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At least 487 records · Page 27Linked to original sources
PubMed1977

[Individual psychotherapy. Theoretical-practical aspect of institutional psychotherapy].

The author explains the characteristics of the psychiatric outpatient population in Hermosillo and mentions that these do not allow for the use of traditional psychotherapy. He underlines the importance of the affective ties of the patient with the institution (based on previously formed stereotypes). The author describes also several short therapy techniques, such as persuasion, suggestion, brief psychotherapy and group psychotherapy (for which special training is required). He tells of his experience using psychotherapy with psychiatric medication in an institution.

Humans↗
PubMed1989

A two-institution study of transfusion practice in 78 consecutive adult elective open-heart procedures.

Blood salvage techniques and increasingly conservative physician transfusion practice in cardiac surgery have led to reports of homologous blood exposure in as few as 10% of patients having elective cardiac revascularization surgery (Ann Thorac Surg 1985;40:380). To identify current prevailing transfusion practice between centers, the authors prospectively audited 49 and 29 consecutive adult elective open-heart surgery cases (78 total) at two centers. Thirty-six of 49 patients (73%) received 245 homologous blood units (HBs) at institution 1 (m = 5.0). Fifteen of 29 (52%) received 84 HBs at institution 2 (m = 2.9, P less than 0.05). Sex, age, duration of surgery, intraoperative blood salvaged, preoperative hematocrit (Hct), nadir Hct, and nadir platelet counts, and the surgeon were all found to be determinants of transfusion practice at institution 1 but not at the other. The data indicate that (1) determinants of homologous blood exposure are not consistent between institutions and instead reflect "prevailing practice" rather than need; (2) a prospective multi-institution audit of prevailing transfusion practice in cardiac revascularization is needed to address this; (3) autologous blood pre-deposit is underused in open-heart surgery.

Blood Transfusion↗
PubMed2002

National Academy of Neuropsychology/Division 40 of the American Psychological Association practice survey of clinical neuropsychology in the United States, Part I: practitioner and practice characteristics, professional activities, and time requirements.

Leaders of the National Academy of Neuropsychology and Division 40 (Clinical Neuropsychology) of the American Psychological Association determined that current information on the professional practice of clinical neuropsychology within the United States (U.S.) was needed. These two organizations co-sponsored a national survey of U.S. clinical neuropsychologists that was conducted in September 2000. The primary goal of the survey was to gather information on such topics as: practitioner and practice characteristics, economic variables (e.g., experience with major third party payors, such as Medicare and managed care), practice expenses, billing methods, experiences with Current Procedural Terminology (CPT) codes, time spent on various clinical tasks, use of assistants, and income. The adjusted return rate of 33.5% (n = 1,406) reflects the number of surveys returned with sufficient data by licensed doctoral level clinicians with membership in one or both sponsoring organizations. In this first of two articles describing the survey results, characteristics of practitioners and practices, various types of professional activities, and time requirements for clinical tasks are presented and discussed. It was noted that the proportion of women in the field is increasing rapidly. Private practice is the predominant employment setting. Findings also document that members of the two sponsoring organizations are very similar with regard to employment setting, professional characteristics, and weekly activities. That is, involvement in clinical practice and research, as well as private practice versus institutional employment, was very similar between organizations. However, across organizations, work setting (private practice vs. institution) was associated with significant and meaningful differences. Private practitioners have a more diverse set of weekly clinical activities, are less likely to use assistants, and engage in more forensic activities. Across work setting, with the exception of forensic evaluations, those using assistants invest a greater number of hours per evaluation, but bill approximately the same numbers of hours per evaluation.

Academies and Institutes↗
PubMed2000

Institutional variability in red blood cell conservation practices for coronary artery bypass graft surgery. Institutions of the MultiCenter Study of Perioperative Ischemia Research Group.

