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Biomedical subjects

P Dore

Publications and source records attributed to P Dore.

At least 19 recordsLinked to original sources
PubMed1997

Adolescents' and providers' perspectives on the need for and use of mental health services.

PURPOSE: This study examines need for and use of services from both the adolescent's and the service provider's viewpoints. METHODS: The Youth Services Project interviewed 792 youths from the juvenile justice, education, primary health care, and child welfare sectors (200 each); gathered anonymous tallies of the mental health of youthful clients at each sector; and conducted focus groups with providers. RESULTS: A high percentage of youths (12-15%) met DSM-IV criteria for a mental health disorder, yet the sector clients were not identified as having mental health problems. Juvenile justice and child welfare sectors identified the highest percentage of adolescent clients as having mental health problems, and provided the most services (50-80%). The primary health care sector recorded no mental health disorders among the tallied clients, and provided the fewest mental health services (< 20%). Providers' complaints that they lacked knowledge concerning mental health assessment and lacked referral or treatment resources closely paralleled the degree to which their sector underserviced youths. CONCLUSION: Lack of knowledge about the extent of need in adolescents, methods for assessing or treating, and referral resources handicap service providers and explain the gap between need and service.

Adolescent↗
PubMed1997

Physical and cognitive functioning among chronically ill African-American and white elderly in home care following hospital discharge.

OBJECTIVES: Although race is recognized as an important variable in health status and medical care, the conditions of African-American and white elders have not been studied sufficiently as they enter home care after hospital discharge. This study tests hypotheses that African-American elders enter home care sicker, more dependent, and cognitively impaired. METHODS: Hypotheses were tested in two independent studies, both conducted in a Midwestern city. Study 1 compares the physical and cognitive conditions of 208 African-Americans and white elders discharged home after hospitalization for congestive heart failure. Data were obtained from medical records and from patient interviews. Study 2 compares the physical and cognitive conditions of 212 African-Americans and white elders discharged home after hospitalization for hip fracture, cerebral vascular accident, and congestive heart failure. Data were obtained from medical records and interviews with patients' discharge planners. RESULTS: African-Americans were found to go home more sick, more dependent, and more cognitively impaired, although no race difference was found in instability at discharge. CONCLUSIONS: These findings raise concerns about African-American elders' access to care in community settings, given their greater needs at discharge.

Activities of Daily Living↗
PubMed1997

Long-term evolution of daytime somnolence in patients with sleep apnea/hypopnea syndrome treated by continuous positive airway pressure.

We demonstrated in a previous study that excessive daytime sleepiness (EDS) in patients who have sleep apnea/hypopnea syndrome (SAHS) and are undergoing continuous positive airway pressure (CPAP) treatment improved differently in two groups of patients: in group I, multiple sleep latency tests (MSLT) were normalized after 50 days of treatment (individual value > 10 minutes), whereas they remained low (individual value < 10 minutes) in group II, with a significant difference between groups. To evaluate the long-term evolution of daytime somnolence under nasal CPAP treatment, five patients from group I and seven patients from group II underwent a new polysomnography and MSLT 4 years after the previous study. Clinical, polysomnographic and MSLT results obtained at baseline before treatment (T1), after the initial 50-day period of CPAP treatment (T2), and after 4 years (T3) were compared. The significant difference in mean MSLT value between the two groups previously observed at T1 and T2 disappeared at T3 (group I: 12.4+/-5.9 minutes; group II: 9.7+/-5.9 minutes). We found that this long-term improvement in excessive daytime somnolence was independent of the initial MSLT value, the severity of SAHS, and the initial MSLT changes under nasal CPAP. Long-term MSLT evolution was significantly correlated to CPAP compliance. These results demonstrate that even in the absence of a significant increase in MSLT at the beginning of CPAP treatment, further improvement is still possible several years later, which may encourage the regular, long-term use of nasal CPAP by patients.

Aged↗
PubMed1996

Racial differences in discharge planning.

Given previously reported findings of racial differences in elderly people's use of posthospital care, this article focuses on discharge planning processes as explanations of differential service utilization. We studied the discharge plans for 369 African American and white elderly patients and examined options pursued for posthospital care by social workers, patients, and families for evidence of racial differences. We also looked for racial differences in ruling out nursing home care for reasons of patient and family preference. Discharge planning with African American patients and family members involved less pursuit of nursing home care and more pursuit of formal services in the home than planning with white patients and families. Implications for practice and future research are discussed.

Black or African American↗
PubMed1995

Post-hospital home care for African-American and white elderly.

This study of 208 chronically ill African-American and white elderly entering home care after hospitalization examined race differences in informal and formal services received and adequacy of care. Controlling for marital status, interference in activities from chronic conditions, socioeconomic status, age, and gender in regression analyses, African-Americans received significantly fewer hours of formal care per week but received significantly more hours of informal care per week from the primary caregiver. However, there was a tendency for African-Americans to rate their care as less adequate. Implications of the findings for practice, policy, and research are discussed.

Black or African American↗
PubMed1995

Person and environment in HIV risk behavior change between adolescence and young adulthood.

