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Biomedical subjects

P Solomon

Publications and source records attributed to P Solomon.

At least 73 records · Page 4Linked to original sources
PubMed1994

Explaining attitudes toward medication compliance among a seriously mentally ill population.

Data from a clinical trial of consumer-delivered case management services were used to construct an explanatory model for attitudes toward medication compliance, focusing on psychosocial factors. A regression model explaining attitudes toward medication compliance shows that more positive attitudes toward compliance are related to older age, fewer symptoms, and a broader array of daily activities involving social relations. Participation in social activities is a practical goal of psychosocial rehabilitation services that support compliance with medication regimens and psychiatric treatment.

Activities of Daily Living↗
PubMed1994

Satisfaction with mental health treatment in a randomized trial of consumer case management.

It was hypothesized that the clients assigned to a consumer team of case managers, because they share similar life experiences interacting with the mental health system, would have greater satisfaction with mental health treatment than clients assigned to a team of nonconsumer case managers. Ninety-one clients with serious and persistent mental illness randomly assigned to consumer and nonconsumer case management teams were interviewed after 1 year of service. While clients served by a consumer team of case managers were less satisfied with mental health treatment, personal characteristics of individual case managers were more important in explaining differences in satisfaction with treatment than whether the client was served by the consumer or nonconsumer team.

Adult↗
PubMed1994

Predictors of reincarceration among patients who received psychiatric services in jail.

OBJECTIVE: The study sought to determine the proportion of patients treated in a jail psychiatric service who were jailed again within a year of release and to identify the factors that most effectively predicted jail recidivism in this population. METHODS: Clinical records for a random sample of 231 persons who received treatment at a jail psychiatric service were reviewed. Logistic regression analysis of 160 cases not transferred from jail to the state prison was used to identify factors, including demographic and clinical variables and prior jail detention, that predicted reincarceration within a year of release from jail. RESULTS: Younger age, a history of substance abuse, and prior jail detention were strong predictors of jail reincarceration. CONCLUSIONS: Return to jail is more likely for a subgroup of jail detainees for whom appropriate, effective treatment is less available in the community. Further research is needed to investigate the relationship between the course of substance abuse and jail reincarceration among younger psychiatric patients. Innovative treatments might be used to engage patients while in jail and follow them into the community after release.

Adolescent↗
PubMed1994

Jail recidivism and receipt of community mental health services.

OBJECTIVE: The authors' aim was to test the relationship between receipt of desired community mental health services by homeless mentally ill forensic clients and whether the clients returned to jail within six months. METHODS: Mentally ill homeless clients leaving jail were randomly assigned to three service conditions: intensive case management provided by an assertive community treatment team, intensive case management provided by individual case managers, and referral to a community mental health center. Data on whether clients' service needs were met were analyzed using discriminant function and chi square analyses. RESULTS: Thirty-two percent of the 105 clients interviewed at six months were reincarcerated during the six-month study period. Jail recidivism was related to receipt of fewer services that clients reported they needed, specifically to receipt of fewer services for developing independent living skills. Service condition was not significantly related to return to jail. CONCLUSIONS: Case management, a flexible community-based service that does not lend itself to clearly prescribed procedures, may easily deteriorate into providing monitoring rather than rehabilitative services for forensic clients and thus may facilitate reincarceration.

Activities of Daily Living↗
PubMed1994

Real-time ultrasonographic analysis of the normal postpartum uterus: technique, variability, and measurements.

We evaluated normal uterine involution prospectively with real-time ultrasonography in 100 women after uncomplicated term vaginal delivery. Transducers easily distorted the spongy uterus during early postpartum scanning, an effect minimized with sector transducers that are superior to linear or convex probes for accurate early postpartum uterine measurement. Long-axis measurements correcting for uterine angulation were the most reproducible and accurate, irrespective of bladder distention. Uterine contractions caused instability of particularly the transverse dimension. Increasing maternal parity was associated with slightly but significantly larger uterine dimensions up to 4 weeks post partum. The uterus reassumed nongravid dimensions by 6 to 8 postpartum weeks. Uterine involution was unrelated to infant birth weight or breast feeding.

Anthropometry↗
PubMed1994

Soft-tissue expansion before total knee arthroplasty in arthrodesed joints. A report of two cases.

We report two cases in which arthrodesed knees were revised to total arthroplasties after the use of soft-tissue expanders. Case 1 had had multiple operations on her knee and had been arthrodesed for septic arthritis two years earlier. Case 2 had had knee arthrodesis for severe osteoarthritis 18 years before revision. In both patients, tissue expanders were used to increase the soft tissues available for cover and to help to mobilise the extensor mechanism. The operations were made much easier, and in both patients a range of motion from 0 degrees to 90 degrees was achieved at operation.

Adult↗
PubMed1993

Sensitivity of Sickness Impact Profile items to measure change over time in a low-back pain patient group.

The purpose of this study was to identify Sickness Impact Profile (SIP) items that are most sensitive to change in patients with low-back pain. Seventy-six patients with low-back pain were administered the SIP at their initial visit and after discharge from physiotherapy treatment. A formal item reduction was performed to identify the most sensitive items. An item was considered sensitive if it showed change in 20% of the patients and had an item-corrected total SIP score correlation greater than 0.30. Twenty items were identified. Seven of the 20 items identified in this study appear on the Roland-Morris disability questionnaire. Also, only 50% of the items identified are from the physical subscale of the SIP.

Activities of Daily Living↗
PubMed1993

Community service utilization by youths hospitalized in a state psychiatric facility.

