordable, easy to operate, and potentially expandable, the introduction of 2-DC system may help to establish practically higher level of radiation management. (author)
DeJesus, Ramona S; Howell, Lisa; Williams, Mark; Hathaway, Julie; Vickers, Kristin S
2014-03-01
Chronic disease management in the primary care setting increasingly involves self-management support from a nurse care manager. Prior research had shown patient acceptance and willingness to work with care managers. This survey study evaluated patient-perceived satisfaction with care management and patient opinions on the effectiveness of care management in promoting self-management. Qualitative and quantitative survey responses were collected from 125 patients (79% female; average age 46; 94% Caucasian) enrolled in care management for depression. Qualitative responses were coded with methods of content analysis by 2 independent analysts. Patients were satisfied with depression care management. Patients felt that care management improved their treatment above and beyond other aspects of their depression treatment (mean score, 6.7 [SD, 2]; 10 = Very much), increased their understanding of depression self-management (mean score, 7.2 [SD, 2]; 10 = Very much), and increased the frequency of self-management goal setting (mean score, 6.9 [SD, 3]; 10 = Very much). Predominant qualitative themes emphasized that patients value emotional, motivational, and relational aspects of the care manager relationship. Patients viewed care managers as caring and supportive, helpful in creating accountability for patients and knowledgeable in the area of depression care. Care managers empower patients to take on an active role in depression self-management. Some logistical challenges associated with a telephonic intervention are described. Care manager training should include communication and motivation strategies, specifically self-management education, as these strategies are valued by patients. Barriers to care management, such as scheduling telephone calls, should be addressed in future care management implementation and study.
Sexual dysfunction, mood, anxiety, and personality disorders in female patients with fibromyalgia
Directory of Open Access Journals (Sweden)
Kayhan F
2016-02-01
Full Text Available Fatih Kayhan,1 Adem Küçük,2 Yılmaz Satan,3 Erdem İlgün,4 Şevket Arslan,5 Faik İlik6 1Department of Psychiatry, Faculty of Medicine, Selçuk University, 2Department of Rheumatology, Faculty of Medicine, Necmettin Erbakan University, 3Department of Psychiatry, Konya Numune State Hospital, 4Department of Physical Therapy and Rehabilitation, Faculty of Medicine, Mevlana University, 5Department of Internal Medicine, Faculty of Medicine, Necmettin Erbakan University, 6Department of Neurology, Faculty of Medicine, Başkent University, Konya, Turkey Background: We aimed to investigate the current prevalence of sexual dysfunction (SD, mood, anxiety, and personality disorders in female patients with fibromyalgia (FM. Methods: This case–control study involved 96 patients with FM and 94 healthy women. The SD diagnosis was based on a psychiatric interview in accordance with the Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria. Mood and anxiety disorders were diagnosed using the Structured Clinical Interview. Personality disorders were diagnosed according to the Structured Clinical Interview for DSM, Revised Third Edition Personality Disorders. Results: Fifty of the 96 patients (52.1% suffered from SD. The most common SD was lack of sexual desire (n=36, 37.5% and arousal disorder (n=10, 10.4%. Of the 96 patients, 45 (46.9% had a mood or anxiety disorder and 13 (13.5% had a personality disorder. The most common mood, anxiety, and personality disorders were major depression (26%, generalized anxiety disorder (8.3%, and histrionic personality disorder (10.4%. Conclusion: SD, mood, and anxiety disorders are frequently observed in female patients with FM. Pain plays a greater role in the development of SD in female patients with FM. Keywords: anxiety, depression, fibromyalgia, sexual dysfunction
Does community-wide chronic kidney disease management improve patient outcomes?
Rayner, Hugh C; Baharani, Jyoti; Dasgupta, Indranil; Suresh, Vijayan; Temple, Robert M; Thomas, Mark E; Smith, Steve A
2014-03-01
The number of patients starting renal replacement therapy (RRT) is increasing in England, as it is worldwide. Improvements in the management of chronic kidney disease (CKD) across communities to alter this trend are a public health priority. We have prospectively studied changes in the incidence and modality of treatment for end-stage renal disease following the introduction of a CKD management programme in the West Midlands region of England. Nephrology service to approximately 700 000 adult population of mixed ethnicity in urban and suburban areas, many with social deprivation. The programme was introduced in stages between 2003 and 2006 and comprised primary care education and financial incentives, personal clinical reports written directly to patients following every consultation, routine laboratory estimated glomerular filtration rate (eGFR) reporting, eGFR graph surveillance to identify and monitor patients at risk, multidisciplinary pre-RRT care and conservative care. Prevalent patients: 10 552 with CKD and 8509 without CKD with diabetes. access to nephrology care, trends in RRT incidence and starting modality, place of death without RRT. Incident count was adjusted for changes in the local adult population recorded in national censuses. Ninety-one per cent of patients aged ≥75 years with incident CKD stage 5 were known to a nephrologist. The population-adjusted incident RRT rate peaked in 2005 and then declined; the proportion starting with transplant, peritoneal dialysis or haemodialysis by arterio-venous fistula increased to 63% by 2012 (P = 0.001 versus 2005). Fifty-two per cent of patients receiving planned conservative care without dialysis died out of hospital. Following the introduction of a community-wide systematic CKD management programme, the population-adjusted incidence of RRT reduced, modality of initiation of RRT improved and a majority of patients receiving planned conservative care without dialysis died out of hospital.
Directory of Open Access Journals (Sweden)
Koekkoek Bauke
2011-06-01
Full Text Available Abstract Background Structured psychotherapy is recommended as the preferred treatment of personality disorders. A substantial group of patients, however, has no access to these therapies or does not benefit. For those patients who have no (longer access to psychotherapy a Collaborative Care Program (CCP is developed. Collaborative Care originated in somatic health care to increase shared decision making and to enhance self management skills of chronic patients. Nurses have a prominent position in CCP's as they are responsible for optimal continuity and coordination of care. The aim of the CCP is to improve quality of life and self management skills, and reduce destructive behaviour and other manifestations of the personality disorder. Methods/design Quantitative and qualitative data are combined in a comparative multiple case study. This makes it possible to test the feasibility of the CCP, and also provides insight into the preliminary outcomes of CCP. Two treatment conditions will be compared, one in which the CCP is provided, the other in which Care as Usual is offered. In both conditions 16 patients will be included. The perspectives of patients, their informal carers and nurses are integrated in this study. Data (questionnaires, documents, and interviews will be collected among these three groups of participants. The process of treatment and care within both research conditions is described with qualitative research methods. Additional quantitative data provide insight in the preliminary results of the CCP compared to CAU. With a stepped analysis plan the 'black box' of the application of the program will be revealed in order to understand which characteristics and influencing factors are indicative for positive or negative outcomes. Discussion The present study is, as to the best of our knowledge, the first to examine Collaborative Care for patients with severe personality disorders receiving outpatient mental health care. With the chosen
How task and person conflict shape the role of positive interdependence in management teams
Janssen, O.; Van de Vliert, E.; Veenstra, C
1999-01-01
A literature-based model defining how task and person conflict modify the relationship between positive goal interdependence and decision-making effectiveness in management teams is presented. The model assumes that positive interdependence fosters effective decision making behaviors only if person
THE ROLE OF ROMANIAN MANAGERS PERSONALITY IN CHOOSING A LEADERSHIP STYLE, A COMPARATIVE APPROACH
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Maria-Elena, GHEORDUNESCU
2014-07-01
Full Text Available Managers are that empowered group of people, specially trained, who direct, coordinate and direct the work of all members of an organization. Managers are those specialists who can make decisions with a large impact on the business activity. No matter the activity profile or size, companies need good managers, who are able to adapt to the specific economic conditions of our times. This paper aims to study the personality of three managers from Romania, who working in the field of road transport and within educational institutions. The purpose of this paper is to identify the personal traits of the analyzed managers and what leadership styles they have. However, through this paper we try to answer questions like: Who are managers and what qualities they must have? Based on both quantitative and qualitative methods, this paper consists in an exploratory research, by highlighting the relevant information in the field. The fact is that a manager is the main pawn in an organization. On his professional training, management, and psycho-behavioral depends the smooth running of the organization.
STYLES OF DECISION MAKING AND MANAGEMENT AND DIMENSIONS OF PERSONALITY OF SCHOOL PRINCIPALS
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Anita Azeska
2017-12-01
Full Text Available This paper explores preference to the style of decision making (managerial, analytical, conceptual and behavioural, (Alan Rowe, 1992, management styles (relationship-oriented leadership and management by objectives, (Fiedler, 1987 and personality traits (extraversion, neuroticism and psychoticism, (Eysenck, 1998. The convenience sample of 61 respondents (principals of primary and secondary schools from Macedonia were subjected to decision making style inventory (Decision Style Inventory - DSI of 20 claims, a questionnaire to assess the management style (Least preferred coworker - LPC composed of 18 bipolar adjectives, and a personality test (Eysenck Personality Questionnaire - EPQ composed of 90 items in the form of questions. Results show that schools lean towards directive style of decision making with a combination of democratic-participatory style that includes subordinates in the process of decision making. The results also demonstrate that school principals prefer management style motivated by relationships; they are more introverted and emotionally stable. The findings indicate a necessity for a new generation of managers who will be different from the traditional managers. It is evident that the future will require managers with leadership styles different from the traditional in Republic of Macedonia. Given that the school is a basic organisational cell on which the educational system of the country is based, the proposed findings present an occasion for developing new ideas and practices that may yield great results. This would increase the flexibility and adaptive capacity of the school as a modern organisation. Thus, these findings have practical implications as they may direct special training of principals in order to apply the best management style, or style that is most appropriate for certain situations, certainly through coordination of the desired profile of the principal and the business strategy, development and maturity of
Towards Personalized Medicine: Leveraging Patient Similarity and Drug Similarity Analytics
Zhang, Ping; Wang, Fei; Hu, Jianying; Sorrentino, Robert
2014-01-01
The rapid adoption of electronic health records (EHR) provides a comprehensive source for exploratory and predictive analytic to support clinical decision-making. In this paper, we investigate how to utilize EHR to tailor treatments to individual patients based on their likelihood to respond to a therapy. We construct a heterogeneous graph which includes two domains (patients and drugs) and encodes three relationships (patient similarity, drug similarity, and patient-drug prior associations). We describe a novel approach for performing a label propagation procedure to spread the label information representing the effectiveness of different drugs for different patients over this heterogeneous graph. The proposed method has been applied on a real-world EHR dataset to help identify personalized treatments for hypercholesterolemia. The experimental results demonstrate the effectiveness of the approach and suggest that the combination of appropriate patient similarity and drug similarity analytics could lead to actionable insights for personalized medicine. Particularly, by leveraging drug similarity in combination with patient similarity, our method could perform well even on new or rarely used drugs for which there are few records of known past performance. PMID:25717413
Chan, Joanne C Y; Sit, Emily N M; Lau, W M
2014-06-01
Conflict management is an essential skill that nursing students need to master as conflict is unavoidable in clinical settings. Examining nursing students' conflict management styles and the associating factors can inform nurse educators on how to equip nursing students for effective conflict management. This study aimed at examining undergraduate nursing students conflict management styles in managing conflict with their supervisors in clinical placement. The associations of emotional intelligence and implicit theories of personality with conflict management styles were also investigated. This is a cross-sectional quantitative survey. This study took place at a nursing school at a university in Hong Kong. 568 undergraduate nursing students participated in the study. Students completed a questionnaire which consisted of demographics, Measure of Implicit Theories of Personality, The Schutte Emotional Intelligence Scale (SEIS) and The Rahim Organizational Conflict Inventory-II (ROCI-II) and received a HKD 20 book coupon as compensation. The data were analyzed by descriptive statistics, reliability analyses, t-tests, correlational and linear regression analyses. For managing conflict with clinical supervisors, students used obliging and integrating most frequently whereas used dominating least. Emotional intelligence was a significant predictor of all five conflict management styles. The higher the emotional intelligence, the more students used integrating, obliging, compromising and dominating. The lower the emotional intelligence, the more students used avoiding. There was a significant association between implicit theories of personality and compromising. The less malleable students perceived personality to be, the more they used compromising. Emotional intelligence was significantly associated with all five conflict management styles while implicit theories of personality were significantly associated with compromising style only. Efforts of nurse educators to
Primary emotional traits in patients with personality disorders.
Karterud, Sigmund; Pedersen, Geir; Johansen, Merete; Wilberg, Theresa; Davis, Ken; Panksepp, Jaak
2016-11-01
There is a longstanding tradition that connects temperament pathology and personality disorders. Emotions are the major constituents of temperament. In mammals, seven primary emotions have been identified: SEEKING, FEAR, CARE, RAGE, SADNESS/PANIC, LUST and PLAY. The study aimed at exploring the relationship between primary emotions and personality disorders (PDs). Five hundred forty-six patients with different degrees and qualities of personality pathology, admitted to treatment in specialized PD services, were diagnosed according to Structured Clinical Interview for DSM-IV Axis II Personality Disorders, and their primary emotional profiles were assessed by the Affective Neuroscience Personality Scales. The Affective Neuroscience Personality Scales explained 19% of the variance in borderline and avoidant criteria. The DSM-IV PD categories displayed different patterns of association to the primary emotions, e.g. the borderline PD profile suggested low thresholds for RAGE and SADNESS, but on the positive side a propensity for SEEKING. In contrast, the dependent PD profile suggested a low threshold for SADNESS but a high threshold for RAGE and SEEKING. The results are promising for a more coherent and evolution-based overall theory of PDs, and the correlations found in this study indicate testable causal pathways to PDs. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
Frisman, Linda K; Mueser, Kim T; Covell, Nancy H; Lin, Hsiu-Ju; Crocker, Anne; Drake, Robert E; Essock, Susan M
2009-11-01
We conducted secondary analyses of data from a randomized trial testing the effectiveness of Assertive Community Treatment (ACT) in delivery of integrated dual disorder treatment (IDDT) to explore the impact of IDDT delivered through ACT teams compared with standard clinical case management for dually-disordered persons with and without antisocial personality disorder (ASPD). This analysis included 36 individuals with ASPD and 88 individuals without ASPD. Participants with ASPD assigned to ACT showed a significantly greater reduction in alcohol use and were less likely to go to jail than those in standard clinical case management, whereas participants without ASPD did not differ between the 2 case management approaches. There were no significant differences for other substance use or criminal justice outcomes. This study provides preliminary evidence that persons with co-occurring serious mental illness, substance use disorders, and ASPD may benefit from delivery of IDDT through ACT teams.
Löffler, Sabine; Knappe, Rainer; Joraschky, Peter; Pöhlmann, Karin
2010-01-01
This study investigated differences in the personal meaning systems of psychotherapists and psychotherapy patients as well as correlations between meaning in life and mental health. We qualitatively assessed the content and structure of the personal meaning systems of 41 psychotherapists and 77 psychotherapy patients. In addition, the participants completed questionnaires measuring meaning in life (LRI-r-d), sense of coherence (SOC-9L), self-esteem (RSES), satisfaction with life (SWLS), self-efficacy (SWK), and depression (BDI). The personal meaning systems of psychotherapists were more complex and coherent compared to psychotherapy patients. In the group of psychotherapy patients, a more elaborate structure of the personal meaning system correlated with the subjective sense of meaning. We were able to confirm correlations between meaning in life and mental health for most of the instances. Psychotherapists had more elaborate and coherent meaning systems than psychotherapy patients. Especially for psychotherapy patients elaborate and coherent meaning systems turned out to be important for mental health.
Cognitive, Personality, and Family Factors in Patients with Migraine Headache
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Reza Johari-Fard
2014-01-01
Full Text Available Migraine is a disorder that has debilitating pain, and affects all aspects of life, including the academic, social, and family life of patients. In addition, studies show the effects of migraine on patient's relationships with family members such as spouse, children, and other family members. In addition to physical pain, migraines are tied to significant psychological and economic costs. Migraineurs tend to have high levels of depression and anxiety, and migraine headaches have a profoundly negative impact on sufferers’ quality of life. In the present research, we investigated the correlations and regressions of cognitive, personality, and family factors with migraine headache, to find predictor factors of migraine. In this study, the following questionnaires were used: For migraine: six-item Headache Impact Test (HIT-6, and Specific Quality of Life Questionnaire Version 2.1.; for cognitive factors: Irrational Beliefs Test and Dysfunctional Attitudes Scale; for personality factors: NEO Personality Inventory; and for family factors: Family Assessment Device. This project was on 58 women with migraine headaches, diagnosed by neurologist. The findings show that, there is a significant regression between cognitive, personality, and family factors and HIT-6. In cognitive factors, frustration reactivity and anxious overconcern, in personality factors, extraversion trait, and in family factors, affective involvement are significant. Moreover, there is a significant regression between cognitive, personality, and family factors and MSQ. In cognitive factors, frustration reactivity, anxious overconcern, and helplessness, in personality factors, agreeableness and consciousness, and in family factors, affective involvement and general functioning are significant. This project showed that cognitive, personality, and family factors have a correlation with migraine headache.
Kim, Bogyun; Lee, Jia
2016-03-01
Current increase and complexity of medical tests and surgical procedures at outpatient department (OPD) require OPD nurses to have customer orientation focusing on various customers' interests and needs. The purpose of this study was to identify the factors associated with customer orientation in nurses working at OPD of hospitals. The study used a descriptive correlational design with cross-sectional survey. The study settings were four general hospitals in Seoul and its metropolitan area. Data were collected from 138 OPD nurses from general hospitals. Study variables were personal traits, emotional intelligence, internal marketing, service management and customer orientation. Factors associated with customer orientation were identified as conscientiousness from personal traits (β = .37, p marketing from environmental characteristics (β = .21, p = .001). Hospital administrators should support OPD nurses to cultivate sincere and sociable personal traits and emotional intelligence, and to consider employees as internal customers to improve patient-oriented services and satisfaction. Copyright © 2015. Published by Elsevier B.V.
Lack of empathy in patients with narcissistic personality disorder.
Ritter, Kathrin; Dziobek, Isabel; Preissler, Sandra; Rüter, Anke; Vater, Aline; Fydrich, Thomas; Lammers, Claas-Hinrich; Heekeren, Hauke R; Roepke, Stefan
2011-05-15
The study's objective was to empirically assess cognitive and emotional empathy in patients with narcissistic personality disorder (NPD). To date, "lack of empathy" is a core feature of NPD solely based on clinical observation. The study's method was that forty-seven patients with NPD, 53 healthy controls, and 27 clinical controls with borderline personality disorder (BPD) were included in the study. Emotional and cognitive empathy were assessed with traditional questionnaire measures, the newly developed Multifaceted Empathy Test (MET), and the Movie for the Assessment of Social Cognition (MASC). The study's results were that individuals with NPD displayed significant impairments in emotional empathy on the MET. Furthermore, relative to BPD patients and healthy controls, NPD patients did not show deficits in cognitive empathy on the MET or MASC. Crucially, this empathic profile of NPD is not captured by the Structured Clinical Interview for DSM-IV for Axis II Disorders (SCID-II). The study's conclusions were that while NPD involves deficits in emotional empathy, cognitive empathy seems grossly unaffected. Copyright © 2010 Elsevier Ltd. All rights reserved.
Yoo, Woohyun; Kim, Soo Yun; Hong, Yangsun; Chih, Ming-Yuan; Shah, Dhavan V; Gustafson, David H
2015-01-01
With the increasing penetration of digital mobile devices among adolescents, mobile texting messaging is emerging as a new channel for patient-clinician communication for this population. In particular, it can promote active communication between healthcare clinicians and adolescents with asthma. However, little is known about the content of the messages exchanged in medical encounters via mobile text messaging. Therefore, this study explored the content of text messaging between clinicians and adolescents with asthma. We collected a total of 2,953 text messages exchanged between 5 nurse case managers and 131 adolescents with asthma through a personal digital assistant. The text messages were coded using a scheme developed by adapting categories from the Roter Interaction Analysis System. Nurse case managers sent more text messages (n=2,639) than adolescents with asthma. Most messages sent by nurse case managers were targeted messages (n=2,475) directed at all adolescents with asthma, whereas there were relatively few tailored messages (n=164) that were created personally for an individual adolescent. In addition, both targeted and tailored messages emphasized task-focused behaviors over socioemotional behaviors. Likewise, text messages (n=314) sent by adolescents also emphasized task-focused over socioemotional behaviors. Mobile texting messaging has the potential to play an important role in patient-clinician communication. It promotes not only active interaction, but also patient-centered communication with clinicians. In order to achieve this potential, healthcare clinicians may need to focus on socioemotional communication as well as task-oriented communication.
Specific features of suicidal behavior in patients with narcissistic personality disorder.
Blasco-Fontecilla, Hilario; Baca-Garcia, Enrique; Dervic, Kanita; Perez-Rodriguez, M Mercedes; Lopez-Castroman, Jorge; Saiz-Ruiz, Jeronimo; Oquendo, Maria A
2009-11-01
Suicidal behavior is a clinically significant but underestimated cause of mortality in narcissistic personality disorder. Currently, there are no reliable estimates of suicidal behavior for this population. The main objective of this study was to test whether or not suicide attempters diagnosed with narcissistic personality disorder are different in terms of impulsivity and expected lethality from suicide attempters with other cluster B personality disorders. In a sample of 446 suicide attempters, patients with cluster B personality disorder diagnoses (n = 254) as assessed by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), version of the International Personality Disorder Examination-Screening Questionnaire (IPDE-SQ) were compared in terms of expected lethality and impulsivity (measured by the Beck Suicidal Intent Scale and the Barratt Impulsiveness Scale, respectively). The subjects were admitted to the emergency departments of the Ramón y Cajal Hospital and the Fundación Jiménez Diaz University Hospital in Madrid, Spain, between January 1999 and January 2003. Suicide attempts of subjects diagnosed with narcissistic personality disorder had higher expected lethality than those of subjects without narcissistic personality disorder (t = -4.24, df = 439, P personality disorder (t = 0.28, df = 439, P = .795), antisocial personality disorder (t = 0.66, df = 439, P = .504), and borderline personality disorder (t = 1.13, df = 439, P = .256), respectively. Suicide attempters diagnosed with narcissistic personality disorder did not significantly differ from suicide attempters without narcissistic personality disorder in terms of impulsivity measures (t = -0.33, df = 442, P = .738), while suicide attempters diagnosed with antisocial personality disorder, histrionic personality disorder, and borderline personality disorder were significantly more impulsive than suicide attempters without these diagnoses (t = -3.96, df = 442, P
TVA nuclear power: Management of the nuclear program through personal services contracts
International Nuclear Information System (INIS)
1987-01-01
Mr. Steven White, a retired admiral, is serving as manager of the TVA Office of Nuclear Power. GAO previously concluded that Mr. White's retention under contractual arrangements constituted the improper use of a personal services contract and represented a circumvention of the statutory ceiling on salary payments to TVA employees. This report finds that Mr. White's rate of pay is within the range of the salaries paid by a sample of nonfederal utilities to their top executives and is over two and a half times the average salary paid to executives who hold positions which appear to have responsibility for managing the utilities' power or nuclear power operations. GAO also found that (1) TVA's Office of Nuclear Power has employed an additional 25 persons since 1986 under arrangements similar to the employing arrangements of Mr. White and (2) TVA's Nuclear Safety Review staff no longer reports directly to the TVA Board of Directors and General Manager. It has relocated from Knoxville, Tennessee to Chattanooga, Tennessee
Emotional and personality changes following brain tumour resection.
