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At least 1,297 records · Page 72Linked to original sources
PubMed2006

Countertransference reactions in therapeutic work with incestuous sexual abusers.

The study was a qualitative investigation aimed at therapists' responses to working with a population of incestuous sexual abusers. Semi-structured interviews were conducted with nine therapists who were recruited from psychotherapy, psychology, and forensic psychology services in the National Health Service (NHS) in the UK. The predominant therapeutic model was psychodynamic; however, cognitive-behavioural and integrative approaches were practiced by some therapists. The data were analyzed using interpretative phenomenological analysis (Smith, 1996). Results suggested that the therapists experienced a considerable amount of negative and difficult feelings and that they tended to experience feeling controlled and deceived, which seemed to influence their ability to create and maintain the therapeutic relationship. It was suggested that the dynamics of incestuous sexual abuse played a part in these difficulties. The results are discussed with reference to the clinical therapeutic literature.

Adult↗
PubMed1996

Tuberculosis in the workplace: OSHA's compliance experience.

OBJECTIVE: Inspections of 272 facilities were performed between May 1992 and October 1994 to determine compliance with applicable Occupational Safety and Health Administration (OSHA) requirements for prevention of tuberculosis (TB) transmission. DESIGN: Retrospective record review of two data sources: (1) OSHA's Computerized Integrated Management Information System and (2) an inspector-completed questionnaire on inspection results. SETTING/PARTICIPANTS: Inspections of five types of facilities: healthcare institutions, correctional facilities, homeless shelters, long-term-care facilities for the elderly, and others, including drug treatment centers that the Centers for Disease Control and Prevention (CDC) identified as having a higher than expected rate of TB. METHODS: The OSHA Compliance Memorandum, based on the 1990 CDC Guidelines, which outlined elements of a TB prevention program, was used in performing 272 inspections of facilities between May 1992 and October 1994. Elements of compliance were recorded and reviewed from the IMIS database and inspectors' questionnaires. RESULTS: Regulated facilities were not fully compliant with OSHA guidance. Generally, healthcare facilities performed better than other facilities. Most facilities (79%) were compliant with administrative elements of a comprehensive TB control program, such as early identification of known or suspected infectious TB patients and skin testing of workers. Only 29% of inspected facilities were found to have acceptable respiratory protection programs for the prevention of occupational TB. CONCLUSION: Facilities have not been fully compliant with the OSHA memorandum describing protection of workers from TB. Facility compliance was better with some traditionally recognized TB infection control elements, but was weaker in the area of respiratory protection programs. This may reflect a lack of familiarity with the latter type of hazard protection.

Facility Regulation and Control↗
PubMed1994

Adequacy of dialysis.

Adequate dialysis is not easily defined. The concept that there is a relationship between dialysis dose and survival is gradually gaining acceptance. Nutritional status and possibly the type of dialyzer membrane used also influence survival in hemodialysis patients. The roles of physicians, patient care staff, technicians, nutritionists, and social workers in assuring adequacy can be clearly delineated in practice. Until recently, health status and quality of life evaluations have received less attention than clinical and laboratory parameters of adequacy. Instruments used to assess quality of life must be further developed and integrated with survival and morbidity data to improve the level of care provided for dialysis patients. The tools are available to enhance adequacy; they need to be utilized.

Humans↗
PubMed2026

Respiratory pandemic risk in the Anthropocene: A One Health framework and GISRS+ agenda.

Recent epidemics and pandemics caused by respiratory viruses, alongside the animal panzootic spread of highly pathogenic avian influenza A(H5Nx), have become a structural feature of the Anthropocene, yet responses remain largely reactive. This review integrates findings from WHO's Global Influenza Surveillance and Response System (GISRS) and related surveillance data (2000-2024), epidemiological studies of influenza A virus, SARS-CoV, MERS-CoV, SARS-CoV-2, and H5Nx, and One Health literature. We examine major groups of respiratory viruses and identify mismatches between risk and surveillance by focusing on spillover potential from animal hosts, human-to-human transmission and its controllability, and Anthropocene characteristics that increase epidemic risk. The analysis indicated that SARS-related coronaviruses and influenza A viruses, particularly H5Nx, are among the leading candidates based on currently available evidence because they have large reservoirs in animal hosts and spillover to humans is highly probable. The previous presymptomatic spread of SARS-CoV-2 and recent mammalian adaptation in H5N1 clade 2.3.4.4b highlight limitations of the traditional symptom-based and pathogen-specific surveillance system. Spillover events tend to occur in tropical and subtropical regions in low- and middle-income countries, but most genomic surveillance is in high-income countries. We propose interventions that address the upstream, midstream, downstream processes of epidemics. Upstream interventions are primary prevention measures related to land use, livestock, wildlife, and urban environments; midstream interventions are GISRS+-based pathogen-agnostic genomic and metagenomic early warning systems triggered by One Health; and downstream interventions include vaccines, antivirals, non-pharmaceutical interventions, and engineering with equity-centred global governance and sustainable financing.

