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PubMedDate not supplied

AIDS knowledge, perceived risk and prevention among adolescent clients of a family planning clinic.

In a survey that measured AIDS knowledge, perceived risk and prevention among 404 sexually active adolescent women who were family planning clinic patients in Baltimore, knowledge about AIDS was high, with the average respondent answering seven out of nine questions correctly. Slightly more than half of the teenagers reported some degree of perceived risk that they could get AIDS. However, perceived AIDS risk was not predictive of condom use at last intercourse. The strongest predictor of condom use was having asked a partner to use one, suggesting that adolescent women may exert a greater influence on condom use than has been previously assumed. The analyses result in recommendations that personalized AIDS prevention programs be integrated into family planning programs, that adolescent clients be advised to use condoms with spermicides, and that they be assisted in acquiring the social skills needed to negotiate condom use with partners.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Inpatient treatment of anorexia nervosa.

In this paper the indications for inpatient treatment of anorexia nervosa are reviewed. Although all programs aim at weight gain and normalization of eating habits, the means for achieving these goals vary widely from nursing encouragement, operant conditioning or, rarely, hyperalimentation. Most programs now utilize an integrated treatment program that includes a weight restoration program, individual psychotherapy and family involvement. Nutritional considerations during inpatient treatment are also reviewed. The signs and symptoms that commonly occur during weight restoration are outlined. The major psychodynamic conflicts that occur are described and psychotherapeutic methods for treating each are presented.

Adolescent↗
PubMed2006

Managing acutely ill substance-abusing patients in an integrated day hospital outpatient program: medical therapies, complications, and overall treatment outcomes.

BACKGROUND: Substance-abusing adults are admitted to hospitals for medical complications from their drug and alcohol use at substantially higher rates than the general public; yet, their care is often defined by against medical advice (AMA) discharges and low rates of referral to addiction treatment programs. METHODS: We present findings from a chart review of consecutive admissions to an integrated medical-substance abuse treatment program designed for acutely ill, hospitalized substance using adults. We specifically looked at factors associated with program completion and medical complications in this cohort of at-risk adults. RESULTS: Overall, 83 patient cases were studied. The mean age was 41.2 years; most were African American (73.5%), male (68.7%), and homeless (77.1%). Heroin (96.4%) and cocaine (88.0%), followed by alcohol (44.6%) were the most commonly used substances before admission. The most common admitting diagnoses were infectious endocarditis (43.4%), abscess or nonhealing ulcer (18.1%), and osteomyelitis (13.3%) with intravenous antibiotic (68.7%), physical therapy (48.2%), or wound care (41.0%), the most commonly prescribed care on the integrated care/day hospital unit. The mean length of stay in the day hospital was 12.4 days. Overall, 69.9% of patients successfully completed their medical therapy, and 63.9% were successfully referred to an outpatient substance abuse treatment program. Only 10.8% required an unscheduled hospital readmission and 15.7% required an after-hours emergency department visit during their stay. CONCLUSION: Outpatient/day hospital-based integrated treatment is a viable option for medically ill substance-abusing adults who would otherwise be hospitalized and is associated with higher than expected completion rates and low rate of complications. Co-locating the unit at a hospital and integrating extensive social supports appear to be key components to this model.

Acute Disease↗
PubMed1988

State government at the grass roots: a community relations approach to mental health program development.

Integrating consultation and education and community organization techniques within a community relations framework has proven effective in catalyzing a productive partnership between grass-roots, community leaders and a state mental health program. The programmatic accomplishments-enhanced mental health services for the most vulnerable populations, including the aged, the chronically mentally ill, and high-risk youth, and enhanced community and political support for mental health services, all achieved without increase in state mental health expenditures-validate a methodology which is applicable in a wide variety of mental health settings.

Community Mental Health Services↗
PubMed2006

An object-oriented programming system for the integration of internet-based bioinformatics resources.