Jenkins, Lisanne M; Drummond, Katharine J; Andrewes, David G
2016-07-01
Psychological distress has a high prevalence in brain tumour patients, and understanding the emotional and personality changes that may follow neurosurgery is important for clinical management of these patients. We aimed to characterise these emotional and personality changes using subjective, observer-rated and clinical measures. We examined subjective changes in emotional experience and observer-rated changes to personality disturbances following neurosurgery for brain tumours (n=44), compared to a control group that had undergone spinal surgery (n=26). Participants completed the Hospital Anxiety and Depression Scale and a Subjective Emotional Change Questionnaire. Observers who knew the patients well also completed the Iowa Rating Scale of Personality Change. Compared to controls, patients with tumours reported significantly more changes to their subjective experience of emotions following neurosurgery, particularly anger, disgust and sadness. For the observer-ratings, tumour patients were described as having significant changes in the personality disturbances of irritability, impulsivity, moodiness, inflexibility, and being easily overwhelmed. Anxiety and depression were not significantly different between groups. Neurosurgical resection of a brain tumour is a major life event that changes patients' subjective experiences of different emotions, and leads to observer-rated changes in personality. In this study, these changes were not accompanied by increases in anxiety or depression. We conclude with a discussion of biological and psychosocial mechanisms that can impact emotional functioning and personality in patients with brain tumours. Copyright © 2015 Elsevier Ltd. All rights reserved.
Discovering Your Personality: A Group Exercise in Personal Sensemaking
Anderson, Marc H.
2008-01-01
Personality affects a wide variety of issues in organizational behavior, human resource management, and strategic management. Instructors teaching personality often have students take personality tests and then give them their scores. This passive approach to giving test feedback suffers from several weaknesses dealing with distinct perceptual…
Effects of induced anger in patients with antisocial personality disorder
Lobbestael, J.; Arntz, A.R.; Cima, M.; Chakhssi, F.
2009-01-01
Background. Anger is the main deregulated emotion in patients with antisocial personality disorder (ASPD). The aim of this study was to examine emotional, cognitive and physiological correlates of anger and compare these between ASPD patients with varying degree of psychopathy (PP) and control
A Generic Context Management Framework for Personal Networking Environments
DEFF Research Database (Denmark)
Sanchez, Luis; Olsen, Rasmus Løvenstein; Bauer, Martin
2006-01-01
on their computational capabilities and their role within the system. We differentiate between Basic Context Nodes (BCN), Enhanced Context Nodes (ECN) and Context Management Nodes (CMN) within the CMF. CMNs operate on two levels, i.e., local/cluster level and PN level. In the paper we also describe how these entities......In this paper we introduce a high level architecture for a context management system for Personal Networks (PN). The main objective of the Context Management Framework (CMF) described in this paper is to support the interactions between context information sources and context aware components......, services and applications in a generic manner, independently of their nature and operation area. To this end, we propose a structure consisting of a context access module, processing and storage module, and a data source abstraction layer. Nodes provide a certain set of these modules depending...
Electronic Personal Health Record Use Among Nurses in the Nursing Informatics Community.
Gartrell, Kyungsook; Trinkoff, Alison M; Storr, Carla L; Wilson, Marisa L
2015-07-01
An electronic personal health record is a patient-centric tool that enables patients to securely access, manage, and share their health information with healthcare providers. It is presumed the nursing informatics community would be early adopters of electronic personal health record, yet no studies have been identified that examine the personal adoption of electronic personal health record's for their own healthcare. For this study, we sampled nurse members of the American Medical Informatics Association and the Healthcare Information and Management Systems Society with 183 responding. Multiple logistic regression analysis was used to identify those factors associated with electronic personal health record use. Overall, 72% were electronic personal health record users. Users tended to be older (aged >50 years), be more highly educated (72% master's or doctoral degrees), and hold positions as clinical informatics specialists or chief nursing informatics officers. Those whose healthcare providers used electronic health records were significantly more likely to use electronic personal health records (odds ratio, 5.99; 95% confidence interval, 1.40-25.61). Electronic personal health record users were significantly less concerned about privacy of health information online than nonusers (odds ratio, 0.32; 95% confidence interval, 0.14-0.70) adjusted for ethnicity, race, and practice region. Informatics nurses, with their patient-centered view of technology, are in prime position to influence development of electronic personal health records. Our findings can inform policy efforts to encourage informatics and other professional nursing groups to become leaders and users of electronic personal health record; such use could help them endorse and engage patients to use electronic personal health records. Having champions with expertise in and enthusiasm for the new technology can promote the adoptionof electronic personal health records among healthcare providers as well as
Directory of Open Access Journals (Sweden)
Reza Bagherian Sararoudi
2011-01-01
Full Text Available Background: Type D personality is based on two global and stable personality traits, including negative affectivity (NA and social inhibition (SI. The aim of this study was to examine the relationship between type D personality and perceived social support in post myocardial infarction (MI patients. Methods: One hundred seventy six consecutive patients following MI admitted to the cardiac care unit (CCU of nine hospitals in Isfahan, Iran from April to September 2006 were selected based on the inclusive and exclusive criteria. The patients completed the Persian version of type D personality scale and the Persian version of multidimensional scale of perceived social support (MSPSS. Also, demographic and medical questionnaire was completed for each patient. Chi-squared test, t-test and MANOVA were used to analyze the data. Results: The findings indicated that 35.8% patients (35.8 % were classified as type D. The results of MANOVA showed that type D patients were significantly different from non-type D patients (F = 8.72, p = 0.0001 on MSPSS scores and on all dimensions including family subscale (F = 11.52, p = 0.001, friends subscale (F= 16.16, p = 0.0001 and significant others subscale (F = 5.04, p = 0.026. Conclusions: Type D personality substantially affects the way MI patients perceive availability of social support from different sources including family, friends, and significant others. One implication of this finding may be to develop tailor-made interventions for MI patients with type D.
Fukao, Atsushi; Takamatsu, Junta; Kubota, Sumihisa; Miyauchi, Akira; Hanafusa, Toshiaki
2011-08-09
We previously reported that depressive personality (the scores of hypochondriasis, depression and psychasthenia determined by the Minnesota Multiphasic Personality Inventory (MMPI)) and daily hassles of Graves' disease (GD) patients treated long trem with antithyroid drug (ATD) were significantly higher in a relapsed group than in a remitted group, even in the euthyroid state. The present study aims to examine the relationship among depressive personality, emotional stresses, thyroid function and the prognosis of hyperthyroidism in newly diagnosed GD patients. Sixty-four untreated GD patients responded to the MMPI for personality traits, the Natsume's Stress Inventory for major life events, and the Hayashi's Daily Life Stress Inventory for daily life stresses before and during ATD treatment. In the untreated thyrotoxic state, depressive personality (T-scores of hypochondriasis, depression or psychasthenia greater than 60 points in MMPI) were found for 44 patients (69%). For 15 (23%) of these patients, the scores decreased to the normal range after treatment. However, depressive personality persisted after treatment in the remaining 29 patients (46%). Normal scores before treatment were found for 20 patients (31%), and the scores were persistently normal for 15 patients (23%). The remaining 5 patients (8%) had higher depressive personality after treatment. Such depressive personality was not associated with the severity of hyperthyroidism. Serum TSH receptor antibody activity at three years after treatment was significantly (p = 0.0351) greater in the depression group than in the non- depression group. The remission rate at four years after treatment was significantly (p = 0.0305) lower in the depression group than in the non- depression group (22% vs 52%). The data indicate that in GD patients treated with ATD, depressive personality during treatment reflects the effect of emotional stress more than that of thyrotoxicosis and that it aggravates hyperthyroidism
Petry, Nancy M.; Ford, Julian D.; Barry, Danielle
2011-01-01
Exposure to sexual victimization is prevalent among persons with substance use disorders (SUDs). Contingency management (CM) treatments utilize concrete and relatively immediate positive reinforcers to retain patients in treatment and reduce substance use, and CM may have particular benefits for patients with histories of sexual victimization. Using data from three randomized trials of CM (N = 393), this study evaluated main and interactive effects of sexual abuse history and treatment condit...
Subtypes of borderline personality disorder patients: a cluster-analytic approach.
Smits, Maaike L; Feenstra, Dine J; Bales, Dawn L; de Vos, Jasmijn; Lucas, Zwaan; Verheul, Roel; Luyten, Patrick
2017-01-01
The borderline personality disorder (BPD) population is notably heterogeneous, and this has potentially important implications for intervention. Identifying distinct subtypes of patients may represent a first step in identifying which treatments work best for which individuals. A cluster-analysis on dimensional personality disorder (PD) features, as assessed with the SCID-II, was performed on a sample of carefully screened BPD patients ( N = 187) referred for mentalization-based treatment. The optimal cluster solution was determined using multiple indices of fit. The validity of the clusters was explored by investigating their relationship with borderline pathology, symptom severity, interpersonal problems, quality of life, personality functioning, attachment, and trauma history, in addition to demographic and clinical features. A three-cluster solution was retained, which identified three clusters of BPD patients with distinct profiles. The largest cluster ( n = 145) consisted of patients characterized by "core BPD" features, without marked elevations on other PD dimensions. A second "Extravert/externalizing" cluster of patients ( n = 27) was characterized by high levels of histrionic, narcissistic, and antisocial features. A third, smaller "Schizotypal/paranoid" cluster ( n = 15) consisted of patients with marked schizotypal and paranoid features. Patients in these clusters showed theoretically meaningful differences in terms of demographic and clinical features. Three meaningful subtypes of BPD patients were identified with distinct profiles. Differences were small, even when controlling for severity of PD pathology, suggesting a strong common factor underlying BPD. These results may represent a stepping stone toward research with larger samples aimed at replicating the findings and investigating differential trajectories of change, treatment outcomes, and treatment approaches for these subtypes. The study was retrospectively registered 16 April 2010
Directory of Open Access Journals (Sweden)
Maurizio Bevilacqua
2014-09-01
Full Text Available Purpose: This work investigates the influence of project managers’ personality on the success of a project in a Multinational Corporation. The methodology proposed for analyzing the project managers’ personality is based on the Myers-Briggs Type Indicator.Design/methodology/approach: Forty projects carried out in 2012 by multinational corporation, concerning new product development (NPD, have been analyzed, comparing the profile of project managers with results obtained in terms of traditional performance indexes (time delay and over-budget of projects and performance indexes usually used in “Lean Production” sector (waste time and type of “wastes”. A detailed analysis of the most important “wastes” during the project development is carried out using the Value Stream Mapping (VSM technique.Findings and Originality/value: Relying on the Myers–Briggs personality instrument, results show that extroverted managers (as opposed to introverted managers carry out projects that show lower delay and lower waste time. Introverted managers often make “Over-processing” and “Defect” types of waste. Moreover, lower delay and over-budget have been shown by perceiving managers.Research limitations: Regarding the limitations of this work it is necessary to highlight that we collected data from project managers in a retrospective way. While we believe that several aspects of our data collection effort helped enhance the accuracy of the results, future research could conduct real-time case study research to get more detailed insights into the proposed relationships and avoid retrospective bias. Moreover we focused on a single respondent, the project manager. This helped us ensure that their interpretations played an important role in product development. But, we cannot examined the opinion of team members that could be different from project managers opinion regarding some questions.Originality/value: This research provides insight useful
Westman, Mina; Etzion, Dalia
1990-01-01
Reactions to 4 versions of a vignette describing a successful manager were obtained from 233 management students, including 50 executives in an extension course. Career success was perceived as a major cause of personal failure. The personal price paid by successful people was perceived differently depending on gender and marital status. (SK)
Werner, Nicole E; Jolliff, Anna F; Casper, Gail; Martell, Thomas; Ponto, Kevin
2018-08-01
Managing chronic illness requires personal health information management (PHIM) to be performed by lay individuals. Paramount to understanding the PHIM process is understanding the sociotechnical system in which it frequently occurs: the home environment. We combined distributed cognition theory and the patient work system model to investigate how characteristics of the home interact with the cognitive work of PHIM. We used a 3D virtual reality CAVE that enabled participants who had been diagnosed with diabetes (N = 20) to describe how they would perform PHIM in the home context. We found that PHIM is distinctly cognitive work, and rarely performed 'in the head'. Rather, features of the physical environment, tasks, people, and tools and technologies present, continuously shape and are shaped by the PHIM process. We suggest that approaches in which the individual (sans context) is considered the relevant unit of analysis overlook the pivotal role of the environment in shaping PHIM. Practitioner Summary: We examined how Personal Health Information Management (PHIM) is performed in the homes of diabetic patients. We found that approaches to studying cognition that focus on the individual, to the exclusion of their context, overlook the pivotal role of environmental, social, and technological features in shaping PHIM.
Contemporary management of TMJ involvement in JIA patients and its orofacial consequences.
Niibo, Priit; Pruunsild, Chris; Voog-Oras, Ülle; Nikopensius, Tiit; Jagomägi, Triin; Saag, Mare
2016-01-01
Juvenile idiopathic arthritis is the most common chronic rheumatic condition during childhood. Temporomandibular joint arthritis is frequently asymptomatic. When it takes place during childhood, it may affect condylar growth; therefore, these children are at risk of unfavorable long-term outcomes from the associated joint damage. The etiology is not completely understood, but it is considered as multifactorial with both genetic and environmental factors involved. The standardized examination and imaging protocols serve important purpose to diagnose temporomandibular joint (TMJ) arthritis not only to establish an early interventional strategy but also to assess craniofacial growth and the progression of signs and symptoms in those patients. Although the treatment of juvenile idiopathic arthritis (JIA) has changed dramatically over the last decades due to new therapeutic options, TMJ arthritis still can develop during the course of the disease. In clinical experience, TMJs appear to respond less well to the standard of care used to treat other joints. More individualized approach to the patient's treatment serves as the main goal of personalized medicine. It could be achieved by adopting new methods of medical imaging such as conebeam computer tomography as well as developing reliable biomarkers which may assist with predicting disease type, course, or severity and predicting response to medication. This article provides an overview of current information on orofacial complications in JIA and its management. Based on information provided in this review, more precise diagnosis, proper tools for recognizing people at risk, and more efficient treatment approaches could be implemented. This may lead to more personalized treatment management strategies of TMJ complications of JIA patients.
[Personalized nursing care in hospital and its effects on the patient-nurse trust relationship].
García-Juárez, María del Rosario; López-Alonso, Sergio R; Moreno-Verdugo, Ana; Guerra-González, Sara; Fernández-Corchero, Juana; Márquez-Borrego, M José; Orozco-Cózar, M José; Ramos-Bosquet, Gádor
2013-01-01
To determine the level of implementation of an inpatient personalized nursing care model in four hospitals of the Andalusian Health Service, and to determine if there is an association between this model and the perception of trust in the nurse by the patient. An observational cross-sectional study included the patients discharged during a period of 12 months from hospital wards that used the Inpatient Personalized Nursing Care Model of the Andalusian Health Service (based on Primary Nursing Model). The level of implemention was evaluated using the Nursing Care Personalized Index (IPC), made by «patient report» methodology, and the nurse-patient trust relationship was evaluated at the same time as the IPC. Statistical analysis included descriptive data analysis, Chi-squared test, and bivariate and multivariate logistic regression, with and without stratifying by hospitals wards. A total of 817 patient were included. The implementation of the inpatient personalized nursing care model varied between 61 and 79%. The IPC values showed a strong association with the nurse-patient trust relationship, and that for each point increase in the IPC score, the probability of a nurse-patient trust relationship increased between 50 and 130% (0.120.58). The implementation of a personalized nursing care model in the wards studied was higher in the surgicals wards and at regular level in medical wards. Furthermore, the influence of the inpatient personalized nursing care model on the nurse-patient trust relationship has been demonstrated using the IPC model. This trust is the main component for the establishment of a therapeutic relationship. Copyright © 2013 Elsevier España, S.L. All rights reserved.
Using patient-reported measurement to pave the path towards personalized medicine
Sprangers, Mirjam A. G.; Hall, Per; Morisky, Donald E.; Narrow, William E.; Dapueto, Juan
2013-01-01
Given the potential and importance of personalized or individualized medicine for health care delivery and its effects on patients' quality of life, a plenary session was devoted to personalized medicine during the 19th Annual Conference of the International Society for Quality of Life Research held
Pustozerov, Evgenii; Popova, Polina; Tkachuk, Aleksandra; Bolotko, Yana; Yuldashev, Zafar; Grineva, Elena
2018-01-09
Personalized blood glucose (BG) prediction for diabetes patients is an important goal that is pursued by many researchers worldwide. Despite many proposals, only a few projects are dedicated to the development of complete recommender system infrastructures that incorporate BG prediction algorithms for diabetes patients. The development and implementation of such a system aided by mobile technology is of particular interest to patients with gestational diabetes mellitus (GDM), especially considering the significant importance of quickly achieving adequate BG control for these patients in a short period (ie, during pregnancy) and a typically higher acceptance rate for mobile health (mHealth) solutions for short- to midterm usage. This study was conducted with the objective of developing infrastructure comprising data processing algorithms, BG prediction models, and an appropriate mobile app for patients' electronic record management to guide BG prediction-based personalized recommendations for patients with GDM. A mobile app for electronic diary management was developed along with data exchange and continuous BG signal processing software. Both components were coupled to obtain the necessary data for use in the personalized BG prediction system. Necessary data on meals, BG measurements, and other events were collected via the implemented mobile app and continuous glucose monitoring (CGM) system processing software. These data were used to tune and evaluate the BG prediction model, which included an algorithm for dynamic coefficients tuning. In the clinical study, 62 participants (GDM: n=49; control: n=13) took part in a 1-week monitoring trial during which they used the mobile app to track their meals and self-measurements of BG and CGM system for continuous BG monitoring. The data on 909 food intakes and corresponding postprandial BG curves as well as the set of patients' characteristics (eg, glycated hemoglobin, body mass index [BMI], age, and lifestyle parameters
An approach to discussing personal and social identity terminology with patients.
Sloboda, Alexander; Mustafa, Aesha; Schober, Justine
2018-03-01
As the United States of America becomes more socially diverse, it is more important now than ever for health care providers to become more aware of their patients' social identities. It is imperative that providers engage with their patients and see how each of them identifies personally in relation to social construction terminology. As with the terminology of human anatomy, there is a vast and diverse vocabulary concerning the anatomy of society, which is also clinically relevant to health care providers. If health care providers take the initiative to discuss how their patients identify, they can understand better how those patients experience the world, and this can significantly affect many facets of their health and health care experience. Giving respect fosters the creation of a strong relationship within which patients can share very personal and intimate information, which in turn allows health care providers the possibility of providing the best healthcare. This discussion will build upon and integrate current academic research and opinion for tangible clinical use while discussing various social and personal identities, including but not limited to race, gender, gender expression, sex, sexual orientation, religion, ethnicity, socioeconomic class, and physical and mental abilities. Clin. Anat. 31:136-139, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.
2010-07-01
... Manager to select and appoint or recommend for appointment the person or legal entity to receive....55 Veterans Service Center Manager to select and appoint or recommend for appointment the person or.... The Veterans Service Center Manager is authorized to select and appoint (or in the case of a court...
Karasneh, Jumana; Al-Omiri, Mahmoud K; Al-Hamad, Khaled Q; Al Quran, Firas A M
2009-11-01
The aim of this study was to investigate the relationship between patients' oral health-related quality of life, satisfaction with their dentition, and their personality profiles. Eighty-four patients (30 males and 54 females; mean age 31.9+/-12.7 years) seeking routine dental treatment were recruited for this study. A "Dental Impact on Daily Living" (DIDL) questionnaire was used to assess dental satisfaction and impact on daily living. An "Oral Health Impact Profile" (OHIP) was used to measure self-reported discomfort, disability, and dysfunction caused by oral conditions. Oral health-related quality of life was assessed using the "United Kingdom Oral Health Related Quality of Life" measure (OHQoL-U.K). A "NEO Five Factor inventory" (NEO-FFI) was used to assess personality profiles. The dentition has a measurable impact on daily living as well as with satisfaction with appearance, pain levels, oral comfort, general performance, and eating capability (p=0.000). Younger patients had more profound oral health impacts (p=0.045) and higher neuroticism scores (0.043). OHIP scores were significantly related to OHQoL-UK scores (p=0.000). DIDL scores had significant correlations with OHIP and OHQoL-UK scores (p<0.05). Significant correlations were established between neuroticism and satisfaction with oral comfort, extraversion and total satisfaction and satisfaction with general performance, and openness and satisfaction with appearance (p<0.05). OHIP and OHQoL-UK scores had no significant correlations with psychological profiles. The status of the oral cavity can have a definitive impact on patients' daily living and quality of life regardless age, gender, and level of education. Patients' satisfaction with their dentition has definitive impacts on daily living, quality of life, and dental perceptions. Personality profiles (neuroticism; extraversion, and openness) may influence dental perceptions, play a significant role in shaping satisfaction with dentition, and help
The role of patient personality in the identification of depression in older primary care patients.
McCray, Laura W; Bogner, Hillary R; Sammel, Mary D; Gallo, Joseph J
2007-11-01
Our aim was to evaluate whether personality factors significantly contribute to the identification of depression in older primary care patients, even after controlling for depressive symptoms. We examined the association between personality factors and the identification of depression among 318 older adults who participated in the Spectrum study. High neuroticism (unadjusted Odds Ratio (OR) 2.36, 95% Confidence Interval (CI) [1.42, 3.93]) and low extraversion (adjusted OR 2.24, CI [1.26, 4.00]) were associated with physician identification of depression. Persons with high conscientiousness were less likely to be identified as depressed by the doctor (adjusted OR 0.45, CI [0.22, 0.91]). Personality factors influence the identification of depression among older persons in primary care over and above the relationship of depressive symptoms with physician identification. Knowledge of personality may influence the diagnosis and treatment of depression in primary care. Copyright 2007 John Wiley & Sons, Ltd.
Directory of Open Access Journals (Sweden)
Marija Ivaniš
2018-06-01
Full Text Available A successful high-level management is aware of the fact that, in competitive surroundings, business ethics enables growth and development, increases efficiency and productivity. In this sense, at the time when ethical behaviour is of paramount importance if one wants to retain an enterprise on the market, it has become essential to perceive the relationship between personal values of high-level management with ethical behaviour which is the purpose of this paper. The results of the research in this paper indicate the correlation between the personal value system and the ethical/unethical behaviour of hotel manager of large companies in Croatia.
Designing smart analytical data services for a personal health framework.
Koumakis, Lefteris; Kondylakis, Haridimos; Chatzimina, Maria; Iatraki, Galatia; Argyropaidas, Panagiotis; Kazantzaki, Eleni; Tsiknakis, Manolis; Kiefer, Stephan; Marias, Kostas
2016-01-01
Information in the healthcare domain and in particular personal health record information is heterogeneous by nature. Clinical, lifestyle, environmental data and personal preferences are stored and managed within such platforms. As a result, significant information from such diverse data is difficult to be delivered, especially to non-IT users like patients, physicians or managers. Another issue related to the management and analysis is the volume, which increases more and more making the need for efficient data visualization and analysis methods mandatory. The objective of this work is to present the architectural design for seamless integration and intelligent analysis of distributed and heterogeneous clinical information in the PHR context, as a result of a requirements elicitation process in iManageCancer project. This systemic approach aims to assist health-care professionals to orient themselves in the disperse information space and enhance their decision-making capabilities, to encourage patients to have an active role by managing their health information and interacting with health-care professionals.
