Biomedical subjects
J Heinik
Publications and source records attributed to J Heinik.
[The new generation of antidepressants: are they really new?].
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Hyperthyroidism and the organic anxiety syndrome.
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Process and organizational characteristics of memory clinics in Israel: a national survey.
A survey was conducted to describe the characteristics and activities of memory clinics in Israel. A structured questionnaire was mailed to 25 memory clinics, accompanied by a cover letter and a returning envelope. The questionnaire included items regarding: (a) administrative structure of the clinic (the period and place of operation, number of staff and their professions); (b) patients' characteristics (monthly number of patients, sources of referral and eligibility criteria); (c) assessment methods used (history, cognitive screening instruments, functional status assessment, neuroimaging and laboratory tests); (d) the assessment process (length of assessment, family involvement); and (e) outcomes of the assessment process. Twelve questionnaires were returned, yielding a 52% response rate. Overall, there was agreement regarding the general operating characteristics of the clinics. The majority was based on an interdisciplinary team including a physician, a nurse and a social worker. The mean number of new monthly patients attending the clinics was 24 (range 7-70), and the main source of referral was the Sick Funds. Mostly all clinics used the Mini Mental State Examination as a screening instrument and performed psychological, physical, neurological, and laboratory examinations. Medication treatment was the main outcome reported by the clinics. In a country like Israel, where geriatric psychiatry services are still developing, there is an increasing need to expand the number and type of services provided by memory clinics.
Social worker estimations of life span in terminal cancer patients.
The objective of this study was to evaluate the accuracy of the social worker estimation (SWE) of the length of survival of patients who were seen at the end stage of their terminal illness, in home-based palliative care treatment. Estimates were filled out on a form every 2 weeks during the time of the visits until the patient's discharge or death. The wording used by the social worker was the 'average survival period'. Survival was measured from the time of each survival prognostication until death from any cause. Both SWE and actual survival were categorized into 12 weeks. Then, 29 estimates were analyzed using the SPSS statistical software package. The mean and median actual survivals of the total cohort were 6.5 and 5.1 weeks, respectively. The minimum and maximum weeks of actual survival were 0.1 and 23.1, respectively. The mean and median differences between SWE and actual survival were 2.1 and 1.6 weeks, respectively (range: 18.7, minimum and maximum differences of -7.3 and 11.4 weeks, respectively). The Pearson correlation coefficient between actual survival and SWE was 0.827 (P<0.001). Overall, 59% (17/29) were correctly assigned by social worker to the correct survival categories. Our study suggests that the oncology social worker can be a valuable resource for information about the patient's prognosis of life span.
Accuracy of recall memory in elderly patients in response to telephone support calls.
During the Gulf War, 93 elderly patients (mean age 74 years) received telephone-based support calls from a hospital-based home care facility. Accuracy of memory recall of these telephone support calls was assessed 6 weeks after the termination of the war by means of a postal questionnaire. The relative accuracy of the recall memory of these patients or their caregivers to the telephone calls received exhibited a sensitivity of 75%, a specificity of 78%, a positive predictive value of 60% and a negative predictive value of 88%. Patients who had received four calls demonstrated better memory recall than those receiving less than four. Thus, relying upon patient's memory alone may be insufficient for evaluating survey data in the elderly. In addition, we found that only patients who correctly remembered receiving four individual telephone support calls tended to exhibit a decrease in the anxiety level. This study emphasizes the importance of repeated interventional telephone calls as a method of increasing recall accuracy and decreasing anxiety in aged patients.