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Sample records for publication patient group

  1. Group therapy in public mental health services: approaches, patients and group therapists.

    Science.gov (United States)

    Lorentzen, S; Ruud, T

    2014-04-01

    Group therapy is used extensively within public mental health services, but more detailed knowledge is needed. All 25 health authorities in Norway were invited to describe their groups: theory, primary tasks, interventions, structure, patients and therapists. Four hundred twenty-six groups, 296 in community mental health centres and 130 in hospitals, were categorized into nine types, based on theoretical background. Psychodynamic groups were most frequent, followed by cognitive-behavioural, psycho-educative, social skills/coping and art/expressive groups. Weekly sessions of 90 min and treatment duration 12 months was most frequent. Main diagnosis for 2391 patients: depression (517), personality disorder (396), schizophrenia/psychosis (313) and social phobia (249). Patients with depression or personality disorder were mostly in psychodynamic groups, psychosis/bipolar disorder in psycho-educative groups. Cognitive-behavioural groups were used across several diagnoses. Most therapists were nurses, only 50% had a formal training in group therapy. There is a plethora of groups, some based on one theoretical school, while others integrate theory from several 'camps'. Patients with similar diagnosis were offered different group approaches, although some trends existed. More research evidence from regular clinical groups is needed, and clinician-researcher networks should be developed. More group therapists with formal training are needed. © 2013 John Wiley & Sons Ltd.

  2. Group Work Publication-1991.

    Science.gov (United States)

    Zimpfer, David G.

    1992-01-01

    Lists 21 new publications in group work, of which 9 are reviewed. Those discussed include publications on group counseling and psychotherapy, structured groups, support groups, psychodrama, and social group work. (Author/NB)

  3. Obtaining consensus about patient-centred professionalism in community nursing: nominal group work activity with professionals and the public.

    Science.gov (United States)

    Hutchings, Hayley; Rapport, Frances; Wright, Sarah; Doel, Marcus; Jones, Aled

    2012-11-01

      To report on the development of a ranked thematic list encompassing the positive and challenging exemplars of patient-centred professionalism in community nursing.   There has been little research exploring what 'patient-centred professionalism' means to those working within the healthcare settings. Consensus methods, such as those developed through Nominal Group Work, can help establish the extent of agreement on a particular issue whilst overcoming some of the problems associated with group decision-making.   Mixed methods studying through consultation workshops.   The study took place in South-west Wales, UK between October 2009-September 2010. Thirty-four participants consisting of community nurses (9), newly qualifying nurses (13), nursing stakeholders (6) and members of the public (6) took part in the study. An adapted Nominal Group Work approach was used in five individual consultation workshops: two with community nurses, one with newly qualifying nurses, one with stakeholders and one with members of the public followed by a mixed-group Forum event.   Each of the five workshops resulted in the production of approximately ten positive and ten challenging exemplars of patient-centred professionalism. The thematization of these exemplars allowed the development of eight broad themes. The Forum event then provided a mechanism for ranking the importance of these themes. The patient, community nurse as a person and nursing ethos were ranked as the most important themes by study participants.   The adapted Nominal Group Work approach was a useful method to allow the development of a ranked thematic list that illustrated the important positive and challenging exemplars of patient-centred professionalism in community nursing. © 2012 Blackwell Publishing Ltd.

  4. How accurate is patients' anatomical knowledge: a cross-sectional, questionnaire study of six patient groups and a general public sample

    Directory of Open Access Journals (Sweden)

    Weinman John

    2009-06-01

    Full Text Available Abstract Background Older studies have shown that patients often do not understand the terms used by doctors and many do not even have a rudimentary understanding of anatomy. The present study was designed to investigate the levels of anatomical knowledge of different patient groups and the general public in order to see whether this has improved over time and whether patients with a specific organ pathology (e.g. liver disease have a relatively better understanding of the location of that organ. Methods Level of anatomical knowledge was assessed on a multiple-choice questionnaire, in a sample of 722 participants, comprising approximately 100 patients in each of 6 different diagnostic groups and 133 in the general population, using a between-groups, cross-sectional design. Comparisons of relative accuracy of anatomical knowledge between the present and earlier results, and across the clinical and general public groups were evaluated using Chi square tests. Associations with age and education were assessed with the Pearson correlation test and one-way analysis of variance, respectively. Results Across groups knowledge of the location of body organs was poor and has not significantly improved since an earlier equivalent study over 30 years ago (χ2 = 0.04, df = 1, ns. Diagnostic groups did not differ in their overall scores but those with liver disease and diabetes were more accurate regarding the location of their respective affected organs (χ2 = 18.10, p 2 = 10.75, p Conclusion Many patients and general public do not know the location of key body organs, even those in which their medical problem is located, which could have important consequences for doctor-patient communication. These results indicate that healthcare professionals still need to take care in providing organ specific information to patients and should not assume that patients have this information, even for those organs in which their medical problem is located.

  5. Improving sexual health for HIV patients by providing a combination of integrated public health and hospital care services; a one-group pre- and post test intervention comparison

    Directory of Open Access Journals (Sweden)

    Dukers-Muijrers Nicole HTM

    2012-12-01

    Full Text Available Abstract Background Hospital HIV care and public sexual health care (a Sexual Health Care Centre services were integrated to provide sexual health counselling and sexually transmitted infections (STIs testing and treatment (sexual health care to larger numbers of HIV patients. Services, need and usage were assessed using a patient perspective, which is a key factor for the success of service integration. Methods The study design was a one-group pre-test and post-test comparison of 447 HIV-infected heterosexual individuals and men who have sex with men (MSM attending a hospital-based HIV centre serving the southern region of the Netherlands. The intervention offered comprehensive sexual health care using an integrated care approach. The main outcomes were intervention uptake, patients’ pre-test care needs (n=254, and quality rating. Results Pre intervention, 43% of the patients wanted to discuss sexual health (51% MSM; 30% heterosexuals. Of these patients, 12% to 35% reported regular coverage, and up to 25% never discussed sexual health topics at their HIV care visits. Of the patients, 24% used our intervention. Usage was higher among patients who previously expressed a need to discuss sexual health. Most patients who used the integrated services were new users of public health services. STIs were detected in 13% of MSM and in none of the heterosexuals. The quality of care was rated good. Conclusions The HIV patients in our study generally considered sexual health important, but the regular counselling and testing at the HIV care visit was insufficient. The integration of public health and hospital services benefited both care sectors and their patients by addressing sexual health questions, detecting STIs, and conducting partner notification. Successful sexual health care uptake requires increased awareness among patients about their care options as well as a cultural shift among care providers.

  6. Effects of participating in public conversation groups

    Directory of Open Access Journals (Sweden)

    Beatriz Adolfo

    2016-11-01

    Full Text Available The aim of this research was to analyze the effects of the participation of health, education and religious professionals in public conversation groups with LGBT people. Participants were interviewed some weeks after the groups for feedback. Professionals declared that this dialogic method (known as Public Conversations Project allowed a qualification of their practices, awareness about the challenges of talking about gender and sexual diversity at their professional’s contexts, and a broader contact with narratives of violence and discrimination against LGBT people. The structure of dialogue allowed participants to talk and listen in a less evaluative context. Differences in the effects produced by each group are discussed in relation to the differences in the group composition and to the specificities of the health, educational and religious contexts.

  7. Report of the Public Cryptography Study Group.

    Science.gov (United States)

    American Council on Education, Washington, DC.

    Concerns of the National Security Agency (NSA) that information contained in some articles about cryptography in learned and professional journals and in monographs might be inimical to the national security are addressed. The Public Cryptography Study Group, with one dissenting opinion, recommends that a voluntary system of prior review of…

  8. 78 FR 36541 - Public Interface Control Working Group (ICWG) Meeting

    Science.gov (United States)

    2013-06-18

    ... Department of the Air Force Public Interface Control Working Group (ICWG) Meeting ACTION: Public ICWG... be hosting a Public Interface Control Working Group (ICWG) meeting for the Navstar GPS public signals....mil by August 7, 2013. Public Interface Control Working Group Meeting (ICWG) Date(s) and Times:...

  9. [Productive films in patient groups].

    Science.gov (United States)

    Allahyari, H

    1975-01-01

    For 3 years I have been trying to establish creative teamwork with a group of drug-addicted adolescents with the aim of stimulating imagination by visual means, thus enlightening hidden problems, and showing a way to self-representation. Especially with these patients an attitude of mistrust makes verbal access difficult. The group consists of some eight adolescents of about the same age, with whom I in no way try to interfere through provocation. We meet twice a week. On one day we discuss ideas, scripts and technical problems, the other day being dedicated to the practical side. My position in the group equals that of the hierarchic dynamic basic formula according to Raoul Schindler. The group is allocentric, work being aimed at common achievement. We try to create a feeling of solidarity, reduce tensions, and encourage individual relationships. So far we have accomplished four films. Teamwork has helped us to come to know each other better. The interpersonal relationships have improved. The barrier between doctor and patient has been completely obliterated.

  10. Physician Compare 2013 Group Practice Public Reporting

    Data.gov (United States)

    U.S. Department of Health & Human Services — This downloadable file includes information regarding group practice participation in 2013 Centers for Medicare & Medicaid (CMS) quality program as well as the...

  11. Private and public patients in public hospitals in Australia.

    Science.gov (United States)

    Shmueli, Amir; Savage, Elizabeth

    2014-04-01

    The nature of the private-public mix in health insurance and in health care is a major issue in most health systems. To compare the hospitalization characteristics of private and public patients hospitalized in public hospitals. We focused on planned, overnight and same-day admissions, discharged during 2004-2005 from the public New South Wales hospitals, and run fixed-effects regressions in order to identify the effect of accommodation status (private/public) on the hospitalization characteristics. Private patients have one third less waiting days than public patients, and they are assigned higher urgency of admission. Length of stay and length of visit are both unrelated to the accommodation status, however, private patients tend to have more hours in ICU and more procedures performed during the hospitalization. In-hospital mortality and the number of transfers (wards) are not affected by the accommodation status. Private patients are treated differently than public patients in public hospitals, reinforcing the private health insurance-related inequity in inpatient care identified by others. Two health policy issues emerge from the findings: the role of private health insurance in the Australian socialized medicine system, and in particular, in the public hospitals; and the way public hospitals are reimbursed for private patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  12. Physician groups' use of data from patient experience surveys.

    NARCIS (Netherlands)

    Friedberg, M.W.; SteelFisher, G.K.; Karp, M.; Schneider, E.C.

    2011-01-01

    BACKGROUND: In Massachusetts, physician groups' performance on validated surveys of patient experience has been publicly reported since 2006. Groups also receive detailed reports of their own performance, but little is known about how physician groups have responded to these reports. OBJECTIVE: To e

  13. Physician groups' use of data from patient experience surveys.

    NARCIS (Netherlands)

    Friedberg, M.W.; SteelFisher, G.K.; Karp, M.; Schneider, E.C.

    2011-01-01

    BACKGROUND: In Massachusetts, physician groups' performance on validated surveys of patient experience has been publicly reported since 2006. Groups also receive detailed reports of their own performance, but little is known about how physician groups have responded to these reports. OBJECTIVE: To

  14. Group-size diversity in public goods games.

    Science.gov (United States)

    Peña, Jorge

    2012-03-01

    Public goods games are models of social dilemmas where cooperators pay a cost for the production of a public good while defectors free ride on the contributions of cooperators. In the traditional framework of evolutionary game theory, the payoffs of cooperators and defectors result from interactions in groups formed by binomial sampling from an infinite population. Despite empirical evidence showing that group-size distributions in nature are highly heterogeneous, most models of social evolution assume that the group size is constant. In this article, I remove this assumption and explore the effects of having random group sizes on the evolutionary dynamics of public goods games. By a straightforward application of Jensen's inequality, I show that the outcome of general nonlinear public goods games depends not only on the average group size but also on the variance of the group-size distribution. This general result is illustrated with two nonlinear public goods games (the public goods game with discounting or synergy and the N-person volunteer's dilemma) and three different group-size distributions (Poisson, geometric, and Waring). The results suggest that failing to acknowledge the natural variation of group sizes can lead to an underestimation of the actual level of cooperation exhibited in evolving populations.

  15. Effectiveness of short-term psychodynamic group therapy in a public outpatient psychotherapy unit

    DEFF Research Database (Denmark)

    Jensen, Hans Henrik; Mortensen, Erik Lykke; Lotz, Martin

    2010-01-01

    BACKGROUND: Short-term psychodynamic group therapy in heterogeneous patient groups is common in the public Danish psychiatric system but is in need of evaluation. AIM: To investigate improvement in 39-session psychodynamic group therapy using three criteria: 1) effect size (Cohen's d), 2) statist...

  16. New Public Key Cryptosystems from Combinatorial Group Theory

    Institute of Scientific and Technical Information of China (English)

    TANG Xueming; WANG Xiaofei; HONG Fan; CUI Guohua

    2006-01-01

    External direct product of some low layer groups such as braid groups and general Artin groups, with a kind of special group action on it, provides a secure cryptographic computation platform, which can keep secure in the quantum computing epoch. Three hard problems on this new platform, Subgroup Root Problem, Multi-variant Subgroup Root Problem and Subgroup Action Problem are presented and well analyzed, which all have no relations with conjugacy. New secure public key encryption system and key agreement protocol are designed based on these hard problems. The new cryptosystems can be implemented in a general group environment other than in braid or Artin groups.

  17. The EWMA Patient Outcome Group

    DEFF Research Database (Denmark)

    Gottrup, F

    2009-01-01

    Across Europe, clinical experts in wound care and industry representatives have joined forces to propose recommendations for clinical data collection on chronic wound management. Here, the chair of the group, Finn Gottrup, outlines its main objectives.......Across Europe, clinical experts in wound care and industry representatives have joined forces to propose recommendations for clinical data collection on chronic wound management. Here, the chair of the group, Finn Gottrup, outlines its main objectives....

  18. Strategic defensiveness: public and private responses to group criticism.

    Science.gov (United States)

    Hornsey, Matthew J; Frederiks, Elisha; Smith, Joanne R; Ford, Lindsay

    2007-12-01

    This paper explores the strategic processes associated with responding to group criticism. In Experiment 1, Australians received criticism of their country from either an in-group or an out-group member. When participants believed their evaluations of the criticisms were private, they reported being more defensive when criticized by an out-group relative to an in-group member. However, this intergroup sensitivity effect disappeared on some measures when participants were led to believe their evaluations of the criticisms could be seen by an in-group audience. In Experiment 2, which focused on participants' identity as social science students, the attenuation of the intergroup sensitivity effect emerged only when the in-group audience was relatively high-status. Furthermore, in both experiments, increased reports of defensiveness in public only occurred in response to an in-group critic and not to an out-group critic. Theoretical and practical implications for intergroup and intragroup communication are discussed.

  19. CPAFFC Publicity Group Visits Australia and New Zealand

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    <正>Invited by the Australia-China Friendship Society and the New Zealand-China Friendship So-ciety, a 4-member CPAFFC publicity group visited Australia and New Zealand from September 14 to 27, 2003. The Group, consisting of Li Shantong, director general of the Research Department of Development Strategy and Regional Economy under the Development Research Centre of the State Council, Wang Qiliang, former Chi

  20. Physician groups' use of data from patient experience surveys.

    Science.gov (United States)

    Friedberg, Mark W; SteelFisher, Gillian K; Karp, Melinda; Schneider, Eric C

    2011-05-01

    In Massachusetts, physician groups' performance on validated surveys of patient experience has been publicly reported since 2006. Groups also receive detailed reports of their own performance, but little is known about how physician groups have responded to these reports. To examine whether and how physician groups are using patient experience data to improve patient care. During 2008, we conducted semi-structured interviews with the leaders of 72 participating physician groups (out of 117 groups receiving patient experience reports). Based on leaders' responses, we identified three levels of engagement with patient experience reporting: no efforts to improve (level 1), efforts to improve only the performance of low-scoring physicians or practice sites (level 2), and efforts to improve group-wide performance (level 3). Groups' level of engagement and specific efforts to improve patient care. Forty-four group leaders (61%) reported group-wide improvement efforts (level 3), 16 (22%) reported efforts to improve only the performance of low-scoring physicians or practice sites (level 2), and 12 (17%) reported no performance improvement efforts (level 1). Level 3 groups were more likely than others to have an integrated medical group organizational model (84% vs. 31% at level 2 and 33% at level 1; P customer service. The most commonly reported improvement initiatives were changing office workflow, providing additional training for nonclinical staff, and adopting or enhancing an electronic health record. Despite statewide public reporting, physician groups' use of patient experience data varied widely. Integrated organizational models were associated with greater engagement, and efforts to enhance clinicians' interpersonal skills were uncommon, with groups predominantly focusing on office workflow and support staff.

  1. The inter-group comparison-intra-group cooperation hypothesis: comparisons between groups increase efficiency in public goods provision.

    Science.gov (United States)

    Böhm, Robert; Rockenbach, Bettina

    2013-01-01

    Identifying methods to increase cooperation and efficiency in public goods provision is of vital interest for human societies. The methods that have been proposed often incur costs that (more than) destroy the efficiency gains through increased cooperation. It has for example been shown that inter-group conflict increases intra-group cooperation, however at the cost of collective efficiency. We propose a new method that makes use of the positive effects associated with inter-group competition but avoids the detrimental (cost) effects of a structural conflict. We show that the mere comparison to another structurally independent group increases both the level of intra-group cooperation and overall efficiency. The advantage of this new method is that it directly transfers the benefits from increased cooperation into increased efficiency. In repeated public goods provision we experimentally manipulated the participants' level of contribution feedback (intra-group only vs. both intra- and inter-group) as well as the provision environment (smaller groups with higher individual benefits from cooperation vs. larger groups with lower individual benefits from cooperation). Irrespective of the provision environment groups with an inter-group comparison opportunity exhibited a significantly stronger cooperation than groups without this opportunity. Participants conditionally cooperated within their group and additionally acted to advance their group to not fall behind the other group. The individual efforts to advance the own group cushion the downward trend in the above average contributors and thus render contributions on a higher level. We discuss areas of practical application.

  2. Interest Groups and Political Economy of Public Education Spending

    Directory of Open Access Journals (Sweden)

    Ece H. Guleryuz

    2015-09-01

    Full Text Available This paper examines the relationship between the lobbying power of different interest groups and public education spending in a panel data estimationduring the period 1996-2009 for 132 countries. The resource rents, manufacture exports, and agriculture value added are used as proxy variables for the lobbying power of the natural resource owners, manufacturers, and landowners, respectively, in order to substantiate the definition of the lobbying power of the interest groups more with economic fundamentals. As lobbying power is mediated through political institutions, different governance indicators are used individually and in interaction terms with the proxy variables in the estimations. It is found that when the country is more politically stable and the more the rule of law applies, the negative (positive effect of the lobbying power of natural resource owners (manufacturers on public education spending intensifies. The negative effect of landowners’ lobbying power diminishes as institutional quality as measured by governance indicators improves.

  3. Interest Groups and Political Economy of Public Education Spending

    Directory of Open Access Journals (Sweden)

    Ece H. Guleryuz

    2015-12-01

    Full Text Available This paper examines the relationship between the lobbying power of different interest groups and public education spending in a panel data estimation during the period 1996-2009 for 132 countries. The resource rents, manufacture exports, and agriculture value added are used as proxy variables for the lobbying power of the natural resource owners, manufacturers, and landowners, respectively, in order to substantiate the definition of the lobbying power of the interest groups more with economic fundamentals. As lobbying power is mediated through political institutions, different governance indicators are used individually and in interaction terms with the proxy variables in the estimations. It is found that when the country is more politically stable and the more the rule of law applies, the negative (positive effect of the lobbying power of natural resource owners (manufacturers on public education spending intensifies. The negative effect of landowners’ lobbying power diminishes as institutional quality as measured by governance indicators improves.

  4. Group therapy for spouses of aphasic patients.

    Science.gov (United States)

    Johannsen-Horbach, H; Crone, M; Wallesch, C W

    1999-01-01

    The setting, course, and results of a counseling and a therapeutic group for relatives of chronic aphasic patients are reviewed. Generally, providing and discussing information on the illness, its consequences, and medical and social services are greatly appreciated by group members. Counseling and group psychotherapy, as conducted by us, did not result in measurable improvements of relatives' perceptions of personal, social, and familial burdens. We assume, however, that group therapy does lead to more realistic attitudes toward burdensome and severely straining situations and may help with coping. Further research into psychotherapeutic strategies for relatives of disabled persons, who themselves suffer from psychological and social handicaps, is needed.

  5. 78 FR 49281 - Trinity Adaptive Management Working Group; Public Meeting, Teleconference and Web-Based Meeting

    Science.gov (United States)

    2013-08-13

    ... Fish and Wildlife Service Trinity Adaptive Management Working Group; Public Meeting, Teleconference and... Trinity Adaptive Management Working Group (TAMWG). DATES: Public meeting, Teleconference, and web-based... Management Working Group (TAMWG) will hold a meeting. Background The TAMWG affords stakeholders...

  6. 78 FR 35312 - Trinity Adaptive Management Working Group; Public Meeting, Teleconference and Web-Based Meeting

    Science.gov (United States)

    2013-06-12

    ... Fish and Wildlife Service Trinity Adaptive Management Working Group; Public Meeting, Teleconference and... Trinity Adaptive Management Working Group (TAMWG). DATES: Public meeting, Teleconference, and web-based... Management Working Group (TAMWG) will hold a meeting. Background The TAMWG affords stakeholders...

  7. Patients' attitudes toward internet cancer support groups.

    Science.gov (United States)

    Im, Eun-Ok; Chee, Wonshik; Lim, Hyun-Ju; Liu, Yi; Guevara, Enrique; Kim, Kyung Suk

    2007-05-01

    To explore patients' attitudes toward Internet cancer support groups (ICSGs) through an online forum. Qualitative study using a feminist perspective. Internet and real settings. 16 patients with cancer. An online forum was held for one month with six discussion topics. The data were analyzed using thematic analysis. Attitudes toward ICSGs. Through the data-analysis process, four themes were found related to patients' attitudes toward ICSGs. First, the participants universalized patients' needs for and attitudes toward ICSGs. Second, most of the participants wanted to use ICSGs for emotional support, information, and interactions. Third, many of the participants used ICSGs because they could reach out to other patients with cancer without traveling and without interrupting their busy schedules. Finally, many participants were concerned about the security of interactions on ICSGs, so they wanted ICSGs that could ensure privacy and safeguard the anonymity and confidentiality of what they shared online. Patients view ICSGs positively. Additional studies should examine gender-specific and multilanguage ICSGs by recruiting more ethnic minority patients. Despite concerns about the security of Internet interactions, ICSGs would be an excellent source of social support that is acceptable to patients with cancer.

  8. 78 FR 46361 - Trinity Adaptive Management Working Group; Public Meeting, Teleconference and Web-Based Meeting

    Science.gov (United States)

    2013-07-31

    ... Fish and Wildlife Service Trinity Adaptive Management Working Group; Public Meeting, Teleconference and.... Fish and Wildlife Service, announce a joint meeting between the Trinity Adaptive Management Working Group (TAMWG) and Trinity Management Council (TMC). DATES: Public meeting, Teleconference, and...

  9. 77 FR 9882 - Arsenic Small Systems Compliance and Alternative Affordability Criteria Working Group; public...

    Science.gov (United States)

    2012-02-21

    ... Working Group; public meeting AGENCY: Environmental Protection Agency (EPA). ACTION: Notice of public meeting. SUMMARY: EPA is holding an initial meeting of the Arsenic Small Systems Working Group to provide... Working Group composed of representatives from States, small publicly owned water systems, local...

  10. Communicating science to our patients and the public.

    Science.gov (United States)

    Mandel, I D

    1994-01-01

    Communicating dental science, especially on issues of health and safety, is assuming increased importance in dental practice and in the relation of the profession to the public. Effective risk communication requires knowledge, balance and sensitivity to the concerns of our patients and the public. It is a skill that takes preparation, training and practice, and schools and professional organizations should be encouraged to include it in their educational programs. Presenting dental science to the public is a more difficult challenge than for the individual patient since there is no readily available site for exchange, such as the office, and no personally established relationship, credibility or trust. A larger cadre of trained spokespersons from the practice, public health, academic and research communities is needed, and more extensive multi-lingual and multi-cultural educational material should be made available for community outreach. Oral presentations to the public require different skills of both a verbal and nonverbal nature than for office communication or professional group presentation-and guidelines are offered.

  11. "The group facilitates everything": meanings patients with type 2 diabetes mellitus assigned to health education groups.

    Science.gov (United States)

    de Melo, Lucas Pereira; de Campos, Edemilson Antunes

    2014-01-01

    to interpret the meanings patients with type 2 diabetes mellitus assign to health education groups. ethnographic study conducted with Hyperdia groups of a healthcare unit with 26 informants, with type 2 diabetes mellitus, and having participated in the groups for at least three years. Participant observation, social characterization, discussion groups and semi-structured interviews were used to collect data. Data were analyzed through the thematic coding technique. four thematic categories emerged: ease of access to the service and healthcare workers; guidance on diabetes; participation in groups and the experience of diabetes; and sharing knowledge and experiences. The most relevant aspect of this study is the social use the informants in relation to the Hyperdia groups under study. the studied groups are agents producing senses and meanings concerning the process of becoming ill and the means of social navigation within the official health system. We expect this study to contribute to the actions of healthcare workers coordinating these groups given the observation of the cultural universe of these individuals seeking professional care in the various public health care services.

  12. "The group facilitates everything": meanings patients with type 2 diabetes mellitus assigned to health education groups

    Directory of Open Access Journals (Sweden)

    Lucas Pereira de Melo

    2014-12-01

    Full Text Available OBJECTIVE: to interpret the meanings patients with type 2 diabetes mellitus assign to health education groups.METHOD: ethnographic study conducted with Hyperdia groups of a healthcare unit with 26 informants, with type 2 diabetes mellitus, and having participated in the groups for at least three years. Participant observation, social characterization, discussion groups and semi-structured interviews were used to collect data. Data were analyzed through the thematic coding technique.RESULTS: four thematic categories emerged: ease of access to the service and healthcare workers; guidance on diabetes; participation in groups and the experience of diabetes; and sharing knowledge and experiences. The most relevant aspect of this study is the social use the informants in relation to the Hyperdia groups under study.CONCLUSION: the studied groups are agents producing senses and meanings concerning the process of becoming ill and the means of social navigation within the official health system. We expect this study to contribute to the actions of healthcare workers coordinating these groups given the observation of the cultural universe of these individuals seeking professional care in the various public health care services.

  13. [Public music concerts in a psychiatric hospital: effects on public opinion and as therapy for patients].

    Science.gov (United States)

    Takasaka, Y; Yokota, O; Tanioka, T; Nagata, K; Yasuoka, K; Toda, H

    2001-01-01

    We investigate the effects of music therapy concerts, which were held 60 times over a four year period, 1992 to 1996, in Geiyo Psychiatric Hospital, Kochi Prefecture and found that; 1) Musicians who performed at the concerts were not only from Kochi prefecture but also from other prefectures (10 times) and from four foreign countries (7 times). 2) Live concerts in a small hall had a positive influence on patients and drew the patient's attention and interest away from their hallucinations and delusions to the real world. Moreover, the concerts provided the patients with chances to acquire social graces such as being well-groomed. 3) Explanations by the musicians, interviews with the musicians and the seasonal choruses accompanied by the musicians were helpful to give the patients motives for recovering communication skills and to interact with society. 4) Inquiries to the patients about the concerts indicated discrepancies between the poor observed estimations during the concerts (83.3%) and the good subjective impressions expressed by the patients (82.0%), suggesting that the patients were not good at expressing their internal emotions through facial expressions or attitudes. 5) Many citizens including children came to the concerts and/or gave aid to the hospital because the concerts were open to the public and we suggest that this contributed to improving the general publics' image of psychiatric hospitals. Questionnaires revealed that 90% of people in a control group had a bad image of psychiatric hospitals in Japan, but only 32% of the members of the general public who attended our concerts had a bad image of psychiatric hospitals. In addition, the revolving ratio of the hospital beds rose from 0.4 to 1.2 over the four years, which also suggests a beneficial effect on the patients.

  14. How to empower patients, and involve the public.

    Science.gov (United States)

    Piper, Stewart

    2014-09-30

    Patient empowerment and patient and public involvement are a focus for NHS policy, with an emphasis on patient decision making and representation as core features of a patient-focused NHS. Patient empowerment and patient and public involvement imply a rebalancing of power in the nurse-patient relationship. In reality this is complicated by wider issues of power and control in a complex health service influenced by professional agendas, healthcare leadership, government targets and a developing business culture. Despite these ideological and organisational constraints, there are many ways in which nurses can support aspects of individual patient empowerment and patient and public involvement.

  15. Expert Groups in the Building of European Public Policy

    Science.gov (United States)

    Robert, Cecile

    2012-01-01

    When it comes to building European public action, expertise is ubiquitous and polymorphic. This article intends to study the ways expertise is being used in the European Commission and the logics underlying its use. The massive use of expertise also has consequences for the practices and identities of actors with whom European institutions…

  16. Expert Groups in the Building of European Public Policy

    Science.gov (United States)

    Robert, Cecile

    2012-01-01

    When it comes to building European public action, expertise is ubiquitous and polymorphic. This article intends to study the ways expertise is being used in the European Commission and the logics underlying its use. The massive use of expertise also has consequences for the practices and identities of actors with whom European institutions…

  17. Does a multidisciplinary diabetes group education visit improve patient outcomes?

    Science.gov (United States)

    O'Dell, Kristi J; O'Dell, Michael L; Taylor, James L

    2009-12-01

    Diabetes is a significant and growing public health concern, and patient education is the primary approach for self-management. The objective of this study is to assess the impact of a single session diabetes group education intervention. The design is a one-group pretest/posttest evaluation. Participants were adult outpatients with diabetes who attended a single session group education visit and volunteered to participate in the study. Survey questions include the Single Item Literacy Screener and diabetes knowledge questions. The survey was mailed and collected before the group visit. Diabetes knowledge was collected immediately after the group visit and again by telephone one to four months later. Hemoglobin A1c (HbA1c), lipids, and blood pressure were collected from the patient electronic medical record before and, where available, three months after the group visit. Data analysis includes descriptive statistics and Students t-testing to determine pre- and posttest differences of diabetes knowledge and physiological markers. Thirty-eight adult outpatients participated in the study. Nearly half responded that they never needed to have someone help with written medical materials. There was a significant increase from pretest to immediate posttest diabetes knowledge scores (N = 3; M = 5.58 to M = 7.53 out of 10), t(38) = -5.217, p = education (M = 9.16 to M = 8.52), t(27) = 2.185, p = .038. A single session diabetes group education visit is effective in increasing patients' diabetes knowledge and decreasing HbA1c levels.

  18. 75 FR 52355 - Draft National Conversation on Public Health and Chemical Exposures Work Group Reports...

    Science.gov (United States)

    2010-08-25

    ... Prevention Draft National Conversation on Public Health and Chemical Exposures Work Group Reports... exposures. This notice announces the availability of draft National Conversation work group reports for... National Conversation Leadership Council and facilitating the work group process. DATES: Draft work...

  19. Report of the Working Group on Publicity and Funding

    DEFF Research Database (Denmark)

    Gammeltoft, Peder

    2014-01-01

    The report highlights the activities of the working group in raising awareness of the need for geographical names standardization and the work of the Group of Experts, particularly in advancing the digital presence of UNGEGN, through web presence and updated Media Kit and Wikipedia presence...

  20. Expert and Advocacy Group Consensus Findings on the Horizon of Public Health Genetic Testing

    Directory of Open Access Journals (Sweden)

    Stephen M. Modell

    2016-01-01

    Full Text Available Description: Among the two leading causes of death in the United States, each responsible for one in every four deaths, heart disease costs Americans $300 billion, while cancer costs Americans $216 billion per year. They also rank among the top three causes of death in Europe and Asia. In 2012 the University of Michigan Center for Public Health and Community Genomics and Genetic Alliance, with the support of the Centers for Disease Control and Prevention Office of Public Health Genomics, hosted a conference in Atlanta, Georgia to consider related action strategies based on public health genomics. The aim of the conference was consensus building on recommendations to implement genetic screening for three major heritable contributors to these mortality and cost figures: hereditary breast and ovarian cancer (HBOC, familial hypercholesterolemia (FH, and Lynch syndrome (LS. Genetic applications for these three conditions are labeled with a “Tier 1” designation by the U.S. Centers for Disease Control and Prevention because they have been fully validated and clinical practice guidelines based on systematic review support them. Methodology: The conference followed a deliberative sequence starting with nationally recognized clinical and public health presenters for each condition, followed by a Patient and Community Perspectives Panel, working group sessions for each of the conditions, and a final plenary session. The 74 conference participants represented disease research and advocacy, public health, medicine and nursing, genetics, governmental health agencies, and industry. Participants drew on a public health framework interconnecting policy, clinical intervention, surveillance, and educational functions for their deliberations. Results: Participants emphasized the importance of collaboration between clinical, public health, and advocacy groups in implementing Tier 1 genetic screening. Advocacy groups could help with individual and institutional

  1. Public Discourse in the Web Does Not Exhibit Group Polarization

    CERN Document Server

    Wu, Fang

    2008-01-01

    We performed a massive study of the dynamics of group deliberation among several websites containing millions of opinions on topics ranging from books to media. Contrary to the common phenomenon of group polarization observed offline, we measured a strong tendency towards moderate views in the course of time. This phenomenon possibly operates through a self-selection bias whereby previous comments and ratings elicit contrarian views that soften the previous opinions.

  2. China’s Largest Nickel Manufacturer Jinchuan Group Launched Program to Get Publicly Listed

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    <正>Jinchuan Group Ltd(hereinafter referred to as"Jinchuan Group"),China’s largest nickel pro- ducer,has put its Initial Public Offering(IPO) on the agenda.According to a statement pub- lished by Jinchuan Group on its website,the Company has formulated clearly defined schedule for going public,and its selection

  3. 78 FR 17226 - Trinity Adaptive Management Working Group; Public Meeting, Teleconference and Web-Based Meeting

    Science.gov (United States)

    2013-03-20

    ... Fish and Wildlife Service Trinity Adaptive Management Working Group; Public Meeting, Teleconference and... Trinity Adaptive Management Working Group (TAMWG). DATES: Public meeting, Teleconference, and web-based... Management Working Group (TAMWG) will hold a teleconference/web-based meeting. Background The TAMWG...

  4. College Students as a Group of the Public

    Science.gov (United States)

    Stegnii, V. N.; Gorbunova, O. V.

    2013-01-01

    In the activity of the university, the choice of channels of communication and the key message are very important. Values to be conveyed include the quality of the education, the solid chances of finding work, and the prestige and status of various specialties. Other essential tasks include determining who opinion and reference group leaders are…

  5. Group Education for patients with rheumatoid arthritis

    NARCIS (Netherlands)

    Taal, Erik; Riemsma, Rob P.; Brus, Herman L.M.; Seydel, Erwin R.; Rasker, Johannes J.; Wiegman, Oene

    1993-01-01

    Patients with rheumatoid arthritis must learn to adjust their exercise, rest and medication to the varying activity of the disease. Patient education can help patients in making the right decisions about adjustments in their treatment regimen and in attaining ¿self-management¿ behaviors. We develope

  6. Employer Cooperation in Group Insurance Coverage for Public-School Personnel, 1964-65.

    Science.gov (United States)

    National Education Association, Washington, DC.

    This study presents data on group insurance coverage for public school personnel during the 1964-65 academic year, collected from 646 school systems of all sizes throughout the United States. Areas covered include (1) group life insurance, (2) group hospitalization insurance, (3) group medical-surgical insurance, (4) group major medical insurance,…

  7. Group-Level Selection Increases Cooperation in the Public Goods Game.

    Science.gov (United States)

    Eckel, Catherine C; Fatas, Enrique; Godoy, Sara; Wilson, Rick K

    2016-01-01

    When groups compete for resources, some groups will be more successful than others, forcing out less successful groups. Group-level selection is the most extreme form of group competition, where the weaker group ceases to exist, becoming extinct. We implement group-level selection in a controlled laboratory experiment in order to study its impact on human cooperation. The experiment uses variations on the standard linear public goods game. Group-level selection operates through competition for survival: the least successful, lowest-earning groups become extinct, in the sense that they no longer are able to play the game. Additional control treatments include group comparison without extinction, and extinction of the least successful individuals across groups. We find that group-level extinction produces very high contributions to the provision of the public good, while group comparison alone or individual extinction fail to cause higher contributions. Our results provide stark evidence that group-level selection enhances within-group cooperation.

  8. 78 FR 69124 - Trinity Adaptive Management Working Group; Public Meeting and Teleconference

    Science.gov (United States)

    2013-11-18

    ... Fish and Wildlife Service Trinity Adaptive Management Working Group; Public Meeting and Teleconference... announce that the Trinity Adaptive Management Working Group (TAMWG) will hold a meeting. Background The... Service, announce a public meeting and teleconference meeting of the Trinity Adaptive Management...

  9. 75 FR 38099 - Establishment of the Advisory Group on Prevention, Health Promotion, and Integrative and Public...

    Science.gov (United States)

    2010-07-01

    ... HUMAN SERVICES Establishment of the Advisory Group on Prevention, Health Promotion, and Integrative and... March 23, 2010. The Advisory Group on Prevention, Health Promotion, and Integrative and Public Health... Prevention, Health Promotion, and Integrative and Public Health, as directed by Executive Order 13544....

  10. Therapists' group attachments and their expectations of patients' attitudes about group therapy.

    Science.gov (United States)

    Marmarosh, Cheri L; Franz, Victoria A; Koloi, Mosetsanagape; Majors, Rebekah C; Rahimi, Amanda M; Ronquillo, Jonne G; Somberg, Rachel J; Swope, Jessica S; Zimmer, Katherine

    2006-07-01

    A large body of literature has supported the application of attachment theory to the understanding of psychotherapy. In addition, a more recent social psychological literature is exploring the application of attachment theory to the area of group dynamics and group process. The current study is designed to integrate these two distinct bodies of literature. In a preliminary fashion, we examined the relationship between group therapists' group attachment styles and their assumptions and expectations of their patients' attitudes about group psychotherapy. Seventy-six therapists completed the Smith, Murphy & Coats (1999) measure of group attachment style. They also completed the Revised Group Therapy Survey (Carter, Mitchell, & Krautheim, 2001) from the viewpoint of a typical patient they treat. As hypothesized, therapists with more group attachment anxiety assumed that patients would hold more negative myths and misconceptions about group treatment than therapists with less group attachment anxiety. The utility of a group attachment construct in future research and practice is discussed.

  11. Pediatric patient with Bombay blood group: A rare case report

    Directory of Open Access Journals (Sweden)

    Sudeshna Bhar (Kundu

    2015-01-01

    Full Text Available Bombay blood group is a rare blood group in which there is the absence of H antigen and presence of anti-H antibodies. At the time of blood grouping, this blood group mimics O blood group due to the absence of H antigen, but it shows incompatibility with O group blood during cross matching. Serum grouping or reverse grouping are essential for confirmation of the diagnosis. Patients carrying this blood group can receive blood only from a person with this blood group. Reported cases of anesthesia in the pediatric patient with Bombay blood group are relatively rare. Here, we present successful anesthetic management along with intraoperative blood transfusion in a pediatric patient with Bombay blood group posted for ovarian cystectomy.

  12. Pediatric patient with Bombay blood group: A rare case report.

    Science.gov (United States)

    Bhar Kundu, Sudeshna; De, Anisha; Saha, Anindita; Bhattacharyya, Chiranjib

    2015-01-01

    Bombay blood group is a rare blood group in which there is the absence of H antigen and presence of anti-H antibodies. At the time of blood grouping, this blood group mimics O blood group due to the absence of H antigen, but it shows incompatibility with O group blood during cross matching. Serum grouping or reverse grouping are essential for confirmation of the diagnosis. Patients carrying this blood group can receive blood only from a person with this blood group. Reported cases of anesthesia in the pediatric patient with Bombay blood group are relatively rare. Here, we present successful anesthetic management along with intraoperative blood transfusion in a pediatric patient with Bombay blood group posted for ovarian cystectomy.

  13. Talking therapy groups on acute psychiatric wards: patients' experience of two structured group formats

    Science.gov (United States)

    Radcliffe, Jonathan; Bird, Laura

    2016-01-01

    Aims and method We report the results of a clinical audit of patients' reactions to two types of talking therapy groups facilitated by assistant psychologists and psychology graduates on three acute wards. Patients' experiences of problem-solving and interpersonal group formats were explored via focus groups and structured interviews with 29 group participants. Results Both group formats generated high satisfaction ratings, with benefits related mostly to generic factors. Clinical implications Adequately trained and supported assistant psychologists and psychology graduates can provide supportive talking groups that patients find helpful. PMID:27512586

  14. [Hepatitis C treatment in special patient groups].

    Science.gov (United States)

    Berenguer, Marina; Jorquera, Francisco; Ángel Serra, Miguel; Sola, Ricard; Castellano, Gregorio

    2014-07-01

    The treatment plan for chronic hepatitis C in special populations varies according to comorbidity and the current evidence on treatment. In patients with hepatitis C virus and HIV coinfection, the results of dual therapy (pegylated interferon plus ribavirin) are poor. In patients with genotype 1 infection, triple therapy (dual therapy plus boceprevir or telaprevir) has doubled the response rate, but protease inhibitors can interact with some antiretroviral drugs and provoke more adverse effects. These disadvantages are avoided by the new, second-generation, direct-acting antiviral agents. In patients who are candidates for liver transplantation or are already liver transplant recipients, the optimal therapeutic option at present is to combine the new antiviral agents, with or without ribavirin and without interferon. The treatment of patients under hemodialysis due to chronic renal disease continues to be dual therapy (often with reduced doses of pegylated interferon and ribavirin), since there is still insufficient information on triple therapy and the new antiviral agents. In mixed cryoglobulinemia, despite the scarcity of experience, triple therapy seems to be superior to dual therapy and may be used as rescue therapy in non-responders to dual therapy. However, a decision must always be made on whether antiviral treatment should be used concomitantly or after immunosuppressive therapy. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  15. Group Health Education in Inpatient Rehabilitation: Patients' Role Perceptions

    Science.gov (United States)

    Schöpf, Andrea C.; Ullrich, Antje; Nagl, Michaela; Farin, Erik

    2016-01-01

    Objective: Group health education is an important aspect of medical rehabilitation. While interaction and active involvement are important characteristics of group health education, little is known about patients' understanding of their role in this form of education. This study explored patients' understanding of their role in group health…

  16. Public reporting, consumerism, and patient empowerment.

    Science.gov (United States)

    Huckman, Robert S; Kelley, Mark A

    2013-11-14

    Public reporting of health care outcomes is largely ignored by consumers, perhaps because it doesn't include concise, comprehensible information on factors such as out-of-pocket costs, the effectiveness of a procedure or treatment, and applicability to their situation.

  17. Evolution of public cooperation in a monitored society with implicated punishment and within-group enforcement.

    Science.gov (United States)

    Chen, Xiaojie; Sasaki, Tatsuya; Perc, Matjaž

    2015-11-24

    Monitoring with implicated punishment is common in human societies to avert freeriding on common goods. But is it effective in promoting public cooperation? We show that the introduction of monitoring and implicated punishment is indeed effective, as it transforms the public goods game to a coordination game, thus rendering cooperation viable in infinite and finite well-mixed populations. We also show that the addition of within-group enforcement further promotes the evolution of public cooperation. However, although the group size in this context has nonlinear effects on collective action, an intermediate group size is least conductive to cooperative behaviour. This contradicts recent field observations, where an intermediate group size was declared optimal with the conjecture that group-size effects and within-group enforcement are responsible. Our theoretical research thus clarifies key aspects of monitoring with implicated punishment in human societies, and additionally, it reveals fundamental group-size effects that facilitate prosocial collective action.

  18. Evolution of public cooperation in a monitored society with implicated punishment and within-group enforcement

    Science.gov (United States)

    Chen, Xiaojie; Sasaki, Tatsuya; Perc, Matjaž

    2015-11-01

    Monitoring with implicated punishment is common in human societies to avert freeriding on common goods. But is it effective in promoting public cooperation? We show that the introduction of monitoring and implicated punishment is indeed effective, as it transforms the public goods game to a coordination game, thus rendering cooperation viable in infinite and finite well-mixed populations. We also show that the addition of within-group enforcement further promotes the evolution of public cooperation. However, although the group size in this context has nonlinear effects on collective action, an intermediate group size is least conductive to cooperative behaviour. This contradicts recent field observations, where an intermediate group size was declared optimal with the conjecture that group-size effects and within-group enforcement are responsible. Our theoretical research thus clarifies key aspects of monitoring with implicated punishment in human societies, and additionally, it reveals fundamental group-size effects that facilitate prosocial collective action.

  19. Group work in the public health context: A proposal for training in psychology.

    Science.gov (United States)

    Rasera, Emerson F; Pegoraro, Renata F; Pereira, Eliane R

    2016-03-01

    The entry of psychologists into the public health sector in Brazil is usually connected to a traditional clinical model, and, thus, marked by a lack of training for group work. A reflection on the training of psychologists for group work is essential. Aiming at contributing to this theme, the objective of this article is to discuss the training for group work in the public health sector. In particular, we aim to introduce a proposal for training in psychology in a Brazilian public university, covering a theoretical-practical module, as well as basic and professionalizing internship programmes.

  20. Diversity in Collaborative Research Communities: A Multicultural, Multidisciplinary Thesis Writing Group in Public Health

    Science.gov (United States)

    Guerin, Cally; Xafis, Vicki; Doda, Diana V.; Gillam, Marianne H.; Larg, Allison J.; Luckner, Helene; Jahan, Nasreen; Widayati, Aris; Xu, Chuangzhou

    2013-01-01

    Writing groups for doctoral students are generally agreed to provide valuable learning spaces for Ph.D. candidates. Here an academic developer and the eight members of a writing group formed in a Discipline of Public Health provide an account of their experiences of collaborating in a multicultural, multidisciplinary thesis writing group. We…

  1. 77 FR 60138 - Trinity Adaptive Management Working Group; Public Teleconference/Web-Based Meeting

    Science.gov (United States)

    2012-10-02

    ... Fish and Wildlife Service Trinity Adaptive Management Working Group; Public Teleconference/ Web-Based... Working Group (TAMWG). DATES: Teleconference/web-based meeting: Wednesday October 17, 2012, from 9 a.m. to... announce that the Trinity Adaptive Management Working Group (TAMWG) will hold a...

  2. Diversity in Collaborative Research Communities: A Multicultural, Multidisciplinary Thesis Writing Group in Public Health

    Science.gov (United States)

    Guerin, Cally; Xafis, Vicki; Doda, Diana V.; Gillam, Marianne H.; Larg, Allison J.; Luckner, Helene; Jahan, Nasreen; Widayati, Aris; Xu, Chuangzhou

    2013-01-01

    Writing groups for doctoral students are generally agreed to provide valuable learning spaces for Ph.D. candidates. Here an academic developer and the eight members of a writing group formed in a Discipline of Public Health provide an account of their experiences of collaborating in a multicultural, multidisciplinary thesis writing group. We…

  3. The Influence of Older Age Groups to Sustainable Product Design Research of Urban Public Facilities

    Science.gov (United States)

    Wen-juan, Zhang; Hou-peng, Song

    2017-01-01

    Through summarize the status quo of public facilities design to older age groups in China and a variety of factors what influence on them, the essay, from different perspective, is designed to put forward basic principle to sustainable design of public facilities for the aged in the city, and thus further promote and popularize the necessity of sustainable design applications in the future design of public facilities for elderly people.

  4. Internet-based public debate of CCS: lessons from online focus groups in Poland and Spain

    OpenAIRE

    Riesch, H; Oltra, C; A. Lis; Upham, P; Pol, M.

    2013-01-01

    This paper makes three contributions to the developing literature on public opinion and understanding of CCS. The first is a discussion of online focus groups as a deliberative method in experimental and perhaps consultative contexts. The second is the role of anchoring and associative reasoning in the development of public opinion of CCS, illustrated through the coincidental timing of the investigation with the Fukushima nuclear accident. The third is a discussion of managing public-facing e...

  5. Cryptographic Research and NSA: Report of the Public Cryptography Study Group.

    Science.gov (United States)

    Davida, George I.

    1981-01-01

    The Public Cryptography Study Group accepted the claim made by the National Security Agency that some information in some publications concerning cryptology could be inimical to national security, and is allowing the establishment of a voluntary mechanism, on an experimental basis, for NSA to review cryptology manuscripts. (MLW)

  6. Importance of patient centred care for various patient groups.

    NARCIS (Netherlands)

    Rademakers, J.J.D.J.M.; Delnoij, D.M.J.; Boer, D. de

    2010-01-01

    Background: Though patient centred care is a somewhat ‘fuzzy’ concept, in general it is considered as something to strive for. However, preliminary evidence suggests that the importance of elements of patient-centred care (PCC), such as communication, information and shared decision making, may vary

  7. Autotransfusion performed on a patient with cis AB blood group.

    Science.gov (United States)

    Kawahito, S; Kitahata, H; Kimura, H; Tanaka, K; Oshita, S

    1999-09-01

    Cis AB blood group is a rare variant of the AB blood group resulting from inheritance of both A and B genes on one chromosome. It may lead to misclassification in ABO grouping and clinical misdiagnosis as a result of its divergence from the laws of Landsteiner and Mendel. We encountered a case of cis AB blood group, and we found that autotransfusion was useful during surgery in this patient with a rare blood group.

  8. Public hospital palliative social work: addressing patient cultural diversity and psychosocial needs.

    Science.gov (United States)

    Parrish, Monique; Cárdenas, Yvette; Epperhart, Regina; Hernandez, Jose; Ruiz, Susana; Russell, Linda; Soriano, Karolina; Thornberry, Kathryn

    2012-01-01

    Through creative practice innovations and a wide range of professional competencies, social work has contributed substantively to the development of the palliative care field (Harper, 2011 ). As the field continues to grow and evolve, new opportunities are emerging to profile palliative social work in diverse health care settings. A statewide initiative to spread palliative care in California's public hospitals provided just such an opportunity. Palliative social workers from six public hospitals participating in the initiative formed a group to discuss palliative social work in this unique hospital setting. This article highlights the group's insights and experiences as they address the significant cultural diversity and psychosocial needs of public hospital patients receiving palliative care.

  9. Stakeholder Groups of Public and Private Universities in the Czech Republic – Identification, Categorization and Prioritization

    Directory of Open Access Journals (Sweden)

    Slabá Marie

    2015-09-01

    Full Text Available With regard to changes in the environment of tertiary education and tertiary educational systems, universities are now unlikely to succeed as ‘separated closed’ institutions that are unresponsive to their environment and stakeholders. Stakeholder analysis is considered as an important part of university management and marketing and universities have to take care of key stakeholder groups and build long term relationships with them. This paper focuses on the stakeholder analysis and adopts the stake-holder theory and analysis for the needs of the Czech market of tertiary education. This paper analyses results of the author’s online questionnaire that provided the input for data analysis deploying basic descriptive analysis and first steps of stakeholder analysis – identification, categorization and prioritization. Results of author’s research show that there are only slight differences between public and private universities and their perspective concerning generic stakeholder groups of universities. However the research revealed two controversial stakeholder groups – donors and competitors. In comparison with other stakeholder groups perception of these two stakeholder groups by public and private universities is very different. Stakeholder groups of public and private universities were categorized into four basic groups - primary internal stakeholder groups, primary external stakeholder groups, secondary internal stakeholder groups, and secondary external stakeholder groups. Primary internal and external stakeholder groups which are crucial for survival of universities are the most important stakeholder groups for universities. The author identified ten most important stakeholder groups for public and private universities separately, based on assigned priorities that will be used for further research.

  10. 75 FR 55846 - Public Meeting/Working Group With Industry on Volcanic Ash

    Science.gov (United States)

    2010-09-14

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Public Meeting/Working Group With Industry on Volcanic Ash AGENCY: Federal... meeting hosted by the FAA's Aviation Weather Group in coordination with the National Oceanic...

  11. Family group conferences in public mental health care : An exploration of opportunities

    NARCIS (Netherlands)

    de Jong, Gideon; Schout, Gert

    2011-01-01

    Family group conferences are usually organized in youth care settings, especially in cases of (sexual) abuse of children and domestic violence. Studies on the application of family group conferences in mental health practices are scarce, let alone in a setting even more specific, such as public ment

  12. Family group conferences in public mental health care : An exploration of opportunities

    NARCIS (Netherlands)

    de Jong, Gideon; Schout, Gert

    2011-01-01

    Family group conferences are usually organized in youth care settings, especially in cases of (sexual) abuse of children and domestic violence. Studies on the application of family group conferences in mental health practices are scarce, let alone in a setting even more specific, such as public ment

  13. Gaussian elimination in split unitary groups with an application to public-key cryptography

    Directory of Open Access Journals (Sweden)

    Ayan Mahalanobis

    2017-07-01

    Full Text Available Gaussian elimination is used in special linear groups to solve the word problem. In this paper, we extend Gaussian elimination to split unitary groups. These algorithms have an application in building a public-key cryptosystem, we demonstrate that.

  14. Family group conferences in public mental health care : An exploration of opportunities

    NARCIS (Netherlands)

    de Jong, Gideon; Schout, Gert

    Family group conferences are usually organized in youth care settings, especially in cases of (sexual) abuse of children and domestic violence. Studies on the application of family group conferences in mental health practices are scarce, let alone in a setting even more specific, such as public

  15. The Role of Public and Self-Stigma in Predicting Attitudes toward Group Counseling

    Science.gov (United States)

    Vogel, David L.; Shechtman, Zipora; Wade, Nathaniel G.

    2010-01-01

    Public and self-stigmas have been implicated as factors in the underutilization of individual counseling. However, group counseling is also underutilized, and yet scholars know very little about the role of different types of stigma on attitudes toward seeking group counseling. Therefore, the current study examined the relationships between public…

  16. 77 FR 43071 - MPS Customer Group v. Maine Public Service Company; Notice of Complaint

    Science.gov (United States)

    2012-07-23

    ... Energy Regulatory Commission MPS Customer Group v. Maine Public Service Company; Notice of Complaint Take... Commission (Commission); 18 CFR 385.206, MPS Customer Group (Complainant) filed a formal complaint against... Complainant certifies that copies of the complaint were served on the contacts for the Respondent. Any...

  17. Participation in online patient support groups endorses patients’ empowerment

    NARCIS (Netherlands)

    Uden-Kraan, van C.F.; Drossaert, C.H.C.; Taal, E.; Seydel, E.R.; Laar, van de M.A.F.J.

    2009-01-01

    Objective: Although much has been expected of the empowering effect of taking part in online patient support groups, there is no direct evidence thus far for the effects of participation on patient empowerment. Hence our exploring to what extent patients feel empowered by their participation in onl

  18. Alternate Level of Care Patients in Public General Hospital Psychiatry.

    Science.gov (United States)

    Marcos, Luis R.; Gil, Rosa M.

    1984-01-01

    Analyzes the interaction between psychiatric services in public general hospitals and in other institutional settings. A one-day census of patients in a New York general hospital showed the hospital was providing care to a large number of patients in need of other, less intensive institutional settings. (BH)

  19. Dreams and fantasies in psychodynamic group psychotherapy of psychotic patients.

    Science.gov (United States)

    Restek-Petrović, Branka; Orešković-Krezler, Nataša; Grah, Majda; Mayer, Nina; Bogović, Anamarija; Mihanović, Mate

    2013-09-01

    Work with dreams in the group analysis represents an important part of the analytical work, with insight into unconscious experiences of the individual dreamer, and his transferrential relations with the therapist, other members of the group, and with the group as a whole. The way dreams are addressed varies from one therapist to another, and in line with that, members of the group have varying frequency of dreams. In groups of psychotic patients dreams are generally rarely discussed and interpreted by the group, with analysis mainly resting on the manifested content. This paper describes a long-term group of psychotic patients which, after sharing the dreams of several members and daydreams of one female patient, their interpretation and reception in the group achieved better cohesion and improved communication and interaction, i.e. created a group matrix. Furthermore, through the content of dreams in the group, traumatic war experiences of several of the group members were opened and discussed, which brought with it recollections of the traumatic life situations of other group members. In expressing a daydream, a female member of the group revealed the background for her behaviour which was earlier interpreted as a negative symptom of the illness.

  20. A coproduced patient and public event: An approach to developing and prioritizing ambulance performance measures.

    Science.gov (United States)

    Irving, Andy; Turner, Janette; Marsh, Maggie; Broadway-Parkinson, Andrea; Fall, Dan; Coster, Joanne; Siriwardena, A Niroshan

    2017-08-25

    Patient and public involvement (PPI) is recognized as an important component of high-quality health services research. PPI is integral to the Pre-hospital Outcomes for Evidence Based Evaluation (PhOEBE) programme. The PPI event described in detail in this article focusses on the process of involving patients and public representatives in identifying, prioritizing and refining a set of outcome measures that can be used to support ambulance service performance measurement. To obtain public feedback on little known, complex aspects of ambulance service performance measurement. The event was codesigned and coproduced with the PhOEBE PPI reference group and PhOEBE research team. The event consisted of brief researcher-led presentations, group discussions facilitated by the PPI reference group members and electronic voting. Data were collected from eighteen patient and public representatives who attended an event venue in Yorkshire. The results of the PPI event showed that this interactive format and mode of delivery was an effective method to obtain public feedback and produced a clear indication of which ambulance performance measures were most highly favoured by event participants. The event highlighted valuable contributions the PPI reference group made to the design process, supporting participant recruitment and facilitation of group discussions. In addition, the positive team working experience of the event proved a catalyst for further improvements in PPI within the PhOEBE project. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  1. How the public perceives the visual effects of timber harvesting: an evaluation of interest group preferences

    Science.gov (United States)

    McCool, Stephen F.; Benson, Robert E.; Ashor, Joseph L.

    1986-05-01

    A total of 25 scenes representing the five visual quality objectives in the US Department of Agriculture Forest Service visual management system were presented to 18 professional and public interest groups in western Montana. The results indicate that nearly all the groups have similar rank orderings of the scenes in terms of visual preference. However, the groups differ according to the absolute values of their ratings. Most groups were unable, in a statistical sense, to differentiate the scenic quality of areas in the preservation and retention visual quality objectives. Landscape architects tended to rate scenes in a way similar to professional forest management groups.

  2. Food allergy knowledge, attitudes and beliefs: Focus groups of parents, physicians and the general public

    Directory of Open Access Journals (Sweden)

    Barnathan Julia A

    2008-09-01

    Full Text Available Abstract Background Food allergy prevalence is increasing in US children. Presently, the primary means of preventing potentially fatal reactions are avoidance of allergens, prompt recognition of food allergy reactions, and knowledge about food allergy reaction treatments. Focus groups were held as a preliminary step in the development of validated survey instruments to assess food allergy knowledge, attitudes, and beliefs of parents, physicians, and the general public. Methods Eight focus groups were conducted between January and July of 2006 in the Chicago area with parents of children with food allergy (3 groups, physicians (3 groups, and the general public (2 groups. A constant comparative method was used to identify the emerging themes which were then grouped into key domains of food allergy knowledge, attitudes, and beliefs. Results Parents of children with food allergy had solid fundamental knowledge but had concerns about primary care physicians' knowledge of food allergy, diagnostic approaches, and treatment practices. The considerable impact of children's food allergies on familial quality of life was articulated. Physicians had good basic knowledge of food allergy but differed in their approach to diagnosis and advice about starting solids and breastfeeding. The general public had wide variation in knowledge about food allergy with many misconceptions of key concepts related to prevalence, definition, and triggers of food allergy. Conclusion Appreciable food allergy knowledge gaps exist, especially among physicians and the general public. The quality of life for children with food allergy and their families is significantly affected.

  3. Supporting academic publication: evaluation of a writing course combined with writers' support group.

    Science.gov (United States)

    Rickard, Claire M; McGrail, Matthew R; Jones, Rebecca; O'Meara, Peter; Robinson, Anske; Burley, Mollie; Ray-Barruel, Gillian

    2009-07-01

    Publication rates are a vital measure of individual and institutional performance, yet many nurse academics publish rarely or not at all. Despite widespread acceptance of the need to increase academic publication rates and the pressure university faculty may experience to fulfil this obligation, little is known about the effectiveness of practical strategies to support academic writing. In this small cohort study (n=8) comprising nurses and other professionals involved in university education, a questionnaire survey was used to evaluate the effectiveness of a one-week "Writing for Publication" course combined with a monthly writers support group to increase publication rates. Two year pre and post submissions increased from 9 to 33 articles in peer-reviewed journals. Publications (in print) per person increased from a baseline of 0.5-1.2 per year. Participants reported increased writing confidence and greater satisfaction with the publishing process. Peer support and receiving recognition and encouragement from line managers were also cited as incentives to publish. Writing for publication is a skill that can be learned. The evaluated model of a formal writing course, followed by informal monthly group support meetings, can effectively increase publication rates.

  4. Group-size effects on the evolution of cooperation in the spatial public goods game

    CERN Document Server

    Szolnoki, Attila; 10.1103/PhysRevE.84.047102

    2011-01-01

    We study the evolution of cooperation in public goods games on the square lattice, focusing on the effects that are brought about by different sizes of groups where individuals collect their payoffs and search for potential strategy donors. We find that increasing the group size does not necessarily lead to mean-field behavior, as is traditionally observed for games governed by pairwise interactions, but rather that public cooperation may be additionally promoted by means of enhanced spatial reciprocity that sets in for very large groups. Our results highlight that the promotion of cooperation due to spatial interactions is not rooted solely in having restricted connections amongst players, but also in individuals having the opportunity to collect payoffs separately from their direct opponents. Moreover, in large groups the presence of a small number of defectors is bearable, which makes the mixed phase region expand with increasing group size. Having a chance of exploiting distant players, however, offers de...

  5. Public and professional attitudes to transplanting alcoholic patients.

    Science.gov (United States)

    Neuberger, James

    2007-11-01

    The discrepancy between the number of people who might benefit from liver transplantation continues to exceed the availability of donor livers available, so rationing of grafts must occur. Alcoholic liver disease (ALD) is an excellent indication for liver transplantation, with outcomes at least as good as for other indications.ALD remains a controversial indication for liver transplantation. There is no robust evidence that public disquiet over distribution of donor livers to those with ALD (even if they return to alcohol) greatly affects organ donation, although this does not mean there is no consequence of such disquiet. Numerous surveys of the general public, patients, and health care professionals indicate the these patients are thought to have lower priority for access to available liver grafts. Public education is required to demonstrate that patients with ALD are carefully selected for liver transplantation and available grafts are used with attention to equity, justice, and utility.

  6. Inpatient group therapeutic interventions for patients with intellectual disabilities.

    Science.gov (United States)

    Reddy, Vilash

    2015-03-01

    Group therapy can be an effective mode of therapy, used on an inpatient unit, as it can allow patients to become allies in their journey to understand and overcome their mental health needs. The therapeutic principles discussed by Dr Irvin Yalom illustrate the significance and importance of group therapy, which was strongly incorporated into interactive behavior therapy (IBT) developed by Dr Daniel J Tomasulo. IBT is a type of group therapy, more action oriented, created to allow patients with intellectual disabilities (IDs) to better comprehend discussed topics, by designing and tailoring activities to meet their cognitive and linguistic capabilities. Additional details found in this article will illustrate the methods by which IBT is capable of meeting the needs of patients with ID. Such adjustments include shorter duration of activities to maximize concentration, proactive role-playing involving the synergistic effort of all members of the group, and limiting the authoritative role of the therapist in a group environment.

  7. ["Family groups" for relatives of patients with anorexia nervosa].

    Science.gov (United States)

    Brunswick, Astrid; Guy-Rubin, Aurore; Satori, Nadine

    2016-01-01

    Anorexia nervosa affects mainly young adults. During care, caregivers seek alliance with patients' friends and family to be able to relate to the patients' symptoms and also their environment. Collaborative work with families helps build confidence. The "family group" is an example of well-intended partnership.

  8. Pseudomonas aeruginosa diversity in distinct paediatric patient groups

    DEFF Research Database (Denmark)

    Tramper-Stranders, G.A.; Ent, C.K. van der; Wolfs, T.F.;

    2008-01-01

    and further typed by pulsed-field gel electrophoresis. Simpson's diversity index was calculated for the five groups. CF-chronic patients carried the highest number of distinct P. aeruginosa phenotypes and genotypes per culture. Isolates from the CF-chronic group were significantly less diverse than those from...

