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PubMedDate not supplied

Stress in adult students with schizophrenia in a supported education program.

The successful integration of former psychiatric inpatients into the community requires innovative programs of psychosocial rehabilitation, including supported education. This article examines psychological distress as an outcome variable, and social support and coping strategies as mediating variables among 70 service-user students (SUS) with schizophrenia and a comparison group of 55 adult students (AS) with no psychiatric diagnosis. Both groups were participants in a supported education program. The study variables were assessed by standardized research instruments: the Talbieh Brief Distress Inventory (TBDI), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Coping Inventory for Stressful Situations (CISS). Univariate and multivariate analyses were used. Compared with the control subjects, SUS reported higher emotional distress and the utilization of emotion-oriented coping strategies, and a lesser availability of social support from family and friends. These variables explained 46.3%, 24.5%, and 22.5%, respectively, of the total variance in psychological distress scores. The findings provide the basis for interventions geared to reduce distress and, as a result, to enable students with severe mental illness to fully utilize the supported education program.

Adaptation, Psychological↗
PubMed2004

[Dual diagnosis of psychosis and addiction. From principles to practice].

The prevalence of comorbidity of psychosis and substance abuse/addiction has been on the rise during the last 10-20 years. Meanwhile, dual diagnosis patients (DD patients) represent a large core group among patients with schizophrenia, and they are difficult to treat. Biological, psychological, and social factors may account for the comorbidity, and the single factors may interact with each other. DD patients tend to have poor compliance and unfavorable outcomes with frequent psychotic relapses and hospitalizations. Efficient treatment models integrate traditional psychiatric therapy and therapy of addiction and modify or adjust the two components to each other. The most successful programs offer integrated treatment for both disorders in one setting. These programs focus on outpatient treatment, they offer pharmacotherapy, motivation therapy, psychoeducation, cognitive-behavioral therapy, and family interventions, and they can achieve significant improvements of social adjustment and decreases of substance use.

Combined Modality Therapy↗
PubMed1988

[Transmission of Dusseldorf Integrated Medical Documentation data by a personal computer. A new concept in the flexibility of the Dusseldorf Integrated Medical Documentation system].

The software package HOST PC was created as an important expansion of the oncological aftercare program INMEDD (Integrated Medical Documentation Düsseldorf). INMEDD itself provides only small evaluation capabilities. HOST PC is able to transmit data from INMEDD on a host computer to a personal computer. This transmission is fully automated. On the personal computer the data is stored in a database, which is completely compatible with the standards of dBase III. These created databases can be evaluated and analyzed by a lot of standard software packages. Therefore a wide range of individual statistical evaluation, analyzing with optional criteria and graphic presentation can be realized with small expenses of time and money. HOST PC increases the attractiveness of INMEDD and therefore improves the aftercare of cancer patients.

Aftercare↗
PubMedDate not supplied

Public health departments providing sexually transmitted disease services.

Results of a 1995 survey reveal that 1,437 local health departments-half of those in the country-provide sexually transmitted disease (STD) services and receive about two million client visits each year. Their clients are predominantly individuals with incomes of less than 250% of the poverty level (83%), women (60%) and non-Hispanic whites or blacks (55% and 35%, respectively); 36% of clients are younger than 20, and 30% are aged 20-24. On average, 23% of clients tested for STDs have chlamydia, 13% have gonorrhea, 3% have early-stage syphilis, 18% have some other STD and 43% have no STD. Virtually all public STD programs offer testing and treatment for gonorrhea and syphilis; only 82% test for chlamydia, but 97% provide treatment for it. Some 14% offer services only in sessions dedicated to STD care, 37% always integrate STD and other services, such as family planning, in the same clinic sessions, and 49% offer both separate and integrated sessions. STD programs that integrate services with other health care typically cover nonmetropolitan areas, have small caseloads, serve mainly women and provide a variety of contraceptives. In contrast, those that offer services only in dedicated sessions generally are in metropolitan areas and have large caseloads; most of their clients are men, and few provide contraceptive methods other than the male condom.

Adolescent↗
PubMedDate not supplied

An interdisciplinary clinical advancement program within a patient-centered care model.

Restructuring in health care does not have to compromise the pursuit of clinical excellence and quality patient care. The clinical advancement program (CAP) at the Hospital for Special Care is a newly developed multidisciplinary reward and recognition program for clinical staff. The program is integrated into the hospital's structure of service line management and, unlike traditional advancement programs, is open to all levels of care providers: professional personnel, technical staff, and aides. This article describes the basic features of the CAP model and how its was developed by a multidisciplinary task force.

Career Mobility↗
PubMed1990

Integrated AIDS management.