The Internet consists of a vast inhomogeneous reservoir of data. Developing software that can integrate a wide variety of different data sources is a major challenge that must be addressed for the realisation of the full potential of the Internet as a scientific research tool. This article presents a semi-automated object-oriented programming system for integrating web-based resources. We demonstrate that the current Internet standards (HTML, CGI [common gateway interface], Java, etc.) can be exploited to develop a data retrieval system that scans existing web interfaces and then uses a set of rules to generate new Java code that can automatically retrieve data from the Web. The validity of the software has been demonstrated by testing it on several biological databases. We also examine the current limitations of the Internet and discuss the need for the development of universal standards for web-based data.

Computational Biology↗
PubMed2006

Evaluation of a comprehensive integrated workplace-based program to reduce occupational musculoskeletal injury and its associated morbidity in a large hospital.

OBJECTIVE: The objective of this study was to investigate the effectiveness of an integrated workplace-based program to reduce musculoskeletal injuries (MSIs) and the impact of those injuries in healthcare workers. METHODS: A pre-/postintervention with concurrent control study design was applied-3 years of data before the program with 1 year of data during the program. RESULTS: Time-loss (TL) MSIs increased at the intervention site during the intervention year. However, the program returned injured employees back to work in a shorter time and, compared with average historical data, reduced compensation costs and healthcare costs associated with TL MSIs during the first year. CONCLUSION: The findings that MSI-associated TL and compensation costs were significantly lower during the program illustrates the effectiveness of this program and demonstrates that increased reporting of MSIs need not be associated with increased claims costs.

Accidents, Occupational↗
PubMed2004

[The Integrated Psychological Treatment (IPT) program in an ambulatory psychiatric context: a clinical study].

Among the actual rehabilitation programs offered to patients with schizophrenic disorders, the IPT (Integrated Psychological Treatment) is one paradigm which combines cognitive and psychosocial strategies. A solid body of evidence, derived from controlled studies, indicates that IPT improves cognitive and social functioning and reduces symptoms severity. Nevertheless, little is known about its efficacy in routine clinical conditions. In this article, the authors address this issue. Our clinical experience with IPT in an ambulatory psychiatric service is presented. The results show that only few patients find useful to participate to all IPT strategies. Patients who refuse or accept to be enrolled in this rehabilitation program share the same demographic, clinical., symptoms and cognitive characteristics. After two years, the outcome of these two groups is similar when we consider the rate of readmissions, the number of hospitalisations, the length of stay and the number of suicides. These observations suggest that IPT strategies in clinical routine are probably less efficient than in well controlled studies. They also raise the question to define an individualised rehabilitation program that fits particular patients' needs.

Adult↗
PubMed2006

Efficacy of an integrated continuing medical education (CME) and quality improvement (QI) program on radiation oncologist (RO) clinical practice.

PURPOSE: There has been little radiation oncologist (RO)-specific research in continuing medical education (CME) or quality improvement (QI) program efficacy. Our aim was to evaluate a CME/QI program for changes in RO behavior, performance, and adherence to department protocols/studies over the first 12 months of the program. METHODS AND MATERIALS: The CME/QI program combined chart audit with feedback (C-AWF), simulation review AWF (SR-AWF), reminder checklists, and targeted CME tutorials. Between April 2003 and March 2004, management of 75 patients was evaluated by chart audit with feedback (C-AWF) and 178 patients via simulation review audit (SR-AWF) using a validated instrument. Scores were presented, and case management was discussed with individualized educational feedback. RO behavior and performance was compared over the first year of the program. RESULTS: Comparing the first and second 6 months, there was a significant improvement in mean behavior (12.7-13.6 of 14, p = 0.0005) and RO performance (7.6-7.9 of 8, p = 0.018) scores. Protocol/study adherence significantly improved from 90.3% to 96.6% (p = 0.005). A total of 50 actions were generated, including the identification of learning needs to direct CME tutorials, the systematic change of suboptimal RO practice, and the alteration of deficient management of 3% of patients audited during the program. CONCLUSION: An integrated CME/QI program combining C-AWF, SR-AWF, QI reminders, and targeted CME tutorials effectively improved targeted RO behavior and performance over a 12-month period. There was a corresponding increase in departmental protocol and study adherence.

Clinical Competence↗