  9. Negative impact of asthma on patients in different age groups

    Directory of Open Access Journals (Sweden)

    Marcela Batan Alith

    2015-02-01

    Full Text Available Objective: To evaluate the impact of asthma on patients in Brazil, by age group (12-17 years, 18-40 years, and ≥ 41 years. Methods: From a survey conducted in Latin America in 2011, we obtained data on 400 patients diagnosed with asthma and residing in one of four Brazilian state capitals (São Paulo, Rio de Janeiro, Curitiba, and Salvador. The data had been collected using a standardized questionnaire in face-to-face interviews. For the patients who were minors, the parents/guardians had completed the questionnaire. The questions addressed asthma control, number of hospitalizations, number of emergency room visits, and school/work absenteeism, as well as the impact of asthma on the quality of life, sleep, and leisure. We stratified the data by the selected age groups. Results: The proportions of patients who responded in the affirmative to the following questions were significantly higher in the 12- to 17-year age group than in the other two groups: "Have you had at least one episode of severe asthma that prevented you from playing/exercising in the last 12 months?" (p = 0.012; "Have you been absent from school/work in the last 12 months?" (p < 0.001; "Have you discontinued your asthma relief or control medication in the last 12 months?" (p = 0.008. In addition, 30.2% of the patients in the 12- to 17-year age group reported that normal physical exertion was very limiting (p = 0.010 vs. the other groups, whereas 14% of the patients in the ≥ 41-year age group described social activities as very limiting (p = 0.011 vs. the other groups. Conclusions: In this sample, asthma had a greater impact on the patients between 12 and 17 years of age, which might be attributable to poor treatment compliance.

  10. Negative impact of asthma on patients in different age groups.

    Science.gov (United States)

    Alith, Marcela Batan; Gazzotti, Mariana Rodrigues; Montealegre, Federico; Fish, James; Nascimento, Oliver Augusto; Jardim, José Roberto

    2015-01-01

    To evaluate the impact of asthma on patients in Brazil, by age group (12-17 years, 18-40 years, and ≥ 41 years). From a survey conducted in Latin America in 2011, we obtained data on 400 patients diagnosed with asthma and residing in one of four Brazilian state capitals (São Paulo, Rio de Janeiro, Curitiba, and Salvador). The data had been collected using a standardized questionnaire in face-to-face interviews. For the patients who were minors, the parents/guardians had completed the questionnaire. The questions addressed asthma control, number of hospitalizations, number of emergency room visits, and school/work absenteeism, as well as the impact of asthma on the quality of life, sleep, and leisure. We stratified the data by the selected age groups. The proportions of patients who responded in the affirmative to the following questions were significantly higher in the 12- to 17-year age group than in the other two groups: "Have you had at least one episode of severe asthma that prevented you from playing/exercising in the last 12 months?" (p = 0.012); "Have you been absent from school/work in the last 12 months?" (p your asthma relief or control medication in the last 12 months?" (p = 0.008). In addition, 30.2% of the patients in the 12- to 17-year age group reported that normal physical exertion was very limiting (p = 0.010 vs. the other groups), whereas 14% of the patients in the ≥ 41-year age group described social activities as very limiting (p = 0.011 vs. the other groups). In this sample, asthma had a greater impact on the patients between 12 and 17 years of age, which might be attributable to poor treatment compliance.

  11. 76 FR 60495 - Patient Safety Organizations: Voluntary Relinquishment From the Patient Safety Group

    Science.gov (United States)

    2011-09-29

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary Relinquishment From the Patient Safety Group AGENCY: Agency for Healthcare Research and Quality (AHRQ), HHS... relinquishment from The Patient Safety Group of its status as a Patient Safety Organization (PSO). The...

  12. Multidisciplinary patient education in groups increases knowledge on Osteoporosis

    DEFF Research Database (Denmark)

    Nielsen, Dorthe; Ryg, Jesper; Nissen, Nis;

    2008-01-01

    of osteoporosis may be increased by a group-based multidisciplinary education programme. Methods: Three hundred patients, aged 45-81 years, recently diagnosed with osteoporosis and started on specific treatment, were randomized to either the ‘‘school'' or ‘‘control'' group. Teaching was performed by nurses......, physiotherapists, dieticians, and doctors, and designed to increase the patient's empowerment. The patient's knowledge of osteoporosis was tested at study entry and at 3 months using a validated questionnaire. Results: At study entry, no differences in age or score (22 (18-24) (median (25-75 percentiles)) vs. 22...

  13. Patient advocacy groups: Need and opportunity in India

    Directory of Open Access Journals (Sweden)

    Kunal Shah

    2011-01-01

    Full Text Available With an increasing number of corporate hospitals, healthcare related issues, research trials and undue attention by media in India, there is a need to focus more on patient′s rights and protection. In India, multiple agencies like regulatory bodies, scientific review committees, ethics committees, NGOs, etc. work toward patient rights and protection. However, these agencies are inadequate to cater to the general issues related to patient′s rights. There′s a need to have a separate group of people who provide advocacy to the patient, or simply, a patient advocacy group which will work explicitly in these areas to increase transparency and credibility of healthcare system in India. This group will provide special attention to patient care and protection of rights from the planning stage rather than at the troubleshooting stage.

  14. Multidisciplinary patient education in groups increases knowledge on Osteoporosis

    DEFF Research Database (Denmark)

    Nielsen, Dorthe; Ryg, Jesper; Nissen, Nis

    2008-01-01

    Abstract Introduction: Specific pharmacological treatment reduces the incidence of fractures significantly in patients with osteoporosis. Unfortunately, compliance with such therapy is low in clinical practice and is inversely related to educational level. We hypothesized that patients' knowledge...... of osteoporosis may be increased by a group-based multidisciplinary education programme. Methods: Three hundred patients, aged 45-81 years, recently diagnosed with osteoporosis and started on specific treatment, were randomized to either the ‘‘school'' or ‘‘control'' group. Teaching was performed by nurses......, physiotherapists, dieticians, and doctors, and designed to increase the patient's empowerment. The patient's knowledge of osteoporosis was tested at study entry and at 3 months using a validated questionnaire. Results: At study entry, no differences in age or score (22 (18-24) (median (25-75 percentiles)) vs. 22...

  15. Beyond the therapeutic: A Habermasian view of self-help groups' place in the public sphere.

    Science.gov (United States)

    Chaudhary, Sarah; Avis, Mark; Munn-Giddings, Carol

    2013-02-01

    Self-help groups in the United Kingdom continue to grow in number and address virtually every conceivable health condition, but they remain the subject of very little theoretical analysis. The literature to date has predominantly focused on their therapeutic effects on individual members. And yet they are widely presumed to fulfil a broader civic role and to encourage democratic citizenship. The article uses Habermas' model of the public sphere as an analytical tool with which to reconsider the literature on self-help groups in order to increase our knowledge of their civic functions. In doing this it also aims to illustrate the continuing relevance of Habermas' work to our understanding of issues in health and social care. We consider, within the context of current health policies and practices, the extent to which self-help groups with a range of different forms and functions operate according to the principles of communicative rationality that Habermas deemed key to democratic legitimacy. We conclude that self-help groups' civic role is more complex than is usually presumed and that various factors including groups' leadership, organisational structure and links with public agencies can affect their efficacy within the public sphere.

  16. 76 FR 58007 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2011-09-19

    ... HUMAN SERVICES Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public... Secretary for Health, Office of the Surgeon General of the United States Public Health Service. ACTION... Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (the ``Advisory...

  17. 76 FR 67731 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2011-11-02

    ... HUMAN SERVICES Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public... Secretary for Health, Office of the Surgeon General of the United States Public Health Service. ACTION... the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (the...

  18. 78 FR 48877 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2013-08-12

    ... HUMAN SERVICES Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health AGENCY: Office of the Surgeon General of the United States Public Health Service, Office of the... Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (the ``Advisory...

  19. 78 FR 14798 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2013-03-07

    ... HUMAN SERVICES Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public... Secretary for Health, Office of the Surgeon General of the United States Public Health Service. ACTION... ] Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (the ``Advisory...

  20. 78 FR 38345 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2013-06-26

    ... HUMAN SERVICES Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health AGENCY: Office of the Surgeon General of the United States Public Health Service, Office of the... Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (the ``Advisory...

  1. 78 FR 69853 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2013-11-21

    ... HUMAN SERVICES Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health AGENCY: Office of the Surgeon General of the United States Public Health Service, Office of the... Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (the ``Advisory...

  2. 77 FR 15372 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2012-03-15

    ... HUMAN SERVICES Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public... Secretary for Health, Office of the Surgeon General of the United States Public Health Service. ACTION... Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (the ``Advisory...

  3. 76 FR 16776 - Advisory Group on Prevention, Health Promotion, and Integrative and Public Health; Notice of Meeting

    Science.gov (United States)

    2011-03-25

    ... HUMAN SERVICES Advisory Group on Prevention, Health Promotion, and Integrative and Public Health; Notice... Assistant Secretary for Health, Office of the Surgeon General of the United States Public Health Service... for the Advisory Group on Prevention, Health Promotion, and Integrative and Public ] Health...

  4. 77 FR 33220 - Advisory Group on Prevention, Health Promotion, and Integrative and Public Health; Notice of Meeting

    Science.gov (United States)

    2012-06-05

    ... HUMAN SERVICES Advisory Group on Prevention, Health Promotion, and Integrative and Public Health; Notice of Meeting AGENCY: Office of the Surgeon General of the United States Public Health Service, Office... be held for the Advisory Group on Prevention, Health Promotion, and Integrative and Public...

  5. 76 FR 26300 - Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2011-05-06

    ... Prevention and Health Promotion Strategy. Public participation during the Web meeting is limited. Members of... HUMAN SERVICES Meeting of the Advisory Group on Prevention, Health Promotion, and Integrative and Public... the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (the...

  6. 78 FR 63223 - Fibromyalgia Public Meeting on Patient-Focused Drug Development; Correction

    Science.gov (United States)

    2013-10-23

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Fibromyalgia Public Meeting on Patient-Focused Drug... public meeting entitled ``Fibromyalgia Public Meeting on Patient-Focused Drug Development''...

  7. Public key cryptosystem and a key exchange protocol using tools of non-abelian group

    Directory of Open Access Journals (Sweden)

    H. K. Pathak,

    2010-07-01

    Full Text Available Public Key Cryptosystems assure privacy as well as integrity of the transactions between two parties. The sizes of the keys play an important role. The larger the key the harder is to crack a block ofencrypted data. We propose a new public key cryptosystem and a Key Exchange Protocol based on the generalization of discrete logarithm problem using Non-abelian group of block upper triangular matrices of higher order. The proposed cryptosystem is efficient in producing keys of large sizes without the need of large primes. The security of both the systems relies on the difficulty of discrete logarithms over finite fields.

  8. [The libraries of the public hospitals in Spain. An economic analysis. The Research Group on Libraries].

    Science.gov (United States)

    Sánchez Gómez, C; Lázaro y de Mercado, P; Poza Sanz, M A; Estrada Lorenzo, J M

    1999-01-01

    The continuous increase in scientific knowledge in the health field, the development of new technologies and the rising cost of publications means that libraries are essential for patient care, medical education and research. In Spain some deficiencies have been seen in hospital libraries, and their cost is unknown. To analyze the cost of public hospital libraries in Spain and to estimate the cost of adapting them to international standards. Cross-sectional survey of public hospitals larger than 100 beds, or smaller public hospitals with teaching accreditation. Information on the variables of interest was collected by questionnaire mailed to the libraries and followed up by telephone. Data collection was completed in 1996. The information on costs is for 1994. A sensitivity analysis was done to examine the effects of imprecise estimates and assumptions. Of the 314 hospitals identified, 211 (67.2%) had libraries. The 1994 cost of the of the 211 libraries was 3,060 million pesetas (mean cost: 14.5 million pesetas). Personnel costs were the most important item (38% of the total), followed by the cost of subscriptions (29%). The cost of hospital libraries represented 0.08% of national public expenditures on health. The cost of correcting inadequacies in accordance with international standards would increase spending by about 400 million pesetas the first year (0.01% of public spending on health). The cost of hospital libraries represents only a small fraction of public spending on health. Correction of the observed deficiencies and the importance of libraries in the health system would require increasing spending to about 0.1% of public spending on health.

  9. The Effectiveness of Structured Group Education on Ankylosing Spondylitis Patients.

    Science.gov (United States)

    Kasapoglu Aksoy, Meliha; Birtane, Murat; Taştekin, Nurettin; Ekuklu, Galip

    2017-04-01

    Ankylosing spondylitis (AS) is a common inflammatory rheumatic disease that affects the axial skeleton which can lead to structural and functional impairments. It has a negative impact on the person's daily life activities. Early diagnosis, exercise and patient education are factors playing a major role on prognosis. The purpose of the study was to compare the structured theoretical and exercise educational program with routine clinic educational efforts on the parameters of the disorder over a 3 month follow up. This randomized, educational intervention study was performed on 41 AS patients. A 5 day structured education and exercise program was applied to the first group of patients (Group 1) in subgroups consisting 4-5 patients each. Patients had group exercises throughout the education program. The second group followed routine clinical care. The effectiveness of the treatment was assessed by Bath ankylosing spondylitis functional (BASFI), Bath ankylosing spondylitis disease activity (BASDAI), Bath ankylosing spondylitis global (BAS-G), Bath ankylosing spondylitis metrology indices (BASMI), chest expansion, short form-36 (SF-36), ankylosing spondylitis quality of life scale (ASQoL) and laboratory parameters in all patients. Patients were evaluated on initiation and after 3 months. Significant improvements in BASFI, BASDAI and BAS-G, chest expansion, SF-36 and ASQoL indices were observed in Group 1 No difference could be found in BASMI and chest expansion. A structured educational and exercise intervention had a positive effect on the functional status,disease activity, and general well-being and quality of life. It also, shows that education programs should be within the routine treatment program for AS.

  10. Pipeline Processing at the Isaac Newton Group: Using ``Live" Images for Public Understanding of Science

    Science.gov (United States)

    Greimel, Robert; Mendez, Javier; Skillen, Ian; Lennon, D. J.; Walton, Nick A.

    The Isaac Newton Group of Telescopes is currently implementing both optical and near-infrared data reduction pipelines for its imaging cameras. For quality control purposes the quicklook pipelines generate postage stamp and full size images (in jpeg format) of all reduced data frames, which can easily be accessed through a web interface. For spectroscopic instruments only the raw data frames are converted into jpeg images. In this poster we show how these images, combined with automated access to the scheduling information and current weather and observing conditions, can be used as input to form near real time web pages for public relations purposes. To enhance the usefulness of this service, a description of the observing project, accessible to the general public, is requested from the observer. Possible use of such a service for planetariums and museums is discussed. This will provide a valuable means for disseminating the dynamic nature of the observatory to the wider public.

  11. Two Important Factors That Effects Patient Satisfaction In A Public Hospital: Communication And Patient Safety Culture

    OpenAIRE

    Vural, Fisun; AYDIN, Ayşe; FİL, Şükran; Torun, Sebahat; Vural, Birol

    2015-01-01

    The measurement of patient satisfaction in health care services is an important measure of quality service provision. The aim of this study was to determine hospitalized patient satisfaction in a public hospital and the related factors affecting satisfaction. Patient satisfaction survey was applied to 120 hospitalized patients during face to face interviews. The major components of healthcare satisfaction were analysed separately as: the personal characteristics of patients, healthcare staffs...

  12. 77 FR 6796 - Notification of Three Public Teleconferences of a Work Group of the Chartered Science Advisory Board

    Science.gov (United States)

    2012-02-09

    ... AGENCY Notification of Three Public Teleconferences of a Work Group of the Chartered Science Advisory... Board (SAB) Staff Office announces three public teleconferences of a work group of the Chartered Science... EPA policy, notice is hereby given that a work group of the chartered SAB will hold three...

  13. [Identification and grouping of pain patients according to claims data].

    Science.gov (United States)

    Freytag, A; Schiffhorst, G; Thoma, R; Strick, K; Gries, C; Becker, A; Treede, R-D; Müller-Schwefe, G; Casser, H-R; Luley, C; Höer, A; Ujeyl, M; Gothe, H; Kugler, J; Glaeske, G; Häussler, B

    2010-02-01

    The ICD classification does not provide the opportunity to adequately identify pain patients. Therefore we developed an alternative method for the identification and classification of pain patients which is based on prescription and diagnoses data from the year 2006 of one nationwide sickness fund (DAK) and which is led by two main assumptions: 1. Beneficiaries without prescription of an analgetic drug but with a diagnosis pattern that is characteristic of patients who are treated with opioids are also likely to be pain patients. 2. Each combination of diagnosis groups can be traced back to one primary diagnosis out of a diagnosis group according to the patient classification system CCS (Clinical Classifications Software). The selection of this diagnosis group (CCS) allows for the allocation of the beneficiary to only one pain type. As a result we identified 65 combinations of CCS diagnosis groups--aggregated to nine "CCS pain types"--to which 77.1% of all patients with at least two opioid prescriptions can be allocated: 26.3% to pain due to arthrosis, 18.0% to pain due to intervertebral disc illnesses, 13.1% to other specific back pain, 6.7% to neuropathic pain, 4.5% to unspecific back pain, 4.2% to headache, 2.4% to pain after traumatic fractures, 1.3% to pain of multimorbid, high-maintenance patients, and 0.6% to cancer pain. Based on our method beneficiaries who have a high probability of suffering from moderate to strong pain can be identified and included in further claims data analyses of health care delivery and utilization pattern of pain-related disorders in Germany.

  14. Cigarette smoking by socioeconomic group, sex, and age: effects of price, income, and health publicity.

    OpenAIRE

    Townsend, J.; Roderick, P; Cooper, J.

    1994-01-01

    OBJECTIVE--To assess effects of price, income, and health publicity on cigarette smoking by age, sex, and socioeconomic group. DESIGN--Econometric multiple regression analysis of data on cigarette smoking from the British general household survey. SUBJECTS--Random sample of adult population in Britain interviewed for biennial general household surveys 1972-90. MAIN OUTCOME MEASURES--Changes in cigarette consumption and prevalence of smoking. RESULTS--Price elasticities of demand for cigarette...

  15. [The function of the group tutorial in training human resources in public health].

    Science.gov (United States)

    Guzmán-Pizarro, L; Rodríguez-Roa, G

    1994-01-01

    Within the educational system, the method of group tutor was developed as a teaching strategy: the tutor goes along with a group of students to field training and works with them on the systematization and analysis of the study to obtain the final report. The purpose of this paper is to recuperate the work experience of the Department of Didactics of the School of Public Health of Mexico during 1991. A relevant conclusion is that this form of work needs to be studied and developed, since it demands a greater amount of independence from the students and requires a different participation from the teacher, both as coordinator and advisor.

  16. The advantages of "Dance-group" for psychotic patients.

    Science.gov (United States)

    Tavormina, Romina; Tavormina, Maurilio Giuseppe Maria; Nemoianni, Eugenio

    2014-11-01

    Psychosocial rehabilitation and in particular group dances allow the recovery of lost or compromised ability of patients with mental illness, and they facilitate their reintegration into the social context. The dance group has enabled users of the Day Centre of the Unit of Mental Health Torre del Greco ASL NA 3 south to achieve the objectives of rehabilitation such as: taking care of themselves, of their bodies and their interests, improving self-esteem , the management of pathological emotions, socialization and integration, overcoming the psychotic closing and relational isolation. In particular, patients with schizophrenia, psychotic and mood disorders had a concrete benefit from such rehabilitation activities, facilitating interpersonal relationships, therapy compliance and significantly improved mood, quality of life, providing them with the rhythm and the security in their relationship with each other. The dance group and for some individuals, also psychotherapy and drug therapy, have facilitated social inclusion, improved the quality of life and cured their diseases. The work is carrying out in a group with patients, practitioners, family members, volunteers, social community workers, following the operating departmental protocols. Using the chorus group "Sing that you go" as an operational tool for psychosocial rehabilitation and therapeutic element we promote the psychological well-being and the enhancement of mood.

  17. Acute Kidney Injury Classification in Neuro-ICU Patient Group

    Directory of Open Access Journals (Sweden)

    Canan Akıncı

    2012-12-01

    Full Text Available Objective: To investigate the role of acute kidney injury (AKI classification system for kidney injury outcome in neuro-Intensive care unit (ICU patients. Material and Method: Total 432 patients who admitted to ICU between 2005 and 2009 evaluated in this study. All patients’ AKI stage, Acute Physiology and Chronic Health Evaluation (APACHE-II, Sequential Organ Failure Assessment Score (SOFA, Glasgow Coma Score (GCS, Glasgow Outcome Score (GOS, mortality rate, length of ICU stay, need for intubation, and mechanical ventilation were recorded. Results: AKI was found in 24 of all 432 patents’ (5.5%. We found that, patients with AKI had higher APHACE-II score, SOFA score and mortality rates; longer ICU stay, duration of mechanical ventilation and intubation and lower GCS and GOS than without AKI group. Conclusion: Length of ICU stay and mortality rate were higher in AKI positive group.

  18. Cortisol responses to a group public speaking task for adolescents: variations by age, gender, and race.

    Science.gov (United States)

    Hostinar, Camelia E; McQuillan, Mollie T; Mirous, Heather J; Grant, Kathryn E; Adam, Emma K

    2014-12-01

    Laboratory social stress tests involving public speaking challenges are widely used for eliciting an acute stress response in older children, adolescents, and adults. Recently, a group protocol for a social stress test (the Trier Social Stress Test for Groups, TSST-G) was shown to be effective in adults and is dramatically less time-consuming and resource-intensive compared to the single-subject version of the task. The present study sought to test the feasibility and effectiveness of an adapted group public speaking task conducted with a racially diverse, urban sample of U.S. adolescents (N=191; 52.4% female) between the ages of 11 and 18 (M=14.4 years, SD=1.93). Analyses revealed that this Group Public Speaking Task for Adolescents (GPST-A) provoked a significant increase in cortisol production (on average, approximately 60% above baseline) and in self-reported negative affect, while at the same time avoiding excessive stress responses that would raise ethical concerns or provoke substantial participant attrition. Approximately 63.4% of participants exhibited an increase in cortisol levels in response to the task, with 59.2% of the total sample showing a 10% or greater increase from baseline. Results also suggested that groups of five adolescents might be ideal for achieving more uniform cortisol responses across various serial positions for speech delivery. Basal cortisol levels increased with age and participants belonging to U.S. national minorities tended to have either lower basal cortisol or diminished cortisol reactivity compared to non-Hispanic Whites. This protocol facilitates the recruitment of larger sample sizes compared to prior research and may show great utility in answering new questions about adolescent stress reactivity and development.

  19. Knowledge Discovery from the Emergence of Group Cognitions in Public Incidents

    Institute of Scientific and Technical Information of China (English)

    Deng Xiao Li

    2012-01-01

      In this paper, the QianXueShen’s seminar hall system is improved under the guiding of the systems science approach. Taking the sustainable development issues of the DianChi Lake as a case, bas-ing on the network platform developing fast, all kinds of discussion opinion on the sustainable development issues of the DianChi Lake are researched. By analyzing the interaction mechanism of three groups of governments, expects, and publics, the emergence of the group wis-dom, the methods of the decision making on the solving public inci-dents by government with the scientifically and democratically are ex-plored. Based on the key words collection from vast cognition to the DianChi issues of each groups, and by applying the technology of in-formation mining to mine out the useful information from the complex network data, the relation of referencing each other among the key words is explored. Based on the approach from the qualitative and quantitative research, the knowledge mining research of the group cog-nition emergence is processed. The research suggests that the core cog-nition ismined out which is accord with the practice and with the prac-tical significance.

  20. Group G streptococcal myositis in a patient with myeloproliferative neoplasm

    Directory of Open Access Journals (Sweden)

    Monica Midha, MD MBS

    2016-01-01

    Full Text Available While many cases of streptococcal infection are due to Lancefield groups A and B, there has been a rise in reported cases of infections due to group G streptococcus. We present a case of an individual with a hematologic malignancy who developed myositis secondary to group G streptococcus, with no clearly identifiable source of infection. The patient was managed with antibiotic therapy rather than surgical intervention due to high surgical risk related to severe thrombocytopenia. Targeted antibiotics initiated early in the course of disease may prevent the need for surgical intervention. Early diagnosis and treatment are critical to avoid the high morbidity and mortality of life-threatening infections caused by group G streptococcus.

  1. Validating a work group climate assessment tool for improving the performance of public health organizations

    Directory of Open Access Journals (Sweden)

    Tracy Allison

    2005-10-01

    Full Text Available Abstract Background This article describes the validation of an instrument to measure work group climate in public health organizations in developing countries. The instrument, the Work Group Climate Assessment Tool (WCA, was applied in Brazil, Mozambique, and Guinea to assess the intermediate outcomes of a program to develop leadership for performance improvement. Data were collected from 305 individuals in 42 work groups, who completed a self-administered questionnaire. Methods The WCA was initially validated using Cronbach's alpha reliability coefficient and exploratory factor analysis. This article presents the results of a second validation study to refine the initial analyses to account for nested data, to provide item-level psychometrics, and to establish construct validity. Analyses included eigenvalue decomposition analysis, confirmatory factor analysis, and validity and reliability analyses. Results This study confirmed the validity and reliability of the WCA across work groups with different demographic characteristics (gender, education, management level, and geographical location. The study showed that there is agreement between the theoretical construct of work climate and the items in the WCA tool across different populations. The WCA captures a single perception of climate rather than individual sub-scales of clarity, support, and challenge. Conclusion The WCA is useful for comparing the climates of different work groups, tracking the changes in climate in a single work group over time, or examining differences among individuals' perceptions of their work group climate. Application of the WCA before and after a leadership development process can help work groups hold a discussion about current climate and select a target for improvement. The WCA provides work groups with a tool to take ownership of their own group climate through a process that is simple and objective and that protects individual confidentiality.

  2. [ABO system blood group ratios in patients with neuroinfections].

    Science.gov (United States)

    Rudometov, Iu P; Umanskiĭ, K G; Ashmarina, E E; Andreeva, L S

    1981-01-01

    The distribution of the ABO blood groups in 2009 patients including 1441 ones suffering from etiologically diverse neuroinfections was studied. Certain correlations between the nosological forms and groups of the diseases on the one hand, and the blood factors on the other are demonstrated. The data obtained point to a certain role of hereditary predisposition in the genesis of the neuroinfections. This predisposition predetermines the risk of the illnesses and the gravity of their course, the fact, which is of a practical importance for the clinician.

  3. Serotonin Signal Transduction in Two Groups of Autistic Patients

    Science.gov (United States)

    2013-12-01

    AD_________________ Award Number: W81XWH-11-1-0820 TITLE: Serotonin Signal Transduction in Two...Report 3. DATES COVERED 15 September 2011-14 September 2013 4. TITLE AND SUBTITLE Serotonin Signal Transduction in Two Groups of Autistic Patients...the arena of serotonin sensitivity, from those cells obtained from autistic subjects with normal serum serotonin . This was not the case, as the

  4. 32 CFR Appendix A to Part 47 - Instructions for Submitting Group Applications Under Public Law 95-202

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false Instructions for Submitting Group Applications Under Public Law 95-202 A Appendix A to Part 47 National Defense Department of Defense OFFICE OF THE... Pt. 47, App. A Appendix A to Part 47—Instructions for Submitting Group Applications Under Public...

  5. 36 CFR 1280.94 - When do Presidential libraries allow other groups to use their public areas for events?

    Science.gov (United States)

    2010-07-01

    ... libraries allow other groups to use their public areas for events? 1280.94 Section 1280.94 Parks, Forests... FACILITIES What Additional Rules Apply for Use of Facilities in Presidential Libraries? § 1280.94 When do Presidential libraries allow other groups to use their public areas for events? (a) Although...

  6. The Difference in the Online Medical Information Searching Behaviors of Hospital Patients and Their Relatives versus the General Public

    Science.gov (United States)

    Wang, Hung-Yuan; Liang, Jyh-Chong; Tsai, Chin-Chung

    2014-01-01

    The purpose of this study is two-fold: to explore the differences in online medical information searching behaviors, including evaluative standards and search strategies, of the general public (general group) and those of hospital patients and their relatives (hospital group); and to compare the predictive relationship between the evaluative…

  7. Narratives of empowerment and compliance: studies of communication in online patient support groups.

    Science.gov (United States)

    Wentzer, Helle S; Bygholm, Ann

    2013-12-01

    New technologies enable new forms of patient participation in health care. The article discusses whether communication in online patient support groups is a source of individual as well as collective empowerment or to be understood within the tradition of compliance. The discussion is based on a qualitative analysis of patient communication in two online groups on the Danish portal sundhed.dk, one for lung patients and one for women with fertility problems. The object of study is the total sum of postings during a specific period of time - a total of 4301 posts are included. The textmaterial was analyzed according to the textual paradigm of Paul Ricoeur, and the three steps of critical interpretation. Thus, the analysis moves from describing communicative characteristics of the site to a thorough semantic analysis of its narrative structure of construing meaning, interaction and collective identity, and finally as a source of collective action. The meta-narratives of the two groups confirm online patient support groups for individual empowerment, for collective group identity, but not for collective empowerment. The collective identities of patienthood on the two sites are created by the users (patients) through specific styles of communication and interaction, referred to as 'multi-logical narratives'. In spite of the potential of online communities of opening up health care to the critical voice of the public, the analysis points to a synthesis of the otherwise opposite positions of empowerment and compliance in patient care. On a collective level, the site is empowering the individual users to comply with 'doctor's recommendations' as a group. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  8. The Pacific Northwest's Climate Impacts Group: Climate Science in the Public Interest

    Science.gov (United States)

    Mantua, N.; Snover, A.

    2006-12-01

    Since its inception in 1995, the University of Washington's Climate Impacts Group (CIG) (funded under NOAA's Regional Integrated Science and Assessments (RISA) Program) has become the leader in exploring the impacts of climate variability and climate change on natural and human systems in the U.S. Pacific Northwest (PNW), specifically climate impacts on water, forest, fish and coastal resource systems. The CIG's research provides PNW planners, decision makers, resource managers, local media, and the general public with valuable knowledge of ways in which the region's key natural resources are vulnerable to changes in climate, and how this vulnerability can be reduced. The CIG engages in climate science in the public interest, conducting original research on the causes and consequences of climate variability and change for the PNW and developing forecasts and decision support tools to support the use of this information in federal, state, local, tribal, and private sector resource management decisions. The CIG's focus on the intersection of climate science and public policy has placed the CIG nationally at the forefront of regional climate impacts assessment and integrated analysis.

  9. Public attitudes towards pricing policies to change health-related behaviours: a UK focus group study

    Science.gov (United States)

    Marteau, Theresa M.; Kinmonth, Ann Louise; Cohn, Simon

    2015-01-01

    Background: Evidence supports the use of pricing interventions in achieving healthier behaviour at population level. The public acceptability of this strategy continues to be debated throughout Europe, Australasia and USA. We examined public attitudes towards, and beliefs about the acceptability of pricing policies to change health-related behaviours in the UK. The study explores what underlies ideas of acceptability, and in particular those values and beliefs that potentially compete with the evidence presented by policy-makers. Methods: Twelve focus group discussions were held in the London area using a common protocol with visual and textual stimuli. Over 300 000 words of verbatim transcript were inductively coded and analyzed, and themes extracted using a constant comparative method. Results: Attitudes towards pricing policies to change three behaviours (smoking, and excessive consumption of alcohol and food) to improve health outcomes, were unfavourable and acceptability was low. Three sets of beliefs appeared to underpin these attitudes: (i) pricing makes no difference to behaviour; (ii) government raises prices to generate income, not to achieve healthier behaviour and (iii) government is not trustworthy. These beliefs were evident in discussions of all types of health-related behaviour. Conclusions: The low acceptability of pricing interventions to achieve healthier behaviours in populations was linked among these responders to a set of beliefs indicating low trust in government. Acceptability might be increased if evidence regarding effectiveness came from trusted sources seen as independent of government and was supported by public involvement and hypothecated taxation. PMID:25983329

  10. Group penalty on the evolution of cooperation in spatial public goods games

    Science.gov (United States)

    Zhang, Chunyan; Zhang, Jianlei; Xie, Guangming; Wang, Long

    2010-12-01

    We study the evolution of cooperation in spatial public goods games, whereby a coevolutionary rule is introduced that aims to integrate group penalty into the framework of evolutionary games. Existing groups are deleted whenever the collective gains of the focal individuals are less than a deletion threshold value. Meanwhile, newcomers are added after each game iteration to maintain the fixed population size. The networking effect is also studied via four representative interaction networks which are associated with the population structure. We conclude that the cooperation level has a strong dependence on the deletion threshold, and the suitable value range of the deletion threshold which is associated with the maximal cooperation frequency has been found. Simulation results also show that optimum values of the deletion threshold can still warrant the most potent promotion of cooperation, irrespective of which of the four topologies is applied.

  11. Public attitudes towards pricing policies to change health-related behaviours: a UK focus group study.

    Science.gov (United States)

    Somerville, Claire; Marteau, Theresa M; Kinmonth, Ann Louise; Cohn, Simon

    2015-12-01

    Evidence supports the use of pricing interventions in achieving healthier behaviour at population level. The public acceptability of this strategy continues to be debated throughout Europe, Australasia and USA. We examined public attitudes towards, and beliefs about the acceptability of pricing policies to change health-related behaviours in the UK. The study explores what underlies ideas of acceptability, and in particular those values and beliefs that potentially compete with the evidence presented by policy-makers. Twelve focus group discussions were held in the London area using a common protocol with visual and textual stimuli. Over 300,000 words of verbatim transcript were inductively coded and analyzed, and themes extracted using a constant comparative method. Attitudes towards pricing policies to change three behaviours (smoking, and excessive consumption of alcohol and food) to improve health outcomes, were unfavourable and acceptability was low. Three sets of beliefs appeared to underpin these attitudes: (i) pricing makes no difference to behaviour; (ii) government raises prices to generate income, not to achieve healthier behaviour and (iii) government is not trustworthy. These beliefs were evident in discussions of all types of health-related behaviour. The low acceptability of pricing interventions to achieve healthier behaviours in populations was linked among these responders to a set of beliefs indicating low trust in government. Acceptability might be increased if evidence regarding effectiveness came from trusted sources seen as independent of government and was supported by public involvement and hypothecated taxation. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association.

  12. Issues experienced while administering care to patients with dementia in acute care hospitals: A study based on focus group interviews

    OpenAIRE

    Risa Fukuda; Yasuko Shimizu; Natsuko Seto

    2015-01-01

    Objective: Dementia is a major public health problem. More and more patients with dementia are being admitted to acute care hospitals for treatment of comorbidities. Issues associated with care of patients with dementia in acute care hospitals have not been adequately clarified. This study aimed to explore the challenges nurses face in providing care to patients with dementia in acute care hospitals in Japan. Methods: This was a qualitative study using focus group interviews (FGIs). The setti...

  13. Focus groups highlight that many patients object to clinicians' focusing on costs.

    Science.gov (United States)

    Sommers, Roseanna; Goold, Susan Dorr; McGlynn, Elizabeth A; Pearson, Steven D; Danis, Marion

    2013-02-01

    Having patients weigh costs when making medical decisions has been proposed as a way to rein in health care spending. We convened twenty-two focus groups of people with insurance to examine their willingness to discuss health care costs with clinicians and consider costs when deciding among nearly comparable clinical options. We identified the following four barriers to patients' taking cost into account: a preference for what they perceive as the best care, regardless of expense; inexperience with making trade-offs between health and money; a lack of interest in costs borne by insurers and society as a whole; and noncooperative behavior characteristic of a "commons dilemma," in which people act in their own self-interest although they recognize that by doing so, they are depleting limited resources. Surmounting these barriers will require new research in patient education, comprehensive efforts to shift public attitudes about health care costs, and training to prepare clinicians to discuss costs with their patients.

  14. Stigma, public awareness about intellectual disability and attitudes to inclusion among different ethnic groups.

    Science.gov (United States)

    Scior, K; Addai-Davis, J; Kenyon, M; Sheridan, J C

    2013-11-01

    Attitudes to the inclusion of people with intellectual disabilities (IDs) have been studied extensively, yet evidence on public awareness about ID and stigma is limited. The relationship between attitudes, knowledge and stigma associated with ID is poorly understood. The present study examined these factors and the relationships between them in the context of a multicultural society. UK residents of working age (n = 1002) were presented with a diagnostically unlabelled vignette of someone with a mild ID. They were asked to label the difficulties presented and to complete measures of social distance and attitudes to the inclusion of people with IDs. While attitudes to the inclusion of people with IDs were relatively positive overall, social contact was viewed with ambivalence. Inclusion attitudes and social distance were only moderately correlated. Across the whole sample 28% recognised typical symptoms of mild ID. Recognition of ID was associated with lower stigma and more positive attitudes than attribution of the difficulties presented to other causes. White Westerners showed increased knowledge, lower stigma and favoured inclusion more than participants from ethnic minorities. Among the latter group, Asians showed lower stigma and attitudes more in line with inclusion policies than participants of Black African/Caribbean backgrounds. Once a host of contextual factors were considered jointly, only contact was consistently associated with the variables measured. Stigma associated with ID is of concern across all ethnic groups, although it appears to be increased among the public from ethnic minorities. Given that contact and awareness are associated with reduced stigma, they should be considered as prime foci for efforts to tackle ID stigma. The current findings serve as baseline for attempts to increase public awareness and tackle stigma. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.

  15. Patient participation in general practice based undergraduate teaching: a focus group study of patient perspectives.

    Science.gov (United States)

    Park, Sophie E; Allfrey, Caroline; Jones, Melvyn M; Chana, Jasprit; Abbott, Ciara; Faircloth, Sofia; Higgins, Nicola; Abdullah, Laila

    2017-04-01

    Patients make a crucial contribution to undergraduate medical education. Although a national resource is available for patients participating in research, none is as yet available for education. This study aimed to explore what information patients would like about participation in general practice based undergraduate medical education, and how they would like to obtain this information. Two focus groups were conducted in London-based practices involved in both undergraduate and postgraduate teaching. Patients both with and without teaching experience were recruited using leaflets, posters, and patient participation groups. An open-ended topic guide explored three areas: perceived barriers that participants anticipated or had experienced; patient roles in medical education; and what help would support participation. Focus groups were audiorecorded, transcribed, and analysed thematically. Patients suggested ways of professionalising the teaching process. These were: making information available to patients about confidentiality, iterative consent, and normalising teaching in the practice. Patients highlighted the importance of relationships, making information available about their GPs' involvement in teaching, and initiating student-patient interactions. Participants emphasised educational principles to maximise exchange of information, including active participation of students, patient identification of student learner needs, and exchange of feedback. This study will inform development of patient information resources to support their participation in teaching and access to information both before and during general practice based teaching encounters. © British Journal of General Practice 2017.

  16. 78 FR 43209 - Narcolepsy Public Meeting on Patient-Focused Drug Development

    Science.gov (United States)

    2013-07-19

    ... HUMAN SERVICES Food and Drug Administration Narcolepsy Public Meeting on Patient-Focused Drug... public comment on Patient-Focused Drug Development for narcolepsy. Patient-Focused Drug Development is... narcolepsy on daily life as well as the available therapies for narcolepsy. DATES: The public meeting will...

  17. 78 FR 58313 - Fibromyalgia Public Meeting on Patient-Focused Drug Development

    Science.gov (United States)

    2013-09-23

    ... HUMAN SERVICES Food and Drug Administration Fibromyalgia Public Meeting on Patient-Focused Drug... public comment on Patient-Focused Drug Development for fibromyalgia. Patient-Focused Drug Development is... fibromyalgia on daily life as well as the available therapies for fibromyalgia. DATES: The public meeting...

  18. Alzheimer Europe's position on involving people with dementia in research through PPI (patient and public involvement)

    DEFF Research Database (Denmark)

    Gove, Dianne; Diaz-Ponce, Ana; Georges, Jean

    2017-01-01

    This paper reflects Alzheimer Europe's position on PPI (patient and public involvement) in the context of dementia research and highlights some of the challenges and potential risks and benefits associated with such meaningful involvement. The paper was drafted by Alzheimer Europe in collaboration...... with members of INTERDEM and the European Working Group of People with Dementia. It has been formally adopted by the Board of Alzheimer Europe and endorsed by the Board of INTERDEM and by the JPND working group 'Dementia Outcome Measures - Charting New Territory'. Alzheimer Europe is keen to promote...

  19. Does a research group increase impact on the scientific community or general public discussion? Alternative metric-based evaluation.

    Science.gov (United States)

    De Gregori, Manuela; Scotti, Valeria; De Silvestri, Annalisa; Curti, Moreno; Fanelli, Guido; Allegri, Massimo; Schatman, Michael E

    2016-01-01

    In this study, we investigated the impact of scientific publications of the Italian SIMPAR (Study In Multidisciplinary PAin Research) group by using altmetrics, defined as nontraditional metrics constituting an alternative to more traditional citation-impact metrics, such as impact factor and H-index. By correlating traditional and alternative metrics, we attempted to verify whether publications by the SIMPAR group collectively had more impact than those performed by its individual members, either in solo publications or in publications coauthored by non-SIMPAR group investigators (which for the purpose of this study we will refer to as "individual publications"). For all the 12 members of the group analyzed (pain therapists, biologists, and pharmacologists), we created Open Researcher and Contributor ID and Impact Story accounts, and synchronized these data. Manually, we calculated the level metrics for each article by dividing the data obtained from the research community by those obtained from the public community. We analyzed 759 articles, 18 of which were published by the SIMPAR group. Altmetrics demonstrated that SIMPAR group publications were more likely to be saved (77.8% vs 45.9%), discussed (61.1% vs 1.1%, Paltmetrics in estimating the value of the research products of a group.

  20. Expression of public idiotypes in patients with Lyme arthritis.

    Science.gov (United States)

    Axford, J S; Watts, R A; Long, A A; Isenberg, D A; Steere, A C

    1993-01-01

    OBJECTIVE: Joints are often affected in Lyme disease and in some instances this may be due to immune autoreactivity. To characterise further the immune response in this disease investigations were carried out to determine the expression of three public idiotypes on serum immunoglobulins in patients with Lyme disease during the development of varying degrees of arthritis. METHODS: The expression of idiotypes (Ids) 16/6, BEG2, and PR4, first identified on monoclonal antibodies to DNA, was determined by an enzyme linked immunosorbent assay (ELISA) in serial blood samples from 12 patients with Lyme disease over a mean period of six years during the development of a variety of arthritic symptoms, and in serum samples from healthy control subjects and control subjects with systemic lupus erythematosus. RESULTS: Expression of serum IgM or IgG public Ids 16/6 and BEG2 was significantly increased in patients with Lyme disease. IgA Id 16/6 expression, in contrast, was significantly increased only during episodes of arthritis and was also related to its severity. IgM and IgG Id 16/6 expression was related to their respective total immunoglobulin concentration and, in the case of IgM, to the level of IgM antibodies to Borrelia burgdorferi, whereas similar findings were not apparent with IgA antibodies. This may indicate that the IgA response is related to the pathogenesis of arthritis, especially as total IgA and IgA Id 16/6 levels were found to increase over the duration of disease. Sequential analysis of antibodies also showed restriction in the expression of Id 16/6 as it was never found on all immunoglobulin isotypes at the same time, and Id PR4 was never expressed. Ids 16/6 and BEG2 expression, however, may be associated as seven patients expressed these idiotypes simultaneously. CONCLUSIONS: These data indicate the use of public idiotypes in the immune response against B burgdorferi, which may be restricted in terms of idiotype class and isotype expression, and a

  1. 77 FR 72296 - Public Meeting of the U.S.-Canada Regulatory Cooperation Council (RCC) Motor Vehicles Working Group

    Science.gov (United States)

    2012-12-05

    ... Cooperation Council (RCC) Motor Vehicles Working Group AGENCY: National Highway Traffic Safety Administration... 30 and 31, 2012, the RCC and its bi-national working groups facilitated stakeholder meetings in Washington, DC. This notice announces a public meeting of the RCC Motor Vehicles Working Group. DATES:...

  2. Assisted vaginal deliveries in mothers admitted as public or private patients in Western Australia.

    Directory of Open Access Journals (Sweden)

    Kristjana Einarsdóttir

    Full Text Available BACKGROUND: Mothers delivering as private patients in Australia have a high rate of assisted deliveries, which could lead to adverse infant outcomes in this group of patients. We investigated whether the risk of adverse infant outcomes after assisted deliveries was different for mothers admitted as public or private patients for delivery, when compared with unassisted deliveries. METHODS AND FINDINGS: We included 158,241 vaginal, singleton, term birth admissions in our study where the infant was live born and without birth defects. The study population was identified from statutory birth and hospital data collections held by the Western Australian (WA Department of Health. We estimated odds ratios and confidence intervals using logistic regression models adjusted for a range of maternal demographic, pregnancy and birth characteristics. Interaction was assessed by including interaction terms in the models. Outcomes included low Apgar scores at five minutes (< 7, neonatal resuscitation and special care admission. Mothers delivering as private patients had an increased risk of assisted vaginal delivery compared with public patients (adjusted OR 1.74, 95% CI  =  1.68-1.80. Compared with unassisted vaginal deliveries, assisted deliveries were associated with increased risk of Apgar scores at five minutes below 7 (OR 1.25, 1.08-1.45, neonatal resuscitation (OR  =  1.69, 1.42-2.00 and admission to special care nursery (OR  =  1.64, 1.53-1.76. The increased risk of neonatal resuscitation was higher for mothers admitted as private patients for delivery (OR  =  2.13 than public patients (OR  = 1 .55, p(interaction  =  0.03. CONCLUSIONS: Our results suggested that the high risk of neonatal resuscitation following assisted vaginal deliveries compared to unassisted is higher in private patients than public patients. Whether this phenomenon is due to the twofold higher rate of assisted vaginal deliveries in this group of patients or a

  3. Generalisations of Hamilton's Rule Applied to Non-Additive Public Goods Games with Random Group Size

    Directory of Open Access Journals (Sweden)

    James A R Marshall

    2014-07-01

    Full Text Available Inclusive fitness theory has been described as being limited to certain special cases of social evolution. In particular some authors argue that the theory can only be applied to social interactions having additive fitness effects, and involving only pairs of individuals. This article takes an elegant formulation of non-additive public goods games from the literature, and shows how the two main generalisations of Hamilton's rule can be applied to such games when group sizes are random. In doing so inclusive fitness theory is thus applied to a very general class of social dilemmas, thereby providing further evidence for its generality. Interestingly, one of the two predominant versions of Hamilton's rule is found to be mathematically easier to apply to the scenario considered, despite both necessarily giving equivalent predictions.

  4. Characterization of a group unrelated patients with arthrogryposis multiplex congenita

    Directory of Open Access Journals (Sweden)

    Margarita Valdés-Flores

    2016-02-01

    Full Text Available ABSTRACT OBJECTIVE: Arthrogryposis multiplex congenita is a relatively rare neuromuscular syndrome, with a prevalence of 1:3000-5000 newborns. In this study, the authors describe the clinical features of a group of 50 unrelated Mexican patients with arthrogryposis multiplex congenita. METHODS: Patients were diagnosed by physical and radiographic examination and the family history was evaluated. RESULTS: Of the 50 cases, nine presented other features (pectum excavatum, cleft palate, mental retardation, ulnar agenesis, etc.. Environmental factors, as well as prenatal and family history, were analyzed. The chromosomal anomalies and clinical entities associated with arthrogryposis multiplex congenita were reported. No chromosomal aberrations were present in the cases with mental retardation. Three unrelated familial cases with arthrogryposis multiplex congenita were observed in which autosomal recessive, autosomal dominant and X-linked inheritance patterns are possible. A literature review regarding arthrogryposis multiplex congenita was also conducted. CONCLUSIONS: It is important to establish patient-specific physical therapy and rehabilitation programs. A multidisciplinary approach is necessary, with medical, surgical, rehabilitation, social and psychological care, including genetic counseling.

  5. INVESTIGATING THE PATIENT SATISFACTION WITHIN ROMANIAN PUBLIC AND PRIVATE HOSPITALS

    Directory of Open Access Journals (Sweden)

    Mihoc Florin

    2011-07-01

    Full Text Available Although it is not commonly accepted within healthcare services industry, the importance of marketing is more and more recognized nowadays by the organizations activating in the field. Current perception resides in a series of factors as: ethical aspects involved in the delivery process; special characteristics of the market; particular profile and behavior of the consumers of healthcare services and probably because of the inadequate understanding of the marketing role in the life of an organization. A deep analysis in the field of healthcare services will emphasize not only its complexity, but also its interdisciplinary feature under many aspects, as it is an area where many fields of interest are intersecting, both economic and social. It also reveals a particular field of study with many particular features - considered a sensitive field (Popa and Vladoi 2010: 232. Generated using the SERVQUAL model, the data presented in the paper are the result of a quantitative research designed to measure and compare the patient/client satisfaction degree for public and private medical services provided by the Romanian hospitals. The aim of the research is to identify and to measure the gap that appears between the patient/client’ expectations and perceptions regarding the delivered services; to identify the potential profile of the private Romanian hospitals’ clients regarding the demographic features and also to pin-point correlations between the image created in the mind of the Romanian patients/clients and the type of medical services (public or private they were using. We consider that the results of this research are valuable for the managers of the medical units in order to initiate series of actions aiming to improve the quality of their services and, as a result the patient/clients’ satisfaction degree. Later being one of the most important performance indicators of an organization that activates in a highly competitive business

  6. Raising awareness of carrier testing for hereditary haemoglobinopathies in high-risk ethnic groups in the Netherlands: a pilot study among the general public and primary care providers

    Directory of Open Access Journals (Sweden)

    Cornel Martina C

    2009-09-01

    Full Text Available Abstract Background In the Netherlands no formal recommendations exist concerning preconceptional or antenatal testing for carriership of hereditary haemoglobinopathies. Those at highest risk may be unaware of the possibility of carrier screening. While universal newborn screening has recently been introduced, neither preconceptional nor antenatal carrier testing is routinely offered by health care services to the general public. A municipal health service and a foundation for public information on medical genetics undertook a pilot project with the aim of increasing knowledge and encouraging informed choice. Two groups were targeted: members of the public from ethnic groups at increased risk, and primary health care providers. This study examines the effectiveness of culturally specific 'infotainment' to inform high-risk ethnic groups about their increased risk for haemoglobinopathies. In addition, the study explores attitudes and intentions of primary care providers towards haemoglobinopathy carrier testing of their patients from high-risk ethnic groups. Methods Informational sessions tailored to the public or professionals were organised in Amsterdam, and evaluated for their effect. Psychological parameters were measured using structured questionnaires based on the Theory of Planned Behaviour. Results The pre-test/post-test questionnaire showed that members of the public gained understanding of inheritance and carriership of haemoglobinopathies from the "infotainment" session (p Conclusion The "infotainment" programme may have a positive effect on people from high-risk groups, but informed general practitioners and midwives were reluctant to facilitate their patients' getting tested. Additional initiatives are needed to motivate primary care providers to facilitate haemoglobinopathy carrier testing for their patients from high-risk backgrounds.

  7. 77 FR 42313 - Recharter of the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health

    Science.gov (United States)

    2012-07-18

    ... Public Health AGENCY: Office of the Assistant Secretary for Health, Office of the Secretary, Department... Public Health. FOR FURTHER INFORMATION CONTACT: Corinne Graffunder, Designated Federal Officer (DFO) of... the President establish the Advisory Group on Prevention, Health Promotion, and Integrative and...

  8. 77 FR 7601 - Notice of Segregation of Public Lands for the Pattern Energy Group Ocotillo Express Wind Energy...

    Science.gov (United States)

    2012-02-13

    ... Bureau of Land Management Notice of Segregation of Public Lands for the Pattern Energy Group Ocotillo Express Wind Energy Project, Imperial County, CA AGENCY: Bureau of Land Management, Interior. ACTION... energy right-of-way (ROW) application for the Ocotillo Express Wind Project. The public land contained...

  9. Evaluation of Public E-Services and Information Technology Accessibility in Different Social Groups

    Directory of Open Access Journals (Sweden)

    Ramutė Naujikienė

    2012-12-01

    Full Text Available The purpose of this study is to develop an approach based on the social quality evaluation square model for evaluation of information technology usage in different social groups. Componential view to the accessibility of e-services including IT means providing the possibility to research the influences of different life conditions to usage of the public e-services. The task of this empirical study is directed towards revealing the differences of e-inclusion and e-services accessibility for social groups of citizens of Lithuania, and to compare this accessibility data with other EU countries.Design/methodology/approach—the approach is based on the square model of social quality evaluation of information technology usage in different social groups. The social division square model includes an assessment of quality according to the evaluation of socioeconomic security, social inclusion, social cohesion, and empowerment. Empowerment can be defined as consisting of individual or collective decisions to act on one’s own life.Findings—the results are demonstrated by the accessibility of public e-services data, which are evaluated by the quality of social group development according to IT applications. The hypothesis was confirmed that the e-government activities can be realized by properly selecting and installing technologies, and using technology facilities. E-services influence the capabilities of state officials to apply modern technology and increase the availability of e-services for social groups. Results consist of individual or collective decisions to act on one’s own life, to implementation of effective information technologies in the e-government activities and using of e-services. An important indicator is the implementation of e-services in the activity of citizens. It is submitted as the index of e-participation in dealing with the activities of citizens and the possibilities of authorities directly related with providing services

  10. Clustering of local group distances: Publication bias or correlated measurements? II. M31 and beyond

    Energy Technology Data Exchange (ETDEWEB)

    De Grijs, Richard [Kavli Institute for Astronomy and Astrophysics, Peking University, Yi He Yuan Lu 5, Hai Dian District, Beijing 100871 (China); Bono, Giuseppe [Dipartimento di Fisica, Università di Roma Tor Vergata, via Della Ricerca Scientifica 1, I-00133, Roma (Italy)

    2014-07-01

    The accuracy of extragalactic distance measurements ultimately depends on robust, high-precision determinations of the distances to the galaxies in the local volume. Following our detailed study addressing possible publication bias in the published distance determinations to the Large Magellanic Cloud (LMC), here we extend our distance range of interest to include published distance moduli to M31 and M33, as well as to a number of their well-known dwarf galaxy companions. We aim at reaching consensus on the best, most homogeneous, and internally most consistent set of Local Group distance moduli to adopt for future, more general use based on the largest set of distance determinations to individual Local Group galaxies available to date. Based on a careful, statistically weighted combination of the main stellar population tracers (Cepheids, RR Lyrae variables, and the magnitude of the tip of the red-giant branch), we derive a recommended distance modulus to M31 of (m−M){sub 0}{sup M31}=24.46±0.10 mag—adopting as our calibration an LMC distance modulus of (m−M){sub 0}{sup LMC}=18.50 mag—and a fully internally consistent set of benchmark distances to key galaxies in the local volume, enabling us to establish a robust and unbiased, near-field extragalactic distance ladder.

  11. Clustering of Local Group distances: publication bias or correlated measurements? II. M31 and beyond

    CERN Document Server

    de Grijs, Richard

    2014-01-01

    The accuracy of extragalactic distance measurements ultimately depends on robust, high-precision determinations of the distances to the galaxies in the local volume. Following our detailed study addressing possible publication bias in the published distance determinations to the Large Magellanic Cloud (LMC), here we extend our distance range of interest to include published distance moduli to M31 and M33, as well as to a number of their well-known dwarf galaxy companions. We aim at reaching consensus on the best, most homogeneous, and internally most consistent set of Local Group distance moduli to adopt for future, more general use based on the largest set of distance determinations to individual Local Group galaxies available to date. Based on a careful, statistically weighted combination of the main stellar population tracers (Cepheids, RR Lyrae variables, and the magnitude of the tip of the red-giant branch), we derive a recommended distance modulus to M31 of $(m-M)_0^{\\rm M31} = 24.46 \\pm 0.10$ mag---ado...

  12. Public acceptance for nuclear energy. Group unconsciousness and personnel self-consciousness

    Energy Technology Data Exchange (ETDEWEB)

    Seki, Yosinobu [Mitsubishi Materials Corp., Tokyo (Japan)

    1995-12-31

    Since commercial usage of nuclear energy, 40 years already has spent. During that time, public acceptance has been told as very important. The procedure itself was changed gradually. Recently, at same time understandable man and non understandable man for nuclear energy are called at the stage, and talked to audience from the stage. They expect the audience will easily understand the nuclear energy. But the problem may come in the selection of good coordinator. Mr. Jung used the word of group unconsciousness. This is some time good for a battle, a religion and a political affairs for a while. Nazis, blend in all over the world, Ohm religion, present cooperated government etc. Japanese people are easily to have group consciousness. To opposite to them a self-consciousness are very important, Human being may have two different feeling, one is very much emotional and another is very much reasonable. Emotional man have tendency to have separate knowledge points and be get his conclusion very much quickly. Reasonable man have tendency to have the stacked knowledge points and take a little bit more time to get his conclusion. To get better nuclear energy PA, it`s very important that self-consciousness excitedly attractive knowledge should be increased. Easy understandable knowledge and high technical knowledge should be mixed up and nuclear energy technique should be easily understood. (author)

  13. Patient satisfaction among Spanish-speaking patients in a public health setting.

    Science.gov (United States)

    Welty, Elisabeth; Yeager, Valerie A; Ouimet, Claude; Menachemi, Nir

    2012-01-01

    Despite the growing literature on health care quality, few patient satisfaction studies have focused upon the public health setting; where many Hispanic patients receive care. The purpose of this study was to examine the differences in satisfaction between English and Spanish-speaking patients in a local health department clinical setting. We conducted a paper-based satisfaction survey of patients that visited any of the seven Jefferson County Department of Health primary care centers from March 19 to April 19, 2008. Using Chi-squared analyses we found 25% of the Spanish-speaking patients reported regularly having problems getting an appointment compared to 16.8% among English-speakers (p < .001). Results of logistic regression analyses indicated that, despite the availability of interpreters at all JCDH primary care centers, differences in satisfaction existed between Spanish and English speaking patients controlling for center location, purpose of visit, and time spent waiting. Specifically, Spanish speaking patients were more likely to report problems getting an appointment and less likely to report having their medical problems resolved when leaving their visit as compared to those who spoke English. Findings presented herein may provide insight regarding the quality of care received, specifically regarding patient satisfaction in the public health setting. © 2011 National Association for Healthcare Quality.

  14. Evaluation of the Patients, Doctors and Nurses View Points about Patient Bill of Rights in Rasht Public Hospitals

    Directory of Open Access Journals (Sweden)

    Zahra Bostani Khalesi

    2012-09-01

    Full Text Available Background & Objective: With the aim to clarify the rights of the patients on the basis of medical ethic norms, Patient Bill of Rights in five categories was developed in Iran for the first time, during 2002. The main objective of this study was to determine the views of patients, physicians and nurses about this aspect of medical ethics and its necessary to comply in Rasht public hospitals. Materials &Methods: In this cross-sectional study the data were collected by filling a reliable and validated questionnaire consisting of demographic part and 25 specific questions about the rights of patients, these questions were answered By 185 patients, 22 nurses and 14 doctors. Each of the criteria necessary to use was measured by the Likert scale from zero (completely disagree to five (fully agree. SPSS software 16 and one way ANOVA tests were used for data analysis. Result: The results showed that all groups were agreeing with the necessity to have a bill and consider the patient's rights during treatment (P<0.05. But the most controversial point were related to the rights of patient to have access to their information and the right to choose and decide (P<0.05. However, 68.2 percent of physicians, 80.05 percent of nurses, and 93 percent of patients were agreed with the Bill of Rights. Conclusion: Although all the groups were agreed with the patient's Bill of rights (P<0.05, It seems it is necessary to reconsider the issue of providing the necessary information to the patient and give attention to their choices and decisions by the medical health service providers.

  15. Cancer-related false knowledge in relatives of cancer patients and the general public.

    Science.gov (United States)

    Turhal, N S; Dane, F; Ulus, C; Sari, S; Senturk, N; Bingol, D

    2010-01-01

    Although there are many myths about cancer in Turkey, there is no study evaluating Turkish public's knowledge about cancer. The goals of our research were to: 1) measure the extent of knowledge of cancer among the Turkish public; 2) determine the differences in extent of cancer-related knowledge between participants who have relatives with cancer and those who do not; and 3) determine the sources of knowledge possessed. Data were obtained from a total of 415 participants (244 female, 171 male), all of them sitting at the Marmara University Faculty of Medicine Hospital (MUFMH) outpatient clinic waiting area for non-cancer-related reasons. Each participant completed a 3-part questionnaire. Appropriate statistical tests were used for comparison. The mean age was 41 years. Of 415 participants, 65.3% stated that they had one or more cancer patient in their immediate family; 70.1% of the participants had a high-school education or greater. The questionnaire showed that, depending on the question, anywhere from 1.7% to 88.5% of the general public possesses some false information; furthermore, the difference in accuracy between relatives of cancer patients and non-relatives was marginal. Only 3 specific questions, related to the following ideas, rendered answers that were statistically significantly different between these 2 groups: breast cancer is only seen in females (p cancer (p cancer is always very painful (p knowledge about cancer was unacceptably high in our cohort. Broader efforts should be made to inform the Turkish public about cancer.

  16. -SH groups and glutathione in cancer patient's blood.

    Science.gov (United States)

    della Rovere, F; Granata, A; Saija, A; Broccio, M; Tomaino, A; Zirilli, A; De Caridi, G; Broccio, G

    2000-01-01

    As reported in previous investigations, erythrocytes are the elements of peripheral blood most affected by free radical activity in the pathogenesis of cancer. In these studies, the level of sulphydrilic groups and reduced glutathione were assayed in the erythrocytes and plasma, while their successful scavenger activity against cell membrane oxidation and peroxidation has already been established. In subjects with cancer, the levels of -SH groups (p < 0.002) and reduced glutathione in both plasma and erythrocytes (p < 0.0001) were shown be a statistically significantly decreased compared to healthy controls. These differences were related to the defence of the hematic tissue against free radical activity. A similar pattern has also been reported when studying vitamin A and E content in the peripheral blood of cancer patients. The role of oxido-reduction phenomena in this disease is discussed, as well as the importance of reducing the oxido-peroxidation involvement of tissues and cell elements. The study of the GSH/GSSG ratio in order to determine the stage of the disease would be useful and might represent a systemic marker for cancerous lesions.

  17. An Intercollegiate Competitive Public Speaking Program: Establishing a Forensic Group to Foster Training in Speech.

    Science.gov (United States)

    Holloway, Hal

    1982-01-01

    Describes a small but successful intercollegiate competitive public speaking program. Success was related to formation of good student-teacher relationships, a productive organizational psycho-environment, and careful teaching of public speaking fundamentals. (Author/RC)

  18. An Intercollegiate Competitive Public Speaking Program: Establishing a Forensic Group to Foster Training in Speech.

    Science.gov (United States)

    Holloway, Hal

    1982-01-01

    Describes a small but successful intercollegiate competitive public speaking program. Success was related to formation of good student-teacher relationships, a productive organizational psycho-environment, and careful teaching of public speaking fundamentals. (Author/RC)

  19. Implementation and scientific evaluation of rehabilitative sports groups for prostate cancer patients: study protocol of the ProRehab Study.

    Science.gov (United States)

    Zopf, Eva M; Braun, Moritz; Machtens, Stefan; Zumbé, Jürgen; Bloch, Wilhelm; Baumann, Freerk T

    2012-07-24

    Although treatment regimen have improved in the last few years, prostate cancer patients following a radical prostatectomy still experience severe disease- and treatment-related side effects, including urinary incontinence, erectile dysfunction and psychological issues. Despite high incidence rates and the common adverse effects there is a lack of supportive measures for male patients and specific physical exercise recommendations for prostate cancer patients during rehabilitation or in the aftercare are still missing. The ProRehab Project aims to establish rehabilitative sports groups particularly for prostate cancer patients and to evaluate the effects of the offered exercise program. Starting 8-12 weeks after prostatectomy or combination therapy, prostate cancer patients will exercise for 15 months within a patient preference randomized controlled trial. One exercise session will be conducted within a pre-established rehabilitative sports group, while the other will be completed independently. Patients in the control group will not participate in the intervention. The main outcomes of the study include aerobic fitness, quality of life, incontinence and erectile dysfunction. By combining science, practice, and public relations the first rehabilitative sports groups for prostate cancer patients in Germany have been set up and thus contribute to the care structure for prostate cancer patients. By offering a 15-month physical exercise intervention that is conducted in supervised group sessions, long-term lifestyle changes and therefore improvements in quality of life in prostate cancer patients can be expected. German Clinical Trials Register DRKS00004184.

  20. Reducing Student Apprehension of Public Speaking: Evaluating Effectiveness of Group Tutoring Practices

    Science.gov (United States)

    Knight, Misty L.; Johnson, Karen Gabrielle; Stewart, Frances

    2016-01-01

    Research indicates that the fear of public speaking is an extraordinarily common phobia and that a significant portion of the population experiences some form of anxiety over public speaking. Although there is a great deal of research available on the etiology of public speaking anxiety, there is far less research available on interventional…

  1. Reducing Student Apprehension of Public Speaking: Evaluating Effectiveness of Group Tutoring Practices

    Science.gov (United States)

    Knight, Misty L.; Johnson, Karen Gabrielle; Stewart, Frances

    2016-01-01

    Research indicates that the fear of public speaking is an extraordinarily common phobia and that a significant portion of the population experiences some form of anxiety over public speaking. Although there is a great deal of research available on the etiology of public speaking anxiety, there is far less research available on interventional…

  2. Sensitivity for Diagnosing Group A Streptococcal Pharyngitis from Manufacturers is 10% Higher than Reported in Peer-Reviewed Publications.