Directory of Open Access Journals (Sweden)
Filipović Vinka
2010-01-01
Full Text Available Background/Aim. Over the recent years customer satisfaction program as a tool for patient satisfaction has been recognized as an important issue in healthcare services. The aim of this preliminary study was to explore an influence of healthcare institution managers' approach and attitudes to marketing and public relations activities (communication activities, in the context of implementation of customer satisfaction programs, on patient satisfaction. Methods. The study was conducted among managers from different state-owned healthcare institutions (healthcare centers, clinics, hospitals in Serbia. The structured questionnaire form, comprising both open and closed questions, was used as a main research tool. The total number of sent questionnaires was 120; 56 questionnaires were sent back, while 49 of them were valid. Results. It was shown that 42.9% of healthcare institutions apply proactive media approach, and that 35.7% of the organizations have a person who, besides his/her basic engagements, performs activities connected with marketing and public relations. Using Chi-square likelihood ratio test it is confirmed that these activities have a significant role in supporting customer satisfaction program implementation (p < 0.05. The results showed that in 69.4% cases, positive attitude of healthcare institutions managers toward marketing and public relations activities had positive influence on patient satisfaction (p < 0.05. Conclusion. Managers in healthcare sector in Serbia who used proactive approach toward media and who had already institutionalized communication activities with external stakeholders have a positive attitude to implementation of customer satisfaction program. Furthermore, managers' attitude toward communication activities has influence on patient satisfaction.
Directory of Open Access Journals (Sweden)
Namat Sotodeh Asl
2013-03-01
Full Text Available Introduction: Substance abuse is one of the most common disorders that exert a high impact on the life of patients and their families. There are many treatment methods for Addiction. The purpose of the present study was to determine the effects of narcotics anonymous (NA program on personality characters in substance abuse patients.Materials and Methods: This quasi experimental design was performed on 100 patients with substance abuse disorders that they had been randomly selected from those patients who were referred to psychiatric clinics and counseling centers in Esfehan in 2008. Then, the subjects were equally divided into two groups; experimental and control. All the patients carried out Eysenk test prior to any intervention and also a demographic questionnaire were filled out by all the subjects. Then, Eysenk test was performed on all the patients following the intervention. Changing in personality character in the experimental group (before and after the intervention was compared with those of the control group. Results: The findings showed that narcotic program has significant effects on personality characters of experimental group to substance abuse in post test, but these effects are not significant in control group.Conclusion: According to the findings of this work, we suggest the effectiveness of NA program in changing personality characters of the patients with substance abuse
Fuji, Kevin T; Abbott, Amy A; Galt, Kimberly A
2015-04-01
Patient use of personal health records (PHRs) to manage their health information has been proposed to enhance patient knowledge and empower patients to make changes in their self-care behaviors. However, there remains a gap in understanding about patients' actual PHR use behaviors. The purpose of this qualitative study was to explore how patients with type 2 diabetes used a PHR to manage their diabetes-related health information for self-care. Fifty-nine patients with type 2 diabetes were interviewed 3-6 months after receiving initial training on a free-of-charge, Web-based PHR. Interviews were audio-recorded, transcribed, and analyzed using an iterative process of in vivo coding, categorization, and theme development. Nine themes emerged, three of which expressed positive experiences: complete and accessible record; increased awareness; and behavioral changes. The remaining six themes expressed negative experiences: out of sight, out of mind; I would have used it if I were sicker; economic, infrastructure, and computer literacy barriers; lack of patient-provider engagement; double tracking; and privacy and security concerns. Despite some potential positive benefits resulting from PHR use, several barriers inhibited sustained and effective use over time. Provider and patient education about the benefits of PHR use and about the potential for filling in information gaps in the provider-based record is key to engage patients and stimulate PHR adoption and use.
Cunningham, James; Ainsworth, John
2017-01-01
The rise of distributed ledger technology, initiated and exemplified by the Bitcoin blockchain, is having an increasing impact on information technology environments in which there is an emphasis on trust and security. Management of electronic health records, where both conformation to legislative regulations and maintenance of public trust are paramount, is an area where the impact of these new technologies may be particularly beneficial. We present a system that enables fine-grained personalized control of third-party access to patients' electronic health records, allowing individuals to specify when and how their records are accessed for research purposes. The use of the smart contract based Ethereum blockchain technology to implement this system allows it to operate in a verifiably secure, trustless, and openly auditable environment, features crucial to health information systems moving forward.
Directory of Open Access Journals (Sweden)
Mohammadi
2015-09-01
Full Text Available Background The present study aimed to investigate personality traits and coping strategies in patients with multiple sclerosis (MS who were admitted to Sina hospital compared with healthy individuals. Objectives The aim of the present study was to compare personality characteristics and coping strategies between patients with MS and healthy controls. Materials and Methods The study sample included 55 patients with MS and 57 matched healthy control individuals. The data were gathered via a demographic form, the ways of coping questionnaire, and the NEO five-factor inventory. The data were analyzed by multivariate analysis of variance (MANOVA, Pearson’s correlation coefficient, and logistic regression. Results No significant differences in personality characteristics were observed between patients and healthy controls (all P > 0.05. Only the coping strategy subscale of Distancing was significant between patients and healthy controls (P 0.05. Only the Neuroticism personality trait and the Distancing coping strategy were predictive of group membership (i.e., healthy or patient. Conclusions Our study suggests that the personality traits of patients with MS and healthy individuals are not significantly different. Patients with MS are likely to use the same coping strategies as healthy individuals, except in the subscale of Distancing.
Personal coping strategies for managing the side effects of ...
African Journals Online (AJOL)
This study describes the burden of side effects from ARV treatment as experienced by a sample of HIV/AIDS patients and identifies the personal strategies they used to cope with ... The most common adverse effects reported were tiredness, nightmares, mood swings, nausea, poor appetite, insomnia, vomiting and dizziness.
"Mad or bad?": burden on caregivers of patients with personality disorders.
Bauer, Rita; Döring, Antje; Schmidt, Tanja; Spießl, Hermann
2012-12-01
The burden on caregivers of patients with personality disorders is often greatly underestimated or completely disregarded. Possibilities for caregiver support have rarely been assessed. Thirty interviews were conducted with caregivers of such patients to assess illness-related burden. Responses were analyzed with a mixed method of qualitative and quantitative analysis in a sequential design. Patient and caregiver data, including sociodemographic and disease-related variables, were evaluated with regression analysis and regression trees. Caregiver statements (n = 404) were summarized into 44 global statements. The most frequent global statements were worries about the burden on other family members (70.0%), poor cooperation with clinical centers and other institutions (60.0%), financial burden (56.7%), worry about the patient's future (53.3%), and dissatisfaction with the patient's treatment and rehabilitation (53.3%). Linear regression and regression tree analysis identified predictors for more burdened caregivers. Caregivers of patients with personality disorders experience a variety of burdens, some disorder specific. Yet these caregivers often receive little attention or support.
Bengtsson, Ulrika; Kjellgren, Karin; Hallberg, Inger; Lundin, Mona; Mäkitalo, Åsa
2018-03-01
This paper reports on how the clinical consultation in primary care is performed under the new premises of patients' daily self-reporting and self-generation of data. The aim was to explore and describe the structure, topic initiation and patients' contributions in follow-up consultations after eight weeks of self-reporting through a mobile phone-based hypertension self-management support system. A qualitative, explorative study design was used, examining 20 audio- (n = 10) and video-recorded (n = 10) follow-up consultations in primary care hypertension management, through interaction analysis. Clinical trials registry: ClinicalTrials.gov NCT01510301. Four primary health care centers in Sweden. Patients with hypertension (n = 20) and their health care professional (n = 7). The consultations comprised three phases: opening, examination and closing. The most common topic was blood pressure (BP) put in relation to self-reported variables, for example, physical activity and stress. Topic initiation was distributed symmetrically between parties and BP talk was lifestyle-centered. The patients' contributed to the interpretation of BP values by connecting them to specific occasions, providing insights to the link between BP measurements and everyday life activities. Patients' contribution through interpretations of BP values to specific situations in their own lives brought on consultations where the patient as a person in context became salient. Further, the patients' and health care professionals' equal contribution during the consultations showed actively involved patients. The mobile phone-based self-management support system can thus be used to support patient involvement in consultations with a person-centered approach in primary care hypertension management Key points The clinical consultation is important to provide opportunities for patients to gain understanding of factors affecting high blood pressure, and for health care professionals to
Zamanzadeh, Vahid; Ahmadi, Fazlollah; Behshid, Mozhgan; Irajpoor, Alireza; Zakeri-Milani, Parvin
2017-06-01
Despite the effectiveness of pharmacotherapy for pain management in patients with osteoarthritis (OA), personal biases in the selection, administration, and continuation of pharmacotherapy challenge the proper management of symptoms and the effectiveness of the therapy. This study was conducted to carry out an in-depth examination of the experiences of patients with OA about their use of pharmacotherapy for the OA pain management and the existing challenges. The present qualitative study was conducted on 17 patients with OA, 5 of their family members and 8 healthcare personnel using a conventional content analysis approach. Data were collected through 35 interviews, which were unstructured at first but became semi-structured later on. Data collection continued until data saturation and analyzed simultaneously. The criteria used to determine the rigor of the study included the credibility, transferability, dependability and conformability of the data. The analysis of the data revealed 3 main categories and 8 subcategories. The main categories including preference for non-pharmacological modalities, preference for symptomatic slow-acting drugs for osteoarthritis (SySADOAs) and preference for vitamins and minerals. Briefing the patients on the therapeutic goals, participating them in the clinical decision-making process, modifying drug administration patterns through prescribing the minimum effective dosage and substituting alternative therapies whenever possible, consistently monitoring the therapeutic responses and any unexpected complications and use of complementary treatments, makes up strategies that can help improve OA pain management. © Georg Thieme Verlag KG Stuttgart · New York.
Directory of Open Access Journals (Sweden)
Ana Jovičić
2011-07-01
Full Text Available The aim of this paper is to present the importance of the connection between personality dimensions of employees with the characteristics of their job in order to achieve more productive work and accomplish maximum customer satisfaction, as well as to create competitive advantage. The survey was conducted on a sample of 50 employees in the hotel “Prezident” in Novi Sad. In the survey was used the questionnaire of personality dimensions of the big five, and traits that have been described in this questionnaire are extroversion, conscientiousness, pleasantness, openness to new experiences and negative affectivity. The results of the survey show that in the selected facility prevail positive personality dimensions, and the negative affectivity is at its lowest level. For that reason this hotel should serve as an example of how to coordinate work in hotel management with the personality dimensions of employees, all in the service of satisfaction of guests. In that sense a very important role has the sector of human resources whose task is identifying personality characteristics and fitting personality characteristics with business activities that an individual performs, and the development of emotional intelligence which is especially important in hotel management.
Patient-centered blood management.
Hohmuth, Benjamin; Ozawa, Sherri; Ashton, Maria; Melseth, Richard L
2014-01-01
Transfusions are common in hospitalized patients but carry significant risk, with associated morbidity and mortality that increases with each unit of blood received. Clinical trials consistently support a conservative over a liberal approach to transfusion. Yet there remains wide variation in practice, and more than half of red cell transfusions may be inappropriate. Adopting a more comprehensive approach to the bleeding, coagulopathic, or anemic patient has the potential to improve patient care. We present a patient-centered blood management (PBM) paradigm. The 4 guiding principles of effective PBM that we present include anemia management, coagulation optimization, blood conservation, and patient-centered decision making. PBM has the potential to decrease transfusion rates, decrease practice variation, and improve patient outcomes. PBM's value proposition is highly aligned with that of hospital medicine. Hospitalists' dual role as front-line care providers and quality improvement leaders make them the ideal candidates to develop, implement, and practice PBM. © 2013 Society of Hospital Medicine.
Management by the process of forming of personality qualities of students
Directory of Open Access Journals (Sweden)
S. V. Kowalewskyy
2013-02-01
Full Text Available The new approach is considered to the process of forming of personality qualities of students from positions of the guided system. A management object is presented in an aggregate with a managing subsystem as an open system. The bifurcation phenomena are watched in an educational process. In an experiment took part 326 students in age 17-20 years. The system of pedagogical technologies, able to provide forming of personality qualities of graduating student of higher educational establishment is certain. It is certain that this system allow in the compressed terms to adapt oneself to the corporate culture of firm-employer. Introduction is recommended in practice of preparation of students of complex special fitness of the programs. Underline, that these programs are directed on complex achievement of indexes of physical development and spiritual level. It is marked that the use of synergetics approach in modern practical activity of higher school is instrumental in enriching of educational educate process the methods of pedagogical co-operation.
Holzman, Samuel B; Zenilman, Avi; Shah, Maunank
2018-04-01
Directly observed therapy (DOT) remains an integral component of treatment support and adherence monitoring in tuberculosis care. In-person DOT is resource intensive and often burdensome for patients. Video DOT (vDOT) has been proposed as an alternative to increase treatment flexibility and better meet patient-specific needs. We conducted a pragmatic, prospective pilot implementation of vDOT at 3 TB clinics in Maryland. A mixed-methods approach was implemented to assess (1) effectiveness, (2) acceptability, and (3) cost. Medication adherence on vDOT was compared with that of in-person DOT. Interviews and surveys were conducted with patients and providers before and after implementation, with framework analysis utilized to extract salient themes. Last, a cost analysis assessed the economic impacts of vDOT implementation across heterogeneous clinic structures. Medication adherence on vDOT was comparable to that of in-person DOT (94% vs 98%, P = .17), with a higher percentage of total treatment doses (inclusive of weekend/holiday self-administration) ultimately observed during the vDOT period (72% vs 66%, P = .03). Video DOT was well received by staff and patients alike, who cited increased treatment flexibility, convenience, and patient privacy. Our cost analysis estimated a savings with vDOT of $1391 per patient for a standard 6-month treatment course. Video DOT is an acceptable and important option for measurement of TB treatment adherence and may allow a higher proportion of prescribed treatment doses to be observed, compared with in-person DOT. Video DOT may be cost-saving and should be considered as a component of individualized, patient-centered case management plans.
Su, M-H; Chen, H-C; Lu, M-L; Feng, J; Chen, I-M; Wu, C-S; Chang, S-W; Kuo, P-H
2018-01-01
To examine the associations between personality traits and suicidal ideation (SI) and attempt (SA) in mood disorder patients and community controls. We recruited 365 bipolar, 296 major depressive disorder patients, and 315 community controls to assess their lifetime suicidality. Participants filled out self-reported personality questionnaires to collect data of personality traits, including novelty seeking (NS), harm avoidance (HA), extraversion (E), and neuroticism (N). We used logistic regression models adjusted for diagnoses to analyze combinational effects of personality traits on the risk of suicide. Additionally, radar charts display personality profiles for suicidal behaviours by groups. All personality traits were associated with the risk of suicidality with various effect size, except for E that showed protective effect. High N or HA had prominent and independent risk effects on SI and SA. Combinations of high N and low E, or high HA and NS were the risk personality profiles for suicidality. Higher N scores further distinguished SA from SI in mood disorder patients. Introvert personality traits showed independent risk effects on suicidality regardless of diagnosis status. Among high-risk individuals with suicidal thoughts, higher neuroticism tendency is further associated with increased risk of suicide attempt. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Directory of Open Access Journals (Sweden)
Miyauchi Akira
2011-08-01
Full Text Available Abstract Background We previously reported that depressive personality (the scores of hypochondriasis, depression and psychasthenia determined by the Minnesota Multiphasic Personality Inventory (MMPI and daily hassles of Graves' disease (GD patients treated long trem with antithyroid drug (ATD were significantly higher in a relapsed group than in a remitted group, even in the euthyroid state. The present study aims to examine the relationship among depressive personality, emotional stresses, thyroid function and the prognosis of hyperthyroidism in newly diagnosed GD patients. Methods Sixty-four untreated GD patients responded to the MMPI for personality traits, the Natsume's Stress Inventory for major life events, and the Hayashi's Daily Life Stress Inventory for daily life stresses before and during ATD treatment. Results In the untreated thyrotoxic state, depressive personality (T-scores of hypochondriasis, depression or psychasthenia greater than 60 points in MMPI were found for 44 patients (69%. For 15 (23% of these patients, the scores decreased to the normal range after treatment. However, depressive personality persisted after treatment in the remaining 29 patients (46%. Normal scores before treatment were found for 20 patients (31%, and the scores were persistently normal for 15 patients (23%. The remaining 5 patients (8% had higher depressive personality after treatment. Such depressive personality was not associated with the severity of hyperthyroidism. Serum TSH receptor antibody activity at three years after treatment was significantly (p = 0.0351 greater in the depression group than in the non- depression group. The remission rate at four years after treatment was significantly (p = 0.0305 lower in the depression group than in the non- depression group (22% vs 52%. Conclusion The data indicate that in GD patients treated with ATD, depressive personality during treatment reflects the effect of emotional stress more than that of
2011-01-01
Background We previously reported that depressive personality (the scores of hypochondriasis, depression and psychasthenia determined by the Minnesota Multiphasic Personality Inventory (MMPI)) and daily hassles of Graves' disease (GD) patients treated long trem with antithyroid drug (ATD) were significantly higher in a relapsed group than in a remitted group, even in the euthyroid state. The present study aims to examine the relationship among depressive personality, emotional stresses, thyroid function and the prognosis of hyperthyroidism in newly diagnosed GD patients. Methods Sixty-four untreated GD patients responded to the MMPI for personality traits, the Natsume's Stress Inventory for major life events, and the Hayashi's Daily Life Stress Inventory for daily life stresses before and during ATD treatment. Results In the untreated thyrotoxic state, depressive personality (T-scores of hypochondriasis, depression or psychasthenia greater than 60 points in MMPI) were found for 44 patients (69%). For 15 (23%) of these patients, the scores decreased to the normal range after treatment. However, depressive personality persisted after treatment in the remaining 29 patients (46%). Normal scores before treatment were found for 20 patients (31%), and the scores were persistently normal for 15 patients (23%). The remaining 5 patients (8%) had higher depressive personality after treatment. Such depressive personality was not associated with the severity of hyperthyroidism. Serum TSH receptor antibody activity at three years after treatment was significantly (p = 0.0351) greater in the depression group than in the non- depression group. The remission rate at four years after treatment was significantly (p = 0.0305) lower in the depression group than in the non- depression group (22% vs 52%). Conclusion The data indicate that in GD patients treated with ATD, depressive personality during treatment reflects the effect of emotional stress more than that of thyrotoxicosis and
Evolution of a web-based, prototype Personal Health Application for diabetes self-management.
Fonda, Stephanie J; Kedziora, Richard J; Vigersky, Robert A; Bursell, Sven-Erik
2010-10-01
Behaviors carried out by the person with diabetes (e.g., healthy eating, physical activity, judicious use of medication, glucose monitoring, coping and problem-solving, regular clinic visits, etc.) are of central importance in diabetes management. To assist with these behaviors, we developed a prototype PHA for diabetes self-management that was based on User-Centered Design principles and congruent with the anticipatory vision of Project Health Design (PHD). This article presents aspects of the prototype PHA's functionality as conceived under PHD and describes modifications to the PHA now being undertaken under new sponsorship, in response to user feedback and timing tests we have performed. In brief, the prototype Personal Health Application (PHA) receives data on the major diabetes management domains from a Personal Health Record (PHR) and analyzes and provides feedback based on clinically vetted educational content. The information is presented within "gadgets" within a portal-based website. The PHR used for the first implementation was the Common Platform developed by PHD. Key changes include a re-conceptualization of the gadgets by topic areas originally defined by the American Association of Diabetes Educators, a refocusing on low-cost approaches to diabetes monitoring and data entry, and synchronization with a new PHR, Microsoft® HealthVault™. Copyright © 2010 Elsevier Inc. All rights reserved.
Informing cancer patient based on his type of personality: the suspicious (paranoid) patient.
Kallergis, G
2013-01-01
Imparting bad news had always been an unpleasant task for the physician, as shown from ancient years to our days. In the healthcare sector and as far as the cancer patient is concerned, the imparting of bad news is performed by the patient's doctor within a therapeutic relationship of course. The fundamental question is how a therapist could tailor the information to any patient and if "Is it possible to determine who should be told what, when and how ?". The aim of this paper was to describe the suspicious character or type of personality thoroughly so that any physician can make a diagnosis and tailor the information strategy to the patient's needs. As method of research was used the qualitative method through groups with doctors and nurses, while research within groups lasted for 5 years. The degree of informing of the suspicious personality in the range "minimal - small - medium - large - very large" is : the degree of denial varies between large and very large. The degree of informing varies between medium and small and sometimes minimal. Informing the Family: The hardest family to deal with. Pay attention to litigious mania. Avoid confrontation or be drawn into agreeing with the family views.
Navaneethan, Sankar D; Jolly, Stacey E; Schold, Jesse D; Arrigain, Susana; Nakhoul, Georges; Konig, Victoria; Hyland, Jennifer; Burrucker, Yvette K; Dann, Priscilla Davis; Tucky, Barbara H; Sharp, John; Nally, Joseph V
2017-09-07
Patient navigators and enhanced personal health records improve the quality of health care delivered in other disease states. We aimed to develop a navigator program for patients with CKD and an electronic health record-based enhanced personal health record to disseminate CKD stage-specific goals of care and education. We also conducted a pragmatic randomized clinical trial to compare the effect of a navigator program for patients with CKD with enhanced personal health record and compare their combination compared with usual care among patients with CKD stage 3b/4. Two hundred and nine patients from six outpatient clinics (in both primary care and nephrology settings) were randomized in a 2×2 factorial design into four-study groups: ( 1 ) enhanced personal health record only, ( 2 ) patient navigator only, ( 3 ) both, and ( 4 ) usual care (control) group. Primary outcome measure was the change in eGFR over a 2-year follow-up period. Secondary outcome measures included acquisition of appropriate CKD-related laboratory measures, specialty referrals, and hospitalization rates. Median age of the study population was 68 years old, and 75% were white. At study entry, 54% of patients were followed by nephrologists, and 88% were on renin-angiotensin system blockers. After a 2-year follow-up, rate of decline in eGFR was similar across the four groups ( P =0.19). Measurements of CKD-related laboratory parameters were not significantly different among the groups. Furthermore, referral for dialysis education and vascular access placement, emergency room visits, and hospitalization rates were not statistically significant different between the groups. We successfully developed a patient navigator program and an enhanced personal health record for the CKD population. However, there were no differences in eGFR decline and other outcomes among the study groups. Larger and long-term studies along with cost-effectiveness analyses are needed to evaluate the role of patient navigators
Amini, Mehdi; Pourshahbaz, Abbas; Mohammadkhani, Parvaneh; Khodaie Ardakani, Mohammad Reza; Lotfi, Mozhgan
2015-08-01
Fundamental problems with Personality Disorders (PD) diagnostic system in the previous version of DSM, led to the revision of DSM. Therefore, a multidimensional system has been proposed for diagnosis of personality disorder features in DSM-5. In the dimensional approach of DSM-5, personality disorders diagnosis is based on levels of personality functioning (Criteria A) and personality trait domains (Criteria B). The purpose of this study was firstly, to examine the DSM-5 levels of personality functioning in antisocial and borderline personality disorders, and second, to explore which levels of personality functioning in patients with antisocial and borderline personality disorders can better predicted severity than others. This study had a cross sectional design. The participants consisted of 252 individuals with antisocial (n = 122) and borderline personality disorders (n = 130). They were recruited from Tehran prisoners, and clinical psychology and psychiatry centers of Razi and Taleghani Hospitals, Tehran, Iran. The sample was selected based on judgmental sampling. The SCID-II-PQ, SCID-II and DSM-5 levels of personality functioning were used to diagnose and assess personality disorders. The data were analyzed by correlation and multiple regression analysis. All statistical analyses were performed using the SPSS 16 software. Firstly, it was found that DSM-5 levels of personality functioning have a strong correlation with antisocial and borderline personality symptoms, specially intimacy and self-directedness (P antisocial personality disorder severity (P personality disorder severity, as well (P personality functioning are a significant predictor of personality disorders severity. The results partially confirm existing studies.