Anthropocene↗
PubMed1994

Security requirements for electronic patients records: the Norwegian view.

Information security, including secrecy, privacy and data integrity, quality and availability, are fundamental issues when electronic patient records are introduced and used. In this paper we outline the results of a project that KITH carried out on an assignment from the Norwegian Ministry of Health. We describe the general and detailed requirements set up in the project for electronic patient records, and to the hospitals that take such into use. We believe that these requirements are the minimum necessary to give a positive answer to the question of whether electronic patient records can meet all the security-related requirements and intentions given by current regulations. In our work we have focused on secrecy, privacy and data integrity, but also on elaborating requirements that allow a user friendly and suitable implementation of electronic patient record systems.

Computer Communication Networks↗
PubMed2004

Social networks and self-rated health in two French-speaking Canadian community dwelling populations over 65.

The objective was to evaluate the associations between older persons' health status and their social integration and social networks (family, children, friends and community), in two French-speaking, Canadian community dwelling populations aged 65 years and over, using the conceptual framework proposed by Berkman and Thomas. Data were taken from two 1995 surveys conducted in the city of Moncton (n = 1518) and the Montreal neighbourhood of Hochelaga-Maisonneuve (n = 1500). Social engagement (a cumulative index of social activities), networks consisting of friends, family and children and social support were measured using validated scales. Multiple logistic regressions based on structured inclusion of potentially mediating variables were fitted to estimate the associations between health status and social networks. Self-rated health was better for those with a high level of social integration and a strong network of friends in both locations. In addition, in Hochelaga-Maisonneuve family and children networks were positively associated with good health, though the effect of friend networks was attenuated in the presence of disability, good social support from children was associated with good health. Age, sex and education were included as antecedent variables; smoking, alcohol consumption, exercise, locus of control and depressive symptoms were considered intermediary variables between social networks and health. In conclusion, social networks, integration and support demonstrated unique positive associations with health. The nature of these associations may vary between populations and cultures.

Activities of Daily Living↗
PubMed2006

[Evaluation of the health target "tobacco control"].

UNLABELLED: "Tobacco control" is one of six health targets of the forum gesundheitsziele.de (health targets). Key stakeholders from health policy and from the health system are involved in the process of defining and deciding about health targets. The goal of gesundheitsziele.de is the improvement of the health of the population through integrated action. Goals are supplemented with recommendations for intervention measures, and indicators to mea sure whether goals had been achieved. The evaluation board of gesundheitsziele.de is committed to assess the availability and appropriateness of German data bases for the evaluation of the health target "tobacco control", and to submit a concept for the evaluation. In particular, the German health monitoring system, and the evaluation and quality assurance of the Federal Center for Health Education provide a good data base for the evaluation of the health target. Lack of data exists regarding outcome and impact evaluation of structural (policy, legal) interventions. RECOMMENDATIONS: Evaluation of health targets requires continuing conduction of representative population surveys. The evaluation of national intervention campaigns and the extension of the topic "tobacco control" within the German health report system are necessary. The collection and documentation of information about intervention measures, programs, and evaluation results is recommended. The evaluation board favors follow-up studies, and the coordination of existing data resources; the creation of new evaluation systems is not required.

Databases, Factual↗
PubMed2000

An integrated confocal and magnetic resonance microscope for cellular research.

Complementary data acquired with different microscopy techniques provide a basis for establishing a more comprehensive understanding of health and disease at a cellular level, particularly when data acquired with different methodologies can be correlated in both time and space. In this Communication, a brief description of a novel instrument capable of simultaneously performing confocal optical and magnetic resonance microscopy is presented, and the first combined images of live Xenopus laevis oocytes are shown. Also, the potential benefits of combined microscopy are discussed, and it is shown that the a priori knowledge of the high-resolution optical images can be used to enhance the boundary resolution and contrast of the MR images.

Animals↗
PubMed2006

Integration of oral health care and mental health services: Dental hygienists' readiness and capacity for secondary prevention of eating disorders.