    Science.gov (United States)

    Vachhani, Raj; Patel, Toral; Centor, Robert M; Estrada, Carlos A

    2017-01-01

    Meta-analyses based on peer-reviewed publications report a sensitivity of approximately 85% for rapid antigen streptococcus tests to diagnose group A streptococcal (GAS) pharyngitis. Because these meta-analyses excluded package inserts, we examined the test characteristics of rapid antigen streptococcal tests and molecular methods that manufacturers report in their package inserts. We included tests available in the US market (Food and Drug Administration, period searched 1993-2015) and used package insert data to calculate pooled sensitivity and specificity. To examine quality, we used the Quality Assessment of Diagnostic Accuracy Studies-2. We excluded 26 tests having different trade names but identical methods and data. The study design was prospective in 41.7% (10 of 24). The pooled sensitivity of the most commonly used method, lateral flow/immunochromatographic, was 95% (95% confidence interval [CI] 94-96) and the pooled specificity was 98% (96-98); 7108 patients. The pooled sensitivity of the polymerase chain reaction or molecular methods was 98% (95% CI 96-98) and the pooled specificity was 96% (95% CI 95-97); 5685 patients. Package inserts include sponsored studies that overestimate the sensitivity of rapid tests to diagnose GAS pharyngitis by approximately 10%. Physicians should understand that package inserts overestimate diagnostic test utility; a negative test cannot be used to exclude GAS pharyngitis.

  3. Acceptance and Commitment Therapy Group Treatment for Symptoms of Borderline Personality Disorder: A Public Sector Pilot Study

    Science.gov (United States)

    Morton, Jane; Snowdon, Sharon; Gopold, Michelle; Guymer, Elise

    2012-01-01

    A pilot study of a brief group-based Acceptance and Commitment Therapy (ACT) intervention (12 two-hour sessions) was conducted with clients of public mental health services meeting four or more criteria for borderline personality disorder (BPD). Participants were randomly assigned to receive the ACT group intervention in addition to their current…

  4. Acceptance and Commitment Therapy Group Treatment for Symptoms of Borderline Personality Disorder: A Public Sector Pilot Study

    Science.gov (United States)

    Morton, Jane; Snowdon, Sharon; Gopold, Michelle; Guymer, Elise

    2012-01-01

    A pilot study of a brief group-based Acceptance and Commitment Therapy (ACT) intervention (12 two-hour sessions) was conducted with clients of public mental health services meeting four or more criteria for borderline personality disorder (BPD). Participants were randomly assigned to receive the ACT group intervention in addition to their current…

  5. Communication barriers in counselling foreign-language patients in public pharmacies: threats to patient safety?

    Science.gov (United States)

    Schwappach, David L B; Meyer Massetti, Carla; Gehring, Katrin

    2012-10-01

    Foreign-language (FL) patients are at increased risk for adverse drug events. Evidence regarding communication barriers and the safety of pharmaceutical care of FL patients in European countries is scarce despite large migrant populations. To investigate Swiss public pharmacists' experiences and current practices in counselling FL patients with a focus on patient safety. In a cross-sectional study heads of public pharmacies in Switzerland were surveyed using an electronic questionnaire. The survey assessed the frequency of communication barriers encountered in medication counselling of FL patients, perceptions of risks for adverse drug events, satisfaction with the quality of counselling provided to FL patients, current strategies to reduce risks, and preferences towards tools to improve safety for FL patients. 498 pharmacists completed the survey (43 % response rate). More than every second pharmacist reported at least weekly encounters at which they cannot provide good medication counselling to FL patients in the regional Swiss language. Ad-hoc interpreting by minors is also common at a considerable number of pharmacies (26.5 % reported at least one weekly occurrence). Approximately 10 % of pharmacies reported that they fail at least weekly to explain the essentials of drug therapy (e.g. dosing of children's medications) to FL patients. 79.8 % perceived the risk of FL patients for adverse drug events to be somewhat or much higher compared to other patients. 22.5 % of pharmacists reported being concerned at least monthly about medication safety when FL patients leave their pharmacy. However, the majority of pharmacists were satisfied with the quality of care provided to FL patients in their pharmacy [78.6 % (very) satisfied]. The main strategy used to improve counselling for FL patients was the employment of multilingual staff. Participants would use software for printing foreign-language labels (41.2 %) and multilingual package inserts (42.0 %) if these were

  6. How do scientists perceive the current publication culture? A qualitative focus group interview study among Dutch biomedical researchers.

    Science.gov (United States)

    Tijdink, J K; Schipper, K; Bouter, L M; Maclaine Pont, P; de Jonge, J; Smulders, Y M

    2016-02-17

    To investigate the biomedical scientist's perception of the prevailing publication culture. Qualitative focus group interview study. Four university medical centres in the Netherlands. Three randomly selected groups of biomedical scientists (PhD, postdoctoral staff members and full professors). Main themes for discussion were selected by participants. Frequently perceived detrimental effects of contemporary publication culture were the strong focus on citation measures (like the Journal Impact Factor and the H-index), gift and ghost authorships and the order of authors, the peer review process, competition, the funding system and publication bias. These themes were generally associated with detrimental and undesirable effects on publication practices and on the validity of reported results. Furthermore, senior scientists tended to display a more cynical perception of the publication culture than their junior colleagues. However, even among the PhD students and the postdoctoral fellows, the sentiment was quite negative. Positive perceptions of specific features of contemporary scientific and publication culture were rare. Our findings suggest that the current publication culture leads to negative sentiments, counterproductive stress levels and, most importantly, to questionable research practices among junior and senior biomedical scientists. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  7. Disinvestment policy and the public funding of assisted reproductive technologies: outcomes of deliberative engagements with three key stakeholder groups.

    Science.gov (United States)

    Hodgetts, Katherine; Hiller, Janet E; Street, Jackie M; Carter, Drew; Braunack-Mayer, Annette J; Watt, Amber M; Moss, John R; Elshaug, Adam G

    2014-05-05

    Measures to improve the quality and sustainability of healthcare practice and provision have become a policy concern. In addition, the involvement of stakeholders in health policy decision-making has been advocated, as complex questions arise around the structure of funding arrangements in a context of limited resources. Using a case study of assisted reproductive technologies (ART), deliberative engagements with a range of stakeholder groups were held on the topic of how best to structure the distribution of Australian public funding in this domain. Deliberative engagements were carried out with groups of ART consumers, clinicians and community members. The forums were informed by a systematic review of ART treatment safety and effectiveness (focusing, in particular, on maternal age and number of treatment cycles), as well as by international policy comparisons, and ethical and cost analyses. Forum discussions were transcribed and subject to thematic analysis. Each forum demonstrated stakeholders' capacity to understand concepts of choice under resource scarcity and disinvestment, and to countenance options for ART funding not always aligned with their interests. Deliberations in each engagement identified concerns around 'equity' and 'patient responsibility', culminating in a broad preference for (potential) ART subsidy restrictions to be based upon individual factors rather than maternal age or number of treatment cycles. Community participants were open to restrictions based upon measures of body mass index (BMI) and smoking status, while consumers and clinicians saw support to improve these factors as part of an ART treatment program, as distinct from a funding criterion. All groups advocated continued patient co-payments, with measures in place to provide treatment access to those unable to pay (namely, equity of access). Deliberations yielded qualitative, socially-negotiated evidence required to inform ethical, accountable policy decisions in the specific

  8. How patients think about social responsibility of public hospitals in China?

    Science.gov (United States)

    Liu, Wenbin; Shi, Lizheng; Pong, Raymond W; Chen, Yingyao

    2016-08-11

    Hospital social responsibility is receiving increasing attention, especially in China where major changes to the healthcare system have taken place. This study examines how patients viewed hospital social responsibility in China and explore the factors that influenced patients' perception of hospital social responsibility. A cross-sectional survey was conducted, using a structured questionnaire, on a sample of 5385 patients from 48 public hospitals in three regions of China: Shanghai, Hainan, and Shaanxi. A multilevel regression model was employed to examine factors influencing patients' assessments of hospital social responsibility. Intra-class correlation coefficients (ICCs) were calculated to estimate the proportion of variance in the dependent variables determined at the hospital level. The scores for service quality, appropriateness, accessibility and professional ethics were positively associated with patients' assessments of hospital social responsibility. Older outpatients tended to give lower assessments, while inpatients in larger hospitals scored higher. After adjusted for the independent variables, the ICC rose from 0.182 to 0.313 for inpatients and from 0.162 to 0.263 for outpatients. The variance at the patient level was reduced by 51.5 and 48.6 %, respectively, for inpatients and outpatients. And the variance at the hospital level was reduced by 16.7 % for both groups. Some hospital and patient characteristics and their perceptions of service quality, appropriateness, accessibility and professional ethics were associated with their assessments of public hospital social responsibility. The differences were mainly determined at the patient level. More attention to law-abiding behaviors, cost-effective health services, and charitable works could improve perceptions of hospitals' adherence to social responsibility.

  9. 78 FR 33851 - Lung Cancer Patient-Focused Drug Development; Public Meeting

    Science.gov (United States)

    2013-06-05

    ... No. FDA-2013-N-0596] Lung Cancer Patient-Focused Drug Development; Public Meeting AGENCY: Food and... Patient-Focused Drug Development for lung cancer. Patient-Focused Drug Development is part of FDA's... cancer on daily life as well as the available therapies for lung cancer. DATES: The public meeting...

  10. Does a research group increase impact on the scientific community or general public discussion? Alternative metric-based evaluation

    Directory of Open Access Journals (Sweden)

    De Gregori M

    2016-06-01

    Full Text Available Manuela De Gregori,1-3,* Valeria Scotti,4,* Annalisa De Silvestri,4 Moreno Curti,4 Guido Fanelli,2,5,6 Massimo Allegri,2,5,6 Michael E Schatman,2,7 1Pain Therapy Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; 2Study In Multidisciplinary PAin Research Group, Parma, Italy; 3Young Against Pain Group, Parma, Italy; 4Center for Scientific Documentation and Biometry Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; 5Anesthesia, Critical Care, and Pain Medicine, Department of Surgical Sciences, University of Parma, Italy; 6Anesthesia, Intensive Care and Pain Therapy Service, Azienda Ospedaliero, Universitaria di Parma, Parma, Italy; 7US Pain Foundation, Bellevue, WA, USA *These authors contributed equally to this work. Abstract: In this study, we investigated the impact of scientific publications of the Italian SIMPAR (Study In Multidisciplinary PAin Research group by using altmetrics, defined as nontraditional metrics constituting an alternative to more traditional citation-impact metrics, such as impact factor and H-index. By correlating traditional and alternative metrics, we attempted to verify whether publications by the SIMPAR group collectively had more impact than those performed by its individual members, either in solo publications or in publications coauthored by non-SIMPAR group investigators (which for the purpose of this study we will refer to as “individual publications”. For all the 12 members of the group analyzed (pain therapists, biologists, and pharmacologists, we created Open Researcher and Contributor ID and Impact Story accounts, and synchronized these data. Manually, we calculated the level metrics for each article by dividing the data obtained from the research community by those obtained from the public community. We analyzed 759 articles, 18 of which were published by the SIMPAR group. Altmetrics demonstrated that SIMPAR group publications were more likely to be saved (77.8% vs 45.9%, discussed

  11. Reinforce the radiation protection of the health personnel, patients and public; Renforcer la protection contre les rayonnements ionisants. Des professionnels de sante, des patients et du public

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2003-03-01

    One of the missions of the IRSN is the public radiation protection. In this context and in order to inform the public, this press document presents the actions of the IRSN in the occupational safety, the patients and the public, with a special interest to the Chernobyl accident consequences in France. The prevention policy against the radon, implemented by the Institute is also presented. (A.L.B.)

  12. [Home based and group based exercise programs in patients with ankylosing spondylitis: systematic review].

    Science.gov (United States)

    Lopes, S; Costa, S; Mesquita, C; Duarte, J

    2016-01-01

    Ankylosing Spondylitis (AS) is a chronic inflammatory rheumatic disease characterized by inflammation of the joints of the spine and sacroiliac and to a lesser percentage of the peripheral joints. It is a debilitating condition which reduces quality of life in patients with AS. The practice of physical therapy is recommended as non-pharmacological treatment as well as the treatment and prevention of associated deformities. To collect and summarize the available evidence in scientific databases to realize the effectiveness of home based and group based programs in patients with AS. Systematic review, where articles for the study were collected from scientific database PubMed. We have found 65 articles with publication date between January 1, 2004 and January 31, 2014. Inclusion and exclusion criteria were established to make the selection of articles to include in the study. All investigators provided their agreement in presencial meeting for a final selection, and at a later stage, the articles were read in full by the three investigators. The present systematic review includes eight randomized controlled trials. All articles show functional benefits in patients with AS subject to exercise programs in group based and / or home based. From the eight articles, 4 addressed programs conducted in home based context and 4 addressed in group based context programs. There appears to be evidence that the programs carried out based on group are more effective than those home based conducted in patients with AS. It was concluded also be advantageous to carry out home based exercise programs than the absence of any exercise program..

  13. Home based and group based exercise programs in patients with ankylosing spondylitis: systematic review

    Directory of Open Access Journals (Sweden)

    Sofia Lopes

    2016-04-01

    Full Text Available Introduction: Ankylosing Spondylitis (AS is a chronic inflammatory rheumatic disease characterized by inflammation of the joints of the spine and sacroiliac and to a lesser percentage of the peripheral joints. It is a debilitating condition which reduces quality of life in patients with AS. The practice of physical therapy is recommended as non-pharmacological treatment as well as the treatment and prevention of associated deformities. Objective: To collect and summarize the available evidence in scientific databases to realize the effectiveness of home based and group based programs in patients with AS. Methods: Systematic review, where articles for the study were collected from scientific database PubMed. We have found 65 articles with publication date between January 1, 2004 and January 31, 2014. Inclusion and exclusion criteria were established to make the selection of articles to include in the study. All investigators provided their agreement in presencial meeting for a final selection, and at a later stage, the articles were read in full by the three investigators. Results: The present systematic review includes eight randomized controlled trials. All articles show functional benefits in patients with AS subject to exercise programs in group based and / or home based. From the eight articles, 4 addressed programs conducted in home based context and 4 addressed in group based context programs. Conclusion: There appears to be evidence that the programs carried out based on group are more effective than those home based conducted in patients with AS. It was concluded also be advantageous to carry out home based exercise programs than the absence of any exercise program.

  14. Consent for use of clinical leftover biosample: a survey among Chinese patients and the general public.

    Science.gov (United States)

    Ma, Yi; Dai, HuiLi; Wang, LiMin; Zhu, LiJun; Zou, HanBing; Kong, XianMing

    2012-01-01

    Storage of leftover biosamples generates rich biobanks for future studies, saving time and money and limiting physical impact to sample donors. To investigate the attitudes of Chinese patients and the general public on providing consent for storage and use of leftover biosamples. Cross-sectional surveys were conducted among randomly selected patients admitted to a Shanghai city hospital (n = 648) and members of the general public (n = 492) from May 2010 to July 2010. Face-to-face interviews collected respondents-report of their willingness to donate residual biosample, trust in medical institutions, motivation for donation, concerns of donated sample use, expectations for research results return, and so on. The response rate was 83.0%. Of the respondents, 89.1% stated that they completely understood or understood most of questions. Willingness to donate residual sample was stated by 64.7%, of which 16.7% desired the option to withdraw their donations anytime afterwards. Only 42.3% of respondents stated they "trust" or "strongly trust" medical institutions, the attitude of trusting or strongly trusting medical institutions were significantly associated with willingness to donate in the general public group.(p<0.05) The overall assent rate for future research without specific consents was also low (12.1%). Hepatitis B virus carriers were significantly less willing than non-carriers to donate biosamples (32.1% vs. 64.7%, p<0.001). Low levels of public trust in medical institutions become serious obstacle for biosample donation and biobanking in China. Efforts to increase public understanding of human medical research and biosample usage and trust in the ethical purposes of biobanking are urgently needed. These efforts will be greatly advanced by the impending legislation on biobanking procedures and intent, and our results may help guide the structure of such law.

  15. Consent for use of clinical leftover biosample: a survey among Chinese patients and the general public.

    Directory of Open Access Journals (Sweden)

    Yi Ma

    Full Text Available BACKGROUND: Storage of leftover biosamples generates rich biobanks for future studies, saving time and money and limiting physical impact to sample donors. OBJECTIVE: To investigate the attitudes of Chinese patients and the general public on providing consent for storage and use of leftover biosamples. DESIGN, SETTING AND PARTICIPANTS: Cross-sectional surveys were conducted among randomly selected patients admitted to a Shanghai city hospital (n = 648 and members of the general public (n = 492 from May 2010 to July 2010. MAIN OUTCOME MEASURES: Face-to-face interviews collected respondents-report of their willingness to donate residual biosample, trust in medical institutions, motivation for donation, concerns of donated sample use, expectations for research results return, and so on. RESULTS: The response rate was 83.0%. Of the respondents, 89.1% stated that they completely understood or understood most of questions. Willingness to donate residual sample was stated by 64.7%, of which 16.7% desired the option to withdraw their donations anytime afterwards. Only 42.3% of respondents stated they "trust" or "strongly trust" medical institutions, the attitude of trusting or strongly trusting medical institutions were significantly associated with willingness to donate in the general public group.(p<0.05 The overall assent rate for future research without specific consents was also low (12.1%. Hepatitis B virus carriers were significantly less willing than non-carriers to donate biosamples (32.1% vs. 64.7%, p<0.001. CONCLUSIONS: Low levels of public trust in medical institutions become serious obstacle for biosample donation and biobanking in China. Efforts to increase public understanding of human medical research and biosample usage and trust in the ethical purposes of biobanking are urgently needed. These efforts will be greatly advanced by the impending legislation on biobanking procedures and intent, and our results may help guide the structure

  16. Ancestral kinship patterns substantially reduce the negative effect of increasing group size on incentives for public goods provision

    OpenAIRE

    Hannes Rusch

    2015-01-01

    Phenomena like meat sharing in hunter-gatherers, self-sacrifice in intergroup conflicts, and voluntary contribution to public goods provision in laboratory experiments have led to the development of numerous theories on the evolution of altruistic in-group beneficial behavior in humans. Many of these theories abstract away from the effects of kinship on the incentives for public goods provision, though. Here, it is investigated analytically how genetic relatedness changes the incentive struct...

  17. An industry perspective on Canadian patients' involvement in medical tourism: implications for public health.

    Science.gov (United States)

    Johnston, Rory; Crooks, Valorie A; Adams, Krystyna; Snyder, Jeremy; Kingsbury, Paul

    2011-05-31

    The medical tourism industry, which assists patients with accessing non-emergency medical care abroad, has grown rapidly in recent years. A lack of reliable data about medical tourism makes it difficult to create policy, health system, and public health responses to address the associated risks and shortcomings, such as spread of infectious diseases, associated with this industry. This article addresses this knowledge gap by analyzing interviews conducted with Canadian medical tourism facilitators in order to understand Canadian patients' involvement in medical tourism and the implications of this involvement for public health. Semi-structured phone interviews were conducted with 12 medical facilitators from 10 companies in 2010. An exhaustive recruitment strategy was used to identify interviewees. Questions focused on business dimensions, information exchange, medical tourists' decision-making, and facilitators' roles in medical tourism. Thematic analysis was undertaken following data collection. Facilitators helped their Canadian clients travel to 11 different countries. Estimates of the number of clients sent abroad annually varied due to demand factors. Facilitators commonly worked with medical tourists aged between 40 and 60 from a variety of socio-economic backgrounds who faced a number of potential barriers including affordability, fear of the unfamiliar, and lack of confidence. Medical tourists who chose not to use facilitators' services were thought to be interested in saving money or have cultural/familial connections to the destination country. Canadian doctors were commonly identified as barriers to securing clients. No effective Canadian public health response to medical tourism can treat medical tourists as a unified group with similar motivations for engaging in medical tourism and choosing similar mechanisms for doing so. This situation may be echoed in other countries with patients seeking care abroad. Therefore, a call for a comprehensive public

  18. An industry perspective on Canadian patients' involvement in Medical Tourism: implications for public health

    Directory of Open Access Journals (Sweden)

    Snyder Jeremy

    2011-05-01

    Full Text Available Abstract Background The medical tourism industry, which assists patients with accessing non-emergency medical care abroad, has grown rapidly in recent years. A lack of reliable data about medical tourism makes it difficult to create policy, health system, and public health responses to address the associated risks and shortcomings, such as spread of infectious diseases, associated with this industry. This article addresses this knowledge gap by analyzing interviews conducted with Canadian medical tourism facilitators in order to understand Canadian patients' involvement in medical tourism and the implications of this involvement for public health. Methods Semi-structured phone interviews were conducted with 12 medical facilitators from 10 companies in 2010. An exhaustive recruitment strategy was used to identify interviewees. Questions focused on business dimensions, information exchange, medical tourists' decision-making, and facilitators' roles in medical tourism. Thematic analysis was undertaken following data collection. Results Facilitators helped their Canadian clients travel to 11 different countries. Estimates of the number of clients sent abroad annually varied due to demand factors. Facilitators commonly worked with medical tourists aged between 40 and 60 from a variety of socio-economic backgrounds who faced a number of potential barriers including affordability, fear of the unfamiliar, and lack of confidence. Medical tourists who chose not to use facilitators' services were thought to be interested in saving money or have cultural/familial connections to the destination country. Canadian doctors were commonly identified as barriers to securing clients. Conclusions No effective Canadian public health response to medical tourism can treat medical tourists as a unified group with similar motivations for engaging in medical tourism and choosing similar mechanisms for doing so. This situation may be echoed in other countries with patients

  19. Determinants of successful methadone maintenance treatments in two groups of patients: a first study

    Directory of Open Access Journals (Sweden)

    Emanuela Colasante

    2012-06-01

    Full Text Available

    Background: drug abuse is a social and public health problem, with high costs to society. It is, therefore, important to develop effective treatments for this problem, and evaluate these by identifying determinants of successful outcomes in order to plan more efficient public health interventions.The methadone maintenance treatment (MMT, at an appropriate dosage, is recognized as the most effective therapy for opiate addiction, but it is very important to consider the motivation and stage of change of patients for reaching treatment success. These must also be considered when investigating the determinants of MMT success. The aim of this study is to identify the determinants of successful MMT given to “heroin-addicts" attending the drug addiction Services of the Local Health unit of the Italian autonomous Province of Trento in two groups of patients, as outlined below.

    Methods: a retrospective cohort study was conducted. 393 heroin addicted patients, admitted for the first time to a MMT program in the drug addiction Services of Trento Local Health unit between the years 2000-2008, were considered. Patients were divided into 2 groups on the basis of the objective of treatment suggested by the clinical team and negotiated with the patient: group a labelled high evolution, group B low evolution.High evolution corresponds to a clinical situation in which, by opinion of the operators, the patient has the ability to pursue goals of change. In these cases, the methadone treatment is aimed at reaching a drug free condition and the goal/outcome is opioid abstinence (negative urine results in 90%-100%. Low evolution is characterized by little or no compliance to the assessment and/or therapeutic proposal aimed at achieving change. In these cases, the methadone treatment is aimed at achieving two or more of the following objectives: retention in treatment regimens, improvement of health and/or psychological

  20. Daytime sleepiness and sleep habits as risk factors of traffic accidents in a group of Turkish public transport drivers

    Science.gov (United States)

    Özer, Cahit; Etcibaşı, Şeref; Öztürk, Levent

    2014-01-01

    Aim: To explore the association of daytime sleepiness, sleep complaints and sleep habits with self-reported car crashes among public transport drivers. Methods: A cross-sectional descriptive study was carried out on male professional public drivers in two different cities using a validated, self-administered sleep questionnaire which comprised of symptoms suggesting sleep disorders, a subjective report of daytime sleepiness and driving characteristics. The subjects (mean age±SD, 40±11 years) were divided into two groups: (1) accident group and (2) no accident group. Results: Forty nine (15.3%) of the 320 public drivers reported that they had at least one sleepiness related motor vehicle accident and/or near-missed accident (Group 1). The mean age, body mass index and annual distance driven were similar in both groups. Although Group 1 reported less sleep time per night, more witnessed apneas, abnormal sleep, alcohol use and had higher mean Epworth Sleepiness Scale scores than Group 2, multivariate analysis of risk factors revealed that only daytime sleepiness increase the risk of traffic accidents [OR: 1.32 (1.19-1.47)]. Conclusion: These results suggest that self-reported sleepiness is a predictive sign of traffic accidents due to driver sleepiness. PMID:24482715

  1. Patients with schizophrenia do not preserve automatic grouping when mentally re-grouping figures: shedding light on an ignored difficulty

    Directory of Open Access Journals (Sweden)

    Anne eGiersch

    2012-08-01

    Full Text Available Looking at a pair of objects is easy when automatic grouping mechanisms bind these objects together, but visual exploration can also be more flexible. It is possible to mentally ‘re-group’ two objects that are not only separate but belong to different pairs of objects. ‘Re-grouping’ is in conflict with automatic grouping, since it entails a separation of each item from the set it belongs to. This ability appears to be impaired in patients with schizophrenia. Here we check if this impairment is selective, which would suggest a dissociation between grouping and ‘re-grouping’, or if it impacts on usual, automatic grouping, which would call for a better understanding of the interactions between automatic grouping and ‘re-grouping’. Sixteen outpatients with schizophrenia and healthy controls had to identify two identical and contiguous target figures within a display of circles and squares alternating around a fixation point. Eye-tracking was used to check central fixation. The target pair could be located in the same or separate hemifields. Identical figures were grouped by a connector (grouped automatically or not (to be re-grouped. Attention modulation of automatic grouping was tested by manipulating the proportion of connected and unconnected targets, thus prompting subjects to focalize on either connected or unconnected pairs. Both groups were sensitive to automatic grouping in most conditions, but patients were unusually slowed down for connected targets while focalizing on unconnected pairs. In addition, this unusual effect occurred only when target were presented within the same hemifield. Patients and controls differed on this asymmetry between within- and across-hemifield presentation, suggesting that patients with schizophrenia do not re-group figures in the same way as controls do. We discuss possible implications on how ‘re-grouping’ ties in with ongoing, automatic perception in healthy volunteers.

  2. Report of the Independent Expert Group on the Future of European Public Health Research

    DEFF Research Database (Denmark)

    Olsen, Jørn

    2013-01-01

    The next EU research and innovation framework programme 'Horizon 2020' will address a number of important societal challenges including health, demographic changes and well-being. To prepare the work in these areas, the Health Directorate of the European Commission's Research & Innovation...... the following four questions: What should the thematic priorities for EU funded public health research under Horizon 2020 be? How to best structure European Public Health Research in the future? How to develop stronger links and synergies between EU funded research and national research activities, EU policy...... agendas and national policy agendas? How to improve the uptake of evidence generated from public health research in the development of public health policy? This report summarises the recommendations from Subgroup 2....

  3. The Effect of Spiritual and Religious Group Psychotherapy on Suicidal Ideation in Depressed Patients: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Hossein Ebrahimi

    2014-06-01

    Full Text Available Introduction: Suicide is a great economical, social and public health problem. It is prevalent worldwide and has a lot of negative effects on individuals, families and society. Depression is often prelude to Suicide. An important part of the treatment of the mentally ill patients is spiritual-religious psychotherapy which should be done after physical treatment. The aim of this study was to determine the effect of spiritual and religious group psychotherapy on suicidal ideation in depressed patients. Methods: 51 depressed patients with suicidal ideation from Razi hospital (Tabriz, Iran participated in this clinical trial. To collect Data questionnaire was used which included demographic and Beck Suicide Scale Ideation. Experimental group participated in 10 sessions of group psychotherapy. Each section lasted 1 hour. Two weeks after the last section post test was done. Statistical software SPSS ver 13 was used for data analysis. Results: Results of independent t-test revealed no difference between two groups in terms of suicidal ideation before intervention but after study there is a statistical difference. Also the results of ANCOVA test showed a significant relationship between spiritual group therapy and decrease in suicidal ideation, so that this intervention can make 57% of variance in suicidal ideation of experimental group.Conclusion: Regarding positive effect of spiritual and religious group psychotherapy on decreasing suicidal ideation of depressed patients, we suggest this intervention to be held in Psychiatric Wards and also more study on depression and other psychiatric patients with greater sample size would be helpful.

  4. Prevalence of autoantibodies in a group of hereditary angioedema patients.

    Science.gov (United States)

    Dortas Junior, Sergio Duarte; Valle, Solange Oliveira Rodrigues; Levy, Soloni Afra Pires; Tortora, Rosangela P; Abe, Augusto Tiaqui; Pires, Gisele Viana; Papi, José Angelo de Souza; França, Alfeu Tavares

    2012-01-01

    Hereditary Angioedema is a dominantly inherited disease. Routine screening of autoantibodies (AAB) is not recommended for individuals with Hereditary Angioedema; however, prevalence of these antibodies in Hereditary Angioedema patients is not well documented. We aim to determine the prevalence of AAB so that individuals at risk of developing autoimmune diseases can be identified. Fifteen patients with Hereditary Angioedema attended at Clementino Fraga Filho University Hospital accepted to participate in this study. Prevalence of AAB was 40%. Our data indicate high prevalence of AAB in patients with Hereditary Angioedema. Large-scale studies should be considered to determine the significance of these AAB in the follow-up care of patients with Hereditary Angioedema.

  5. Mental health leadership and patient access to care: a public-private initiative in South Africa.

    Science.gov (United States)

    Szabo, Christopher Paul; Fine, Jennifer; Mayers, Pat; Naidoo, Shan; Zabow, Tuviah

    2017-01-01

    Mental health leadership is a critical component of patient access to care. More specifically, the ability of mental health professionals to articulate the needs of patients, formulate strategies and engage meaningfully at the appropriate level in pursuit of resources. This is not a skill set routinely taught to mental health professionals. A public-private mental health leadership initiative, emanating from a patient access to care programme, was developed with the aim of building leadership capacity within the South African public mental health sector. The express aim was to equip health care professionals with the requisite skills to more effectively advocate for their patients. The initiative involved participants from various sites within South Africa. Inclusion was based on the proposal of an ongoing "project", i.e. a clinician-initiated service development with a multidisciplinary focus. The projects were varied in nature but all involved identification of and a plan for addressing an aspect of the participants' daily professional work which negatively impacted on patient care due to unmet needs. Six such projects were included and involved 15 participants, comprising personnel from psychiatry, psychology, occupational therapy and nursing. Each project group was formally mentored as part of the initiative, with mentors being senior professionals with expertise in psychiatry, public health and nursing. The programme design thus provided a unique practical dimension in which skills and learnings were applied to the projects with numerous and diverse outcomes. Benefits were noted by participants but extended beyond the individuals to the health institutions in which they worked and the patients that they served. Participants acquired both the skills and the confidence which enabled them to sustain the changes that they themselves had initiated in their institutions. The initiative gave impetus to the inclusion of public mental health as part of the curriculum

  6. Epidemiology of Brucellosis in High Risk Group & PUO Patients of Western – Rajasthan

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    Prabhu Prakash, Suman Bhansali, Ekta Gupta, Dinesh Kothari, Arvind Mathur, Sneha Ambuwani

    2012-01-01

    Full Text Available Background: Brucellosis is an important re-emerging zoonosis with a worldwide distribution. Brucellosis in India is yet a very common but often neglected disease. Methods: A retro prospective study was done in western Rajasthan on PUO patients those who attended Hospital attached of Dr. SNMC Jodhpur. Total 570 samples were tested for Brucella antibodies titration. In study group samples of PUO Patients (420, Milkmen & Veterinarians (70, Meat Handlers (30 & Healthy Control (50 were taken for finding their Antibrucella antibody titers Typhoid by Widal Test, Malaria by MP Strip Test were included in exclusion criteria for PUO patients All samples were tested by Stained Febrile Antigen. Results: Positivity for Antibrucella Antibody was 25.72%, 26.66%, 37.14%& 6.00% in PUO Patients, Meat Handlers & Veterinarians, Milkman & Healthy Control respectively. Conclusion & Recommendations: As climatic conditions of Western Rajasthan mimics with Middle East where Brucellosis is prevalent, in clinical practice Brucellosis should be kept in differential diagnosis & management of PUO& all preventive measure should be used for prevention of this Zoonotic disease.. A safe and effective vaccine in human is not yet available. Prevention is dependent upon increasing public awareness through health education programmes and safe livestock practices. Active co-operation between health and veterinary services should be promoted.

  7. Communication needs of patients with altered hearing ability: Informing pharmacists' patient care services through focus groups.

    Science.gov (United States)

    Ferguson, McKenzie; Liu, Min

    2015-01-01

    The purpose of this research is to identify communication barriers and needs for Deaf and hard-of-hearing (HOH) patients when they seek pharmaceutical care, and to better understand the impact of poor communication upon medication adherence and medication errors among this underserved population. Focus group discussion. Midwestern United States in September 2013 through April 2014. Deaf/HOH patients aged 18 years or older who used American Sign Language as their primary method of communication and were taking at least two long-term prescription medications. Qualitative themes. Many of the Deaf/HOH still perceived community pharmacists in a dispensing role and lacked an understanding of other services being offered in this setting. In addition, pharmacists who demonstrated a lack of sensitivity and patience towards the Deaf/HOH risk weakening the relationship between patient and provider. As a result, safe use of medications is compromised. Deaf and HOH patients have unique needs that pharmacists must understand and address. Effective communication and literacy assessment is essential to ensure safe medication use and optimal health outcomes. Pharmacist education and staff training are needed to increase awareness of this patient population's needs and to strengthen the patient-pharmacist relationship.

  8. Inequities in maternal postnatal visits among public and private patients: 2004 Pelotas cohort study

    Directory of Open Access Journals (Sweden)

    Marco Paula L

    2009-09-01

    Full Text Available Abstract Background The postnatal period is the ideal time to deliver interventions to improve the health of both the newborn and the mother. However, postnatal care shows low-level coverage in a large number of countries. The objectives of this study were to: 1 investigate inequities in maternal postnatal visits, 2 examine differences in postnatal care coverage between public and private providers and 3 explore the relationship between the absence of maternal postnatal visits and exclusive breastfeeding, use of contraceptive methods and maternal smoking three months after birth. Methods In the calendar year of 2004 a birth cohort study was started in the city of Pelotas, Brazil. Mothers were interviewed soon after delivery and at three months after birth. The absence of postnatal visits was defined as having no consultations between the time of hospital discharge and the third month post-partum. Logistic regression analysis was used to estimate the association between absence of postnatal visits and type of insurance scheme adjusting for potential confounding factors. Results Poorer women, black/mixed, those with lower level of education, single mothers, adolescents, multiparae, smokers, women who delivered vaginally and those who were not assisted by a physician were less likely to attend postnatal care. Postnatal visits were also less frequent among women who relied in the public sector than among private patients (72.4% vs 96% among public and private patients, respectively, x2 p Conclusion Postpartum care is available for every woman free of charge in the Brazilian Publicly-funded health care system. However, low levels of postpartum care were seen in the study (77%. Efforts should be made to increase the percentage of women receiving postpartum care, particularly those in socially disadvantaged groups. This could include locally-adapted health education interventions that address women's beliefs and attitudes towards postpartum care. There

  9. [The importance of social psychological and clinical factors for prescribing group psychotherapy for neurosis patients].

    Science.gov (United States)

    Grineva, I M; Khokholeva, A A; Obora, V V; Karagodina, E G; Lazarenko, A N

    1989-11-01

    Socio-psychological and clinical factors and their significance for group psychotherapy were investigated in 62 patients with neuroses. The obtained statistically valid differences of some characteristic aspects between groups of patients with positive and negative directives. This indicates the necessity of differential approach to group psychotherapy and active individual and group work on the creation of positive motivation to this type of treatment.

  10. Speech Criticism, Group Presentations, and Centrality: A Marriage Made in Heaven for the Basic Public Speaking Course.

    Science.gov (United States)

    Ayres, Joe; Sonandre, Debbie Ayres

    This paper presents an exercise which serves as an addition to public speaking courses. Showing students how to uncover the speech patterns that shape their lives allows them to appreciate the importance of speech communication in their lives. In the exercise, groups analyze speeches and report their findings to the class. The exercise improves…

  11. Comparing the Math Anxiety of Secondary School Female Students in Groups (Science and Mathematical Physics) Public Schools

    Science.gov (United States)

    Vakili, Khatoon; Pourrazavy, Zinat alsadat

    2017-01-01

    The aim of this study is comparing math anxiety of secondary school female students in groups (Science and Mathematical Physics) Public Schools, district 2, city of Sari. The purpose of the research is applied research, it is a development branch, and in terms of the nature and method, it is a causal-comparative research. The statistical…

  12. Group Projects as a Method of Promoting Student Scientific Communication and Collaboration in a Public Health Microbiology Course

    Science.gov (United States)

    Walton, Kristen L. W.; Baker, Jason C.

    2009-01-01

    Communication of scientific and medical information and collaborative work are important skills for students pursuing careers in health professions and other biomedical sciences. In addition, group work and active learning can increase student engagement and analytical skills. Students in our public health microbiology class were required to work…

  13. Interest Groups Vie for Public Support: The Battle Over Anti-Affirmative Action Initiatives in California and Michigan

    Science.gov (United States)

    Hinz, Serena E.

    2016-01-01

    Although affirmative action in college admissions has not been declared unconstitutional by the Supreme Court, the consideration of race in admissions has been banned in nine states--in six of them by public vote. This article analyzes the campaigns to ban affirmative action in California and Michigan as a battle between interest groups. The…

  14. Breaking through Marginalisation in Public Mental Health Care with Family Group Conferencing : Shame as Risk and Protective Factor

    NARCIS (Netherlands)

    de Jong, Gideon; Schout, Gert

    2013-01-01

    From January 2011 until December 2012, forty Family Group Conferences (FGCs) will be studied in the public mental health care (PMHC) setting in the province of Groningen, the Netherlands. Research should yield an answer to whether FGCs are valuable for clients in PMHC as a means to generate social s

  15. Breaking through marginalisation in public mental health care with Family Group Conferencing: shame as risk and protective factor

    NARCIS (Netherlands)

    Jong, Gideon de; Schout, Gert

    2013-01-01

    From January 2011 until December 2012, forty Family Group Conferences (FGCs) will be studied in the public mental health care (PMHC) setting in the province of Groningen, the Netherlands. Research should yield an answer to whether FGCs are valuable for clients in PMHC as a means to generate social s

  16. The impact of advertising patient and public involvement on trial recruitment: embedded cluster randomised recruitment trial.

    Science.gov (United States)

    Hughes-Morley, Adwoa; Hann, Mark; Fraser, Claire; Meade, Oonagh; Lovell, Karina; Young, Bridget; Roberts, Chris; Cree, Lindsey; More, Donna; O'Leary, Neil; Callaghan, Patrick; Waheed, Waquas; Bower, Peter

    2016-12-08

    Patient and public involvement in research (PPIR) may improve trial recruitment rates, but it is unclear how. Where trials use PPIR to improve design and conduct, many do not communicate this clearly to potential participants. Better communication of PPIR might encourage patient enrolment, as trials may be perceived as more socially valid, relevant and trustworthy. We aimed to evaluate the impact on recruitment of directly advertising PPIR to potential trial participants. This is a cluster trial, embedded within a host trial ('EQUIP') recruiting service users diagnosed with severe mental illness. The intervention was informed by a systematic review, a qualitative study, social comparison theory and a stakeholder workshop including service users and carers. Adopting Participatory Design approaches, we co-designed the recruitment intervention with PPIR partners using a leaflet to advertise the PPIR in EQUIP and sent potential participants invitations with the leaflet (intervention group) or not (control group). Primary outcome was the proportion of patients enrolled in EQUIP. Secondary outcomes included the proportions of patients who positively responded to the trial invitation. Thirty-four community mental health teams were randomised and 8182 service users invited. For the primary outcome, 4% of patients in the PPIR group were enrolled versus 5.3% of the control group. The intervention was not effective for improving recruitment rates (adjusted OR = 0.75, 95% CI = 0.53 to 1.07, p = 0.113). For the secondary outcome of positive response, the intervention was not effective, with 7.3% of potential participants in the intervention group responding positively versus 7.9% of the control group (adjusted OR = 0.74, 95% CI = 0.53 to 1.04, p = 0.082). We did not find a positive impact of directly advertising PPIR on any other outcomes. To our knowledge, this is the largest ever embedded trial to evaluate a recruitment or PPIR intervention

  17. Patient advisory groups in practice improvement: sample case presentation with a discussion of best practices.

    Science.gov (United States)

    Angstman, Kurt B; Bender, Robert O; Bruce, Steven M

    2009-01-01

    Using patient advisory groups can affect practice changes and create a patient-centric focus for a primary care practice. A successful patient advisory group has been developed for our primary care clinics. Utilizing this group, we have implemented practice improvement changes that have had a significant impact in patient care. This will be demonstrated in a case presentation involving the implementation of depression care managers at our practice sites. We will review key "best practices," as defined by the group, regarding size, composition, and meeting frequency that can be used for the development of a clinical patient advisory group.

  18. Unique transcriptomic response to sepsis is observed among patients of different age groups.

    Science.gov (United States)

    Raymond, Steven L; López, María Cecilia; Baker, Henry V; Larson, Shawn D; Efron, Philip A; Sweeney, Timothy E; Khatri, Purvesh; Moldawer, Lyle L; Wynn, James L

    2017-01-01

    Sepsis is a major cause of morbidity and mortality, especially at the extremes of age. To understand the human age-specific transcriptomic response to sepsis, a multi-cohort, pooled analysis was conducted on adults, children, infants, and neonates with and without sepsis. Nine public whole-blood gene expression datasets (636 patients) were employed. Age impacted the transcriptomic host response to sepsis. Gene expression from septic neonates and adults was more dissimilar whereas infants and children were more similar. Neonates showed reductions in inflammatory recognition and signaling pathways compared to all other age groups. Likewise, adults demonstrated decreased pathogen sensing, inflammation, and myeloid cell function, as compared to children. This may help to explain the increased incidence of sepsis-related organ failure and death in adults. The number of dysregulated genes in septic patients was proportional to age and significantly differed among septic adults, children, infants, and neonates. Overall, children manifested a greater transcriptomic intensity to sepsis as compared to the other age groups. The transcriptomic magnitude for adults and neonates was dramatically reduced as compared to children and infants. These findings suggest that the transcriptomic response to sepsis is age-dependent, and diagnostic and therapeutic efforts to identify and treat sepsis will have to consider age as an important variable.

  19. Interest Groups and Governmental Institutions: The Politics of State Funding of Public Higher Education

    Science.gov (United States)

    Tandberg, David

    2010-01-01

    In attempting to explain state support of public higher education, this study develops a theory-driven, comprehensive conceptualization of the state political system within a larger theoretical framework that consists of state economic and demographic factors and higher education system attributes. Furthermore, although the higher education policy…

  20. The Public Law Outline and Family Group Conferences in Childcare Practice

    Science.gov (United States)

    Evans, Carly Anne

    2011-01-01

    In the United Kingdom, the Children Act (1989) states that children are best brought up with their families. However, if a child is suffering from or likely to suffer from significant harm, then the local authorities may initiate care proceedings under section 31 of the Children Act (1989). The Public Law Outline is a judicial case management tool…

  1. Some Determinants of Public Acceptance of Randomized Control Group Experimental Designs

    Science.gov (United States)

    Hillis, Jay W.; Wortman, Camille B.

    1976-01-01

    Subjects read a supposedly real news account of a medical experiment in which the scarcity of the treatment employed and the amount of scientific justification for the experiment were experimentally varied. Factors that might influence public attitudes about social experiments are explored. (Author/DEP)

  2. Selected Publications on Teenagers and Alcohol. Grouped Interest Guide No. 8-2.

    Science.gov (United States)

    National Inst. on Alcohol Abuse and Alcoholism (DHEW/PHS), Rockville, MD.

    This brief bibliography is part of a series produced by the Current Awareness Services of the National Clearinghouse for Alcohol Information, and informational service of the National Institute on Alcohol Abuse and Alcoholism. The publications provide readers with regularly codified bibliographic references to recent, topical literature in…

  3. Histomorphologic liver abnormalities in a group of alcoholic patients

    Directory of Open Access Journals (Sweden)

    Libán Álvarez Cáceres

    2010-11-01

    Full Text Available Background: the ingestion of alcohol has been directly involved in the development of liver diseases. Nowadays, the liver damage by ethanol is a serious health problem all over the world. To achieve satisfactory results In order to face it, it is necessary to provide multidisciplinary attention. Objective: to determine the histomorphologic liver impairments in alcoholic patients. Methods: an observational, descriptive, co-relational and prospective study conducted in 23 patients with an alcoholism diagnosis at the Provincial University Hospital "Arnaldo Milián Castro" in Villa Clara. Inclusion and exclusion criteria were taken into account. The variables studied were: laparoscopic evolution, period of time consuming alcohol (in years, histologic evolution and alanine aminotransferase. Results: both trough laparoscopic and liver biopsy, the most frequent diagnosis was steatosis, followed by chronic hepatitis. In one patient cirrhosis was diagnosed through laparoscopy: a biopsy was not performed in this case. Conclusion: there were a high proportion of patients with impaired liver aminotransferases and severe histological diagnoses, especially those of chronic hepatitis and liver cirrhosis.

  4. Implementation and scientific evaluation of rehabilitative sports groups for prostate cancer patients: study protocol of the ProRehab Study

    Directory of Open Access Journals (Sweden)

    Zopf Eva M

    2012-07-01

    Full Text Available Abstract Background Although treatment regimen have improved in the last few years, prostate cancer patients following a radical prostatectomy still experience severe disease- and treatment-related side effects, including urinary incontinence, erectile dysfunction and psychological issues. Despite high incidence rates and the common adverse effects there is a lack of supportive measures for male patients and specific physical exercise recommendations for prostate cancer patients during rehabilitation or in the aftercare are still missing. Methods/Design The ProRehab Project aims to establish rehabilitative sports groups particularly for prostate cancer patients and to evaluate the effects of the offered exercise program. Starting 8–12 weeks after prostatectomy or combination therapy, prostate cancer patients will exercise for 15 months within a patient preference randomized controlled trial. One exercise session will be conducted within a pre-established rehabilitative sports group, while the other will be completed independently. Patients in the control group will not participate in the intervention. The main outcomes of the study include aerobic fitness, quality of life, incontinence and erectile dysfunction. Discussion By combining science, practice, and public relations the first rehabilitative sports groups for prostate cancer patients in Germany have been set up and thus contribute to the care structure for prostate cancer patients. By offering a 15-month physical exercise intervention that is conducted in supervised group sessions, long-term lifestyle changes and therefore improvements in quality of life in prostate cancer patients can be expected. Trial registration German Clinical Trials Register DRKS00004184

  5. Assessment of pain among a group of Nigerian dental patients.

    Science.gov (United States)

    Odai, Emeka Danielson; Ehizele, Adebola Oluyemisi; Enabulele, Joan Emien

    2015-06-19

    Pain is considered a key symptom associated with possible impairment of oral-health-related quality of life and its assessment is important for the planning and evaluation of preventive and treatment effort. The tools for assessing pain must therefore be valid and consistent. The objective of this study was to assess dental patients' level of pain based on the clinical diagnosis of their dental condition and the correlation between two pain assessment scales, Visual analogue scale (VAS) and the Full Cup Test (FCT), for the assessment of pain among dental patients. A total of 185 patients presenting at the University of Benin Teaching Hospital dental outpatient clinics with various forms of orofacial pain were included in this study. The mean VAS scores and mean FCT scores for the different dental conditions were compared. Agreement between VAS and FCT was evaluated using the Intra-class correlation (ICC) coefficients and Cronbach alpha coefficient was also calculated to assess consistency of the two pain scales. Majority i.e. 95.1, 96.2 and 100% who presented with acute pulpitis, acute apical periodontitis and pericoronitis respectively, presented with moderate to severe pain levels (p < 0.05). Only 25.9 and 4% who presented with chronic marginal gingivitis and chronic pulpitis respectively presented with no pain (p < 0.05). A large proportion (75%) of patients with no pain had single diagnosis while more than half (52.1%) of those who presented with severe pain had multiple diagnoses (p = 0.025). The mean VAS and FCT scores for acute pain were 6.1 ± 2.1 and 5.9 ± 2.4 respectively and for chronic pain 3.9 ± 2.7 and 3.7 ± 2.7 respectively (P = 0.001). The interclass correlation coefficient revealed that the mean VAS and FCT scores were statistically correlated and reliable with a Cronbach alpha coefficient of 0.85. It can be concluded that patients who presented with either acute or chronic dental conditions may experience moderate to severe level of pain, with

  6. assessment of nutritional status of a group of hypertensive patients ...

    African Journals Online (AJOL)

    2014-03-01

    Mar 1, 2014 ... Objective: To assess the prevalence of overweight and obesity among adult hypertensive ... smoking tobacco while 53.8% of the respondents engaged in regular physical exercise. The BMI showed ..... Rural School Going Children in Ludhiana. Indian ... Pressure Education Program Working Group. Arch.

  7. Patient Engagement Practices in Clinical Research among Patient Groups, Industry, and Academia in the United States: A Survey.

    Directory of Open Access Journals (Sweden)

    Sophia K Smith

    Full Text Available Patient-centered clinical trial design and execution is becoming increasingly important. No best practice guidelines exist despite a key stakeholder declaration to create more effective engagement models. This study aims to gain a better understanding of attitudes and practices for engaging patient groups so that actionable recommendations may be developed.Individuals from industry, academic institutions, and patient groups were identified through Clinical Trials Transformation Initiative and Drug Information Association rosters and mailing lists. Objectives, practices, and perceived barriers related to engaging patient groups in the planning, conduct, and interpretation of clinical trials were reported in an online survey. Descriptive and inferential statistical analysis of survey data followed a literature review to inform survey questions.Survey respondents (n = 179 valued the importance of involving patient groups in research; however, patient group respondents valued their contributions to research protocol development, funding acquisition, and interpretation of study results more highly than those contributions were valued by industry and academic respondents (all p < .001. Patient group respondents placed higher value in open communications, clear expectations, and detailed contract execution than did non-patient group respondents (all p < .05. Industry and academic respondents more often cited internal bureaucratic processes and reluctance to share information as engagement barriers than did patient group respondents (all p < .01. Patient groups reported that a lack of transparency and understanding of the benefits of collaboration on the part of industry and academia were greater barriers than did non-patient group respondents (all p< .01.Despite reported similarities among approaches to engagement by the three stakeholder groups, key differences exist in perceived barriers and benefits to partnering with patient groups among the

  8. Patient-centered care in affective, non-affective, and schizoaffective groups: patients' opinions and attitudes.

    Science.gov (United States)

    Tempier, Raymond; Hepp, Shelanne L; Duncan, C Randy; Rohr, Betty; Hachey, Krystal; Mosier, Karen

    2010-10-01

    An outcome evaluation was conducted to obtain psychiatric inpatients' perspectives on acute care mental health treatment and services. The applicability of diagnostic categories based on affective, non-affective, and schizoaffective disorder were considered in the predictability of responses to treatment regimens and the related services provided in an inpatient psychiatric unit. A multidimensional approach was used to survey patients, which included the DAI-30, the BMQ, the SERVQUAL, and the CSQ-8. Overall, findings indicate that inpatient satisfaction could be improved with tailoring treatment to suit their respective symptoms. Furthermore, this exploratory study demonstrates some preliminary support for the inclusion of patients with a diagnosis of schizoaffective disorder as a separate group toward improving acute mental health care while hospitalized.

  9. Reducing Preschoolers' Disruptive Behavior in Public with a Brief Parent Discussion Group

    Science.gov (United States)

    Joachim, Sabine; Sanders, Matthew R.; Turner, Karen M. T.

    2010-01-01

    This study examined the efficacy of a brief 2-h discussion group for parents of preschool children that show disruptive behavior on shopping trips. Forty-six parents with children aged 2-6 years were randomly assigned to either the intervention condition or a waitlist control group. Significant intervention effects were found for measures of…

  10. Patient and public perspectives shaping scientific and medical research: panels for data, discussions, and decisions

    Directory of Open Access Journals (Sweden)

    Oliver S

    2012-01-01

    Full Text Available Seilin Uhm1, Kristin Liabo1, Ruth Stewart1,2, Rebecca Rees1, Sandy Oliver11Social Science Research Unit, Institute of Education, University of London, London, UK; 2The Centre for Language and Culture, University of Johannesburg, Johannesburg, South AfricaAbstract: This paper explores the role of patient panels for shaping research for health, scientific research about health and illness, and applied medical research. After examining the history and purposes of involving patients in discussions and decision making for research, it outlines the expertise and skills required if panels are to be successful. The paper also analyses existing guidance for panels that include patients. Panels benefit from the experiential knowledge of panel members, craft knowledge of panel facilitators, and organizational knowledge gained through previous experience of hosting panels. Guidance is available that addresses structures and resources (for panel funders and interpersonal communication and group dynamics (for panel members and facilitators. This guidance is most comprehensive when it has itself been developed by all these types of stakeholders.Keywords: public involvement, patient panels, expert panels, guidelines, guidance

  11. Is prosthodontic treatment age-dependent in patients 60 years and older in Public Dental Services?

    Science.gov (United States)

    Hiltunen, K; Vehkalahti, M M; Mäntylä, P

    2015-06-01

    Prosthodontic treatment is a common procedure for the elderly as tooth loss is a reality in old age. Dentists take care of increasingly older patients with physiological age manifesting as cognitive impairment, frailty or multiple chronic diseases or who have side effects of medicines. We evaluated how patients' age affects prosthodontic treatment choice and whether we could identify the age when a change in practice occurs. In addition, we determined how common the treatment method of fixed prostheses is among patients aged 60 years or over in Public Dental Services (PDS) and how common rehabilitation of dentition with new dentures is compared with repair of existing dentures. Our data cover all patients aged 60 years and older (n = 130,060) treated in Helsinki PDS in 2007-2012. Data were aggregated into seven groups: 60-64, 65-69, 70-74, 75-79, 80-84, 85-89, and 90 years and over. During the 6-year period, the mean annual number of the population was about 114,000 and the mean annual number of patients treated with prosthodontics 1700. Prosthodontic treatment choices (repair, removable prosthodontics, fixed prostheses, fibre-reinforced composite fixed prostheses) vary by age; the older the patient, the rarer fixed or fibre-reinforced composite fixed prostheses and removable prostheses and the more frequent repairs (P < 0.001). Denture repair was virtually the only treatment that patients over 90 years received. Based on our results, the age at which prosthodontic treatment practices in PDS change is around 70 years. Beyond this age, fixed prosthodontic treatment modalities are very rare and repairs are more common.

  12. Biomass district heating methodology and pilot installations for public buildings groups

    Science.gov (United States)

    Chatzistougianni, N.; Giagozoglou, E.; Sentzas, K.; Karastergios, E.; Tsiamitros, D.; Stimoniaris, D.; Stomoniaris, A.; Maropoulos, S.

    2016-11-01

    The objective of the paper is to show how locally available biomass can support a small-scale district heating system of public buildings, especially when taking into account energy audit in-situ measurements and energy efficiency improvement measures. The step-by-step methodology is presented, including the research for local biomass availability, the thermal needs study and the study for the biomass district heating system, with and without energy efficiency improvement measures.

  13. Group Living Enhances Individual Resources Discrimination: The Use of Public Information by Cockroaches to Assess Shelter Quality

    Science.gov (United States)

    Canonge, Stéphane; Deneubourg, Jean-Louis; Sempo, Grégory

    2011-01-01

    In group-living organisms, consensual decision of site selection results from the interplay between individual responses to site characteristics and to group-members. Individuals independently gather personal information by exploring their environment. Through social interaction, the presence of others provides public information that could be used by individuals and modulates the individual probability of joining/leaving a site. The way that individual's information processing and the network of interactions influence the dynamics of public information (depending on population size) that in turn affect discrimination in site quality is a central question. Using binary choice between sheltering sites of different quality, we demonstrate that cockroaches in group dramatically outperform the problem-solving ability of single individual. Such use of public information allows animals to discriminate between alternatives whereas isolated individuals are ineffective (i.e. the personal discrimination efficiency is weak). Our theoretical results, obtained from a mathematical model based on behavioral rules derived from experiments, highlight that the collective discrimination emerges from competing amplification processes relying on the modulation of the individual sheltering time without shelters comparison and communication modulation. Finally, we well demonstrated here the adaptive value of such decision algorithm. Without any behavioral change, the system is able to shift to a more effective strategy when alternatives are present: the modification of the spatio-temporal distributions of individuals leading to the collective selection of the best resource. This collective discrimination implying such parsimonious and widespread mechanism must be shared by many group living-species. PMID:21701692

  14. Group living enhances individual resources discrimination: the use of public information by cockroaches to assess shelter quality.

    Science.gov (United States)

    Canonge, Stéphane; Deneubourg, Jean-Louis; Sempo, Grégory

    2011-01-01

    In group-living organisms, consensual decision of site selection results from the interplay between individual responses to site characteristics and to group-members. Individuals independently gather personal information by exploring their environment. Through social interaction, the presence of others provides public information that could be used by individuals and modulates the individual probability of joining/leaving a site. The way that individual's information processing and the network of interactions influence the dynamics of public information (depending on population size) that in turn affect discrimination in site quality is a central question. Using binary choice between sheltering sites of different quality, we demonstrate that cockroaches in group dramatically outperform the problem-solving ability of single individual. Such use of public information allows animals to discriminate between alternatives whereas isolated individuals are ineffective (i.e. the personal discrimination efficiency is weak). Our theoretical results, obtained from a mathematical model based on behavioral rules derived from experiments, highlight that the collective discrimination emerges from competing amplification processes relying on the modulation of the individual sheltering time without shelters comparison and communication modulation. Finally, we well demonstrated here the adaptive value of such decision algorithm. Without any behavioral change, the system is able to shift to a more effective strategy when alternatives are present: the modification of the spatio-temporal distributions of individuals leading to the collective selection of the best resource. This collective discrimination implying such parsimonious and widespread mechanism must be shared by many group living-species.

  15. Group living enhances individual resources discrimination: the use of public information by cockroaches to assess shelter quality.

    Directory of Open Access Journals (Sweden)

    Stéphane Canonge

    Full Text Available In group-living organisms, consensual decision of site selection results from the interplay between individual responses to site characteristics and to group-members. Individuals independently gather personal information by exploring their environment. Through social interaction, the presence of others provides public information that could be used by individuals and modulates the individual probability of joining/leaving a site. The way that individual's information processing and the network of interactions influence the dynamics of public information (depending on population size that in turn affect discrimination in site quality is a central question. Using binary choice between sheltering sites of different quality, we demonstrate that cockroaches in group dramatically outperform the problem-solving ability of single individual. Such use of public information allows animals to discriminate between alternatives whereas isolated individuals are ineffective (i.e. the personal discrimination efficiency is weak. Our theoretical results, obtained from a mathematical model based on behavioral rules derived from experiments, highlight that the collective discrimination emerges from competing amplification processes relying on the modulation of the individual sheltering time without shelters comparison and communication modulation. Finally, we well demonstrated here the adaptive value of such decision algorithm. Without any behavioral change, the system is able to shift to a more effective strategy when alternatives are present: the modification of the spatio-temporal distributions of individuals leading to the collective selection of the best resource. This collective discrimination implying such parsimonious and widespread mechanism must be shared by many group living-species.

  16. ABO blood group is a predictor of survival in patients with laryngeal cancer.

    Science.gov (United States)

    Jin, Ting; Li, Pei-Jing; Chen, Xiao-Zhong; Hu, Wei-Han

    2016-10-13

    Whether the ABO blood group is associated with the survival of patients with laryngeal cancer remains unknown. The purpose of this study was to investigate the association between the ABO blood group and clinicopathologic characteristics of patients with laryngeal cancer and assess whether the ABO blood group was associated with prognosis. We analyzed the records of 1260 patients with laryngeal cancer who underwent curative treatment at Sun Yat-sen University Cancer Center between January 1993 and December 2009. The Chi-square test was used to assess the relationship between the ABO blood group and clinicopathologic characteristics. The Kaplan-Meier method was used to estimate 3-, 5-, and 10-year overall survival (OS) rates. The Cox proportional hazards model was used in univariate and multivariate analyses of OS. No significant association was found between the ABO blood group and clinicopathologic characteristics except for primary tumor site. The median OS for patients with blood groups A, B, AB, and O were 87.0, 80.0, 90.0, and 72.5 months, respectively. The 3-, 5-, and 10-year OS rates were 82.4%, 76.0%, and 67.5% for patients with blood group A; 77.4%, 69.8%, and 58.4% for patients with blood group B; 82.2%, 73.1%, and 65.6% for patients with blood group AB; and 71.7%, 66.4%, and 55.5% for patients with blood group O, respectively. Univariate and multivariate analyses showed that the ABO blood group had significant effects on prognosis in patients with laryngeal cancer. The ABO blood group is associated with survival in patients with laryngeal cancer. Patients with blood group O had significantly shorter OS than patients with other ABO blood groups.

  17. Patient involvement in diabetes care: experiences in nine diabetes care groups

    Directory of Open Access Journals (Sweden)

    Lidwien Lemmens

    2015-12-01

    Full Text Available Introduction: Despite the expected beneficial effects on quality of care, patient involvement in diabetes care groups, which deliver a bundled paid integrated care programme for diabetes type 2, seems to be limited. The aim of this study was to gain insight into levels and methods of patient involvement, into facilitators and barriers, and into the future preferences of care groups and patient representatives.Theory and methods: Semi-structured interviews were held with 10 representatives of care groups and 11 representatives of patient advocacy groups. An adapted version of Arnstein's ladder of citizen participation was used to define five levels of patient involvement.Results: Patient involvement in care groups was mostly limited to informing and consulting patients. Higher levels, i.e., advising, co-producing and decision-making, were less frequently observed. Care groups and patient representatives perceived largely the same barriers and facilitators and had similar preferences regarding future themes and design of patient involvement.Conclusion: Constructive collaboration between diabetes care groups and patient representatives to enhance patient involvement in the future seems viable. Several issues such as the lack of evidence for effectiveness of patient involvement, differences in viewpoints on the role and responsibilities of care groups and perceived barriers need to be addressed.

  18. Self-Reported Differences in Empowerment Between Lurkers and Posters in Online Patient Support Groups

    NARCIS (Netherlands)

    Uden-Kraan, van Cornelia F.; Drossaert, Constance H.C.; Taal, Erik; Seydel, Erwin R.; Laar, van de Mart A.F.J.

    2008-01-01

    Background: Patients who visit online support groups benefit in various ways. Results of our earlier study indicated that participation in online support groups had a profound effect on the participants’ feelings of “being empowered.” However, most studies of online patient support groups have focus

  19. Index of the Nevada Applied Ecology Group and associated publications available in the Coordination and Information Center

    Energy Technology Data Exchange (ETDEWEB)

    Maza, B.G.

    1991-02-01

    This publication was created by the Coordination and Information Center (CIC) to provide a readily available research tool for use by researchers interested in a specific area covered in the holdings of the CIC Archives. The Nevada Applied Ecology Group (NAEG) was formed and functioned in agreement with Planning Directive NVO-76 (July 29, 1970 and revised January 1, 1974, (CIC-165845 and CIC-16439) respectively) to coordinate the ecological and other environmental programs necessary to support the continued nuclear testing activities; and to provide a mechanism to effectively comply with requirements of the National Environmental Policy Act of 1969, Executive Order 11514, and AEC Manual Chapter 0510.'' The publication contains only citations to documents currently available at the CIC. It represents a significant portion of the principal research findings of the Nevada Applied Ecology Group.

  20. PUBLIC POLICIES OF RIGHT TO EDUCATION FOR ELDERLY PATIENTS

    Directory of Open Access Journals (Sweden)

    Hamilton de Oliveira Telles Júnior

    2017-08-01

    Full Text Available The people are living more. The population is going by great transformations, so much social as technological, that point to the need of specific education processes for senior people. The seniors tend to be separated socially, with damages for his/her health and, consequently, his/her life quality. This study, of qualitative approach, has as objective to describe the public politics for the senior's education interned in hospitals or institutions and to analyze the applicable Public Politics to the education based an express analysis model by Di Giovanni, where there are the actors of this public policy and its related interests. How possible middle for attainment of a program driven to the seniors' education is evidenced in the inclusion possibility in the hospital class and the possibility of the use of education programs for youths and adults, with the initiative of third sector, that in the extent of the education no formal he/she brings great transformations for society and education for the senior.

  1. Looking Upstream: Findings from Focus Groups on Public Perceptions of Source Water Quality in British Columbia, Canada.

    Directory of Open Access Journals (Sweden)

    Natalie Henrich

    Full Text Available In association with the development of new microbial tests for source water quality (SWQ, focus groups with members of the public were conducted to gain insight into their perceptions of SWQ, behaviours and contaminants they think pose the greatest threat to its quality, and what/how they want to know about SWQ. Discussions revealed a low concern about SWQ in general, and in particular about microbial contamination. Participants identified behaviours that threaten SWQ, barriers to changing behaviour and suggestions for inducing change. A strong desire was expressed for water quality information to be interpreted and communicated in terms of how SWQ may impact human health and how their actions should be altered in response to test results. The information can be used to inform communication strategies and possibly impact policies associated with water quality testing and implementation of new tests. More broadly, awareness of the public's understanding and beliefs about source water can be used in working with the public to adopt water-friendly behaviours, influence the content and methods of communicating with the public about water issues and water quality, and could contribute to the direction of future research and investment into water technologies to align with the public's priorities.

  2. LOCAL ACTION GROUPS – A NEW FORM OF PUBLIC-PRIVATE PARTNERSHIP IN RURAL AREAS OF BULGARIA

    Directory of Open Access Journals (Sweden)

    Zornitsa STOYANOVA

    2012-01-01

    Full Text Available Purpose of the paper is to assess the problems of creation and functioning of local action groups as form of public-private partnership. It is based on the survey and data provided by Ministry of Agriculture and Food. Conclusions in this report reflect the results of a research project of the University of National and World Economy, developed by the author team.