Personality Modulates the Efficacy of Treatment in Patients With Major Depressive Disorder
Wardenaar, Klaas J.; Conradi, Henk Jan; Bos, Elisabeth H.; de Jonge, Peter
OBJECTIVE: Effects of depression treatment are obscured by heterogeneity among patients. Personality types could be one source of heterogeneity that explains variability in treatment response. Clinically meaningful variations in personality patterns could be captured with data-driven subgroups. The
From leeches to personalized medicine: evolving concepts in the management of polycythemia vera
Vannucchi, Alessandro M.
2017-01-01
Polycythemia vera is a clonal disorder of hematopoietic stem/progenitor cells. It manifests as an expansion of red cell mass. It is the most common chronic myeloproliferative neoplasm. In virtually all cases, it is characterized by a V617F point mutation in JAK2 exon 14 or less common mutations in exon 12. The landmark discovery of the autonomously activated JAK/STAT signaling pathway paved the way for the clinical development of the first target drug, the JAK1 and JAK2 inhibitor ruxolitinib. This is now approved for patients with resistance or intolerance to hydroxyurea. Phlebotomies and hydroxyurea are still the cornerstone of treatment, and aim to prevent the first appearance or recurrence of cardiovascular events that, together with progression to post-polycythemia vera myelofibrosis and leukemia, represent the main causes of death. Interferon-α is an alternative drug and has been shown to induce molecular remissions. It is currently undergoing phase III trials that might eventually lead to its approval for clinical use. The last few years have witnessed important advances towards an accurate early diagnosis of polycythemia vera, greater understanding of its pathogenesis, and improved patient management. This review will focus on the most recent achievements and will aim to unify the different concepts involved in a personalized approach to the patient with polycythemia vera. In spite of many recent advances in the understanding of its pathogenesis and improved disease management, polycythemia vera remains a life-threatening myeloproliferative neoplasm for which there is no cure. This review will present a critical overview of evolving concepts in diagnosis and treatment of this disease. PMID:27884974
Patient SWAP-200 personality dimensions and FFM traits: Do they predict therapist responses?
Tanzilli, Annalisa; Lingiardi, Vittorio; Hilsenroth, Mark
2018-05-01
The main aim of this study was to examine the relationship between therapists' emotional responses and patients' personality evaluated by 3 dimensional diagnostic approaches empirically derived from the Shedler-Westen Assessment Procedure-200 (SWAP-200; Westen & Shedler, 1999a, 1999b): Two of these rely on the 5-factor model (FFM) domains, that were assessed with different SWAP-200 FFM versions developed by Shedler and Westen (SW-FFM scales; 2004) and McCrae, Löckenhoff, and Costa (MLC-FFM scales; 2005); the third approach is based on a multifaceted model of personality syndromes (SWAP personality dimension scales; see Shedler & Westen, 2004). A national sample of psychiatrists and psychologists (N = 166) of various theoretical orientations completed the Therapist Response Questionnaire (TRQ; Zittel Conklin & Westen, 2003) to identify patterns of therapist response, and the SWAP-200 to assess personality regarding a patient currently in their care. The findings showed good levels of construct validity between the SW-FFM and MLC-FFM scales, with the exception of the Openness trait. Moreover, specific SW-FFM and MLC-FFM scales were significantly associated with distinct SWAP personality dimension scales according in a conceptually meaningful nomological network. Although there were significant, theoretically coherent, and systematic relationships between therapists' responses and patients' personality features, overall the contribution of the SW-FFM and MLC-FFM traits in predicting therapists' responses was less sizable than the SWAP personality dimensions. These results seem to confirm the diagnostic and therapeutic value of countertransference as an essential tool in understanding psychological traits/dimensions that underlie the patients' psychopathology, both from within and outside of the FFM. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
LENUS (Irish Health Repository)
Cooney, Fionnuala
2009-09-01
This article demonstrates that a patient satisfaction survey can be carried out to evaluate the acceptability of a hepatitis B vaccination programme among persons with an intellectual disability. In this exploratory study, involving six clients, 41 care staff and three managers of intellectual disability services, core themes were identified on the acceptability of the programme. The following recommendations are made: a respectful attitude should be shown to all clients by the healthcare providers; appropriate information about the programme should be provided that is tailored to the needs and receptive capability of all recipients and their carers; the intervention should be delivered in an environment, and by healthcare personnel, familiar to clients; carers should be attentive to the possibility of adverse effects; and explicit, ethically stringent policies should be in place on the use of physical restraint. The article makes suggestions regarding future work in assessing patient satisfaction among this client group.
van Zutphen, Linda; Siep, Nicolette; Jacob, Gitta A.; Domes, Gregor; Sprenger, Andreas; Willenborg, Bastian; Goebel, Rainer; Arntz, Arnoud
2018-01-01
Background Borderline personality disorder (BPD) is characterized by emotion dysregulation; however, it is unclear whether this is restricted to negative emotional stimuli or to what degree this is specific to BPD. We investigated neural correlates of hypothesized increased emotional sensitivity and impaired emotion regulation in patients with BPD. Methods During functional MRI (fMRI) scanning, patients with BPD, non-patient controls and patients with cluster-C personality disorder completed an emotion regulation task, including negative, positive and erotic social pictures. Results We included 55 patients with BPD, 42 nonpatient controls and 24 patients with cluster-C personality disorder in our analyses. Passive viewing of negative stimuli resulted in greater activity in the anterior insula, temporoparietal junction and dorsolateral prefrontal cortex in patients with BPD than in nonpatient controls. The increased activity in the anterior insula and temporoparietal junction was also present when patients with BPD viewed positive stimuli. During regulation of negative stimuli compared with passive viewing, nonpatient controls showed greater activity in the dorsal anterior cingulate cortex, dorsolateral prefrontal cortex, middle temporal gyrus and bilateral inferior parietal lobule. Patients with BPD did not show this increase in activity. Limitations Findings cannot be generalized to men, and patients represented a heterogeneous group regarding comorbid diagnoses and medication. Conclusion When looking at emotional stimuli, patients with BPD showed a unique pattern of activity, suggesting an increase in brain activity involved in emotion generation. In the case of negative stimuli this is accompanied by increased activity in regulation areas. In contrast, increase of regulation processes seems absent when patients with BPD are explicitly instructed to regulate. Results of diagnosis specificity support a dimensional rather than a dichotomous differentiation between
Do patients with rapid eye movement sleep behavior disorder have a disease-specific personality?
Sasai, Taeko; Inoue, Yuichi; Matsuura, Masato
2012-06-01
Rapid eye movement sleep behavior disorder (RBD) occurs idiopathically (iRBD), frequently representing a prodromal phase of Parkinson's disease (PD). Previous reports have described that patients with PD have premorbid personality profiles such as industriousness, inflexibility, cautiousness, and lack of novelty seeking. As well, psychological stress often aggravates RBD symptoms. These phenomena encouraged us to investigate personality profiles in iRBD patients. In this study, 53 patients with iRBD and 49 age and sex-matched healthy controls (HC) were enrolled. We used the revised version of the NEO Personality Inventory (NEO-PIR) to measure the personality of these subjects, and the 5 domains and the 30 facets of the NEO-PIR were compared between the two groups. Within the iRBD group, we investigated the association between RBD variables, e.g. the proportion of REM sleep without atonia (RWA/REM), length of RBD morbidity, frequency of vocalization or abnormal behavior, and the variables of NEO-PIR. In the patients, olfactory function was significantly lower than that of healthy controls, but the inventory differences were not significant. The inventory showed no association with any RBD variable, or the existence of aggravation of these symptoms triggered by psychological stress, or olfactory dysfunction. These results suggest that RBD patients do not have a personality profile that might predict PD development. The personality profile itself cannot explain the psychological-stress-dependent aggravation of RBD symptoms. Copyright © 2011 Elsevier Ltd. All rights reserved.
Personalized mortality prediction driven by electronic medical data and a patient similarity metric.
Lee, Joon; Maslove, David M; Dubin, Joel A
2015-01-01
Clinical outcome prediction normally employs static, one-size-fits-all models that perform well for the average patient but are sub-optimal for individual patients with unique characteristics. In the era of digital healthcare, it is feasible to dynamically personalize decision support by identifying and analyzing similar past patients, in a way that is analogous to personalized product recommendation in e-commerce. Our objectives were: 1) to prove that analyzing only similar patients leads to better outcome prediction performance than analyzing all available patients, and 2) to characterize the trade-off between training data size and the degree of similarity between the training data and the index patient for whom prediction is to be made. We deployed a cosine-similarity-based patient similarity metric (PSM) to an intensive care unit (ICU) database to identify patients that are most similar to each patient and subsequently to custom-build 30-day mortality prediction models. Rich clinical and administrative data from the first day in the ICU from 17,152 adult ICU admissions were analyzed. The results confirmed that using data from only a small subset of most similar patients for training improves predictive performance in comparison with using data from all available patients. The results also showed that when too few similar patients are used for training, predictive performance degrades due to the effects of small sample sizes. Our PSM-based approach outperformed well-known ICU severity of illness scores. Although the improved prediction performance is achieved at the cost of increased computational burden, Big Data technologies can help realize personalized data-driven decision support at the point of care. The present study provides crucial empirical evidence for the promising potential of personalized data-driven decision support systems. With the increasing adoption of electronic medical record (EMR) systems, our novel medical data analytics contributes to
Personalized mortality prediction driven by electronic medical data and a patient similarity metric.
Directory of Open Access Journals (Sweden)
Joon Lee
Full Text Available Clinical outcome prediction normally employs static, one-size-fits-all models that perform well for the average patient but are sub-optimal for individual patients with unique characteristics. In the era of digital healthcare, it is feasible to dynamically personalize decision support by identifying and analyzing similar past patients, in a way that is analogous to personalized product recommendation in e-commerce. Our objectives were: 1 to prove that analyzing only similar patients leads to better outcome prediction performance than analyzing all available patients, and 2 to characterize the trade-off between training data size and the degree of similarity between the training data and the index patient for whom prediction is to be made.We deployed a cosine-similarity-based patient similarity metric (PSM to an intensive care unit (ICU database to identify patients that are most similar to each patient and subsequently to custom-build 30-day mortality prediction models. Rich clinical and administrative data from the first day in the ICU from 17,152 adult ICU admissions were analyzed. The results confirmed that using data from only a small subset of most similar patients for training improves predictive performance in comparison with using data from all available patients. The results also showed that when too few similar patients are used for training, predictive performance degrades due to the effects of small sample sizes. Our PSM-based approach outperformed well-known ICU severity of illness scores. Although the improved prediction performance is achieved at the cost of increased computational burden, Big Data technologies can help realize personalized data-driven decision support at the point of care.The present study provides crucial empirical evidence for the promising potential of personalized data-driven decision support systems. With the increasing adoption of electronic medical record (EMR systems, our novel medical data analytics
DEFF Research Database (Denmark)
Jess, P; von der Lieth, L; Matzen, Peter
1989-01-01
One hundred consecutive out-patients with duodenal ulceration from a hospital and a gastroenterological clinic were tested with the Minnesota Multiphasic Personality Inventory (MMPI). This was carried out in order to investigate whether neuroticism or other personality disorders were characterist......One hundred consecutive out-patients with duodenal ulceration from a hospital and a gastroenterological clinic were tested with the Minnesota Multiphasic Personality Inventory (MMPI). This was carried out in order to investigate whether neuroticism or other personality disorders were...
LeRouge, Cynthia M; Tao, Donghua; Ohs, Jennifer; Lach, Helen W; Jupka, Keri; Wray, Ricardo
2014-01-01
"Baby Boomers" (adults born between the years of 1946 and 1964) make up the largest segment of the population in many countries, including the United States (about 78 million Americans) [1]. As Baby Boomers reach retirement age and beyond, many will have increasing medical needs and thus demand more health care resources that will challenge the healthcare system. Baby Boomers will likely accelerate the movement toward patient self-management and prevention efforts. Consumer Health Information Technologies (CHIT) hold promise for empowering health consumers to take an active role in health maintenance and disease management, and thus, have the potential to address Baby Boomers' health needs. Such innovations require changes in health care practice and processes that take into account Baby Boomers' personal health needs, preferences, health culture, and abilities to use these technologies. Without foundational knowledge of barriers and opportunities, Baby Boomers may not realize the potential of these innovations for improving self-management of health and health outcomes. However, research to date has not adequately explored the degree to which Baby Boomers are ready to embrace consumer health information technology and how their unique subcultures affect adoption and diffusion. This position paper describes an ecological conceptual framework for understanding and studying CHIT aimed at satisfying the personal health needs of Baby Boomers. We explore existing literature to provide a detailed depiction of our proposed conceptual framework, which focuses characteristics influencing Baby Boomers and their Personal Health Information Management (PHIM) and potential information problems. Using our ecological framework as a backdrop, we provide insight and implications for future research based on literature and underlying theories represented in our model.
Purdom, Catherine L; Kirlin, Kristin A; Hoerth, Matthew T; Noe, Katherine H; Drazkowski, Joseph F; Sirven, Joseph I; Locke, Dona E C
2012-12-01
The Somatic Complaints scale (SOM) and Conversion subscale (SOM-C) of the Personality Assessment Inventory perform best in classifying psychogenic non-epileptic seizures (PNES) from epileptic seizures (ES); however, the impact of positive impression management (PIM) and negative impression management (NIM) scales on SOM and SOM-C classification has not been examined. We studied 187 patients from an epilepsy monitoring unit with confirmed PNES or ES. On SOM, the best cut score was 72.5 T when PIM was elevated and 69.5 T when there was no bias. On SOM-C, when PIM was elevated, the best cut score was 67.5 T and 76.5 T when there was no bias. Negative impression management elevations (n=9) were too infrequent to analyze separately. Despite similarities in classification accuracy, there were differences in sensitivity and specificity with and without PIM, impacting positive and negative predictive values. The presence of PIM bias generally increases positive predictive power of SOM and SOM-C but decreases negative predictive power. Copyright © 2012 Elsevier Inc. All rights reserved.
Reuben, David B; Gazarian, Priscilla; Alexander, Neil; Araujo, Katy; Baker, Dorothy; Bean, Jonathan F; Boult, Chad; Charpentier, Peter; Duncan, Pamela; Latham, Nancy; Leipzig, Rosanne M; Quintiliani, Lisa M; Storer, Thomas; McMahon, Siobhan
2017-12-01
In response to the epidemic of falls and serious falls-related injuries in older persons, in 2014, the Patient Centered Outcomes Research Institute (PCORI) and the National Institute on Aging funded a pragmatic trial, Strategies to Reduce Injuries and Develop confidence in Elders (STRIDE) to compare the effects of a multifactorial intervention with those of an enhanced usual care intervention. The STRIDE multifactorial intervention consists of five major components that registered nurses deliver in the role of falls care managers, co-managing fall risk in partnership with patients and their primary care providers (PCPs). The components include a standardized assessment of eight modifiable risk factors (medications; postural hypotension; feet and footwear; vision; vitamin D; osteoporosis; home safety; strength, gait, and balance impairment) and the use of protocols and algorithms to generate recommended management of risk factors; explanation of assessment results to the patient (and caregiver when appropriate) using basic motivational interviewing techniques to elicit patient priorities, preferences, and readiness to participate in treatments; co-creation of individualized falls care plans that patients' PCPs review, modify, and approve; implementation of the falls care plan; and ongoing monitoring of response, regularly scheduled re-assessments of fall risk, and revisions of the falls care plan. Custom-designed falls care management software facilitates risk factor assessment, the identification of recommended interventions, clinic note generation, and longitudinal care management. The trial testing the effectiveness of the STRIDE intervention is in progress, with results expected in late 2019. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.
Adewuya, Abiodun O; Adeyeye, Olufunke O
2017-04-01
To estimate the rate of anxiety and depression in adult asthma patients and examine the possible association with sociodemographic, clinical and other significant variables. Adult asthmatics (n = 203) were recruited from the asthma outpatient clinic and assessed for sociodemographic and clinical profiles, their levels of disability, social support, asthma treatment stigma and personality traits. The Mini International Neuropsychiatric Interview (M.I.N.I) was used to assess for the diagnosis of Anxiety and Depression in comparison with matched healthy controls (n = 205). Seventy (34.5%) of the patients with asthma have a diagnosis of Anxiety or Depression compared with 15 (7.3%) of matched healthy controls and the difference was significant (OR 6.67, 95% CI 3.58-13.04). Although older age, lower income, use of oral corticosteroid, patients perceived severity of asthma, disability, social support and personality traits were initially significant in univariate analysis, a subsequent logistic regression analysis revealed that only disability scores above the group mean (OR 4.50, 95% CI 2.28-8.87) and not having a strong social support (OR 2.88, 95% CI 1.443-5.78) were the only variables independently associated with diagnosis of Anxiety and Depression in the group of patients with asthma. Anxiety and depression are significantly more common in adult outpatients with asthma when compared with healthy control in Nigeria and was significantly associated with levels of disability and social support. These factors should be considered while formulating predictive models for management of psychosocial problems in asthma in this environment.
Foss, Christina
2011-07-01
This study focuses on how older persons' accounts of participation might be framed and constructed based on their social and historical situatedness. The picture emerging from contemporary research tends to portray older people as a group who prefer to leave decisions to the professionals during a hospital stay. Through an approach that sought to contextualise the respondents' accounts of participation, different features of patient participation became visible. The study is based on a postmodern framework using a discursive approach, informed by the works of Foucault and on works that have been developed in line with his main ideas. Eighteen individual in-depth interviews with older people (age 80+) were conducted between one to two weeks after discharge from hospital. Findings indicate that older people actively position themselves in relation to various discourses at play in the hospital, and display a wide variety of strategies aimed at gaining influence. To the older persons in this study, participation was practised in a subtle and discreet way, as a matter of choosing a good strategy to interact with the personnel. Participation was also seen as a matter of balancing their own needs against the needs of others and as a behaviour that required self-confidence. The accounts of patient participation given by the older persons differed from the dominant and taken-for-granted discourse of patient participation as a right. As the older persons' understanding and practice of patient participation do not 'fit' the contemporary idea of participation, it is in danger of being ignored or overlooked by care-givers as well as by researchers. To identify older patients' wish to participate, one must actively search for it. © 2011 Blackwell Publishing Ltd.
Childhood abuse in Chinese patients with borderline personality disorder.
Huang, Jianjun; Yang, Yunping; Wu, Jiang; Napolitano, Lisa A; Xi, Yingjun; Cui, Yonghua
2012-04-01
This study examined (1) the relative prevalence of childhood abuse and other pathological childhood experiences in China reported by outpatients with borderline personality disorder (BPD), with other personality disorders, and without personality disorders; and, (2) whether the primary predictors of BPD in North America are associated with the development of BPD in China. The childhood experiences of 203 outpatients with BPD, 109 outpatients with other personality disorders, and 70 outpatients without Axis II diagnoses were assessed with the Chinese version of the Childhood Experience of Care and Abuse Questionnaire (CECA.Q). Patients with BPD reported significantly more physical, emotional, and sexual abuse than either comparison group. Four types of childhood experiences were significant predictors of BPD: maternal neglect, paternal antipathy, sexual abuse, and maternal physical abuse. The findings suggest that maternal physical abuse is as strong a predictor of BPD in China as sexual abuse, a finding not replicated in North America.
Quantifying the role of personal management style in the success of investment portfolios
E.A. Wagenaar; J.H. Van Vuuren
2014-01-01
It is extremely difficult to quantify the effect of different management styles of portfolio managers upon the success of their portfolios. Various mathematical models in the literature attempt to predict the risk and returns of portfolios according to changes in the economic arena, but these models usually do not take into account the personal styles of portfolio managers. The aim of this paper is a modest attempt at quantifying the effect of different managerial styles upon decisions regard...
Heckemann, Birgit; Peter, Karin A; Halfens, Ruud Jg; Schols, Jos Mga; Kok, Gerjo; Hahn, Sabine
2017-12-01
To explore nurse managers' behaviours, attitudes, perceived social norms, and behavioural control in the prevention and management of patient and visitor aggression in general hospitals. Patient and visitor aggression in general hospitals is a global problem that incurs substantial human suffering and organizational cost. Managers are key persons for creating low-aggression environments, yet their role and behaviours in reducing patient and visitor aggression remains unexplored. A qualitative descriptive study underpinned by the Reasoned Action Approach. Between October 2015-January 2016, we conducted five focus groups and 13 individual interviews with nurse leaders in Switzerland. The semi-structured interviews and focus groups were recorded, transcribed, and analysed in a qualitative content analysis. We identified three main themes: (i) Background factors: "Patient and visitor aggression is perceived through different lenses"; (ii) Determinants and intention: "Good intentions competing with harsh organizational reality"; (iii) Behaviours: "Preventing and managing aggressive behaviour and relentlessly striving to create low-aggression work environments". Addressing patient and visitor aggression is difficult for nurse managers due to a lack of effective communication, organizational feedback loops, protocols, and procedures that connect the situational and organizational management of aggressive incidents. Furthermore, tackling aggression at an organizational level is a major challenge for nurse managers due to scant financial resources and lack of interest. Treating patient and visitor aggression as a business case may increase organizational awareness and interest. Furthermore, clear communication of expectations, needs and resources could optimize support provision for staff. © 2017 John Wiley & Sons Ltd.
Directory of Open Access Journals (Sweden)
Abdol Reza Sabahi
2014-08-01
Full Text Available Background: World Health Organization reports described migraine as one of the 4 most disabling chronic medical disorders. A day with migraine is as disabling as a day with quadriplegia, schizophrenia, or dementia in who is view 87% of people with migraine has some degree of disability. Migraine headaches are associated with psychological factors and personality characteristics. This study compares the personality characteristics of migraine patients with Attention Deficit Hyperactivity Disorder (ADHD and without ADHD. Materials and Methods: Eighty patients with migraine were evaluated in this cross sectional study with simple sampling method. All participants were assessed with semi structured clinical interview, adult ADHD self-report scale (ASRS and Millone clinical multiaxial inventory questionnaire. The migraine patients were divided into two groups, with and without ADHD. The correlation of variables was tested by χ2 test and t-test with 0.05 significance with the use of software SPSS-20. Results: Our participants were 80% female, 56% married and 36.2% with at least graduation from high school. Patients with migraine and ADHD were younger and their first headache experience had occurred in lower age compared with non-ADHD patients (p<0.05. In current study, we showed that there is a significant correlation between ADHD and depressive and independent personality traits and dysthymic clinical syndrome in migraine patients (p<0.05. Conclusion: Our results demonstrate that personality characteristics in migraine patients may be affected by some other mental disorders such as ADHD. These findings might be helpful in early treatment and prevention of dysfunctioning in patients with migraine.
Setareh Jani; Mehri Molaee
2016-01-01
Introduction: Given the disruptive effects of personality disorders on personal and family life, it is essential to recognize their predisposing factors to understand them more accurately, and identify their preventive measures treatment facilitators. Therefore, the present study aimed to examine the relationship of severe personality disorders with behavioral activation and inhibition systems in patients with paranoid, borderline and schizotypal personality disorders. Methods: The present...
Dependent personality features in a complex case of borderline personality disorder.
Nirestean, Tudor; Lukacs, Emese; Nirestean, Aurel; Gabos Grecu, Iosif
2016-11-01
Borderline personality disorder is a complex disease model as it encompasses a diversity of pathological personality traits and psychopathological symptoms. It is not surprising, therefore, that it is often manifested by personality disorders across all three clusters and accompanied by other mental (Axis I) disorders. This melange makes both psychological treatment and pharmacotherapy especially challenging, and this paper describes the case of a particularly complex case of a 33-year-old Romanian patient, who has a history of severe deprivation in childhood, mood and substance use disorder in association with borderline pathology. In the course of treatment from many sources and interventions, it has become clear that dependence is a key component of the pathology and has been rewarded with a degree of success in management. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
Self-management support for peritoneal dialysis patients.