This article explores how personal and environmental variables influence change in human immunodeficiency virus (HIV)-related risk behaviors between adolescence and young adulthood. Repeated interviews with 602 youths from 10 cities across the United States provide the data. These interviews first occurred in 1984-1985 and 1985-1986 when the youths were adolescents and were repeated again in 1989-1990 and 1991-1992 when they were all young adults. A longitudinal multivariate analysis shows that 31% of the variance in HIV risk behaviors by inner-city young adults is predicted by a combination of adolescent risk behaviors, personal variables (suicidality, substance misuse, antisocial behavior), environmental variables (history of child abuse, poor relations with parents, stressful events, peer misbehavior, number of AIDS prevention messages), and interactions between variables (number of neighborhood murders with child abuse, number of neighborhood murders with substance misuse, and unemployment rates with antisocial behavior).

Adolescent↗
PubMed1994

Predictive factors of long-term compliance with nasal continuous positive airway pressure treatment in sleep apnea syndrome.

The long-term acceptability of treatment with nasal continuous positive airway pressure (CPAP) was studied prospectively in 44 patients with obstructive sleep apnea syndrome. At 14 months on the average after starting treatment with CPAP, 30 patients (68 percent) were found to be compliant (characterized by use of the apparatus every night throughout the night, for more than 5 h per night). The daily use of nasal CPAP was significantly correlated to the initial apnea/hypopnea index (p = 0.013; r = 0.37), as well as to the percentage of light sleep (p = 0.045; r = 0.30) and slow-wave sleep (p = 0.037; r = -0.31) during the initial polygraphic recording. We found a strong correlation between the daily use of nasal CPAP and the difference in the apnea/hypopnea index (p = 0.025; r = -0.34), the difference in mean oxygen saturation during sleep (p = 0.013; r = 0.38), and the difference in hypersomnia scores (p = 0.006; r = -0.40) obtained before and after treatment by nasal CPAP. Thus, patients used CPAP much more if they had an initial significant clinical handicap and if they were aware of the beneficial effects of CPAP. Under these conditions, patients tended to use the apparatus for the optimal length of time, regardless of the side effects linked to the treatment. This ensured efficacy and the maintenance of good compliance. This study confirms the importance of supervision of the time counter, as well as regular encouragement of patients to use the treatment as long as possible each night, in order to extract a maximum benefit from treatment by nasal CPAP.

Adult↗
PubMed1994

Inner-city youths and condom use: health beliefs, clinic care, welfare, and the HIV epidemic.

This paper examines questions concerning condom use and determinants of change in use by inner-city youths who appear to be in the direct path of the AIDS epidemic. Detailed information gathered in interviews with 548 youths in 1989-90 and 1991-92, provide a history of change in condom use and HIV-related high-risk behaviors. Condom use as a whole increased with time and age. Positive beliefs concerning condoms and awareness of HIV transmission were determinants of increases in use, and negative beliefs were determinants of decreases. Nevertheless, those youths who engaged in the highest HIV-risk behaviors (prostitution, IV drug use, and male homosexuality) were no more likely than lower-risk youths to increase their condom use. Financial need, indicated by receipt of welfare, appeared to be a significant barrier to increasing condom use. Also noteworthy was the negative association between using health clinics and condom use. Although youths with high-risk behaviors make more clinic visits, those visits do not result in condom use.

Adolescent↗
PubMed1994

[Sacral tuberculous osteitis].

The authors report a case of a 5 year old child suffering from isolated sacral tuberculosis which presented as sudden and total loss of function of the left leg. The rarity of this bony site, and the recurrence at nine months of a presacral abscess after 9 months of anti-tuberculous treatment in an HIV negative child, vaccinated with BCG, justify the presentation of this observation.

Child, Preschool↗
PubMed1993

Magic Johnson.

Explore the source record for details and available documents.

Adolescent↗
PubMed1992

[Bilateral chylothorax after mild trauma: apropos of a case].

The authors report a new case of bilateral chylothorax predominant on the left side, which occurred after movements of body trunk hyperextension in a 52-year old woman without any notable history. The clinical signs revealing the lesion were left thoracic pain and dyspnoea. The effusion had been preceded by a painless and transient left cervical tumefaction. The outcome was favourable after two left pleural draining punctures and rest.

Athletic Injuries↗
PubMed1992

[Inflammatory polyp: a rare benign endobronchial tumor].

We report a case of inflammatory polyp in a male patient, which was totally obstructing the left main bronchus but could be removed by simple endoscopic traction. The polyp was responsible for an absence of left lung ventilation which in turn produced by reflex an absence of left lung perfusion completely reversible after removal of the polyp. Inflammatory polyp is a rare benign tumour. Its physiopathology is controverted, but it seems to result from local irritation of the bronchial mucosa. Bronchial endoscopy is the essential examination which in most cases make it possible to diagnose and treat the tumour.

Adult↗
PubMed1992

[Mucoepidermoid bronchial carcinoma. Review of the literature apropos of a new case].

Muco-epidermoid bronchial tumours are rare and characterized by the coexistence of epidermoid, mucus-secreting and intermediate cells. The authors report the case of a 22-year old unmarried woman hospitalized for exploration of a febrile dyspnoea related to a right superior lobar atelectasis. Endoscopy showed a smooth, pediculate tumour arising from the right superior lobar bronchus where bronchial biopsy was negative. Right superior lobectomy was performed through thoracotomy and established the diagnosis of muco-epidermoid bronchial tumour. Surgery was followed by radiotherapy of the chest. Over a 5-year follow-up period there was no local or extrathoracic recurrence, and the patient is in good condition.

Adult↗