  3. Clustering of Local Group distances: publication bias or correlated measurements? I. The Large Magellanic Cloud

    CERN Document Server

    de Grijs, Richard; Bono, Giuseppe

    2014-01-01

    The distance to the Large Magellanic Cloud (LMC) represents a key local rung of the extragalactic distance ladder. Yet, the galaxy's distance modulus has long been an issue of contention, in particular in view of claims that most newly determined distance moduli cluster tightly - and with a small spread - around the "canonical" distance modulus, (m-M)_0 = 18.50 mag. We compiled 233 separate LMC distance determinations published between 1990 and 2013. Our analysis of the individual distance moduli, as well as of their two-year means and standard deviations resulting from this largest data set of LMC distance moduli available to date, focuses specifically on Cepheid and RR Lyrae variable-star tracer populations, as well as on distance estimates based on features in the observational Hertzsprung-Russell diagram. We conclude that strong publication bias is unlikely to have been the main driver of the majority of published LMC distance moduli. However, for a given distance tracer, the body of publications leading ...

  4. patients' satisfaction with dental care provided by public dental ...

    African Journals Online (AJOL)

    2006-04-04

    Apr 4, 2006 ... known with regard to equity, efficiency, geographical equality of access, patient ... (vi) Physical environment features of setting in which care is delivered: (e.g. .... This exercise, which will involve equipping the clinics with the ...

  5. Comparing demographics, clinical presentation, treatments and outcome between systemic lupus erythematosus patients treated in a public and private health system in Santa Fe, Argentina.

    Science.gov (United States)

    Schmid, María Marcela; Roverano, Susana Graciela; Paira, Sergio Oscar

    2014-01-01

    The study includes 159 SLE patients seen between 1987 and 2011, of whom 116 were treated in the public health system and 43 in private practice. In the comparison between both groups, it was shown that patients in the public health system were younger at first consultation and at the onset of SLE, and that the mean duration of their disease prior to nephropathy was statistically significantly shorter. They also presented with more SLE activity (measured by Systemic Lupus Erythematosus Activity Index) such as fever, lower levels of C4, and elevated erythrocyte sedimentation rate. Although cyclophosphamide was administered more frequently to patients in the public health system group, there were no statistically significant differences in renal histological findings. A second renal biopsy was performed on 20 patients due to the presence of persistent proteinuria, peripheral edema, urinary casts, or because of previous defective renal specimens. The overall 10-year survival of the patients in the public health system was 78% compared to a survival rate of 91% for the patients in private practices. When survival was evaluated at 15 years, however, no differences were found (log rank test: 0.65). Patients from both public and private groups attended medical specialist practices and received early diagnoses and close follow-ups.

  6. ABO blood group is a predictor of survival in patients with laryngeal cancer

    OpenAIRE

    Jin, Ting; Li, Pei-Jing; Chen, Xiao-zhong; Hu, Wei-Han

    2016-01-01

    Background Whether the ABO blood group is associated with the survival of patients with laryngeal cancer remains unknown. The purpose of this study was to investigate the association between the ABO blood group and clinicopathologic characteristics of patients with laryngeal cancer and assess whether the ABO blood group was associated with prognosis. Methods We analyzed the records of 1260 patients with laryngeal cancer who underwent curative treatment at Sun Yat-sen University Cancer Center ...

  7. DE-EE0006699 Final Technical Report_Sunvestment Group Public Facing_Sep24

    Energy Technology Data Exchange (ETDEWEB)

    PAULSWORTH, ASHLEY; KURTZ, JIM; BRUN DE PONTENT, STEPHANIE

    2016-09-27

    Sunvestment Energy Group (previously called Sunvestment Group) was established to create a web application that brings together site hosts, those who will obtain the energy from the solar array, with project developers and funders, including affinity investors. Sunvestment Energy Group (SEG) uses a community-based model that engages with investors who have some affinity with the site host organization. In addition to a financial return, these investors receive non-financial value from their investments and are therefore willing to offer lower cost capital. This enables the site host to enjoy more savings from solar through these less expensive Community Power Purchase Agreements (CPPAs). The purpose of this award was to develop an online platform to bring site hosts and investors together virtually.

  8. Metacognitive group training for schizophrenia spectrum patients with delusions : a randomized controlled trial

    NARCIS (Netherlands)

    van Oosterhout, B.; Krabbendam, L.; de Boer, K.; Ferwerda, J.; van der Helm, M.; Stant, A. D.; van der Gaag, M.

    2014-01-01

    Background. Metacognitive training (MCT) for patients with psychosis is a psychological group intervention that aims to educate patients about common cognitive biases underlying delusion formation and maintenance, and to highlight their negative consequences in daily functioning. Method. In this ran

  9. Who's that sleeping in my bed? Potential and actual utilization of public and private in-patient beds in Irish acute public hospitals.

    Science.gov (United States)

    O'Reilly, Jacqueline; Wiley, Miriam

    2010-10-01

    To examine the impact of the unusual public/private mix on public and private in-patient bed utilization within Irish acute public hospitals. Data from the Department of Health and Children and the Hospital In-Patient Enquiry were used to estimate and compare potential and actual utilization of public and private designated in-patient beds in 54 acute public hospitals from 2000 to 2004. Private in-patients used more bed days than were potentially available to them in 14.1% of hospital-year observations. The equivalent figure for public in-patients was 12.6%. Although the prevalence of excess utilization of private beds was relatively small, it did increase over the study period. Hospitals with excess private utilization were characterized by a relatively low proportion of private- or non-designated beds despite their patient profile being broadly similar to that of hospitals where there was no excess private utilization. Despite policies designed to limit private practice in Irish acute public hospitals, some hospitals have apparently been able to overcome these restrictions. In a system where financial incentives to treat private patients exist both for consultants and hospitals, it is not clear whether this excess private practice in public hospitals reflects a more efficient utilization of resources (when demand from public patients is low) or the displacement of public patients in favour of private patients. However, that a smaller number on hospital waiting lists possess private health insurance provides some support for the displacement hypothesis. Thus, it appears that policy-makers may need to reconsider attempts to ensure an appropriate division of acute public hospital resources between public and private patients.

  10. An experimental public: heterogeneous groups defining embodiment in the early twenty-first century.

    Science.gov (United States)

    Laki, Julia

    2014-01-01

    In this paper, I take a look at certain forms of contemporary art as practices that allow meanings within biomedical science and medical practice to emerge in novel ways. I claim that conceptual art and biological art are two unique spaces within which the understanding of embodiment and disease comes to be shaped actively and reflexively, sometimes on the very level of the materiality of the body, sometimes through the articulation and representation of medical images and technologies. I link these developments to Paul Rabinow's notion of biosociality and argue that the molecularization and geneticization of the medical gaze, conjoined with certain social and cultural shifts, results in the formation of an experimental public of artists, scientists and lay people, all invested in actively shaping the conceptualization of bodies and diseases. This will take me to a consideration of the intertwining of art and medicine beyond the domain of the visual.

  11. THE FACTORS AFFECTING SATISFACTION LEVELS IN HOSPITALIZED PATIENTS: AN APPLICATION IN PUBLIC HOSPITAL

    Directory of Open Access Journals (Sweden)

    Neşe ACAR

    2017-09-01

    Full Text Available This study was conducted to determine the factors that affect the level of satisfaction of services provided by public hospitals. Patients' satisfaction levels were measured by interviewing 156 patients in a public hospital. Factor analysis of the data obtained from the research resulted in five factors called nurses 'behaviors, physical conditions, doctors' behavior, technical staff behaviors, food and beverage. MANOVA analysis was conducted to determine the differences in the perception of factors with respect to the demographic characteristics of the patients and differences were found in terms of profession. It has been seen that it is important that public hospitals have specialist doctors and modern equipment and that they have qualities such as the quality of the health personnel in preferring patients to public hospitals.

  12. Patient and public understanding and knowledge of antimicrobial resistance and stewardship in a UK hospital: should public campaigns change focus?

    Science.gov (United States)

    Micallef, Christianne; Kildonaviciute, Kornelija; Castro-Sánchez, Enrique; Scibor-Stepien, Aleksandra; Santos, Reem; Aliyu, Sani H; Cooke, Fiona J; Pacey, Sarah; Holmes, Alison H; Enoch, David A

    2017-01-01

    The rising global tide of antimicrobial resistance is a well-described phenomenon. Employing effective and innovative antimicrobial stewardship strategies is an essential approach to combat this public health threat. Education of the public and patients is paramount to enable the success of such strategies. A panel of hospital multidisciplinary healthcare professionals was set up and a short quiz containing true/false statements around antimicrobial stewardship and resistance was designed and piloted. An educational leaflet with the correct replies and supporting information was also produced and disseminated. Participants were recruited on a single day (18 November 2015) from the hospital outpatient clinics and the hospital outpatient pharmacy waiting room. One hundred and forty-five completed quizzes were returned, providing a total of 1450 answers. Overall, 934 of 1450 (64%) statements were scored correctly whilst 481 (33%) were scored incorrectly; 35 (3%) statements were left unscored. We speculate that these results may demonstrate that respondents understood the statements, as only a small proportion of statements were left unanswered. The question dealing with the definition of antimicrobial resistance and the question dealing with the definition of antimicrobial stewardship obtained the most incorrect replies (85% and 72%, respectively). However, a specific factual recall question regarding only one microorganism (MRSA) received the most correct responses (99%). We describe a simple, innovative method of engagement with patients and the general public to help educate and disseminate important public health messages around antimicrobial resistance and stewardship. We also identified the need for public health campaigns to address the knowledge gaps found around this topic. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  13. Experiences of action learning groups for public health sector managers in rural KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Blanchard, Catherine P; Carpenter, Bryan

    2012-01-01

    The World Health Organisation identifies strengthening leadership and management as an essential component in scaling up health services to reach the UN's Millennium Development Goals. There is an identified need for informal, practically based management training programs, such as action learning, which allow trainees to reflect on their own work environment. Action learning, in essence, is learning by sharing real problems with others, as opposed to theoretical classroom learning. The objective of this study was to pilot an action learning group program with managers in a rural public health setting and to explore participants' experience of the program. An eleven-month action learning group program was conducted for public health sector managers in a rural health district in northern KwaZulu-Natal. On conclusion of the action learning group program, a qualitative study using focus group discussions was conducted to explore participants' experience of the action learning groups and their potential usefulness as a development opportunity. Respondents' commitment to the project was evident from the high attendance at group meetings (average of 95%). On conclusion of the program, all participants had presented a work related problem to their respective groups and all participants had developed an action plan, and provided feedback on their action plan. Ten participants were still actively working on their action plans and seven participants had completed their action plans. The main themes that emerged from the qualitative data were understandings of action learning; elements that enabled the program; perceived benefits; and reported changes over the course of the program. The major benefits reported by participants were enhanced teamwork and collaboration, and providing participants with the skills to apply action learning principles to other challenges in their working lives. From the participants' shared perspectives, although the findings cannot be generalised

  14. CWTS crown indicator measures citation impact of a research group's publication oeuvre

    OpenAIRE

    2010-01-01

    The article "Caveats for the journal and field normalizations in the CWTS (`Leiden') evaluations of research performance", published by Tobias Opthof and Loet Leydesdorff (arXiv:1002.2769) deals with a subject as important as the application of so called field normalized indicators of citation impact in the assessment of research performance of individual researchers and research groups. Field normalization aims to account for differences in citation practices across scientific-scholarly subj...

  15. The Effects of Cognitive Behavorial Therapy Group and Social Support Group on the Self Esteem among Breast Cancer Patients

    Directory of Open Access Journals (Sweden)

    Namora Lumongga Lubis

    2011-12-01

    Full Text Available This study is aimed to determine the main effects of CBT group, social support group (DS and control group (KK on the self esteem among breast cancer patients. Rosemberg self esteem scale (RSE was used to measure self-esteem. The treatment group consisted of CBT and DS groups. Each treatment group received 12 counselling sessions within six weeks. Quantitative analysis general linear model (GLM repeated measures was used to identify the groups’ (CBT, DS, and KK main effect, the repeated test RSE scale (pre test, post test 1, post test 2, and post test 3 main effect and the interaction effect (CBT, DS, and KK, and repeated tests RSE scale (pre test, post test 1,post test 2, post test 3. There was no significant difference in the groups (CBT, DS, and KK main effect on the Rosenberg Self Esteem (RSE scores. There was a significant difference (F (3.10 = 66.823,p = 0.0001 (Wilk's Lambda on the repeated test RSE scale (pre test, post test 1, post test 2, and post test 3 main effects on self esteemscore. Overall findings showed an increase in RSE scores between the pre test, post test 1, post test 2 and post test 3.

  16. Ethics and technology transfer: patients, patents, and public trust.

    Science.gov (United States)

    Zucker, Deborah

    2011-06-01

    Universities and academic medical centers have been increasing their focus on technology transfer and research commercialization. With this shift in focus, academic-industry ties have become prevalent. These relationships can benefit academic researchers and help then to transform their research into tangible societal benefits. However, there also are concerns that these ties and the greater academic focus on commercialization might lead to conflicts of interest, especially financial conflicts of interest. This paper briefly explores some of these conflicts of interest, particularly relating to research and training. This paper also discusses some of the policies that have been, and are being, developed to try to mitigate and manage these conflicts so that academic involvement in technology transfer and commercialization can continue without jeopardizing academic work or the public's trust in them.

  17. Clustering of Local Group distances: publication bias or correlated measurements? IV. The Galactic Center

    CERN Document Server

    de Grijs, Richard

    2016-01-01

    Aiming at deriving a statistically well-justified Galactic Center distance, $R_0$, and reducing any occurrence of publication bias, we compiled the most comprehensive and most complete database of Galactic Center distances available to date, containing 273 new or revised $R_0$ estimates published since records began in October 1918 until June 2016. We separate our $R_0$ compilation into direct and indirect distance measurements. The latter include a large body of estimates that rely on centroid determinations for a range of tracer populations as well as measurements based on kinematic observations of objects at the solar circle, combined with a mass and/or rotational model of the Milky Way. Careful assessment of the Galactic Center distances resulting from orbital modeling and statistical parallax measurements in the Galactic nucleus yields our final Galactic Center distance recommendation of $R_0 = 8.3 \\pm 0.2 \\mbox{ (statistical)} \\pm 0.4 \\mbox{ (systematic)}$ kpc. The centroid-based distances are in good a...

  18. The role of public relations for image creating in health services: a sample patient satisfaction survey.

    Science.gov (United States)

    Kirdar, YalçIn

    2007-01-01

    This study discusses the role of public relations for image creating in health services. Hospitals require public relations activities to distinguish them from competitors, provide bidirectional communication between the society and the hospital, and assist to create of a strong hospital image and culture. A satisfaction survey was conducted on 264 patients who have received health services at Maltepe University Hospital. The research focused on how the Hospital's examination, care, catering and physical services; doctor and nurse politeness towards patients and patient relatives, their attitudes and behaviors; examination, check-in, bedding and discharge operations; public relations activities in and out of the hospital were perceived. Another subject of the study was the degree of recommendation of patients who have been served by the hospital's health services to prospective patients seeking treatment.

  19. Occupational Therapy in the practice of therapeutic groups and workshops with mental health patients

    Directory of Open Access Journals (Sweden)

    Janaina Bussola Montrezor

    2013-12-01

    Full Text Available In this study, we aimed to demonstrate the effectiveness of occupational therapy to patients with mental disorders through therapy groups in an intensive inpatient unit. The following treatment groups were performed: focus groups, operative groups, drawing workshops, and arts workshops. The study included 280 patients (46.07% with ICD F20-29, 23.57% with ICD F30-39, and 14.28% with ICD F19. Of all the patients studied (n = 280, 54.00% participated in the operative groups, 52.85% in the focus groups, 46.80% in the drawing workshops, and 45.70% in the art workshops. In all groups, the participation of the ICD F20-29 group was higher (focus group with 49.25%, 54.00% in the operative group, 51.00% in the workshops of drawing, and 66.00% in art workshops, followed by the ICD F30-39 group with 24.25% in the focus group, 27.00% in the operative group, and 22.00% in the drawing workshops; the ICD F19 group stood out in the arts workshops. Patients with schizophrenia, psychoses, bipolar disorders, among others (ICD F20-20 and ICD F30-39 were the most active in the therapeutic groups, which discussed contents such as joy, anger, fear, thoughts of death, etc. The ICD F19 group presented the greatest participation in the art workshops, a fact that can be explained by the profile of these patients, because many have been in prison and/or admitted to long-stays in hospitals where they learned to perform manual tasks for subsequent survival in society. We concluded that therapeutic groups are effective in treating mental health patients because they contribute to hospital discharge and improve patients’ conditions.

  20. Patient perspectives on the impact of acromegaly: results from individual and group interviews.

    Science.gov (United States)

    Gurel, Michelle H; Bruening, Paul R; Rhodes, Christine; Lomax, Kathleen G

    2014-01-09

    Acromegaly is a chronic condition resulting from a growth hormone-secreting pituitary tumor that can substantially impact patients' physical and emotional well-being. We sought to understand the impact of acromegaly on disease-related concerns and treatment choices from the patient perspective. The path to diagnosis, current disease management, interactions with the treating health care providers (HCPs), and support networks were also assessed. Acromegaly patients were recruited primarily from a patient support group (Acromegaly Community). In Phase I, ten patients participated over the course of 5 days in a moderated online discussion board and they answered questions about their disease. In Phase II, a separate nine-patient cohort participated in face-to-face interviews conducted during an acromegaly patient conference. Data were summarized qualitatively by grouping similar answers and quotations. Nineteen acromegaly patients were recruited across the two cohorts, and both groups shared similar concerns. They demonstrated a notable interest in understanding their disease and its treatment. Patients were focused on the impact of the disease on their life, and they expressed a desire to get beyond reminders of their disease. The patients described long journeys to a correct diagnosis and relief at having a name for their condition. Many shared a sense of shock at needing pituitary surgery and felt unsatisfied by the treatment decision process, motivating them to discuss it with other patients. Patients not connected to a patient support group reported feeling helpless and lonely. Most patients shared a desire to improve their general knowledge about acromegaly to spare others their protracted diagnostic period. Patients also reported hesitancy in asking questions or sharing details about the disease's impact on their lives with their HCPs. Acromegaly can be a life-changing diagnosis with profound, ongoing effects on patients' lives. Patients struggle with many

  1. Group Therapy with Patients in the Waiting Room of an Oncology Clinic.

    Science.gov (United States)

    Arnowitz, Edward; And Others

    1983-01-01

    Describes a therapy group for cancer patients, conducted by cotherapists in an oncology waiting room. Group members provided mutual support and shared concerns and coping methods. Medical staff members became more involved and were more able to address the affective needs of the patients and their families. (JAC)

  2. Individual neuropsychological support and group sessions for relatives to TBI patients

    DEFF Research Database (Denmark)

    Siert, Lars

    TITLE: Individual neuropsychological support and group sessions for relatives to TBI patients. OBJECTIVE: To describe how the neuropsychologist work with early and ongoing individual support and group sessions for relatives to adult TBI patients in the acute and sub acute phase and after discharge...

  3. [Impulsivity-focused Group Intervention to reduce Binge Eating Episodes in Patients with Binge Eating Disorder - A Group Training Program].

    Science.gov (United States)

    Schag, Kathrin; Leehr, Elisabeth J; Skoda, Eva-Maria; Becker, Sandra; Zipfel, Stephan; Giel, Katrin E

    2016-11-01

    Binge Eating Disorder (BED) is an eating disorder where cognitive behavioural therapy (CBT) could already show reliable efficacy. Relying on basic research, CBT interventions which especially focus on impulsivity could be effective, because binge eating episodes represent highly impulsive eating behaviour. For this reason, we developed a treatment concept about an impulsivity-focused behavioural group intervention for patients with BED, called IMPULS. The efficacy of IMPULS is currently investigated in a randomised controlled trial 1. IMPULS is drafted as a weekly group training programme with 5-6 participants per group. The essential interventions are food-related cue exposure with response prevention and the development of self-control strategies. These interventions are adapted onto the impulsivity concept from conventional treatment of addictive disorders and BED. © Georg Thieme Verlag KG Stuttgart · New York.

  4. International patients within the NHS: a case of public sector entrepreneurialism.

    Science.gov (United States)

    Lunt, Neil; Exworthy, Mark; Hanefeld, Johanna; Smith, Richard D

    2015-01-01

    Many public health systems in high- and middle-income countries are under increasing financial pressures as a result of ageing populations, a rise in chronic and non-communicable diseases and shrinking public resources. At the same time the rise in patient mobility and concomitant market in medical tourism provides opportunities for additional income. This is especially the case where public sector hospitals have a reputation as global centres of excellence. Yet, this requires public sector entrepreneurship which, given the unique features of the public sector, means a change to professional culture. This paper examines how and under what conditions public sector entrepreneurship develops, drawing on the example of international patients in the UK NHS. It reports on a subset of data from a wider study of UK medical tourism, and explores inward flows and NHS responses through the lens of public entrepreneurship. Interviews in the English NHS were conducted with managers of Foundation Trusts with interest in international patient work. Data is from seven Foundation Trusts, based on indepth, semi-structured interviews with a range of NHS managers, and three other key stakeholders (n = 16). Interviews were analysed using a framework on entrepreneurship developed from academic literature. Empirical findings showed that Trust managers were actively pursuing a strategy of expanding international patient activity. Respondents emphasised that this was in the context of the current financial climate for the NHS. International patients were seen as a possible route to ameliorating pressure on stretched NHS resources. The analysis of interviews revealed that public entrepreneurial behaviour requires an organisational managerial or political context in order to develop, such as currently in the UK. Public sector workers engaged in this process develop entrepreneurship - melding political, commercial and stakeholder insights - as a coping mechanism to health system constraints.

  5. CWTS crown indicator measures citation impact of a research group's publication oeuvre

    CERN Document Server

    Moed, Henk F

    2010-01-01

    The article "Caveats for the journal and field normalizations in the CWTS (`Leiden') evaluations of research performance", published by Tobias Opthof and Loet Leydesdorff (arXiv:1002.2769) deals with a subject as important as the application of so called field normalized indicators of citation impact in the assessment of research performance of individual researchers and research groups. Field normalization aims to account for differences in citation practices across scientific-scholarly subject fields. As the primary author of the papers presenting the "Leiden" indicators and of many reports and articles reporting on the outcomes of assessments actually using these measures, I comment on the 3 main issues addressed in the paper by Opthof and Leydesdorff.

  6. Clustering of Local Group distances: publication bias or correlated measurements? III. The Small Magellanic Cloud

    CERN Document Server

    de Grijs, Richard

    2015-01-01

    Aiming at providing a firm mean distance estimate to the Small Magellanic Cloud (SMC), and thus to place it within the internally consistent Local Group distance framework we recently established, we compiled the current-largest database of published distance estimates to the galaxy. Based on careful statistical analysis, we derive mean distance estimates to the SMC using eclipsing binary systems, variable stars, stellar population tracers, and star cluster properties. Their weighted mean leads to a final recommendation for the mean SMC distance of $(m-M)_0^{\\rm SMC} = 18.96 \\pm 0.02$ mag, where the uncertainty represents the formal error. Systematic effects related to lingering uncertainties in extinction corrections, our physical understanding of the stellar tracers used, and the SMC's complex geometry---including its significant line-of-sight depth, its irregular appearance which renders definition of the galaxy's center uncertain, as well as its high inclination and possibly warped disk---may contribute a...

  7. Public perceptions of low carbon energy technologies. Results from a Dutch large group workshop

    Energy Technology Data Exchange (ETDEWEB)

    Brunsting, S.; Van Bree, B.; Feenstra, C.F.J.; Hekkenberg, M. [ECN Policy Studies, Petten (Netherlands)

    2011-06-15

    This report describes the outcomes of a large group workshop held in Utrecht, the Netherlands on 21 May 2011. The workshop aims to learn about Dutch citizens perspectives on climate change and low emission energy technologies and how these perspectives may change after receiving and discussing objective information. This report presents participants environmental profile, stated beliefs, knowledge and attitudes, support for different energy technologies, and environmental behaviours and intentions, derived from questionnaire answers and observations during the day. The report also presents observed changes on the above over the course of the workshop. Whereas the report provides some conclusions and inferences throughout its sections, the focus of the report is on presenting the observations. No overall conclusions are drawn.

  8. Benefits of groups in managing systemic arterial hypertension: perceptions of patients and physicians

    OpenAIRE

    Rodrigo Pereira do Amaral; Charles Dalcanale Tesser; Pedro Müller

    2013-01-01

    Objective: To investigate the nature of the benefits of using groups within primary care services to manage hypertension, from the point of view of both patients and physicians. Methods: A qualitative descriptive study using semi-structured interviews with patients and doctors attending distinct consolidated groups, which have been purposely selected and carried out in physician-patient pairs until reaching data saturation. The interviews were subjected to thematic analysis. Results and discu...

  9. The Skills of Facilitator Nurses in Psycho-Social Group Intervention for Cancer Patients

    OpenAIRE

    Chujo, Masami; Okamura, Hitoshi

    2015-01-01

    Background The objective of this study was to provide cancer patients with a psychosocial group intervention consisting of 3 parts, i.e., education on how to cope with stress and solve problems, group discussions, and progressive muscle relaxation, and to investigate the intervention techniques of Japanese facilitators. Methods Group interventions for breast cancer patients performed by 3 facilitators were analyzed qualitatively and inductively using a phenomenological approach. Results The s...

  10. Comparison of patients' experiences in public and private primary care clinics in Malta.

    Science.gov (United States)

    Pullicino, Glorianne; Sciortino, Philip; Calleja, Neville; Schäfer, Willemijn; Boerma, Wienke; Groenewegen, Peter

    2015-06-01

    Demographic changes, technological developments and rising expectations require the analysis of public-private primary care (PC) service provision to inform policy makers. We conducted a descriptive, cross-sectional study using the dataset of the Maltese arm of the QUALICOPC Project to compare the PC patients' experiences provided by public-funded and private (independent) general practitioners in Malta. Seven hundred patients from 70 clinics completed a self-administered questionnaire. Direct logistic regression showed that patients visiting the private sector experienced better continuity of care with more difficulty in accessing out-of-hours care. Such findings help to improve (primary) healthcare service provision and resource allocation.

  11. Issues experienced while administering care to patients with dementia in acute care hospitals: A study based on focus group interviews

    Directory of Open Access Journals (Sweden)

    Risa Fukuda

    2015-02-01

    Full Text Available Objective: Dementia is a major public health problem. More and more patients with dementia are being admitted to acute care hospitals for treatment of comorbidities. Issues associated with care of patients with dementia in acute care hospitals have not been adequately clarified. This study aimed to explore the challenges nurses face in providing care to patients with dementia in acute care hospitals in Japan. Methods: This was a qualitative study using focus group interviews (FGIs. The setting was six acute hospitals with surgical and medical wards in the western region of Japan. Participants were nurses in surgical and internal medicine wards, excluding intensive care units. Nurses with less than 3 years working experience, those without experience in dementia patient care in their currently assigned ward, and head nurses were excluded from participation. FGIs were used to collect data from February to December 2008. Interviews were scheduled for 1–1.5 h. The qualitative synthesis method was used for data analysis. Results: In total, 50 nurses with an average experience of 9.8 years participated. Eight focus groups were formed. Issues in administering care to patients with dementia at acute care hospitals were divided into seven groups. Three of these groups, that is, problematic patient behaviors, recurrent problem, and problems affecting many people equally, interact to result in a burdensome cycle. This cycle is exacerbated by lack of nursing experience and lack of organization in hospitals. In coping with this cycle, the nurses develop protection plans for themselves and for the hospital. Conclusions: The two main issues experienced by nurses while administering care to patients with dementia in acute care hospitals were as follows: (a the various problems and difficulties faced by nurses were interactive and caused a burdensome cycle, and (b nurses do their best to adapt to these conditions despite feeling conflicted.

  12. Issues experienced while administering care to patients with dementia in acute care hospitals: a study based on focus group interviews.

    Science.gov (United States)

    Fukuda, Risa; Shimizu, Yasuko; Seto, Natsuko

    2015-01-01

    Dementia is a major public health problem. More and more patients with dementia are being admitted to acute care hospitals for treatment of comorbidities. Issues associated with care of patients with dementia in acute care hospitals have not been adequately clarified. This study aimed to explore the challenges nurses face in providing care to patients with dementia in acute care hospitals in Japan. This was a qualitative study using focus group interviews (FGIs). The setting was six acute hospitals with surgical and medical wards in the western region of Japan. Participants were nurses in surgical and internal medicine wards, excluding intensive care units. Nurses with less than 3 years working experience, those without experience in dementia patient care in their currently assigned ward, and head nurses were excluded from participation. FGIs were used to collect data from February to December 2008. Interviews were scheduled for 1-1.5 h. The qualitative synthesis method was used for data analysis. In total, 50 nurses with an average experience of 9.8 years participated. Eight focus groups were formed. Issues in administering care to patients with dementia at acute care hospitals were divided into seven groups. Three of these groups, that is, problematic patient behaviors, recurrent problem, and problems affecting many people equally, interact to result in a burdensome cycle. This cycle is exacerbated by lack of nursing experience and lack of organization in hospitals. In coping with this cycle, the nurses develop protection plans for themselves and for the hospital. The two main issues experienced by nurses while administering care to patients with dementia in acute care hospitals were as follows: (a) the various problems and difficulties faced by nurses were interactive and caused a burdensome cycle, and (b) nurses do their best to adapt to these conditions despite feeling conflicted.

  13. 77 FR 42737 - Patient Safety Organizations: Delisting for Cause for The Steward Group PSO

    Science.gov (United States)

    2012-07-20

    ... Cause for The Steward Group PSO AGENCY: Agency for Healthcare Research and Quality (AHRQ), HHS. ACTION: Notice of delisting. SUMMARY: AHRQ has delisted The Steward Group PSO as a Patient Safety Organization... Steward Group PSO failed to respond to a Notice of Preliminary Finding of Deficiency sent by AHRQ...

  14. Metoprolol in acute myocardial infarction. Patient population. The MIAMI Trial Research Group.

    Science.gov (United States)

    1985-11-22

    During the recruitment phase of the MIAMI trial (December 1982 to March 1984), data on 26,439 patients eligible for inclusion were entered. Of these, 5,778 patients were included. Current treatment with either beta blockers or calcium-channel blockers (51%) was the most predominant reason for exclusion. The randomized and excluded patients differed. The randomized patients were younger and more often men. The mean age of the patients was 59 years in both the placebo and the metoprolol groups. The 2 groups were evenly balanced with regard to basic demographic variables. The median delay between onset of symptoms and randomization was 7 hours, and 25% of the patients were included within 4 hours. Previous clinical history and pharmacologic treatment given before admission were well balanced in the groups. Mean heart rate for the 2 groups before randomization was 83 beats/min and systolic blood pressure was 141 mm Hg. Approximately 15% of randomized patients presented with pulmonary rales. Before randomization 20% of the patients had normal electrocardiograms; 70% could be classified as having electrocardiographic signs of acute myocardial infarction; and 10% presented with other electrocardiographic abnormalities. Electrocardiographic signs at entry suggested a predominance of anterior wall infarctions. The randomized patients were not representative of eligible patients and the treatment groups were well balanced at entry.

  15. Quality of life research: types of publication output over time for cancer patients, a systematic review.

    Science.gov (United States)

    Bailey, L J; Sanson-Fisher, R; Aranda, S; D'Este, C; Sharkey, K; Schofield, P

    2010-09-01

    To examine the type of published research regarding quality of life for cancer patients over two 24-month periods: 1995-1996 and 2005-2006. A computer-based literature search was conducted using Medline. Two random samples of 120 publications identified in 1995-1996 and in 2005-2006 were coded as data-based research, reviews or programme descriptions. Data-based publications were further coded as measurement, descriptive or intervention research. Intervention publications were coded as psychosocial- or biomedical-based. Psychosocial intervention papers were coded using Cochrane Review criteria. In 1995-1996, 419 publications were identified and 1271 publications in 2005-2006. The majority of publications were data-based. The proportion of types of publications (data-based, reviews or programme description/case report categories) did not change significantly over time. Descriptive research dominated data-based publication outputs in 1995-1996 and 2005-2006. The current approach to quality of life research for cancer patients may be less than optimal for providing successful development of knowledge, improving healthcare delivery and lessening the burden of suffering.

  16. Information sharing between different groups: a qualitative study of information service to business in Japanese public libraries

    Directory of Open Access Journals (Sweden)

    Shunsaku Tamura

    2007-01-01

    Full Text Available Introduction. This paper is the first report of a research project on the effects of information service to business in Japanese public libraries. The overall goals of the project are to develop a conceptual framework for understanding effects of a library service and then to examine them in business information service. The objective of this first report is to get an overview of current practice of business information service in Japanese public libraries and examine images of users and uses by librarians in charge. Method. The project consists of three stages. At the first stage a series of field trips was conducted with semi-structured interviews in 22 libraries all over Japan and a focused group interview of librarians in charge of the service was also conducted (not reported here. Results. A variety of services are provided by public libraries. Levels of reference service and relationships with other agencies and organizations are the most important factors in determining the nature and kind of service provided. The process of providing the service is actually a complex process influenced by many factors. Conclusion. . Results suggest strongly the complex process of value creation. Images of users and uses are formed not only by direct contact with users but as a result of this complex process. Sometimes images have political connotations as both librarians and other stakeholders hope the service to be useful in promoting local business and/or industry and advancing local lives.

  17. Architecture and the Ideology of Productivity: Four Public Housing Projects by Groupe Structures in Brussels (1950-65

    Directory of Open Access Journals (Sweden)

    Sven Sterken

    2014-08-01

    Full Text Available The field of public housing in Belgium formed the backdrop for two crucial phenomena in the shaping of the welfare state: first, the general compartmentalization along ideological lines of all aspects of society, including housing policy and town planning; second, the adaptation of the nation’s industry, and the building trade in particular, to postwar economic conditions. In the study of welfare state housing policies in Belgium, the latter aspect has so far been overlooked. This paper therefore proposes to look into a couple of public housing projects by Groupe Structures, the largest architectural firm in the country in the postwar period. As it will be argued, the stylistic and typological evolution of these schemes reveals the growing impact of a ‘productivist ideology’ on public housing in the 1950s. Paralyzed by the steeply rising building costs, the central buzzwords became standardization, industrialization and prefabrication. However, as the paper argues, the productivity doctrine failed to live up to its expectations as the sector’s turnover remained too marginal to put sufficient pressure on the construction industry.

  18. The use, publication and future directions of immunocytochemistry in veterinary medicine: a consensus of the Oncology-Pathology Working Group.

    Science.gov (United States)

    Priest, H L; Hume, K R; Killick, D; Kozicki, A; Rizzo, V L; Seelig, D; Snyder, L A; Springer, N L; Wright, Z M; Robat, C

    2016-03-22

    One of the primary objectives of the Oncology Pathology Working Group (OPWG), a joint initiative of the Veterinary Cancer Society and the American College of Veterinary Pathologists, is for oncologists and pathologists to collaboratively generate consensus documents to standardize aspects of and provide guidelines for oncologic pathology. Consensus is established through review of relevant peer-reviewed literature relative to a subgroup's particular focus. In this document, the authors provide descriptions of the literature reviewed, the review process, and a summary of the information gathered on immunocytochemistry. The intent of this publication is to help educate practitioners and pathologists on the process of immunocytochemistry and to provide a guide for the use of this technique in veterinary medicine. This document represents the opinions of the working group and the authors and does not constitute a formal endorsement by the American College of Veterinary Pathologists or the Veterinary Cancer Society.

  19. Dementia research--what do different public groups want? A survey by the Scottish Dementia Clinical Research Network.

    Science.gov (United States)

    Law, Emma; Starr, John M; Connelly, Peter John

    2013-01-01

    Scotland's National Dementia Strategy calls for people with dementia and their carers to give voice to what they see as the priorities for dementia research. We sent questionnaires on dementia research priorities, locus and type of research, desired outcome measures and willingness to volunteer, to two groups of dementia research stakeholders: (1) people with dementia and their carers who may or may not be participating in research and (2) those who are directly participating in research. We also made the questionnaire available on a national dementia research website. Five hundred and fourteen responses were received. The top four topics rated by importance were identical across all three groups of respondents: early detection (38.1%), drug trials (14.2%), studies on people living at home (9.7%) and study of carers (6.0%). The data can help shape the dementia research agenda, but more information needs to be made available to the public about other potential research areas.

  20. Orthopedics nursing patients' profile of a public hospital in Salvador-Bahia

    OpenAIRE

    Castro,Renata Reis Matutino de; Ribeiro,Natália Fonseca; de Andrade, Aline Mendonça; Jaques,Bruno Dórea

    2013-01-01

    OBJECTIVES: To describe the profile of patients treated in the trauma and orthopedics nursing of a trauma care referral public hospital of in the state of Bahia. METHODS: Cross-sectional study in which data were collected from medical records of patients in the period from July to December 2008. RESULTS: The profile of the patients involved was formed by subjects mostly male young subjects, victims of trauma from accidents, especially those with motorcycles or car runover. On the other hand,t...

  1. Patient and public attitudes towards informed consent models and levels of awareness of Electronic Health Records in the UK

    Science.gov (United States)

    Riordan, Fiona; Papoutsi, Chrysanthi; Reed, Julie E.; Marston, Cicely; Bell, Derek; Majeed, Azeem

    2015-01-01

    Background The development of Electronic Health Records (EHRs) forms an integral part of the information strategy for the National Health Service (NHS) in the UK, with the aim of facilitating health information exchange for patient care and secondary use, including research and healthcare planning. Implementing EHR systems requires an understanding of patient expectations for consent mechanisms and consideration of public awareness towards information sharing as might be made possible through integrated EHRs across primary and secondary health providers. Objectives To explore levels of public awareness about EHRs and to examine attitudes towards different consent models with respect to sharing identifiable and de-identified records for healthcare provision, research and planning. Methods A cross-sectional questionnaire survey was administered to adult patients and members of the public in primary and secondary care clinics in West London, UK in 2011. In total, 5331 individuals participated in the survey, and 3157 were included in the final analysis. Results The majority (91%) of respondents expected to be explicitly asked for consent for their identifiable records to be accessed for health provision, research or planning. Half the respondents (49%) did not expect to be asked for consent before their de-identified records were accessed. Compared with White British respondents, those from all other ethnic groups were more likely to anticipate their permission would be obtained before their de-identified records were used. Of the study population, 59% reported already being aware of EHRs before the survey. Older respondents and individuals with complex patterns of interaction with healthcare services were more likely to report prior awareness of EHRs. Individuals self-identifying as belonging to ethnic groups other than White British, and those with lower educational qualifications were less likely to report being aware of EHRs than White British respondents and

  2. Patients' experiences and expectations of general practice: a questionnaire study of differences by ethnic group

    Science.gov (United States)

    Ogden, Jane; Jain, Asha

    2005-01-01

    Background Research has highlighted variations in morbidity, mortality and health needs by ethnic group, and suggests that some ethnic groups may receive a poorer service. Aim To explore the impact of ethnic group on patients' experiences and expectations of their general practice consultation. Design of study Cross-sectional survey. Setting One general practice in a multicultural area of London. Method A total of 604 consecutive patients attending their general practice (response rate = 60.4%) who described their ethnic group as white British, black African, black African Caribbean or Vietnamese completed a measure relating to their experiences and their expectations of the general practice consultation in terms of treatment, communication, patients' agenda, patients' choice and doctor consistency. Results No differences were found for the black African or black African Caribbean patients. The Vietnamese patients reported better experiences of communication, more focus on their agenda and more attention to their choices than the white British patients. However, they also reported expecting lower levels of communication, less focus on their own agenda and reported wanting less GP consistency than the other ethnic groups. Conclusion Vietnamese patients state that they are receiving better standards of care in general practice than other ethnic groups. However, they also state that they expect less. This may illustrate a problem with assessing experiences of primary care. Higher scores of experience may not illustrate better consultations as such, but only better when compared with a lower level of initial expectation. A lower expectation is easier to fulfil. PMID:15904553

  3. CLASSIFICATION OF ORTHOGNATHIC SURGERY PATIENTS INTO LOW AND HIGH BLEEDING RISK GROUPS USING THROMBELASTOGRAPHY

    DEFF Research Database (Denmark)

    Elenius Madsen, Daniel

    2012-01-01

    Title: CLASSIFICATION OF ORTHOGNATHIC SURGERY PATIENTS INTO LOW AND HIGH BLEEDING RISK GROUPS USING THROMBELASTOGRAPHY Objectives: Orthognathic surgery involves surgical manipulation of jaw and face skeletal structure. A subgroup of patients undergoing orthognathic surgery suffers from excessive ...... to their bleeding risk. This valuable knowledge will be useful with regard to optimization of patient safety, staff composition and transfusion preparations. This pilot study included only 41 patients, and further studies are needed to consolidate the observations done....

  4. CLASSIFICATION OF ORTHOGNATHIC SURGERY PATIENTS INTO LOW AND HIGH BLEEDING RISK GROUPS USING THROMBELASTOGRAPHY

    DEFF Research Database (Denmark)

    Elenius Madsen, Daniel

    2012-01-01

    Title: CLASSIFICATION OF ORTHOGNATHIC SURGERY PATIENTS INTO LOW AND HIGH BLEEDING RISK GROUPS USING THROMBELASTOGRAPHY Objectives: Orthognathic surgery involves surgical manipulation of jaw and face skeletal structure. A subgroup of patients undergoing orthognathic surgery suffers from excessive...... intraoperative blood loss. Classification of patients according to their bleeding risk will improve the surgical procedure with regard to staff composition, blood transfusion and patient safety. Thrombelastography is a global coagulation assay measuring the viscoelastic properties of whole blood samples, taking...

  5. The anonymity paradox in patient engagement: reputation, risk and web-based public feedback.

    Science.gov (United States)

    Speed, Ewen; Davison, Charlie; Gunnell, Caroline

    2016-06-01

    The UK National Health Service (NHS) has long espoused patient and public engagement. Recent years have seen increasing use of internet-based methods of collecting feedback about patient experience and public and staff views about NHS services and priorities. Often hailed as a means of facilitating participative democratic patient engagement, these processes raise a number of complex issues. A key aspect of it is the opportunity for comment to be made anonymously. Our research reveals an anonymity paradox whereby patients clearly demonstrate a perception that anonymity is a prerequisite for effective use of these feedback processes, whereas professionals demonstrate a perception that patient anonymity is a barrier to effective use. The risks of anonymity are constructed very differently by patients and professionals. Patient concerns around anonymity were not motivated by a general concern about a loss of privacy, but more that a positive identification might compromise future care. For professionals, concerns were voiced more around risks of reputational damage for specific practitioners or practices (in that anyone could say anything) and also that this anonymous feedback was available publicly and that it might go against the medical opinion of the professional. These concerns pointed to important differences in perceptions of patient and professional vulnerability. In the qualitative analysis that follows the key finding was that while anonymity makes service users feel less vulnerable, it can have the opposite effect on managers and clinical staff. This raises important implications for the use and utility of internet-based methods of collecting patient feedback.

  6. Title: The Comparison of Anxiety Sensitivity and Happiness in Irritable Bowel Syndrome Patients with Normal Matched Group in Shiraz

    Directory of Open Access Journals (Sweden)

    2012-09-01

    Full Text Available Background & Objective: The purpose of this study was the comparison of anxiety sensitivity and happiness between patients with Irritable Bowel Syndrome (IBS and normal matched group. Materials & Methods: The Subjects were 35 (21 females and 14 male IBS patients diagnosed by gastroenterologist and 35 (25 female and 10 males normal matched group all in 14– 63 old age. Anxiety Sensitivity Index (ASI-R, Oxford Happiness Questionnaire (OHQ, and a checklist applied as measures of anxiety sensitivity, happiness and demographic information. Results: Data analysis indicates that IBS patients significantly are higher than matched group in fear of publicly observable symptoms (P= 0.032, fear of cardiovascular symptoms (P= 0.01, fear of gastrointestinal symptoms (P= 0.001, fear of dissociative and neurological symptoms (P= 0.018, & general anxiety sensitivity (P= 0.003, and lower in joy (P= 0.005, control (P= 0.008, self- esteem (P= 0.001 calm (P= 0.006 and general happiness (P= 0.001. Although no significant differences were found in life satisfaction (P= 0.083 & efficacy (P= 0.09, fear of respiratory symptoms (P= 0.067, and fear of cognitive control deficiency (p= 0.097. Conclusion: As a psychological variable anxiety sensitivity can predict treatment seeking of IBS patient, and happiness negatively influenced by both anxiety sensitivity and IBS.

  7. Challenges in the doctor-patient relationship: 12 tips for more effective peer group discussion.

    Science.gov (United States)

    Wilson, Hamish

    2015-09-01

    In New Zealand, almost all general practitioners are members of peer groups, which provide opportunities for both clinical discussion and collegial support. This article proposes that peer groups can also be a useful medium for exploring specific challenges within the doctor-patient relationship. However, the peer group culture needs to be receptive to this particular goal. Structured discussion can help peer group members explore interpersonal issues more thoroughly.

  8. Operationalization of the Ghanaian Patients' Charter in a Peri-urban Public Hospital: Voices of Healthcare Workers and Patients.

    Science.gov (United States)

    Yarney, Lily; Buabeng, Thomas; Baidoo, Diana; Bawole, Justice Nyigmah

    2016-04-23

    Health is a basic human right necessary for the exercise of other human rights. Every human being is, therefore, entitled to the highest possible standard of health necessary to living a life of dignity. Establishment of patients' Charter is a step towards protecting the rights and responsibilities of patients, but violation of patients' rights is common in healthcare institutions, especially in the developing world. This study which was conducted between May 2013 and May 2014, assessed the operationalization of Ghana's Patients Charter in a peri-urban public hospital. Qualitative data collection methods were used to collect data from 25 healthcare workers and patients who were purposively selected. The interview data were analyzed manually, using the principles of systematic text condensation. The findings indicate that the healthcare staff of the Polyclinic are aware of the existence of the patients' Charter and also know some of its contents. Patients have no knowledge of the existence or the contents of the Charter. Availability of the Charter, community sensitization, monitoring and orientation of staff are factors that promote the operationalization of the Charter, while institutional implementation procedures such as lack of complaint procedures and low knowledge among patients militate against operationalization of the Charter. Public health facilities should ensure that their patients are well-informed about their rights and responsibilities to facilitate effective implementation of the Charter. Also, patients' rights and responsibilities can be dramatized and broadcasted on television and radio in major Ghanaian languages to enhance awareness of Ghanaians on the Charter.

  9. Comparison of familial and psychological factors in groups of encopresis patients with constipation and without constipation.

    Science.gov (United States)

    Çengel-Kültür, S Ebru; Akdemir, Devrim; Saltık-Temizel, İnci N

    2014-01-01

    The study aimed to evaluate the differences between groups of encopresis patients with constipation and without constipation. The Symptom Checklist- 90-Revised, the COPE Questionnaire, the Relationship Scales Questionnaire, the McMaster Family Assessment Device and the Parenting Style Scale were used to evaluate, respectively, maternal psychiatric symptoms, coping abilities, attachment style, family functioning and children's perceptions of parenting behaviors. Psychiatric diagnoses were evaluated using the K-SADS. A higher level of maternal psychiatric symptoms, impaired role and affective involvement functioning of the family and less psychological autonomy were observed in the group of encopresis patients with constipation than in the group of encopresis patients without constipation. No significant differences were found between the groups in psychiatric comorbidities, maternal coping abilities and attachment style. The two groups had a similar pattern of comorbid psychiatric disorders and maternal psychological factors, although some familial factors-related mainly to parental authority-were differentiated in the encopresis with constipation group.

  10. Rethinking the relationship between science and society: Has there been a shift in attitudes to Patient and Public Involvement and Public Engagement in Science in the United Kingdom?

    Science.gov (United States)

    Boaz, Annette; Biri, Despina; McKevitt, Christopher

    2016-06-01

    The policy imperative to engage the public and patients in research can be seen as part of a wider shift in the research environment. This study addresses the question: Has there been a shift in attitudes to Patient and Public Involvement (PPI) and Public Engagement in Science (PES) amongst researchers? Attitudes to PPI and PES within a cluster of three NIHR supported Biomedical Research Centres were explored through in-depth interviews with 19 researchers. Participants distinguished PPI (as an activity involving patients and carers in research projects and programmes) from PES (as an activity that aims to communicate research findings to the public, engage the public with broader issues of science policy or promote a greater understanding of the role of science in society). While participants demonstrated a range of attitudes to these practices, they shared a resistance to sharing power and control of the research process with the public and patients. While researchers were prepared to engage with the public and patients and listed the advantages of engagement, the study revealed few differences in their underlying attitudes towards the role of society in science (and science in society) to those reported in previous studies. To the participants science remains the preserve of scientists, with patients and the public invited to 'tinker at the edges'. © 2014 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  11. Inclusive public participation in health: Policy, practice and theoretical contributions to promote the involvement of marginalised groups in healthcare.

    Science.gov (United States)

    de Freitas, Cláudia; Martin, Graham

    2015-06-01

    Migrants and ethnic minorities are under-represented in spaces created to give citizens voice in healthcare governance. Excluding minority groups from the health participatory sphere may weaken the transformative potential of public participation, (re)producing health inequities. Yet few studies have focused on what enables involvement of marginalised groups in participatory spaces. This paper addresses this issue, using the Participation Chain Model (PCM) as a conceptual framework, and drawing on a case study of user participation in a Dutch mental health advocacy project involving Cape Verdean migrants. Data collection entailed observation, documentary evidence and interviews with Cape Verdeans affected by psychosocial problems (n = 20) and institutional stakeholders (n = 30). We offer practice, policy and theoretical contributions. Practically, we highlight the importance of a proactive approach providing minorities and other marginalised groups with opportunities and incentives that attract, retain and enable them to build and release capacity through involvement. In policy terms, we suggest that both health authorities and civil society organisations have a role in creating 'hybrid' spaces that promote the substantive inclusion of marginalised groups in healthcare decision-making. Theoretically, we highlight shortcomings of PCM and its conceptualisation of users' resources, suggesting adaptations to improve its conceptual and practical utility. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Group-based trajectory modeling to assess adherence to biologics among patients with psoriasis

    Directory of Open Access Journals (Sweden)

    Li Y

    2014-04-01

    Full Text Available Yunfeng Li,1 Huanxue Zhou,2 Beilei Cai,1 Kristijan H Kahler,1 Haijun Tian,1 Susan Gabriel,1 Steve Arcona11Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA; 2KMK Consulting Inc., Florham Park, NJ, USABackground: Proportion of days covered (PDC, a commonly used adherence metric, does not provide information about the longitudinal course of adherence to treatment over time. Group-based trajectory model (GBTM is an alternative method that overcomes this limitation.Methods: The statistical principles of GBTM and PDC were applied to assess adherence during a 12-month follow-up in psoriasis patients starting treatment with a biologic. The optimal GBTM model was determined on the basis of the balance between each model's Bayesian information criterion and the percentage of patients in the smallest group in each model. Variables potentially predictive of adherence were evaluated.Results: In all, 3,249 patients were included in the analysis. Four GBTM adherence groups were suggested by the optimal model, and patients were categorized as demonstrating continuously high adherence, high-then-low adherence, moderate-then-low adherence, or consistently moderate adherence during follow-up. For comparison, four PDC groups were constructed: PDC Group 4 (PDC ≥75%, PDC Group 3 (25%≤ PDC <50%, PDC Group 2 (PDC <25%, and PDC Group 1 (50%≤ PDC <75%. Our findings suggest that the majority of patients (97.9% from PDC Group 2 demonstrated moderate-then-low adherence, whereas 96.4% of patients from PDC Group 4 showed continuously high adherence. The remaining PDC-based categorizations did not capture patients with uniform adherence behavior based on GBTM. In PDC Group 3, 25.3%, 17.2%, and 57.5% of patients exhibited GBTM-defined consistently moderate adherence, moderate-then-low adherence, or high-then-low adherence, respectively. In PDC Group 1, 70.8%, 23.6%, and 5.7% of patients had consistently moderate adherence, high-then-low adherence, and

  13. Patients' experience of home and hospital based cardiac rehabilitation: a focus group study.

    Science.gov (United States)

    Jones, Miren I; Greenfield, Sheila; Jolly, Kate

    2009-03-01

    New cardiac rehabilitation (CR) programmes, such as home programmes using the Heart Manual, are being introduced but little is known about patients' experiences of these. To compare the views of patients who had completed a home or hospital-based CR programme and explore the benefits and problems of each programme. 16 patients from 4 hospital programmes attended one of 3 focus groups; 10 home programme patients attended one of 2 focus groups. Some themes were common to all focus groups: loss of confidence; continuing to exercise and lifestyle changes; understanding of heart disease. Hospital programme patients particularly enjoyed exercising in a group and mixing with other people, and gained motivation and support from others. Home programme patients spoke very highly of the Heart Manual and valued the one-to-one support of the nurse facilitators. They described the home programme as a lifestyle change compared to the hospital programme which they suggested was more like a treatment. Patients in the hospital programme enjoyed the camaraderie of group exercise and patients in the home programme valued the wealth of information and advice in the Heart Manual and this gave them a feeling of being in control of their health.

  14. Frequency of ABO/Rhesus Blood Groups in Patients with Diabetes Mellitus.

    Science.gov (United States)

    Oner, Can; Dogan, Burcu; Telatar, Berrin; Celik Yagan, Canan Fidan; Oguz, Aytekin

    2016-01-01

    The correlation between ABO/Rh blood groups and diabetes mellitus is still controversial. The aim of this study was to determine the relationship between ABO/Rhesus blood groups and diabetes in Turkish population. This cross-sectional study was conducted in Istanbul Medeniyet University Göztepe Education and Training Hospital's Diabetes Units. The study group was composed of 421 patients with type-1 diabetes, 484 patients with type-2 diabetes and 432 controls. Blood samples were collected and tested for ABO/Rhesus blood groups. Data was analyzed by SPSS version 17.0. A significant association was found between blood groups and diabetes mellitus. The frequency of AB blood group was significantly higher in type-1 diabetics; and A blood group was significantly higher in type-2 diabetics. Furthermore, Rh negativity were significantly more frequent in type-2 diabetics.

  15. PREVALENCE OF VITAMIN D DEFICIENCY IN DIFFERENT GROUPS OF CHRONIC RENAL FAILURE PATIENTS.

    Directory of Open Access Journals (Sweden)

    Bistra T. Galunska

    2015-09-01

    Full Text Available Purpose: To determine and compare the vitamin D status of different groups CKD patients on hemodialysis, peritoneal dialysis, or no renal replacement therapy and to evaluate the effect of vitamin D therapy. Patients and Methods: This pilot study enrolled 40 consecutive CKD patients (21 men, 19 women divided into three groups: 15 CKD patients in 1,2,3,4 stage of the disease without renal replacement therapy (RRT; 10CKD patients on hemodialysis (HD and 15 CKD patients on peritoneal dialysis (PD, ten of which were on vitamin D therapy. Vitamin D status was determined by serum 25-xydroxyvitamin D (25OHD. Results: Ninety percent of patients were in vitamin D deficiency/insufficiency; and only 4 patients (10.0% reached 25OHD levels above 75nmol/L. The median 25OHD level was 31.15nmol/L (interquartile range: 16.67-48.33nmol/L.Tendency of worse vitamin D status in women than in men was observed. Higher 25OHD levels were found in pre-dialysis patients (median 44.81nmol/L, 25%-75% percentile 16.24-52.21nmol/L and lower in HD (median 31.15nmol/L, 25%-75% percentile 13.04-64.45nmol/L and PD patients (median 33.38nmol/L, 25%-75% percentile 23.15-48.49nmol/L, but the difference did not reach statistical significance. Better vitamin D status was found in the PD group of patients receiving vitamin D preparations (p<0.05. Conclusions: 25OHD deficiency/insufficiency is prevalent in renal failure patients with or without renal replacement therapy. It seems that vitamin D therapy improves the vitamin D status of PD patients. Further larger studies are needed to clarify the effect of specific type vitamin D therapy on serum 25OHD levels and clinical outcome in different groups of CKD patients.

  16. Patient perspectives on the impact of acromegaly: results from individual and group interviews

    Directory of Open Access Journals (Sweden)

    Gurel MH

    2014-01-01

    Full Text Available Michelle H Gurel,1 Paul R Bruening,2 Christine Rhodes,2 Kathleen G Lomax31Neuroendocrine Clinical Center, Massachusetts General Hospital, Boston, MA, USA; 2Nicholas Research Associates International, New York, NY, USA; 3Medical Affairs, Ipsen Biopharmaceuticals, Inc., Basking Ridge, NJ, USAPurpose: Acromegaly is a chronic condition resulting from a growth hormone-secreting pituitary tumor that can substantially impact patients' physical and emotional well-being. We sought to understand the impact of acromegaly on disease-related concerns and treatment choices from the patient perspective. The path to diagnosis, current disease management, interactions with the treating health care providers (HCPs, and support networks were also assessed.Methods: Acromegaly patients were recruited primarily from a patient support group (Acromegaly Community. In Phase I, ten patients participated over the course of 5 days in a moderated online discussion board and they answered questions about their disease. In Phase II, a separate nine-patient cohort participated in face-to-face interviews conducted during an acromegaly patient conference. Data were summarized qualitatively by grouping similar answers and quotations.Results: Nineteen acromegaly patients were recruited across the two cohorts, and both groups shared similar concerns. They demonstrated a notable interest in understanding their disease and its treatment. Patients were focused on the impact of the disease on their life, and they expressed a desire to get beyond reminders of their disease. The patients described long journeys to a correct diagnosis and relief at having a name for their condition. Many shared a sense of shock at needing pituitary surgery and felt unsatisfied by the treatment decision process, motivating them to discuss it with other patients. Patients not connected to a patient support group reported feeling helpless and lonely. Most patients shared a desire to improve their general

  17. International Pediatric Otolaryngology Group (IPOG) consensus recommendations : Hearing loss in the pediatric patient

    NARCIS (Netherlands)

    Liming, Bryan J; Carter, John; Cheng, Alan; Choo, Daniel; Curotta, John; Carvalho, Daniela; Germiller, John A; Hone, Stephen; Kenna, Margaret A; Loundon, Natalie; Preciado, Diego; Schilder, Anne; Reilly, Brian J; Roman, Stephane; Strychowsky, Julie; Triglia, Jean-Michel; Young, Nancy; Smith, Richard J H

    OBJECTIVE: To provide recommendations for the workup of hearing loss in the pediatric patient. METHODS: Expert opinion by the members of the International Pediatric Otolaryngology Group. RESULTS: Consensus recommendations include initial screening and diagnosis as well as the workup of

  18. The effect of peer support group on self-transcendence in patients undergoing haemodialysis

    Directory of Open Access Journals (Sweden)

    Maryam Jadid Milani

    2017-03-01

    Full Text Available Introduction: Self-transcendence helps patients undergoing haemodialysis to organize the variety of challenges caused by the disease in order to make them feel well. This study  was   conducted  to determine the effect of counterpart group on improving self-transcendence level in patients undergoing haemodialysis. Materials and Methods: This clinical trial was conducted with two groups of intervention and control, with 55 patients undergoing hemodialysis. The samples were divided in 2 groups of intervention and control through block randomization. Two-hour counterpart group sessions were held for eight weeks for intervention group. The session's topics were based on the patients’ needs and interests. Research tools were questionnaire, demographic information and "Reed’s Self-Transcendence Scale (STS". The descriptive and inferential statistics were used for data analysis using the SPSS v18. Results: There was a significant difference between self-transcendence scores in two groups of intervention and control (P<0.05. A significant increase in the level of self-transcendence in both groups was seen at the end of the study compared to basal status (P<0.05. Conclusions: According to the study results, attending the counterpart groups improved  self-transcendence in patients undergoing haemodialysis. The results can be used in nursing education and management. Training Self-transcendence evaluation is recommended for other chronic diseases with the emphasize on participating in counterpart groups for assessing its efficiency.

  19. Distribution of ABO and Rh Blood Groups in Patients With Keratoconus: A Case-Control Study.

    Science.gov (United States)

    Naderan, Mohammad; Rajabi, Mohammad Taher; Shoar, Saeed; Kamaleddin, Mohammad Amin; Naderan, Morteza; Rezagholizadeh, Farzaneh; Zolfaghari, Masoome; Pahlevani, Rozhin

    2015-07-01

    Association of keratoconus (KC) with genetic predisposition and environmental factors has been well documented. However, no single study has investigated the possible relationship between ABO and Rh blood groups and KC. A case-control study was designed in a university hospital enrolling 214 patients with KC in the case group and equal number of age- and sex-matched healthy subjects in the control group. Primary characteristics, ABO blood group, and Rh factors were compared between the two groups. Topographic findings of KC eyes and the severity of the diseases were investigated according to the distribution of the blood groups. Blood group O and Rh(+) phenotype were most frequent in both groups. There was no significant difference between the two groups in terms of ABO blood groups or Rh factors. Mean keratometery (K), central corneal thickness, thinnest corneal thickness, flat K, steep K, sphere and cylinder, spherical equivalent, and uncorrected visual acuity were all similar between ABO blood groups and Rh(+) and Rh(-) groups. However, the best spectacle-corrected visual acuity (BCVA) had the highest value in AB blood group (0.35 ± 0.22 logMAR, P=0.005). Moreover, the blood group AB revealed the highest frequency for grade 3 KC, followed by grades 1, 2, and 4 (P=0.003). We observed no significant excess of any particular blood group among KC cases compared with healthy subjects. Except BCVA, none of the keratometric or topographic findings was significantly different between blood groups.

  20. Group art therapy as adjunct therapy for the treatment of schizophrenic patients in day hospital

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    Mandić-Gajić Gordana

    2013-01-01

    Full Text Available Introduction. The schizophrenics are frequently disinterested and resistant to standard care. Case report. We presented clinical observations of group art therapy of two schizophrenic patients during integrative therapy in Day Hospital. We modified the original “Synallactic collective image technique” (Vassiliou G, Vassiliou V.. The group is open, heterogeneous, meets once a week and discusses on exhibited drawings, drawn by free associations. The patients' drawings and group protocols showed clinical improvement by lowering depressive themes, more human figures and self-confidence. The obvious severity of markedly impairment on Clinical Global Impression (CGI and Global Assessment of Functioning (GAF scales on admission with minimal improvement at discharge was rated. Conclusion. Group art therapy enables visual expression of emotions, perceptions and cognitions, develops creative potentials and support within the group, thus facilitating the integrative therapeutic process of schizophrenics. It may be useful adjunctive therapy for schizoprenic patients.

  1. Intestinal parasitic infections in different groups of immunocompromised patients in Kashan and Qom cities, central Iran.

    Science.gov (United States)

    Rasti, Sima; Hassanzadeh, Malihe; Hooshyar, Hossein; Momen-Heravi, Mansooreh; Mousavi, Seyed Gholam Abbas; Abdoli, Amir

    Intestinal parasitic infections (IPIs) are important causes of morbidity and mortality in patients with immunocompromising conditions. The aim of this study was to determine the prevalence of IPIs in different groups of immunocompromised patients, including hemodialysis patients (HD), renal transplant recipients (RTR), cancer and HIV/AIDS patients in comparison with healthy individuals in two central cities of Iran (Kashan and Qom). In this case-control study, the stool samples of 135 HD, 50 RTR, 60 cancer patients, 20 HIV/AIDS patients and 120 healthy subjects were tested using direct-smear, formol-ether concentration, Ziehl-Neelsen staining and Agar plate method. The overall infection rate was 11.7% (31/265) in patient groups and 0% (0/120) in the control group. The frequency of parasites was 25% in HIV/AIDS patients, 11.9% (16/135) in HD, 12.0% (6/50) in RTR and 6.7% (4/60) in cancer patients. Blastocystis hominis (4.2%) and Giardia lamblia (3.0%) were the most prevalent parasites in patient groups. The infection rate was significantly higher in male (17.6%) than female (5.4%) patients (p = .002), but no statistically significant association was observed according to the age and educational levels. This study showed a high prevalence of IPIs in immunocompromised patients. The results of this study suggest that periodic stool examinations for screening of IPIs should be included as a part of routine medical care in these patients.