Sarian, Mari; Brault, Diane; Perreault, Nathalie
2012-01-01
The increasing prevalence of chronic illnesses and kidney disease, in particular, makes it necessary to adopt new approaches towards their management (Wagner, 1998). Evidence suggests that promoting self-management improves the health status of peritoneal dialysis (PD) patients, as they manage upwards of 90% of their own care. Patients who are unable to self-manage suffer from various complications. This project proposes an intervention aimed at improving self-management skills among PD patients. To promote self-management in peritoneal dialysis patients. This is achieved through the following objectives: (a) develop an algorithm that can improve patients' ability to solve the specific problem of fluid balance maintenance, (b) develop an educational session for patients on how to use the algorithm, and (c) develop an implementation strategy in collaboration with the PD nurse. Three measures evaluate the effectiveness of the intervention. First, a telephone call log shows that participating patients call the clinic less to inquire about fluid balance maintenance. Next, a pre- and post-intervention knowledge test measures definite knowledge increase. Finally, a Patient Satisfaction Questionnaire reveals overall satisfaction with the intervention. This project, which proved beneficial to our patient population, could be duplicated in other clinics. The algorithm "How do I choose a dialysis bag" and the slides of the educational sessions can be shared with PD nurses across the country for the benefit of PD patients.
System-centred tobacco management: from 'whole-person' to 'whole-system' change.
Bonevski, Billie
2014-01-01
Patient-centred tobacco management is a pragmatic approach for helping smokers achieve their goals in terms of either cessation or harm reduction. However, the success of the approach is dependent on clinicians embracing and delivering it as intended. There are a number of structural and systemic organisational barriers which are limiting clinician-delivered patient-centred tobacco dependence. In response, 'whole system' approaches which help support clinicians in the delivery of patient-centred tobacco management are required. Health system changes to support clinicians and facilitate the delivery of patient-centred tobacco management are worth further investigation, particularly in settings where tobacco smoking rates are high. © 2013 Australasian Professional Society on Alcohol and other Drugs.
Zimmerman, Mark; Ellison, William; Morgan, Theresa A; Young, Diane; Chelminski, Iwona; Dalrymple, Kristy
2015-10-01
The morbidity associated with bipolar disorder is, in part, responsible for repeated calls for improved detection and recognition. No such commentary exists for the improved detection of borderline personality disorder. Clinical experience suggests that it is as disabling as bipolar disorder, but no study has directly compared the two disorders. To compare the levels of psychosocial morbidity in patients with bipolar disorder and borderline personality disorder. Patients were assessed with semi-structured interviews. We compared 307 patients with DSM-IV borderline personality disorder but without bipolar disorder and 236 patients with bipolar disorder but without borderline personality disorder. The patients with borderline personality disorder less frequently were college graduates, were diagnosed with more comorbid disorders, more frequently had a history of substance use disorder, reported more suicidal ideation at the time of the evaluation, more frequently had attempted suicide, reported poorer social functioning and were rated lower on the Global Assessment of Functioning. There was no difference between the two patient groups in history of admission to psychiatric hospital or time missed from work during the past 5 years. The level of psychosocial morbidity associated with borderline personality disorder was as great as (or greater than) that experienced by patients with bipolar disorder. From a public health perspective, efforts to improve the detection and treatment of borderline personality disorder might be as important as efforts to improve the recognition and treatment of bipolar disorder. © The Royal College of Psychiatrists 2015.
Tan, Hung-Jui; Filson, Christopher P; Litwin, Mark S
2015-01-01
Although kidney cancer incidence and nephrectomy rates have risen in tandem, clinical advances have generated new uncertainty regarding the optimal management of patients with small renal tumors, especially the elderly. To clarify existing practice patterns, we assessed contemporary trends in the incidence and management of patients with early-stage kidney cancer. Using Surveillance, Epidemiology, and End Results data, we identified adult patients diagnosed with T1aN0M0 kidney cancer from 2000 to 2010. We determined age-adjusted and age-specific incidence and management rates (i.e., nonoperative, ablation, partial nephrectomy [PN], and radical nephrectomy) per 100,000 adults and determined the average annual percent change (AAPC). Finally, we compared management groups using multinomial logistic regression accounting for patient characteristics, cancer information, and county-level measures for health. From 2000 to 2010, we identified 41,645 adults diagnosed with T1aN0M0 kidney cancer. Overall incidence increased from 3.7 to 7.0 per 100,000 adults (AAPC = 7.0%, Pmanagement and ablation approached nephrectomy rates for those aged 75 to 84 years and became the predominant strategy for patients older than 84 years. Adjusting for clinical, oncological, and environmental factors, older patients less frequently underwent PN and more often received ablative or nonoperative management (P<0.001). As the incidence of early-stage kidney cancer rises, patients are increasingly treated with nonoperative and nephron-sparing strategies, especially among the most elderly. The broader array of treatment options suggests opportunities to better personalize kidney cancer care for seniors. Published by Elsevier Inc.
Bassirnia, Anahita; Briggs, Jessica; Kopeykina, Irina; Mednick, Amy; Yaseen, Zimri; Galynker, Igor
2015-12-15
Internalized stigma of mental disorders has significant negative outcomes for patients with bipolar disorder and their families. The aim of this study is to evaluate the association between personality traits and internalized stigma of mental disorders in bipolar patients and their treatment partners. Five different questionnaires were utilized in this study: (1) Demographic data questionnaire, (2) Millon Clinical Multiaxial Inventory-III (MCMI-III) for personality traits, (3) Internalized Stigma of Mental Illness (ISMI) for stigma, (4) Self Report Manic Inventory (SRMI) for mania and (5) Center for Epidemiological Studies-Depression Scale (CES-D) for depression. The scores of personality traits were combined to create externalizing and internalizing personality trait scores. Results showed that patients with bipolar disorder and their treatment partners both experienced internalized stigma of mental health disorders. There was a significant positive correlation between internalized stigma and internalizing personality traits, but not externalizing traits. In a multi-variate regression analysis, internalizing personality trait score was found to be a significant predictor of internalized stigma. In conclusion, patients with bipolar disorder and their treatment partners perceive higher level of internalized stigma of mental disorders if they have internalizing personality traits. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Geometric data perturbation-based personal health record transactions in cloud computing.
Balasubramaniam, S; Kavitha, V
2015-01-01
Cloud computing is a new delivery model for information technology services and it typically involves the provision of dynamically scalable and often virtualized resources over the Internet. However, cloud computing raises concerns on how cloud service providers, user organizations, and governments should handle such information and interactions. Personal health records represent an emerging patient-centric model for health information exchange, and they are outsourced for storage by third parties, such as cloud providers. With these records, it is necessary for each patient to encrypt their own personal health data before uploading them to cloud servers. Current techniques for encryption primarily rely on conventional cryptographic approaches. However, key management issues remain largely unsolved with these cryptographic-based encryption techniques. We propose that personal health record transactions be managed using geometric data perturbation in cloud computing. In our proposed scheme, the personal health record database is perturbed using geometric data perturbation and outsourced to the Amazon EC2 cloud.
Geometric Data Perturbation-Based Personal Health Record Transactions in Cloud Computing
Balasubramaniam, S.; Kavitha, V.
2015-01-01
Cloud computing is a new delivery model for information technology services and it typically involves the provision of dynamically scalable and often virtualized resources over the Internet. However, cloud computing raises concerns on how cloud service providers, user organizations, and governments should handle such information and interactions. Personal health records represent an emerging patient-centric model for health information exchange, and they are outsourced for storage by third parties, such as cloud providers. With these records, it is necessary for each patient to encrypt their own personal health data before uploading them to cloud servers. Current techniques for encryption primarily rely on conventional cryptographic approaches. However, key management issues remain largely unsolved with these cryptographic-based encryption techniques. We propose that personal health record transactions be managed using geometric data perturbation in cloud computing. In our proposed scheme, the personal health record database is perturbed using geometric data perturbation and outsourced to the Amazon EC2 cloud. PMID:25767826
Geometric Data Perturbation-Based Personal Health Record Transactions in Cloud Computing
Directory of Open Access Journals (Sweden)
S. Balasubramaniam
2015-01-01
Full Text Available Cloud computing is a new delivery model for information technology services and it typically involves the provision of dynamically scalable and often virtualized resources over the Internet. However, cloud computing raises concerns on how cloud service providers, user organizations, and governments should handle such information and interactions. Personal health records represent an emerging patient-centric model for health information exchange, and they are outsourced for storage by third parties, such as cloud providers. With these records, it is necessary for each patient to encrypt their own personal health data before uploading them to cloud servers. Current techniques for encryption primarily rely on conventional cryptographic approaches. However, key management issues remain largely unsolved with these cryptographic-based encryption techniques. We propose that personal health record transactions be managed using geometric data perturbation in cloud computing. In our proposed scheme, the personal health record database is perturbed using geometric data perturbation and outsourced to the Amazon EC2 cloud.
Jibeen, Tahira; Mahfooz, Musferah; Fatima, Shamem
2017-08-30
The current study examined the moderating role of personality traits (neuroticism and extraversion) on the relationship between spiritual transcendence and positive change, and spiritual transcendence and distress in burn patients. The sample (N = 98) comprised adult burn patients (age = 25-50) admitted to three hospitals in Lahore, Pakistan. They were assessed according to a demographic information sheet, the NEO Personality Inventory (McCrae and Costa in J Personal Soc Psychol 52:81-90, 1987), the Spiritual Transcendence Index (Seidlitz et al. in J Sci Study Relig 41:439-453, 2002), the Depression, Anxiety, Stress Scales-21 (Lovibond and Lovibond in Manual for the Depression Anxiety Stress scales, Psychology Foundation, Sydney, 1995), and the Perceived Benefit Scales (McMillen and Fisher in Soc Work Res 22(3):173-186, 1998). Stepwise moderated regression analysis showed that both personality traits (neuroticism and extraversion) played a moderating role in the relationship between spiritual transcendence and positive change, and spiritual transcendence and distress in burn patients. The findings highlight the potential role spiritual transcendence may have in understanding and improving the psychological adjustment of burn patients.
PERIOPERATIVE MANAGEMENT OF PATIENTS WITH RHEUMATOID ARTHRITIS
Directory of Open Access Journals (Sweden)
V. N. Amirdzhanova
2014-01-01
Full Text Available The paper considers the joint management of rheumatoid arthritis patients needing endoprosthetic replacement of the large joints of the lower extremities by rheumatologists and orthopedic traumatologists.Due to the fact that there are no conventional standards or guidelines for the perioperative management of patients with rheumatic diseases, adopted by international rheumatology associations, the authors generalize their experience in managing the patients in terms of international approaches and guidelines from different countries. The medical assessment and reduction of cardiovascular risks, the prevention of infectious complications, hemorrhages, and lower extremity deep vein thrombosis, and the specific features of management of patients with osteoporosis are under consideration. The authors' experience in managing the patients receiving antirheumatic therapy with nonsteroidal antiinflammatory and disease-modifying antirheumatic drugs, such as methotrexate, leflunomide, sulfasalazine, and hydroxychloroquine, is detailed. Recommendations for managing patients taking glucocorticoids and biologic agents (tumor necrosis factor-α inhibitors, anti-B-cell therapy, and interleukin-6 receptor inhibitors in the preoperative andpostoperative periods are given.
Directory of Open Access Journals (Sweden)
Gerhard Dammann
2017-11-01
Full Text Available The schizoid personality disorder is characterized by a lack of interest in close relationships, both in the family and in other interpersonal relationships, including intimate/sexual interactions, a superiority of introverted activities, emotional coldness, estrangement and flattened affect (DSM-5. This video lecture is devoted to the review of the prevalence, diagnosis, and treatment of this disorder. In addition, the lecture examines clinical cases and an example of managing such patients.
Guide on medical management of persons exposed in radiation accidents
International Nuclear Information System (INIS)
1990-01-01
The present guide has been prepared in order to provide guidance to medical and para-medical personnel regarding medical management of the different types of radiation accidents. It discusses briefly the physical aspects and biological effect of radiation, for the benefit of those who have not specialised in radiation medicine. The diagnosis, medical management and follow-up of persons involved in different types of radiation accidents are also dealt with. The implementation of the procedures described calls for organisation of appropriate facilities and provision of requisite equipment as well as education and training of the staff. It is emphasised that major radiation accidents are rare events and the multi-disciplinary nature of the response required to deal with them calls for proper planning and continuous liaison among plant management, radiation protection personnel, first-aid assistants and medical and paramedical staff. The organisation and conduct of emergency drills may help in maintaining preparedness of the medical facilities for efficient management of radiation casualities. (original). 64 refs., tabs., figs
[Disease management for chronic heart failure patient].
Bläuer, Cornelia; Pfister, Otmar; Bächtold, Christa; Junker, Therese; Spirig, Rebecca
2011-02-01
Patients with chronic heart failure (HF) are limited in their quality of life, have a poor prognosis and face frequent hospitalisations. Patient self-management was shown to improve quality of life, reduce rehospitalisations and costs in patients with chronic HF. Comprehensive disease management programmes are critical to foster patient self-management. The chronic care model developed by the WHO serves as the basis of such programmes. In order to develop self-management skills a needs orientated training concept is mandatory, as patients need both knowledge of the illness and the ability to use the information to make appropriate decisions according to their individual situation. Switzerland has no established system for the care of patients with chronic diseases in particular those with HF. For this reason a group of Swiss experts for HF designed a model for disease management for HF patients in Switzerland. Since 2009 the Swiss Heart Foundation offers an education programme based on this model. The aim of this programme is to offer education and support for practitioners, patients and families. An initial pilot evaluation of the program showed mixed acceptance by practitioners, whereas patient assessed the program as supportive and in line with their requirements.
Vollmann, Manja; Pukrop, Jörg; Salewski, Christel
2016-04-01
A rheumatic disease can severely impair a person's quality of life. The degree of impairment, however, is not closely related to objective indicators of disease severity. This study investigated the influence and the interplay of core psychological factors, i.e., personality and coping, on life satisfaction in patients with rheumatic diseases. Particularly, it was tested whether coping mediates the effects of personality on life satisfaction. In a cross-sectional design, 158 patients diagnosed with a rheumatic disease completed questionnaires assessing the Big 5 personality traits (BFI-10), several disease-related coping strategies (EFK) and life satisfaction (HSWBS). Data were analyzed using a complex multiple mediation analysis with the Big 5 personality traits as predictors, coping strategies as mediators and life satisfaction as outcome. All personality traits and seven of the nine coping strategies were associated with life satisfaction (rs > |0.16|, ps ≤ 0.05). The mediation analysis revealed that personality traits had no direct, but rather indirect effects on life satisfaction through coping. Neuroticism had a negative indirect effect on life satisfaction through less active problem solving and more depressive coping (indirect effects > -0.03, ps 0.06, ps rheumatic diseases. The interplay of these variables should be considered in psychological interventions for patients with rheumatic diseases.
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Wong Eliza LY
2011-05-01
Full Text Available Abstract Background Patient self-management is a key approach to manage non-communicable diseases. A pharmacist-led approach in patient self-management means collaborative care between pharmacists and patients. However, the development of both patient self-management and role of pharmacists is limited in Hong Kong. The objectives of this study are to understand the perspectives of physicians, pharmacists, traditional Chinese medicine (TCM practitioners, and dispensers on self-management of patients with chronic conditions, in addition to exploring the possibilities of developing pharmacist-led patient self-management in Hong Kong. Methods Participants were invited through the University as well as professional networks. Fifty-one participants comprised of physicians, pharmacists, TCM practitioners and dispensers participated in homogenous focus group discussions. Perspectives in patient self-management and pharmacist-led patient self-management were discussed. The discussions were audio recorded, transcribed and analysed accordingly. Results The majority of the participants were in support of patients with stable chronic diseases engaging in self-management. Medication compliance, monitoring of disease parameters and complications, lifestyle modification and identifying situations to seek help from health professionals were generally agreed to be covered in patient self-management. All pharmacists believed that they had extended roles in addition to drug management but the other three professionals believed that pharmacists were drug experts only and could only play an assisting role. Physicians, TCM practitioners, and dispensers were concerned that pharmacist-led patient self-management could be hindered, due to unfamiliarity with the pharmacy profession, the perception of insufficient training in disease management, and lack of trust of patients. Conclusions An effective chronic disease management model should involve patients in stable
Patient-reported outcomes in borderline personality disorder
Hasler, Gregor; Hopwood, Christopher J.; Jacob, Gitta A.; Brändle, Laura S.; Schulte-Vels, Thomas
2014-01-01
Patient-reported outcome (PRO) refers to measures that emphasize the subjective view of patients about their health-related conditions and behaviors. Typically, PROs include self-report questionnaires and clinical interviews. Defining PROs for borderline personality disorder (BPD) is particularly challenging given the disorder's high symptomatic heterogeneity, high comorbidity with other psychiatric conditions, highly fluctuating symptoms, weak correlations between symptoms and functional outcomes, and lack of valid and reliable experimental measures to complement self-report data. Here, we provide an overview of currently used BPD outcome measures and discuss them from clinical, psychometric, experimental, and patient perspectives. In addition, we review the most promising leads to improve BPD PROs, including the DSM-5 Section III, the Recovery Approach, Ecological Momentary Assessments, and novel experimental measures of social functioning that are associated with functional and social outcomes. PMID:25152662
MANAGING PERSONAL FINANCES: EXAMPLES AND LESSONS FROM CROATIAN STUDENT POPULATION
Branko Matic; Hrvoje Serdarusic; Maja Vretenar Cobovic
2015-01-01
In this paper the authors present the results of their research related to financial involvement and management of personal finances of the student population on the territory of eastern Croatia. The research focused on the reasons for the entrance of student population into the financial system, the amount of their use of credit institutions’ services as well as their motives for choosing a certain credit institution
Shafiee-Kandjani, Ali Reza; Amiri, Shahrokh; Arfaie, Asghar; Ahmadi, Azadeh; Farvareshi, Mahmoud
2014-01-01
Objectives. Inflexible personality traits play an important role in the development of maladaptive behaviors among patients who attempt suicide. This study was conducted to investigate the relationship between personality profiles and suicide attempt via medicine poisoning among the patients hospitalized in a public hospital. Materials and Methods. Fifty-nine patients who attempted suicide for the first time and hospitalized in the poisoning ward were selected as the experimental group. Sixty-three patients hospitalized in the other wards for a variety of reasons were selected as the adjusted control group. Millon Clinical Multiaxial Personality Inventory, 3rd version (MCMI-III) was used to assess the personality profiles. Results. The majority of the suicide attempters were low-level graduates (67.8% versus 47.1%, OR = 2.36). 79.7% of the suicide attempters were suffering from at least one maladaptive personality profile. The most common maladaptive personality profiles among the suicide attempters were depressive personality disorder (40.7%) and histrionic personality disorder (32.2%). Among the syndromes the most common ones were anxiety clinical syndrome (23.7%) and major depression (23.7%). Conclusion. Major depression clinical syndrome, histrionic personality disorder, anxiety clinical syndrome, and depressive personality disorder are among the predicators of first suicide attempts for the patients hospitalized in the public hospital due to the medicine poisoning.
Problems in developing an instrument for the rapid assessment of personality status.
Van Horn, E; Manley, C; Leddy, D; Cicchetti, D; Tyrer, P
2000-06-01
To assess the validity of a quick assessment instrument (10 minutes) for assessing personality status, the Rapid Personality Assessment Schedule (PAS-R). The PAS-R was evaluated in psychotic patients recruited in one of the centres involved in a multicentre randomised controlled trial of intensive vs standard case management (the UK700 case management trial). Patients were assessed using both a full version of the PAS (PAS-I - ICD version) and the PAS-R. The weighted kappa statistic was used to gauge the (criterion-related) validity of the PAS-R using the PAS-I as the gold standard. Both measure code personality status using a four-point rating of severity in addition to recording individual categories of personality disorder. One hundred fifty-five (77%) of 201 patients recruited were assessed with both instruments. The weighted kappa statistic was 0.31, suggesting only moderate agreement between the PAS-I and PAS-R instruments under the four-point rating format, and 0.39 for the dichotomous personality disorder/no disorder separation. The sensitivity (64%) and specificity (82%) of the PAS-R in predicting PAS-I personality disorder were as satisfactory as for other screening instruments but still somewhat disappointing, and the PAS-R had an overall diagnostic accuracy of 78%. The PAS-R is a quick and rough method of detecting personality abnormality but is not a substitute for a fuller assessment.
Attributional "Tunnel Vision" in Patients With Borderline Personality Disorder.
Schilling, Lisa; Moritz, Steffen; Schneider, Brooke; Bierbrodt, Julia; Nagel, Matthias
2015-12-01
We aimed to examine the profile of interpersonal attributions in BPD. We hypothesized that patients show more mono-causal and internal attributions than healthy controls. A revised version of the Internal, Personal, Situational and Attributions Questionnaire was assessed in 30 BPD patients and 30 healthy controls. BPD patients and controls differed significantly in their attributional pattern. Patients displayed more mono-causal inferences, that is, they had difficulties considering alternative explanatory factors. For negative events, patients made more internal attributions compared to healthy controls. We concluded that mono-causal "trapped" thinking might contribute to (interpersonal) problems in BPD patients by fostering impulsive consequential behaviors, for example, harming one's self or others. A self-blaming tendency likely promotes depressive symptoms and low self-esteem.
[Psychotherapy of patients with personality disorders with predominance of hypochondria].
Burno, M E; Igovskaia, A S
2008-01-01
A standard of psychotherapeutic help to patients with hypochondriac disorder developed in paranoid, schizoid, anxiety and dependent personality disorders is worked out. In this case, hypochondria is inseparable from the personality structure. Patients of investigated group (61 people) received traditional medical treatment, individual differential symptomatic psychotherapy and a short group course with a variant of the therapy by means of creative sell-expression (TCSEB) worked out by M. Burno. This course aimed at preventing new hypochondriac symptoms and acquiring spiritual creative ways to overcome themselves. The control group (70 people) differed from the index-group by not receiving CSEB. A statistical analysis revealed a significant therapeutic efficacy of the mentioned new clinical psychotherapeutic standard compared to the psychotherapeutic tactics without TCSEB.
For Our Patients, for Ourselves: The Value of Personal Reflection in Oncology.
Schapira, Lidia; Meisel, Jane Lowe; Srivastava, Ranjana
2017-01-01
Caring for patients with cancer is a great privilege as well as an emotionally and intellectually challenging task. Stress and burnout are prevalent among oncology clinicians, with serious repercussions for the care of patients. Professional societies must provide guidance for trainees and practicing physicians to mitigate the negative consequences of stress on their personal lives and medical practice. Reflection, reading, and writing about personal experiences provide outlets for fortifying personal reserves and promoting resilience to allow us to recognize the joy and meaning of our work and to forge connections with our peers. Herein, we present some of our own reflections on how and why one might take time to write, and about the power of the written word in oncology and medicine.
Huang, Jianjun; Napolitano, Lisa A; Wu, Jiang; Yang, Yunping; Xi, Yingjun; Li, Yawen; Li, Kai
2014-02-01
The primary purposes of this study were to (1) compare the characteristics of childhood experiences of parental rearing patterns in China reported by patients with borderline personality disorder (BPD), patients with other personality disorders and patients without personality disorders; (2) identify the reported parental rearing patterns associated with BPD in China; and (3) determine whether these patterns differ for males and females. One hundred and fifty-two patients with BPD, 79 patients with other personality disorders and 55 patients without Axis II diagnoses were administered the Chinese version of the McLean Screening Instrument for BPD and completed the Egna Minnen av Barndoms Uppfostran (EMBU), a self-report measure of childhood parental rearing patterns. Parental rearing patterns reported by the BPD group were characterized by less emotional warmth, and greater punishment, rejection and control than patterns reported by the other two groups. Within the BPD group, males were more likely than females to report parental punishment, rejection and control. Paternal punishment, low maternal emotional warmth and female gender predicted BPD diagnosis. Negative parental rearing patterns appear to contribute to the development of BPD in China and vary with the gender of the child. Maternal emotional warmth may be a protective factor against BPD. © 2013 International Union of Psychological Science.