Often the first to observe overt health effects of eating disorders, dentists and dental hygienists play a fundamental role in the secondary prevention of eating disorders. The purpose of this study was to explore readiness and capacity for integration of oral health and mental health services. Employing a randomized cross-sectional study based upon the Transtheoretical and Health Belief Models, data were collected from 378 dental hygienists. Results reveal that the majority do not currently engage in secondary prevention practices. Only 18% of respondents indicated referring patients exhibiting oral manifestations of eating disorders to treatment. Significantly increasing the likelihood of assessment, referral, and case management included modifying factors regarding greater perceived self-efficacy, and knowledge of oral cues of disordered eating, as well as the individual's perception pertaining to severity of eating disorders. Implications for bridging dental care to mental health services include increasing behavioral capacity among dental hygienists via consciousness raising and improved self-efficacy.

Adult↗
PubMed1994

Major issues in user interface design for health professional workstations: summary and recommendations.

Lack of good user interfaces has been a major impediment to the acceptance and routine use of health-care professional workstations. Health-care providers, and the environment in which they practice, place strenuous demands on the interface. User interfaces must be designed with greater consideration of the requirements, cognitive capabilities, and limitations of the end-user. The challenge of gaining better acceptance and achieving widespread use of clinical information systems will be accentuated as the variety and complexity of multi-media presentation increases. Better understanding of issues related to cognitive processes involved in human-computer interactions is needed in order to design interfaces that are more intuitive and more acceptable to health-care professionals. Critical areas which deserve immediate attention include: improvement of pen-based technology, development of knowledge-based techniques that support contextual presentation, and development of new strategies and metrics to evaluate user interfaces. Only with deliberate attention to the user interface, can we improve the ways in which information technology contributes to the efficiency and effectiveness of health-care providers.

Cognition↗
PubMed2006

Medicinal plants used to induce labour during childbirth in western Uganda.

Traditional medicine usage in rural Ugandan population for day-to-day health care needs is close to 90%. Women and children form the bulk of the people reliant on herbal medicine. This study was undertaken to document how ethnomedical folklore aids childbirth in rural western Uganda by conducting field surveys, discussions and interviews with the resource users (mothers) and health providers (traditional birth attendants). Health surveys revealed that over 80% of childbirths are conducted at home by using herbal remedies in Bushenyi district. Seventy-five plants have been recorded for usage in inducing labour and some of these plants may be oxytocic. The dilemma lies in the toxicity levels and the unspecified dosages that may threaten the life of the unborn baby and the mother. The high population growth rate, high total fertility rate coupled with high maternal mortality and morbidity in Uganda calls for rethinking in gendered health provision policies and programmes for which herbal medicine integration in health care systems seems viable.

Adult↗
PubMedDate not supplied

Monitoring and evaluating disease management: information requirements.

This paper addresses information essential to the creation, monitoring, and evaluation of disease management programs within managed-care organizations. Sound procedures for the collection and analysis of data are vital components of any effective disease management program. This presentation argues for a systemwide, rather than an atomistic, approach to data collection and analysis. Because every health system serves different populations, reliable demographic and health resource use data must be collected. Similarly, baseline data on physician prescribing behavior, patient compliance, and treatment costs are necessary to identify areas in need of improvement. Particular care must be taken to ensure that valid statistical models are developed to reflect the realities of the health system. The strengths and weaknesses of various internal and external data sources are discussed, with an emphasis on correlating and integrating information to provide comprehensive analyses of treatments and outcomes. The effects of different financial arrangements on data issues are also discussed, particularly in terms of contracting issues at successive stages in the development of a disease management program. This paper examines, in detail, data issues relating to monitoring prescribing behavior, modeling therapy interventions, classifying outcomes, and utilization of resources and treatments. Finally, this presentation makes specific recommendations for designing valid procedures for data collection and analysis.

Costs and Cost Analysis↗
PubMed1999

Security in health-care information systems--current trends.

Ever since health-care information systems have been implemented, their security is being considered an important issue, especially in the light of the fact that their data are deemed to comprise extremely sensitive information. The prospect of storing health information in electronic form raises concerns about patient privacy and data security. Any attempt to introduce computerised health-care information systems should, therefore, guarantee adequate protection of the confidentiality and integrity of patient information. At the same time, the patient information also needs to be readily available to all authorised health-care providers, in order to ensure the proper treatment of the patient. The principal aim of the present paper is, however, not to make a new contribution to the subject of security per se, but rather to give an overview of current trends in the security aspects of health-care information systems. The final section of the paper will be devoted to a number of proposals for further research possibilities in the domain of health-care information systems security.