  2. Public versus Private Drug Insurance and Outcomes of Patients Requiring Biologic Therapies for Inflammatory Bowel Disease

    Science.gov (United States)

    Rumman, Amir; Candia, Roberto; Sam, Justina J.; Croitoru, Kenneth; Silverberg, Mark S.; Steinhart, A. Hillary

    2017-01-01

    Background. Antitumor necrosis factor (anti-TNF) therapy is a highly effective but costly treatment for inflammatory bowel disease (IBD). Methods. We conducted a retrospective cohort study of IBD patients who were prescribed anti-TNF therapy (2007–2014) in Ontario. We assessed if the insurance type was a predictor of timely access to anti-TNF therapy and nonroutine health utilization (emergency department visits and hospitalizations). Results. There were 268 patients with IBD who were prescribed anti-TNF therapy. Public drug coverage was associated with longer median wait times to first dose than private one (56 versus 35 days, P = 0.002). After adjusting for confounders, publicly insured patients were less likely to receive timely access to anti-TNF therapy compared with those privately insured (adjusted hazard ratio, 0.66; 95% CI: 0.45–0.95). After adjustment for demographic and clinical characteristics, publicly funded subjects were more than 2-fold more likely to require hospitalization (incidence rate ratio [IRR], 2.30; 95% CI: 1.19–4.43) and ED visits (IRR 2.42; 95% CI: 1.44–4.08) related to IBD. Conclusions. IBD patients in Ontario with public drug coverage experienced greater delays in access to anti-TNF therapy than privately insured patients and have a higher rate of hospitalizations and ED visits related to IBD. PMID:28239601

  3. Public versus Private Drug Insurance and Outcomes of Patients Requiring Biologic Therapies for Inflammatory Bowel Disease

    Directory of Open Access Journals (Sweden)

    Amir Rumman

    2017-01-01

    Full Text Available Background. Antitumor necrosis factor (anti-TNF therapy is a highly effective but costly treatment for inflammatory bowel disease (IBD. Methods. We conducted a retrospective cohort study of IBD patients who were prescribed anti-TNF therapy (2007–2014 in Ontario. We assessed if the insurance type was a predictor of timely access to anti-TNF therapy and nonroutine health utilization (emergency department visits and hospitalizations. Results. There were 268 patients with IBD who were prescribed anti-TNF therapy. Public drug coverage was associated with longer median wait times to first dose than private one (56 versus 35 days, P=0.002. After adjusting for confounders, publicly insured patients were less likely to receive timely access to anti-TNF therapy compared with those privately insured (adjusted hazard ratio, 0.66; 95% CI: 0.45–0.95. After adjustment for demographic and clinical characteristics, publicly funded subjects were more than 2-fold more likely to require hospitalization (incidence rate ratio [IRR], 2.30; 95% CI: 1.19–4.43 and ED visits (IRR 2.42; 95% CI: 1.44–4.08 related to IBD. Conclusions. IBD patients in Ontario with public drug coverage experienced greater delays in access to anti-TNF therapy than privately insured patients and have a higher rate of hospitalizations and ED visits related to IBD.

  4. Patient Engagement Practices in Clinical Research among Patient Groups, Industry, and Academia in the United States: A Survey.

    Science.gov (United States)

    Smith, Sophia K; Selig, Wendy; Harker, Matthew; Roberts, Jamie N; Hesterlee, Sharon; Leventhal, David; Klein, Richard; Patrick-Lake, Bray; Abernethy, Amy P

    2015-01-01

    Patient-centered clinical trial design and execution is becoming increasingly important. No best practice guidelines exist despite a key stakeholder declaration to create more effective engagement models. This study aims to gain a better understanding of attitudes and practices for engaging patient groups so that actionable recommendations may be developed. Individuals from industry, academic institutions, and patient groups were identified through Clinical Trials Transformation Initiative and Drug Information Association rosters and mailing lists. Objectives, practices, and perceived barriers related to engaging patient groups in the planning, conduct, and interpretation of clinical trials were reported in an online survey. Descriptive and inferential statistical analysis of survey data followed a literature review to inform survey questions. Survey respondents (n = 179) valued the importance of involving patient groups in research; however, patient group respondents valued their contributions to research protocol development, funding acquisition, and interpretation of study results more highly than those contributions were valued by industry and academic respondents (all p research is needed to define and optimize key success factors.

  5. Patient confidentiality within the context of group medical visits: is there cause for concern?

    Science.gov (United States)

    Wong, Sabrina T; Lavoie, Josee G; Browne, Annette J; MacLeod, Martha L P; Chongo, Meck

    2015-10-01

    Group medical visits (GMVs), clinical encounters with a medical component delivered to groups of patients, have emerged as an innovative approach to potentially increasing efficiency while enhancing the quality of primary health care (PHC). GMVs have created the need to pay explicit attention to patient confidentiality. What strategies are used by providers and patients to address issues of confidentiality within GMVs? In-depth interviews were conducted with 34 PHC providers and 29 patients living in nine rural communities in British Columbia, Canada. Data were analysed using interpretive thematic analysis and a relational autonomy approach. We found three main themes: (i) choosing to disclose: balancing benefits and drawbacks of GMVs, (ii) maintaining confidentiality in GMVs and (iii) gaining strength from interdependent relationships: patients learning from each other. Confidentiality can be addressed and was not a major concern for patients attending or providers facilitating GMVs in these rural communities. Patients adopted strategies to address their own and others' concerns related to confidential health information. Providers used multiple strategies to maintain confidentiality within the group, including renegotiating what information is shared and providing examples of what information ought to be kept confidential. Although GMVs are not for all patients, a relational autonomy approach is useful in drawing attention to the context and structures which may influence their patients' ability to act autonomously. Successful delivery of GMVs requires both patients and providers to negotiate between maintaining confidentiality and an appropriate level of disclosure. © 2013 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  6. Interest in a group psychotherapy program among Philippine breast cancer patients and its associated factors.

    Science.gov (United States)

    Ledesma, Dianne; Takahashi, Miyako; Kai, Ichiro

    2011-09-01

    A wide variety of psychosocial interventions are available for cancer patients, among which group psychotherapy (GPT) programs have made improvements in cancer patients' quality of life, coping abilities, and emotional distress. Few research data are available describing Philippine breast cancer patients' interest in GPT. This study aimed at enumerating the factors that determine Philippine breast cancer patients' interest in a GPT program. Patients recruited from the University of Santo Tomas Hospital Benavides Cancer Institute were asked to answer a survey questionnaire about their demographic, clinical, and psychosocial status, as well as whether they would be interested in joining GPT and why. Of 135 patients approached, 123 patients completed the survey. 104 (85%) women indicated interest in GPT. Patients were mostly interested because they wanted to learn coping skills (79%) and gain knowledge or information in dealing with cancer (69%). Patients said they were 'very interested' in learning about cancer recurrence (96%) and treatments (94%). Bivariate analysis showed that compared to the uninterested group, interested patients were younger, more likely to be married, and were more likely to have used complementary therapy for breast cancer. Logistic regression showed that married women were more likely to be interested in GPT (OR 3.30, CI 1.07-10.20). There is a potentially high interest in GPT among Philippine breast cancer patients. The attributes of Philippine patients interested in GPT are similar to and yet unique, compared to other populations. Copyright © 2010 John Wiley & Sons, Ltd. Copyright © 2010 John Wiley & Sons, Ltd.

  7. Reaching out for patients: public relations and events with real results.

    Science.gov (United States)

    Kuechel, Marie Czenko

    2010-02-01

    In today's market, the aesthetic physician needs to connect with patients using methods that are personal, educational, and that will glean the interest of prospective patients whose attention and dollars are sought by countless facial plastic surgery competitors near and far. Public relations, or reaching your prospective patient without a direct solicitation (advertising) for services, are traditional means that include media relations and charitable and social events. With the added component of social media, today the opportunities to reach out for new patients and garner real results are more varied and more affordable than ever before.

  8. The Additive Impact of Group and Individual Publicly Displayed Feedback: Examining Individual Response Patterns and Response Generalization in a Safe-Driving Occupational Intervention

    Science.gov (United States)

    Ludwig, Timothy D.; Geller, E. Scott; Clarke, Steven W.

    2010-01-01

    Additive effects of publicly posting individual feedback following group goal-setting and feedback were evaluated. The turn-signal use of pizza deliverers was studied in a multiple baseline design across two pizza stores. After baseline observations, pizza deliverers voted on a group turn-signal goal and then received 4 weeks of group feedback on…

  9. Emotional coping differences among breast cancer patients from an online support group: A longitudinal study

    NARCIS (Netherlands)

    Batenburg, A.E.; Das, H.H.J.

    2014-01-01

    Background: Previous research on the effects of online peer support on psychological well-being of patients with cancer showed mixed findings. There is a need for longitudinal studies explaining if and when online peer-led support groups are beneficial. How patients cope with emotions that come

  10. Ground reaction force analysed with correlation coefficient matrix in group of stroke patients.

    Science.gov (United States)

    Szczerbik, Ewa; Krawczyk, Maciej; Syczewska, Małgorzata

    2014-01-01

    Stroke is the third cause of death in contemporary society and causes many disorders. Clinical scales, ground reaction force (GRF) and objective gait analysis are used for assessment of patient's rehabilitation progress during treatment. The goal of this paper is to assess whether signal correlation coefficient matrix applied to GRF can be used for evaluation of the status of post-stroke patients. A group of patients underwent clinical assessment and instrumented gait analysis simultaneously three times. The difference between components of patient's GRF (vertical, fore/aft, med/lat) and normal ones (reference GRF of healthy subjects) was calculated as correlation coefficient. Patients were divided into two groups ("worse" and "better") based on the clinical functional scale tests done at the beginning of rehabilitation process. The results obtained by these two groups were compared using statistical analysis. An increase of median value of correlation coefficient is observed in all components of GRF, but only in non-paretic leg. Analysis of GRF signal can be helpful in assessment of post-stroke patients during rehabilitation. Improvement in stroke patients was observed in non-paretic leg of the "worse" group. GRF analysis should not be the only tool for objective validation of patient's improvement, but could be used as additional source of information.

  11. Are multi family groups appropriate for patients with first episode psychosis?

    DEFF Research Database (Denmark)

    Rossberg, Jan Ivar; Johannessen, J O; Klungsoyr, O

    2010-01-01

    OBJECTIVE: To compare outcome over 5 years for patients who participated in multi family groups (MFGs) to those who refused or were not offered participation. METHOD: Of 301 first episode psychotic patients aged 15-65 years, 147 participated in MFGs. Outcome was measured by drop-out rates, positive...

  12. Cancer patients' perspectives on multidisciplinary team working: an exploratory focus group study.

    Science.gov (United States)

    Lamb, Benjamin W; Jalil, Rozh T; Shah, Sujay; Brown, Katrina; Allchorne, Paula; Vincent, Charles; Green, James S A; Sevdalis, Nick

    2014-01-01

    This qualitative, focus-group study explores what patients understand about the multidisciplinary team (MDT) in cancer care. Participants were positive towards MDT working, and by strengthening the role of nurses in MDT decision-making, the representation of patients' interests can be improved.

  13. A Group Therapy Approach to the Treatment of Coronary Heart Patients.

    Science.gov (United States)

    Reid, Grace S.

    This study investigates the coronary heart patient's "here and now" feelings and attitudes toward his illness prior to and following group treatment. This study also attempts to investigate the change in a patient's acceptance of his heart condition. To measure the change in general health level, a questionnaire was administered to eight patients…

  14. Non-typhoidal Salmonella group D bacteremia and urosepsis in a patient diagnosed with HIV Infection

    Directory of Open Access Journals (Sweden)

    Said Abuhasna

    2012-01-01

    Full Text Available Urinary tract infections caused by non-typhoid Salmonella are rare and usually develops in patients with predisposing factors such as immune deficiency or occult urologic problems. This report describes a case where Salmonella Group D was isolated from the blood and urine of a patient with documented human acquired immunodeficiency syndrome who developed urosepsis and was successfully treated with antibiotics.

  15. Non-typhoidal Salmonella group D bacteremia and urosepsis in a patient diagnosed with HIV Infection.

    Science.gov (United States)

    Abuhasna, Said; Al Jundi, Amer; Rahman, Masood Ur; Said, Walaa

    2012-10-01

    Urinary tract infections caused by non-typhoid Salmonella are rare and usually develops in patients with predisposing factors such as immune deficiency or occult urologic problems. This report describes a case where Salmonella Group D was isolated from the blood and urine of a patient with documented human acquired immunodeficiency syndrome who developed urosepsis and was successfully treated with antibiotics.

  16. Small-Group Standardized Patient Encounter Improves Athletic Training Students' Psychosocial Intervention and Referral Skills

    Science.gov (United States)

    Walker, Stacy E.; Weidner, Thomas G.; Thrasher, Ashley B.

    2016-01-01

    Context: Athletic trainers provide psychological support, counseling, intervention, and referral to patients during clinical practice. However, students are rarely exposed to real-life opportunities to develop these skills. Objective: To determine if a small-group standardized patient (SP) encounter improved athletic training students'…

  17. Acute Hemolytic Transfusion Reaction in a Patient with Bombay Phenotype: Implications for ABO Grouping.

    Science.gov (United States)

    Malhotra, Sheetal; Dhawan, Hari Krishan; Jain, Ashish; Sachdev, Suchet; Marwaha, Neelam

    2014-09-01

    Bombay blood group is a rare phenotype that is characterized serologically by absence of H, A and B antigens on red cell surface and presence of corresponding antibodies in the serum. We report a case of 45-year old patient having Bombay blood group phenotype who experienced an acute reaction due to transfusion of mismatched blood unit.

  18. Interaction between participants in focus groups with older patients and general practitioners.

    Science.gov (United States)

    Moen, Janne; Antonov, Karolina; Nilsson, J Lars G; Ring, Lena

    2010-05-01

    Group interaction is put forward as the principal advantage for focus group research, although rarely reported on. The aim of the article is to contribute to the methodological knowledge regarding focus group research by providing an empirical example of the application of the Lehoux, Poland, and Daudelin template suggested for analysis of the interaction in focus groups. The data source was 18 focus groups' performance in Sweden: 12 with older patients and 6 with general practitioners (GPs). GPs found common ground in belonging to the same profession, whereas the older patients, instead of constituting a group in the word's real sense, started just sharing a common focus. We found the template easy to understand and use, except for identifying participants' explicit and implicit purposes for participating. Furthermore, adding an interaction analysis to the content analysis helped us appreciate and clarify the contexts from which these data were created.

  19. The effectiveness of support groups in Asian breast cancer patients: An integrative review

    Directory of Open Access Journals (Sweden)

    Fang-Yu Chou

    2016-01-01

    Full Text Available Cancer support group has been studied as an intervention to improve patient psychosocial well-being. The effectiveness of support groups among Asian breast cancer (BC patients has been unclear and received limited attention to the evidence of its effectiveness. The social-cognitive processing theory underlies the principles of support groups and advocates that a positive, supportive social environment can improve cognitive processing. The purpose of this paper is to present an integrative review of research evidence on the effectiveness of cancer support groups with Asian BC patients. Empirical studies related to support group among Asian and Asian American BC patients published between 1982 and April 2014 are reviewed. There are 15 studies selected (12 from the Asian-Pacific region and 3 from Western countries. The review includes 1 qualitative study, 3 descriptive studies, 1 mixed method design, and 10 experimental or quasi-experimental studies. The support group intervention activities include psycho-educational program such as health education, problem-solving, and stress management. These studies support the effectiveness of support group in alleviating psychological distress and supporting quality of life of Asian BC women. Overall, there is limited research on the use and effectiveness of support groups with Asians cancer patients in Asia and in Western countries. Without accounting for Asian immigrants overseas, the Asian population is expected to grow from 4.3 to 5.3 billion by 2050. As cancer patients become more diverse due to global emigration, more rigorous studies examining the effectiveness of psychosocial intervention among transcultural cancer patients are needed.

  20. The Effectiveness of Support Groups in Asian Breast Cancer Patients: An Integrative Review.

    Science.gov (United States)

    Chou, Fang-Yu; Lee-Lin, Frances; Kuang, Lily Y

    2016-01-01

    Cancer support group has been studied as an intervention to improve patient psychosocial well-being. The effectiveness of support groups among Asian breast cancer (BC) patients has been unclear and received limited attention to the evidence of its effectiveness. The social-cognitive processing theory underlies the principles of support groups and advocates that a positive, supportive social environment can improve cognitive processing. The purpose of this paper is to present an integrative review of research evidence on the effectiveness of cancer support groups with Asian BC patients. Empirical studies related to support group among Asian and Asian American BC patients published between 1982 and April 2014 are reviewed. There are 15 studies selected (12 from the Asian-Pacific region and 3 from Western countries). The review includes 1 qualitative study, 3 descriptive studies, 1 mixed method design, and 10 experimental or quasi-experimental studies. The support group intervention activities include psycho-educational program such as health education, problem-solving, and stress management. These studies support the effectiveness of support group in alleviating psychological distress and supporting quality of life of Asian BC women. Overall, there is limited research on the use and effectiveness of support groups with Asians cancer patients in Asia and in Western countries. Without accounting for Asian immigrants overseas, the Asian population is expected to grow from 4.3 to 5.3 billion by 2050. As cancer patients become more diverse due to global emigration, more rigorous studies examining the effectiveness of psychosocial intervention among transcultural cancer patients are needed.

  1. The sonographic findings of subclinical atherosclerosis in common carotid arteries: Rheumatoid arthritis patients Versus control group

    Directory of Open Access Journals (Sweden)

    Rahmani M

    2010-09-01

    Full Text Available "nBackground: High Resolution sonography of common carotid artery is a safe method for rapid diagnosis of atherosclerosis in Rheumatoid Arthritis (RA. The purpose of this study was to compare sonographic findings of subclinical atherosclerosis in rheumatoid arthritis patients and control group and comparing the prevalence of atheromatous plaques and Intima- media thickness in arteries of the groups. "nMethods: Fifty RA patients and fifty non-RA persons were evaluated in a cross- sectional, Descriptive study. The sonographic findings of common carotid artery of these two groups were compared."n "nResults: After analysis of the sonographic findings of common carotid arteries of 100 females in our study (50 patients with the mean age of 48.1y/o [23-61] and 50 control group with the mean age of 47y/o [23-61], the prevalence of RA patients with atheromatous plaques was 32% and in control group was 6%. [OR=7.4, 95%CI=2-27.3, p=0.001]. The mean (SD of the Intima- Media Thickness (IMT in RA patients was 7.76 mm (1, 04 while in control group was 6.10 mm (0.95. From 38 RA patients with less or equal 5 joints involvement in hand radiography, 13.2% had atheromatous plaques and the mean (SD of the IMT was 7.6 (±1.1 mm. From 12 patients with more than 5 joints involvement in radiography, 91.7% had atheromatous plaques and the mean (SD of the IMT was 8.4 (±0.7 mm. [p=0.012]."n "nConclusions: Regarding higher prevalence of vascular problems in RA patients, screening and early diagnosis of vascular pathologies could be of value in reducing morbidity and mortality of these patients.

  2. Impact of ABO blood group on the prognosis of patients undergoing surgery for esophageal cancer

    OpenAIRE

    Wang,Wei; Liu, Lei; Wang, Zhiwei; WEI, MIN; He, Qi; Ling, Tianlong; CAO, ZIANG; Zhang, Yixin; Wang, Qiang; Shi, Minxin

    2015-01-01

    Background ABO blood type is an established prognostic factor in several malignancies, but its role in esophageal cancer (EC) is largely unknown. The aim of this study is to determine whether ABO blood group is associated with survival after esophagectomy for EC. Methods A total of 406 patients who underwent surgery for EC were enrolled. The associations of ABO blood group with clinical and pathological variables were assessed using chi-square test. Associations of ABO blood group with the su...

  3. The impact of advertising patient and public involvement on trial recruitment:embedded cluster randomisedrecruitment trial

    OpenAIRE

    Hughes-Morley, Adwoa; Hann, Robert; Fraser , Claire; Meade, Oonagh; Lovell, Karina; Young, Bridget; Roberts, Christopher; Cree, Lindsey; More, Donna; O'Leary, Neil; Callaghan, Patrick; Waheed, Waquas; Bower, Peter

    2016-01-01

    BackgroundPatient and public involvement in research (PPIR) may improve trial recruitment rates, but it is unclear how. Where trials use PPIR to improve design and conduct, many do not communicate this clearly to potential participants. Better communication of PPIR might encourage patient enrolment, as trials may be perceived as more socially valid, relevant and trustworthy. We aimed to evaluate the impact on recruitment of directly advertising PPIR to potential trial participants.MethodsThis...

  4. Prevalence of suicidal behaviour & associated factors among tuberculosis patients in public primary care in South Africa

    OpenAIRE

    Karl Peltzer; Julia Louw

    2013-01-01

    Background & objectives: In spite of the high prevalence of tuberculosis worldwide, there are only a few studies on its psychiatric complications such as suicidal behaviour. We undertook this study to assess the prevalence of suicidal behaviour and its associated factors among tuberculosis patients in public primary care in South Africa. Methods: In a cross-sectional survey conducted in three provinces of South Africa new TB and new re-treatment patients were assessed within one month of ...

  5. Comparison of Right and Left Side Heart Functions in Patients with Thalassemia Major, Patients with Thalassemia Intermedia, and Control Group

    Directory of Open Access Journals (Sweden)

    Noormohammad Noori

    2015-10-01

    Full Text Available Background: Heart disease is the main cause of mortality and morbidity in patients with beta thalassemia, rendering its early diagnosis vital. We studied and compared echocardiographic findings in patients with beta thalassemia major, patients with beta thalassemia intermedia, and a control group.Methods: Eighty asymptomatic patients with thalassemia major and 22 asymptomatic cases with thalassemia intermedia (8-25 years old were selected from those referred to Ali Asghar Hospital (Zahedan-Iran between June 2008 and June 2009. Additionally, 80 healthy individuals within the same age and sex groups were used as controls. All the individuals underwent echocardiography, the data of which were analyzed with the Student t-test.Results: The mean value of the pre-ejection period/ejection time ratio of the left ventricle during systole, the diameter of the posterior wall of the left ventricle during diastole, the left and right isovolumic relaxation times, and the right myocardial performance index in the patients with beta thalassemia major and intermedia increased significantly compared to those of the controls, but the other parameters were similar between the two patient groups. The mean values of the left and right pre- ejection periods, left ventricular end systolic dimension, and left isovolumic contraction time in the patients with thalassemia intermedia increased significantly compared to those of the controls. In the left side, myocardial performance index, left ventricular mass index, isovolumic contraction time, and deceleration time exhibited significant changes between the patients with thalassemia major and those with thalassemia intermedia, whereas all the echocardiographic parameters of the right side were similar between these two groups.Conclusion: The results showed that the systolic and diastolic functions of the right and left sides of the heart would be impaired in patients with thalassemia major and thalassemia intermedia

  6. Can "The New Social Studies" Survive in the Public Schools?: A Case Study of the Perceptions of Significant School Related Groups Regarding Nationalistic Instruction.

    Science.gov (United States)

    Naylor, David T.

    A review and discussion of the new social studies introduces the problem of whether nationalism and patriotism are "closed areas" or if an open examination of these areas is possible in the public schools. Two sets of hypotheses, one dealing with public school educators and the other with school-related groups, were tested by administration of a…

  7. Psychosocial functioning in patients with treatment-resistant depression after group cognitive behavioral therapy

    Directory of Open Access Journals (Sweden)

    Kunisato Yoshihiko

    2010-03-01

    Full Text Available Abstract Background Although patients with Treatment Resistant Depression (TRD often have impaired social functioning, few studies have investigated the effectiveness of psychosocial treatment for these patients. We examined whether adding group cognitive behavioral therapy (group-CBT to medication would improve both the depressive symptoms and the social functioning of patient with mild TRD, and whether any improvements would be maintained over one year. Methods Forty-three patients with TRD were treated with 12 weekly sessions of group-CBT. Patients were assessed with the Global Assessment of Functioning scale (GAF, the 36-item Short-Form Health Survey (SF-36, the Hamilton Rating Scale for Depression (HRSD, the Dysfunctional Attitudes Scale (DAS, and the Automatic Thought Questionnaire-Revised (ATQ-R at baseline, at the termination of treatment, and at the 12-month follow-up. Results Thirty-eight patients completed treatment; five dropped out. For the patients who completed treatment, post-treatment scores on the GAF and SF-36 were significantly higher than baseline scores. Scores on the HRSD, DAS, and ATQ-R were significantly lower after the treatment. Thus patients improved on all measurements of psychosocial functioning and mood symptoms. Twenty patients participated in the 12-month follow-up. Their improvements for psychosocial functioning, depressive symptoms, and dysfunctional cognitions were sustained at 12 months following the completion of group-CBT. Conclusions These findings suggest a positive effect that the addition of cognitive behavioural group therapy to medication on depressive symptoms and social functioning of mildly depressed patients, showing treatment resistance.

  8. Results of a transparent expert consultation on patient and public involvement in palliative care research

    Science.gov (United States)

    Daveson, Barbara A; de Wolf-Linder, Susanne; Witt, Jana; Newson, Kirstie; Morris, Carolyn; Higginson, Irene J; Evans, Catherine J

    2015-01-01

    Background: Support and evidence for patient, unpaid caregiver and public involvement in research (user involvement) are growing. Consensus on how best to involve users in palliative care research is lacking. Aim: To determine an optimal user-involvement model for palliative care research. Design: We hosted a consultation workshop using expert presentations, discussion and nominal group technique to generate recommendations and consensus on agreement of importance. A total of 35 users and 32 researchers were approached to attend the workshop, which included break-out groups and a ranking exercise. Descriptive statistical analysis to establish consensus and highlight divergence was applied. Qualitative analysis of discussions was completed to aid interpretation of findings. Setting/participants: Participants involved in palliative care research were invited to a global research institute, UK. Results: A total of 12 users and 5 researchers participated. Users wanted their involvement to be more visible, including during dissemination, with a greater emphasis on the difference their involvement makes. Researchers wanted to improve productivity, relevance and quality through involvement. Users and researchers agreed that an optimal model should consist of (a) early involvement to ensure meaningful involvement and impact and (b) diverse virtual and face-to-face involvement methods to ensure flexibility. Conclusion: For involvement in palliative care research to succeed, early and flexible involvement is required. Researchers should advertise opportunities for involvement and promote impact of involvement via dissemination plans. Users should prioritise adding value to research through enhancing productivity, quality and relevance. More research is needed not only to inform implementation and ensure effectiveness but also to investigate the cost-effectiveness of involvement in palliative care research. PMID:25931336

  9. Patient education in groups increases knowledge of osteoporosis and adherence to treatment

    DEFF Research Database (Denmark)

    Nielsen, Dorthe; Ryg, Jesper; Nielsen, Winnie

    2010-01-01

    OBJECTIVE: Non-adherence to pharmacological treatment in osteoporosis is a well-recognized problem. We hypothesized that a group-based educational programme would increase patients' knowledge and level of adherence with medical treatment. METHODS: A total of 300 patients (32 men aged 65 ± 9 years...... empowerment. Patients' knowledge about osteoporosis and adherence to treatment was assessed with self-completed questionnaires at baseline and after 3, 12, and 24 months. RESULTS: There were no significant differences at baseline between the two groups with respect to knowledge score or level of adherence...

  10. Comparison of pain control medication in three age groups of elderly patients.

    Science.gov (United States)

    Honari, S; Patterson, D R; Gibbons, J; Martin-Herz, S P; Mann, R; Gibran, N S; Heimbach, D M

    1997-01-01

    There are no published reports of burn pain management in the elderly population. To assess the range of requirement and use of opioids among elderly patients with burns of different age categories, a retrospective review of 89 consecutive admissions of patients over 55 years of age (January 1995 through July 1996) was conducted. Complete data were available on 44 patients with a burn mean total body surface area of 17.2%. Patient ages ranged from 55 to 92 years. Individuals were divided into three age categories: Group I (55 to 65) n = 20; Group II (66 to 75) n = 14; and Group III (76 to 92) n = 10. Use of commonly prescribed opioids for procedural pain and breakthrough pain were evaluated. We compared the opioid equivalents of medications prescribed versus the actual amount administered. Paired t tests comparing minimum amount of medication ordered with that given revealed Group I patients received significantly more procedural medication than the minimum prescribed (t = 3.88, p = 0.001), and that Group III patients were given significantly less as needed medication than the minimum prescribed (t = 2.58, p < 0.05).

  11. Systematic biases in group decision-making: implications for patient safety.

    Science.gov (United States)

    Mannion, Russell; Thompson, Carl

    2014-12-01

    Key decisions in modern health care systems are often made by groups of people rather than lone individuals. However, group decision-making can be imperfect and result in organizational and clinical errors which may harm patients-a fact highlighted graphically in recent (and historical) health scandals and inquiries such as the recent report by Sir Robert Francis into the serious failures in patient care and safety at Mid Staffordshire Hospitals NHS Trust in the English NHS. In this article, we draw on theories from organization studies and decision science to explore the ways in which patient safety may be undermined or threatened in health care contexts as a result of four systematic biases arising from group decision-making: 'groupthink', 'social loafing', 'group polarization' and 'escalation of commitment'. For each group bias, we describe its antecedents, illustrate how it can impair group decisions with regard to patient safety, outline a range of possible remedial organizational strategies that can be used to attenuate the potential for adverse consequences and look forward at the emerging research agenda in this important but hitherto neglected area of patient safety research.

  12. DISTRIBUTION OF CLASSICAL ABO BLOOD GROUPS AMONG TYPE 2 DIABETES MELLITUS PATIENTS : AN ANALYSIS

    Directory of Open Access Journals (Sweden)

    Rama Devi

    2015-04-01

    Full Text Available BACKGROUND: At present Diabetes Mellitus is a global phenomenon with the disease topping the list, comprising of about 32 million cases , India is in the forefront with 30% of the cases . The disease affects multiple organs and is a leading cause of much morbidity and mortality. Since it is a multi - factorial disease a major step would be to identify different associated factors, for an early diagnosis and prompt treatment. The ABO blood groups are often associated with several diseases, with one blood group more often seen with the patients of a particular disease. Our study will help to determine the frequency and distribution of blood groups in correlation with Diabetes Mellitus. MATERIAL & METHODS: This study was conducted in the Gandhi Medical College, Secunderabad, during a two year period. A random study involving every third diabetic patient was chosen and their blood group was determined. A total of 3 00 patients were selected with 150 male and 150 female patients. Another 300 volunteers who were not diabetics were chosen as controls and their blood groups were also determined. A pro - forma was given to both diabetics and controls which included the following variables : 1 . Demographic data 2. Blood grouping 3. Fasting and post prandial blood sugar. Following this, blood groups of both cohorts and controls were determined by antigen antibody agglutination method. Data analysis was do ne after data was entered into excel sheet and double checked for errors using SPSS Software RESULTS: Our a nalysis showed that O group was significantly more among diabetic patients when all patients were compared to control . ² there was a preponderance of blood group O among female diabetics and B among male diabetics. CONCLUSION: ABO blood groups have been determined in 300 diabetic patients and compared with the controls comprising of a series of 300 voluntary blood donors. When the results were analysed on the basis of sex, there was preponderance

  13. Patient and public involvement in scope development for a palliative care health technology assessment in europe

    NARCIS (Netherlands)

    Brereton, L.; Goyder, E.; Ingleton, C.; Gardiner, C.; Chilcott, J.; Wilt, G.J. van der; Oortwijn, W.; Mozygemba, K.; Lysdahl, K.B.; Sacchini, D.; Lepper, W.

    2014-01-01

    BACKGROUND: Patient and Public Involvement (PPI) helps to ensure that study findings are useful to end users but is under-developed in Health Technology Assessment (HTA). "INTEGRATE-HTA, (a co-funded European Union project -grant agreement 30614) is developing new methods to assess complex health te

  14. staff/bed and staff/patient ratios in south african public sector mental ...

    African Journals Online (AJOL)

    service levels; numbers of psychiatric beds; and numbers of patients who attend ... staff at all levels of public sector health care in South Africa. The information ..... distribution,''3 have been a cause of concern in recent South. African mental ...

  15. Kodamaea (Pichia) ohmeri fungemia in a pediatric patient admitted in a public hospital

    NARCIS (Netherlands)

    De Barros, J.D.; Do Nascimento, S.M.; de Araujo, F.J.; Braz Rde, F.; Andrade, V.S.; Theelen, B.J.F.; Boekhout, T.; Illnait-Zaragozi, M.T.; Gouveia, M.N.; Fernandes, M.C.; Monteiro, M.G.; De Oliveira, M.T.

    2009-01-01

    Kodamaea (Pichia) ohmeri is a yeast species that has not been reported to be a frequent cause of human infections. The current report describes a case of fungemia caused by K. ohmeri in a 3-year-old female patient hospitalized in the public hospital Maria Alice Fernandes, Natal, RN, Brazil. The

  16. Relation of ABO blood groups to coronary lesion complexity in patients with stable coronary artery disease.

    Science.gov (United States)

    Kaya, Ahmet; Tanboğa, İbrahim Halil; Kurt, Mustafa; Işık, Turgay; Kaya, Yasemin; Günaydın, Zeki Yüksel; Aksakal, Enbiya

    2014-02-01

    We aimed to investigate the relationship between ABO blood groups and complexity of coronary lesions assessed by SYNTAX score (SS) in stable coronary artery disease (CAD) patients. Our cross-sectional and observational study population consisted of 559 stable CAD patients. From all patients, ABO blood group was determined and the SS was calculated as low SYNTAX score (0-22), intermediate SYNTAX (23-32) score and high SYNTAX score (>32). Statistical analysis was performed using Student's t-test or Mann-Whitney U test, ANOVA, or Kruskal-Wallis test and chi-square test. Multiple logistic regression analysis was used to identify the independent predictors of high SS. The analysis between the SS tertiles revealed that the frequency of non-O blood group was significantly higher in the upper SS tertiles (56.2% vs. 75.9 vs. 80.2%, pABO blood groups and complexity of angiographic CAD.

  17. Upper gastrointestinal bleeding: predictors of risk in a mixed patient group including variceal and nonvariceal haemorrhage.

    Science.gov (United States)

    Lahiff, Conor; Shields, William; Cretu, Ion; Mahmud, Nasir; McKiernan, Susan; Norris, Suzanne; Silke, Bernard; Reynolds, John V; O'Toole, Dermot

    2012-02-01

    Effective management of upper gastrointestinal bleeding (UGIB) relies on the application of clinical risk scores. The validation of risk scores has to date focused mainly on nonvariceal UGIB groups. We aimed to evaluate our clinical and endoscopic management of UGIB, and to validate existing risk scores for a mixed patient population with a high percentage of variceal bleeds. Analysis included UGIB patients presenting consecutively to a tertiary referral university hospital. All patients had been admitted by our emergency department and had undergone upper gastrointestinal endoscopy. Clinical, biochemical and endoscopic data were recorded. Clinical and complete Rockall and Blatchford risk scores were calculated for all patients and statistical analysis was carried out by a multiple logistical regression model. A total of 21% of patients had variceal bleeds. There was considerable heterogeneity between groups with the variceal group having more comorbidities (P=0.003), lower haemoglobin (P=0.003) and lower systolic blood pressure (P=0.013) at presentation. This translated to higher risk scores (Pbleeding or mortality. However, no patient with a Blatchford score of 0 had an adverse clinical outcome. Postendoscopic Rockall score can be used as a predictor of outcome for mixed UGIB groups. Although Blatchford score did not predict outcome in our study, at a 0 level it does appear to be a safe triage tool for pre-endoscopic identification of patients with variceal bleeds, even where there is no known history of liver disease.

  18. [THE PERCENTAGE OF BLOOD SERUM TESTS WITH HEMOLYSIS IN DIFFERENT GROUPS OF PATIENTS].

    Science.gov (United States)

    Moshkin, A V

    2015-06-01

    In the process of laboratory analysis most of the errors occur at the pre-analytical stage. The percentage of blood serum tests with hemolysis is largely applied as an indicator of quality of sampling and transport of blood tests in laboratory. The study was carried out to analyze percentage of tests with hemolysis in different groups of in- and out-patients. The percentage of tests with hemolysis was estimated according actual recommendation of IFCC working group "Laboratory Errors and Patient Safety" as percentage oftests with free hemoglobin more than 0.5 g/l of total amount of serum tests analyzed on biochemical analyzer capable to measure hemolysis index. The hemolysis was identified in 199 (1.4%) out of 14 170 samples. The large dispersion of results in different groups of patient was established. In children younger than 7 years treated in hospital percentage of hemolysis amounted to 2.44%, in patients of reanimation department - 2.38%. In adult patients of hospital this indicator of quality ranged from 0.31% to 1.59%. In two groups of out-patients this indicator amounted to 0.36% (clinic personnel, dispensarization) and 1.81% (out-patients). Such a dispersion complicates inter-laboratory comparison of quality according this particular indicator. The necessity is substantiated to apply more efforts concerning harmonization of indicators of quality in laboratory medicine.

  19. N-Acetyltransferase 2 gene polymorphism in a group of senile dementia patients in Shanghai suburb

    Institute of Scientific and Technical Information of China (English)

    Wei-chao GUO; Guo-fang LIN; Yong-lin ZHA; Ke-jian LOU; Qing-wen MA; Jian-hua SHEN

    2004-01-01

    AIM: To investigate the possible association of hereditary polymorphism of N-acetyltransferase 2 (NAT2) gene with the susceptibility towards senile dementia in farmer population of Shanghai suburb. METHODS: NAT2 gene genotyping was performed at 7 major polymorphic loci (G191A, C282T, T341C, C481T, G590A, A803G, and .G857A) with a polymerase chain reaction-based restriction fragment length polymorphism based procedure in 2 groups of farmer subjects in Shanghai suburb. A group of 51 diagnosed dementia patients [comprising 29 sporadic Alzheimer disease(AD) patients and 22 sporadic vascular dementia (VD) patients] and a group of 112 healthy individuals were in the same area. RESULTS: The homogenous rapid genotypes (R/R, including*4/*4, *13/*13, and *4/*13) was found over-present in both groups of patients, compared with healthy individuals, for all farmer dementia patients, 52.9 %vs 33.0 %, P=0.016, OR (95 % CI): 2.28(1.16-4.48); for AD group only, 51.7 % vs 33.0 %, P=0.063, OR (95 %CI): 2.18 (0.95-4.97); for VD group 54.5 % vs 33.0 %, P=0.055, OR (95 % CI): 2.43 (0.96-2.43). The significant frequency difference of genotype *4/* 7B between farmer dementia patients and healthy individuals, and that of solo-alleles *13, and *7B were observed between the healthy individuals and both groups of dementia patients.CONCLUSION: Our data suggest the involvement of various NAT2 rapid-acetylating genotypes in the individual susceptibility to senile dementia. Variant genotypes of NAT2 might serve as a hereditary risk factor for AD and VD in Chinese population.

  20. Development of sedentary communities in the Maya lowlands: coexisting mobile groups and public ceremonies at Ceibal, Guatemala.

    Science.gov (United States)

    Inomata, Takeshi; MacLellan, Jessica; Triadan, Daniela; Munson, Jessica; Burham, Melissa; Aoyama, Kazuo; Nasu, Hiroo; Pinzón, Flory; Yonenobu, Hitoshi

    2015-04-07

    Our archaeological investigations at Ceibal, a lowland Maya site located in the Pasión region, documented that a formal ceremonial complex was built around 950 B.C. at the onset of the Middle Preclassic period, when ceramics began to be used in the Maya lowlands. Our refined chronology allowed us to trace the subsequent social changes in a resolution that had not been possible before. Many residents of Ceibal appear to have remained relatively mobile during the following centuries, living in ephemeral post-in-ground structures and frequently changing their residential localities. In other parts of the Pasión region, there may have existed more mobile populations who maintained the traditional lifestyle of the preceramic period. Although the emerging elite of Ceibal began to live in a substantial residential complex by 700 B.C., advanced sedentism with durable residences rebuilt in the same locations and burials placed under house floors was not adopted in most residential areas until 500 B.C., and did not become common until 300 B.C. or the Late Preclassic period. During the Middle Preclassic period, substantial formal ceremonial complexes appear to have been built only at a small number of important communities in the Maya lowlands, and groups with different levels of sedentism probably gathered for their constructions and for public rituals held in them. These collaborative activities likely played a central role in socially integrating diverse groups with different lifestyles and, eventually, in developing fully established sedentary communities.

  1. Neural correlates of out-group bias predict social impairment in patients with schizophrenia.

    Science.gov (United States)

    Blackford, J U; Williams, L E; Heckers, S

    2015-05-01

    Social impairments are a hallmark feature of schizophrenia and are a key predictor of functional disability. Deficits in social information processing likely underlie social impairment; however, this relationship is understudied. We previously demonstrated that patients with schizophrenia fail to habituate to neutral faces, providing evidence for an alteration in basic social information processing. It remains unknown whether patients with schizophrenia also show deficits in processing of more complex social information. Out-group bias provides an excellent opportunity to test complex social information processing because the bias requires basic face processing skills, the ability to discriminate between groups, as well as the ability to categorize oneself into a salient social group. Study participants were 23 patients with schizophrenia and 21 controls. Using functional magnetic resonance imaging, habituation of response to 120 s of repeated presentations of faces was assessed in participants who viewed either same-gender faces or opposite-gender faces. The interaction between face gender (same/opposite) and group was examined in three key regions: amygdala, hippocampus, and visual cortex. Social impairment was measured using the PANSS and correlations between social impairment and out-group effect (main effect of face type) were performed in patients. Patients with schizophrenia had aberrant neural responses to opposite-gender faces (interaction, psocial impairment. Patients with no social impairment showed a heightened neural response to opposite-gender faces after 30s, whereas patients with mild-moderate social impairment failed to ever show a heightened response. Alterations in neural responses during out-group processing predicted degree of social impairment in patients with schizophrenia; thus, neural responses to opposite-gender faces may provide a novel measure for studies of treatment response and disease outcome. Copyright © 2015 Elsevier B.V. All

  2. 公共图书馆如何为特殊群体服务%How the Public Library to Serve the Special Groups

    Institute of Scientific and Technical Information of China (English)

    高瑾

    2015-01-01

    阐述了公共图书馆特殊群体的范畴,从定向服务群体、弱势群体两个方面,论述了公共图书馆为特殊群体服务的具体措施和建议.%This paper expounds the category of special groups of public library, and from two aspects of directional service groups and disadvantaged groups, discusses the concrete measures and suggestions public library's service for special groups.

  3. Comparing Facial Emotional Recognition in Patients with Borderline Personality Disorder and Patients with Schizotypal Personality Disorder with a Normal Group

    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.

  4. Usefulness of Patients-Reported Outcomes in Rheumatoid Arthritis Focus Group

    Directory of Open Access Journals (Sweden)

    Jenny Amaya-Amaya

    2012-01-01

    Full Text Available Objective. Patient-reported outcomes (PROs have become an essential part of the assessment of patients with rheumatoid arthritis (RA. We aimed to evaluate the agreement and correlation between PROs and the physician's measurements. Methods. This was a cross-sectional analytical study in which 135 patients with RA were clinically evaluated during two different sessions of focus group interviews. Rheumatologist recorded 28 swollen (SJCs and tender joint counts (TJCs. The patients filled out the PROs instruments (MDHAQ, RADAI, RAPID3, 4, and 5 and self-report articular index (SAI diagram for pain and joint swelling. DAS28 was calculated (C-reactive protein. An adjusted multiple lineal regression model was done (DAS28 as dependent variable. Results. Highly significant agreements were found between SJC and TJC registered by the physician and patient. There was moderate correlation between DAS28 with patient SJC (r=0.52, patient TJC (r=0.55, RADAI (r=0.56, RAPID3 (r=0.52, RAPID4 (r=0.56, RAPID5 (r=0.66, and VAS-Global (r=0.51. Likewise, we found moderate to high correlations between CDAI and SDAI with all variable measurements done by the patients. The resulting predictive equation was DAS28(CRP=2.02+0.037×RAPID4+0.042× patient SJC. Conclusion. PROs applied in focus groups interview are a useful tool for managing patients with RA regardless of gender, educational level, and duration of disease.

  5. Prognostic value of ABO blood group in patients with surgically resected colon cancer.

    Science.gov (United States)

    Cao, X; Wen, Z-S; Sun, Y-J; Li, Y; Zhang, L; Han, Y-J

    2014-07-08

    Previous studies supported a link between the ABO blood type and survival for several types of malignancies. Nonetheless, the relationship between ABO blood type and survival in colon cancer patients has not been rigorously evaluated. The goal of this retrospective analysis was to discern the correlations between ABO blood group and colon cancer survival. A total of 1555 colon cancer patients that underwent curative-intent surgery between October 1995 and June 2002 were eligible for this study. The primary outcomes measured were the association between ABO blood group and patient survival. Compared with patients with non-AB blood types (blood types A, B, and O), patients with blood type AB were more likely to have better survival. The mean overall survival (OS) of the blood type AB patients was 113.9 months, whereas the mean OS of the non-AB blood type patients was significantly lower, 106.1 months (Ptest). Compared with patients with blood type AB, the hazard ratios for patients with A, B, and O were 4.37 (95% confidence interval (95% CI), 2.65-7.20), 2.99 (95% CI, 1.81-4.96), and 2.78 (95% CI, 1.69-4.56), respectively. Blood type AB is a favourable prognostic factor for patients with colon cancer.

  6. Usefulness of Patients-Reported Outcomes in Rheumatoid Arthritis Focus Group

    Science.gov (United States)

    Amaya-Amaya, Jenny; Botello-Corzo, Diana; Calixto, Omar-Javier; Calderón-Rojas, Rolando; Domínguez, Aura-Maria; Cruz-Tapias, Paola; Montoya-Ortiz, Gladis; Mantilla, Ruben-Dario; Anaya, Juan-Manuel; Rojas-Villarraga, Adriana

    2012-01-01

    Objective. Patient-reported outcomes (PROs) have become an essential part of the assessment of patients with rheumatoid arthritis (RA). We aimed to evaluate the agreement and correlation between PROs and the physician's measurements. Methods. This was a cross-sectional analytical study in which 135 patients with RA were clinically evaluated during two different sessions of focus group interviews. Rheumatologist recorded 28 swollen (SJCs) and tender joint counts (TJCs). The patients filled out the PROs instruments (MDHAQ, RADAI, RAPID3, 4, and 5 and self-report articular index (SAI) diagram for pain and joint swelling). DAS28 was calculated (C-reactive protein). An adjusted multiple lineal regression model was done (DAS28 as dependent variable). Results. Highly significant agreements were found between SJC and TJC registered by the physician and patient. There was moderate correlation between DAS28 with patient SJC (r = 0.52), patient TJC (r = 0.55), RADAI (r = 0.56), RAPID3 (r = 0.52), RAPID4 (r = 0.56), RAPID5 (r = 0.66), and VAS-Global (r = 0.51). Likewise, we found moderate to high correlations between CDAI and SDAI with all variable measurements done by the patients. The resulting predictive equation was DAS28(CRP) = 2.02 + 0.037 × RAPID4 + 0.042× patient SJC. Conclusion. PROs applied in focus groups interview are a useful tool for managing patients with RA regardless of gender, educational level, and duration of disease. PMID:23097701

  7. Dentists' experience with low-income patients benefiting from a public insurance program.

    Science.gov (United States)

    Pegon-Machat, E; Tubert-Jeannin, S; Loignon, C; Landry, A; Bedos, C

    2009-08-01

    France has a system of public coverage that guarantees low-income earners full payment of basic dental health costs. In spite of this coverage and major needs for care, deprived populations have lower access to dental care. The aim of this qualitative study was to explore dentists' experience with low-income patients benefiting from the French universal healthcare coverage system. This study is based on 17 one-on-one semistructured interviews carried out with French private dentists. Dentists distinguished two categories of low-income patients: 'good patients', described as being regular attenders; and 'bad patients', whose main characteristic is irregular attendance. Dentists explained that they have difficulties in dealing with patients who do not keep their appointments. First, dentists feel that they fail in conducting their mission of being a care provider (therapeutic failure). The absence of the patient is also seen as a lack of recognition (relationship failure). Furthermore, dentists do not earn money when patients miss their appointments (financial failure). In this context, many dentists feel discouraged and powerless (personal failure). Moreover, dentists do not understand why patients renounce the dental-care opportunities offered under the system of public coverage (failure of the system). Dentists who repeatedly experience failures related to irregular attendance tend to adopt exclusion strategies.

  8. [Effects of Meek skin grafting on patients with extensive deep burn at different age groups].

    Science.gov (United States)

    Di, H P; Niu, X H; Li, Q; Li, X L; Xue, J D; Cao, D Y; Han, D W; Xia, C D

    2017-03-20

    Objective: To investigate the effect of Meek skin grafting on patients with extensive deep burn at different age groups. Methods: Eighty-four patients with extensive deep burns conforming to the study criteria were hospitalized in our unit from April 2011 to April 2015. Patients were divided into children group (C, with age less than 12 years old), young and middle-aged group (YM, with age more than 18 years and less than 50 years old), and old age group (O, with age more than 55 years old) according to age, with 28 patients in each group. All patients received Meek skin grafting treatment. The use of autologous skin area, operation time, wound healing time, and hospitalization time were recorded. The survival rate of skin graft on post operation day 7, complete wound healing rate in post treatment week 2, and the mortality were calculated. Data were processed with one-way analysis of variance, t test, and χ(2) test. Results: The use of autologous skin area of patients in group C was (5.1±1.0)% total body surface area (TBSA), significantly less than (8.3±1.0)%TBSA and (8.3±1.4)%TBSA in groups YM and O, respectively (with t values 32.900 and 52.624, respectively, P values below 0.05). The operation time, wound healing time, and hospitalization time of patients in group C were (1.368±0.562) h, (9.6±0.6) and (32±11) d, significantly shorter than those in group YM [(3.235±0.011) h, (16.9±2.6) and (48±12) d, respectively] and group O [(3.692±0.481) h, (17.3±2.6) and (46±13) d, respectively, with t values from 4.350 to 21.160, P values below 0.05]. The survival rate of skin graft of patients on post operation day 7 in group C was (92±15)%, significantly higher than (81±10)% and (72±12)% in groups YM and O, respectively (with t values 5.509 and 3.229, respectively, P values below 0.05). The above indexes in groups YM and O were similar (with t values from 0.576 to 22.958, P values above 0.05). Complete wound healing rate in post treatment week 2 and the

  9. The orodental status of a group of elderly in-patients: a preliminary assessment.

    Science.gov (United States)

    McNally, L; Gosney, M A; Doherty, U; Field, E A

    1999-12-01

    To provide a preliminary assessment of the orodental status and dental treatment requirements of a group of elderly in-patients. Cross-sectional. Acute Care of the Elderly and Stroke Rehabilitation units at teaching hospitals in Merseyside. 150 patients aged 58 to 94 years, in which a history could be validated at interview. Questionnaire administered by dentist and clinical examination. Registration with a dentist, prosthetic status and difficulties with dentures, denture hygiene and identification marking, dental treatment needs and evidence of mucosal pathology. Only 27% of patients claimed registration with a dentist. Three quarters of the patients were edentulous and 66 patients wore full dentures; 18 had no prostheses. Difficulties were experienced by one quarter of patients with upper dentures, compared with a half of lower denture wearers. Of the dentures available for inspection, 61% had removable soft debris, 66% were left out at night and 75% were cleaned by the patient, whilst on the ward. No dentures had evidence of identification marking. Of the 39 partially dentate patients, 75% required interventive dental treatment. Denture stomatitis was diagnosed in 29% of patients and 19 had evidence of benign mucosal pathology. The orodental status of this group of elderly in-patients was poor, with a high proportion being edentulous. Few were registered with a dentist and denture hygiene was inadequate. Lack of identification marking is a matter of concern. Closer liaison between hospital staff responsible for elderly in-patients is required, to improve the orodental health and quality of life of this medically compromised group of patients.

  10. How mindfulness changed my sleep: focus groups with chronic insomnia patients

    OpenAIRE

    Hubbling, Amber; Reilly-Spong, Maryanne; Kreitzer, Mary Jo; Gross, Cynthia R.

    2014-01-01

    Background Chronic insomnia is a major public health problem affecting approximately 10% of adults. Use of meditation and yoga to develop mindful awareness (‘mindfulness training’) may be an effective approach to treat chronic insomnia, with sleep outcomes comparable to nightly use of prescription sedatives, but more durable and with minimal or no side effects. The purpose of this study was to understand mindfulness training as experienced by patients with chronic insomnia, and suggest proced...

  11. A comparison of the content of memory rehabilitation groups for patients with neurological disabilities.

    Science.gov (United States)

    O'Brien, Marie Claire; das Nair, Roshan; Lincoln, Nadina B

    2013-01-01

    The aim of the study was to compare the fidelity of manualised group memory rehabilitation programmes for participants with neurological disabilities. A sample of 11 neurological patients with memory problems, enrolled in a randomised controlled trial comparing compensation, restitution and self-help treatments, were observed during group sessions. Time-sampling was used to record the activity of the participants and the content of the discussion at one minute intervals. There was a significant difference between groups in the amount of time the group leader and participants spent talking (p memory rehabilitation discussion than participants in the self-help group (p memory aids in the compensation and restitution groups (p rehabilitation groups.

  12. The power of symbolic capital in patient and public involvement in health research.

    Science.gov (United States)

    Locock, Louise; Boylan, Anne-Marie; Snow, Rosamund; Staniszewska, Sophie

    2017-10-01

    Policy-makers and health research funders increasingly require researchers to demonstrate that they have involved patients in the design and conduct of research. However, the extent to which patients and public have the power to get involved on an equal footing is dependent on their economic, cultural, social and symbolic capital. To explore power relations in patient and public involvement (PPI) in research, particularly how patients may wield symbolic capital to develop a more equal relationship. Narrative interviews with a maximum variation sample of 38 people involved as patients, carers or public in health research, analysed thematically. Symbolic capital may be demonstrated in a range of ways (sometimes alongside or in the absence of other forms of capital): illness experience, technical illness knowledge and the challenging outsider. Symbolic capital is unstable and dependent on others for recognition and legitimacy. Nonetheless, participants identify a gradual shift in power relations over time. Research into PPI has been conceptually and theoretically poor, limiting our understanding of its mechanisms and wider contextual elements. Our findings demonstrate the importance of reflecting on the forms of power and capital wielded by the health research community, and of acknowledging the way in which PPI is challenging the status quo. As one of the first papers to conceptualize how different forms of symbolic capital operate and their critical role in challenging the balance of power, our findings may help researchers better plan their PPI activities and reflect on their own power. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  13. Changing characteristics of psychiatric patients: private and public care in Chicago.

    Science.gov (United States)

    Greenley, J R; Kepecs, J G; Henry, W E

    1982-01-01

    There is increasing evidence that the social and cultural characteristics of psychiatric patients have been changing over time. It is important from a professional and public policy point of view to understand better the nature of these changes, and to what they are related. This paper presents data showing that: 1) psychiatric care is increasingly reaching patients of lower socio-economic status, and 2) changes in patient characteristics are related to the growth in the proportion of psychiatric care given in organisationally based non-private practice settings.

  14. Holy transgressions: breaching the wall between public religion and patient care.

    Science.gov (United States)

    Curlin, Farr A

    2014-01-01

    The stories in this collection can be described as stories of transgression. The writers have learned that public expressions of religious faith or reasoning are to be kept separate from the practices of caring for patients. Mixing the two is dangerous. Yet, as the stories indicate, many health practitioners cannot help themselves: their religion comes through, shaping their encounters with patients in all manner of ways. Religion comes through not as a distraction from medicine but as integral to their efforts to care well for their patients.

  15. Differences in outcomes between GOLD groups in patients with COPD in the TIOSPIR® trial

    Directory of Open Access Journals (Sweden)

    Dusser D

    2016-01-01

    Full Text Available Daniel Dusser,1 Robert A Wise,2 Ronald Dahl,3 Antonio Anzueto,4,5 Kerstine Carter,6 Andy Fowler,7 Peter M Calverley8 1Service de Pneumologie, Hôpital Cochin, AP-HP, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; 2Asthma and Allergy Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA; 3Allergy Centre, Odense University Hospital, Odense C, Denmark; 4Pulmonary/Critical Care, University of Texas, 5South Texas Veterans Health Care System, San Antonio, TX, USA; 6Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, CT, USA; 7Boehringer Ingelheim Pharma Ltd, Bracknell, UK; 8Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK  Background: The aim of this study was to evaluate whether Global Initiative for Chronic Obstructive Lung Disease (GOLD classification could predict mortality risk factors and whether baseline treatment intensity would relate to mortality within each group, using data from TIOSPIR®, the largest randomized clinical trial in COPD performed to date.Methods: A total of 17,135 patients from TIOSPIR® were pooled and grouped by GOLD grading (A–D according to baseline Medical Research Council breathlessness score, exacerbation history, and spirometry. All-cause mortality and adjudicated cardiovascular (CV and respiratory mortality were assessed.Results: Of the 16,326 patients classified, 1,248 died on treatment. Group B patients received proportionally more CV treatment at baseline. CV mortality risk, but not all-cause mortality risk, was significantly higher in Group B than Group C patients (CV mortality – hazard ratio [HR] =1.74, P=0.004; all-cause mortality – HR =1.18, P=0.11. Group D patients had a higher incidence of all-cause mortality than Group B patients (10.9% vs 6.6%. Similar trends were observed regardless of respiratory or CV medication at baseline. In contrast, respiratory deaths increased consistently from Groups A–D (0.3%, 0.8%, 1.6%, and 4.2% of

  16. SANTA vs. public tuberculosis hospitals: the patient experience in the Free State, 2001/2002

    Directory of Open Access Journals (Sweden)

    J.C Heunis

    2007-09-01

    Full Text Available This paper reflects on the appropriateness of the decision to close down a nongovernmental organisation (NGO, state-aided tuberculosis (TB hospital in the Free State in 2003. Henceforth hospitalisation of TB patients would take place at public district hospitals. A survey conducted late-2001/'early-2002 revealed a more positive patient experience of hospitalisation forTB in public hospitals than in the NGO hospital. Consideration of the patient experience serves to inform the debate concerning continued outsourcing of TB hospital care to NGOs in South Africa. This study discusses comparative findings in respect of patients’ biographic and socio-economic characteristics, health beliefs, satisfaction with hospitalisation, experience of stigmatisation, adherence to treatment and absconding from hospital.

  17. Optimizing the Power of Genome-Wide Association Studies by Using Publicly Available Reference Samples to Expand the Control Group

    Science.gov (United States)

    Zhuang, Joanna J; Zondervan, Krina; Nyberg, Fredrik; Harbron, Chris; Jawaid, Ansar; Cardon, Lon R; Barratt, Bryan J; Morris, Andrew P

    2010-01-01

    Genome-wide association (GWA) studies have proved extremely successful in identifying novel genetic loci contributing effects to complex human diseases. In doing so, they have highlighted the fact that many potential loci of modest effect remain undetected, partly due to the need for samples consisting of many thousands of individuals. Large-scale international initiatives, such as the Wellcome Trust Case Control Consortium, the Genetic Association Information Network, and the database of genetic and phenotypic information, aim to facilitate discovery of modest-effect genes by making genome-wide data publicly available, allowing information to be combined for the purpose of pooled analysis. In principle, disease or control samples from these studies could be used to increase the power of any GWA study via judicious use as “genetically matched controls” for other traits. Here, we present the biological motivation for the problem and the theoretical potential for expanding the control group with publicly available disease or reference samples. We demonstrate that a naïve application of this strategy can greatly inflate the false-positive error rate in the presence of population structure. As a remedy, we make use of genome-wide data and model selection techniques to identify “axes” of genetic variation which are associated with disease. These axes are then included as covariates in association analysis to correct for population structure, which can result in increases in power over standard analysis of genetic information from the samples in the original GWA study. Genet. Epidemiol. 34: 319–326, 2010. © 2010 Wiley-Liss, Inc. PMID:20088020

  18. Risk Profile in a Sample of Patients with Breast Cancer from the Public Health Perspective

    Directory of Open Access Journals (Sweden)

    Sorina IRIMIE

    2010-12-01

    Full Text Available Cancer represents a major public health and economical burden in developed countries and has emerged as a major public health problem in developing countries, matching its effect in industrialized nations. Although there have been recent declines in breast cancer mortality rates in some European Union countries, breast cancer remains of key importance to public health in Europe. Now days there is increasing recognition of the causative role of lifestyle factors, as smoking, diet, alcohol consumption, or lake of physical activity. The present study aimed to appreciate the presence and magnitude of modifiable risk factors for breast cancer in a sample of patients diagnosed with the disease, and to outline a risk profile liable to be changed in the intention of reducing the global risk. Risk factors have been investigated in 65 patients diagnosed with breast cancer using a questionnaire for breast cancer risk factors evaluation. The high risk profile was identified as taking shape for urban environment, modulated by the impact of overweight-obesity, smoking, reproductive factors and environmental exposure to different chemical substances. From the public health perspective, the control of overweight and obesity comes out in the foreground of preventive activities. Public health approaches emphasize on inexpensive, practical methods and in this perspective the approach of obesity should focus on the alteration of environmental context, promoting healthy eating and increased physical activity which could have a positive, independent impact on breast cancer risk

  19. Public reporting on quality, waiting times and patient experience in 11 high-income countries.

    Science.gov (United States)

    Rechel, Bernd; McKee, Martin; Haas, Marion; Marchildon, Gregory P; Bousquet, Frederic; Blümel, Miriam; Geissler, Alexander; van Ginneken, Ewout; Ashton, Toni; Saunes, Ingrid Sperre; Anell, Anders; Quentin, Wilm; Saltman, Richard; Culler, Steven; Barnes, Andrew; Palm, Willy; Nolte, Ellen

    2016-04-01

    This article maps current approaches to public reporting on waiting times, patient experience and aggregate measures of quality and safety in 11 high-income countries (Australia, Canada, England, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland and the United States). Using a questionnaire-based survey of key national informants, we found that the data most commonly made available to the public are on waiting times for hospital treatment, being reported for major hospitals in seven countries. Information on patient experience at hospital level is also made available in many countries, but it is not generally available in respect of primary care services. Only one of the 11 countries (England) publishes composite measures of overall quality and safety of care that allow the ranking of providers of hospital care. Similarly, the publication of information on outcomes of individual physicians remains rare. We conclude that public reporting of aggregate measures of quality and safety, as well as of outcomes of individual physicians, remain relatively uncommon. This is likely to be due to both unresolved methodological and ethical problems and concerns that public reporting may lead to unintended consequences. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  20. [Coping in patients after liver transplantation with regard to their membership in a self-group].

    Science.gov (United States)

    Nickel, R; Egle, U T; Wunsch, A; Lohse, A W; Otto, G

    2002-05-01

    Within the past 15 years, liver transplantation has proven itself to be the treatment of choice among patients with terminal liver disease. The one-year survival rate is about 80 %; after 8 years 61 % of the patients are still alive. The present study investigates the influence of active or depressive coping on the physical and mental quality of life in two different groups of patients after liver transplantation. Members (n = 65) and non-members (n = 20) of a German self-help group were asked to fill out a postal survey. Patients were included if their liver transplantation was conducted 6 to 36 months ago. The health-related quality of life was surveyed using the SF-36 and coping strategies were investigated with the Freiburg questionnaire on coping with illness. All patients had a good physical and mental quality of life compared with a German normative sample. Members of the self-help group showed substantially higher active coping with illness (p mental health-related quality of life (r between -0.24 and -0.68). This was true for both groups investigated. Based on an overall good health-related quality of life, depressive coping as well as aspects of the social environment contribute considerably in determining the well-being and quality of life in patients after liver transplantation.

  1. Psychosocial group intervention for patients with primary breast cancer: a randomised trial.

    Science.gov (United States)

    Boesen, Ellen H; Karlsen, Randi; Christensen, Jane; Paaschburg, Birgitte; Nielsen, Dorte; Bloch, Iben Seier; Christiansen, Birgitte; Jacobsen, Kathrine; Johansen, Christoffer

    2011-06-01

    To test the effectiveness of a psycho-educational group intervention to improve psychological distress measured by POMS TMD, Quality of Life measured by European Organisation for Research and Treatment of Cancer (EORTC), the core and breast cancer module, Mental Adjustment measured by MAC and marital relationship measured by BLRI in women with primary breast cancer conducted 10 weeks after surgery. A secondary outcome was 4-year survival. We randomly assigned 210 patients with primary breast cancer to a control or an intervention group. Patients in the intervention group were offered two weekly 6-h sessions of psycho-education and eight weekly 2-h sessions of group psychotherapy. All participants were followed up for Quality of Life, coping ability and social relations 1, 6 and 12 months after the intervention and on survival 4 years after surgical treatment. No statistically significant effects of the intervention were found on any of the psychosocial questionnaire outcomes. There were not enough cases of death to analyse overall survival. The only statistically significant result was for patients who used anti depressive medication, for whom almost all measures improved over time, in both the control and intervention groups. Psycho-education and group psychotherapy did not decrease psychological distress or increase Quality of Life, Mental Adjustment or improve marital relationship among patients with primary breast cancer. Copyright © 2011. Published by Elsevier Ltd.

  2. Preferences for engagement in health technology assessment decision-making: a nominal group technique with members of the public

    National Research Council Canada - National Science Library

    Wortley, Sally; Tong, Allison; Howard, Kirsten

    2016-01-01

    To identify characteristics (factors) about health technology assessment (HTA) decisions that are important to the public in determining whether public engagement should be undertaken and the reasons for these choices...