OBJECTIVE: To assess whether substantial institutional variability exists in red blood cell conservation practices associated with coronary artery bypass graft (CABG) surgery. DESIGN: Prospective, randomized patient enrollment and data collection. SETTING: Twenty-four U.S. academic institutions participating in the Multicenter Study of Perioperative Ischemia. PARTICIPANTS: A well-defined subset of primary CABG surgery patients (n = 713) expected to be at low risk for bleeding and exposure to allogeneic transfusion. INTERVENTIONS: None (observational study). MEASUREMENTS AND MAIN RESULTS: Frequency of use of red blood cell conservation techniques was determined among institutions. Correlation was determined between use of each technique and transfusion of allogeneic red blood cells and between use of each technique and median institutional blood loss. Significant variability (p < 0.01) was detected in institutional transfusion practice with respect to the use of predonated autologous whole blood, normovolemic hemodilution, red cell salvage, and reinfusion of shed mediastinal blood. The frequency of institutional use of these techniques was not associated with allogeneic transfusion (r2 < 0.15) or blood loss (r2 < 0.10) in the low-risk population of patients examined. CONCLUSIONS: Institutions vary significantly in perioperative blood conservation practices for CABG surgery. Further study to determine the appropriate use of these techniques is warranted.

Blood Loss, Surgical↗
PubMed2000

[Current status and need for neurological practices from regional medical institutions].

We studied the current status of, and need for, neurological practices from regional medical institutions, including in-home services. These institutions classify patients with neurological diseases into three categories: cerebrovascular disease, intractable diseases, and other diseases with neurological symptoms. As acute and chronic neurological diseases run their course, patients require appropriate care, including diagnosis, treatment, rehabilitation, and in-home medical care. Rehabilitation is essential for patients with intractable or progressive disease because it helps to prevent progression, enhances mental health, and encourages the use of abilities that are unaffected by disease. As neurologists, we must consider how we can have a positive impact on the patient, the hospital, and the community. In Japan, the majority of patients who receive in-home medical care have neurological disorders, such as cerebrovascular disease or other intractable diseases. We have provided in-home support to 18 patients with amyotrophic lateral sclerosis who use ventilators. This year, a long-term care insurance system was instituted in Japan. Now, a support system needs to be established to provide community-based medical care, health care, and welfare services. As our population ages, we believe neurologists will play an increasingly important role in this support system.

Amyotrophic Lateral Sclerosis↗
PubMed2003

Institutional variability in transfusion practice for liver transplantation.

We prospectively evaluated the institutional variability in perioperative transfusion therapy in orthotopic liver transplantation (OLT). Adult OLTs completed during a 12-mo period were studied until the 48th postoperative hour at 8 centers. A multivariate analysis using mixed-effects logistic regression included variables predisposing to blood loss and a center random effect. In addition, the influence of the calculated perioperative hemoglobin (Hb) loss on the individual probability of receiving red blood cells (RBCs), fresh frozen plasma (FFP), and platelets in excess of the overall median were explored. The analysis was performed on 301 cases. The overall median numbers transfused were 5 RBC units, 6 FFP units, and the median platelet dose was 5.10(11), with significant intercentric differences in the proportions of cases given more than the overall median. Intercentric differences remained significant after adjustment for factors independently associated with a large blood component use. Intercentric differences in RBCs, FFP, and platelet use decreased but persisted after adjustment for the perioperative Hb loss. Intercentric differences in RBC use disappeared after adjustment for the postoperative Hb concentration. The significant heterogeneity in transfusion therapy mandates reassessment of the rational use of blood products in OLT.

Adult↗
PubMed1977

[Individual psychotherapy. Institutional psychotherapy: theoretical-practical aspect].

The author describes his experience in institutional psychotherapy, at the Clínica Hospital of Villahermosa, Tabasco. He mentions factors in the patient, in the psychiatrist, in the institution and in the culture, as fostering the success or the failure of institutional psychotherapy. He shows the effectiveness of this type of treatment in this enviroment and describes ways of improving this kind of work.

Humans↗
PubMedDate not supplied

Finding a practical method to increase engagement of residents on a dementia care unit.

Previous research has shown that it is possible to increase the engagement of residents with dementia in daily activities by making changes in institutional care practices. However, these changes often require expensive and cumbersome staff training programs that long-term care facilities may be unlikely to adopt and maintain. This study evaluates a simple, inexpensive recording and feedback procedure to increase resident engagement in a way that may be more amenable to adoption by long-term care facilities. Nursing assistants working in a locked dementia care unit were asked to complete a daily activity record on which they recorded the amount and quality of resident engagement. The facility's activity director was asked to read these activity records each day and give immediate, positive feedback to the nursing assistants. This procedure was evaluated by using a control series design. Results revealed baseline engagement observations with a mean of 11 percent, which increased to a mean of 44 percent during observations under treatment conditions. This study suggests that simple, inexpensive changes in institutional practices can make meaningful improvements in the level of engagement of residents with dementia.

Activities of Daily Living↗