Perrin, Fabien; Castro, Maïté; Tillmann, Barbara; Luauté, Jacques
2015-01-01
Sensory stimuli are used to evaluate and to restore cognitive functions and consciousness in patients with a disorder of consciousness (DOC) following a severe brain injury. Although sophisticated protocols can help assessing higher order cognitive functions and awareness, one major drawback is their lack of sensitivity. The aim of the present review is to show that stimulus selection is crucial for an accurate evaluation of the state of patients with disorders of consciousness as it determines the levels of processing that the patient can have with stimulation from his/her environment. The probability to observe a behavioral response or a cerebral response is increased when her/his personal history and/or her/his personal preferences are taken into account. We show that personally relevant stimuli (i.e., with emotional, autobiographical, or self-related characteristics) are associated with clearer signs of perception than are irrelevant stimuli in patients with DOC. Among personally relevant stimuli, music appears to be a promising clinical tool as it boosts perception and cognition in patients with DOC and could also serve as a prognostic tool. We suggest that the effect of music on cerebral processes in patients might reflect the music's capacity to act both on the external and internal neural networks supporting consciousness.
Directory of Open Access Journals (Sweden)
Fabien ePerrin
2015-07-01
Full Text Available Sensory stimuli are used to evaluate and to restore cognitive functions and consciousness in patients with a disorder of consciousness (DOC following a severe brain injury. Although sophisticated protocols can help assessing higher order cognitive functions and awareness, one major drawback is their lack of sensitivity. The aim of the present review is to show that stimulus selection is crucial for an accurate evaluation of the state of patients with disorders of consciousness as it determines the levels of processing that the patient can have with stimulation from his/her environment. The probability to observe a behavioral response or a cerebral response is increased when her/his personal history and/or her/his personal preferences are taken into account. We show that personally-relevant stimuli (i.e. with emotional, autobiographical or self-related characteristics are associated with clearer signs of perception than are irrelevant stimuli in patients with DOC. Among personally-relevant stimuli, music appears to be a promising clinical tool as it boosts perception and cognition in patients with DOC and could also serve as a prognostic tool. We suggest that the effect of music on cerebral processes in patients might reflect the music’s capacity to act both on the external and internal neural networks supporting consciousness.
International Nuclear Information System (INIS)
Kim, Jin Hee; Park, Tae Joon; Choi, Tae Haing; Lim, Se Hwan; Joon Yang Noh; Kim, Sung Jin
1996-01-01
With the use of personal computers generalized, departmental society leveled computerization is going on in some other departments. So we tried to develop a program having a simple user interface, various retrieval functions and, analytic and statistic process system to effectively help patient care suitable for works concerned with department of diagnostic radiology and works of department. This program deals with such target works as department of diagnostic radiology and some works to need a lot of bookkeeping. It is deviced to operate with Windows (Microsoft, America), and central processing unit(486DX-2), memory unit(8 Mbyte). As a developmental tool, Foxpro 2.6 for windows R (Microsoft, America). This program can be easily accessed even by staffs poor at computer and it can make many books recording various check-ups and operations unnecessary, which were difficult to keep. Besides, it can keep data as a unified form, and so it provides patient care and other works with convenience and helps applying those stored data scientific research. The above result shows that works of department can be effectively controlled by analyzing or printing various check-up and operation done by department of diagnostic radiology
THE ROLE OF ROMANIAN MANAGERS PERSONALITY IN CHOOSING A LEADERSHIP STYLE, A COMPARATIVE APPROACH
Maria-Elena, GHEORDUNESCU
2014-01-01
Managers are that empowered group of people, specially trained, who direct, coordinate and direct the work of all members of an organization. Managers are those specialists who can make decisions with a large impact on the business activity. No matter the activity profile or size, companies need good managers, who are able to adapt to the specific economic conditions of our times. This paper aims to study the personality of three managers from Romania, who working in the field of road transpo...
Bernhard, Gerda; Ose, Dominik; Baudendistel, Ines; Seidling, Hanna M; Stützle, Marion; Szecsenyi, Joachim; Wensing, Michel; Mahler, Cornelia
2017-04-01
Purpose The purpose of this qualitative study was to investigate the challenges and strategies of patients with type 2 diabetes mellitus (T2DM) regarding daily management of their medication regimen focusing on the role of their support networks. Methods A purposeful sample of 25 patients with T2DM was recruited from local self-help groups, general practitioner practices, and a university hospital in southwestern Germany. Four semi-structured focus groups were conducted to identify the challenges patients experienced, the strategies they used, and their collaboration with support networks to assist them in self-managing their medication regimen. Sessions were audio- and video-recorded, fully transcribed, and subjected to computer-aided qualitative content analysis, guided by the Self- and Family Management Framework (SFMF). Results Patients with T2DM experienced numerous challenges affecting medication self-management arising from their personal situation, health status and resources, characteristics of their regimen, and how health care is currently organized. Patients' self-initiated strategies included activating health care, community, social, and online resources; taking ownership of medication-related needs; and integrating medication-taking into daily life. Patients drew on self-help groups, family, and friends to discuss concerns regarding medication safety and receive experience-based information and advice for navigating within the health care system as well as practical hands-on support with daily medication self-management. Conclusions Understanding the challenges and building on strategies patients with T2DM devised help diabetes educators to better address patients' needs and priorities and guide patient-centered interventions to support patients' self-management activities. Community and social support networks operating in patients' lives need to be engaged in the self-management support.
Work-related stress, work/life balance and personal life coaching.
Hawksley, Barbara
2007-01-01
Work-related stress adversely affects personal performance, organizational efficiency and patient care as well as costing the NHS millions of pounds each year. Reducing the effects of work-related stress is a legal duty for all employers. There are a number of resources available to help both employees and employers, such as the Health and Safety Executive stress management standards. Personal life coaching is one approach to reducing work-related stress, which is well established amongst business and management executives as well as some public sector organizations.
Preventive Psychiatric Admission for Patients With Borderline Personality Disorder: A Pilot Study
Koekkoek, B.W.; Snoek, R. van der; Oosterwijk, K.; Meijel, B.K.G. van
2010-01-01
PURPOSE. The purpose of this study was to establish the preliminary effects of preventive psychiatric admission of patients with severe borderline personality disorder (BPD) on the rate of agreement over treatment, patient service use, and patient views on the intervention. DESIGN AND METHODS. A
Self-management in patients with psoriasis
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Pathak SN
2014-07-01
Full Text Available Swetha Narahari Pathak,1 Pauline L Scott,1 Cameron West,1 Steven R Feldman,1–3 1Center for Dermatology Research, Departments of Dermatology, 2Center for Dermatology Research, Departments of Pathology, 3Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA Abstract: Psoriasis is a chronic inflammatory disorder effecting the skin and joints. Additionally, multiple comorbidities exist, including cardiovascular, metabolic, and psychiatric. The chronic nature of psoriasis is often frustrating for both patients and physicians alike. Many options for treatment exist, though successful disease management rests largely on patients through the application of topical corticosteroids, Vitamin D analogs, and calcineurin inhibitors, amongst others and the administration of systemic medications such as biologics and methotrexate. Phototherapy is another option that also requires active participation from the patient. Many barriers to effective self-management of psoriasis exist. Successful treatment requires the establishment of a strong doctor-patient relationship and patient empowerment in order to maximize adherence to a treatment regimen and improve outcomes. Improving patient adherence to treatment is necessary in effective self-management. Many tools exist to educate and empower patients, including online sources such as the National Psoriasis Foundation and online support group, Talk Psoriasis, amongst others. Effective self management is critical in decreasing the physical burden of psoriasis and mitigating its multiple physical, psychological, and social comorbidities, which include obesity, cardiovascular disease, alcohol dependence, depression, anxiety, and social anxiety. Keywords: psoriasis, adherence, self management, compliance
Management of pregnant patient in dentistry.
Kurien, Sophia; Kattimani, Vivekanand S; Sriram, Roopa Rani; Sriram, Sanjay Krishna; Rao V K, Prabhakara; Bhupathi, Anitha; Bodduru, Rupa Rani; N Patil, Namrata
2013-02-01
The purpose of this article is to update general dentists and maxillofacial surgeons in the perioperative management of the pregnant patient. Pregnancy results in physiologic changes in almost all organ systems in the body mediated mainly by hormones; which influences the treatment schedule. Understanding these normal changes is essential for providing quality care for pregnant women. The general principles that apply in this situation are discussed, followed by the relevant physiologic changes and their treatment implications, the risks of various medications to the mother and fetus, the management of concomitant medical problems in the pregnant patient, appropriate timing of oral and maxillofacial surgery during pregnancy, and management of emergencies during pregnancy. Information about the compatibility, complications, and excretion of the common drugs during pregnancy is provided. Guidelines for the management of a pregnant patient in the dental office are summarized. How to cite this article: Kurien S, Kattimani V S, Sriram R, Sriram S K, Prabhakar Rao V K, Bhupathi A, Bodduru R, Patil N N. Management of Pregnant Patient in Dentistry. J Int Oral Health 2013; 5(1):88-97.
Assessment of self-perception of transsexual persons: pilot study of 15 patients.
Barišić, Jasmina; Milosavljević, Marija; Duišin, Dragana; Batinić, Borjanka; Vujović, Svetlana; Milovanović, Srdjan
2014-01-01
There have been few studies in the area of Self-Perception in transsexual persons, except for the population of transsexual adolescents. Bearing in mind its importance not only in the assessment of personality but also in predicting adaptive capacity, the goal of our research is based on the examination of Self-Perception of adult transsexual persons. The study was conducted using a Rorschach test, which provides an insight into various aspects of Self-Perception. The sample consisted of 15 transsexual persons, who passed the standard diagnostic procedure. The results suggest that transsexual persons manage to maintain Adequate Self-Esteem. Hypervigilance Index and Obsessive Style Index are negative, while the values showing a negative quality of Self-Regard and the capacity for introspection tend to increase. In the process of Self-Introspection, negative and painful emotional states are often perceived. The estimation of Self-Perception in adult transsexual persons indicates a trend of subjective perception of a personal imperfection or inadequacy. This is probably the result of experiencing discomfort for a number of years due to gender incongruence and dysphoria, in particular in persons who enter the sex reassignment procedure later in their adulthood.
Older Patients' Perspectives on Managing Complexity in CKD Self-Management.
Bowling, C Barrett; Vandenberg, Ann E; Phillips, Lawrence S; McClellan, William M; Johnson, Theodore M; Echt, Katharina V
2017-04-03
Patients with CKD are asked to perform self-management tasks including dietary changes, adhering to medications, avoiding nephrotoxic drugs, and self-monitoring hypertension and diabetes. Given the effect of aging on functional capacity, self-management may be especially challenging for older patients. However, little is known about the specific challenges older adults face maintaining CKD self-management regimens. We conducted an exploratory qualitative study designed to understand the relationship among factors facilitating or impeding CKD self-management in older adults. Six focus groups ( n =30) were held in August and September of 2014 with veterans≥70 years old with moderate-to-severe CKD receiving nephrology care at the Atlanta Veterans Affairs Medical Center. Grounded theory with a constant comparative method was used to collect, code, and analyze data. Participants had a mean age (range) of 75.1 (70.1-90.7) years, 60% were black, and 96.7% were men. The central organizing concept that emerged from these data were managing complexity. Participants typically did not have just one chronic condition, CKD, but a number of commonly co-occurring conditions. Recommendations for CKD self-management therefore occurred within a complex regimen of recommendations for managing other diseases. Participants identified overtly discordant treatment recommendations across chronic conditions ( e.g., arthritis and CKD). Prioritization emerged as one effective strategy for managing complexity ( e.g. , focusing on BP control). Some patients arrived at the conclusion that they could group concordant recommendations to simplify their regimens ( e.g. , protein restriction for both gout and CKD). Among older veterans with moderate-to-severe CKD, multimorbidity presents a major challenge for CKD self-management. Because virtually all older adults with CKD have multimorbidity, an integrated treatment approach that supports self-management across commonly occurring conditions may be
Dickens, Geoffrey; Piccirillo, Maria; Alderman, Nick
2013-12-01
Nurses' attitudes about the causes and management of aggression affects their choice of intervention. We aimed to compare the attitudes held by patients and staff in a forensic mental health service with the Management of Aggression and Violence Attitudes Scale, and examine the factor validity of the tool in this setting by conducting a prospective comparative questionnaire survey. Staff (n = 72) and patient (n = 98) attitudes differed to a limited extent. Confirmatory factor analysis refuted the previously reported structure of the tool. Exploratory factor analysis suggested three underlying factors related to modifiability of aggression, hands on management, and hands off management. Patients were more optimistic than nurses about the modifiability of aggressive behaviour. Male patients and those with diagnoses other than personality disorder were significantly more likely to agree about modifiability than controls. Forensic inpatients recognize the need for the use of a range of techniques to prevent and manage aggression and violence, but selected groups are most likely to believe that aggression is modifiable. Prevention and management of aggression training should emphasize the modifiability of aggressive behaviour. The development of measures of modifiability and management style would assist in the evaluation of training and would offer new avenues for research. © 2012 The Authors; International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.
Effective Self-Management Interventions for Patients With Lupus: Potential Impact of Peer Mentoring.
Williams, Edith M; Egede, Leonard; Faith, Trevor; Oates, James
2017-06-01
Systemic lupus erythematosus (SLE) is associated with significant mortality, morbidity and cost for the individual patient and society. In the United States, African Americans (AAs) have 3-4 times greater prevalence of lupus, risk of developing lupus at an earlier age and lupus-related disease activity, organ damage and mortality compared with whites. Evidence-based self-management interventions that incorporate both social support and health education have reduced pain, improved function and delayed disability among patients with lupus. However, AAs and women are still disproportionately affected by lupus. This article presents the argument that peer mentoring may be an especially effective intervention approach for AA women with SLE. SLE peers with a track record of success in lupus management and have a personal perspective that clinicians often lack. This commonality and credibility can establish trust, increase communication and, in turn, decrease disparities in healthcare outcomes. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
Type D Personality in infarcted patients a study with the Rorschach projective technique
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Irene Pagano Dritto
2015-12-01
Full Text Available Background: The Type D personality is a vulnerability factor associated with the psychological suffering that affects the physical and mental health state. Literature shows that the Type D personality is defined by a combination of two independent constructs: the negative affectivity (NA which refers to the tendency to experience negative emotions over time and in several situations; and the social inhibition (SI or the tendency to inhibit emotions and behaviors in social interactions. Objective: The present study aims to explore the emotions of a group of patients with heart disease, through the use of the Rorschach projective tecnique. Method: Fourty subjects with an history of heart attack, aged between 32 and 76 years, were evaluated in order to find some possible indicators of Type D personality such as the quality of contents, movements response, popular responses and Erlebnistypus. Results: Findings shows that the majority of patients present a prevalence of responses belonging to Animal and Anatomy contents and the Erlebnistypus is mostly introversive. Conclusions: The study points out some scientific element useful both in research and in clinical practice, confirming the Rorschach potential in the assessment and identification of specific personality traits, involved in the Type D personality, that characterizes the majority of cardiac impared patients.
Personalized Mortality Prediction Driven by Electronic Medical Data and a Patient Similarity Metric
Lee, Joon; Maslove, David M.; Dubin, Joel A.
2015-01-01
Background Clinical outcome prediction normally employs static, one-size-fits-all models that perform well for the average patient but are sub-optimal for individual patients with unique characteristics. In the era of digital healthcare, it is feasible to dynamically personalize decision support by identifying and analyzing similar past patients, in a way that is analogous to personalized product recommendation in e-commerce. Our objectives were: 1) to prove that analyzing only similar patients leads to better outcome prediction performance than analyzing all available patients, and 2) to characterize the trade-off between training data size and the degree of similarity between the training data and the index patient for whom prediction is to be made. Methods and Findings We deployed a cosine-similarity-based patient similarity metric (PSM) to an intensive care unit (ICU) database to identify patients that are most similar to each patient and subsequently to custom-build 30-day mortality prediction models. Rich clinical and administrative data from the first day in the ICU from 17,152 adult ICU admissions were analyzed. The results confirmed that using data from only a small subset of most similar patients for training improves predictive performance in comparison with using data from all available patients. The results also showed that when too few similar patients are used for training, predictive performance degrades due to the effects of small sample sizes. Our PSM-based approach outperformed well-known ICU severity of illness scores. Although the improved prediction performance is achieved at the cost of increased computational burden, Big Data technologies can help realize personalized data-driven decision support at the point of care. Conclusions The present study provides crucial empirical evidence for the promising potential of personalized data-driven decision support systems. With the increasing adoption of electronic medical record (EMR) systems, our
Sher, Leo; Siever, Larry J; Goodman, Marianne; McNamara, Margaret; Hazlett, Erin A; Koenigsberg, Harold W; New, Antonia S
2015-10-30
Gender is an important variable in the study of mental health because of the actual and perceived differences between men and women. Relatively little is known how males and females differ in their manifestations of antisocial personality disorder (ASPD). Demographic and clinical features of 323 participants with ASPD were assessed and recorded. Women had fewer episodes of antisocial behavior involving or not involving police, higher scores on the Childhood Trauma Questionnaire (CTQ) and on Emotional Abuse and Sexual Abuse subscales of the CTQ compared to men. CTQ scores positively correlated with the number of episodes of antisocial behavior involving police in men but not in women. The percentage of patients with comorbid borderline and histrionic personality disorders was higher and the percentage of participants with cocaine use disorder was lower among women compared to men. Comorbid alcohol use disorder was frequent in both groups, while a higher percentage of women had comorbid mood disorders compared to men. Logistic regression analysis demonstrates that CTQ scores, histrionic personality disorder, and antisocial behavior involving the police drive the difference between the groups. Our findings indicate that treatment of individuals with ASPD should focus on the management of comorbid psychiatric disorders. Published by Elsevier Ireland Ltd.
A multidisciplinary approach to therapeutic risk management of the suicidal patient
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Grant CL
2015-06-01
Full Text Available Cynthia L Grant,1,2 Jaimie L Lusk3 1Arapahoe/Douglas Mental Health Network, Englewood, CO, 2School of Education and Human Development, University of Colorado Denver, Denver, CO, 3Mental Health Service, VA Portland Health Care System, Portland, OR, USA Abstract: As health care trends toward a system of care approach, providers from various disciplines strive to collaborate to provide optimal care for their patients. While a multidisciplinary approach to suicide risk assessment and management has been identified as important for reducing suicidality, standardized clinical guidelines for such an approach do not yet exist. In this article, the authors propose the adoption of the therapeutic risk management of the suicidal patient (TRMSP to improve suicide risk assessment and management within multidisciplinary systems of care. The TRMSP, which has been fully articulated in previous articles, involves augmenting clinical risk assessment with structured instruments, stratifying risk in terms of both severity and temporality, and developing and documenting a safety plan. Augmenting clinical risk assessments with reliable and valid structured instruments serves several functions, including ensuring important aspects of suicide are addressed, establishing a baseline for suicidal thoughts and behaviors, facilitating interprofessional communication, and mitigating risk. Similarly, a two-dimensional risk stratification qualifying suicide risk in terms of both severity and temporality can enhance communication across providers and settings and improve understanding of acute crises in the context of chronic risk. Finally, safety planning interventions allow providers and patients to collaboratively create a personally meaningful plan for managing a suicidal crisis that can be continually modified across time with multiple providers in different care settings. In a busy care environment, the TRMSP can provide concrete guidance on conducting clinically and
A rare case of trichotillomania with antisocial personality disorder
Directory of Open Access Journals (Sweden)
Priti Singh
2015-01-01
Full Text Available Trichotillomania (TTM is characterised by recurrent and irresistible urge to pull out one’s own body hair. It is often associated with trichorrhizophagia in which there is a habit to eat the roots of pulled out hairs. It can also present with many comorbid psychiatric problems including personality disorders. High rates of comorbid mood, anxiety, and substance use disorders have been detected in patients of TTM. The lifetime prevalence of comorbid personality disorders has been much less extensively studied. We present a rare case of 28-year-old male having TTM with antisocial personality disorder and discuss difficult management issues with this comorbidity. Our patient improved with a combination of fluoxetine and sodium valproate.
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Abdallah Kamal Eldine
2017-06-01
Full Text Available The majority of workers have many occasional difficulties that sometimes become a problem affecting the worker’s performance. When this will repeatedly fail to meet expectations, a serious problem may become the main reason which contributes to the job decline. Therefore, a pattern of reduced performance indicates the need for a supervisory action from managers. Poor performance could be reflected under three main categories, such as employee availability, employee productivity, and employee conduct. The reasons and causes of this poor performance could be a personal issue related to the employee. Many types of personal problems are affecting the job performance in organizations, such as marital strife, financial difficulties and child care complication. More serious difficulties and the abuse of these problems-if not resolved-may cause unending issues at work. This problem is highly important especially that it can affect the job performance and the company income. Moreover, it can simply result in the failure of the employee to meet the performance standards, which kills productivity. The purpose of this qualitative exploratory phenomenological study is to clarify the management role in dealing with employees personal issues in the Lebanese organizations as perceived by the lived experience of managers. The research instrument which will be used is a face-to-face structured interview with six managers of the major functions in different Lebanese organizations. The sample type will be by convenience.
Shepherd, Stephane M; Campbell, Rachel E; Ogloff, James R P
2018-02-01
This study identified the presence of psychopathy (as measured by the PCL-R/PCL:SV instruments) and antisocial personality disorder (APD) and their relationship with future reconviction in an Australian forensic sample ( N = 136) of patients with a mental disorder. Patients were tracked for over 4 years postrelease to determine associations between a diagnosis of APD/psychopathy and reoffense. Patients with higher psychopathy scores were found to have an increased likelihood of reincarceration, a higher rate of reconviction, and were reconvicted earlier compared with patients with lower psychopathy scores. Patients with APD were more likely to be reconvicted and reincarcerated during the follow-up period than patients without an APD diagnosis. Despite demonstrating associations with general reconviction, the PCL instruments did not exhibit statistically significant relationships with violence. Implications for the clinical identification of personality disordered patients in forensic settings are discussed.
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Wei-Chih Chen
2017-09-01
Conclusions: IC/BPS patients frequently exhibit several mental health disorders and negative personality traits. Therefore, in addition to targeting the bladder pathological condition, psychological intervention focusing on personality traits and anxiety mood status should be provided to improve quality of life of IC/BPS patients.
The distressed (Type D) personality. A risk marker for poor health outcomes in ICD patients
DEFF Research Database (Denmark)
Pedersen, Susanne S.; Schiffer, A A
2011-01-01
The distressed (Type D) personality is an emerging risk marker for poor health outcomes in patients with cardiovascular disease. Patients with this personality disposition are typified by a general propensity to experience psychological distress. The contribution focuses on the impact of Type D p...
Nurses' Written Responses to Pain Management Values Education: A Content Analysis.