  3. The Control Attitudes Scale-Revised: psychometric evaluation in three groups of patients with cardiac illness.

    Science.gov (United States)

    Moser, Debra K; Riegel, Barbara; McKinley, Sharon; Doering, Lynn V; Meischke, Hendrika; Heo, Seongkum; Lennie, Terry A; Dracup, Kathleen

    2009-01-01

    Perceived control is a construct with important theoretical and clinical implications for healthcare providers, yet practical application of the construct in research and clinical practice awaits development of an easily administered instrument to measure perceived control with evidence of reliability and validity. To test the psychometric properties of the Control Attitudes Scale-Revised (CAS-R) using a sample of 3,396 individuals with coronary heart disease, 513 patients with acute myocardial infarction, and 146 patients with heart failure. Analyses were done separately in each patient group. Reliability was assessed using Cronbach's alpha to determine internal consistency, and item homogeneity was assessed using item-total and interitem correlations. Validity was examined using principal component analysis and testing hypotheses about known associations. Cronbach's alpha values for the CAS-R in patients with coronary heart disease, acute myocardial infarction, and heart failure were all greater than .70. Item-total and interitem correlation coefficients for all items were acceptable in the groups. In factor analyses, the same single factor was extracted in all groups, and all items were loaded moderately or strongly to the factor in each group. As hypothesized in the final construct validity test, in all groups, patients with higher levels of perceived control had less depression and less anxiety compared with those of patients who had lower levels of perceived control. This study provides evidence of the reliability and validity of the 8-item CAS-R as a measure of perceived control in patients with cardiac illness and provides important insight into a key patient construct.

  4. Comparison of Plasma Copper Concentrations in Patients with Brucellosis and Control Group

    Directory of Open Access Journals (Sweden)

    A.R. Mobaien

    2008-07-01

    Full Text Available Introduction & Objective : There are some reports about influence of the rare nutrients such as copper and zinc on immune system. Serum concentrations of copper alter in patients with brucellosis. Brucellosis is a common and endemic disease and a health problem in Iran. We compared serum concentrations of copper in patients with brucellosis and healthy individuals.Materials & Methods: In a cross sectional study, serum concentrations of copper was measured in patients with brucellosis and control group. Eighty six subjects were enrolled in the study, including 43 patients with brucellosis (34 men and 9 women and 43 healthy individuals. Serum concentrations of copper was measured by automatic absorptive spectrophotometer in patients with brucellosis and compared with control group. We employed a non parametrical test, kolmogrov – smirnov, to determine if data distribution was normal or not. Results: Mean age of patients with brucellosis was 40.1415.10 years with the range of 14-60 years. The most frequent symptoms were arthralgia (86%. Serum concentrations of copper in patients with brucellosis were significantly higher than healthy subjects (160.8454.61, 101.7427.37 g/dl respectively, p<0.001.Conclusion: Serum concentrations of copper in patients with brucellosis showed significant alterations in comparison with healthy subjects. So, we recommend using serum copper concentrations in patients with brucellosis as a marker in brucellosis diagnosis. Also we recommend another study for detection of serum copper concentrations before and during treatment.

  5. The effect of multiple sclerosis on the professional life of a group of Brazilian patients

    Directory of Open Access Journals (Sweden)

    Yára Dadalti Fragoso

    2010-12-01

    Full Text Available OBJECTIVE: To assess the impact of multiple sclerosis (MS on the professional life of Brazilian patients. METHOD: One hundred MS patients were randomly selected from the database of the Brazilian Multiple Sclerosis Association (ABEM. An individual interview was carried out by telephone by a member of ABEM, who collected data on the patients' clinical status, educational level and professional lives. RESULTS: Complete data were obtained from 96 patients (27 males and 69 females aged 55.0±14.1 years, with average disease duration of 4.6±4.0 years. Eighty percent had eleven or more years of schooling. Among the whole group, 66% did not present limitations on walking. The longer the disease duration and the older the patient were, the higher the chances were that the patient was retired or receiving workers' compensation benefits. However, even among patients with MS for less than five years, the rate of non-participation in the workforce was 47.7%. Fatigue, paresthesia, cognitive dysfunction and pain were often cited as the motives for not working. CONCLUSION: MS patients presented high levels of unemployment, retirement and receipt of workers' compensation benefits, despite their high schooling levels. Age, disease duration and disability influenced these results for the whole group. However, even among younger patients with shorter disease duration and low disability, this finding remained.

  6. Positive and Negative Perfectionism in Migrainus Patients Compaired with Control Group

    Directory of Open Access Journals (Sweden)

    H Afshar

    2008-01-01

    Full Text Available ABSTRACT: Introduction & Objective: The positive and negative effects of perfectionism on human cognition, affection and behavior have been emphasized. Perfectionism has been conceptualized as a multidimensional construct, with both adaptive and maladaptive aspects, which is one of the common personality traits that cause lifelong stress in human and results in anxiety, depression and physical and mental distress.The aim of this study was to assess the positive and negative perfectionism in migrainus patients in comparison with control group. Materials & Methods: This is an analytical (Case-control study which was performed on 91 migraine patients and 88 healthy individuals. The pqtients and controls completed a standard 40 item questionnaire for perfectionism – PANPS (20 for positive and 20 for negative perfectionism . The patients in both groups were matched for gender and age. Mean of positive and negative perfectionism scores for two groups was statistically analysed using SPSS software. Results: Mean positive perfectionism score was 83.47±8.5 for migraine group and 65.47±7.54 for control group (p=0.0001. The difference between two groups was significant. Mean of negative perfectionism score was 74.12±10.6 for migraine group and 51.79±7.8 for control group(p=0.0001. Conclusion: The results show that migraine patients have higher mean of perfectionism scores than healthy individuals. Based on this study and other clinical experiences more attention to psychotherapy is necessary for better management of migraine and recognition of personality profile in migraine patient helps to reduce patient’s complaints.

  7. The Inequity of Bariatric Surgery: Publicly Insured Patients Undergo Lower Rates of Bariatric Surgery with Worse Outcomes.

    Science.gov (United States)

    Hennings, Dietric L; Baimas-George, Maria; Al-Quarayshi, Zaid; Moore, Rachel; Kandil, Emad; DuCoin, Christopher G

    2017-06-30

    Bariatric surgery has been shown to be the most effective method of achieving weight loss and alleviating obesity-related comorbidities. Yet, it is not being used equitably. This study seeks to identify if there is a disparity in payer status of patients undergoing bariatric surgery and what factors are associated with this disparity. We performed a case-control analysis of National Inpatient Sample. We identified adults with body mass index (BMI) greater than or equal to 25 kg/m(2) who underwent bariatric surgery and matched them with overweight inpatient adult controls not undergoing surgery. The sample was analyzed using multivariate logistic regression. We identified 132,342 cases, in which the majority had private insurance (72.8%). Bariatric patients were significantly more likely to be privately insured than any other payer status; Medicare- and Medicaid-covered patients accounted for a low percentage of cases (Medicare 5.1%, OR 0.33, 95% CI 0.29-0.37, p bariatric surgery had an increased risk of complications compared to privately insured patients. Publicly insured patients are significantly less likely to undergo bariatric surgery. As a group, these patients experience higher rates of obesity and related complications and thus are most in need of bariatric surgery.

  8. A Comparison of Occupational Groups with Regard to Knowledge of Public School Finance in the Upper Cumberland Region of Tennessee.

    Science.gov (United States)

    Reddick, Thomas L.; Fletcher, Richard K., Jr.

    This study attempted to determine the knowledge of Tennessee public school finance on the part of teachers, businessmen, school administrators, elected officials, and industrial workers. Students in a class on public school finance administered the questionnaire to over 1,000 subjects. Results revealed that respondents feel that public education…

  9. Group consultations in antenatal care: Patients’ perspectives on what patient-patient communication provides

    DEFF Research Database (Denmark)

    Jensen, Matilde Nisbeth; Fage-Butler, Antoinette Mary

    of the written materials found the juxtaposition of biomedical and patient empowerment discourses; these findings form the backdrop to the interviews, which are currently being undertaken. Conclusions: This study not only presents empirical findings on a relatively new, but increasingly used, setting for client...

  10. Analyzing patient's waiting time in emergency & trauma department in public hospital - A case study

    Science.gov (United States)

    Roslan, Shazwa; Tahir, Herniza Md; Nordin, Noraimi Azlin Mohd; Zaharudin, Zati Aqmar

    2014-09-01

    Emergency and Trauma Department (ETD) is an important element for a hospital. It provides medical service, which operates 24 hours a day in most hospitals. However overcrowding is not exclusion for ETD. Overflowing occurs due to affordable services provided by public hospitals, since it is funded by the government. It is reported that a patient attending ETD must be treated within 90 minutes, in accordance to achieve the Key Performance Indicator (KPI). However, due to overcrowd situations, most patients have to wait longer than the KPI standard. In this paper, patient's average waiting time is analyzed. Using Chi-Square Test of Goodness, patient's inter arrival per hour is also investigated. As conclusion, Monday until Wednesday was identified as the days that exceed the KPI standard while Chi-Square Test of Goodness showed that the patient's inter arrival is independent and random.

  11. Containing psychotic patients with fragile boundaries: a single-session group case study.

    Science.gov (United States)

    Lavarenne, Anaïs; Segal, Emily; Sigman, Maxine

    2013-01-01

    This case study describes a single group psychotherapy session of six individuals suffering from schizophrenia or schizoaffective illness, which was characterized by numerous manifestations of fragile Ego boundaries. Based on these illustrations of fragile Ego boundaries, we explore some of the group's core therapeutic actions against psychosis. We discuss how the group (1) provides access to a structuring auxiliary Ego, (2) acts as a containing object by establishing firm boundaries and by mentalizing patients' psychotic productions, and (3) may become a solid object representation introjected by individuals wrestling with porous Ego boundaries and a poor sense of self. We conclude that, in addition to the known role of group therapy in increasing mature defenses, developing insight and providing social support, the group promotes healthier Ego boundaries, and eventually improves self-differentiation, and also tolerance to interpersonal proximity. This case study clarifies group therapy dynamics with individuals suffering from psychosis.

  12. [Effects of group psychological counseling on self-confidence and social adaptation of burn patients].

    Science.gov (United States)

    Dang, Rui; Wang, Yishen; Li, Na; He, Ting; Shi, Mengna; Liang, Yanyan; Zhu, Chan; Zhou, Yongbo; Qi, Zongshi; Hu, Dahai

    2014-12-01

    To explore the effects of group psychological counseling on the self-confidence and social adaptation of burn patients during the course of rehabilitation. Sixty-four burn patients conforming to the inclusion criteria and hospitalized from January 2012 to January 2014 in Xijing Hospital were divided into trial group and control group according to the method of rehabilitation, with 32 cases in each group. Patients in the two groups were given ordinary rehabilitation training for 8 weeks, and the patients in trial group were given a course of group psychological counseling in addition. The Rosenberg's Self-Esteem Scale was used to evaluate the changes in self-confidence levels, and the number of patients with inferiority complex, normal feeling, self-confidence, and over self-confidence were counted before and after treatment. The Abbreviated Burn-Specific Health Scale was used to evaluate physical function, psychological function, social relationship, health condition, and general condition before and after treatment to evaluate the social adaptation of patients. Data were processed with t test, chi-square test, Mann-Whitney U test, and Wilcoxon test. (1) After treatment, the self-confidence levels of patients in trial group were significantly higher than those in control group (Z = -2.573, P inferiority complex was 17 (53.1%) before treatment, which was decreased to 6 (18.8%) after treatment; the number of patients with normal feeling and that of self-confidence were 8 (25.0%) and 4 (12.5%) before treatment, which were respectively increased to 13 (40.6%) and 10 (31.3%) after treatment. The overall difference in trial group was obvious between before and after treatment (Z = -4.123, P 0.05). (2) After treatment, the scores of psychological function, social relationship, health condition, and general condition were (87 ± 3), (47.8 ± 3.6), (49 ± 3), and (239 ± 10) points in trial group, which were significantly higher than those in control group [(79 ± 4), (38

  13. Patient-perceived value of Medication Therapy Management (MTM services: a series of focus groups

    Directory of Open Access Journals (Sweden)

    Amanda Brummel, PharmD

    2012-01-01

    Full Text Available Objective: To determine the patient-perceived value of MTM services and non-financial barriers preventing patients with insurance coverage from receiving MTM services. Design: Focus groups. Setting: Fairview Pharmacy Services, Minneapolis, MN.Participants: Three focus groups, each with five to nine participants, consisting of different participant populations: (i patients who paid out-of-pocket to receive MTM services; (ii insurance beneficiaries, under which MTM is a covered benefit and participants may have received incentives for receiving MTM services; (iii patients with an insurance plan which covers MTM services who were recruited to receive MTM services but declined. Intervention: MTM services. Main Outcome Measure: Patient-perceived value of MTM services and non-financial barriers. Results: Seven themes were identified relating to the patient-perceived value of MTM services: collaboration of the health care team, MTM pharmacist as a supporter/advocate/confidant, MTM pharmacist as a resource for questions and education, accessibility to the MTM pharmacist, financial incentives for participation in MTM services, MTM pharmacy as a specialty field, and the MTM pharmacist as a coordinator. Three themes were identified regarding patient-perceived non-financial barriers to receiving MTM services, including: availability of the MTM pharmacist, patient/physician lack of knowledge of MTM services, patient’s belief that MTM services are not needed. Conclusion: MTM is a service which patients identify as valuable. Patients are able to identify non-financial barriers that may prevent some patients from receiving MTM services. This study provides preliminary evidence of both the value and barriers perceived by patients.

  14. Relapse Analysis of Irradiated Patients Within the HD15 Trial of the German Hodgkin Study Group

    Energy Technology Data Exchange (ETDEWEB)

    Kriz, Jan; Reinartz, Gabriele [Department of Radiation Oncology, University of Münster, Münster (Germany); Dietlein, Markus; Kobe, Carsten; Kuhnert, Georg [Department of Nuclear Medicine, University of Cologne, Cologne (Germany); Haverkamp, Heinz [First Department of Internal Medicine, University of Cologne, Cologne (Germany); Haverkamp, Uwe [Department of Radiation Oncology, University of Münster, Münster (Germany); Engenhart-Cabillic, Rita [Department of Radiation Oncology, University of Marburg, Marburg (Germany); Herfarth, Klaus [Department of Radiation Oncology, University Heidelberg, Heidelberg (Germany); Lukas, Peter [Department of Radiation Oncology, University of Innsbruck, Innsbruck (Austria); Schmidberger, Heinz [Department of Radiation Oncology, University of Mainz, Mainz (Germany); Staar, Susanne [Department of Radiation Oncology, Klinikum Bremen-Mitte, Bremen (Germany); Hegerfeld, Kira [Department of Radiation Oncology, University of Münster, Münster (Germany); Baues, Christian [Department of Radiation Oncology, University of Cologne, Cologne (Germany); Engert, Andreas [First Department of Internal Medicine, University of Cologne, Cologne (Germany); Eich, Hans Theodor, E-mail: hans.eich@ukmuenster.de [Department of Radiation Oncology, University of Münster, Münster (Germany)

    2015-05-01

    Purpose: To determine, in the setting of advanced-stage of Hodgkin lymphoma (HL), whether relapses occur in the irradiated planning target volume and whether the definition of local radiation therapy (RT) used by the German Hodgkin Study Group (GHSG) is adequate, because there is no harmonization of field and volume definitions among the large cooperative groups in the treatment of advanced-stage HL. Methods and Materials: All patients with residual disease of ≥2.5 cm after multiagent chemotherapy (CTX) were evaluated using additional positron emission tomography (PET), and those with a PET-positive result were irradiated with 30 Gy to the site of residual disease. We re-evaluated all sites of disease before and after CTX, as well as the PET-positive residual tumor that was treated in all relapsed patients. Documentation of radiation therapy (RT), treatment planning procedures, and portal images were carefully analyzed and compared with the centrally recommended RT prescription. The irradiated sites were compared with sites of relapse using follow-up computed tomography scans. Results: A total of 2126 patients were enrolled, and 225 patients (11%) received RT. Radiation therapy documents of 152 irradiated patients (68%) were analyzed, with 28 irradiated patients (11%) relapsing subsequently. Eleven patients (39%) had an in-field relapse, 7 patients (25%) relapsed outside the irradiated volume, and an additional 10 patients (36%) showed mixed in- and out-field relapses. Of 123 patients, 20 (16%) with adequately performed RT relapsed, compared with 7 of 29 patients (24%) with inadequate RT. Conclusions: The frequency and pattern of relapses suggest that local RT to PET-positive residual disease is sufficient for patients in advanced-stage HL. Insufficient safety margins of local RT may contribute to in-field relapses.

  15. CAG repeat polymorphism in the androgen receptor (AR) gene of SBMA patients and a control group.

    Science.gov (United States)

    Sułek, Anna; Hoffman-Zacharska, Dorota; Krysa, Wioletta; Szirkowiec, Walentyna; Fidziańska, Elzbieta; Zaremba, Jacek

    2005-01-01

    Spinobulbar muscular atrophy (SBMA) is an X-linked form of motor neuron disease characterized by progressive atrophy of the muscles, dysphagia, dysarthria and mild androgen insensitivity. SBMA is caused by CAG repeat expansion in the androgen receptor gene. CAG repeat polymorphism was analysed in a Polish control group (n = 150) and patients suspected of SBMA (n = 60). Normal and abnormal ranges of CAG repeats were established in the control group and in 21 patients whose clinical diagnosis of SBMA was molecularly confirmed. The ranges are similar to those reported for other populations.

  16. Indirect and direct costs of treating patients with ankylosing spondylitis in the Brazilian public health system

    Directory of Open Access Journals (Sweden)

    Valderilio Feijó Azevedo

    2016-04-01

    Full Text Available ABSTRACT Introduction: Patients with Ankylosing Spondylitis (AS require a team approach from multiple professionals, various treatment modalities for continuous periods of time, and can lead to the loss of labour capacity in a young population. So, it is necessary to measure its socio-economic impact. Objectives: To describe the use of public resources to treat AS in a tertiary hospital after the use of biological medications was approved for treating spondyloarthritis in the Health Public System, establishing approximate values for the direct and indirect costs of treating this illness in Brazil. Material and methods: 93 patients selected from the ambulatory spondyloarthritis clinic at the Hospital de Clínicas of the Federal University of Paraná between September 2011 and September 2012 had their direct costs indirect treatment costs estimation. Results: 70 patients (75.28% were male and 23 (24.72% female. The mean age was 43.95 years. The disease duration was calculated based on the age of diagnosis and the mean was 8.92 years (standard deviation: 7.32; 63.44% were using anti-TNF drugs. Comparing male and female patients the mean BASDAI was 4.64 and 5.49 while the mean BASFI was 5.03 and 6.35 respectively. Conclusions: The Brazilian public health system's spending related to ankylosing spondylitis has increased in recent years. An important part of these costs is due to the introduction of new, more expensive health technologies, as in the case of nuclear magnetic resonance and, mainly, the incorporation of anti-TNF therapy into the therapeutic arsenal. The mean annual direct and indirect cost to the Brazilian public health system to treat a patient with ankylosing spondylitis, according to our findings, is US$ 23,183.56.

  17. Emotional Intelligence in a group of patients with first-episode psychosis in Iran.

    Science.gov (United States)

    Basseda, Zahra; Amini, Homayoun; Sharifi, Vandad; Kaviani, Hosein; Pooretemad, Hamid Reza; Zadbood, Asieh

    2012-01-01

    This study was aimed to evaluate the Emotional Intelligence (EI) of a group of patients with first episode psychosis in Iran as compared with a healthy control group. A case-control design was used. EI was assessed using Persian version of Bar-On Emotional Quotient inventory (EQ-i) administered on 25 patients with history of a single psychotic episode in the last two years, as well as 64 healthy participants. The mean (±SD) of EI scores of patients' and healthy controls' group was 319.8 (±40.9) and 328.8 (±33.3), respectively. Two-independent sample t-test revealed no significant difference in the EI scores of two groups (P=0.29). In contrast with chronic schizophrenia, the patients with first-episode psychosis were not different from the healthy subjects in terms of emotional intelligence score. It might be implied that the low emotional intelligence of the patients with chronic psychotic disorders is an accumulative result of the underlying disease over time.

  18. Emotional Intelligence in a Group of Patients with First-Episode Psychosis in Iran

    Directory of Open Access Journals (Sweden)

    Hamid Reza Pooretemad

    2012-02-01

    Full Text Available This study was aimed to evaluate the Emotional Intelligence (EI of a group of patients with first episode psychosis in Iran as compared with a healthy control group. A case-control design was used. EI was assessed using Persian version of Bar-On Emotional Quotient inventory (EQ-i administered on 25 patients with history of a single psychotic episode in the last two years, as well as 64 healthy participants. The mean (±SD of EI scores of patients and healthy controls group was 319.8 (±40.9 and 328.8 (±33.3, respectively. Two-independent sample t-test revealed no significant difference in the EI scores of two groups (P=0.29. In contrast with chronic schizophrenia, the patients with first-episode psychosis were not different from the healthy subjects in terms of emotional intelligence score. It might be implied that the low emotional intelligence of the patients with chronic psychotic disorders is an accumulative result of the underlying disease over time.

  19. Auto-Immune Hemolytic Anemia in Patient who his Serum React with all ABO Blood Group

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    A Pourazar

    2004-12-01

    Full Text Available There are several irregular antibodies associated with various blood group systems which may cause some problems during blood cross matching in transfusion. The atypical antibodies are included auto and alloantibodies such as anti-I, anti-HI, anti-P… . In order to detect these antibodies, generally the agglutination reaction technique and anti-human-globulin (coombs tests would be performed and a panel of identified red blood cells will use if necessary for further investigation. During our work, we encountered with one serum sample that showed agglutination reaction with all the blood groups (A, B, O, and AB. We tested pooled red blood cells with OI group of adult and pooled cord red blood cells of Oi group with the patient serum. it was shown that the serum was reactive with OI but not with Oi. For confirmation of the result, the sample was sent to Institute of Immunohematology (I.I.H., India. The report approved that the serum contained anti-I specificity. To solve the transfusion problem for this patient, the recommendation is using the blood group with minimum coombs titration if the patient life is in threatened. Further investigations disclosed that the patient had leukemia. Keywords: Anti-I, Ii antigen, Allo-Autoantibody.

  20. Patient groups in art therapies: A case study of the health care field in Latvia

    OpenAIRE

    Vende K.; Vaverniece I.; Upmale A.; Martinsone K.

    2012-01-01

    The aim of the paper is to introduce the reader with an example of the arts therapies work in a children hospital in Latvia in order to describe art therapies work similarities and differences in three different specializations. Comparison will take place of patient groups in the work of art therapists in each specialization (art therapy, dance movement therapy and music therapy). The question of the research is: with which patient groups’ a specialist from a particular arts therapies special...

  1. Response of chronic myelogenous leukemia patients to COAP-splenectomy. A Southwest Oncology Group study.

    Science.gov (United States)

    Hester, J P; Waddell, C C; Coltman, C A; Morrison, F S; Stephens, R L; Balcerzak, S P; Baker, L H; Chen, T T

    1984-11-01

    Eighty-seven patients from 18 institutions with a confirmed diagnosis of chronic myelogenous leukemia were registered on a Southwest Oncology Group protocol for multiagent induction and single-agent maintenance chemotherapy, with randomization to an immunotherapy arm. Elective surgical splenectomy was performed for 42 patients at the completion of 3 months of induction therapy. Final analysis of the study revealed statistically significant survival advantages were correlated with age, splenectomy, the absence of hepatic leukemic infiltrate at the time of splenectomy, and race.

  2. Patient self-management and pharmacist-led patient self-management in Hong Kong: A focus group study from different healthcare professionals' perspectives

    Directory of Open Access Journals (Sweden)

    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

  3. Editorial research and the publication process in biomedicine and health: Report from the Esteve Foundation Discussion Group, December 2012.

    Science.gov (United States)

    Marušić, Ana; Malički, Mario; von Elm, Erik

    2014-01-01

    Despite the fact that there are more than twenty thousand biomedical journals in the world, research into the work of editors and publication process in biomedical and health care journals is rare. In December 2012, the Esteve Foundation, a non-profit scientific institution that fosters progress in pharmacotherapy by means of scientific communication and discussion organized a discussion group of 7 editors and/or experts in peer review biomedical publishing. They presented findings of past editorial research, discussed the lack of competitive funding schemes and specialized journals for dissemination of editorial research, and reported on the great diversity of misconduct and conflict of interest policies, as well as adherence to reporting guidelines. Furthermore, they reported on the reluctance of editors to investigate allegations of misconduct or increase the level of data sharing in health research. In the end, they concluded that if editors are to remain gatekeepers of scientific knowledge they should reaffirm their focus on the integrity of the scientific record and completeness of the data they publish. Additionally, more research should be undertaken to understand why many journals are not adhering to editorial standards, and what obstacles editors face when engaging in editorial research.

  4. The impact of itch symptoms in psoriasis: results from physician interviews and patient focus groups

    Directory of Open Access Journals (Sweden)

    Bayliss Martha S

    2009-07-01

    Full Text Available Abstract Background The objective of this qualitative study was to better understand the impact of psoriasis symptoms using a 3-part process: 1 develop a disease model for psoriasis to identify the most important concepts relevant to psoriasis patients; 2 conduct interviews with dermatologists to identify key areas of clinical concern; and 3 explore psoriasis patients' perceptions of the impact of psoriasis. Methods A disease model was developed from a review of the published literature and later revised based on the findings of clinician interviews and patient focus groups. To confirm the clinical relevance of the concepts identified in the disease model, 5 dermatologists were selected and interviewed one-on-one. They were asked to rate major psoriasis symptoms according to importance and bothersomeness level to patients on separate scales of 1 to 10. Results of clinician interviews were used to develop interview guides for patient focus groups. To identify important domains of psoriasis, 39 patients participated in 5 separate concept elicitation focus groups. Four focus groups included patients with severe psoriasis (n = 31 and one included patients with mild psoriasis (n = 8. Patients were asked to describe their current psoriasis symptoms and to rate them on a scale of 1 to 10, according to importance, severity, and troublesomeness. An average mean rating was calculated for each symptom throughout all focus groups. Results Clinicians most frequently mentioned itch (n = 5, psoriatic arthritis or "joint pains" (n = 4, flaking (n = 4, and pain (n = 3 as primary physical symptoms of psoriasis. Three clinicians gave a rating of 10 for the importance of itch; two clinicians gave ratings of 8 and 7 for importance. The majority of patients rated itch as the most important (31/39, most severe (31/39, and most troublesome (24/39 symptom and noted that itch negatively impacted daily activities (eg, concentration, sleep, ability to attend work or school

  5. The impact of itch symptoms in psoriasis: results from physician interviews and patient focus groups.

    Science.gov (United States)

    Globe, Denise; Bayliss, Martha S; Harrison, David J

    2009-07-06

    The objective of this qualitative study was to better understand the impact of psoriasis symptoms using a 3-part process: 1) develop a disease model for psoriasis to identify the most important concepts relevant to psoriasis patients; 2) conduct interviews with dermatologists to identify key areas of clinical concern; and 3) explore psoriasis patients' perceptions of the impact of psoriasis. A disease model was developed from a review of the published literature and later revised based on the findings of clinician interviews and patient focus groups. To confirm the clinical relevance of the concepts identified in the disease model, 5 dermatologists were selected and interviewed one-on-one. They were asked to rate major psoriasis symptoms according to importance and bothersomeness level to patients on separate scales of 1 to 10. Results of clinician interviews were used to develop interview guides for patient focus groups. To identify important domains of psoriasis, 39 patients participated in 5 separate concept elicitation focus groups. Four focus groups included patients with severe psoriasis (n = 31) and one included patients with mild psoriasis (n = 8). Patients were asked to describe their current psoriasis symptoms and to rate them on a scale of 1 to 10, according to importance, severity, and troublesomeness. An average mean rating was calculated for each symptom throughout all focus groups. Clinicians most frequently mentioned itch (n = 5), psoriatic arthritis or "joint pains" (n = 4), flaking (n = 4), and pain (n = 3) as primary physical symptoms of psoriasis. Three clinicians gave a rating of 10 for the importance of itch; two clinicians gave ratings of 8 and 7 for importance. The majority of patients rated itch as the most important (31/39), most severe (31/39), and most troublesome (24/39) symptom and noted that itch negatively impacted daily activities (eg, concentration, sleep, ability to attend work or school), as well as emotions (eg, anxiety and

  6. When and why placebo-prescribing is acceptable and unacceptable: a focus group study of patients' views.

    Directory of Open Access Journals (Sweden)

    Felicity L Bishop

    Full Text Available Surveys of doctors suggest that they use placebos and placebo effects clinically to help patients. However, patients' views are not well-understood. We aimed to identify when and why placebo-prescribing in primary care might be acceptable and unacceptable to patients.A purposive diverse sample of 58 English-speaking adults (18 men; aged 19-80 years participated in 11 focus groups. Vignettes describing doctors prescribing placebos in primary care were used to initiate discussions. Data were analyzed inductively.Participants discussed diverse harms and benefits of placebo-prescribing for individual patients, carers, healthcare providers, and society. Two perspectives on placebo-prescribing were identified. First, the "consequentialist" perspective focused on the potential for beneficial outcomes of placebo-prescribing. Here, some participants thought placebos are beneficial and should be used clinically; they often invoked the power of the mind or mind-body interactions. Others saw placebos as ineffective and therefore a waste of time and money. Second, the "respecting autonomy" perspective emphasized the harms caused by the deceptive processes thought necessary for placebo-prescribing. Here, participants judged placebo-prescribing unacceptable because placebo-prescribers deceive patients, thus a doctor who prescribes placebos cannot be trusted and patients' autonomy is compromised. They also saw placebo-responders as gullible, which deterred them from trying placebos themselves. Overall, the word "placebo" was often thought to imply "ineffective"; some participants suggested alternative carefully chosen language that could enable doctors to prescribe placebos without directly lying to patients.Negative views of placebos derive from beliefs that placebos do not work and/or that they require deception by the doctor. Positive views are pragmatic in that if placebos work then any associated processes (e.g. mechanisms, deception are deemed unimportant

  7. Mentalization and Life Stories among Patients with Borderline Personality Disorder (BPD) and a Control Group

    DEFF Research Database (Denmark)

    Lind, Majse; Bøye, Rikke; Heinskou, Torben;

    2016-01-01

    been examined in patients with BPD and this was the aim of our ongoing study. 30 patients with BPD and 30 controls will participate in the study. Mentalization is assessed using both self-report and performance measures (Empathic Quotient, Toronto Alexithymia Scale-20 and Mayer, Salovey, Caruso...... Emotional Intelligence Test). Life stories are assessed by having participants describe up to 10 chapters and rate causal coherence of these chapters. We expect that patients with BPD will show poorer mentalization and less causally coherent life stories compared to the control group. Furthermore, we expect...

  8. [Health education and group work during in-patient rehabilitation following myocardial infarction (author's transl)].

    Science.gov (United States)

    Herzog, M; König, K; Maas, A; Neufert, R

    1982-02-01

    Starting from the usual in-patient rehabilitation measures for myocardial infarction patients and based on the authors' clinical experiences, a working model is presented concerning the health educational care of patients undergoing rehabilitation procedures immediately following infarction or bypass operation. The new concept is based on a psychosomatic view of the cardiovascular diseases, and uses group-dynamic elements in its methodological approach. The rehabilitational tasks of health education are understood as therapeutic strategies and are aimed at achieving changes on the attitudinal and behavioural level.

  9. [Evaluation of an educational group intervention in the control of patients with cardiovascular risk].

    Science.gov (United States)

    Puig-Girbau, M Núria; Lladó-Blanch, M Magdalena; Seco-Salcedo, M Carmen; Gómez-Saldaña, Ana; Medina-Peralta, Manuel; Riera-Torres, Roser; Pera, Guillem

    2011-01-01

    To compare an educational group intervention with individual care to improve clinical and management variables among patients with cardiovascular risk (CVR) in community health care (PC). A randomised controlled experimental study was developed in 7 PC centres of Barcelona (Spain). A total of 2,127 patients included in the chronic diseases protocol of the centres were selected. The intervention group (IG) attended four educative workshops led by their nurses during one year. Clinical and management variables (number of visits, pharmaceutical expenditure, nurse time consumption) were measured at baseline and 3 months after the intervention in the IG and in the control group (CG). Pre-post-intervention and IG vs. CG differences were analysed. Among the 672 patients belonging to the IG, 144 were lost due to failing to attend the workshops. CG (n=824) had no withdrawals. At the end of follow-up there were no significant differences between their clinical variables. The number of visits and pharmaceutical expenditure increased in the IG. However, the annual dedication of nurses per patient per year was 39.59 minutes in the IG and 60 minutes in the CG. Nurse group control of patients with CVR in PC saves nurse-time compared with the usual individual visits. However, further studies are needed to better define what type of patient that is more susceptible to follow cardiovascular control through group workshops and whether this time-saving is related to the use of other health resources. Copyright © 2010 Elsevier España, S.L. All rights reserved.

  10. Patient's perceptions about the service quality of public hospitals located at District Kohat.

    Science.gov (United States)

    Aman, Bakhtiar; Abbas, Faisal

    2016-01-01

    To determine patients' perception regarding service and quality of healthcare at public-sector institutions. The descriptive quantitative study was conducted in Kohat district, Pakistan, between July and December 2014, and focussed on 30 variables to assess the participants' perceptions of the actual healthcare service quality delivered. SERVQUAL instrument was used to measure the reliability and cronbach alpha was calculated to measure the reliability and validity of the instrument. A total of 200 questionnaires were distributed and 157(78.5%) were received back fully filled. Of them, 105(67%) were men and 52(33%) were women.The mean value of Assurance parameter was 3.05±0.88, indicating trust in public hospitals was high as they had experienced and capable doctors. On the other hand, the lowest mean value of 2.61±0.84 was for Empathy, highlighting the fact that public hospitals lacked the ability to handle patients' problem properly, services were not offered in time and they were short of staff. Public hospitals were largely seen as failing to deliver quality service.

  11. [Symptomatic and asymptomatic infections of Demodex spp. in eye lashes of patients of different age groups].

    Science.gov (United States)

    Kuźna-Grygiel, Wanda; Kosik-Bogacka, Danuta; Czepita, Damian; Sambor, Izabella

    2004-01-01

    Demodex folliculorum and Demodex brevis were looked for on eyelashes sampled from 481 people, aged 3 through 96. The persons studied were divided into 9 age groups. Magnitude of the infection symptoms was assessed based on macroscopic changes of eye-lid edges and on interviews with patients. An increase of the prevalence of infection and intensification of the symptoms were observed to coincide with the age increase of the persons studied. No significant differences were demonstrated between the infection frequencies of women and men. Symptoms of ocular demodecosis were more frequent only in women of group III (aged 21-30) and group V (41-50) (p < 0.05).

  12. Through the Looking Glass: Public and Professional Perspectives on Patient-centred Professionalism in Modern-day Community Pharmacy

    Directory of Open Access Journals (Sweden)

    Frances Rapport

    2009-11-01

    Full Text Available This paper presents five consultation workshops with 29 community pharmacists, stakeholders and patients that examined "patient-centred professionalism" in terms of pharmacists' working day and environment. The concept is ill-defined in both medical and pharmacy literature and the study aimed to clarify the situated nature of the term for patients and health professionals across settings. Workshops were supported by bio-photographic datasets of "in-situ" practice and Nominal Group Work. The thematic content analyses led to the following aspects: building caring relationships; managing external forces; the effects of space and environment, and different roles and expectations. The study reveals how patient-centred professionalism cannot be defined in any singular or stationary sense, but should be seen as a "moveable feast", best understood through everyday examples of practice and interaction, in relation to whose experience is being expressed, and whose needs considered. The phrase is being mobilised by a whole set of interests and stakeholders to reshape practice, the effect of which remains both uncertain and contested. Whilst patients prioritise a quick and efficient dispensing service from knowledgeable pharmacists, pharmacists rail against increasing public demands and overtly formalised consultations that take them away from the dispensary where the defining aspects of their professionalism lie. URN: urn:nbn:de:0114-fqs100177

  13. Patients' preferences for video cassette recorded information: effect of age, sex and ethnic group.

    Science.gov (United States)

    Thomas, R; Deary, A; Kaminski, E; Stockton, D; De Zueew, N

    1999-06-01

    The emotional turmoil patients endure following a diagnosis of cancer can impair their ability to retain complex treatment-related information. Manoeuvres which increase the intensity of information have been shown to increase the amount retained. Providing details of treatment in a video format is one method of intensifying information provision, but the attitudes of patients to this format have not previously been evaluated. In this pilot study, the attitudes of 300 patients to video directed information were evaluated via questionnaires, of which 210 (70%) were returned. Eighty-nine per cent had easy access to a video cassette player. A highly significant number felt that the video would be very helpful or helpful (78%) compared to not helpful, worrying or equivocal 21% (P < 0.0001). This trend was particularly strong in patients < 60 years (83% versus 17%) (P < 0.0001) and those from ethnic groups (95% versus 5%) (P < 0.0001). As a result of this trial, a 20-min film (HEP) has been commissioned. It describes details of the two main treatments for cancer after surgery, namely chemotherapy and radiotherapy, shows patients actually having treatment, and explains the common side-effects and ways to alleviate them. Patients satisfaction with the film and its effect on anxiety and depression are currently being evaluated in an international prospective randomized trial. If it proves advantageous for patients--in view of the ethnic group bias in this study--it will be translated into the ethnic languages of the UK.

  14. Obesity in general practice: a focus group study on patient experiences.

    Science.gov (United States)

    Malterud, Kirsti; Ulriksen, Kjersti

    2010-12-01

    To explore obese patients' experiences with GPs' management of their weight problems. Focus-group study with a purposive sample of 13 participants (eight women and five men), aged 30-55 years, with BMI above 40, or BMI above 35 with additional weight-related problems. Two focus-group interviews were conducted, inviting the participants to speak about their health care experiences from general practice. Analysis applied Systematic Text Condensation inspired by Giorgi's approach, searching for issues describing or discussing participants' experiences of GPs' obesity management. Obese patients want their GPs to put their weight problems on the agenda. When the patient appears reluctant, it may be a sign of embarrassment rather than rejection of the issue. However, restricted attention to obesity could lead to neglect of patients' problems. Participants complained that GPs often demonstrated insufficient engagement and knowledge regarding service resources for obesity treatment, leaving the responsibility for information on available referral resources to the patient. Finally, considerate attitudes in the GPs are needed for follow-up to be experienced as helpful by the patients. Vulnerable feelings of failure could be reinforced by well-intended advice. Degrading attitudes were perceived as especially subversive when they came from doctors. The challenge for the GP is to increase his or her competence in individualized and evidence-based counselling, while acknowledging the efforts needed by the patient to achieve permanent change, and shifting attention from shame to coping.

  15. Detection of rare blood group, Bombay (Oh) phenotype patients and management by acute normovolemic hemodilution.

    Science.gov (United States)

    Shrivastava, Manisha; Navaid, Seema; Peethambarakshan, A; Agrawal, Kalpana; Khan, Athar

    2015-01-01

    Due to lack of correct blood grouping practices, the rare Bombay Oh phenotype may be missed, subjecting patients to the risk of severe hemolytic transfusion reaction. In the absence of blood donor registry, transfusion management of patients needing immediate surgery is a challenge. This study presents detection of rare Bombay Oh phenotype patients and their management by acute peri-operative acute normovolemic hemodilution (ANH) in a hospital from central India. Blood grouping of patients and blood donors with a standard tube method was carried out and samples identified as rare Bombay phenotype were confirmed by saliva inhibition test. Surgical management of cases needing transfusion was done by ANH, as per the British Committee for Standards in Hematology guidelines. The incidence of Bombay phenotype was 0.002% or 1 in 51,924 in the study. Amongst three cases (patients) identified as Bombay phenotype, one was Bombay Oh, Rh negative. Two cases were missed in the first instance and one case actually did not require transfusion. In the absence of a blood donor registry for Bombay phenotype, the cases needing transfusion were successfully managed with ANH in the operation theatre. A simple test like blood grouping should be done with serious intention with incorporation of both forward and reverse grouping, so that no patient receives wrong blood leading to fatal hemolysis due to transfusion. ANH is a cost-effective transfusion option for suitable patients. Appropriate clinical decision making, use of strategies to decrease peri-operative blood losses and cost-effective country based planning could be more widely applied to improve clinical transfusion practice.

  16. Detection of rare blood group, Bombay (Oh phenotype patients and management by acute normovolemic hemodilution

    Directory of Open Access Journals (Sweden)

    Manisha Shrivastava

    2015-01-01

    Full Text Available Background: Due to lack of correct blood grouping practices, the rare Bombay Oh phenotype may be missed, subjecting patients to the risk of severe hemolytic transfusion reaction. In the absence of blood donor registry, transfusion management of patients needing immediate surgery is a challenge. This study presents detection of rare Bombay Oh phenotype patients and their management by acute peri-operative acute normovolemic hemodilution (ANH in a hospital from central India. Materials and Methods: Blood grouping of patients and blood donors with a standard tube method was carried out and samples identified as rare Bombay phenotype were confirmed by saliva inhibition test. Surgical management of cases needing transfusion was done by ANH, as per the British Committee for Standards in Hematology guidelines. Results: The incidence of Bombay phenotype was 0.002% or 1 in 51,924 in the study. Amongst three cases (patients identified as Bombay phenotype, one was Bombay Oh, Rh negative. Two cases were missed in the first instance and one case actually did not require transfusion. In the absence of a blood donor registry for Bombay phenotype, the cases needing transfusion were successfully managed with ANH in the operation theatre. Conclusion: A simple test like blood grouping should be done with serious intention with incorporation of both forward and reverse grouping, so that no patient receives wrong blood leading to fatal hemolysis due to transfusion. ANH is a cost-effective transfusion option for suitable patients. Appropriate clinical decision making, use of strategies to decrease peri-operative blood losses and cost-effective country based planning could be more widely applied to improve clinical transfusion practice.

  17. Study of serum syndecan-1 levels in a group of Egyptian juvenile systemic lupus erythematosus patients.

    Science.gov (United States)

    Mosaad, Naglaa Abd Elrahman; Lotfy, Hala Mohamed; Farag, Yomna Mohamed; Mahfouz, Rasha Hossam El-Din; Shahin, Rasha Mohamad Hosny

    2017-01-01

    The aim of the study was to assess the serum levels of Syndecan-1 in a group of Egyptian juvenile systemic lupus erythematosus (JSLE) patients and to study any possible associations with disease activity, renal activity and organ damage. Serum level of Syndecan-1 was assessed in 60 Egyptian JSLE patients and 30 apparently healthy age and gender matched children using ELISA. SLE Disease Activity Index-2000 (SLEDAI-2K), renal SLEDAI-2K, renal activity score and the Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index were assessed for all patients. Serum SDC-1 levels were higher in patients with JSLE than in healthy controls (p<0.001) and were positively correlated with SLEDAI-2K (p<0.001), with renal SLEDAI score (p=0.008) and renal activity score (p=0.04). So, Syndecan-1 might be used as a marker for disease activity and renal activity in JSLE patients.

  18. Impact of ABO blood group on the prognosis of patients undergoing surgery for esophageal cancer.

    Science.gov (United States)

    Wang, Wei; Liu, Lei; Wang, Zhiwei; Wei, Min; He, Qi; Ling, Tianlong; Cao, Ziang; Zhang, Yixin; Wang, Qiang; Shi, Minxin

    2015-09-29

    ABO blood type is an established prognostic factor in several malignancies, but its role in esophageal cancer (EC) is largely unknown. The aim of this study is to determine whether ABO blood group is associated with survival after esophagectomy for EC. A total of 406 patients who underwent surgery for EC were enrolled. The associations of ABO blood group with clinical and pathological variables were assessed using chi-square test. Associations of ABO blood group with the survival were estimated using univariable and multivariable Cox proportional hazards regression models. The ABO blood group proportionally associated with the grade of EC tumor (P = 0.049). The ABO blood group status did not correlate with disease-free survival (DFS) in univariable analysis or multivariable analysis (P > 0.05). And there was no significant relationship between the ABO blood group and overall survival (OS) in univariable analysis or multivariable analysis (P > 0.05). Our results suggested that no association between ABO blood group and the survival was observed in patients undergoing surgery for EC.

  19. SERVICE QUALITY PERCEPTIONS AND PATIENTS' SATISFACTION: A COMPARATIVE CASE STUDY OF A PUBLIC AND A PRIVATE SECTOR HOSPITAL IN PAKISTAN

    OpenAIRE

    Kanwal Nasim; Saquib Yusaf Janjua

    2014-01-01

    Management of hospitals should take initiatives to improve the overall service quality of patient care. Regular feed-back from patients should be taken and rules should be made considering the expectations and requirements of patients. This study attempts to examine the satisfaction of patients from service quality they received from hospitals. Moreover, satisfaction is measured in both public and private hospital.

  20. Influenza vaccination for immunocompromised patients: systematic review and meta-analysis from a public health policy perspective.

    Directory of Open Access Journals (Sweden)

    Charles R Beck

    Full Text Available BACKGROUND: Immunocompromised patients are vulnerable to severe or complicated influenza infection. Vaccination is widely recommended for this group. This systematic review and meta-analysis assesses influenza vaccination for immunocompromised patients in terms of preventing influenza-like illness and laboratory confirmed influenza, serological response and adverse events. METHODOLOGY/PRINCIPAL FINDINGS: Electronic databases and grey literature were searched and records were screened against eligibility criteria. Data extraction and risk of bias assessments were performed in duplicate. Results were synthesised narratively and meta-analyses were conducted where feasible. Heterogeneity was assessed using I(2 and publication bias was assessed using Begg's funnel plot and Egger's regression test. Many of the 209 eligible studies included an unclear or high risk of bias. Meta-analyses showed a significant effect of preventing influenza-like illness (odds ratio [OR]=0.23; 95% confidence interval [CI]=0.16-0.34; p<0.001 and laboratory confirmed influenza infection (OR=0.15; 95% CI=0.03-0.63; p=0.01 through vaccinating immunocompromised patie nts compared to placebo or unvaccinated controls. We found no difference in the odds of influenza-like illness compared to vaccinated immunocompetent controls. The pooled odds of seroconversion were lower in vaccinated patients compared to immunocompetent controls for seasonal influenza A(H1N1, A(H3N2 and B. A similar trend was identified for seroprotection. Meta-analyses of seroconversion showed higher odds in vaccinated patients compared to placebo or unvaccinated controls, although this reached significance for influenza B only. Publication bias was not detected and narrative synthesis supported our findings. No consistent evidence of safety concerns was identified. CONCLUSIONS/SIGNIFICANCE: Infection prevention and control strategies should recommend vaccinating immunocompromised patients. Potential for bias

  1. Positive psychology group intervention for breast cancer patients: a randomised trial.

    Science.gov (United States)

    Victoria Cerezo, M; Ortiz-Tallo, Margarita; Cardenal, Violeta; De La Torre-Luque, Alejandro

    2014-08-01

    This study assessed the effects of a psychological group intervention based on positive psychology in women with breast cancer. 175 women were randomly assigned either to an experimental group, receiving the 14-session intervention (n = 87), or to a wait list group (n = 88) that did not receive any type of intervention. For treatment, a group intervention was applied, based on improving psychological strengths and enhancing positive psychology-based styles of coping. Strength-related outcomes, self-esteem, well-being, and happiness were assessed before and after the intervention. The experimental group showed higher scores on all of the study variables after the intervention. Participants reported improved self-esteem, emotional intelligence-related abilities, resilience, and optimism, as well as positive affectivity, well-being, and happiness. The results show a beneficial effect of this psychological intervention based on positive psychology on female breast cancer patients' psychological health.

  2. Focus Groups in Elderly Ophthalmologic Patients: Setting the Stage for Quantitative Preference Elicitation.

    Science.gov (United States)

    Danner, Marion; Vennedey, Vera; Hiligsmann, Mickaël; Fauser, Sascha; Stock, Stephanie

    2016-02-01

    Patients suffering from age-related macular degeneration (AMD) are rarely actively involved in decision-making, despite facing preference-sensitive treatment decisions. This paper presents a qualitative study to prepare quantitative preference elicitation in AMD patients. The aims of this study were (1) to gain familiarity with and learn about the special requirements of the AMD patient population for quantitative data collection; and (2) to select/refine patient-relevant treatment attributes and levels, and gain insights into preference structures. Semi-structured focus group interviews were performed. An interview guide including preselected categories in the form of seven potentially patient-relevant treatment attributes was followed. To identify the most patient-relevant treatment attributes, a ranking exercise was performed. Deductive content analyses were done by two independent reviewers for each attribute to derive subcategories (potential levels of attributes) and depict preference trends. The focus group interviews included 21 patients. The interviews revealed that quantitative preference surveys in this population will have to be interviewer assisted to make the survey feasible for patients. The five most patient-relevant attributes were the effect on visual function [ranking score (RS): 139], injection frequency (RS: 101), approval status (RS: 83), side effects (RS: 79), and monitoring frequency (RS: 76). Attribute and level refinement was based on patients' statements. Preference trends and dependencies between attributes informed the quantitative instrument design. This study suggests that qualitative research is a very helpful step to prepare the design and administration of quantitative preference elicitation instruments. It especially facilitated familiarization with the target population and its preferences, and it supported attribute/level refinement.

  3. Macrolide and clindamycin resistance in Streptococcus milleri group isolates from the airways of cystic fibrosis patients.

    Science.gov (United States)

    Grinwis, Margot E; Sibley, Christopher D; Parkins, Michael D; Eshaghurshan, Christina S; Rabin, Harvey R; Surette, Michael G

    2010-07-01

    Organisms belonging to the Streptococcus milleri group (SMG) are known for their role in pyogenic infections but have recently been implicated as etiological agents of pulmonary exacerbation in adult patients with cystic fibrosis (CF). The prolonged exposure of CF patients to antibiotics prompted us to investigate the susceptibility profiles of 118 SMG isolates from the airways of CF patients to 12 antibiotics compared to 43 SMG isolates from patients with invasive infections. We found that approximately 60% of all isolates failed to grow using the standard medium for disc diffusion, Mueller-Hinton blood agar (MHBA), so we explored the usefulness of brain heart infusion (BHI) agar for susceptibility testing. Zone-of-inhibition comparisons between BHI and MHBA showed strong correlations for six antibiotics, and interpretations were similar for both medium types. For ceftriaxone and cefepime, both groups of isolates were highly susceptible. Tetracycline resistance levels were comparable between the two groups (22% in CF isolates and 17.4% in invasive isolates). However, more than half of the CF isolates were not susceptible to azithromycin, erythromycin, and clindamycin, compared to 11%, 13%, and 6.5% of invasive isolates, respectively. There were 5-fold and 8-fold increased risks of azithromycin and clindamycin resistance, respectively, for the isolates from the airways of CF patients relative to the invasive isolates. Macrolide resistance was strongly linked to chronic azithromycin therapy in CF patients. This study shows that BHI agar is a suitable alternative for antimicrobial susceptibility testing for the SMG and that SMG isolates from the airways of CF patients are more resistant to macrolides and clindamycin than strains isolated from patients with invasive infections.

  4. International Pediatric Otolaryngology Group (IPOG) consensus recommendations : Hearing loss in the pediatric patient

    NARCIS (Netherlands)

    Liming, Bryan J; Carter, John; Cheng, Alan; Choo, Daniel; Curotta, John; Carvalho, Daniela; Germiller, John A; Hone, Stephen; Kenna, Margaret A; Loundon, Natalie; Preciado, Diego; Schilder, Anne; Reilly, Brian J; Roman, Stephane; Strychowsky, Julie; Triglia, Jean-Michel; Young, Nancy; Smith, Richard J H

    2016-01-01

    OBJECTIVE: To provide recommendations for the workup of hearing loss in the pediatric patient. METHODS: Expert opinion by the members of the International Pediatric Otolaryngology Group. RESULTS: Consensus recommendations include initial screening and diagnosis as well as the workup of sensorineural

  5. Extensive Validation of the Pain Disability Index in 3 Groups of Patients With Musculoskeletal Pain

    NARCIS (Netherlands)

    Soer, Remko; Koke, Albere J. A.; Vroomen, C.A.J.; Stegeman, Patrick; Smeets, Rob J. E. M.; Coppes, Maarten H.; Reneman, Michiel F.

    2013-01-01

    Study Design. A cross-sectional study design was performed. Objective. To validate the pain disability index (PDI) extensively in 3 groups of patients with musculoskeletal pain. Summary of Background Data. The PDI is a widely used and studied instrument for disability related to various pain syndrom

  6. Adjustment to cancer: exploring patients' experiences of participating in a psychodramatic group intervention.

    Science.gov (United States)

    Menichetti, J; Giusti, L; Fossati, I; Vegni, E

    2016-09-01

    The main purpose of the present study was to understand the subjective experience of patients adjusting to cancer by focusing on how that experience might be affected by participating in a psychodramatic group intervention. In-depth interviews using an interpretative-phenomenological approach were conducted with eight cancer patients involved in a psychodrama group. Four key themes were identified: (1) outside and inside relationships; (2) identities: nurturing other selves; (3) a feelings' gym: performing the internal world; and (4) many ends: mourning death and dying. Participation in cancer group using a psychodramatic approach provided positive results. In detail, the group setting: (1) favoured relationships in which it was possible to freely express oneself and (2) empowered patients in their feelings of being able to give and receive help; the psychodramatic approach: (1) supported the physical mobilisation of sense of agency and (2) permitted to deal with the grieving process. Cancer healthcare pathways would benefit from psychotherapeutic programmes using a similar approach, since psychodrama by actively involving body seems to works on areas that are often underwhelmed by other approaches, such as (i.e., physical mobilisation, body engagement, grieving adjustment). Psychodrama supports patients to achieve insights into their own possibilities to actively participate in their own life situations despite having cancer and undergoing treatment for it.

  7. Participation in sports groups for patients with cardiac problems : An experimental study

    NARCIS (Netherlands)

    Schaperclaus, G; deGreef, M; Rispens, P; deCalonne, D; Landsman, M; Lie, KI; Oudhof, J

    1997-01-01

    An experimental study was carried out to determine the influence of participation in Sports Groups for Patients with Cardiac Problems (SPCP) on physical and mental fitness and on risk factor level after myocardial infarction. SPCP members (n = 74; 67 men and 7 women) were compared with Nonsporting P

  8. Extensive Validation of the Pain Disability Index in 3 Groups of Patients With Musculoskeletal Pain

    NARCIS (Netherlands)

    Soer, Remko; Koke, Albere J. A.; Vroomen, C.A.J.; Stegeman, Patrick; Smeets, Rob J. E. M.; Coppes, Maarten H.; Reneman, Michiel F.

    2013-01-01

    Study Design. A cross-sectional study design was performed. Objective. To validate the pain disability index (PDI) extensively in 3 groups of patients with musculoskeletal pain. Summary of Background Data. The PDI is a widely used and studied instrument for disability related to various pain

  9. Hydatid Disease in Yemeni Patients attending Public and Private Hospitals in Sana’a City, Yemen

    Directory of Open Access Journals (Sweden)

    Abdulbasit Alghoury

    2010-04-01

    Full Text Available Objectives: Hydatid disease is endemic and represents a major health problem in Yemen. The aim of this study is to determine the magnitude of the problem of hydatidosis in patients attending Public and Private Hospitals at Sana’a city, Yemen.Methods:66 patients with hydatid disease were identified during the period from August 2006 to February 2007. Complete medical history for all CE patients were collected and analyzed.Results: Among the 66 CE patients, 67% were females and 33% males. Liver was the most common involved organ. Single cyst was more frequently detected than multiple cysts and approximately 94% of the cysts were ≥5 cm. Moreover, Public hospitals were the main source of patients with CE disease.Conclusion: Hydatidosis is still an endemic disease and an important health problem in Yemen which needs to be studied further. Therefore, accurate information on the distribution of the disease is the first step for the control and prevention of the disease. Moreover, it is crucial to investigate the role of different intermediate hosts and genotypes of E. granulosus in humans and animals.

  10. [Involving patients, the insured and the general public in healthcare decision making].

    Science.gov (United States)

    Mühlbacher, Axel C; Juhnke, Christin

    2016-01-01

    No doubt, the public should be involved in healthcare decision making, especially when decision makers from politics and self-government agencies are faced with the difficult task of setting priorities. There is a general consensus on the need for a stronger patient centeredness, even in HTA processes, and internationally different ways of public participation are discussed and tested in decision making processes. This paper describes how the public can be involved in different decision situations, and it shows how preference measurement methods are currently being used in an international context to support decision making. It distinguishes between different levels of decision making on health technologies: approval, assessment, pricing, and finally utilization. The range of participation efforts extends from qualitative surveys of patients' needs (Citizen Councils of NICE in the UK) to science-based documentation of quantitative patient preferences, such as in the current pilot projects of the FDA in the US and the EMA at the European level. Possible approaches for the elicitation and documentation of preference structures and trade-offs in relation to alternate health technologies are decision aids, such as multi-criteria decision analysis (MCDA), that provide the necessary information for weighting and prioritizing decision criteria.

  11. Diplopia of pediatric orbital blowout fractures: a retrospective study of 83 patients classified by age groups.

    Science.gov (United States)

    Su, Yun; Shen, Qin; Lin, Ming; Fan, Xianqun

    2015-01-01

    Orbital blowout fractures are relatively rare in patients under 18 years of age, but may lead to serious complications. We conducted this retrospective study to evaluate diplopia, clinical characteristics, and postoperative results in cases of orbital blowout fractures in the pediatric population. Eighty-three patients, all less than 18 years old, with orbital blowout fractures, were divided into 3 groups by age: 0 to 6 years old, 7 to 12 years old, and 13 to 18 years old. The cause of injury, fracture locations, diplopia grades, ocular motility restrictions, enophthalmos, and postoperative results were reviewed from their records. Chi-square tests, Fisher's exact analyses, analyses of variance, and logistic regressions were performed to determine characteristics associated with diplopia, and to identify factors related to residual diplopia in pediatric patients. The most common causes of injuries were traffic accidents in the 0 to 6 years old group, normal daily activities in the 7 to 12 years old group, and assaults in the 13 to 18 years old group. Floor fractures were the most common location in both the 0 to 6- and 7 to 12 years old groups, and medial-floor fractures were the most common location in the 13 to 18 years old group. The occurrence of preoperative diplopia was related to ocular motility restriction and enophthalmos, but not with the age group, the gender, the cause of injury, or the fracture locations. The time interval from injury to surgery was significant in the outcome of postoperative diplopia (P diplopia among the 3 age groups (P diplopia after surgery.

  12. Impact of a CBT psychotherapy group on post-operative bariatric patients.

    Science.gov (United States)

    Beaulac, Julie; Sandre, Daniella

    2015-01-01

    Psychological difficulties for patients seeking bariatric surgery are greater and in the post-operative phase, a significant minority go on to experience significant psychosocial difficulties, increasing their risk of poorer post-operative adjustment and associated weight regain. 17 post-operative patients participated in an eight-week cognitive behavioral therapy (CBT) based psychotherapy group at the Ottawa Hospital. A pre-post design with a 3-month follow-up investigated the impact of the group on emotional eating, general as well as obesity-specific adjustment, psychological distress, and attachment. There were significant and meaningful improvements in patients' level of psychological distress, perceived difficulties in their lives, and weight-related adjustment that were maintained at a 3-month follow-up period. Although statistical change was not significant, there were also meaningful improvements in emotional overeating and relationship anxiety and avoidance. The intervention also appeared to be acceptable to patients in that attendance and satisfaction were good. Findings suggest that a short-term CBT psychotherapy group led to significant and meaningful benefits in psychological wellbeing for post-surgical bariatric patients.

  13. [Helpful Factors of Ambulant Art Therapy in the Group and Changes of Experiences in Psychosomatic Patients].

    Science.gov (United States)

    Oster, Jörg; Moser, Anna Sophie; Danner-Weinberger, Alexandra; von Wietersheim, Jörn

    2016-02-01

    The aim of this study was to analyze the experiences of patients suffering from mostly chronic psychosomatic disorders in an ambulant art therapy in the group. Especially, the focus was on the experienced changes, helpful factors and specifics of the therapy as well as on the experienced benefit. For this, 30 patients were interviewed in a semi-standardized way. Additionally, the symptom-based strain was psychometrically recorded in a part of the patients (21) at the beginning of the therapy and after at least 6 months of participation. The evaluation of those interviews with the qualitative analysis of the therapy subjects surrendered an improvement of the health state in most of the participants. Especially group factors, art as a mean of communication, becoming aware of feelings but also diversion and fun were proved to be beneficial. The art therapy also serves for structuring the week as well as a contact point and a resource in the interpersonal communication of everyday life. Nearly all of the patients referred to some important turning point pictures. Mostly, the benefit was valued as being high. But, in contrast, the psychometric measure did not show any significant change. The results emphasize the stabilizing function of art therapy in the examined patients, whereat the classification of the psychometric result is complicated by the absence of a control group. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Relation between ABO blood groups and Helicobacter pylori infection in symptomatic patients

    Directory of Open Access Journals (Sweden)

    Jaff MS

    2011-09-01

    Full Text Available Mohamad Salih Jaff Pathology Department, College of Medicine, Hawler Medical University (formerly Salahuddin University, Erbil, Kurdistan Region, Iraq Abstract: Epidemiological studies have demonstrated higher frequencies of the O blood group and the nonsecretor phenotype of ABH antigens among patients suffering from peptic ulcers. Since Helicobacter pylori has been established as the main etiological factor in this disease, controversies about the associations of the ABO and Lewis blood group phenotypes and secretor and nonsecretor phenotypes in relation to susceptibility towards infection by this bacillus have been presented. The aim of this study was to verify the frequencies of ABO and Rhesus (Rh blood groups in H. pylori seropositive symptomatic patients. The study included (n = 1108 patients with dyspepsia symptoms referred from an outpatient clinic in Erbil city for investigation. Age, sex, and residency were recorded as a routine laboratory framework. Patients underwent SD Bioline (Standard Diagnostics Inc, Kyonggi-do, South Korea and enzyme-linked immunosorbent assay serologic tests for H. pylori. ABO blood group phenotypes were determined by a standard hemagglutination test. Results showed that 64.8% of patients (n = 718/1108 were seropositive for H. pylori infection, and (35.2% (n = 390/1108 were seronegative. Of the seropositive patients, 40.8% (n = 293/718 were male and 59.2% (n = 425/718 were female; while of the seronegative patients, 46.7% (n = 182/390 were male and 53.3% (n = 208/390 were female. The mean age for seropositives and seronegatives was (38.0 ± 14.6 years and (37.6 ± 15.7 years respectively. The frequency of the ABO and Rh-positive (Rh+ blood groups among seropositive patients was (A = 32.0%, B = 19.5%, AB = 6.7%, O = 41.8%, and Rh+ = 92.5% and was (A = 32.3%, B = 28.2%, AB = 8.0%, O = 31.5%, and Rh+ = 92.5% in seronegatives. The results of this study suggest that ABO blood groups, age, and gender influence

  15. Post-bariatric surgery body contouring treatment in the public health system: cost study and perception by patients.

    Science.gov (United States)

    Vilà, Jordi; Balibrea, José María; Oller, Benjamí; Alastrué, Antonio; Poyatos, Jordi Vilà; Balibrea del Castillo, José María; Sales, Benjamí Oller; Vidal, Antonio Alastrué

    2014-09-01

    Post-bariatric, body contouring surgery to treat the sequelae of massive weight loss is an undervalued topic by patients and in most of the literature. The objective of this study was to determine the mean cost per patient of this treatment in a public morbid obesity unit, and compare it with the perception by the patients. Costs were estimated using a specific Diagnosis-Related Group-based method and a questionnaire in a sample of 100 patients who had completed body contouring treatment. This study included 23 men and 77 women with a mean age of 48.5 years, a mean reduction of body mass index of 20.77 kg/m, and a median follow-up of 58 months. These patients had undergone surgery, as needed, as follows: on the lower part of the trunk (109 operations; mean cost, &OV0556;6348.6), cruroplasty (43 operations; mean cost, &OV0556;3490), brachioplasty (28 operations; mean cost &OV0556;3150), and the upper part of the trunk (10 operations; mean cost, &OV0556;4290). The rate of complications has been high (up to 50 percent) and, although the more severe complications are rare (10.5 percent Clavien grade IIIb), these represent high costs (mean, &OV0556;24462.6). Forty-five patients answered the questionnaire. Although they think that this surgery improves their quality of life, they have undervalued its total cost (17.58 percent; &OV0556;2034) (p = 0.16). The average cost of post-bariatric surgery body contouring treatment in this unit is &OV0556;8263.95 (1.66 operations per patient). The severe complications increase by 2.96 times the average cost per patient.

  16. Magnetic resonance imaging in elderly patients with temporomandibular disorders. Comparison with other age groups

    Energy Technology Data Exchange (ETDEWEB)

    Yura, Shinya; Mabuchi, Akiko; Izumiyama, Yuri; Deyama, Ayako; Totsuka, Yasunori; Inoue, Nobuo [Hokkaido Univ., Sapporo (Japan). Graduate School of Dental Medicine

    2002-12-01

    To estimate the incidence of disc displacement, disc deformity, and bone changes of the temporomandibular joint in elderly patients with temporomandibular disorders, 55 elderly patients (110 joints) were examined by magnetic resonance imaging. The ages of the patients ranged from 65 to 89 years (average, 70 years). They consisted of 13 men and 42 women. Normal disc position was found in 40 joints (36.4%), anterior disc displacement with reduction in 17 joints (15.5%), and anterior disc displacement without reduction in 53 joints (48.2%) on magnetic resonance imaging. Thirty-eight (71.6%) of the 53 joints with anterior disc displacement without reduction had disc deformity and 33 (62.3%) had bone changes. The frequency of bone changes in the elderly group was higher than that in the younger group. Women had a higher incidence of bone changes than men. (author)

  17. A COGNITIVE-BEHAVIOURAL GROUP TREATMENT IMPROVED WORK ABILITY IN PATIENTS WITH SEVERE FUNCTIONAL SOMATIC SYNDROMES

    DEFF Research Database (Denmark)

    Schröder, Andreas; Ørnbøl, Eva; Jensen, Jens Søndergaard

    2014-01-01

    Objective: Functional somatic syndromes (FSS) such as fibromyalgia, irritable bowel and chronic fatigue syndrome often disrupt employment and may lead to long-term dependence on social benefits and permanently reduced work ability. Cognitive-behavioural treatments (CBT) relief symptoms and improve...... functioning in FSS, but their effect on work ability is unclear. The aim of this study was to estimate the long-term effect of group CBT on work ability in patients with severe FSS. Methods: 120 Patients from a recently published randomised controlled trial comparing group CBT with enhanced usual care (EUC...... before to 3 years after treatment by means of random effects modelling allowing individual levels and slopes. Results: Compared with the general population, FSS patients showed a continuous decline in self-support, leading to markedly reduced work ability at trial entry. In the following years, EUC...

