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Biomedical subjects

J H Shore

Publications and source records attributed to J H Shore.

At least 37 records · Page 2Linked to original sources
PubMed1988

Developing minimal national standards for clinical experience in psychiatric training.

There are no minimum standards for the clinical training of psychiatrists with regard to the type and number of patients evaluated or treated. Interest in establishing such standards derives from a need for greater accountability, a high fail rate on the clinical portion of the American Board of Psychiatry and Neurology examinations, and an increasing demand for precise documentation of competence in specific areas by hospital privileging committees. Although considerable disagreement exists as to what the overall requirements should be, some minimum requirements can be agreed on. The authors discuss concerns about minimal standards and make suggestions for further development of standards.

Clinical Competence↗
PubMed1987

The Oregon experience with impaired physicians on probation. An eight-year follow-up.

Sixty-three addicted or impaired physicians who had been on probation with the Oregon Board of Medical Examiners were followed up in a new rehabilitation program for eight years. A majority (59%) were still on probation at follow-up, and 75% were rated as stable and improved. Problems of addiction affected 78%. The most successful treatment outcomes were for addicted physicians whose improvement was significantly associated with random urine monitoring to detect repetitive drug abuse. This research confirms an effective treatment approach for addicted or impaired physicians and is compared with other outcome studies.

Adult↗
PubMed1987

A comparison of schizophrenic patients in different community support treatment approaches.

Recent advances in the care of the chronically mentally ill in the community have resulted in a "community support system" approach to maintaining chronically mentally ill persons outside the hospital. Yet, very little is known of what a community support system actually is for the chronic mental patient. This paper looks at three different sorts of community support programs and compares a sample of patients within them with respect to network variables, role performance, and demographic variables. Implications regarding the use of network oriented approaches are discussed and directions for further research are explored.

Aftercare↗
PubMed1987

Academic, community and state mental health program collaboration: the Oregon experience.

The authors review the relationship that has evolved over the years between the Department of Psychiatry at Oregon Health Sciences University and Oregon's community and state mental health programs. They describe the compatibility that exists between the basic requirements of academic psychiatry departments and public mental health programs and demonstrate how these organizations have been able to fulfill one another's needs in Oregon. Specific examples of successful collaborations in the areas of education, administration, research, and service are presented to illustrate how relationships that have been designed to meet specific requirements of one organization can fulfill many requirements of both. Suggestions are provided for those organizations contemplating similar collaborative endeavors.

Community Mental Health Centers↗
PubMed1987

Psychiatric side effects from topical ocular timolol, a beta-adrenergic blocker.

Neuropsychiatric side effects have been reported with various systemic betablockers. Data submitted to the National Registry of Drug-Induced Ocular Side Effects appear to indicate similar adverse reactions secondary to topical ophthalmic timolol. One hundred sixty-three of 369 central nervous system cases (44%) reported depression, psychosis, confusion, and hallucinations following topical ophthalmic timolol administration. The psychiatric community should be aware that sudden changes in mental status or onset of common psychiatric conditions, such as depression, may be due to topical ocular timolol. Withdrawal of the drug usually results in disappearance of these effects in 1 to 7 days.

Aged↗
PubMed1986

Psychiatric reactions to disaster: the Mount St. Helens experience.

Following the 1980 Mount St. Helens volcanic eruption, psychiatric reactions were studied in the disaster area and in a control community. Using the new criterion-based diagnostic method for psychiatric epidemiologic research, the Diagnostic Interview Schedule, the authors found a significant prevalence of disaster-related psychiatric disorders. These Mount St. Helens disorders included depression, generalized anxiety, and posttraumatic stress reaction. There was a progressive "dose-response" relationship in the comparison of control, low-exposure, and high-exposure groups. The dose-response pattern occurred among both the bereaved and the property-loss victims.

Adolescent↗
PubMed1986

Evaluation of mental effects of disaster, Mount St. Helens eruption.

This psychiatric epidemiology study following the Mount St. Helens volcanic disaster revealed a significant morbidity for psychiatric disorders. The increased prevalence showed a dose response pattern in three population groups. The findings are reported as relative and attributable risk for the two exposed populations as compared to a control group. Patterns of significant risk are presented for sex, age, and for victims with pre-existing physical illness. The research utilized a new criteria-based interview schedule for the identification of psychiatric disorders. The methodology is reviewed in the context of the controversies and assumptions within the field of behavioral response to disaster stress. There are important implications for public health planning and intervention.

Adult↗
PubMed1985

Does community care for the mentally ill make a difference? A tale of two cities.

Matched groups of schizophrenic patients in Portland, Ore., and Vancouver, B.C., were compared approximately 1 year following discharge from an index hospitalization. Whereas Vancouver boasts a rich network of accessible private services and a public mental health system that provides a model of care for the chronically mentally ill, Portland's aftercare facilities at the time of the study were limited. One year after discharge the Vancouver cohort experienced fewer readmissions, was more apt to be employed, and reported a higher level of well-being, all of which suggest that community aftercare positively affects the negative symptoms of schizophrenia.

Adolescent↗
PubMed1984

The VA psychiatry service as a setting for residency education.

The authors report data from a survey of chairmen of academic departments of psychiatry and chiefs of Veterans Administration (VA) psychiatry services concerning administrative relationships between academic psychiatry departments and VA psychiatry services and the education of psychiatry residents in VA settings. The extent and quality of relationships, the interdependence of academic departments and VA psychiatry services, factors important for good VA training, and advantages and disadvantages of using the VA for residency education are documented. The authors present their conclusions and recommendations for improving the quality of relationships between academic departments and VA psychiatry services and for strengthening psychiatric education in the VA setting.

Academic Medical Centers↗
PubMed1981

Morbidity and mortality in the commitment process.

This study reports a prospective evaluation of 189 patients who entered the commitment process in Oregon. Patients were assessed for commitment status, morbidity, and mortality at six and 19 months. Twenty-nine percent were formally committed. The committed group consisted largely of violence-prone, psychotic patients plus a small number of elderly, demented subjects with serious medical illness. A mortality of 10% included the elderly who died of medical causes and young adult patients who completed suicide. The findings justify psychiatry's concern for patient welfare in commitment systems, especially for the group that is released and not committed. The study is compared with six additional commitment studies, with emphasis on methodology and implications for further research.

Adult↗
PubMed1981

Training psychiatrists to work with community support systems for chronically mentally ill persons.

Community support programs are becoming a major priority in community mental health centers throughout the country. The authors present a training design that integrates principles and skills associated with this model into a 4-year residency training program. The aim of such programs is to keep young psychiatrists involved and in the forefront of the newer approaches to the treatment of chronically mentally ill persons.

Chronic Disease↗
PubMed1981

Psychopharmacology in medical practice--the benefits and the risks.

Psychopharmacology has become a major approach to treatment in primary medical care. However, combined psychiatric and medical illness can give rise to some challenging diagnostic problems. Furthermore, drug treatment of patients with such illnesses can involve important drug-disease interactions and drug-drug interactions. One should keep in mind the issues that arise when an emotionally troubled patient would benefit from a psychotropic drug but a concurrent medical illness complicates this treatment. An awareness of both the medical and psychiatric issues involved may make successful treatment possible.

Adult↗