Bernhofer, Esther I; Hosler, Rose; Karius, Diana
2016-12-01
Providing optimal pain care for patients is essential to the work of nursing and a measure of patient satisfaction prompting some hospitals to offer pain management classes for clinicians. Although nurses generally do well on knowledge tests after attending a pain class, actual improvement in pain care for patients may not occur. The personal values of the clinician may be a key driver of pain-management decision making. Therefore, a segment on how clinicians' personal values influence pain care decisions was added to a large Midwestern hospital's pain management class. The purpose of this study was to examine the written answers to questions posed to nurses regarding any practice changes they have made to caring for patients with pain after participating in a class that included a segment on personal values. This study used a qualitative content analysis method. A large Midwestern healthcare system. Twenty clinical registered nurses who attended a pain class in April 2014. Participants provided written answers to two open-ended interview questions. Data were analyzed using conventional content analysis of the text. Four themes were identified among participants' answers: understanding the patient, importance of pain education, nurse's self-awareness, and interpretation of personal values. Nurses who learned how their personal values affect their pain management decisions described new insights into their own approach to pain management. More research is needed to fully understand the impact of knowing one's own values and determining which clinician values are associated with optimal pain care. Copyright © 2016 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.
Fassino, Secondo; Amianto, Federico; Gastaldi, Filippo; Abbate-Daga, Giovanni; Brambilla, Francesca; Leombruni, Paolo
2009-01-30
Family environment is a pathogenic factor of borderline personality disorder (BPD). However, the personality traits of patients with BPD and their parents have never been assessed using the same instrument and then examined for relationships. In the present study, we explored the temperament and character traits of BPD patients and their parents to investigate possible interactions. In total, 56 patients with BPD and their parents were evaluated with the Temperament and Character Inventory (TCI) and compared with 53 control families. Discriminant and correlation analyses indicated that subjects with BPD displayed higher levels of novelty seeking, harm avoidance, and self-transcendence and lower levels of self-directedness than control subjects. Their fathers displayed higher levels of novelty seeking and lower levels of persistence and self-directedness, and their mothers displayed lower levels of self-directedness compared with levels in control parents. In BPD families, temperament and character traits displayed high levels of discriminatory power. Novelty seeking in offspring with borderline personality disorder was significantly correlated with their mothers' novelty seeking and their fathers' self-transcendence. Self-directedness in borderline offspring was significantly correlated with both their mothers' and fathers' novelty seeking, and their self-transcendence was significantly correlated with their mothers' novelty seeking and harm avoidance. The different correlational pattern for borderline and control families is discussed. Characteristic personality patterns were found in BPD offspring and in both parents. The relationship between personality traits of borderline offspring and those of their parents may be related to both genetic transmission and family dynamics. Ramifications for treatment are discussed.
Corvol, A; Balard, F; Moutel, G; Somme, D
2014-01-01
Case management is a new professional field in France. It is addressed to elderly persons living in community whose situation is regarded as particularly complex. Case managers have to assess needs and coordinate necessary services. One common criteria of complexity is refusal of care. The objective of this study is to compare the words of users with those of case managers about refusal of care, in order to understand its meaning, professionals' attitudes and ethical challenges. Two researchers have cooperated on this qualitative research: the first one, anthropologist, interviewed 19 individuals, and 11 of their caregivers. The second one, geriatrician and researcher in medical ethics, lead four focus groups gathering a total of 18 case managers. Refusal of care often is the result of the will of preserving one's identity, compromised by illness. Individuals seek control on their life. Facing this behaviour, case managers try to secure the individual, by establishing a personal relationship that respects their choices, even if care has to be delayed. Refusal of care may sometimes disclose a desire to vanish, in front of which professionals meet their own limits. To recognise an elderly person that refuses care as a unique individual who can make choices secure his identity, and allow him to change. Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.
[Skills Training for Patients with Borderline Personality Disorder].
Armbrust, Michael; Ehrig, Christian
2016-07-01
The emotionally instable personality disorder, mostly called borderline disorder, shows central abnormalities in impulse control as well as instability of mood and identity. It is composed of behaviour problems in creating relationships and in self-management, first of all by high psychophysiological tension. The prevalence of this disorder is 10 % in outpatients and 20 % in inpatients and has therefore high relevance for the medical-psychotherapeutic care system. The treatment is deemed to be complex and interminable. Regarding all evaluated techniques of treatment the best examined is the Dialectical Behavioral Therapy (DBT). This specific therapy, developed in the eighties by Marsha M. Linehan, can be used for inpatient and outpatient treatment and combines single and group sessions. It is essential in mental health care of this disorder, but not available everywhere. Essential part of DBT is the skill training, a specific technique for the acquirement and for exercising skills for mindfulness, modulation of tension, regulation of emotions, structuring of social competence and developing self value. The central goal of DBT is to ensure the survival of the patients, to reduce self- and external aggressive behaviour and to provide inpatient crisis interventions. For sustained crisis management skills for reality acceptance are best fitting. But before, fast available sensory and active body-related skills should be used. Radical acceptance is the most important, since most effective, skill. The skills training, although in use for only twenty years, is permanently expanding in practice and is meanwhile also used for other disorders such as, for example, PTSD or ADHD. Since 2010, there also exists an elaborated DBT-version for adolescents. For medical care politics and health-economic reasons a supply with skills training for in- and outpatients all over the country is desirable. © Georg Thieme Verlag KG Stuttgart · New York.
Wu, Jia-Rong; Song, Eun Kyeung; Moser, Debra K
2015-01-01
Type D personality is associated with medication non-adherence. Both Type D personality and non-adherence are predictors of poor outcomes. Self-efficacy, which is modifiable, is also associated with medication adherence. To determine the relationships among Type D personality, self-efficacy, and medication adherence in 84 heart failure patients. Self-efficacy, Type D personality, medication adherence, demographic and clinical data were collected. Hierarchical linear regression was used. Type D patients were more likely to have lower self-efficacy (p = .023) and medication non-adherence (p = .027) than non-Type D patients. Low self-efficacy was associated with medication non-adherence (p mediation. Self-efficacy mediates the relationship between Type D personality and medication adherence. Developing and applying interventions to enhance self-efficacy may help to sever the link between Type D personality and poor outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.
Secretion management in the mechanically ventilated patient.
Branson, Richard D
2007-10-01
Secretion management in the mechanically ventilated patient includes routine methods for maintaining mucociliary function, as well as techniques for secretion removal. Humidification, mobilization of the patient, and airway suctioning are all routine procedures for managing secretions in the ventilated patient. Early ambulation of the post-surgical patient and routine turning of the ventilated patient are common secretion-management techniques that have little supporting evidence of efficacy. Humidification is a standard of care and a requisite for secretion management. Both active and passive humidification can be used. The humidifier selected and the level of humidification required depend on the patient's condition and the expected duration of intubation. In patients with thick, copious secretions, heated humidification is superior to a heat and moisture exchanger. Airway suctioning is the most important secretion removal technique. Open-circuit and closed-circuit suctioning have similar efficacy. Instilling saline prior to suctioning, to thin the secretions or stimulate a cough, is not supported by the literature. Adequate humidification and as-needed suctioning are the foundation of secretion management in the mechanically ventilated patient. Intermittent therapy for secretion removal includes techniques either to simulate a cough, to mechanically loosen secretions, or both. Patient positioning for secretion drainage is also widely used. Percussion and postural drainage have been widely employed for mechanically ventilated patients but have not been shown to reduce ventilator-associated pneumonia or atelectasis. Manual hyperinflation and insufflation-exsufflation, which attempt to improve secretion removal by simulating a cough, have been described in mechanically ventilated patients, but neither has been studied sufficiently to support routine use. Continuous lateral rotation with a specialized bed reduces atelectasis in some patients, but has not been shown
Personalized medicine: reality and reality checks.
Leeder, J Steven; Spielberg, Stephen P
2009-05-01
The evolving era of pharmacogenomics and personalized medicine is greeted with optimism by many, but this sentiment is not universally shared. The existence of diametrically opposed opinions concerning the potential benefits and obstacles facing the widespread implementation of genomic medicine should stimulate discussion and guide the design of studies to establish the value of interventions targeted at the level of individual patients. One of the more controversial aspects of personalized medicine is whether the anticipated benefits will be realized at an acceptable cost. Recently released analyses suggest that the returns on investment depend on the particular scenario and are different for different stakeholders. On the other hand, cost is only one of the challenges regarding implementation of personalized medicine. Among these are the development of universal standards for managing genomic information in electronic medical records, improvement in the collection and interpretation of clinical phenotype data, and new strategies to educate practitioners and patients/consumers. The reality is that personalized medicine is upon us; open discourse and periodic reality checks will be necessary as we confront it.
Russell, Siân; Ogunbayo, Oladapo J; Newham, James J; Heslop-Marshall, Karen; Netts, Paul; Hanratty, Barbara; Beyer, Fiona; Kaner, Eileen
2018-01-17
Self-management interventions for chronic obstructive pulmonary disease (COPD) can improve quality of life, reduce hospital admissions, and improve symptoms. However, many factors impede engagement for patients and practitioners. Qualitative research, with its focus on subjective experience, can provide invaluable insights into such factors. Therefore, a systematic review and synthesis of qualitative evidence on COPD self-management from the perspective of patients, carers, and practitioners was conducted. Following a systematic search and screening, 31 studies were appraised and data extracted for analysis. This review found that patients can adapt to COPD; however, learning to self-manage is often a protracted process. Emotional needs are considerable; frustration, depression, and anxiety are common. In addition, patients can face an assortment of losses and limitations on their lifestyle and social interaction. Over time, COPD can consume their existence, reducing motivation. Support from family can prove vital, yet tinged with ambivalence and burden. Practitioners may not have sufficient time, resources, or appropriate skills or confidence to provide effective self-management support, particularly in regard to patients' psychosocial needs. This can compound patients' capability to engage in self-management. For COPD self-management to be effective, patients' psychosocial needs must be prioritised alongside medication and exacerbation management. In addition, patients' personal beliefs regarding COPD and its management should be reviewed periodically to avoid problematic behaviours and enhance positive adaptions to the disease. Patients with COPD are not a homogenous group and no one intervention will prove effective for all. Finally, practitioners require greater education, training, and support to successfully assist patients.
Schwaiger, Johannes P; Kopriva-Altfahrt, Gertrude; Söllner, Wolfgang; König, Paul
2007-01-01
Personality psychology is increasingly used in various clinical medicine settings to help in decision-making in difficult situations, especially in chronic disease. Patients with chronic renal disease are very dependent on modern medicine, and psychological aspects could help give answers in certain circumstances. Logotherapy and Existence analysis, after Viktor Frankl (Third Viennese School of Psychotherapy), is the theory of the possibilities and conditions for a fulfilled existence and evaluates a different aspect of personality psychology, namely meaning (in life). We used the existence scale questionnaire in this pilot study to investigate the personal abilities self-distancing, self-transcendence, freedom and responsibility in dialysis patients and compared a group of hemodialysis (HD) patients with patients treated with continuous ambulatory peritoneal dialysis (CAPD). We studied a mixed dialysis cohort (24 HD, 24 CAPD) at two Austrian centers (Innsbruck Medical University Hospital and Wilhelminenspital of the City of Vienna). Overall, results for dialysis patients (n = 48) were very close to those reported for healthy persons; however, CAPD patients scored significantly better than HD patients (p = 0.017) on the subscale self-distancing. This significant difference was also seen in the overall scores (p = 0.045). Our results might indicate that contented CAPD patients have personal abilities that predestine them for this type of treatment. The existence scale might help decide between CAPD and HD treatment alternatives.
The image database management system of teaching file using personal computer
International Nuclear Information System (INIS)
Shin, M. J.; Kim, G. W.; Chun, T. J.; Ahn, W. H.; Baik, S. K.; Choi, H. Y.; Kim, B. G.
1995-01-01
For the systemic management and easy using of teaching file in radiology department, the authors tried to do the setup of a database management system of teaching file using personal computer. We used a personal computer (IBM PC compatible, 486DX2) including a image capture card(Window vision, Dooin Elect, Seoul, Korea) and video camera recorder (8mm, CCD-TR105, Sony, Tokyo, Japan) for the acquisition and storage of images. We developed the database program by using Foxpro for Window 2.6(Microsoft, Seattle, USA) executed in the Window 3.1 (Microsoft, Seattle, USA). Each datum consisted of hospital number, name, sex, age, examination date, keyword, radiologic examination modalities, final diagnosis, radiologic findings, references and representative images. The images were acquired and stored as bitmap format (8 bitmap, 540 X 390 ∼ 545 X 414, 256 gray scale) and displayed on the 17 inch-flat monitor(1024 X 768, Samtron, Seoul, Korea). Without special devices, the images acquisition and storage could be done on the reading viewbox, simply. The image quality on the computer's monitor was less than the one of original film on the viewbox, but generally the characteristics of each lesions could be differentiated. Easy retrieval of data was possible for the purpose of teaching file system. Without high cost appliances, we could consummate the image database system of teaching file using personal computer with relatively inexpensive method
Balancing personalized medicine and personalized care.
Cornetta, Kenneth; Brown, Candy Gunther
2013-03-01
The current description of personalized medicine by the National Institutes of Health is "the science of individualized prevention and therapy." Although physicians are beginning to see the promise of genetic medicine coming to fruition, the rapid pace of sequencing technology, informatics, and computer science predict a revolution in the ability to care for patients in the near future. The enthusiasm expressed by researchers is well founded, but the expectations voiced by the public do not center on advancing technology. Rather, patients are asking for personalized care: a holistic approach that considers physical, mental, and spiritual well-being. This perspective considers psychological, religious, and ethical challenges that may arise as the precision of preventive medicine improves. Psychological studies already highlight the barriers to single gene testing and suggest significant barriers to the predictive testing envisioned by personalized medicine. Certain religious groups will likely mount opposition if they believe personalized medicine encourages embryo selection. If the technology prompts cost-containment discussions, those concerned about the sanctity of life may raise ethical objections. Consequently, the availability of new scientific developments does not guarantee advances in treatment because patients may prove unwilling to receive and act on personalized genetic information. This perspective highlights current efforts to incorporate personalized medicine and personalized care into the medical curriculum, genetic counseling, and other aspects of clinical practice. Because these efforts are generally independent, the authors offer recommendations for physicians and educators so that personalized medicine can be implemented in a manner that meets patient expectations for personalized care.
Pain management: association with patient satisfaction among emergency department patients.
Bhakta, Hemangini C; Marco, Catherine A
2014-04-01
Patient satisfaction with emergency care is associated with timeliness of care, empathy, technical competence, and information delivery. Previous studies have demonstrated inconsistent findings regarding the association between pain management and patient satisfaction. This study was undertaken to determine the association between pain management and patient satisfaction among Emergency Department (ED) patients presenting with acute painful conditions. In this survey study, a standardized interview was conducted at the Emergency Department at the University of Toledo Medical Center in May-July 2011. Participants were asked to answer 18 questions pertaining to patient satisfaction. Additional data collected included demographic information, pain scores, and clinical management. Among 328 eligible participants, 289 (88%) participated. The mean triage pain score on the verbal numeric rating scale was 8.2 and the mean discharge score was 6.0. The majority of patients (52%) experienced a reduction in pain of 2 or more points. Participants received one pain medication dose (44%), two medication doses (14%), three medication doses (5%), or four medication doses (2%). Reduction in pain scores of 2 or more points was associated with a higher number of medications administered. Reduction in pain scores was associated with higher satisfaction as scored on questions of patient perceptions of adequate assessment and response to pain, and treatment of pain. There was a significant association between patient satisfaction and a reduction in pain of 2 or more points and number of medications administered. Effective pain management is associated with improved patient satisfaction among ED patients with painful conditions. Copyright © 2014 Elsevier Inc. All rights reserved.
DEFF Research Database (Denmark)
Bukh, Jens Drachmann; Bock, Camilla; Vinberg, Maj
2010-01-01
for comorbid personality disorder among patients suffering from depression would be of clinical use. METHOD: The present study aimed to assess the utility of the Standardised Assessment of Personality - Abbreviated Scale (SAPAS) as a screen for personality disorder in a population of patients recently......BACKGROUND: Personality disorder frequently co-occurs with depression and seems to be associated with a poorer outcome of treatment and increased risk for recurrences. However, the diagnosing of personality disorder can be lengthy and requires some training. Therefore, a brief screening interview...... diagnosed with first episode depression. A total number of 394 patients with an ICD-10 diagnosis of a single depressive episode were sampled consecutively via the Danish Psychiatric Central Research Register during a 2years inclusion period and assessed by the screening interview and, subsequently...
Physician-patient communication in managed care.
Gordon, G H; Baker, L; Levinson, W
1995-01-01
The quality of physician-patient communication affects important health care outcomes. Managed care presents a number of challenges to physician-patient communication, including shorter visits, decreased continuity, and lower levels of trust. Good communication skills can help physicians create and maintain healthy relationships with patients in the face of these challenges. We describe 5 communication dilemmas that are common in managed care and review possible solutions suggested by recent ...
Fagerberg, Tomas; Söderman, Erik; Petter Gustavsson, J; Agartz, Ingrid; Jönsson, Erik G
2018-02-27
Personality is considered as an important aspect in persons with psychotic disorders. Several studies have investigated personality in schizophrenia. However, no study has investigated stability of personality traits exceeding three years in patients with schizophrenia. This study aims to investigate the stability of personality traits over a five-year period among patients with schizophrenia and non-psychotic individuals and to evaluate case-control differences. Patients with psychotic disorders (n = 36) and non-psychotic individuals (n = 76) completed Swedish universities Scales of Personality (SSP) at two occasions five years apart. SSP scores were analysed for effect of time and case-control differences by multiple analysis of covariance (MANCOVA) and within-subjects correlation. MANCOVA within-subjects analysis did not show any effect of time. Thus, SSP mean scale scores did not significantly vary during the five-year interval. Within subject correlations (Spearman) ranged 0.30-0.68 and 0.54-0.75 for the different SSP scales in patients and controls, respectively. Patients scored higher than controls in SSP scales Somatic Trait Anxiety, Psychic Trait Anxiety, Stress Susceptibility, Lack of Assertiveness, Detachment, Embitterment, and Mistrust. The stability of the SSP personality trait was reasonably high among patients with psychotic disorder, although lower than among non-psychotic individuals, which is in accordance with previous research.
Trajectories of personal control in cancer patients receiving psychological care
Zhu, Lei; Schroevers, Maya J.; van der Lee, Marije; Garssen, Bert; Stewart, Roy E.; Sanderman, Robbert; Ranchor, Adelita V.
Objective: This study aimed to (1) identify subgroups of cancer patients with distinct personal control trajectories during psychological care, (2) examine whether socio-demographic, clinical, and psychological care characteristics could distinguish trajectories, and (3) examine differential
Karamanolaki, Hara; Spyropoulou, Areti C; Iliadou, Aggeliki; Vousoura, Eleni; Vondikaki, Stamatia; Pantazis, Nikos; Vaslamatzis, Grigoris
2016-01-01
The purpose of this study was to assess the possible effect of recalled traumatic experiences, perceived parental rearing styles, and family parameters on the occurrence of borderline personality disorder (BPD) versus other personality disorders (other-PDs). A total of 88 adult outpatients with personality disorders completed the Traumatic Antecedents Questionnaire and the Egna Minnen av Barndoms Uppfostran, which measures perceptions regarding parental rearing. Results indicated that incidence of traumatic childhood experiences was higher among those in the BPD group compared to those in the other-PD group. Firstborns were less likely to carry a diagnosis of BPD over other-PDs. Also, significantly more BPD compared to other-PD patients reported being the father's favorite child over siblings. Results suggest that traumatic experiences, birth order, and family interactions in the presence of siblings seem to differentially affect the formation of borderline diagnosis compared to other-PDs. Limitations and clinical implications of the study are discussed in detail.
Oldenburg, J; Aparicio, J; Beyer, J; Cohn-Cedermark, G; Cullen, M; Gilligan, T; De Giorgi, U; De Santis, M; de Wit, R; Fosså, S D; Germà-Lluch, J R; Gillessen, S; Haugnes, H S; Honecker, F; Horwich, A; Lorch, A; Ondruš, D; Rosti, G; Stephenson, A J; Tandstad, T
2015-05-01
Testicular cancer (TC) is the most common neoplasm in males aged 15-40 years. The majority of patients have no evidence of metastases at diagnosis and thus have clinical stage I (CSI) disease [Oldenburg J, Fossa SD, Nuver J et al. Testicular seminoma and non-seminoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013; 24(Suppl 6): vi125-vi132; de Wit R, Fizazi K. Controversies in the management of clinical stage I testis cancer. J Clin Oncol 2006; 24: 5482-5492.]. Management of CSI TC is controversial and options include surveillance and active treatment. Different forms of adjuvant therapy exist, including either one or two cycles of carboplatin chemotherapy or radiotherapy for seminoma and either one or two cycles of cisplatin-based chemotherapy or retroperitoneal lymph node dissection for non-seminoma. Long-term disease-specific survival is ∼99% with any of these approaches, including surveillance. While surveillance allows most patients to avoid additional treatment, adjuvant therapy markedly lowers the relapse rate. Weighing the net benefits of surveillance against those of adjuvant treatment depends on prioritizing competing aims such as avoiding unnecessary treatment, avoiding more burdensome treatment with salvage chemotherapy and minimizing the anxiety, stress and life disruption associated with relapse. Unbiased information about the advantages and disadvantages of surveillance and adjuvant treatment is a prerequisite for informed consent by the patient. In a clinical scenario like CSI TC, where different disease-management options produce indistinguishable long-term survival rates, patient values, priorities and preferences should be taken into account. In this review, we provide an overview about risk factors for relapse, potential benefits and harms of adjuvant chemotherapy and active surveillance and a rationale for involving patients in individualized decision making about their treatment rather than adopting
Anesthetic management of a patient with multiple sclerosis - case report
Directory of Open Access Journals (Sweden)
Eduardo Barbin Zuccolotto
Full Text Available Abstract Background and objectives: Multiple sclerosis is a demyelinating disease of the brain and spinal cord, characterized by muscle weakness, cognitive dysfunction, memory loss, and personality disorders. Factors that promote disease exacerbation are stress, physical trauma, infection, surgery, and hyperthermia. The objective is to describe the anesthetic management of a case referred to urological surgery. Case report: A female patient, 44 years of age, with multiple sclerosis, diagnosed with nephrolithiasis, referred for endoscopic ureterolythotripsy. Balanced general anesthesia was chosen, with midazolam, propofol and remifentanil target-controlled infusion; sevoflurane via laryngeal mask airway; and spontaneous ventilation. Because the patient had respiratory difficulty presenting with chest wall rigidity, it was decided to discontinue the infusion of remifentanil. There was no other complication or exacerbation of disease postoperatively. Conclusion: The use of neuromuscular blockers (depolarizing and non-depolarizing is a problem in these patients. As there was no need for muscle relaxation in this case, muscle relaxants were omitted. We conclude that the combination of propofol and sevoflurane was satisfactory, not resulting in hemodynamic instability or disease exacerbation.
Trajectories of personal control in cancer patients receiving psychological care
Zhu, Lei; Schroevers, Maya J.; van der Lee, Marije; Garssen, Bert; Stewart, Roy E.; Sanderman, Robbert; Ranchor, A.V.
