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PubMed1992

HIV counseling and testing services from public and private providers--United States, 1990.

Human immunodeficiency virus (HIV) counseling and testing (CT) services are key elements of the national HIV-prevention strategy (1,2). Although the number and characteristics of persons receiving CT through publicly funded programs are monitored by CDC's CT data system (3), this system does not provide information about persons tested for HIV antibody by physicians in the private sector, hospitals, and other nonpublicly funded sources. This report summarizes data from CDC's 1990 National Health Interview Survey (NHIS) AIDS Supplement (4) regarding CT received from public and private providers.

Adolescent↗
PubMed1964

THE FUNCTIONING OF A PRIVATE PSYCHIATRIC CLINIC.

SOME OF THE CLINICAL ADVANTAGES OF A PRIVATE PSYCHIATRIC CLINIC ORGANIZED FOR GROUP PRACTICE ARE: Readily available consultations with colleagues; cross-referral with better communication; more evenly filled hours; larger pools of patients for establishing and maintaining group therapy; better off-duty coverage; ready availability of the three disciplines, psychiatry, psychology and social work; satisfaction to the private psychiatrist of being able to arrange competent and prompt treatment for patients unable to meet usual fees; and cooperative research.Financial advantages include economies of time and money, a profit sharing plan, and availability of group life insurance, health benefits and social security.

California↗
PubMed2003

Preliminary evaluation of occupational hearing loss risk among private farmers.

The article presents a preliminary evaluation of occupational hearing loss risk in a group of farmers selected at random and exposed to a mean annual level of exposure to noise L(EX,8h) = 89.1 dB. The study covered 31 family farms carrying out mixed production (plant-animal), possessing arable land of the size 5-40 ha, and equipped with the basic mechanical equipment (tractors, agricultural machinery, machines for production of animal fodder, workshop machinery, saws). Polish Standard: PN-ISO 1999:2000 was used in order to evaluate the expected hearing threshold among private farmers, an expected hearing loss due to noise, as well as risk of hearing impairment. The risk of hearing impairment was determined for the population of males aged 50, regularly exposed to noise for 30 years of occupational activity, assuming as a basis for calculations the mean value for 3 audiometric frequencies (1, 2 and 4 kHz). The results of the study showed that the mean expected hearing loss (median; N(0.50)), associated only with noise for 50-year-old males after 30 years of employment will be: 5.5 dB (together with age-related loss: 14.5 dB). The risk of hearing impairment due to exposure to noise (for the allowable value of hearing loss: 30 dB), which may cause an occupational acoustic trauma, reaches the value 9.4 %. The results obtained confirm that noise present in the working environment of private farmers creates a significant risk for the organ of hearing.

Agricultural Workers' Diseases↗
PubMed1992

Problems in performing a double-blind multicenter study using a hypnotic in private practice.

1. The procedure described--the immediate data transfer and entry system (ITES)--is suitable to improve the quality of data collected in multicentre studies in private practice. 2. The results of the study show that regarding influence on sleep quality and daytime well-being the non-benzodiazepine Z is significantly superior to placebo and slightly superior to the benzodiazepines F and T. 3. The advantage of Z treatment is the better daytime well-being after taking the hypnotic for sleep induction the night before. 4. This study shows that a quality standard equal to that in clinical practice may be achieved in private practice.

Adolescent↗
PubMedDate not supplied

[Between the public and the private. New incentives in health care].

This paper discusses some of the proposals regarding the improvement of the efficiency in the delivery of health care services. Several countries have implemented different strategies based on the experience of the Health Maintenance Organizations, which have used the market to stimulate competition between providers and insurance companies. One of the proposals includes the creation of agencies that would compete in quality and in price. Another one implies the creation of a National Health Service capable of hiring public or private services from local agencies. The ideal strategy would enable a consumer to choose between insurance companies and public and private providers, and would hopefully create cost conditions reasonably correlated with the efficiency and quality of the rendered services.

Delivery of Health Care↗
PubMed2004

Management of acute respiratory infections in drug shops and private pharmacies in Uganda: a study of counter attendants' knowledge and reported behaviour.