  18. Emergency dilatation and curettage in a patient with Bombay blood group.

    Science.gov (United States)

    Ali, Muhammad Asghar; Sohaib, Muhammad

    2014-08-01

    Bombay blood group is a rare autosomal recessive phenotype within the ABO blood group. It represents genetically suppressed A, B and H genes. When considering such patients for transfusion, only blood of identical Bombay type can be safely transfused. We are reporting a patient having Bombay phenotypic blood, underwent emergency dilatation and curettage with active per vaginal bleeding due to retained products of placenta. There are numerous anaesthetic considerations, including emergency surgery with hemodynamic instability due to ongoing blood loss, dilutional coagulopathy as well as presence of Bombay phenotype that severely limit the possibility of red blood cell transfusion. Only four donors were registered with the blood bank of the institution and none was traceable. It becomes a real challenge for the anesthesiologist to manage such type of patients without having units of red packed cell which management is described hereby.

  19. Psychosocial support groups for patients with multidrug-resistant tuberculosis: five years of experience.

    Science.gov (United States)

    Acha, J; Sweetland, A; Guerra, D; Chalco, K; Castillo, H; Palacios, E

    2007-01-01

    This detailed case history traces the first 5 years of a psychosocial support group intervention aimed to improve adherence to individualized drug regimens for multidrug-resistant tuberculosis (MDR-TB) in Peru. A total of eight groups were established in metropolitan Lima and two provinces of Peru led by teams of psychiatrists and nurses. The intervention consisted of bi-monthly support groups, recreational excursions, symbolic celebrations, and periodic family workshops. Notably, of the 285 patients who participated in this intervention, only 3.5% defaulted from treatment. Details include the description of services, patient data, major psychosocial difficulties faced by this population, key challenges, and implications. Psychosocial support is a crucial component of treatment for MDR-TB in order to ensure completion of complicated treatment regimens and enable psychosocial rehabilitation after treatment.

  20. Impact of a patient-centered pharmacy program and intervention in a high-risk group.

    Science.gov (United States)

    Moore, Janice M; Shartle, Deborah; Faudskar, Larry; Matlin, Olga S; Brennan, Troyen A

    2013-04-01

    with hypertension and dyslipidemia had pre-post increases in MPR of 2.29% and 2.10%, respectively, while the control group had decreases of 2.31% and 2.61% (both P  less than  0.001). The mean MPRs for members with diabetes, depression, and asthma did not change in either group. Program costs per patient in 2009 were estimated to be $478. The program had a return on investment (ROI) of 2.0 in 2009. This study found that the pharmacist-managed MTM program to reconcile the medication therapies of high-risk patients and improve adherence, as measured by MPR, was effective in reducing total health care costs. The results show that those patients in the intervention group with hypertension and dyslipidemia had significant improvements in medication adherence, as compared with the control group. In fact, the intervention group used significantly more days of therapy in the intervention period, and the control group used significantly fewer days than either group used during the baseline period. MTM interventions were associated with a significant decrease in the MTM members' overall plan-paid health care costs, driven largely by decreases in inpatient utilization and mediated by increases in average days supply and in MPR increases for hypertension and dyslipidemia. Overall, the MTM program was cost-effective. The ROI estimated for this program of 2.0 is only slightly lower than the average disease management ROIs reported in the literature.

  1. Visuo-spatial memory deficits following medial temporal lobe damage: A comparison of three patient groups.

    Science.gov (United States)

    Esfahani-Bayerl, Nazli; Finke, Carsten; Braun, Mischa; Düzel, Emrah; Heekeren, Hauke R; Holtkamp, Martin; Hasper, Dietrich; Storm, Christian; Ploner, Christoph J

    2016-01-29

    The contributions of the hippocampal formation and adjacent regions of the medial temporal lobe (MTL) to memory are still a matter of debate. It is currently unclear, to what extent discrepancies between previous human lesion studies may have been caused by the choice of distinct patient models of MTL dysfunction, as disorders affecting this region differ in selectivity, laterality and mechanisms of post-lesional compensation. Here, we investigated the performance of three distinct patient groups with lesions to the MTL with a battery of visuo-spatial short-term memory tasks. Thirty-one subjects with either unilateral damage to the MTL (postsurgical lesions following resection of a benign brain tumor, 6 right-sided lesions, 5 left) or bilateral damage (10 post-encephalitic lesions, 10 post-anoxic lesions) performed a series of tasks requiring short-term memory of colors, locations or color-location associations. We have shown previously that performance in the association task critically depends on hippocampal integrity. Patients with postsurgical damage of the MTL showed deficient performance in the association task, but performed normally in color and location tasks. Patients with left-sided lesions were almost as impaired as patients with right-sided lesions. Patients with bilateral post-encephalitic lesions showed comparable damage to MTL sub-regions and performed similarly to patients with postsurgical lesions in the association task. However, post-encephalitic patients showed additional impairments in the non-associative color and location tasks. A strikingly similar pattern of deficits was observed in post-anoxic patients. These results suggest a distinct cerebral organization of associative and non-associative short-term memory that was differentially affected in the three patient groups. Thus, while all patient groups may provide appropriate models of medial temporal lobe dysfunction in associative visuo-spatial short-term memory, additional deficits in

  2. The group matters: an explorative study of group cohesion and quality of life in cancer patients participating in physical exercise intervention during treatment

    DEFF Research Database (Denmark)

    Klausen, Julie Midtgaard; Rørth, Mikael Rahbek; Stelter, Reinhard

    2006-01-01

    -C30) was assessed at baseline and after Week 6. The interviews revealed that group cohesion was an interim goal aimed to maximize peak performance potential by patients. Group cohesion was characterized by a special 'esprit de corps' and enabled the group members to feel like sport teams....... The programme made purposeful togetherness possible while allowing the patients an opportunity to let their illness fade into the background. Questionnaire data showed significant improvements in mental health, social and emotional functioning. This study identified a conceptualization of group cohesion...

  3. Technicians or patient advocates?--still a valid question (results of focus group discussions with pharmacists)

    DEFF Research Database (Denmark)

    Almarsdóttir, Anna Birna; Morgall, Janine Marie

    1999-01-01

    discussions with community pharmacists in the capital area Reykjavík and rural areas were employed to answer the research question: How has the pharmacists' societal role evolved after the legislation and what are the implications for pharmacy practice? The results showed firstly that the public image......, the results showed that the pharmacists have difficulties reconciling their technical paradigm with a legislative and professional will specifying customer and patient focus. This study describes the challenges of a new legislation with a market focus for community pharmacists whose education emphasized...... technical skills. This account of the changes in the drug distribution system in Iceland highlights some of the implications for pharmacists internationally....

  4. Potential role of group clinics to boost outcomes among elderly Spanish-only speaking stroke patients.

    Science.gov (United States)

    Ovbiagele, Bruce

    2010-06-01

    Ethnic minorities are generally at higher risk for experiencing a stroke and dying from a stroke than non-Hispanic Whites, but are less likely to have optimal stroke risk factor control. Part of this ethnic disparity in stroke outcomes can be attributed to sociocultural factors. As such, there is a need to use culturally sensitive qualitative analysis to explore various strategies for enhancing vascular risk reduction in minority stroke patients encountered in under-resourced health systems. One potential strategy could be the use of nurse-led group clinics. Group clinics might be a relatively straightforward way of supplementing physician-centered efforts to improve outcomes in under-resourced settings by improving efficiency and encouraging patient self-management. However, research is limited on the implementation of group clinics among low-income, ethnic minority populations. This study aimed to obtain information about the feasibility of successfully implementing group clinics to boost treatment adherence among elderly Spanish-speaking only stroke patients within an under-resourced urban health system. A total of 13 Spanish-only speaking participants aged >or=60 years discharged from a local government hospital in Los Angeles within 18 months of an index ischemic stroke, and 6 caregivers, engaged in focus groups and interviews. Structured interviews were conducted with 11 care providers and 9 administrators at the hospital. Framework analysis examined the data and elicited themes necessary for successful execution of nurse-led group clinics for promoting vascular risk reduction treatment adherence among Elderly Spanish-only speaking stroke patients encountered within an urban health care system.

  5. Clinical course teaching in transport of critically ill patients: Small group methods

    Directory of Open Access Journals (Sweden)

    Mohammad Taghi Beigmohammadi

    2016-10-01

    Full Text Available Critically ill patient transfer is potentially risky and may be lead to morbidity and mortality. Physicians' skill is very important for safe transport. We want to evaluate the effect of clinical course teaching on the promotion of physicians' abilities in the transport of critically ill patients. In an interventional study, 320 interns, male and female, were taught about patient transfer in two groups include in one day clinical course as the small group system (n=160 and other group the lecture base learning (n=160. In the clinical course, each participant under observation of an anesthesiologist in the operation room and ICU was acquainted with mask ventilation, intubation and learned to work with a defibrillator, infusion pump, portable ventilator and pulse oximeter. In lecture group, the anesthesiologist explained the topics by video and dummy. At the end of education course, the interns’ abilities were evaluated based on checklist method and scored by the project colleague in all educational items. Three hundred twenty interns, 122 males, and 198 females; were enrolled, two groups. The clinical course training caused improvements in the interns’ knowledge and abilities in intubation and use of the defibrillator and portable ventilator vs.lecture group significantly (P<0.005. The males were better than females in laryngoscopy, but the progress of the females was significantly better than males (P=0.003. The rate of adverse events was reduced significantly after clinical course teaching (P=0.041 Clinical course teaching could promote interns' clinical competencies in the transport of critically ill patients.

  6. Self-help group and the quality of life of patients with multiple sclerosis - Pilot study

    Directory of Open Access Journals (Sweden)

    Anna Eliášová

    2015-12-01

    Full Text Available Aim: The goal of the pilot study was to compare the quality of life of patients with multiple sclerosis in the Presov region with or without the support of a self-help group. Design: The character of this pilot study on patients with MS was related to the use of self-help groups and their impact on the assessment of the quality of life of the respondents, with the help of a questionnaire (WHOQOL-BREF. Methods: The research was carried out in the Prešov region with the help of the standardized WHOQOL-BREF questionnaire. Ninety-one patients with MS participated in the pilot study (46 respondents attended a self-help group and 35 did not. Results: The groups, when compared, aided by the statistically evaluated WHOQOL-BREF domains, were found to show significant differences in their evaluation of quality of life in three domains: domain one: physical health; domain two: surviving; domain three: social relations. Better scores were achieved in these domains by those who attended a group. In the physical sphere, we noticed significant differences in sleep quality, and sexual satisfaction (p < 0.001, while in social and economic areas, there were significant differences in satisfaction with personal relationships (p < 0.001, and economic circumstances (p < 0.01, self-contentment (p < 0.01, and coping with negative feelings (p < 0.05. Conclusion: Patients with multiple sclerosis can live normal lives provided they are supported by their families, friends, health care professionals, and self-help groups.

  7. Altering Public University Admission Standards to Preserve White Group Position in the United States: Results from a Laboratory Experiment

    Science.gov (United States)

    Samson, Frank L.

    2013-01-01

    This study identifies a theoretical mechanism that could potentially affect public university admissions standards in a context of demographic change. I explore how demographic changes at a prestigious public university in the United States affect individuals' evaluations of college applications. Responding to a line graph that randomly displays a…

  8. Circadian Rhythms of Oxidative Stress Markers and Melatonin Metabolite in Patients with Xeroderma Pigmentosum Group A

    Directory of Open Access Journals (Sweden)

    Rie Miyata

    2016-01-01

    Full Text Available Xeroderma pigmentosum group A (XPA is a genetic disorder in DNA nucleotide excision repair (NER with severe neurological disorders, in which oxidative stress and disturbed melatonin metabolism may be involved. Herein we confirmed the diurnal variation of melatonin metabolites, oxidative stress markers, and antioxidant power in urine of patients with XPA and age-matched controls, using enzyme-linked immunosorbent assay (ELISA. The peak of 6-sulfatoxymelatonin, a metabolite of melatonin, was seen at 6:00 in both the XPA patients and controls, though the peak value is lower, specifically in the younger age group of XPA patients. The older XPA patients demonstrated an increase in the urinary levels of 8-hydroxy-2′-deoxyguanosine and hexanoyl-lysine, a marker of oxidative DNA damage and lipid peroxidation, having a robust peak at 6:00 and 18:00, respectively. In addition, the urinary level of total antioxidant power was decreased in the older XPA patients. Recently, it is speculated that oxidative stress and antioxidant properties may have a diurnal variation, and the circadian rhythm is likely to influence the NER itself. We believe that the administration of melatonin has the possibility of ameliorating the augmented oxidative stress in neurodegeneration, especially in the older XPA patients, modulating the melatonin metabolism and the circadian rhythm.

  9. Evaluation of psychological outcomes following the intervention 'teaching group': study on predialysis patients.

    Science.gov (United States)

    Gutiérrez Vilaplana, Josep Maria; Zampieron, Alessandra; Craver, Lourdes; Buja, Alessandra

    2009-09-01

    Aims of the study were to evaluate the effects of the intervention 'Group education' (NIC 5604) on patients' coping, fear control, anxiety and the association between demographic and clinical variables with the outcomes. We studied all predialysis patients treated, at Lleida University Hospital, from 1 January 2007 till 31 March 2008, who received the total intervention for six months. There were 41 patients, 33 male and 8 female. They had a mean age of 60.56 years (SD 13.96); 66% declared family support. Forty-one percent had a low educational level. The Charlson Comorbidity test showed a mean of 5.07 (SD 1.77). All patients were independent, using the Karnofsky scale and Barthel index. Patients reported a significant improvement in all the outcomes evaluated (anxiety, coping and fear response). Logistic regression showed that the reduction in anxiety and the improved nursing outcomes were not related to demographic and clinical variables. The group educational programme was effective on the defined psychological outcomes in predialysis patients. Hence, it should be available for all clients.

  10. Importance of support groups for intersex (disorders of sex development) patients, families and the medical profession.

    Science.gov (United States)

    Cull, M L; Simmonds, M

    2010-09-01

    Taboo still surrounds intersex/disorders of sex development, in spite of more openness in society regarding sex. Peer support is valuable in providing information and emotional support to those affected. Support groups also work with clinicians to promote better care, to assist with research studies and to increase clinical awareness and expertise by helping to stage symposia. They also foster greater public understanding via media involvement and training videos; and play an advocacy role, providing one voice to channel the concerns of a scattered population with these rare conditions.

  11. 'Waiting for' and 'waiting in' public and private hospitals: a qualitative study of patient trust in South Australia.

    Science.gov (United States)

    Ward, Paul R; Rokkas, Philippa; Cenko, Clinton; Pulvirenti, Mariastella; Dean, Nicola; Carney, A Simon; Meyer, Samantha

    2017-05-05

    Waiting times for hospital appointments, treatment and/or surgery have become a major political and health service problem, leading to national maximum waiting times and policies to reduce waiting times. Quantitative studies have documented waiting times for various types of surgery and longer waiting times in public vs private hospitals. However, very little qualitative research has explored patient experiences of waiting, how this compares between public and private hospitals, and the implications for trust in hospitals and healthcare professionals. The aim of this paper is to provide a deep understanding of the impact of waiting times on patient trust in public and private hospitals. A qualitative study in South Australia, including 36 in-depth interviews (18 from public and 18 from private hospitals). Data collection occurred in 2012-13, and data were analysed using pre-coding, followed by conceptual and theoretical categorisation. Participants differentiated between experiences of 'waiting for' (e.g. for specialist appointments and surgery) and 'waiting in' (e.g. in emergency departments and outpatient clinics) public and private hospitals. Whilst 'waiting for' public hospitals was longer than private hospitals, this was often justified and accepted by public patients (e.g. due to reduced government funding), therefore it did not lead to distrust of public hospitals. Private patients had shorter 'waiting for' hospital services, increasing their trust in private hospitals and distrust of public hospitals. Public patients also recounted many experiences of longer 'waiting in' public hospitals, leading to frustration and anxiety, although they rarely blamed or distrusted the doctors or nurses, instead blaming an underfunded system and over-worked staff. Doctors and nurses were seen to be doing their best, and therefore trustworthy. Although public patients experienced longer 'waiting for' and 'waiting in' public hospitals, it did not lead to widespread distrust

  12. Comparison of Personality Characteristics and Coping Strategies in Patients With Multiple Sclerosis and Control Group

    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.

  13. Young patients', parents', and survivors' communication preferences in paediatric oncology: Results of online focus groups

    Directory of Open Access Journals (Sweden)

    Kamps Willem A

    2007-11-01

    Full Text Available Abstract Background Guidelines in paediatric oncology encourage health care providers to share relevant information with young patients and parents to enable their active participation in decision making. It is not clear to what extent this mirrors patients' and parents' preferences. This study investigated communication preferences of childhood cancer patients, parents, and survivors of childhood cancer. Methods Communication preferences were examined by means of online focus groups. Seven patients (aged 8–17, 11 parents, and 18 survivors (aged 8–17 at diagnosis participated. Recruitment took place by consecutive inclusion in two Dutch university oncological wards. Questions concerned preferences regarding interpersonal relationships, information exchange and participation in decision making. Results Participants expressed detailed and multi-faceted views regarding their needs and preferences in communication in paediatric oncology. They agreed on the importance of several interpersonal and informational aspects of communication, such as honesty, support, and the need to be fully informed. Participants generally preferred a collaborative role in medical decision making. Differences in views were found regarding the desirability of the patient's presence during consultations. Patients differed in their satisfaction with their parents' role as managers of the communication. Conclusion Young patients' preferences mainly concur with current guidelines of providing them with medical information and enabling their participation in medical decision making. Still, some variation in preferences was found, which faces health care providers with the task of balancing between the sometimes conflicting preferences of young cancer patients and their parents.

  14. Patient perspectives on the impact of Crohn's disease: results from group interviews.

    Science.gov (United States)

    Norton, Beth-Ann; Thomas, Rosemarie; Lomax, Kathleen G; Dudley-Brown, Sharon

    2012-01-01

    To understand the impact of Crohn's disease (CD) on various aspects of daily life from the perspective of patients living with CD. Awareness of the disease and biologic therapies, patient satisfaction and adherence, and physician (provider) relationships were also assessed. CD is a chronic, inflammatory, autoimmune disorder of the gastrointestinal tract that substantially impacts patients' physical and emotional well-being. For patients eligible for biologic therapy, anti-tumor necrosis factor agents represent an important addition to the available therapies for CD. The study sample included biologic-naïve and biologic-experienced patients who had self-reported moderate to severe CD, were under the care of a specialist, and agreed to film a video diary and participate in a focus group. Data from the videos and group interviews were collected from May to June of 2009 and summarized qualitatively by grouping similar answers and quotations. Of the 44 participants who submitted video diaries, 23 were biologic-experienced and 21 were biologic-naïve. Participants stated that CD caused fear and embarrassment, that they were reluctant to share the full impact of CD with family and providers, and that they relied on their provider for treatment decisions. Many participants accepted a new state of normalcy if their current medication helped their most bothersome symptoms without providing sustained remission. Participants receiving biologic therapy generally were more informed, more satisfied, and more likely to adhere to treatment regimens. Participants' responses suggest a need for more patient education and more collaborative relationships between patients and providers (physicians) regarding treatment decisions.

  15. Patient perspectives on the impact of Crohn’s disease: results from group interviews

    Directory of Open Access Journals (Sweden)

    Norton BA

    2012-07-01

    Full Text Available Beth-Ann Norton,1 Rosemarie Thomas,2 Kathleen G Lomax,2 Sharon Dudley-Brown31Massachusetts General Hospital, Boston, MA, USA; 2Abbott Laboratories, Abbott Park, IL, USA; 3Johns Hopkins University, Schools of Medicine and Nursing, Baltimore, MD, USAAim: To understand the impact of Crohn’s disease (CD on various aspects of daily life from the perspective of patients living with CD. Awareness of the disease and biologic therapies, patient satisfaction and adherence, and physician (provider relationships were also assessed.Background: CD is a chronic, inflammatory, autoimmune disorder of the gastrointestinal tract that substantially impacts patients’ physical and emotional well-being. For patients eligible for biologic therapy, anti-tumor necrosis factor agents represent an important addition to the available therapies for CD.Methods: The study sample included biologic-naïve and biologic-experienced patients who had self-reported moderate to severe CD, were under the care of a specialist, and agreed to film a video diary and participate in a focus group. Data from the videos and group interviews were collected from May to June of 2009 and summarized qualitatively by grouping similar answers and quotations.Results: Of the 44 participants who submitted video diaries, 23 were biologic-experienced and 21 were biologic-naïve. Participants stated that CD caused fear and embarrassment, that they were reluctant to share the full impact of CD with family and providers, and that they relied on their provider for treatment decisions. Many participants accepted a new state of normalcy if their current medication helped their most bothersome symptoms without providing sustained remission. Participants receiving biologic therapy generally were more informed, more satisfied, and more likely to adhere to treatment regimens.Conclusion: Participants’ responses suggest a need for more patient education and more collaborative relationships between patients and

  16. Polymyalgia Rheumatica (PMR) Special Interest Group at OMERACT 11: outcomes of importance for patients with PMR.

    Science.gov (United States)

    Mackie, Sarah L; Arat, Seher; da Silva, Jose; Duarte, Catia; Halliday, Sue; Hughes, Rod; Morris, Marianne; Pease, Colin T; Sherman, Jeffrey W; Simon, Lee S; Walsh, Maggie; Westhovens, René; Zakout, Samy; Kirwan, John R

    2014-04-01

    We worked toward developing a core outcome set for clinical research studies in polymyalgia rheumatica (PMR) by conducting (1) patient consultations using modified nominal group technique; (2) a systematic literature review of outcome measures in PMR; (3) a pilot observational study of patients presenting with untreated PMR, and further discussion with patient research partners; and (4) a qualitative focus group study of patients with PMR on the meaning of stiffness, using thematic analysis. (1) Consultations included 104 patients at 4 centers. Symptoms of PMR included pain, stiffness, fatigue, and sleep disturbance. Function, anxiety, and depression were also often mentioned. Participants expressed concerns about diagnostic delay, adverse effects of glucocorticoids, and fear of relapse. (2) In the systematic review, outcome measures previously used for PMR include pain visual analog scores (VAS), morning stiffness, blood markers, function, and quality of life; standardized effect sizes posttreatment were large. (3) Findings from the observational study indicated that asking about symptom severity at 7 AM, or "on waking," appeared more relevant to disease activity than asking about symptom severity "now" (which depended on the time of assessment). (4) Preliminary results were presented from the focus group qualitative study, encompassing broad themes of stiffness, pain, and the effect of PMR on patients' lives. It was concluded that further validation work is required before a core outcome set in PMR can be recommended. Nevertheless, the large standardized effect sizes suggest that pain VAS is likely to be satisfactory as a primary outcome measure for assessing response to initial therapy of PMR. Dissection of between-patient heterogeneity in the subsequent treatment course may require attention to comorbidity as a potential confounding factor.

  17. Doctor-Patient Relationship Between Individuals With Fibromyalgia and Rheumatologists in Public and Private Health Care in Mexico.

    Science.gov (United States)

    Colmenares-Roa, Tirsa; Huerta-Sil, Gabriela; Infante-Castañeda, Claudia; Lino-Pérez, Leticia; Alvarez-Hernández, Everardo; Peláez-Ballestas, Ingris

    2016-10-01

    The aim of this article was to describe and analyze the doctor-patient relationship between fibromyalgia patients and rheumatologists in public and private health care contexts within the Mexican health care system. This medical anthropological study drew on hospital ethnography and patients' illness narratives, as well as the experiences of rheumatologists from both types of health care services. The findings show how each type of medical care subsystem shape different relationships between patients and doctors. Patient stigmatization, overt rejection, and denial of the disease's existence were identified. In this doctor-patient-with-fibromyalgia relationship, there are difficult encounters, rather than difficult patients. These encounters are more fluid in private consultations compared with public hospitals. The doctor-centered health care model is prevalent in public institutions. In the private sector, we find the characteristics of the patient-centered model coexisting with the traditional physician-centered approach.

  18. O grupo multifamiliar como recurso no tratamento dos transtornos alimentares Multifamily group therapy for patients diagnosed with eating disorders

    Directory of Open Access Journals (Sweden)

    Maria Amelia da Silva Jaeger

    2011-01-01

    Full Text Available INTRODUÇÃO: O presente artigo é resultado do trabalho sistemático dos autores com grupos multifamiliares de pacientes com diagnóstico de transtorno alimentar (anorexia nervosa, bulimia nervosa e transtorno alimentar não especificado, conjuntamente com seus familiares. As sessões são oferecidas em um hospital público na cidade de Porto Alegre (RS. MÉTODO: Os registros em vídeo de quatro sessões de terapia de grupo multifamiliar foram analisados qualitativamente utilizando-se a técnica de análise de conteúdo. RESULTADOS: Grupos multifamiliares assim constituídos não foram encontrados na revisão da literatura, e sim apenas relatos de grupos multifamiliares com finalidades exclusivamente psicoeducativas, sem a participação dos pacientes identificados. Na avaliação final, a modalidade de atendimento multifamiliar revelou-se como positiva para o atendimento dos casos avaliados. CONCLUSÕES: A pesquisa demonstrou que esse tipo de abordagem, associado ao tratamento unifamiliar e individual, pode tornar-se uma ferramenta eficaz de tratamento para esses pacientes e suas famílias.INTRODUCTION: This article is the result of the systematic experience of the authors with multifamily group therapy for patients with a diagnosis of eating disorders (anorexia nervosa, bulimia nervosa and not otherwise specified eating disorders and their families. Sessions are held at a public hospital in the municipality of Porto Alegre, southern Brazil. METHOD: Video recordings of four multifamily group therapy sessions were qualitatively assessed using the content analysis technique. RESULTS: References to similar multifamily group therapy programs were not found in the literature review; rather, only some reports of multifamily group sessions with exclusively psychoeducational purposes were retrieved, however not including direct patient participation. At the final evaluation, multifamily group therapy was considered to have positive therapeutic

  19. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients.

    Science.gov (United States)

    Bergamaschi, Mateus M; Queiroz, Regina Helena Costa; Chagas, Marcos Hortes Nisihara; de Oliveira, Danielle Chaves Gomes; De Martinis, Bruno Spinosa; Kapczinski, Flávio; Quevedo, João; Roesler, Rafael; Schröder, Nadja; Nardi, Antonio E; Martín-Santos, Rocio; Hallak, Jaime Eduardo Cecílio; Zuardi, Antonio Waldo; Crippa, José Alexandre S

    2011-05-01

    Generalized Social Anxiety Disorder (SAD) is one of the most common anxiety conditions with impairment in social life. Cannabidiol (CBD), one major non-psychotomimetic compound of the cannabis sativa plant, has shown anxiolytic effects both in humans and in animals. This preliminary study aimed to compare the effects of a simulation public speaking test (SPST) on healthy control (HC) patients and treatment-naïve SAD patients who received a single dose of CBD or placebo. A total of 24 never-treated patients with SAD were allocated to receive either CBD (600 mg; n=12) or placebo (placebo; n=12) in a double-blind randomized design 1 h and a half before the test. The same number of HC (n=12) performed the SPST without receiving any medication. Each volunteer participated in only one experimental session in a double-blind procedure. Subjective ratings on the Visual Analogue Mood Scale (VAMS) and Negative Self-Statement scale (SSPS-N) and physiological measures (blood pressure, heart rate, and skin conductance) were measured at six different time points during the SPST. The results were submitted to a repeated-measures analysis of variance. Pretreatment with CBD significantly reduced anxiety, cognitive impairment and discomfort in their speech performance, and significantly decreased alert in their anticipatory speech. The placebo group presented higher anxiety, cognitive impairment, discomfort, and alert levels when compared with the control group as assessed with the VAMS. The SSPS-N scores evidenced significant increases during the testing of placebo group that was almost abolished in the CBD group. No significant differences were observed between CBD and HC in SSPS-N scores or in the cognitive impairment, discomfort, and alert factors of VAMS. The increase in anxiety induced by the SPST on subjects with SAD was reduced with the use of CBD, resulting in a similar response as the HC.

  20. Prevalence of suicidal behaviour & associated factors among tuberculosis patients in public primary care in South Africa

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    Karl Peltzer

    2013-01-01

    Full Text Available Background & objectives: In spite of the high prevalence of tuberculosis worldwide, there are only a few studies on its psychiatric complications such as suicidal behaviour. We undertook this study to assess the prevalence of suicidal behaviour and its associated factors among tuberculosis patients in public primary care in South Africa. Methods: In a cross-sectional survey conducted in three provinces of South Africa new TB and new re-treatment patients were assessed within one month of anti-tuberculosis treatment. The sample included 4900 (54.5% men and women 45.5% consecutively selected tuberculosis patients from 42 public primary care clinics in three districts in South Africa. Results: A total of 322 patients (9.0% reported suicidal ideation and 131 (3.1% had a history of a suicide attempt. In multivariate analysis female gender [Odds Ratio (OR= 0.56, Confidence Interval (CI= 0.43-0.74], psychological distress (OR=2.36, CI=1.04-2.29, post-traumatic stress disorders (PTSD (OR=4.98, CI=3.76-6.59, harmful alcohol use (OR=1.97, CI=1.25-3.09 and being a TB re-treatment patient (OR=1.76, CI=1.32-2.34 were associated with suicidal ideation, and psychological distress (OR=3.27, CI=1.51-7.10, PTSD symptoms (OR=4.48, CI=3.04-6.61 and harmful alcohol use (OR=3.01, CI=1.83-4.95 were associated with a suicide attempt. Interpretation & conclusions: Our findings suggest that co-morbid illnesses of psychological distress, PTSD and harmful alcohol use and HIV infection should be assessed in TB patients under TB control programmes to prevent suicidal behaviour. Clinicians should be aware about suicidality in tuberculosis patients to reduce mortality.

  1. Mutations of the tyrosinase gene in patients with oculocutaneous albinism from various ethnic groups in Israel

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    Gershoni-Baruch, R. (Technion-Israel Institute of Technology, Haifa (Israel)); Rosenmann, A. (Hadassah Medical Center, Jerusalem (Israel)); Droetto, S.; Holmes, S.; Tripathi, R.K.; Spritz, R.A. (Univ. of Wisconsin, Madison, WI (United States))

    1994-04-01

    The authors have analyzed the tyrosinase (TYR) gene in 38 unrelated patients with oculocutaneous albinism (OCA), derived from several different ethnic groups of the diverse population of Israel. They detected TYR gene mutations in 23 of the 34 patients with apparent type I (i.e., tyrosinase-deficient) OCA and in none of the patients with other clinical forms of albinism. Among Moroccan Jews with type IA (i.e., tyrosinase-negative) OCA, they detected a highly predominant mutant allele containing a missense substitution, Gly47Asp (G47D). This mutation occurs on the same haplotype as in patients from the Canary Islands and Puerto Rico, suggesting that the G47D mutation in these ethnically distinct populations may stem from a common origin. 28 refs., 1 fig., 2 tabs.

  2. Assessment of acutely mentally ill patients' satisfaction of care: there is a difference among ethnic groups.

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    Anders, Robert L; Olson, Tom; Bader, Julia

    2007-03-01

    The relationship between quality of care and patient satisfaction has been documented. The specific research aim related to this study is to determine if differences exist among Caucasians, Asians, and Pacific Islanders who are hospitalized for an acute mental illness with regard to their perceived satisfaction with the care. The results of the overall study have been reported elsewhere. The sample was composed of 138 patients, of whom 34.7% were Caucasian, 31.2% Pacific Islanders, and 34.8% Asians. Within 24 hours of discharge, patients completed the Perceptions of Care instrument. Caucasians were over-represented in our sample in comparison to their percentage in the general population of Hawaii. These patients were significantly more satisfied (p = .04) with their care than the other ethnic groups. No single variable was found to specifically indicate why they were more satisfied than Pacific Islanders and Asians.

  3. Adapting and Implementing a Community Program to Improve Retention in Care among Patients with HIV in Southern Haiti: “Group of 6”

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    John A. Naslund

    2014-01-01

    Full Text Available Objective. In Mozambique, a patient-led Community ART Group model developed by Médecins Sans Frontières improved retention in care and adherence to antiretroviral therapy (ART among persons with HIV. We describe the adaptation and implementation of this model within the HIV clinic located in the largest public hospital in Haiti’s Southern Department. Methods. Our adapted model was named Group of 6. Hospital staff enabled stable patients with HIV receiving ART to form community groups with 4–6 members to facilitate monthly ART distribution, track progress and adherence, and provide support. Implementation outcomes included recruitment success, participant retention, group completion of monthly monitoring forms, and satisfaction surveys. Results. Over one year, 80 patients from nine communities enrolled into 15 groups. Six participants left to receive HIV care elsewhere, two moved away, and one died of a non-HIV condition. Group members successfully completed monthly ART distribution and returned 85.6% of the monthly monitoring forms. Members reported that Group of 6 made their HIV management easier and hospital staff reported that it reduced their workload. Conclusions. We report successful adaptation and implementation of a validated community HIV-care model in Southern Haiti. Group of 6 can reduce barriers to ART adherence, and will be integrated as a routine care option.

  4. Combined use of focalized meditation and group psychological intervention in patients with terminal chronic renal failure

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    Enma Taimara Cisneros Acosta

    2016-01-01

    Full Text Available Background: chronic renal failure is within the first 35 death causes in the country within the last five years.Objective: to determine the effectiveness of the combined use of the group psychological intervention with the focalized meditation (FM in the psychological rehabilitation of patients suffering from terminal chronic renal failure who underwent hemodialysis treatment in “Juan Bruno Zayas” General Hospital in Santiago de Cuba from January to June, 2014.Methods: a pre-test, post-test and control group intervention was carried out. The study sample was divided into three groups: one for the group psychological intervention (GPI, another one for the focalized meditation FM and the other one for the combined use of them both. The research process had three stages: the diagnostic phase with the use of: interview, observation, state-trait anxiety inventory (STAI, Beck Diagnostic Inventory (BDI, and coping ways questionnaire; the intervention, where treatment was imposed with six sessions of group psychological intervention to a group, eight sessions of focalized meditation to another one and the combination of them both to the other one; and the last phase, which was the post-intervention one, was carried out to evaluate the changes of the impaired adjustment and coping with emotional states, applying the same diagnostic techniques.Results: after the application of the therapeutic modalities, the results were: in the groups treated with the GPI and FM separately, the 80 % of the subjects reduced their anxiety levels; meanwhile, with the combination of the techniques, improvement was for the 100 % of the patients. The variable depression had a similar behavior. As for the coping styles: in the GPI group, 80 % of the subjects got active coping styles and the 20 % got mixed ones; in the FM group, the 40 % showed active styles, another 40 % passive styles, and 20 % got mixed ones; in the group with the combined treatment, the results were the

  5. Patients' views on improving sickle cell disease management in primary care: focus group discussion.

    Science.gov (United States)

    Aljuburi, Ghida; Phekoo, Karen J; Okoye, Nv Ogo; Anie, Kofie; Green, Stuart A; Nkohkwo, Asaah; Ojeer, Patrick; Ndive, Comfort; Banarsee, Ricky; Oni, Lola; Majeed, Azeem

    2012-12-01

    To assess sickle cell disease (SCD) patient and carer perspectives on the primary care services related to SCD that they receive from their general practitioner (GP). A focus group discussion was used to elicit the views of patients about the quality of care they receive from their primary health-care providers and what they thought was the role of primary care in SCD management. The focus group discussion was video recorded. The recording was then examined by the project team and recurring themes were identified. A comparison was made with notes made by two scribes also present at the discussion. Sickle Cell Society in Brent, UK. Ten participants with SCD or caring for someone with SCD from Northwest London, UK. Patients' perceptions about the primary care services they received, and a list of key themes and suggestions. Patients and carers often bypassed GPs for acute problems but felt that GPs had an important role to play around repeat prescriptions and general health care. These service users believed SCD is often ignored and deemed unimportant by GPs. Participants wanted the health service to support primary health-care providers to improve their knowledge and understanding of SCD. Key themes and suggestions from this focus group have been used to help develop an educational intervention for general practice services that will be used to improve SCD management in primary care.

  6. A Randomized Controlled Trial of a Mindfulness and Acceptance Group Therapy for Residential Substance Use Patients.

    Science.gov (United States)

    Shorey, Ryan C; Elmquist, Joanna; Gawrysiak, Michael J; Strauss, Catherine; Haynes, Ellen; Anderson, Scott; Stuart, Gregory L

    2017-09-19

    Substance use disorders are understood as a chronically relapsing condition that is difficult to treat. However, in recent years there have been promising developments in the treatment of substance use disorders, specifically with interventions based on mindfulness and acceptance and commitment therapy. Little research has examined whether these types of interventions may positively impact residential substance use treatment outcomes. Thus, in the current study we developed and examined, in a randomized controlled trial, a 4-week, eight-session, adjunctive mindfulness and acceptance group therapy for patients in residential substance use treatment. Our primary outcomes were substance use cravings, psychological flexibility, and dispositional mindfulness at treatment discharge. Patients (N = 117) from a private residential substance use facility were randomized to receive the adjunctive mindfulness and acceptance group or treatment-as-usual. Patients were assessed at treatment intake and at discharge from a 28-30-day residential program. Although treatment groups did not statistically differ at discharge on any primary outcome, small effect sizes favored the mindfulness and acceptance group on cravings and psychological flexibility. Conclusions/Importance: Continued research is needed to determine whether the addition of mindfulness and acceptance-based interventions improve outcomes long term following residential substance use treatment.

  7. Economic evaluation of human albumin use in patients with nephrotic syndrome in four Brazilian public hospitals: pharmacoeconomic study.

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    Toledo, Leonardo Augusto Kister de; Noblat, Antônio Carlos Beisl; Nascimento, Harrison Floriano do; Noblat, Lúcia de Araújo Costa Beisl

    2017-01-01

    In 2004, the Brazilian National Health Surveillance Agency (Agência Nacional de Vigilância Sanitária, ANVISA) published a resolution establishing guidelines for albumin use. Although the published data do not indicate any definitive conclusions about the benefits of albumin use in patients with nephrotic syndrome (NS), the guidelines recommend this procedure only in cases of edema that is refractory to use of diuretics. The aim here was to analyze albumin use among patients with nephrotic syndrome. Pharmacoeconomic study conducted in four large public referral hospitals for nephrology services in northeastern Brazil. Cost-effectiveness and cost-utility economic evaluations were performed on a concurrent cohort of patients with nephrotic syndrome, who were divided into two groups according to compliance or noncompliance with the guidelines. Quality-of-life data were obtained from the SF36 and CHQ-PF50 questionnaires. This study enrolled 109 patients (60% adults and 56% women); 41.3% were using albumin in accordance with the guidelines. The weight, diuresis and fluid balance parameters were more cost-effective for patients who adhered to the guidelines. Regarding days of hospitalization avoided, the incremental ratio showed a daily cost of R$ 55.33, and guideline-compliant patients were hospitalized for five days or fewer. The quality of life improved by 8%, and savings of R$ 3,458.13/QALY (quality-adjusted life year) for the healthcare system were generated through guideline compliance. The economic analyses of this study demonstrated that there were greater cost benefits for patients whose treatment followed the guidelines.

  8. Clinical manifestation of HIV/AIDS patients: differences between public and private hospitals in Jakarta

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    Herdiman T. Pohan

    2004-12-01

    Full Text Available The aims of this study is to determine the demographic data, risk factors, clinical presentations, opportunistic/co-infections and its difference between public and private hospitals. A retrospective -descriptive study was conducted in Dr. Cipto Mangunkusumo National General Hospital (public hospital and Medistra Hospital (private hospital, Jakarta. The inclusion criteria were new HIV/AIDS cases admitted in year 2002-2003 and positive HIV serology (Elisa method. Secondary data were collected form medical record. Sixty-six subjects were enrolled in this study (public hospital 30 subjects and private hospital 36 subjects, consist of 59 male (89.4% and 7 female (10.6%. Thirty-seven percent subjects were defined as HIV and 62% AIDS. Risk factors obtained include drug user (59.1%, homosexual (13.6%, heterosexual (21.1%, transfusion (1.5% and maternal-child (perinatal (1.5%. The clinical symptoms mainly present as acute fever (56.2%, weight loss (39.4%, cough (38.8%, shortness of breath (27.2%, chronic diarrhea (22.8%, prolong fever (19.7%, loss of conciousness (15.3%, anorexia (15.3%. Significant differences between public and private hospitals were seen in fever and cough symptoms. Clinical presentation of HIV/AIDS patients during admission were : pneumonia (56%, oral trush (22.6%, anemia (56.5%, leucopenia (32.3%, lymphopenia (55.9%, elevated AST/ALT (66.1%, hypoalbuminemia (46.9%, limphadenopathy (10.6%, brain space occuping lesion (7.6%, encephalopathy (6.0%, pulmonary tb and pleural effusion (10.6%. The opportunistic and co-infections present were candidiasis (25.8%, chronic hepatitis C (24.2%, chronic hepatitis B and C (4.5%, pulmonary tb, lymphadenitis and miliary tb. Candidiasis and pulmonary tb were frequently found in public hospital. In conclusion from this study that clinical manifestation of HIV/AIDS were young man or woman, with one or more possible risk factor, had fever, respiratory complain, loss of body weight, chronic diarrhea

  9. Human Papillomavirus (HPV in breast tumors: prevalence in a group of Mexican patients

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    Cetina Lucely

    2009-01-01

    Full Text Available Abstract Background Breast cancer is one of the main health problems in developed countries, occupying first place in mortality in women. It is well-known that there are risk factors associated with breast cancer development. Nonetheless, in 50–80% of cases known risk factors have not been identified, this has generated the attempt to identify new factors related with this neoplasia as viral infections. The aim of this work is investigate the prevalence of HPV DNA in patients with breast lesions at the Instituto Nacional de Cancerologia de Mexico. Methods Fifty-one cases of breast cancer were selected from the files of the institute and compared by age and tumor size with 43 cases of non malignant breast lesions (fibroadenoma, fibrocystic disease and phyllodes tumor. Paraffin embedded specimens were selected, HPV DNA was analyzed by polymerase chain reaction (PCR and sequenced for different types of HPV in case of positivity for HPV-DNA. Descriptive analysis of clinical and pathological variables was performed and comparisons between positive and negative cases was done. Results All patients were mexican, mean age was 53.3, median age of menarche was 13 and median tumor size 9 cms. Cervicovaginal cytology was performed to all patients, 1 patient (1.9% of cancer group had HPV and none in the other group, no cases were diagnosed with cervical dysplasia. In the group of carcinomas 36 (70.5% were negative and 15 (29.4% were positive to HPV-DNA, 10(66.6% were positive for HPV 16, 3(20% for HPV 18, two cases (13.4% were positive for both. In the group of benign conditions all were negative to HPV-DNA. Conclusion Presence of HPV in breast cancer in our group of cases is high in comparison to other authors; larger numbers of cases need to be analyzed in order to establish the exact role of this virus in the pathogenesis of breast cancer.

  10. Free does not mean affordable: maternity patient expenditures in a public hospital in Bangladesh

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    Khan Suhaila H

    2005-01-01

    Full Text Available Abstract Objective This study investigated a the amount and types of out-of-pocket expenditures by patients for nominally free services in a large public hospital in Bangladesh, b the factors influencing these expenses, and c the impact of these expenses on household income. Methods Eighty-one maternity patients were interviewed during their hospitalization in the Dhaka Medical College Hospital. Patients were selected by quota sample to match the distribution of maternity patient categories in the hospital. Patients were interviewed with a semi-structured, in-depth questionnaire. Results All interviewees incurred substantial out-of-pocket expenditures for travel, hospital admission fees, medicine, tests, food, and tips. Only two of the expenditures, travel expenses and admission fees, were not supposed to be provided free of charge by the hospital. The median total per-patient expenditure was $65 (range $2–$350, equivalent to 7% (range 0.04%–225% of annual household income. Half of all patients reported that their families had to borrow to pay for care at interest rates of 5%–30% per month. A third of these families reported selling jewelry, land or household items to moneylenders. The rural patients reported more difficulty in paying for care than the urban patients. Factors increasing the expenditures were duration of hospitalization, rural residence, and necessary (e.g. C-section, hysterectomy and unnecessary (e.g. episiotomy medical procedures. Conclusion Free maternity services in Bangladesh impose large out-of-pocket expenditures on patients. Authorities could reduce the burden by reducing the duration of hospital stays, limiting use of medical procedures, eliminating tips, and moving routine services closer to potential users. Fee for service could reduce unofficial expenditures if the fee were lower than and replaced typical unofficial expenditures, otherwise adding service fees without reform of current hospital practices would

  11. Evaluation of oral-motor movements and facial mimic in patients with head and neck burns by a public service in Brazil

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    Dicarla Motta Magnani

    2015-05-01

    Full Text Available OBJECTIVES: The purpose of this study was to analyze the characteristics of oral-motor movements and facial mimic in patients with head and neck burns. METHODS: An observational descriptive cross-sectional study was conducted with patients who suffered burns to the head and neck and who were referred to the Division of Orofacial Myology of a public hospital for assessment and rehabilitation. Only patients presenting deep partial-thickness and full-thickness burns to areas of the face and neck were included in the study. Patients underwent clinical assessment that involved an oral-motor evaluation, mandibular range of movement assessment, and facial mimic assessment. Patients were divided into two groups: G1 - patients with deep partial-thickness burns; G2 - patients with full-thickness burns. RESULTS: Our final study sample comprised 40 patients: G1 with 19 individuals and G2 with 21 individuals. The overall scores obtained in the clinical assessment of oral-motor organs indicated that patients with both second- and third-degree burns presented deficits related to posture, position and mobility of the oral-motor organs. Considering facial mimic, groups significantly differed when performing voluntary facial movements. Patients also presented limited maximal incisor opening. Deficits were greater for individuals in G2 in all assessments. CONCLUSION: Patients with head and neck burns present significant deficits related to posture, position and mobility of the oral myofunctional structures, including facial movements.

  12. Evaluation of Salivary Nitric Oxide and Epidermal Growth Factor in Diabetic Patients and Healthy Group

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    Hamid Reza Abdolsamadi

    Full Text Available Introduction: Nitric oxide (NO and epidermal growth factor (EGF play an important role in biologic systems. The aim of the present study was to evaluate salivary NO and EGF levels changes in type I and II diabetes mellitus comparing to the control group. Materials & Methods: In this cross-sectional study, five ml, saliva of 20 patients with type 1 diabetes mellitus and five ml saliva of 20 patients with type 2 diabetes mellitus attended to Hamadan diabetes research center as well as 20 healthy individuals matched according to age and sex, were collected. NO and EGF were assessed via Griess reaction and Immunoassay methods respectively. Data were analyzed by t-test and Mann-Whitney test.Results: Compared to the control group, the level of NO was increased in patients with type I diabetes (P=0.037, while it did not significantly increase in type II diabetes (P=0.058. The level of EGF in diabetic patients was significantly higher than the control group. There was no significant difference between the salivary level of EGF and NO of patient with type 1 and type 2 mellitus diabetes (P>0.05. The correlation coefficient between NO and EGF levels in type II diabetic patients was -0.278 (P=0.0235. The level of NO and EGF was significantly related to fasting blood sugar and HbA1c (P=0.001.Conclusion: The level of salivary NO in type I diabetes and EGF in type I and II diabetes was higher compared to those of healthy individuals and was related to the severity of the disease.

  13. Found in translation: exporting patient-centered communication and small group teaching skills to China.

    Science.gov (United States)

    Blatt, Benjamin; Kallenberg, Gene; Lang, Forrest; Mahoney, Patrick; Patterson, JoEllen; Dugan, Beverly; Sun, Shaobang

    2009-06-26

    The Chinese Medical Doctor's Association asked us to develop a train-the-trainers program in doctor-patient communication and in teaching skills for a select group of Chinese health care professionals, who would then serve as trainers for practicing physicians throughout China. The request came in the context of increasing doctor-patient friction related, in part, to the dissolution of the socialist health care safety net in China. In this article we recount the implementation of our 5-day training program in Beijing. We explore cross-cultural issues that arose in presenting the program's two principal training domains: small group teaching and patient-centered doctor-patient communication. We also explore the linguistic challenges we encountered as non-Chinese speaking teachers. Finally, we reflect on the lessons learned from this project that may be of value to others called upon to export Western doctor-patient communications training to other cultures. In this age of increasing globalization, cross-cultural sharing of medical education represents a growing trend.

  14. Found in Translation: Exporting Patient-Centered Communication and Small Group Teaching Skills to China

    Science.gov (United States)

    Blatt, Benjamin; Kallenberg, Gene; Lang, Forrest; Mahoney, Patrick; Patterson, JoEllen; Dugan, Beverly; Sun, Shaobang

    2009-01-01

    The Chinese Medical Doctor's Association asked us to develop a train-the-trainers program in doctor-patient communication and in teaching skills for a select group of Chinese health care professionals, who would then serve as trainers for practicing physicians throughout China. The request came in the context of increasing doctor-patient friction related, in part, to the dissolution of the socialist health care safety net in China. In this article we recount the implementation of our 5-day training program in Beijing. We explore cross-cultural issues that arose in presenting the program's two principal training domains: small group teaching and patient-centered doctor-patient communication. We also explore the linguistic challenges we encountered as non-Chinese speaking teachers. Finally, we reflect on the lessons learned from this project that may be of value to others called upon to export Western doctor-patient communications training to other cultures. In this age of increasing globalization, cross-cultural sharing of medical education represents a growing trend. PMID:20165520

  15. Patient groups in art therapies: A case study of the health care field in Latvia

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    Vende K.

    2012-10-01

    Full Text Available The aim of the paper is to introduce the reader with an example of the arts therapies work in a children hospital in Latvia in order to describe art therapies work similarities and differences in three different specializations. Comparison will take place of patient groups in the work of art therapists in each specialization (art therapy, dance movement therapy and music therapy. The question of the research is: with which patient groups’ a specialist from a particular arts therapies specialization has worked within a year in VSIA BKUS children hospital “Gaiļezers” during the time period from 05.2009 to 05.2010?The results were gained by comparing patient groups at the age from 2,5 to 17 years in the children hospital and they showed that the art therapists and dance movement therapist most frequently were working with patients who have behaviour and emotional disorders. However music therapists are working more frequently with patients who have mental retardation.

  16. The efficacy and safety of canagliflozin across racial groups in patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Gavin, James R; Davies, Melanie J; Davies, Michael; Vijapurkar, Ujjwala; Alba, Maria; Meininger, Gary

    2015-01-01

    Canagliflozin, a sodium-glucose co-transporter 2 inhibitor, enhances urinary glucose excretion through an insulin-independent mode of action, and improves glycemic control in patients with type 2 diabetes mellitus (T2DM). This study assessed the efficacy and safety of canagliflozin across racial groups. The efficacy of canagliflozin 100 mg and 300 mg was evaluated by racial group using data pooled from four placebo-controlled phase 3 studies and two placebo-controlled sub-studies of a population of patients with inadequately controlled T2DM (N = 4158). Least-squares mean changes from baseline were calculated for hemoglobin A1c (HbA1c), systolic blood pressure (SBP), body weight (BW), cholesterol, and triglycerides. Safety/tolerability evaluation included reporting of general and prespecified adverse events (AEs). A total of 75% of patients were White, 13% were Asian, 4% were Black/African American, and 8% were 'Other' (American Indian, Alaskan Native, mixed race, Native Hawaiian or other Pacific Islander, not reported, and unknown). Baseline demographics were similar for these groups. Dose-related reductions in HbA1c, BW, and SBP were observed with both canagliflozin doses in all racial groups. Canagliflozin was generally safe and well tolerated. Treatment with canagliflozin was associated with an increased rate of genital mycotic infections (GMIs) and urinary tract infections (UTIs) in all racial groups. GMIs were observed more often in Black/African American males and males from the 'Other' racial group, whereas UTIs and osmotic diuresis-related AEs were less common in Asians. Key study limitations include the high proportion of White patients compared with other racial groups and the fact that included studies were not powered to evaluate racial differences. Canagliflozin was generally well tolerated and consistently associated with reductions in HbA1c, BW, and SBP in patients with T2DM independent of racial background. (ClinicalTrials.gov numbers: NCT

  17. The Skills of Facilitator Nurses in Psycho-Social Group Intervention for Cancer Patients.

    Science.gov (United States)

    Chujo, Masami; Okamura, Hitoshi

    2015-06-01

    The objective of this study was to provide cancer patients with a psychosocial group intervention consisting of 3 parts, i.e., education on how to cope with stress and solve problems, group discussions, and progressive muscle relaxation, and to investigate the intervention techniques of Japanese facilitators. Group interventions for breast cancer patients performed by 3 facilitators were analyzed qualitatively and inductively using a phenomenological approach. The skills of facilitators included 10 intervention techniques and 1 problem in interventions. Intervention techniques, which promote group dynamics and thereby help participants acquire improvements in their coping abilities and quality of life (QOL), were somewhat different between new and experienced facilitators, with the content showing immaturity and maturity in the new and experienced facilitators, respectively. Both experienced and new facilitators faced the risk of experiencing problems in interventions, which countered the purpose of the intervention of improving the participants' coping abilities or QOL. While intervention skills are necessary for facilitators to execute group interventions, it must be borne in mind, that even well-experienced facilitators may not always be able to accomplish skillful intervention.

  18. Lipid Status and Predisposing Genes in Patients with Diabetes Mellitus Type 1 from Various Ethnic Groups.

    Science.gov (United States)

    Kolesnikova, L I; Kolesnikov, S I; Darenskaya, M A; Grebenkina, L A; Semenova, N V; Osipova, E V; Gnusina, S V; Bardymova, T A

    2015-12-01

    The peculiarities of HLA class II profile and lipid metabolism were examined in Buryat and Russian ethnic groups of patients with diabetes mellitus type 1. The incidence of type 1 haplotypes in HLA class II gene family was lower in Buryats than that in Russians. In comparison with Russians, the course of diabetes mellitus type 1 in Buryat patients was characterized with a lower content of total lipids, triacylglycerols, total cholesterol, and LDL, which probably explains a more favorable course of the disease in Buryat population.

  19. THE MODERN THEORETICAL APPROACHES IN THE ANALYSIS OF PUBLIC-PRIVATE PARTNERSHIPS: FROM INTEREST GROUPS TO CORPORATE CITIZENSHIP

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    Votchenko, E.S.

    2016-04-01

    Full Text Available This scientific article touches a vital topic of contemporary relations between business and government - public-private partnerships (PPP in the system of public discourse. The article discusses the various modern theoretical approaches to the study of the social aspects of interaction between business and government in modern political science. The author considers the concept and models of foreign public-private partnerships, social investments and corporate citizenship. In the end, the author makes an interesting conclusion that in the modern scientific community is formed and becomes stable a new institutional paradigm of PPP – practice of corporate citizenship. Corporate social responsibility in the narrow sense of the definition goes beyond charity and philanthropy, and today it is expressed in a broad sense - as corporate citizenship, which implies mutual responsibility of business and government to the public.

  20. Outcomes of 847 childhood-onset systemic lupus erythematosus patients in three age groups.

    Science.gov (United States)

    Lopes, S R M; Gormezano, N W S; Gomes, R C; Aikawa, N E; Pereira, R M R; Terreri, M T; Magalhães, C S; Ferreira, J C; Okuda, E M; Sakamoto, A P; Sallum, A M E; Appenzeller, S; Ferriani, V P L; Barbosa, C M; Lotufo, S; Jesus, A A; Andrade, L E C; Campos, L M A; Bonfá, E; Silva, C A

    2017-08-01

    Objective The objective of this study was to assess outcomes of childhood systemic lupus erythematosus (cSLE) in three different age groups evaluated at last visit: group A early-onset disease (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR-DI) (0 (0-9) vs 0 (0-6) vs 0 (0-7), p = 0.065) was comparable in the three groups. Further analysis of organ/system damage revealed that frequencies of neuropsychiatric (21% vs 10% vs 7%, p = 0.007), skin (10% vs 1% vs 3%, p = 0.002) and peripheral vascular involvements (5% vs 3% vs 0.3%, p = 0.008) were more often observed in group A compared to groups B and C. Frequencies of severe cumulative lupus manifestations such as nephritis, thrombocytopenia, and autoimmune hemolytic anemia were similar in all groups ( p > 0.05). Mortality rate was significantly higher in group A compared to groups B and C (15% vs 10% vs 6%, p = 0.028). Out of 69 deaths, 33/69 (48%) occurred within the first two years after diagnosis. Infections accounted for 54/69 (78%) of the deaths and 38/54 (70%) had concomitant disease activity. Conclusions This large multicenter study provided evidence that early-onset cSLE group had distinct outcomes. This group was characterized by higher mortality rate and neuropsychiatric/vascular/skin organ damage in spite of comparable frequencies of severe cumulative lupus manifestations. We also identified that overall death in cSLE patients was an early event mainly attributed to infection associated with disease activity.

  1. Internet use, online information seeking and knowledge among third molar patients attending public dental services.

    Science.gov (United States)

    Hanna, K; Sambrook, P; Armfield, J M; Brennan, D S

    2017-09-01

    While Australians are searching the internet for third molar (TM) information, the usefulness of online sources may be questioned due to quality variation. This study explored: (i) internet use, online information-seeking behaviour among TM patients attending public dental services; and (ii) whether patients' TM knowledge scores are associated with the level of internet use and eHealth Literacy Scale (eHEALS) scores. Baseline survey data from the 'Engaging Patients in Decision-Making' study were used. Variables included: sociodemographics, internet access status, online information-seeking behaviour, eHEALS, the Control Preferences Scale (CPS) and TM knowledge. Participants (N = 165) were mainly female (73.8%), aged 19-25 years (42.4%) and had 'secondary school or less' education (58.4%). A majority (N = 79, 52.7%) had sought online dental information which was associated with active decisional control preference (odds ratio = 3.1, P = 0.034) and higher educational attainment (odds ratio = 2.7, P = 0.040). TM knowledge scores were not associated with either the level of internet use (F(2,152) = 2.1, P = 0.094, χ(2) = 0.0310) or the eHEALS scores (r = 0.147, P = 0.335). 'The internet-prepared patient' phenomena exists among public TM patients and was explained by preference for involvement in decision-making. However, internet use was not associated with better TM knowledge. Providing TM patients with internet guidance may be an opportunity to improve TM knowledge. © 2017 Australian Dental Association.

  2. Health related quality of life in pregeriatric patients with chronic diseases at urban, public supported clinics

    Directory of Open Access Journals (Sweden)

    Nguyen Kim M

    2003-10-01

    Full Text Available Abstract Background Understanding health-related quality of life (HRQOL leads to more effective and focused healthcare. America's growing health disparities makes it is increasingly necessary to understand the HRQOL of pregeriatric individuals who are now 55–64 years old, i.e. before they are eligible for federally mandated health care at age 65. Our study measured the self-perceived HRQOL of pregeriatric, poor patients with multiple chronic diseases treated at 2 public clinics. Methods Consecutive patients aged 55–64 years, many with multiple chronic diseases, responded in an interview to the 36-Item Short-Form Health Survey (SF–36 as a general measure of HRQOL during a regular visit to one of two university-staffed urban public clinics. Results The perceived physical and mental functioning of 316 pregeriatric patients was tabulated from SF–36 scores to yield their HRQOL. Their scores were statistically significantly lower than those of the general US pregeriatric population and lower than averages for US patients with multiple chronic diseases. All eight subscale scores of SF–36 were 16% to 36% lower compared with the averages of the general US pregeriatric population. Further, as the number of chronic diseases increased, the lower was the HRQOL. Lower physical and mental scores were associated with a lower income, unemployment, and higher numbers of multiple chronic diseases. Conclusion Chronic diseases have a powerful negative impact on perceived mental and physical functioning in pregeriatric patients. HRQOL information can assist health care providers to gain a more complete picture of their pregeriatric patients' health.

  3. Public knowledge and public trust.

    Science.gov (United States)

    Cunningham-Burley, Sarah

    2006-01-01

    As health care applications derived from human genetics research are likely to move increasingly from 'clinic to community', there is growing interest not just in how patients understand and take up health-related genetic information but also in the views of the wider population, as well as a range of professional groups. In this paper, issues relating public knowledge and public trust are raised and discussed in an attempt to move forward debates about public involvement in genomic research and the role of sociologists within interdisciplinary teams. As the field of public understanding of science has developed, we have seen a shift from a focus on the lack of scientific literacy as problem to a recognition of the range of different knowledges that people have and use as they confront science and technology in their everyday lives. As a mood for dialogue pervades many institutions in their relations with 'publics', attention must now be paid to the way in which knowledge and expertise is expressed, heard and acted upon in dialogic encounters. There is increasing concern about public trust in science and calls to increase public confidence, particularly through more open engagement with a range of publics. However, lack of trust or loss of confidence may be constructed as problems rather than reflecting empirical reality, where more complex relationships and attitudes prevail. Lack of trust is often privatized, deeply rooted in lived experience and routinely managed. Trust relations are generally characterized by ambivalence, uncertainty and risk, and are always provisional. Drawing on selected literature and empirical research to review and illustrate this field, this paper argues that scepticism or ambivalence on the part of publics are not necessarily problems to be overcome in the interest of scientific progress, but rather should be mobilized to enhance open and public debates about the nature and direction of genomics research, medicine, and the related

  4. Status of occurrence of recurrent apthous stomatitis in a group of Libyan patients

    Directory of Open Access Journals (Sweden)

    Sujata M. Byahatti

    2014-01-01

    Full Text Available Aim/Objective: This prospective study had a questionnaire prepared to get the information regarding recurrent apthous stomatitis (RAS in a group of Libyan patients. Materials and Methods: A questionnaire containing a total of 14 questions giving personal and apthous ulcer details were recorded. All the details of each patient were entered into Microsoft Excel sheet and the details were recoded and interpreted. Results: Among 7500 patients who visit the outpatient department every year 460 (6% of them who were volunteers and gave a history of RAS were selected in the study group. The age of these patients ranged between 10 and 45 years. Among different types of ulcers, 48 (10% of them showed major apthous ulcer formation, 404 (88% of them had minor apthous ulcer formation, whereas 8 (2% of them had herpetiform ulcers. Among 460 patients with h/o RAS 46 (10% of them were sufferings from different systemic health problems. Total 120 (26% of them had triggers before the occurrence of RAS and 325 (70% patients were without any triggers 15 (4% of them were not aware of any triggers. When the question was asked about occurrence of RAS whether it is related to stress, 384 (83% of them correlated it with stress and 76 (17% of them did not. Different sites with their recurrence and duration of the ulcer were recorded. About 45 (9% were on different treatment modalities. Among 460 of them, 156 (34% of them had RAS at the day of examination and 304 of them were free from ulcers 304 (66%. Conclusion: Early detection and management of these patients by finding underlying etiology is essential for better management of these cases.

  5. The Effects of Group Musical Activity on Psychiatric Patients in India.

    Directory of Open Access Journals (Sweden)

    Katrina Rumball

    2010-07-01

    Full Text Available Musical activity, particularly as the application of music therapy, has been found to produce numerous benefits within a psychiatric setting. This study has explored a selection of these benefits in psychiatric patients in a hospital in India, examining these effects within a culture not typically studied in this field. Observations of seven sessions of group musical activity was undertaken and questionnaire and interview data collected from both patients and staff. Questionnaire data demonstrated improvements in mood, energy, and attention levels, both during and following the sessions. The quantitative data was integrated with interview responses and is discussed with reference to previous research. Interviews and observation found improvements in the categories of interaction, learning and confidence. Alongside these variables, specific musical factors were considered which strongly indicate that the application of musical activity as a therapy, as distinct from other group effects, contributed to the benefits found.

  6. Group behavioral activation for patients with severe obesity and binge eating disorder: a randomized controlled trial.

    Science.gov (United States)

    Alfonsson, Sven; Parling, Thomas; Ghaderi, Ata

    2015-03-01

    The aim of the present study was to assess whether behavioral activation (BA) is an efficacious treatment for decreasing eating disorder symptoms in patients with obesity and binge eating disorder (BED). Ninety-six patients with severe obesity and BED were randomized to either 10 sessions of group BA or wait-list control. The study was conducted at an obesity clinic in a regular hospital setting. The treatment improved some aspects of disordered eating and had a positive effect on depressive symptoms but there was no significant difference between the groups regarding binge eating and most other symptoms. Improved mood but lack of effect on binge eating suggests that dysfunctional eating (including BED) is maintained by other mechanisms than low activation and negative mood. However, future studies need to investigate whether effects of BA on binge eating might emerge later than at post-assessment, as in interpersonal psychotherapy for bulimia nervosa.