AIDS is a multi-disciplinary problem, but also a multi-disciplinary opportunity, given the capacity of individuals, groups and organizations to integrate talents and resources. The impact of AIDS in east, southern and central Africa is discussed in general terms to answer the question. "Why integrate?" Ways in which integration is expressed are discussed, including integration within the definition of AIDS management, integration within programs, and between team members, between the community and the hospital, and from field programs to Ministries of Health, donor organizations and the World Health Organization. Issues in integration at the field level, including management models, the concept of teams, and consensus on major goals, are discussed, and comment is made on the key integrative theme of families and communities.

Acquired Immunodeficiency Syndrome↗
PubMed1990

A set of programs for analysis of kinetic and equilibrium data.

A program package that can be used for analysis of a wide range of kinetic and equilibrium data is described. The four programs were written in Turbo Pascal and run on PC, XT, AT and compatibles. The first of the programs allows the user to fit data with 16 predefined and one user-defined function, using two different non-linear least-squares procedures. Two additional programs are used to test both the evaluation of model functions and the least-squares fits. One of these programs uses two simple procedures to generate a Gaussian-distributed random variable that is used to simulate the experimental error of measurements. The last program simulates kinetics described by differential equations that cannot be solved analytically, using numerical integration. This program helps the user to judge the validity of steady-state assumptions or treatment of kinetic measurements as relaxations.

Algorithms↗
PubMedDate not supplied

The integration of problem-based learning strategies in distance education.

The authors explore the redesign of a traditional distance nursing program to integrate problem-based learning (PBL) strategies. Using pre- and postcourse questionnaires, learning satisfaction was compared between students who attended the PBL course face-to-face and those who received the course via audio-teleconferencing. Tutor and student perceptions of PBL via audio-teleconferencing are also described. Study results suggest that audio-teleconferencing is an effective means of delivering PBL by distance education.

Adult↗
PubMed2004

Perspectives on integrated child health information systems: parents, providers, and public health.

The efforts of families, health care providers, and public health programs to optimize health care and health outcomes for children are often limited by the lack of timely, complete, and accurate health information. Families frequently serve as the messenger between providers in providing clinical details that they may not understand, because the paper record of previous care is unavailable. Providers believe in the value of good information, but haven't the time, training, or financial resources to create better data sharing methods. Public health programs often must rely on unacceptably slow, redundant, or otherwise limited data collection efforts to provide population-based assessments of child health problems that inform public policy and program development. Integrated child health information systems allow the appropriate, secure sharing of health data that are critical to improving these processes. Developing such systems will require a strong commitment from these 3 stakeholder groups and attention to human values as well as technical challenges.

Attitude↗
PubMedDate not supplied

Reovirus serology in broiler parents and their progeny and its correlation with performance.

An intensive vertically integrated monitoring program for broiler breeders and their offspring was set up in a Belgian poultry integration between 1993 and 1997. Serology for anti-reovirus antibodies was performed by enzyme-linked immunosorbent assay on blood samples taken from the broiler parents throughout rearing and production and also on blood samples taken at day-old and at slaughter from the broilers. Furthermore, production parameters of the birds were registered. All data were used two by two in a simple correlation study to calculate the degree to which these variables were linearly correlated. The reovirus antibody pattern indicated frequent field infections breaking through vaccinal immunity in the broiler parents. Under the epidemiologic conditions of this study, high antibody titers in the parents or in the broilers at day-old were significantly correlated with poor feed conversion, increased mortality, increased slaughterhouse condemnation, and low production score in the broilers. These correlations strongly support the view that reovirus infections can be economically important under European conditions of broiler production. Improvement of reovirus vaccines or the vaccination scheme in broiler parents or both may lead to better production results in the broiler offspring.

Animal Husbandry↗
PubMed2002

Screening for colorectal cancer: the business case.

Colorectal cancer screening is advocated by expert groups based on strong evidence of effectiveness, yet only approximately 1 in 3 Americans are screened. For a screening program to be effective, it is necessary for providers to offer and patients to accept screening, insurers to pay for screening, and provider groups to have monitoring and reminder systems and the expertise and facilities to perform the tests well. Whether and when such screening programs become successful depends on the priorities of healthcare decision makers as much as on the efforts of individual physicians and patients. There are strong arguments for decision makers giving colorectal cancer screening programs high priority: it saves as many lives as other services now in common use; it is a good use of scarce resources, costing less than $20,000 per year of life saved; and members of insurance programs increasingly expect screening benefits and programs, and failure to offer them might lead to member dissatisfaction and malpractice claims. Screening is costly, however, taking into account the cost of screening, follow-up tests, and treatments, and the costs occur many years before the benefits. Programs that are promoted to members but not fully implemented could create disappointment and backlash. Also, this screening can cause medical complications. Nevertheless, successful programs have been developed, proving that they are feasible in today's cost-conscious environment. We believe that colorectal cancer screening programs are integral to any organization purporting to provide high-quality care. Organizations without such programs should give them high priority for implementation.

Aged↗