BACKGROUND: In Uganda, private pharmacies and drug shops are important sources of drugs for the majority of the population. In addition to selling drugs, these outlets often serve as primary sources of information about illness and drug therapy. However, the appropriateness of dispensing by staff in these drug outlets has been found to be suboptimal. Yet there has been no study documenting the determinants that underlie the dispensing pattern at these outlets. This study evaluated counter attendants' training background, their knowledge of acute respiratory infections (ARI), and their reported behaviour in the management of ARI in order to identify factors associated with dispensing behaviours. STUDY DESIGN AND SETTING: This descriptive study was conducted in Kampala District, Uganda and used a cross-sectional survey research design to analyse the practice of 197 drug outlets including 28 pharmacies and 169 drug stores. MAIN OUTCOME MEASURES: Counter attendants' training background; their knowledge of the causes, signs and symptoms of ARI; their perception of the dangers of ARI; and the drugs and advice offered for the management of mild and severe ARI. RESULTS: Majority of the counter attendants had medical or pharmacy training. Most of them were nurses. The attendants' workload was generally low. High levels of self-medication among clients were reported at the outlets. Staff at a management level had low knowledge of the aetiology, signs and symptoms, and dangers of ARI. Prescribing an antibiotic was found to be the usual practice for managing ARI cases. Counter attendants at those outlets seldom gave advice or referrals for ARI cases. In particular, patient demand was a main barrier to appropriate dispensing. Strategies suggested by attendants for improving rational dispensing were to educate the public, provide training for the attendants, and re-enforce government supervision of drug outlets. CONCLUSIONS: This study identified several self-reported inappropriate behaviours in the outlets. The formal training background and workload of counter attendants at drug shops and pharmacies were not found to be important contributors to irrational prescribing. The results of this study suggest that a combination of regulatory and educational interventions may yield to improvement in counter attendants' practices in private drug outlets.

Acute Disease↗
PubMed2004

Health hazard evaluation in private dental practices: a survey in a province of northen Italy.

The purpose of this questionnaire survey was to evaluate the knowledge and attitudes of private dental health care workers about cross-infection hazards through examination of practising behaviour in respect of infection control. A questionnaire was sent by mail to the private dentists operating in Parma province. The survey concerned 7 groups of questions about demographic data, personal protective equipment, immunization, sterilization and disinfection, waste disposal and occupationally acquired injuries, behaviour. Four hundred questionnaires were sent to the members of the Medical and Dentist College of Parma: 122 were returned and analysed (30.5%). Among the infectious diseases 45% of the interviewed think that the most dangerous diseases are Hepatitis B and C, followed by HIV infection (21.5%). The most used personal protective equipments are gloves (98%), masks (95%) and protective eyewear (94%). Sixty eighth per cent of the dentists treat HBV, HCV, HIV, TB, HSV suffering patients at the end of the working day. Twenty nine point 7% of them claim to have written protocols to follow in case of accident. Altogether the results show a good knowledge of the most important risks related to dentistry activity and of the main procedures for the infection control and management.

Adult↗
PubMed1992

Drownings in a private lake--North Carolina, 1981-1990.

Drowning is the third most common cause of death from unintentional injury in the United States (1); in 1989, in North Carolina, drownings were the leading cause of years of potential life lost before age 65 per death (2). From July 1 through August 31, 1990, two drownings occurred in a private lake in Beaufort County (1990 population: 42,283), North Carolina. A review of data from the Office of the Chief Medical Examiner (OCME) in North Carolina identified two additional drownings at this lake during 1981-1990, and a total of 17 drownings in the county during the 10-year period. At the request of the local health director, in October 1990, the North Carolina Department of Environment, Health, and Natural Resources (DEHNR) investigated the drownings using information from OCME files, hospital medical records, and ambulance reports. This report summarizes the investigation of the four drownings in the private lake, recommendations to prevent additional drownings, and characteristics of drownings in North Carolina in 1989.

Adolescent↗
PubMed2005

[Private expenditure in health by state in Mexico].

OBJECTIVE: Present information on the magnitude and composition of private health expenditure (PHE) in Mexico. MATERIAL AND METHODS: Total PHE by state was calculated using the System of National Health Accounts and National Performance Assessment Survey 2002-2003 by means of elasticities and growth relative contributions. RESULTS: 58% of the total PHE was private and 90% of this was out-of-pocket expenditure. Most of the latter is expenditure in ambulatory care and drugs. 60% of the PHE was concentrated in only six states. PHE was lower than public expenditure in six states. CONCLUSIONS: The magnitude of out-of-pocket expenditure in health is worrying, since it is the most unfair, inefficient and regressive way of financing health care. Health authorities should look for alternative ways to finance health care, like the Popular Health Insurance.

Ambulatory Care↗
PubMed1992

Government, private health insurance, and the goal of universal health care coverage.

The Health Insurance Association of America advocates joint efforts by federal and state governments and the private sector to achieve the goal of universal access to health care. It recommends several changes in the small employer market to provide greater predictability and protection to those insured, including establishment of private, not-for-profit reinsurance organizations authorized by the states. State risk pools for uninsurable individuals who are not part of an employer group are also proposed. The federal government role would include expanding Medicaid eligibility and exempting all insured plans from state mandated benefits. HIAA's proposal also stresses the continued growth and use of managed care programs.

Cost Control↗
PubMed2005

The influence of well construction on bacterial contamination of private water wells in Pennsylvania.