A majority of a cohort of 62 children and adolescents who had been hospitalized in a state psychiatric facility was found to have received less restrictive services such as outpatient mental health services prior to their index admission. Also, a number had been involved with the juvenile justice system and almost two-thirds had been placed out-of-home. Ninety percent had at least one prior psychiatric hospitalization. Just over half of the cohort received case management and individual counseling post release. About a third received family counseling, and a few received other types of services. At least a third were rehospitalized within a year of release. Although 90% of the cohort received some type of service post release, a higher proportion of non service receivers were rehospitalized than service receivers. Even those who received services had a high rate of rehospitalization. These findings raise questions as to the appropriateness of service provision during and following hospitalization.

Adolescent↗
PubMed1993

An assessment of gender as a factor among severely mentally disabled case management clients.

Ninety-four clients who were receiving intensive case management services were assessed for gender differences on a variety of sociodemographic and clinical characteristics, functioning level, social network and subjective and objective quality of life. The high degree of similarities among male and female clients in the study suggests the possibility that mental disability is more socially handicapping than gender. An alternative explanation is that there is a paucity of gender sensitive measures available to evaluate mental health services. Regardless of gender, younger clients were less satisfied with their living arrangement and were less satisfied with family relations, although young women were least satisfied with family relations. The need for development of gender sensitive measures and the development and evaluation of services addressing needs of women with serious mental illness is discussed.

Adult↗
PubMed1993

Clinical evaluation: physiotherapists' ranking of competencies.

The competencies to be assessed as part of the process of clinical evaluation of students need to be determined. This paper describes a method establishing the emphasis or weights assigned to each area of competency. Clinicians and clinical educators were asked to rate a number of dummy student evaluation forms and the individual competencies on each form. Category weights were derived and the magnitude of these weights were used to rank the categories. The derived ranks were compared to the rater's overt ranking of the categories. The weightings are compared to those reported in other studies which examine the value placed on clinical competencies by clinicians.

Attitude of Health Personnel↗
PubMed1993

Horner's syndrome following a thyroidectomy.

A case of Horner's syndrome following a thyroidectomy for a benign multinodular goiter is presented, the literature reviewed, and possible explanations are discussed. Theories to explain this phenomenon include: local trauma to the sympathetic chain during retraction of the carotid sheath, anatomical variations which leave a patient susceptible to damage to the sympathetic chain, postoperative hematoma compressing the sympathetic chain, and ischemic damage to the sympathetic chain.

Aged↗
PubMed1992

Service needs of youths released from a state psychiatric facility as perceived by service providers and families.

The following article reports on the results of service needs assessments of a cohort of youths released from a state psychiatric facility as perceived by service providers and families/caregivers. Families as well as service providers consistently agreed on three service areas of high need--psychotherapy for the child, family therapy and parent skill training. However, families perceived a need for a number of other services that are not traditionally provided by the mental health system such as after school recreation activities and self-help and support groups for the child. The discrepancies between service providers and families' perceptions of assessed needs may lead to families dropping out of service due to the unresponsiveness of the services in meeting their perceived needs. Steps that service providers need to take to be more responsive to the needs of families are discussed.

Adolescent↗
PubMed1992

The efficacy of case management services for severely mentally disabled clients.

A comprehensive review of published and unpublished research studies of case management for severely mentally disabled adults was undertaken. This yielded 20 studies of four models of case management, Full Support, Personal Strengths, Rehabilitation and Expanded Broker Models. This article reviews these models, the research studies, the outcomes of these studies and conclusions that can be drawn regarding the efficacy of case management services for severely mentally disabled adults. Future directions for research in this area are recommended.

Adaptation, Psychological↗
PubMed1992

Assessment of therapeutic relationship of community-agency workers.

This article reports on the ratings of the personal and professional characteristics of community-based workers for children and adolescents who had recently been released from a psychiatric inpatient service. The child/adolescent's family members/caregivers and the community workers both responded to the same items of a questionnaire. Families/caregivers rated the community workers with whom they were the most and the least satisfied. Community workers rated themselves in relation to these study children and/or their families. Findings indicate that both family members/caregivers and the community workers themselves saw community workers performing relatively well in the areas of providing information and offering support to families. Likewise, both assessed the service providers as having the greatest deficits in the area of teaching skills for child/adolescent home management. Suggestions for meeting the needs of the families and for ensuring that a system of care for child/adolescents is child-centered and family-focused are discussed.

Adolescent↗
PubMed1992

The closing of a state hospital: what is the quality of patients' lives one year post-release?

The closing of a state psychiatric facility afforded an opportunity to assess the quality of life of a cohort of patients who were released. Patients were interviewed a month after release and again a year later. Patients spent about half their time in mental health programs, but few were engaged in community activities or in employment. Cohort members mainly turned to mental health workers and case managers for support and problem resolution, as they had limited supports to turn to otherwise. Patients desired assistance in such areas as money management. In a number of areas of daily living, cohort members desired assistance a year after discharge, more so than upon release. Despite this, a year after release patients appeared to be quite positive toward themselves and their quality of life.

Activities of Daily Living↗
PubMed1992

Learning contracts in clinical education: evaluation by clinical supervisors.

Learning contracts can be a useful learning and evaluation tool within a clinical setting provided the supervisor shifts their role from one of imparter of knowledge to facilitator of learning. If this role is not assumed then a student's learning experience could be jeopardized. In a survey of 59 student supervisors, 90 percent found the learning contract to be a useful evaluation and teaching tool. Advantages stated suggest that the learning contract promotes negotiation between student and teacher, provides a flexible learning environment and promotes acquisition of self-directed learning skills. These qualities are important in a clinical or practical setting where learning experiences cannot be standardized.

Canada↗