  7. Palliative care experiences of adult cancer patients from ethnocultural groups: a qualitative systematic review protocol.

    Science.gov (United States)

    Busolo, David; Woodgate, Roberta

    2015-01-01

    The objective of this review is to synthesize the best available evidence on palliative care experiences of adult cancer patients from ethnocultural groups.More specifically, this systematic review seeks to answer the following questions:1. What are the palliative care experiences of adult cancer patients from diverse ethnocultural groups?2. What meanings do adult patients with cancer from diverse ethnocultural groups assign to their experiences with palliative care? Globally, over 20.4 million people need palliative care services annually. The majority of these people (19 million) are adults, with 34% of them being patients diagnosed with cancer. With the current increase in the aging population, especially in developed countries, the number of adults requiring palliative care is expected to rise. Furthermore, how palliative care is offered and received continues to be shaped by culture and ethnicity. Likewise, culture and ethnicity influence how palliative care patients experience diseases like cancer, and seek and utilize palliative care services. Also, healthcare providers sometimes find it challenging to address the palliative care needs of patients from different ethnocultural groups. Sometimes these challenges are believed to be due to cultural incompetence of the care provider. When palliative care patients and their providers differ in their perception of care needs and how to address them, negative palliative care experiences are likely to ensue. Therefore, as the demand for palliative care increases, and ethnocultural factors continue to affect palliation, it is important to gain a better understanding of palliative care experiences of patients from different ethnocultural groups.The terms culture and ethnicity have been defined and used differently in literature which sometimes lead to confusion. Ethnicity has been defined as distinctive shared origins or social backgrounds and traditions of a group of people that are maintained between generations and

  8. Is There a Relation between ABO Blood Groups and Clinical Outcome in Patients with Pemphigoid? A Case-Control Study

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    Sedigheh Bakhtiari

    2016-01-01

    Full Text Available Background. Relationship between blood groups and dermatologic diseases remains controversial and was not yet fully elucidated nor explained clearly. The aim of this study was to examine if any relation exists between different types of pemphigoid diseases and ABO blood group. Methods. In this case-control study, 159 pemphigoid patients and 152 healthy matched-controls were evaluated. All blood group (including Rh status data for the study was obtained from the hospital medical records. Statistical comparisons were completed with chi-square test and logistic regression. Results. Blood group “O” was found in 32.9% of patients and 38.2% of control group. Blood group “A” was found among 30.8% of patients and 34.2% of control group, while group “B” was reported in 27.4% of cases and 21.1% of controls and “AB” was identified among 8.9% of patients and 6.6% of control group. 84.9% of patients were Rh positive, while in the control group 86.2% of patients were Rh positive. No significant differences were found regarding ABO blood groups (P=0.46 or Rh (P=0.76 between pemphigoid patients and control group. Also, older females had the higher risk of developing bullous pemphigoid. Conclusion. We found no relationship between ABO blood groups and pemphigoid disease.

  9. Pharmaceutical digital marketing and governance: illicit actors and challenges to global patient safety and public health.

    Science.gov (United States)

    Mackey, Tim K; Liang, Bryan A

    2013-10-16

    Digital forms of direct-to-consumer pharmaceutical marketing (eDTCA) have globalized in an era of free and open information exchange. Yet, the unregulated expansion of eDTCA has resulted in unaddressed global public health threats. Specifically, illicit online pharmacies are engaged in the sale of purportedly safe, legitimate product that may in fact be counterfeit or substandard. These cybercriminal actors exploit available eDTCA mediums over the Internet to market their suspect products globally. Despite these risks, a detailed assessment of the public health, patient safety, and cybersecurity threats and governance mechanisms to address them has not been conducted. Illicit online pharmacies represent a significant global public health and patient safety risk. Existing governance mechanisms are insufficient and include lack of adequate adoption in national regulation, ineffective voluntary governance mechanisms, and uneven global law enforcement efforts that have allowed proliferation of these cybercriminals on the web. In order to effectively address this multistakeholder threat, inclusive global governance strategies that engage the information technology, law enforcement and public health sectors should be established. Effective global "eHealth Governance" focused on cybercrime is needed in order to effectively combat illicit online pharmacies. This includes building upon existing Internet governance structures and coordinating partnership between the UN Office of Drugs and Crime that leads the global fight against transnational organized crime and the Internet Governance Forum that is shaping the future of Internet governance. Through a UNODC-IGF governance mechanism, investigation, detection and coordination of activities against illicit online pharmacies and their misuse of eDTCA can commence.

  10. Pharmaceutical digital marketing and governance: illicit actors and challenges to global patient safety and public health

    Science.gov (United States)

    2013-01-01

    Background Digital forms of direct-to-consumer pharmaceutical marketing (eDTCA) have globalized in an era of free and open information exchange. Yet, the unregulated expansion of eDTCA has resulted in unaddressed global public health threats. Specifically, illicit online pharmacies are engaged in the sale of purportedly safe, legitimate product that may in fact be counterfeit or substandard. These cybercriminal actors exploit available eDTCA mediums over the Internet to market their suspect products globally. Despite these risks, a detailed assessment of the public health, patient safety, and cybersecurity threats and governance mechanisms to address them has not been conducted. Discussion Illicit online pharmacies represent a significant global public health and patient safety risk. Existing governance mechanisms are insufficient and include lack of adequate adoption in national regulation, ineffective voluntary governance mechanisms, and uneven global law enforcement efforts that have allowed proliferation of these cybercriminals on the web. In order to effectively address this multistakeholder threat, inclusive global governance strategies that engage the information technology, law enforcement and public health sectors should be established. Summary Effective global “eHealth Governance” focused on cybercrime is needed in order to effectively combat illicit online pharmacies. This includes building upon existing Internet governance structures and coordinating partnership between the UN Office of Drugs and Crime that leads the global fight against transnational organized crime and the Internet Governance Forum that is shaping the future of Internet governance. Through a UNODC-IGF governance mechanism, investigation, detection and coordination of activities against illicit online pharmacies and their misuse of eDTCA can commence. PMID:24131576

  11. CLINICAL EXPERIENCES IN TREATING PTSD PATIENTS BY COMBINIG INDIVIDUAL AND GROUP PSYCHOTERAPY

    OpenAIRE

    Bilić, Vedran; Nemčić-Moro, Iva; Karšić, Vana; Grgić, Vesna; Stojanović-Špehar, Stanislava; Marčinko, Darko

    2010-01-01

    PTSD is a complex psychobiological disorder that couses disfunctionality in many areas. In treating PTSD different models have been applied, however, no general consensus on the method of treatment has yet been achieved. At the Clinic for Psychol.ogical Medicine we have developed the model of combined treatment for PTSD patients that involves outpatient individual psychoterapy, psychopharmacotherapy and group psyhoterapeutic techniques introduced within repeated day-hospital treatments. In th...

  12. Physiotherapy management of joint hypermobility syndrome - a focus group study of patient and health professional perspectives.

    OpenAIRE

    Palmer, S.; Terry, R.; Rimes, K. A.; Clark, Carol J.; Simmonds, J; Horwood, J.

    2016-01-01

    Objective: To develop an understanding of patient and health professional views and experiences of physiotherapy to manage joint hypermobility syndrome (JHS).Design: An explorative qualitative design. Seven focus groups were convened, audio recorded, fully transcribed and analysed using a constant comparative method to inductively derive a thematic account of the data.Setting: Four geographical areas of the UK.Participants: 25 people with JHS and 16 health professionals (14 physiotherapists a...

  13. Vibrotactile sense in patients with different upper limb disorders compared with a control group

    DEFF Research Database (Denmark)

    Laursen, Lise Hedegaard; Jepsen, Jørgen Riis; Sjøgaard, Gisela

    2006-01-01

    BACKGROUND: Upper limb disorders (ULDs) are common, and so are the difficulties with regard to their specific diagnoses. According to diagnostic consensus criteria, specific diagnoses include neuropathy and muscular- and connective-tissue disorders (MCDs). There is a need for valid objective...... diagnostic tools to reveal underlying mechanisms for specific diagnoses. OBJECTIVE: To investigate the possible differences in vibration perception threshold (VPT) and tolerance to suprathreshold stimulation (STS) between controls and specific diagnostic ULD patient groups with uni- and bilateral neuropathy...

  14. Knowledge, attitudes, practices, and barriers reported by patients receiving diabetes and hypertension primary health care in Barbados: a focus group study

    Directory of Open Access Journals (Sweden)

    Adams O Peter

    2011-12-01

    Full Text Available Abstract Background Deficiencies in the quality of diabetes and hypertension primary care and outcomes have been documented in Barbados. This study aimed to explore the knowledge, attitudes and practices, and the barriers faced by people with diabetes and hypertension in Barbados that might contribute to these deficiencies. Methods Five structured focus groups were conducted for randomly selected people with diabetes and hypertension. Results Twenty-one patients (5 diabetic, 5 hypertensive, and 11 with both diseases with a mean age of 59 years attended 5 focus group sessions. Patient factors that affected care included the difficulty in maintaining behaviour change. Practitioner factors included not considering the "whole person" and patient expectations, and not showing enough respect for patients. Health care system factors revolved around the amount of time spent accessing care because of long waiting times in public sector clinics and pharmacies. Society related barriers included the high cost and limited availability of appropriate food, the availability of exercise facilities, stigma of disease and difficulty taking time off work. Attendees were not familiar with guidelines for diabetes and hypertension management, but welcomed a patient version detailing a place to record results, the frequency of tests, and blood pressure and blood glucose targets. Appropriate education from practitioners during consultations, while waiting in clinic, through support and education groups, and for the general public through the schools, mass media and billboards were recommended. Conclusions Primary care providers should take a more patient centred approach to the care of those with diabetes and hypertension. The care system should provide better service by reducing waiting times. Patient self-management could be encouraged by a patient version of care guidelines and greater educational efforts.

  15. Orthopedics nursing patients' profile of a public hospital in Salvador-Bahia.

    Science.gov (United States)

    de Castro, Renata Reis Matutino; Ribeiro, Natália Fonseca; de Andrade, Aline Mendonça; Jaques, Bruno Dórea

    2013-07-01

    To describe the profile of patients treated in the trauma and orthopedics nursing of a trauma care referral public hospital of in the state of Bahia. Cross-sectional study in which data were collected from medical records of patients in the period from July to December 2008. The profile of the patients involved was formed by subjects mostly male young subjects, victims of trauma from accidents, especially those with motorcycles or car runover. On the other hand,the most frequent traumas associated with urban violence were perforations by gunshot and stab wounds. The primary injury presented by these individuals was exposed fracture of the femur and the most common treatment was external fixation. The most frequent in-hospital complication was wound infection, which required another surgical approach. Most inpatients were discharged and only one death was reported during this period. The results of this study corroborate those from other institutions in the country, which may contribute to elaborate public policies for accidents and violence prevention. Level of Evidence IV, Case Series.

  16. Implementation of a trauma registry in a Brazilian public hospital: the first 1,000 patients.

    Science.gov (United States)

    Carreiro, Paulo Roberto Lima; Drumond, Domingos André Fernandes; Starling, Sizenando Vieira; Moritz, Mônica; Ladeira, Roberto Marini

    2014-01-01

    Show the steps of a Trauma Registry (TR) implementation in a Brazilian public hospital and evaluate the initial data from the database. Descriptive study of the a TR implementation in João XXIII Hospital (Hospital Foundation of the state of Minas Gerais) and analysis of the initial results of the first 1,000 patients. The project was initiated in 2011 and from January 2013 we began collecting data for the TR. In January 2014 the registration of the first 1000 patients was completed. The greatest difficulties in the TR implementation were obtaining funds to finance the project and the lack of information within the medical records. The variables with the lowest completion percentage on the physiological conditions were: pulse, blood pressure, respiratory rate and Glasgow coma scale. Consequently, the Revised Trauma Score (RTS) could be calculated in only 31% of cases and the TRISS methodology applied to 30.3% of patients. The main epidemiological characteristics showed a predominance of young male victims (84.7%) and the importance of aggression as a cause of injuries in our environment (47.5%), surpassing traffic accidents. The average length of stay was 6 days, and mortality 13.7%. Trauma registries are invaluable tools in improving the care of trauma victims. It is necessary to improve the quality of data recorded in medical records. The involvement of public authorities is critical for the successful implementation and maintenance of trauma registries in Brazilian hospitals.

  17. Implementation of a trauma registry in a brazilian public hospital: the first 1,000 patients

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Lima Carreiro

    Full Text Available OBJECTIVE: Show the steps of a Trauma Registry (TR implementation in a Brazilian public hospital and evaluate the initial data from the database.METHODS: Descriptive study of the a TR implementation in João XXIII Hospital (Hospital Foundation of the state of Minas Gerais and analysis of the initial results of the first 1,000 patients.RESULTS: The project was initiated in 2011 and from January 2013 we began collecting data for the TR. In January 2014 the registration of the first 1000 patients was completed. The greatest difficulties in the TR implementation were obtaining funds to finance the project and the lack of information within the medical records. The variables with the lowest completion percentage on the physiological conditions were: pulse, blood pressure, respiratory rate and Glasgow coma scale. Consequently, the Revised Trauma Score (RTS could be calculated in only 31% of cases and the TRISS methodology applied to 30.3% of patients. The main epidemiological characteristics showed a predominance of young male victims (84.7% and the importance of aggression as a cause of injuries in our environment (47.5%, surpassing traffic accidents. The average length of stay was 6 days, and mortality 13.7%.CONCLUSION: Trauma registries are invaluable tools in improving the care of trauma victims. It is necessary to improve the quality of data recorded in medical records. The involvement of public authorities is critical for the successful implementation and maintenance of trauma registries in Brazilian hospitals.

  18. Prevalence of cytomegalovirus infection in different patient groups of a urban university in Brazil

    Directory of Open Access Journals (Sweden)

    José Hermôgenes Rocco Suassuna

    1995-06-01

    Full Text Available This study sought for etndence of previous CMV infection in patients of a general hospital serving the low income population of Rio de Janeiro. An enzyme immunoassay was used to detect anti-CMV antibodies in 713 typical hospital patients classified into eight different groups. Positive tests were found in 87% of pregnant women, 85% of newborns, 61% of pediatric patients, 77% of adolescent patients, 81% of adult patients, 87% of dialysed transplant candidates, 89% of kidney donors, and 92% of patients after transplantation. Depending of the subgroup studied these results carry different meanings and necessitate different clinical approaches. The risk of congenital disease is probably low in view of the reduced number of pregnant women still susceptible to primary infection. The number of primary infections will also be low in transplant recipients. However, those still susceptible will almost certainly acquire the infection from, their donor. Prophylactic CMV matching in kidney transplantation is not a realistic approach due to the low probability of finding pairs of seronegative donors and recipients.

  19. Comparison of serum levels of copper and zinc among multiple sclerosis patients and control group.

    Directory of Open Access Journals (Sweden)

    Behnaz Sedighi

    2013-12-01

    Full Text Available There have been several studies done on the role of metals in the occurrence of multiple sclerosis (MS disease, but their roles have not been confirmed yet. Because of the lack of information on this issue, this study compared the serum level of copper and zinc in MS patients with their levels in a control group.This was an analytical, cross-sectional study conducted in Kerman (a medium size city, Iran. We assessed the serum level of copper and zinc in 58 MS patients and 39 healthy individuals, who were selected from the relatives of cases and matched for age and sex.The average serum level of Copper in cases and controls were 93.7 and 88.9 ml/dl, respectively. The corresponding numbers for Zinc were 36.7 and 40.9 ml/dl, respectively. There was no significant difference between the two groups (copper: P = 0.459; zinc: P = 0.249.The groups were matched for age, sex, and family. However, we did not find a considerable difference between the level of these metals in MS patients and controls.

  20. Clinical and genetic characteristics in a group of 45 patients with Turner syndrome (monocentric study

    Directory of Open Access Journals (Sweden)

    Bucerzan S

    2017-05-01

    chromosome sequences were found in only one patient, who subsequently underwent gonadectomy.Conclusion: The importance of this study resides, to the best of our knowledge, in the fact that the largest group of patients in Romania was analyzed and assessed. To draw firm conclusions on the most valuable clinical indicators for Turner syndrome diagnosis in clinical practice, studies on large groups of patients should be conducted. Keywords: Turner syndrome, diagnosis, phenotype, karyotype, GH treatment, Y chromosome sequences

  1. Exploring the Knowledge, Attitudes, Beliefs, and Communication Preferences of the General Public regarding HPV: Findings from CDC Focus Group Research and Implications for Practice

    Science.gov (United States)

    Friedman, Allison L.; Shepeard, Hilda

    2007-01-01

    Genital human papillomavirus (HPV) infection is the most common sexually transmitted virus in the United States, causing genital warts, cervical cell abnormalities, and cervical cancer in women. To inform HPV education efforts, 35 focus groups were conducted with members of the general public, stratified by gender, race/ethnicity, and urban/rural…

  2. Risk and benefit of dual antiplatelet treatment among nonrevascularized myocardial infarction patients in different age groups

    DEFF Research Database (Denmark)

    Juul, Nikolai; Gislason, Gunnar; Olesen, Jonas Bjerring;

    2017-01-01

    BACKGROUND: Dual anti-platelet treatment with clopidogrel and aspirin is indicated for most patients after myocardial infarction. We examined the risk/benefit relationship of dual anti-platelet treatment according to age in a nationwide cohort of 30,532 myocardial infarction patients without...... revascularization. METHODS: Patients admitted with first-time myocardial infarction in 2002-2010, not undergoing revascularization, were identified from nationwide Danish registers. Dual anti-platelet treatment use was assessed by claimed prescriptions. Stratified into age groups, risk of bleeding, all...... included (mean age 67.02 (±13.8) years and 64.7% males). Use of dual anti-platelet treatment decreased with age: 80% (79 years). We found a reduced risk of cardiovascular death, recurrent myocardial infarction and ischaemic stroke in users

  3. Assessing patient care: summary of the breakout group on assessment of observable learner performance.

    Science.gov (United States)

    Takayesu, James Kimo; Kulstad, Christine; Wallenstein, Joshua; Gallahue, Fiona; Gordon, David; Leone, Katrina; Kessler, Chad

    2012-12-01

    There is an established expectation that physicians in training demonstrate competence in all aspects of clinical care prior to entering professional practice. Multiple methods have been used to assess competence in patient care, including direct observation, simulation-based assessments, objective structured clinical examinations (OSCEs), global faculty evaluations, 360-degree evaluations, portfolios, self-reflection, clinical performance metrics, and procedure logs. A thorough assessment of competence in patient care requires a mixture of methods, taking into account each method's costs, benefits, and current level of evidence. At the 2012 Academic Emergency Medicine (AEM) consensus conference on educational research, one breakout group reviewed and discussed the evidence supporting various methods of assessing patient care and defined a research agenda for the continued development of specific assessment methods based on current best practices. In this article, the authors review each method's supporting reliability and validity evidence and make specific recommendations for future educational research.

  4. [Daily life of schizofrenia patients after the use of clozapine and group follow up].

    Science.gov (United States)

    Durão, Ana Maria Sertori; Mello e Souza, Maria Conceição Bernardo; Miasso, Adriana Inocenti

    2007-06-01

    This study was carried out with a sample of 11 patients who are part of the atypical medication group at the Hospital das Clínicas of the University of São Paulo at Ribeirão Preto's School of Medicine. For data collection semi-structured interviews guided by a script were held in April 2003. The interviews were first taped and fully transcribed afterwards. Results indicated an improvement in patients' symptoms, demonstrated by decreased social isolation, resumption of home/work activities and studies, as well as by participation in social events. They also point out to the need for a new vision regarding patients who suffer from mental disorders and their family members in the sense of searching for adequate therapeutic attitudes that have an impact on the production of life, aimed at giving a new existential meaning in the different forms of social contact and sociability.

  5. Temporal lobe contribution to perceptual function: A tale of three patient groups.

    Science.gov (United States)

    Behrmann, M; Lee, A C H; Geskin, J Z; Graham, K S; Barense, M D

    2016-09-01

    There has been growing recognition of the contribution of medial and anterior temporal lobe structures to non-mnemonic functions, such as perception. To evaluate the nature of this contribution, we contrast the perceptual performance of three patient groups, all of whom have a perturbation of these temporal lobe structures. Specifically, we compare the profile of patients with focal hippocampal (HC) lesions, those with more extensive lesions to the medial temporal lobe (MTL) that include HC and perirhinal cortex (PrC), and those with congenital prosopagnosia (CP), whose deficit has been attributed to the disconnection of the anterior temporal lobe from more posterior structures. All participants completed a range of'oddity' tasks in which, on each trial, they determined which of four visual stimuli in a display was the'odd-one-out'. There were five stimulus categories including faces, scenes, objects (high and low ambiguity) and squares of different sizes. Comparisons were conducted separately for the HC, MTL and CP groups against their matched control groups and then the group data were compared to each other directly. The group profiles were easily differentiable. Whereas the HC group stood out for its difficulty in discriminating scenes and the CP group stood out for its disproportionate difficulty in discriminating faces with milder effects for scenes and high ambiguity objects, the MTL group evinced a more general discrimination deficit for faces, scenes and high ambiguity objects. The group differences highlight distinct profiles for each of the three groups and distinguish the signature perceptual impairments following more extended temporal lobe alterations. In the recent reconsideration of the role of the hippocampus and neocortex, Moscovitch and colleagues (Moscovitch et al., 2016) note that the medial temporal lobe structures play a role in non-mnemonic functions, such as perception, problem solving, decision-making and language. Here, we address this

  6. Effect of Yoga Nidra on physiological variables in patients of menstrual disturbances of reproductive age group.

    Science.gov (United States)

    Monika; Singh, Uma; Ghildiyal, Archana; Kala, Sarswati; Srivastava, Neena

    2012-01-01

    Aim of this study was to see any effect on autonomic functions in menstrual disturbances patients after Yoga Nidra practice. The subjects for the study were 150 females with menstrual irregularities, 28.08 +/- 7.43 years of mean age, referred from department of Obstetrics and Gynecology CSMMU, UP, Lucknow. Subjects were divided randomly in to two groups' intervention and in control groups -seventy five (75) in each group. Out of these, one hundred twenty six (126) completed the study protocol. The yogic intervention consisted of 35-40 minutes/day, five days in a week till six months. An autonomic function testing was done in both the groups at zero time and after six months. A significant positive effect was observed when yoga therapy was used as an adjunct in the patients of menstrual disturbances. There were significant improvements in the blood pressure, postural hypotension and sustained hand grip, heart rate expiration inspiration ratio and 30:15 beat ratios of the subjects after yogic practice.

  7. Patient satisfaction with inpatient care provided by the Sydney Gynecological Oncology Group

    Directory of Open Access Journals (Sweden)

    Vivek Arora

    2010-11-01

    Full Text Available Vivek Arora, Shannon Philp, Kathryn Nattress, Selvan Pather, Christopher Dalrymple, Kenneth Atkinson, Sofia Smirnova, Stephen Cotterell, Jonathan CarterSydney Gynecological Oncology Group, Royal Prince Alfred Hospital, University of Sydney, Sydney, AustraliaPurpose: Patient satisfaction with the provision of hospital oncology services can have a significant impact on their overall treatment experience.Aims: To assess patient satisfaction with the inpatient hospital services in the gynecological oncology setting using the IN-PATSAT32 questionnaire developed by the European Organization for Research and Treatment of Cancer (EORTC.Methods: A modified version of the IN-PATSAT32 questionnaire with additional 16 items was administered to 52 adult surgical inpatients admitted with the Sydney Gynecological Oncology Group. All participants were provided with an information leaflet regarding the survey and written consent obtained.Results: A high response rate (100% from patients with varied social, ethnic, and educational backgrounds confirmed the acceptability of the survey. Standard of medical care provided, frequency of doctors’ visits, exchange of information with doctors, friendliness of the staff, and state of the room ranked highly (>95% on the patient satisfaction scales. Problems were identified with ease of access to and within the hospital, quality of food, and exchange of information with other hospital staff.Conclusions: Overall the satisfaction with inpatient care was rated very highly in most areas. Deficiencies in certain elements of provision of medical care to the patients were identified and steps have been taken to improve upon these shortcomings.Keywords: patient satisfaction, EORTC, IN-PATSAT32, gynecological oncology, survey

  8. What do pharmaceutical industry professionals in Europe believe about involving patients and the public in research and development of medicines? A qualitative interview study.

    Science.gov (United States)

    Parsons, Suzanne; Starling, Bella; Mullan-Jensen, Christine; Tham, Su-Gwan; Warner, Kay; Wever, Kim

    2016-01-07

    To explore European-based pharmaceutical industry professionals' beliefs about patient and public involvement (PPI) in medicines research and development (R&D). Pharmaceutical companies in the UK, Poland and Spain. 21 pharmaceutical industry professionals, four based in the UK, five with pan-European roles, four based in Spain and eight based in Poland. Qualitative interview study (telephone and face-to-face, semistructured interviews). All interviews were audio taped, translated (where appropriate) and transcribed for analysis using the Framework approach. 21 pharmaceutical industry professionals participated. Key themes were: beliefs about (1) whether patients and the public should be involved in medicines R&D; (2) the barriers and facilitators to PPI in medicines R&D and (3) how the current relationships between the pharmaceutical industry, patient organisations and patients influence PPI in medicines R&D. Although interviewees appeared positive about PPI, many were uncertain about when, how and which patients to involve. Patients and the public's lack of knowledge and interest in medicines R&D, and the pharmaceutical industry's lack of knowledge, interest and receptivity to PPI were believed to be key challenges to increasing PPI. Interviewees also believed that relationships between the pharmaceutical industry, patient organisations, patients and the public needed to change to facilitate PPI in medicines R&D. Existing pharmaceutical industry codes of practice and negative media reporting of the pharmaceutical industry were also seen as negative influences on these relationships. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. Financial analysis of diabetic patients hospitalizations submitted to lower limb amputation in a public hospital

    Directory of Open Access Journals (Sweden)

    Renata Santos Silva

    2015-03-01

    Full Text Available This study is a documental descriptive analysis which aimed to verify the cost established in 2006, in relation to the hospitalization of 21 diabetic patients submitted to the lower limb amputation in a public hospital and the value transferred by the Unified Health System (SUS regarding this procedure. Among the studied patients, 57.14% were female and 42.86% male, aged 40 to 90 years. The time of diagnosis varied from 5 to 25 years. The average of hospitalization was 14 days per patient. The cost to the hospital was R$ 99,455.74, average cost per patient was R$ 4,735.98. The total amount transferred by SUS to the hospital was R$ 27,740.15, a cost 3.6 times lower than the hospital costs. The SUS transferring is in accordance with the predetermined values for its table of procedure. Prevention is the only alternative to reduce the rate of amputation and improve survival of diabetes patients. It is necessary an early diagnosis and better control of diabetes mellitus with appropriate government and institutional policies.

  10. Tip and Torque Angle of Permanent Teeth: A Comparison Between Treated Patients and Normal Group

    Directory of Open Access Journals (Sweden)

    A.F. Miresmaeili

    2005-01-01

    Full Text Available The angle of long axis of tooth crown is called tip in mesiodostal and torque in faciolingual direction. Both have special importance for producing an ideal occlusion. The aim of the present study was determination of the average tip and torque of each permanent tooth in well treated patients with edgewise system compare to control group with normal occlusion. In this study, 19 well treated cases through standard edgewise technique with non extraction strategy and 20 students of pre-university schools with normal occlusion according to IOTN were selected. Reference points and lines were marked on facial surface of each tooth on casts. Special device was designed for measuring the faciolingual and mesiodistal inclination of crowns. After 3 times measuring the tip and torque of teeth, student t-test and Kruskal – Wallis analysis were used for statistical analysis.The mean age of control group was 18.8 ± 0.5 year and in treated group was 20.3 ± 0.8. There was significant difference between mean of torque in control group and treated group for upper lateral incisor (4.75±5.21 , 8.76±5.82 respectively , p<0.03 . Also a significant difference was seen in average torque of lower second premolar between control group and treated one ( -23.48±5.99 , -26.66±4.64 respectively , p<0.05. There were no significant differences in tip of teeth between two groups. In comparison with Andrews study, in normal occlusion group, upper canine & first molar and lower lateral & first premolar had more buccal root torque. Except the torque of upper lateral incisor and lower 2nd premolar, torque and tip of other teeth had no significant difference.

  11. LEGAL BASES FOR DISCLOSING CONFIDENTIAL PATIENT INFORMATION FOR PUBLIC HEALTH: DISTINGUISHING BETWEEN HEALTH PROTECTION AND HEALTH IMPROVEMENT.

    Science.gov (United States)

    Taylor, Mark J

    2015-01-01

    The disclosure of confidential patient data without an individual's explicit consent should be for purposes that persons have reason to both expect and accept. We do not currently have the required level of clarity or consistency in understanding regarding the disclosure of confidential patient information for public health purposes to support effective public dialogue. The Health Service (Control of Patient Information) Regulations 2002 establish a legal basis in England and Wales for data to be disclosed for public health purposes without patient consent. Under the Regulations, there is more than one potential route towards lawful processing: Data may be processed for public health purposes under both Regulations 3 and 5. The alternatives have different safeguards and conditions attached, and their respective applicability to processing for purposes of public health improvement is currently unclear and subject to review. Beyond the need for clarity regarding the safeguards applicable to processing for particular public health purposes, there are reasons to prefer recognition that Regulation 5 is the most appropriate legal basis for disclosure when the purpose is public health improvement rather than public health protection. Where health improvement, rather than protection, is the aim, there is no justification for discarding the additional safeguards associated with processing under Regulation 5.

  12. Development of an information source for patients and the public about general practice services: an action research study.

    NARCIS (Netherlands)

    Marshall, M.; Noble, J.; Davies, H.; Waterman, H.; Walshe, K.; Sheaff, R.; Elwyn, G.

    2006-01-01

    OBJECTIVE: The publication of information about the performance of health-care providers is regarded as central to promoting greater accountability and empowering patients to exercise choice. The evidence suggests that the public is not very interested in accessing or using current sources of inform

  13. The Effect of Group Cognitive Therapy on Reducing Depression in the Female Patients with Severe Obsessive-compulsive Disorder

    Directory of Open Access Journals (Sweden)

    Vida Mohammadi Heris

    2016-09-01

    Full Text Available Introduction: The high prevalence of mental health problems among psychiatric patients with severe obsessivecompulsive disorder is depression that is one of the methods of non-pharmacological treatment of group cognitive therapy. In this study, the effect of cognitive therapy in reducing depression of female patients suffering from severe obsessive-compulsive disorder examined. Methods: In this study, patients were randomly divided into control and experimental groups and both groups were tested by Beck Depression Inventory before the intervention (second revision. The experimental group participated in ten sessions of cognitive therapy while the control group received no intervention. At the end of the intervention, both groups were evaluated by the test. Results: The data obtained using dependent and independent T test were evaluated. A positive impact in the cognitive therapy group showed decreased depression. Conclusion: The method of group cognitive therapy is effective in reducing depression in patients with severe obsessive-compulsive.

  14. Change mechanisms of schema-centered group psychotherapy with personality disorder patients.

    Directory of Open Access Journals (Sweden)

    Wolfgang Tschacher

    Full Text Available BACKGROUND: This study addressed the temporal properties of personality disorders and their treatment by schema-centered group psychotherapy. It investigated the change mechanisms of psychotherapy using a novel method by which psychotherapy can be modeled explicitly in the temporal domain. METHODOLOGY AND FINDINGS: 69 patients were assigned to a specific schema-centered behavioral group psychotherapy, 26 to social skills training as a control condition. The largest diagnostic subgroups were narcissistic and borderline personality disorder. Both treatments offered 30 group sessions of 100 min duration each, at a frequency of two sessions per week. Therapy process was described by components resulting from principal component analysis of patients' session-reports that were obtained after each session. These patient-assessed components were Clarification, Bond, Rejection, and Emotional Activation. The statistical approach focused on time-lagged associations of components using time-series panel analysis. This method provided a detailed quantitative representation of therapy process. It was found that Clarification played a core role in schema-centered psychotherapy, reducing rejection and regulating the emotion of patients. This was also a change mechanism linked to therapy outcome. CONCLUSIONS/SIGNIFICANCE: The introduced process-oriented methodology allowed to highlight the mechanisms by which psychotherapeutic treatment became effective. Additionally, process models depicted the actual patterns that differentiated specific diagnostic subgroups. Time-series analysis explores Granger causality, a non-experimental approximation of causality based on temporal sequences. This methodology, resting upon naturalistic data, can explicate mechanisms of action in psychotherapy research and illustrate the temporal patterns underlying personality disorders.

  15. Public expectations of health professionals when patients telephone for medical advice.

    Science.gov (United States)

    Smith, Saxon; Werren, Julia

    2008-08-01

    This article focuses on the ethical, social and liability implications of patients obtaining unsolicited medical advice over the phone. The ethical discussion centres on the demise of paternalism and the increase in patient autonomy and individualism and the growing public expectations of health professionals. The article then discusses the advantages and disadvantages of telephone consultations from a social and policy perspective. In light of these considerations it considers what the liability implications are for phone consultations. It argues that the ethic of individualism, coupled with recent Australian tort reforms, suggests that only in limited circumstances would a doctor be found liable for negligence in relation to telephone consultations. However, the increasing expectations being placed on medical personnel, as evidenced by the increase in unsolicited telephone consultations, if left untempered, may lead to a situation with which the health care system is ill equipped to deal.

  16. From plans to actions in patient and public involvement: qualitative study of documented plans and the accounts of researchers and patients sampled from a cohort of clinical trials.

    Science.gov (United States)

    Buck, Deborah; Gamble, Carrol; Dudley, Louise; Preston, Jennifer; Hanley, Bec; Williamson, Paula R; Young, Bridget

    2014-12-04

    : Patient and public involvement (PPI) in research is increasingly required, although evidence to inform its implementation is limited. Inform the evidence base by describing how plans for PPI were implemented within clinical trials and identifying the challenges and lessons learnt by research teams. We compared PPI plans extracted from clinical trial grant applications (funded by the National Institute for Health Research Health Technology Assessment Programme between 2006 and 2010) with researchers' and PPI contributors' interview accounts of PPI implementation. Analysis of PPI plans and transcribed qualitative interviews drew on the Framework technique. Of 28 trials, 25 documented plans for PPI in funding applications and half described implementing PPI before applying for funding. Plans varied from minimal to extensive, although almost all anticipated multiple modes of PPI. Interview accounts indicated that PPI plans had been fully implemented in 20/25 trials and even expanded in some. Nevertheless, some researchers described PPI within their trials as tokenistic. Researchers and contributors noted that late or minimal PPI engagement diminished its value. Both groups perceived uncertainty about roles in relation to PPI, and noted contributors' lack of confidence and difficulties attending meetings. PPI contributors experienced problems in interacting with researchers and understanding technical language. Researchers reported difficulties finding 'the right' PPI contributors, and advised caution when involving investigators' current patients. Engaging PPI contributors early and ensuring ongoing clarity about their activities, roles and goals, is crucial to PPI's success. Funders, reviewers and regulators should recognise the value of preapplication PPI and allocate further resources to it. They should also consider whether PPI plans in grant applications match a trial's distinct needs. Monitoring and reporting PPI before, during and after trials will help the

  17. Holter monitoring for syncope: diagnostic yield in different patient groups and impact on device implantation.

    Science.gov (United States)

    Kühne, M; Schaer, B; Moulay, N; Sticherling, C; Osswald, S

    2007-12-01

    Holter monitoring is routinely used in patients referred for the evaluation of syncope, but its diagnostic value in different patient groups is unclear, as is its impact on device implantation (pacemaker or cardioverter-defibrillator). To determine the diagnostic yield of Holter monitoring in the routine evaluation of syncope, and its impact on subsequent device implantation. Retrospective record review. We reviewed all Holter studies in patients referred with syncope between 2000 and 2005. Strict criteria were applied to determine whether a study was diagnostic. The diagnostic value of Holter monitoring (overall and in five subgroups: age, gender, structural heart disease, ejection fraction, medication) and its impact on the implantation of devices, were determined. Of 4877 Holter studies, 826 were performed in patients with syncope (age 72 +/- 15 years): 71 (8.6%) were considered to explain the syncope. Structural heart disease, ejection fraction and age were significant predictors of a diagnostic study (all p Holter did not explain their syncope, after mean 7 months, whereas 45 patients (5.4%) received a pacemaker based on the Holter results (p = 0.32). The overall diagnostic yield of Holter monitoring in the evaluation of syncope was 8.6%, with dramatic differences between subgroups. Our data suggest that the impact of Holter monitoring on device implantation is generally overestimated.

  18. The prevalence of clinical diagnostic groups in patients with temporomandibular disorders.

    Science.gov (United States)

    Machado, Luciana Pimenta e Silva; Nery, Cláudio de Góis; Leles, Cláudio Rodrigues; Nery, Marianita Batista de Macedo; Okeson, Jeffrey P

    2009-07-01

    The aim of this study was to observe the prevalence of diagnostic groups of temporomandibular disorders (TMD) in patients who were referred or sought treatment for TMD and/or orofacial pain in a private clinic. The clinical records of 357 patients were evaluated and selected based on inclusion/exclusion criteria; the mean age was 32 years. A clinical examination was performed and the diagnosis was based on the American Academy of Orofacial Pain criteria. Results showed that 86.8% of patients were women and 93.3% of the patients presented more than one diagnosis. The most frequent chief complaint (n = 216, chi2 = 30.68, p = 0.001) and total diagnosis realized (n = 748, chi2 = 14.14, p = 0.001) were muscle related. We concluded that women seek treatment for dysfunction/disorders of orofacial structures more than men do; patients seeking specialized treatment have more than one diagnosis and muscle dysfunction is more prevalent than intra-articular disorders.

  19. Examining adherence among challenging patients in public and private HIV care in Argentina

    Science.gov (United States)

    Jones, Deborah; Cook, Ryan; Cecchini, Diego; Sued, Omar; Bofill, Lina; Weiss, Stephen; Waldrop-Valverde, Drenna; Lopez, Maria R; Spence, Andrew

    2015-01-01

    Treatment engagement, retention and adherence to care are required for optimal HIV outcomes. Yet, patients may fall below the treatment recommendations for achieving undetectable viral load or not be retained in care. This study examined the most challenging patients in Buenos Aires, Argentina, those non-adherent to HIV care. Men (n = 61) and women (n = 59) prescribed antiretrovirals (ARVs) and non-adherent to treatment in the prior 3 to 6 months were enrolled and assessed regarding adherence, knowledge, motivation and attitudes regarding treatment. Private clinic patients had lower viral load and higher self-reported adherence than public clinic patients. Motivations to be adherent and positive beliefs regarding ARVs were associated with increased adherence in public clinic participants. Increased self-efficacy was associated with increased adherence among participants from both clinics. Results support patient and provider interventions that strengthen the characteristics supporting adherence, engagement and retention in public and private clinic settings. Resumen El compromiso, la retención en el cuidado y adherencia al tratamiento son esenciales para el manejo óptimo del paciente con VIH. Sin embargo, muchos pacientes con VIH no siguen las el tratamiento para lograr tener una carga viral indetectable, o no permanecen bajo cuidado médico. Este estudio examina los pacientes más difíciles de retener en el cuidado médico en Buenos Aires, Argentina. Hombres (n = 61) y mujeres (n = 59) a los que se les habían recetado antiretrovirales pero seguían el tratamiento en los últimos 3 - 6 meses participaron en el estudio. Adherencia, conocimiento, motivación y actitudes frente al tratamiento fueron evaluados. Los pacientes en la clínica privada tenían menor carga viral y mejor adherencia que los de la clínica pública. Motivación y pensamientos positivos con respecto a antiretrovirales estaban asociados con mejor adherencia en los pacientes de la clínica p

  20. Public Awareness toward Patients with AIDS%公众对艾滋病患者的认知心理

    Institute of Scientific and Technical Information of China (English)

    王仪

    2011-01-01

    After AIDS was discovered in 1981, it spreads around the world, and maintains the increasing trend in China. By the end of September 2004, a total of 89 067 HIV infection cases were reported in China, but this report is only the tip of the iceberg. Faced with such a special large groups, the level of social and psychological tolerance and care toward HIV/AIDS patients is lower than the demands of patients. Now this enormous contrast has become a problem of social public health and mental disorder. The public awareness levels on HIV/AIDS medical knowledge are generally not high. The incorrect psychological cognition is the social root of prejudice and discrimination. It is important to improve the social and psychological cognition level, promote the social psychological support for patients, guide the public to care this group and give a correct attitude toward AIDS patients, and learn the knowledge a-bout AIDS. Patients and the public should work together to improve the harmonious development of society, as so to achieve the goal of AIDS control and prevention.%艾滋病(AIDS)自1981年被发现后,已在全球肆虐蔓延,在我国也是保持着增长的流行趋势,截至2004年9月底,全国累计报告艾滋病病毒(HIV)感染者89 067例,此报告只是冰山一角.面对这么一个特殊的大群体,中国对HIV/AIDS罹患者的社会心理容忍、支持和关怀程度是低于罹患者本人社会心理支持需求的,这种强烈反差已成为目前我国社会公共卫生和精神障碍问题之一.公众对HIV/AIDS医学问题的社会认知水平普遍认识不高、心理认知不正确是产生偏见、歧视的社会根源.提高社会心理认知水平,促进社会对患者的心理支持,从心理学的角度指导公众关爱这个群体,正确对待AIDS病人,认识AIDS关传播知识,患者和公众齐心协力,使社会和谐发展,进而达到控制和预防AIDS的目的.

  1. The Supreme Court Permits Religious Groups To Use Public School Facilities: Good News Club v. Milford Central School.

    Science.gov (United States)

    Russo, Charles J.; Mawdsley, Ralph D.

    2001-01-01

    Reviews basis for U.S. Supreme Court's June 2001 decision in "Good News Club v. Milford Central School," where Court held that the Christian religious club for students had the Constitutional right under the Free Speech Clause to use public school facilities after school hours. Explains impact of decision on board of education policy.…

  2. The Impact of Public Private Partnerships on Education: A Case Study of Sewell Group Plc and Victoria Dock Primary School

    Science.gov (United States)

    Gibson, Helen; Davies, Brent

    2008-01-01

    Purpose: The purpose of this paper is to examine the implications of Public Private Partnerships (PPPs) for education delivery, attainment, attitude, behaviour and attendance. Partnership success factors are identified, and transferable lessons extracted. Barriers to the success of the partnership are explored and suggestions for improvement are…

  3. Duffy blood group genotypes among malariaPlasmodiumvivax patients of Baoulch population in southeastern Iran

    Institute of Scientific and Technical Information of China (English)

    Ebrahim Miri-Moghaddam; Zakaria Bameri; Mehdi Mohamadi

    2014-01-01

    Objective:To determine the distribution ofDuffy blood group genotypes inBalouch population as a major ethnic group that living in a sub-tropical area in southEast ofIran.Methods:In this study, theDuffy blood groupFY phenotypes were determined using indirect anti-globulin technique and also genotype byPCR-RFLP in160 vivax malaria patients and160 control individuals.Results:The results showed that the most commonDuffy genotype wasFYA/FYB (46.6%) followed byFYA/FYA(15.3%),FYA/FYO(14.4%),FYB/FYO(11.9%),FYB/FYB(10%) and FYO/FYO(1.9%).In case individuals, frequency ofFYA,FYB andFYO alleles were0.471,0.431 and0.097, respectively compaired to0.444,0.353 and0.203, respectively in control(non-infected) group.Conclusions:This data provide evidence that individuals with theFYA/FYB genotype have higher susceptibility to malaria and there are significant associations betweenDuffy blood group variants and susceptibility or resistance to vivax malaria.

  4. Distribution of ABO and Rh blood groups in patients with HELLP syndrome.

    Science.gov (United States)

    Sezik, M; Toyran, H; Yapar, E G

    2002-11-01

    The aim of this retrospective study was to evaluate the relationship between HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome and the maternal blood groups. Five hundred and forty-seven women with severe preeclampsia were included and divided into eight groups according to their blood groups: A Rh-positive (n=203), A Rh-negative (n=38), B Rh-positive (n=83), B Rh-negative (n=10), 0 Rh-positive (n=148), 0 Rh-negative (n=21), AB Rh-positive (n=39), and AB Rh-negative (n=5). The groups were controlled by analysis of variance and found to be homogeneous with respect to parity, gestational age, blood pressure, hemoglobin, hematocrit, platelet values, prothrombin time, partial thromboplastin time, fibrinogen, creatinine, alanine aminotransferase, aspartate aminotransferase, bilirubin, uric acid, and proteinuria. Incidence of HELLP syndrome was 24% in the overall study population whereas 48% of the patients with the blood group O Rh-negative had HELLP syndrome associated with an increase in risk by a factor of 3.1. To our knowledge this is the first report of such an association.

  5. Heart Failure Predictors in a Group of Patients with Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Sokol Myftiu

    2016-09-01

    Full Text Available AIM: The present study considers of the prevalence of heart failure (HF in patients suffering from acute myocardial infarction (AMI in the University Hospital Centre of Tirana (UHCT “Mother Theresa”; the demographic and clinical characteristics of the sample during hospitalization; and the main predictors of heart failure occurrence inside the group of patients suffering an AMI. MATERIAL AND METHODS: During a period of study from 2013-2015 we studied demographic and clinical data from 587 consecutive patients presenting with AMI; Framingham criteria were adopted for classifying patients with HF upon admission. RESULTS: A Killip class ≥ 2 was the main diagnostic criterion of HF during hospitalisation. HF was identified in 156 patients (26.6%. The subgroup with HF had significant differences when compared with the other patients with regard to age, sex (male, heart rate upon admission, systolic blood pressure on admission, previous episodes of AMI, glycemia on admission, previous antihypertensive treatment, previous revascularization procedures, peripheral vascular disease, chronic renal disease, ejection fraction (EF, anemia, and atrial fibrillation presence. Independent predictors for HF occurrence in the logistic regression model were EF, previous revascularization, peripheral vascular disease, age, sex, previous AMI, systolic blood pressure upon admission, and anaemia. CONCLUSION: As a conclusion, HF seems to be a common occurrence after AMI, in spite of changes in the epidemiological profile of the acute coronary syndrome. An increase in the incidence is registered as well, parallel to a decrease in the mortality following AMI. Attention must be shown for highly risked subpopulations, aged persons, patients with the previous coronary disease, and concomitant conditions.

  6. Disability in a Group of Long-stay Patients with Schizophrenia: Experience from a Mental Hospital.

    Science.gov (United States)

    Narayan, Kalita Kamal; Kumar, Deuri Sailendra

    2012-01-01

    Recovery from schizophrenia is a complex concept. Remission of symptoms of psychotic illnesses is not necessarily linked to better functioning. Among various causes of disability, mental illnesses account for 12.3% of the global burden of diseases. Long-term hospitalization has been recognized as counterproductive and a contributory factor of disability associated with schizophrenia. Under various circumstances, many persons with mental illness are brought to mental hospitals but the measures taken for their rehabilitation and follow-up care is insufficient. In the present study we tried to find out the level of psychopathology and the associated disability in a group of patients with schizophrenia who have been staying in a mental health institution for more than 5 years due to lack of proper caregivers in the society or in their home. The study is conducted in a mental hospital of northeast India. Of the 40 patients staying for more than 5 years in the hospital, 28 fulfilled the criteria for inclusion. The Brief Psychiatric Rating Scale and World Health Organization Disability Assessment Schedule II (WHO DASII) were used for those patients. Analytical statistical methods were used subsequently. Male patients were significantly older and had prolonged duration of stay. But the level of psychopathology did not differ significantly between male and female patients. Under WHODASII, understanding and communication problems are more prominent in both the groups. Of late, there are very few cases that required prolonged stay in the hospital. Many patients are fairly functional and are considered suitable for care outside hospital premises. Prolonged hospital stay is associated with more disability. Shorter hospital stays with proper family support is an ideal way to counteract this issue. However, due to the inadequate mandate in the Mental Health Act (MHA) 1987 and lack of other supportive facilities, patientsoften tend to languish in the hospital for longer duration

  7. Disability in a Group of Long-stay Patients with Schizophrenia: Experience from a Mental Hospital

    Directory of Open Access Journals (Sweden)

    Kalita Kamal Narayan

    2012-01-01

    Full Text Available Background: Recovery from schizophrenia is a complex concept. Remission of symptoms of psychotic illnesses is not necessarily linked to better functioning. Among various causes of disability, mental illnesses account for 12.3% of the global burden of diseases. Long-term hospitalization has been recognized as counterproductive and a contributory factor of disability associated with schizophrenia. Under various circumstances, many persons with mental illness are brought to mental hospitals but the measures taken for their rehabilitation and follow-up care is insufficient. Aim: In the present study we tried to find out the level of psychopathology and the associated disability in a group of patients with schizophrenia who have been staying in a mental health institution for more than 5 years due to lack of proper caregivers in the society or in their home. Materials and Methods: The study is conducted in a mental hospital of northeast India. Of the 40 patients staying for more than 5 years in the hospital, 28 fulfilled the criteria for inclusion. The Brief Psychiatric Rating Scale and World Health Organization Disability Assessment Schedule II (WHO DASII were used for those patients. Analytical statistical methods were used subsequently. Results: Male patients were significantly older and had prolonged duration of stay. But the level of psychopathology did not differ significantly between male and female patients. Under WHODASII, understanding and communication problems are more prominent in both the groups. Of late, there are very few cases that required prolonged stay in the hospital. Many patients are fairly functional and are considered suitable for care outside hospital premises. Conclusion: Prolonged hospital stay is associated with more disability. Shorter hospital stays with proper family support is an ideal way to counteract this issue. However, due to the inadequate mandate in the Mental Health Act (MHA 1987 and lack of other supportive

  8. Using CD4 counts to evaluate the stages and epidemiology of HIV infection in South Carolina public clinic patients.

    Science.gov (United States)

    Luby, S; Jones, J; Horan, J

    1994-01-01

    OBJECTIVES. CD4 lymphocyte counts decrease with the duration of human immunodeficiency virus (HIV) infection. We used CD4 counts collected for clinical reasons to evaluate the stage of HIV infection and the epidemiology of recent HIV infections among attendees of South Carolina's public health clinics. METHODS. We measured the CD4 T-lymphocyte counts of persons newly diagnosed with HIV infection April 1989 through June 1990 at South Carolina public health clinics who returned for follow-up. RESULTS. Of 812 newly diagnosed HIV-infected health department patients, 420 (52%) had their CD4 lymphocyte counts measured. Of these 420, 51 (12%) had CD4 counts of or = 900), which are associated with more recent HIV infection, were more common in females. CONCLUSIONS. In South Carolina, almost half of newly reported HIV-infected persons who agreed to CD4 testing at the health department might benefit from immediate drug therapy. Within this population, women may be an emerging risk group that requires specifically directed HIV prevention efforts. PMID:7907458

  9. The global counterfeit drug trade: patient safety and public health risks.

    Science.gov (United States)

    Mackey, Tim K; Liang, Bryan A

    2011-11-01

    Counterfeit drugs are a global problem with significant and well-documented consequences for global health and patient safety, including drug resistance and patient deaths. This multibillion-dollar industry does not respect geopolitical borders, and threatens public health in both rich and resource-poor nations alike. The epidemiology of counterfeits is also wide in breadth and scope, including thousands of counterfeit incidents per year, encompassing all types of therapeutic classes, and employing a complex global supply chain network enabling this illegal activity. In addition, information technologies available through the Internet and sales via online pharmacies have allowed the criminal element to thrive in an unregulated environment of anonymity, deception, and lack of adequate enforcement. Though recent global enforcement efforts have led to arrests of online counterfeit sellers, such actions have not stemmed supplies from illegal online sellers or kept up with their creativity in illegally selling their products. To address this issue, we propose a global policy framework utilizing public-private partnership models with centralized surveillance reporting that would enable cooperation and coordination to combat this global health crisis. Copyright © 2011 Wiley-Liss, Inc.

  10. Perpetuating 'New Public Management' at the expense of nurses' patient education: a discourse analysis.

    Science.gov (United States)

    Bergh, Anne-Louise; Friberg, Febe; Persson, Eva; Dahlborg-Lyckhage, Elisabeth

    2015-09-01

    This study aimed to explore the conditions for nurses' daily patient education work by focusing on managers' way of speaking about the patient education provided by nurses in hospital care. An explorative, qualitative design with a social constructionist perspective was used. Data were collected from three focus group interviews and analysed by means of critical discourse analysis. Discursive practice can be explained by the ideology of hegemony. Due to a heavy workload and lack of time, managers could 'see' neither their role as a supporter of the patient education provided by nurses, nor their role in the development of nurses' pedagogical competence. They used organisational, financial, medical and legal reasons for explaining their failure to support nurses' provision of patient education. The organisational discourse was an umbrella term for 'things' such as cost-effectiveness, which were prioritised over patient education. There is a need to remove managerial barriers to the professional development of nurses' patient education. Managers should be responsible for ensuring and overseeing that nurses have the prerequisites necessary for providing patient education as well as for enabling continuous reflective dialogue and opportunities for learning in practice.

  11. Multifactorial Analysis of Cardiovascular Risk Factors in a Group of Patients with Acute Myocardial Infarction

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    Maxim George Razvan

    2014-12-01

    Full Text Available Background and Aims: Acute myocardial infarction is one of the main causes of mortality worldwide, atherosclerosis being the most common mechanism of coronary artery obstruction. Many cardiovascular (CV risk factors are associated with these pathogenic processes. The aim of our study was to investigate a group of patients with ST-segment elevation acute myocardial infarction in terms of the prevalence of cardiovascular risk factors. Materials and Methods: We investigated 97 patients with acute myocardial infarction (AMI and 30 persons without AMI (control group for CV risk parameters (metabolic syndrome, diabetes, sedentary, dyslipidemia, glycosylated hemoglobin- HbA1c, and the risk of developing AMI. Results: We found statistically significant differences (p<0.05 for the patients with metabolic syndrome, diabetes, sedentary lifestyle, high level of total cholesterol, LDLc, HbA1c, low level of HDLc for the risk to develop AMI. Conclusion: This study emphasizes the need to implement measures of primary and secondary prevention, and carry out a strict control of cardiovascular risk factors as well as implicitly improve the therapeutic conduct.

  12. Testing the effectiveness of group-based memory rehabilitation in chronic stroke patients.

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    Miller, Laurie A; Radford, Kylie

    2014-01-01

    Memory complaints are common after stroke, yet there have been very few studies of the outcome of memory rehabilitation in these patients. The present study evaluated the effectiveness of a new manualised, group-based memory training programme. Forty outpatients with a single-stroke history and ongoing memory complaints were enrolled. The six-week course involved education and strategy training and was evaluated using a wait-list crossover design, with three assessments conducted 12 weeks apart. Outcome measures included: tests of anterograde memory (Rey Auditory Verbal Learning Test: RAVLT; Complex Figure Test) and prospective memory (Royal Prince Alfred Prospective Memory Test); the Comprehensive Assessment of Prospective Memory (CAPM) questionnaire and self-report of number of strategies used. Significant training-related gains were found on RAVLT learning and delayed recall and on CAPM informant report. Lower baseline scores predicted greater gains for several outcome measures. Patients with higher IQ or level of education showed more gains in number of strategies used. Shorter time since onset was related to gains in prospective memory, but no other stroke-related variables influenced outcome. Our study provides evidence that a relatively brief, group-based training intervention can improve memory functioning in chronic stroke patients and clarified some of the baseline factors that influence outcome.

  13. Clinical experiences in treating PTSD patients by combining individual and group psychotherapy.

    Science.gov (United States)

    Bilić, Vedran; Nemcić-Moro, Iva; Karsić, Vana; Grgić, Vesna; Stojanović-Spehar, Stanislava; Marcinko, Darko

    2010-06-01

    PTSD is a complex psychobiological disorder that causes disfunctionality in many areas. In treating PTSD different models have been applied, however, no general consensus on the method of treatment has yet been achieved. At the Clinic for Psychological Medicine we have developed the model of combined treatment for PTSD patients that involves outpatient individual psychotherapy, psychopharmacotherapy and group psychotherapeutic techniques introduced within repeated day-hospital treatments. In this paper the efficiency of the above mentioned model has been explored. Three PTSD patients have been presented. We assessed changes in psychological functioning of our subjects on the basis of clinical observation and analysis of the session protocols. The model of combined and long-term treatment of PTSD in which the approach to traumatized patients has been mostly supportive, including supportive psychotherapeutic interventions and psychopharmacotherapy, has proved to be efficient in achieving integration of traumatic experiences and consolidation of the traumatised Self. Combination of individual and group approach facilitates the analysis of traumatic transference, whereas more mature defence patterns become stronger and integration of traumatic experiences improved. Consolidation of the Self leads to better socialization.

  14. [Advances of selenium supplementation in posttraumatic stress disorder risk group patients].

    Science.gov (United States)

    Voĭtsekhovskis, V V; Voĭtsekhovska, Iu G; Shkesters, A; Antsane, G; Silova, A; Ivashchenko, T; Michans, Ia; Vaĭvads, N

    2014-01-01

    Posttraumatic stress disorder (PTSD) is a complex of symptoms developed in a patient after traumatic event. The basis of PTSD pathophysiology is hyper activation of neurones under stress factors influence, so-called excitotoxicity, followed by oxidative stress (OS) because of an accumulation of free radicals. Lipid peroxidation can lead to neurons damage. Neurons are especially susceptible to OS, changing signal transduction and information processing mechanisms. Clinically excitotoxicity preforms as different acute and/or chronic stress reactions and can cause PTSD. Selenium (Se) is involved on different stages of transport and metabolism of Glutamate. Research aim: to access PTSD incidence, OS parameters and their adjustment advances using organic Se in PTSD risk group patients. PTSD symptomatic severity (in PCL-M points) reduced for 5.85% to baseline, Prevalence Rate reduced for 46.03% to baseline in Se group patients. We can conclude that: 1) there is a statistically reliable correlations between the incidence of PTSD and OS parameters, between PTSD symptomatic severity and OS parameters; 2) the use of Se during the mission can reduce the OS parameters, minimize the incidence of PTSD and reduce the PTSD symptomatic severity.

  15. Study on occupational therapy groups for caregivers of families with schizophrenia patients

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    Angélica da Silva Araujo

    2014-04-01

    Full Text Available Objective: To know the main aspects featuring the experience of caring for a family member who is schizophrenic and discuss the possible therapeutic benefits which arise from the participation of caregivers in occupational therapy groups. Methodological procedures: Qualitative-descriptive study, performed in a mental health ambulatory at a general hospital in the state of São Paulo. Data was collected through audio-recording in occupational therapy groups which counted on the participation of 10 family-caregivers of schizophrenic patients with follow-up treatment at this ambulatory. The data were analyzed through the thematic content analysis of Lawrence Bardin. Results: Caregivers of schizophrenic patients face daily difficulties arising from living together with their beloved ones and coping with their behaviors. These caregivers stress the importance of groups as a possible opportunity to have contact with other experiences of people under similar conditions, which not only enables them to clear doubts concerning the illness and the provided care, but also to reflect on the importance of taking care of themselves. Conclusions: There is great need for new studies that address this issue and develop continuous therapeutic interventions that offer caregivers the possibility to be heard about their experiences and to share information, aiming to prepare them to offer a more effective care for the schizophrenic family member and others with mental disorders. The importance of evaluating such interventions is therefore highlighted.

  16. 'Never heard of it'- understanding the public's lack of awareness of a new electronic patient record.

    Science.gov (United States)

    Bratan, Tanja; Stramer, Katja; Greenhalgh, Trisha

    2010-12-01

    The introduction of electronic patient records that are accessible by multiple providers raises security issues and requires informed consent - or at the very least, an opportunity to opt out. Introduction of the Summary Care Record (SCR) (a centrally stored electronic summary of a patient's medical record) in pilot sites in the UK was associated with low awareness, despite an intensive public information programme that included letters, posters, leaflets, and road shows. To understand why the public information programme had limited impact and to learn lessons for future programmes. Linguistic and communications analysis of components of the programme, contextualized within a wider mixed-method case study of the introduction of the SCR in pilot sites. Theoretical insights from linguistics and communication studies were applied. The context of the SCR pilots and the linked information programme created inherent challenges which were partially but not fully overcome by the efforts of campaigners. Much effort was put into designing the content of a mail merge letter, but less attention was given to its novelty, linguistic style, and rhetorical appeal. Many recipients viewed this letter as junk mail or propaganda and discarded it unread. Other components of the information programme were characterized by low visibility, partly because only restricted areas were participating in the pilot. Relatively little use was made of interpersonal communication channels. Despite ethical and legal imperatives, informed consent for the introduction of shared electronic records may be difficult to achieve through public information campaigns. Success may be more likely if established principles of effective mass and interpersonal communication are applied. © 2010 Blackwell Publishing Ltd.

  17. SERVICE QUALITY PERCEPTIONS AND PATIENTS' SATISFACTION: A COMPARATIVE CASE STUDY OF A PUBLIC AND A PRIVATE SECTOR HOSPITAL IN PAKISTAN

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    Kanwal Nasim

    2014-09-01

    Full Text Available Management of hospitals should take initiatives to improve the overall service quality of patient care. Regular feed-back from patients should be taken and rules should be made considering the expectations and requirements of patients. This study attempts to examine the satisfaction of patients from service quality they received from hospitals. Moreover, satisfaction is measured in both public and private hospital.

  18. Short-term operational evaluation of a group-parenting program for Japanese mothers with poor psychological status: adopting a Canadian program into the Asian public service setting.

    Science.gov (United States)

    Goto, Aya; Yabe, Junko; Sasaki, Hitomi; Yasumura, Seiji

    2010-07-01

    Although parenting practices differ across various sociocultural settings, scientific research on parenting intervention in Asia is scarce. We adopted a Canadian multilanguage group-based parenting program (Nobody's Perfect) into the Japanese public health service setting and evaluated its impact. Our program was feasible as a public service; was well-accepted among the participants with low psychological status, many of whom were first-time mothers; and had a potential positive impact on the mood of mothers and the self-evaluation of their abilities in society. Our results may facilitate and provide direction for similar research in Asia.

  19. Communication in a Human biomonitoring study: Focus group work, public engagement and lessons learnt in 17 European countries.

    Science.gov (United States)

    Exley, Karen; Cano, Noemi; Aerts, Dominique; Biot, Pierre; Casteleyn, Ludwine; Kolossa-Gehring, Marike; Schwedler, Gerda; Castaño, Argelia; Angerer, Jürgen; Koch, Holger M; Esteban, Marta; Schoeters, Greet; Den Hond, Elly; Horvat, Milena; Bloemen, Louis; Knudsen, Lisbeth E; Joas, Reinhard; Joas, Anke; Dewolf, Marie-Christine; Van de Mieroop, Els; Katsonouri, Andromachi; Hadjipanayis, Adamos; Cerna, Milena; Krskova, Andrea; Becker, Kerstin; Fiddicke, Ulrike; Seiwert, Margarete; Mørck, Thit A; Rudnai, Peter; Kozepesy, Szilvia; Cullen, Elizabeth; Kellegher, Anne; Gutleb, Arno C; Fischer, Marc E; Ligocka, Danuta; Kamińska, Joanna; Namorado, Sónia; Reis, M Fátima; Lupsa, Ioana-Rodica; Gurzau, Anca E; Halzlova, Katarina; Jajcaj, Michal; Mazej, Darja; Tratnik, Janja Snoj; Huetos, Olga; López, Ana; Berglund, Marika; Larsson, Kristin; Sepai, Ovnair

    2015-08-01

    A communication strategy was developed by The Consortium to Perform Human Biomonitoring on a European Scale (COPHES), as part of its objectives to develop a framework and protocols to enable the collection of comparable human biomonitoring data throughout Europe. The framework and protocols were tested in the pilot study DEMOCOPHES (Demonstration of a study to Coordinate and Perform Human biomonitoring on a European Scale). The aims of the communication strategy were to raise awareness of human biomonitoring, encourage participation in the study and to communicate the study results and their public health significance. It identified the audiences and key messages, documented the procedure for dissemination of results and was updated as the project progressed. A communication plan listed the tools and materials such as press releases, flyers, recruitment letters and information leaflets required for each audience with a time frame for releasing them. Public insight research was used to evaluate the recruitment material, and the feedback was used to improve the documents. Dissemination of results was coordinated in a step by step approach by the participating countries within DEMOCOPHES, taking into account specific national messages according to the needs of each country. Participants received individual results, unless they refused to be informed, along with guidance on what the results meant. The aggregate results and policy recommendations were then communicated to the general public and stakeholders, followed by dissemination at European level. Several lessons were learnt that may assist other future human biomonitoring studies. Recruitment took longer than anticipated and so social scientists, to help with community engagement, should be part of the research team from the start. As a European study, involving multiple countries, additional considerations were needed for the numerous organisations, different languages, cultures, policies and priorities

  20. THE RELATIONSHIP BETWEEN MARKETING MIX AND PATIENT LOYALTY IN INTENSIVE CARE UNIT, ANUTAPURA PUBLIC HOSPITAL PALU

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    Muh. Ryman Napirah

    2016-09-01

    Full Text Available Background: The problem generally faced by hospital is unable to pro