Pennsylvania has a large population that relies on private water wells, but no statewide regulations govern the location or construction of the wells. Bacterial contamination occurs in nearly half of these water supplies, representing a health risk to rural residents. The role of large-scale aquifer contamination versus wellhead contamination from poor construction is poorly understood. The authors disinfected and installed sanitary well caps on 16 wells that contained coliform bacteria and retested them after 30-60 days and one year. Coliform bacteria were present in seven of the 16 wells within 30-60 days and all but two wells within one year. The occurrence and prevalence of bacteria in wells appeared to be influenced by weather conditions during the study. The few wells where disinfection and installation of a sanitary well cap were successful had low initial coliform bacteria and no E. coli. Samples were also collected from 24 new wells that were constructed with a grout seal and sanitary well cap. Twenty-nine percent contained coliform bacteria, and 17 percent contained E. coli. The results from this limited number of wells suggest that bacterial contamination of private wells in Pennsylvania may often originate from areas away from the wellhead.

Escherichia coli↗
PubMed1992

Testing for HIV in the public and private sectors--Oregon, 1988-1991.

Counseling and testing persons for human immunodeficiency virus (HIV) infection is a key component of the public health strategy for reducing transmission of HIV in the United States (1,2). In 1991, the federal government allocated $100 million to state and local health agencies to provide counseling and testing programs in public clinics for at-risk persons, including persons who may not otherwise use public health services. However, the relative contribution of HIV-testing in public clinics to HIV testing in the private sector is unknown. To compare HIV testing in Oregon public clinics to overall HIV testing, the Health Division (HD) of the Oregon Department of Human Resources, in cooperation with CDC, reviewed data collected from September 1, 1988, through August 31, 1991, on public and private HIV testing in Oregon. This report summarizes findings for HIV testing rates and assesses the importance of publicly funded testing in identifying HIV-seropositive persons.

Adolescent↗
PubMed2006

[The growing endangerment of specialists in private practice--opening up access to hospital outpatient clinics from a legal point of view].

There are two new rules of the German Health System Modernisation Act (GMG) affecting the activity of specialists in private practice: the authorization of a hospital according to Sect. 116 a (SGB V; Title Five of the Social Code) subsidiary to the registration of a SHI physicians and the authorization of a hospital-based physician. Negative effects on office-based physician in private practice will only occur if, for example, an ambulatory healthcare centre (MVZ) is being established by the hospital owner. Currently, Sect. 116 b SGB V also does not have any negative impact on office-based specialists. The benefits catalogue according to Sect. 116 b Para 3 SGB V has so far been narrowly defined. And, in the face of the diverging interests within the Joint Federal Committee Health Insurances/NationalAssociation of Statutory Health Insurance Physicians and Health Reform Consensus Act (GKG)--a noticeable broadening of this catalogue is not to be expected. Also, such a broadening of the scope of this catalogue will be counteracted by the fact that no legal right exists to the conclusion of a contract with the health insurance companies and that the health insurers will actually have to additionally reimburse for medical services according to the catalogue of Sect. 116b Para 3 SGB V beyond the total reimbursement budget.

Germany↗
PubMedDate not supplied

Private practice results of screw-type tapered implants: survival and evaluation of risk factors.

PURPOSE: The aims of this study were to examine the long-term survival and the prosthetic treatment outcome of screw-type, tapered implants placed in a private practice setting and to explore potential risk factors of implant failures. MATERIALS AND METHODS: In this retrospective analysis of patients treated with endosseous screw-type tapered implants, data relative to implant placement and failure, implant length, location, prosthetic treatment, medical history, smoking habits, and oral health behavior were gathered by chart review and questionnaire. An oral examination was also conducted. Cumulative survival rates were estimated through Kaplan-Meier methods. Comparisons between subgroups of patients were made using the log-rank statistical test. The association between several factors and implant failures was analyzed using Cox regression analyses (random and dependent models). Differences were considered significant when P < .05. RESULTS: The survival rate of 663 implants placed in 159 patients (65 men, 94 women; 80.7% of 197 eligible patients) was 91.8% after 120 months. Mandibular implants had a higher survival rate than maxillary implants (96% versus 89%, P = .011). The failure rates for implants were 15.0% among current smokers, 9.6% among former smokers, and 3.6% among nonsmokers. The differences between nonsmokers, former smokers, and current smokers were significant (nonsmokers versus former smokers: P = .036, nonsmokers versus current smokers: P < .001, former smokers versus current smokers: P = .003). Only number of years of smoking was significantly associated with an increased risk of implant failures (P = .036 using dependent estimation; P = .004 using independent estimation). The HR increased to 6.6 for patients who had smoked for 45 years. Loosening of prosthetic components were rare (n=12). No fractures of screws or implants were found. DISCUSSION: Higher failure rates for former smokers and a dose-response effect between duration of smoking and implant failure rates suggested that permanent tissue damage from smoking may occur in addition to immediate local and systemic effects. The frequency of prosthetic complications was comparable to other studies. CONCLUSIONS: Screw-type tapered implants placed in a private dental office demonstrated a cumulative survival rate of 91.8%. The relative risk of implant failure increased with the duration of smoking.