Computer Security↗
PubMed2006

Diabetes information systems: a rapidly emerging support for diabetes surveillance and care.

BACKGROUND: With the rapid advances in information technology in the last decade, various diabetes information systems have evolved in different parts of the world. Availability of new technologies and information systems for monitoring and treating diabetes is critical to achieving recommended metabolic control, including glycosylated hemoglobin levels. The first step is to develop a registry, including a patient identifier that can link multiple data sources, which can then serve as a springboard to electronic mechanisms for practitioners to gain information on performance and results. OBJECTIVE: The aim is to review the provisions for diabetes surveillance in different parts of the world. This is a systematic review of national and regional information systems for diabetes surveillance. LITERATURE REVIEW: A comprehensive review was undertaken using Medline literature review, internet search using the Google search engine, and e-mail consultation with opinion leaders. TOPICS REVIEW: National/regional-level diabetes surveillance systems in Europe, the United States, Australia/New Zealand, and Asia have been reviewed. State-of-the-art diabetes information systems linking multiple data sources, with extensive audit and feedback capabilities, have also been looked at. RESULTS: National/regional-level audit databases have been tabulated. Diabetes information systems linking multiple data sources have been described. Most of the developed countries have now implemented systems such as diabetes registers and audits for diabetes surveillance in at least some regions, if not nationally. Developing nations are beginning to recognize the need for chronic disease management. CONCLUSIONS: With the advancements in information technology, the diabetes registers have the potential to rise beyond their traditional functions with dynamic data integration, decision support, and data access, as demonstrated by some diabetes information systems. With the rapid pace of development in electronic health records and health information systems, countries that are beginning to build their health information technology infrastructure could benefit from planning and funding along these lines.

Diabetes Mellitus↗
PubMed1999

EEG and clinical associations with mortality in comatose patients in a general intensive care unit.

The authors examined EEG findings and clinical factors for their association with outcome in comatose patients in their general intensive care unit. The following individual and combinations of factors were strongly related to mortality, with positive predictive values of >0.80 and odds ratios >2.0: age over 65 years, anoxic/ischemic encephalopathy, EEG suppression, lack of EEG reactivity; anoxia-ischemia with partial or complete cranial nerve areflexia, anoxia-ischemia with EEG suppression; anoxia-ischemia and generalized epileptiform activity; anoxia-ischemia with partial cranial nerve areflexia and EEG suppression. Conversely, the following factors favored survival rather than death: systemic infection/sepsis, metabolic derangement (excluding anoxic-ischemic insult), trauma; dysrhythmia, focal epileptiform activity, and regional delta and reactivity on EEGs. The findings of this study support the integration of these data into intensive care unit prognostic scoring systems, such as later versions of the Acute Physiology and Chronic Health Evaluation (APACHE).

Coma↗
PubMedDate not supplied

Information in medical decision making: how consistent is our management?

BACKGROUND: The use of outcomes data in clinical environments requires a correspondingly greater variety of information used in decision making, the measurement of quality, and clinical performance. As information becomes integral in the decision-making process, trustworthy decision support data are required. METHODS: Using data from a national census of certified health information managers, variation in automated data quality management practices was examined. RESULTS: Relatively low overall adoption of automated data management exists in health care organizations, with significant geographic and practice setting variation. Nonuniform regional adoption of computerized data management exists, despite national mandates that promote and in some cases require uniform adoption. Overall, a significant number of respondents (42.7%) indicated that they had not adopted policies and procedures to direct the timeliness of data capture, with 57.3% having adopted such practices. CONCLUSIONS: The inconsistency of patient data policy suggests that provider organizations do not use uniform information management methods, despite growing federal mandates to do so.

Administrative Personnel↗
PubMed1995

Religiosity as a dimension of well-being: a challenge for professional nursing.

The principles of holistic nursing require understanding the human individual as a complex and coherent entity consisting of physical, psychic, social, and spiritual dimensions. Considering the research evidence about people's experiences of well-being, the spiritual dimension, here regarded as synonymous with religiosity, does not seem to receive due attention in nursing. This article describes the appearance of religiosity as an integral part of people's experiences of well-being. Data from interviews with 40 adults who had contacted the primary health care system were analyzed on the basis of a qualitative, thematic analysis. Christians who belonged to the Evangelical Lutheran Church of Finland incorporated their religious values into their experiences of well-being. These values were reflected in ideas of the good life, in solutions to everyday problems, and in self-care. The results highlight the importance of a nursing concept that recognizes each patient's individual well-being.

Adult↗