2015-01-01
Objective This study aimed to (1) identify subgroups of cancer patients with distinct personal control trajectories during psychological care, (2) examine whether socio-demographic, clinical, and psychological care characteristics could distinguish trajectories, and (3) examine differential patterns
Di Pierro, Rossella; Preti, Emanuele; Vurro, Nicoletta; Madeddu, Fabio
2014-08-01
Although dual diagnosis has been a topic of great scientific interest for a long time, few studies have investigated the personality traits that characterize patients suffering from substance use disorders and co-occurring personality disorders through a dimensional approach. The present study aimed to evaluate structural personality profiles among dual-diagnosis inpatients to identify specific personality impairments associated with dual diagnosis. The present study involved 97 participants divided into three groups: 37 dual-diagnosis inpatients, 30 psychiatric outpatients and 30 nonclinical controls. Dimensions of personality functioning were assessed and differences between groups were tested using Kernberg's dimensional model of personality. Results showed that dual diagnosis was associated with the presence of difficulties in three main dimensions of personality functioning. Dual-diagnosis inpatients reported a poorly integrated identity with difficulties in the capacity to invest, poorly integrated moral values, and high levels of self-direct and other-direct aggression. The present study highlighted that a dimensional approach to the study of dual diagnosis may clarify the personality functioning of patients suffering from this pathological condition. The use of the dimensional approach could help to advance research on dual diagnosis, and it could have important implications on clinical treatment programs for dual-diagnosis inpatients. Copyright © 2014 Elsevier Inc. All rights reserved.
International Nuclear Information System (INIS)
2006-03-01
This sheet aims at providing elements for the preparation of the management of a patient by a department or unit other than a nuclear medicine department after this patient has been submitted to an examination or treatment involving the use of radionuclides in unsealed sources, as this exposure may result in an internal or external exposure risk for the personnel, other persons and relatives. It briefly describes the modalities of performance of nuclear medicine act, the modalities of information of patients and of their relatives, indicates instructions to departments hosting the patient (instruction regarding the patient and wastes), and instructions for pregnant or breast feeding women
Tanum, L; Malt, U F
2000-09-01
We investigated the relationship between personality traits and response to treatment with the tetracyclic antidepressant mianserin or placebo in patients with functional gastrointestinal disorder (FGD) without psychopathology. Forty-eight patients completed the Buss-Durkee Hostility Inventory, Neuroticism Extroversion Openness -Personality Inventory (NEO-PI), and Eysenck Personality Questionnaire (EPQ), neuroticism + lie subscales, before they were consecutively allocated to a 7-week double-blind treatment study with mianserin or placebo. Treatment response to pain and target symptoms were recorded daily with the Visual Analogue Scale and Clinical Global Improvement Scale at every visit. A low level of neuroticism and little concealed aggressiveness predicted treatment outcome with the antidepressant drug mianserin in non-psychiatric patients with FGD. Inversely, moderate to high neuroticism and marked concealed aggressiveness predicted poor response to treatment. These findings were most prominent in women. Personality traits were better predictors of treatment outcome than serotonergic sensitivity assessed with the fenfluramine test. Assessment of the personality traits negativism, irritability, aggression, and neuroticism may predict response to drug treatment of FGD even when serotonergic sensitivity is controlled for. If confirmed in future studies, the findings point towards a more differential psychopharmacologic treatment of FGD.
Directory of Open Access Journals (Sweden)
Shao Y
2017-03-01
Full Text Available Yechang Shao,1,2 Honglei Yin,3 Chengsong Wan4 1School of Public Health, Southern Medical University, 2Department of Internal Medicine, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 3Department of Psychiatry, Nanfang Hospital, 4Department of Microbiology, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, People’s Republic of China Objective: The aim of this study was to estimate the prevalence of Type D personality and assess the relationship between this personality type and self-efficacy/social support in Chinese patients with type 2 diabetes mellitus (T2DM.Patients and methods: From January 1, 2014, to July 31, 2014, 532 consecutive patients with T2DM were recruited from two hospitals in Guangzhou, China. The participants completed questionnaires containing questions about sociodemographic characteristics, Type D personality, self-efficacy, and social support scales, and their medical records were reviewed for additional data.Results: Of the 532 patients, 18.2% had Type D personality. Patients with this personality type reported significantly lower levels of self-efficacy (P<0.001, total social support (P<0.001, subjective support (P<0.001, and support utilization (P=0.003, but similar level of objective support (P=0.314, compared to those of patients without Type D personality. Negative affectivity and social inhibition, two intrinsic traits of Type D personality, negatively correlated with self-efficacy and social support scores. Type D personality was significantly associated with less self-efficacy and social support (P<0.001, controlling for other sociodemographic factors. Glycosylated hemoglobin (HbA1c levels were significantly higher in T2DM patients with Type D personality than in patients with non-Type D personality.Conclusion: This study provides new evidence linking Type D personality with self-efficacy, social support, and poor
Perioperative Management of Patients with Rheumatic Diseases
Bissar, Lina; Almoallim, Hani; Albazli, Khaled; Alotaibi, Manal; Alwafi, Samar
2013-01-01
This paper aims to explore the assessment of patients with rheumatologic diseases, especially rheumatoid arthritis (RA), before undergoing orthopedic surgery. Perioperative assessment ensures an early diagnosis of the patient's medical condition, overall health, medical co-morbidities, and the assessment of the risk factors associated with the proposed procedures. Perioperative assessment allows for proper postoperative management of complications and of the management of drugs such as disease-modifying anti-rheumatic drugs (DMARD) and anti-platelets, and corticosteroids. The assessment also supports follow up plans, and patient education. Perioperative assessment enables the discussion of the proposed treatment plans and the factors associated with them in each case among the different specialists involved to facilitate an appropriate early decision-making about the assessment and treatment of patients with rheumatologic diseases. It also enables the discussion of both condition and procedure with the patient to ensure a good postoperative care. The article identifies the components of perioperative medical evaluation, discusses perioperative management of co-morbidities and the management of specific clinical problems related to RA, systemic lupus erythematosus, the management of DMARDs, like methotrexate (MTX) and biologic therapies, prophylactic antibiotics, and postoperative follow up, including patient education and rehabilitation PMID:24062860
ePatient Conference Explores Future of Personalized Medicine | NIH MedlinePlus the Magazine
... page please turn Javascript on. ePatient Conference Explores Future of Personalized Medicine Past Issues / Spring - Summer 2010 Table of Contents ... your healthcare provider communicate better in the digital future? What is personalized medicine? Some of the nation's top health researchers, computer ...
Vestberg, Susanna; Passant, Ulla; Risberg, Jarl; Elfgren, Christina
2007-11-01
The aims are to study personality characteristics of patients with memory complaints and to assess the presence of objective (OMI) versus subjective (SMI) memory impairment, the affective status, as well as potential gender differences. The patients were assessed by means of a neuropsychiatric examination and a neuropsychological test-battery. The Swedish version of the revised NEO Personality Inventory (NEO PI-R) and the Hospital Anxiety and Depression Scale (HADS) were used. The 57 patients (38 women, 19 men, mean age 56.9) differed from the Swedish normative group in three of the five personality factors: neuroticism, extraversion and agreeableness. This was mainly because of the scores of the female patients. Approximately half of the patients had OMI. No differences regarding personality factors or affective status were found between OMI and SMI patients. The female patients scored significantly higher than the male patients on symptoms of anxiety and depression. Neuroticism and symptoms of depression interacted with memory performance and gender. Our findings demonstrate the importance of applying an objective assessment of memory functions and a gender perspective when studying patients with memory complaints.
Smith, Meredith Y; DuHamel, Katherine N; Egert, Jennifer; Winkel, Gary
2010-10-01
This study examined the impact of a brief pain communication/education intervention on patient outcomes in breast cancer. We hypothesized that our intervention would improve patient communication and reduce misconceptions ("Barriers") concerning pain management, and that patients with lower Barriers, or who perceived their physician as being more facilitative and receptive, would report better outcomes. Female breast cancer patients with persistent pain (n=89) were randomly assigned to either a 30-min in-person pain education/communication intervention or control condition and followed for 12 weeks. Intervention group patients reported a significant decrease in pain Barriers but not in other outcomes. Overall, patients with lower barrier scores reported less distress and better emotional well-being. Patients who scored higher in active communication (e.g., asking questions, giving information) reported fewer Barriers and better pain relief. Individuals who perceived their physicians as being more receptive reported better pain management while those who perceived their physicians as being both more receptive and facilitative were more satisfied with their health care. A brief education/communication intervention reduced patients' Barriers to pain management but did not impact other patient outcomes. Pain outcomes may be improved by addressing patients' pain misconceptions and emphasizing a receptive and responsive communication style. (c) 2009 Elsevier Ireland Ltd. All rights reserved.
Personal disclosure revisited.
Olarte, Silvia W
2003-01-01
In this paper personal disclosure is defined as a conscious verbal presentation to the patient by the therapist of a personal vignette accompanied by the appropriate dynamic formulation and resolution of a given personal area of conflict. It is conceptualized within theoretical formulations which consider the therapeutic relationship a dyad, where the reality of the patient and the reality of the therapist influence each other, providing the matrix through which the resolution of the patient's past life experiences takes place in the context of this new interpersonal experience. It is specifically differentiated from a boundary violation, because the personal disclosure is brought to the patient's interactional awareness not for gratification of the therapist's sexual or narcissistic needs, but to provoke a response in the patient's conceptualization of a phenomenon being presented in the session and to actively influence the intersubjective field. Within the conceptual framework developed in this paper, personal disclosure reaffirms the patient's current self-discovery and provides for a different formative experience. Personal disclosure is not to be used by the therapist as a vehicle to resolve personal conflicts or as source of personal gratification. When used within the context developed in this paper, personal disclosure enhances both the patient's therapeutic process and the therapist's ever-evolving growth.
Directory of Open Access Journals (Sweden)
Elizabeth Davis
Full Text Available Case management programs for chronically ill, homeless people improve health and resource utilization by linking patients with case managers focused on improving management of medical and psychosocial problems. Little is known about participants' perspectives on case management interventions.This qualitative study used in-depth, one-on-one interviews to understand the impact of a case management program from the perspective of participants. A standardized interview guide with open-ended questions explored experiences with the case management program and feelings about readiness to leave the program.FOUR RECURRENT THEMES EMERGED: (1 Participants described profound social isolation prior to case management program enrollment; (2 Participants perceived that caring personal relationships with case managers were key to the program; (3 Participants valued assistance with navigating medical and social systems; and (4 Participants perceived that their health improved through both the interpersonal and the practical aspects of case management.Chronically ill, homeless people enrolled in a case management program perceived that social support from case managers resulted in improved health. Programs for this population should consider explicitly including comprehensive social support interventions. Further research on case management should explore the impact of different types of social support on outcomes for homeless chronically ill patients.
Fitousi, N
2017-12-01
Due to the upcoming European Directive (2013/59/EURATOM) and the increased focus on patient safety in international guidelines and regulations, Patient Dose Monitoring Systems, also called Dose Management Systems (DMS), are introduced in medical imaging departments. This article focusses on the requirements for a DMS, its benefits and the necessary implementation steps. The implementation of a DMS can be perceived as a lengthy, yet worthy, procedure: users have to select the appropriate system for their applications, prepare data collection, validate, perform configuration, and start using the results in quality improvement projects. A state of the art DMS improves the quality of service, ensures patient safety and optimizes the efficiency of the department. The gain is multifaceted: the initial goal is compliance monitoring against diagnostic reference levels. At a higher level, the user gets an overview of the performance of the devices or centers that are under his supervision. Error identification, generation of alerts and workflow analysis are additional benefits. It can also enable a more patient-centric approach with personalized dosimetry. Skin dose, size-specific dose estimates and organ doses can be calculated and evaluated per patient. A DMS is a powerful tool and essential for improved quality and patient care in a radiology department. It can be configured to the needs of medical physicists, radiologists, technologists, even for the management of the hospital. Collaboration between all health professionals and stakeholders, input-output validation and communication of findings are key points in the process of a DMS implementation. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
Secure management of personal health records by applying attribute-based encryption
Ibraimi, L.; Asim, M.; Petkovic, M.
2009-01-01
The confidentiality of personal health records is a major problem when patients use commercial Web-based systems to store their health data. Traditional access control mechanisms have several limitations with respect to enforcing access control policies and ensuring data confidentiality. In
Haemodialysis patients and end-of-life decisions: a theory of personal preservation.
Calvin, Amy Olivier
2004-06-01
Lack of knowledge about the end-of-life treatment preferences of patients undergoing haemodialysis is problematic in the acute care setting as, often, patients are unable to communicate their treatment wishes effectively and have not previously documented their desires in the form of advance directives. Existing theoretical models offer an incomplete explanation of end-of-life treatment decisions in haemodialysis patients. This paper reports a study exploring decisions about end-of-life treatment (e.g. cardiopulmonary resuscitation, mechanical ventilation) in people with kidney failure undergoing haemodialysis. Grounded theory was used. Theoretical sampling led to selection of 20 haemodialysis patients (11 men and nine women with a mean age of 56) who attended three dialysis outpatient centres in central Texas. They were interviewed about end-of-life treatment plans and the use of advance directives (i.e. living wills and durable powers of attorney for health care). Interviews, transcripts and field notes from the first 12 patients were analysed by making constant comparisons. The remaining eight interviews were used for validation purposes. Data collection and analysis spanned the years 1997-2000. When prompted to think about and discuss end-of-life treatments, haemodialysis patients chose to focus on living rather than dying. A substantive theory of 'personal preservation' was developed. This consists of three phases: knowing the odds for survival, defining individuality (beating the odds, discovering meaning, being optimistic and having faith in a higher force) and personal preservation (being responsible and taking chances). The theory of personal preservation furthers understanding of illness behaviour and the process by which patients make decisions about end-of-life treatments. It can be used to sensitize health care professionals to patients' desires and to enhance patient-professional communication.
A Vertical Approach to Knowledge Management: Codification and Personalization in Software Processes
DEFF Research Database (Denmark)
Jahn, Karsten; Nielsen, Peter Axel
2011-01-01
Software process improvement is a practical concern in software companies today and it has been addressed in research. Part of this research has applied a knowledge management perspective. Researchers point out that two different strategies exist where a mixture is difficult to maintain......: Personalization (focus on people and their collaboration) and codification (focus on documents and their accessibility). This paper addresses different knowledge management problems of a software company and how they can be alleviated. A prototype, which distinguishes between different organizational levels (e.......g., software managers and software developers) and applies different knowledge management strategies, was built. It consists of a wiki and an enterprise system. This article shows how each part of the system focuses on one of the strategies and describes the differences for tool support. This combination could...
Abedi, G; Molazadeh-Mahali, Q A; Mirzaian, B; Nadi-Ghara, A; Heidari-Gorji, A M
2016-01-01
Todays people are spending most of their time life in their workplace therefore investigation for job satisfaction related factors is necessities of researches. The purpose of this research was to analyze the effect of manager's personality traits on employee job satisfaction. The present study is a descriptive and causative-comparative one utilized on a statistical sample of 44 managers and 119 employees. It was examined and analyzed through descriptive and inferential statistics of Student's t -test (independent T), one-way ANOVA, and Kolmogorov-Smirnov test. Findings showed that the managers and supervisors with personality traits of extraversion, eagerness to new experiences, adaptability, and dutifulness had higher subordinate employee job satisfaction. However, in the neurotic trait, the result was different. The results showed that job satisfaction was low in the aspect of neurosis. Based on this, it is suggested that, before any selection in managerial and supervisory positions, candidates receive a personality test and in case an individual has a neurotic trait, appropriate interference takes place both in this group and the employees' one.
Personality modulates the efficacy of treatment in patients with major depressive disorder.
Wardenaar, Klaas J; Conradi, Henk Jan; Bos, Elisabeth H; de Jonge, Peter
2014-09-01
Effects of depression treatment are obscured by heterogeneity among patients. Personality types could be one source of heterogeneity that explains variability in treatment response. Clinically meaningful variations in personality patterns could be captured with data-driven subgroups. The aim of this study was to identify such personality types and to explore their predictive value for treatment efficacy. Participants (N = 146) in the current exploratory study came from a randomized controlled trial in primary care depressed patients, conducted between January 1998 and June 2003, comparing different treatments. All participants were diagnosed with a major depressive disorder (MDD) according to the DSM-IV. Primary (care as usual [CAU] or CAU plus a psychoeducational prevention program [PEP]) and specialized (CAU + PEP + psychiatric consultation or cognitive-behavioral therapy) treatment were compared. Personality was assessed with the Neuroticism-Extraversion-Openness Five-Factor Inventory (NEO-FFI). Personality classes were identified with latent profile analysis (LPA). During 1 year, weekly depression ratings were obtained by trimonthly assessment with the Composite International Diagnostic Interview. Mixed models were used to analyze the effects of personality on treatment efficacy. A 2-class LPA solution fit best to the NEO-FFI data: Class 1 (vulnerable, n = 94) was characterized by high neuroticism, low extraversion, and low conscientiousness, and Class 2 (resilient, n = 52) by medium neuroticism and extraversion and higher agreeableness and conscientiousness. Recovery was quicker in the resilient class (class × time: P Personality profile may predict whether specialized clinical efforts have added value, showing potential implications for planning of treatments. © Copyright 2014 Physicians Postgraduate Press, Inc.
Comparison of serum from gastric cancer patients and from healthy persons using FTIR spectroscopy
Sheng, Daping; Wu, Yican; Wang, Xin; Huang, Dake; Chen, Xianliang; Liu, Xingcun
2013-12-01
Since serum can reflect human beings' physiological and pathological conditions, FTIR spectroscopy was used to compare gastric cancer patients' serum with healthy persons' serum in this study. The H2959/H2931, H1646/H1550, H1314/H1243, H1453/H1400 and H1080/H1550 ratios were calculated, among these ratios, the H2959/H2931 ratio might be a standard for distinguishing gastric cancer patients from healthy persons. Then curve fitting was processed using Gaussian curves in the 1140-1000 cm-1 region, and the result showed that the RNA/DNA ratios of gastric cancer patients' serum were obviously lower than those of healthy persons' serum. The results suggest that FTIR spectroscopy may be a potentially useful tool for diagnosis of gastric cancer.
Sieswerda, Simkje; Arntz, Arnoud; Wolfis, Marionne
2005-09-01
According to cognitive models of borderline personality disorder (BPD), an important cause for the instability of patients with BPD is dichotomous thinking (DT). Object-relation theories assume that the similar phenomenon of splitting is central in BPD. Previous studies focusing on interpersonal situations found support for DT being prominent in BPD. The aim of this study was to investigate whether patients with BPD also make use of dichotomous and schema-specific evaluations in noninterpersonal situations. An experiment was designed in which a frustrating and rewarding situation was induced by computer games that subjects had to play. Participants evaluated both themselves and the games. Patients with BPD (n=24) were characterized by somewhat more extreme game evaluations in the emotionally negative situations than normal controls (n=25), participants with a cluster C (n=10) or an anti-social personality disorder (ASPD) (n=16). Patients with BPD appeared to be characterized best by a general negative evaluative style, more than by DT or splitting. ASPD participants showed a positivity bias in both conditions.
Fairbrother, Peter; Pinnock, Hilary; Hanley, Janet; McCloughan, Lucy; Sheikh, Aziz; Pagliari, Claudia; McKinstry, Brian
2013-12-01
To explore patient and professional views on self-management in the context of telemonitoring in chronic obstructive pulmonary disease (COPD). Semi-structured interviews with patients with COPD and healthcare professionals participating in a randomized controlled trial of telemonitoring in Lothian, Scotland, explored experiences of using telemonitoring, and dynamics in patient-practitioner relationships. Transcribed data were analyzed using the Framework approach. 38 patients (mean age 67.5 years) and 32 professionals provided 70 interviews. Patients considered that telemonitoring empowered self-management by enhancing their understanding of COPD and providing additional justification for their decisions to adjust treatment or seek professional advice. Professionals discussed telemonitoring as promoting compliance with medical advice and encouraged patients to exercise personal responsibility within clinical parameters, but expressed concerns about promoting the sick role and creating dependence on telemonitoring. Telemonitoring assisted many patients to embrace greater responsibility for their health but the model of service provision remained clinician-centered. A medical model of 'compliant self-management' may paradoxically have promoted dependence on professionals. Patients and professionals shared responsibility for meeting the central objective of prompt management of exacerbations of COPD. Care is needed, however, to minimize the risk in some patients, of telemonitoring increasing dependence on practitioner support. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Using personality as a predictor of diet induced weight loss and weight management
Directory of Open Access Journals (Sweden)
Munro Irene A
2011-11-01
Full Text Available Abstract Background A major challenge for successful weight management is tailoring weight loss programs to individual needs. The aim of this study was to investigate whether personality traits could be used to match individuals to a compatible weight loss program that would maximize weight loss. Method Two different weight loss trials were conducted, both with a weight loss greater than 5% the measure of success. Fifty-four individuals, BMI 30-40 kg/m2, either followed a slow, healthy eating weight loss diet (HEWLD of 5000-6000 kJ/day for 12 weeks (n = 22, or a fast, very low energy diet (VLED of 3000 kJ/day for 4 weeks (n = 32. Anthropometric measurements were recorded at baseline, at the end of the weight loss period and, for VLED, at the end of 10 weeks of weight maintenance. Personality traits were measured at baseline using the Tangney Self Control Scale plus 3 of the scales from the Five Factor Model - Neuroticism, Conscientiousness and Extraversion. Results The percentage weight loss was significantly greater in VLED (-7.38% compared to HEWLD (-4.11%, (p Conclusion The personality factor, Neuroticism, was linked to successful weight loss (that is ≥ 5% with a particular weight loss treatment, suggesting that there is a potential to use measures of personality to identify appropriate weight loss/management strategies for individuals. Trial registration Australia and New Zealand Clinical Trials Register (ANZCTR: ACTRN12611000716965
Asthma in intellectual disability: are we managing our patients appropriately?
2016-01-01
People with intellectual disability are a vulnerable group of people with asthma that has, to date, largely been ignored in the medical literature. Although guidelines for medication management for people with intellectual disability suggest asthma is treated as for other populations, there are special considerations that should be taken into account when managing asthma in this group. Due to their cognitive impairment as well as comorbidities, they are likely to require support with asthma self-management, including inhaler use. Their varying degrees of autonomy mean that there is often a need to provide education and information to both the person and their caregivers. Educational aims To understand general principles of health of people with intellectual disability and how this affects the healthcare professional’s approach to asthma management. To understand how intellectual disability affects cognition, autonomy and communication, and therefore the ability of a person to self-manage asthma. To recognise ways of mitigating respiratory disease risk in people with intellectual disability. To describe ways for healthcare professionals to support people with intellectual disability and their caregivers in asthma management. PMID:28210318
Comorbid personality disorders among patients with depression
Directory of Open Access Journals (Sweden)
Wongpakaran N
2015-04-01
Full Text Available Nahathai Wongpakaran, Tinakon Wongpakaran, Vudhichai Boonyanaruthee, Manee Pinyopornpanish, Suthi Intaprasert Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand Purpose: To investigate the personality disorders (PDs diagnosed in patients with depressive disorders.Material and methods: This study included a cross-sectional analysis, and was an extension of the Thai Study of Affective Disorder (THAISAD project. Eighty-five outpatients with depressive disorders were interviewed using the Mini International Neuropsychiatric Inventory to assess for depression, in accordance with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision and using the Thai version of the Structured Clinical Interview for PDs to assess for PD.Results: Seventy-seven percent of the patients had at least one PD, 40% had one PD and 60% had two or more PDs (mixed cluster. The most common PDs found were borderline PD (20% and obsessive–compulsive PD (10.6%, while the occurrence of avoidant PD was low when compared to the findings of previous, related studies. Among the mixed cluster, cluster A combined with cluster C was the common mix. Both dysthymic disorder and double depression were found to have a higher proportion of PDs than major depressive disorder (85.7% versus 76.1%. Dependent PD was found to be less common in this study than in previous studies, including those carried out in Asia.Conclusion: The prevalence of PDs among those with depressive disorder varied, and only borderline PD seems to be consistently high within and across cultures. Mixed cluster plays a prominent role in depression, so more attention should be paid to patients in this category. Keywords: personality disorders, depressive disorder, prevalence, Asian, mixed cluster, SCID-II