Adolescent↗
PubMedDate not supplied

[Private and public self-awareness changes in psychotherapy of alcohol-addicted felons].

AIM: Testing effectiveness of psychotherapy by evaluating changes in private and public self-consciousness of alcohol addicted persons and imprisoned felons. METHOD: The questionnaire known as Self-Consiousness Scale Fenigstein, Scheier, Buss's was applied. The tool is based on the theory of Duval and Wicklund and that of Carver and Scheier. Treatment curriculum--was based on two models of alcohol addiction. the psychological one and the other derived of assumptions defined in the Alcoholics Anonymous movement. RESULTS: In the course of the psychotherapeutic treatment--discordantly with prior research expectations--neither the so-called private nor the public self-consciousness changed. In turn, as hypothesised, social anxiety decreased significantly. CONCLUSIONS: 1. Decrease of social anxiety shows effectiveness of the therapeutic approach, which is higher than that of the sole Alcoholics Anonymous programme. 2. Further research should be focused on refinement of both the tool measuring self-consciousness changes and some elements of the therapeutic agenda.

Adult↗
PubMed2006

Epidemiologic situation of human immunodeficiency virus (HIV/AIDS patients) in a private clinic in Tehran, Iran.

BACKGROUND: Injection drug use has been the major route of HIV transmission over the past several years in some countries. The aim of this study was to describe epidemiologic and demographic factors, as well as the risk behavior data in HIV-positive patients referred to a private clinic in Tehran. METHODS: A retrospective study was conducted in 2005 based on documents of 150 HIV-infected patients referred to a private clinic from 1992 through 2004 in Tehran. RESULTS: Documents of 150 HIV-positive patients (124 males and 26 females) were analyzed. Injection drug use with one other risk factor, namely shared needle (n = 46), injection drug use without any other known risk factor (n = 37), and sexual activity (n = 25) were the major possible routes of transmission of HIV infection. The major possible route of transmission in female patients was sexual activity (n = 17), mostly from infected husbands (13/17). There was no patient with a history of drug abuse from 1992 to 1997. The frequency of HIV-positive injection drug users was 1 in 1997 - 1998, 6 in 1999, 3 in 2000, 24 in 2001, 32 in 2002, 37 in 2003, and 11 in 2004. Eighty-three (55%) of 150 and 64 (74%) of 86 patients had a history of drug abuse and incarceration, respectively. CONCLUSION: We observed high rates of hepatitis C and B virus coinfection in our HIV-positive patients. Injection drug use is the main risk factor associated with HIV infection in Iran.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Short dental implants as a treatment option: results from an observational study in a single private practice.

PURPOSE: The purpose was to evaluate clinical outcome of short (6- and 8-mm) dental implants placed in sites with low bone availability (7 to 11 mm) in a single private practice and to compare their survival with that of longer implants. MATERIALS AND METHODS: Implants were placed by a single private practitioner in a variety of clinical indications. Exclusion criteria included uncontrolled diabetes mellitus, alcoholism, and systemic immune disorders. Clinical data relating to implant placement and follow-up appointments, including adverse events, were entered into an electronic database. Two-year survival rates were calculated and life table analyses undertaken for implants measuring 6, 8, and 10 to 16 mm. RESULTS: A total of 630 Straumann implants were placed in 264 patients between April 1994 and December 2003. Of these, 35 implants were 6 mm long, 141 were 8 mm long, and 454 were 10 to 16 mm long. Maximum follow-up was 64.6 months, 83.7 months, and 102 months for implants measuring 6 mm, 8 mm, and 10 to 16 mm, respectively. Two-year survival rates were 94.3%, 99.3%, and 97.4% for 6-mm, 8-mm, and 10- to 16-mm implants, respectively. DISCUSSION: The results indicated that the 2-year outcome for 6-mm and 8-mm implants was comparable to that for longer (10- to 16-mm) implants in this patient population. CONCLUSION: In this study, short (6- or 8-mm) implants were used with good reliability in patients with limited bone availability, without the need for ridge augmentation. Shorter implant length was not associated with reduced survival at 2 years, compared with longer implants.

Adolescent↗
PubMed1991

Private fostering. Racial and health implications.

Why should health visitors be concerned with private fostering? First, writes Carol Woollard, because it affects a small but significant number of children, both in London and in county areas throughout England, whose particular health needs should not be ignored. Second, because the Children Act 1989 is bringing in legislative changes which have clear implications for health policies and practices relating to private fostering. It is essential that health visitors be aware of these changes and be able to act on them appropriately.

Africa, Western↗